Down Came the Rain

by Brooke Shields
Hyperion, 2005
Review by Leo Uzych, J.D., M.P.H. on Jul 17th 2007

Down Came the Rain, penned remarkably well by well known actress Brooke Shields, describes her personal journey through postpartum depression. Following the birth of her daughter, Rowan, rain came pouring down, and Shields was in grave danger of being swept away emotionally, by the swelling tide of postpartum depression. In sobering fashion, Shields recounts her frightful descent into the psychological nether world of postpartum depression as well as her ascent eventually to mental health recovery. As described, metaphorically, by Shields, postpartum depression is flying headfirst into the windshield, in an awful car accident. But, as Shields recovered, there were times when she desired to inhale her beloved Rowan into her lungs, and pour Rowan through her veins.

Throughout the book, Shields unflinchingly flays the skin of her emotions, painfully revealing at a visceral level her emotional vulnerabilities, fears, and frustrations. In painting painstakingly the canvas of her sojourn in the realm of postpartum depression, Shields likewise exposes to plain view a fascinating multitude of highly personal details which enliven the book with great animating force. For the reader willing to patiently probe the book's terrain, an abundance of richly edifying deposits will likely be unearthed.

Shields opens her discourse by focusing principally, in the book's first chapter, on her frustrating efforts to become a mother. In determined pursuit of motherhood, Shields gamely traverses an obstacle strewn path cluttered frustratingly with: vexing fertility issues, the demanding ordeal of in vitro fertilization therapy, a pregnancy truncated by an emotionally jarring miscarriage, and further fertility treatments (resulting, again, in pregnancy).

In Chapter Two, Shields describes vividly the expansive gamut of emotions, reaching to joy, pain, thrill, anxiety, and fear, conflictingly tugging and pulling at her and her husband as she was pregnant (with her "little cashew"). The emotional malaise continued, after Rowan's birth. As chronicled poignantly in the chapters that follow, the great joy occasioned by Rowan's birth was followed by Shields' bittersweet roller coaster ride, along a bipolar route of thrilling and agonizing emotions.

The growing cascade of negative emotions casting a heavy pall of gloom over the early days of her motherhood is the core subject of Chapter Three. As Shields plaintively recollects, she was crying more than her baby. And she felt very unjoyously disconnected from her baby. Actually, for her, motherhood sadly was akin to a lingering nightmare. At first, the medical explanation given to Shields for her depressed feelings was that she was going through the "baby blues", which likely would end when hormonal imbalances tied to postpartum hormonal shifts eventually corrected. Although Shields' doctor raised the possibility of going on medication, she explains that she associated the taking of medicine, to remedy emotional problems, with shame, weakness, and failure. Shields was concerned additionally about possibly becoming drug addicted.

As explained in Chapter Four, however, when Rowan was about two weeks old, Shields relented, and grudgingly started taking an antidepressant. But Shields' self image remained yoked firmly to her professional identify; and the feeling that motherhood was interfering with her professional acting career continued to vex her. Shields' efforts to gingerly navigate a course leading to a satisfactory balance between the competing demands of parenthood and her professional career garner further attention in later chapters.

The tenuous resolve of Shields to take antidepressant medication proved to be fleeting. As fleshed out, in Chapter Five, Shields abruptly pulled the plug on her antidepressant (without first telling her doctor), when she started to feel less hopeless. Before long, a flood of tears poured down. Feeling scared and desperate, Shields heeded her doctor's advice to go back on antidepressant medication. Acting on her doctor's belief that she might be suffering from postpartum depression, rather than simply experiencing the baby blues, Shields strived to self educate herself about postpartum depression. As Shields dug deeply to educate herself about postpartum depression, she uncovered an important realization: to properly address her severe emotional difficulties, she needed to talk about her feelings with a professional.

And in fact, as recollected in Chapter Six, Shields commenced therapy. The therapeutic experience proved to be cathartic. In therapy, Shields and her therapist worked hard to disentangle knotty emotional strands bound sorely to such issues as: what it means to bring a child into the world, the both frightening and thrilling rite of passage flowing from motherhood, and problematic mother child connectedness.

At the beginning of concluding Chapter Nine, Shields notes that over a year had passed, since Rowan's birth. Although Shields was feeling stronger and happier, postpartum depression had been the most frightening and devastating challenge in her life. An important lesson imparted by this engrossingly instructive book is that it may be very dangerous medically for a depressed mother to seek to overcome depression without professional help, because an initial drizzle of symptoms may portend an eventual overwhelming deluge. Shields pensively muses, in the book's last chapter, that she waited too long to seek professional help for her depression. And, in tune with this introspective rumination, Shields, in a pithy "afterword", sounds the clarion note that a mother should seek professional help immediately, if she suspects that she may be suffering from some form of postpartum mood disorder.

Academically entrenched critics may carp that the book, although immensely interesting, is styled in an academically informal manner. And that, substantively, Shields draws from a well of anecdotal contents, thus significantly diluting the book's academic potency. Moreover, in important ways, Shields' personal experience with postpartum depression may differ substantially from the particular experiences of other mothers afflicted with this condition.

Yet, Shields' willingness to describe, in detailed fashion, the thicket of thorny challenges she encountered personally may especially enthrall women suffering from depressive disorders, and their families. Shields' riveting account may further be of absorbing interest to those with a professional interest in postpartum depression, including: psychiatrists, psychologists, fertility specialists, obstetricians, and pediatricians.

Leo Uzych (based in Wallingford, PA) earned a law degree, from Temple University; and a master of public health degree, from Columbia University. His area of special professional interest is healthcare.

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