Self Appreciation Daily: Accentuate the Positive Blog Hop!

Jaime over at James & Jax is introducing a weekly blog hop.  What a great way to kick off the new year!

I promised I would link up before the end of the week, so here I am.  I sat there for a while tonight, pondering what I did this week that deserves a pat on the back.  Other than the relatively stand-up job I did at work this past week, it took me a while to come up with the rest.

I hope that by participating in this weekly blog hop, it will help me stay more focused on the things I do well, and help build on the confidence that I know is growing over time.  Self awareness and self appreciation is an evolutionary process that takes time and occurs over a life time.   My self confidence and self esteem have been steadily growing.  Given how stark my outlook was as a teenager, I am truly amazed and thrilled that I have come this far.  This growth has occurred mostly from the time I emerged from my postpartum depression (PPD) through the publication of my book.

But it isn’t stopping with the end of my book writing journey.  I’m going to challenge myself to take more notice of the things that I do each and every day that deserve more than to be forgotten–basically taken for granted– by the next day.  My memory finds anything past a day challenging to remember as I get older.

Thank you, Jaime for this inspiration that, blog hop or no blog hop, we all need to focus more on self care, in terms of taking better care of ourselves, as well as patting ourselves on the back for not just the big accomplishments but the little ones that are all too often easily ignored.

Well, here is my list of things I want to pat myself on the back for this week:

  1. Not only did I make it through one helluva stressful week at work, I handled it with confidence and managing to stay organized and meeting deadlines, while not letting the stress get the better of me like it has done so often in the past.
  2. I handled seeing and even talking to the two people that made me feel bad in a previous encounter like a real trooper.  The thought of seeing one of them twice a week and the other one once a week for the next couple of months is not having the kind of impact (i.e., dread) it would’ve had on me in years past.
  3. I handled my daughter’s breakdown on day 1 of her new swim class, new instructor and new pool like a trooper, in my opinion (which is saying a lot, since I’m pretty hard on myself usually).  Thankfully, she didn’t spend too much time crying and before I knew it, she was swimming in the pool….and I avoided the kind of embarrassing episode that left me looking helpless and defeated in the past.
  4. I survived another week of my lovely–and sometimes very long and irritating– commute to/from the City.  I didn’t let 4 separate occurrences of my 10 pet peeves I encountered get to me.
  5. Granted, I’m nowhere near the level of chauffering my other friends do with their multiple kids and their various weekend activities.  But I think I am doing a decent job as schedule keeper/chauffeur, if I do say so myself!  I always make sure my daughter and I get up 1-1/2 hours before any weekend activities, including Chinese school, ballet, and swimming.  That gives us time to eat breakfast (and she’s a very slow eater) and get some TV or playtime in before leaving home.  Transitioning environments has always been somewhat of a challenge for our daughter, but thankfully, she is getting better about it as she gets older!

Please click on the “I’m Doing It Right” button below to check out Jaime’s post and the other blog hop participants’ posts, and consider joining us in this weekly blog hop!  If you can’t join weekly, that’s alright, just join when you can!  It just might make a positive difference in your outlook!

What Do Pregnancy Loss and PPD Have in Common?

On Facebook yesterday, I stumbled across a link to an article on Babble.com titled “Suffering in Silence — How One Woman Coped With the Loss of Her Baby.”  It is truly one of the best written articles on pregnancy loss–in this case, miscarriage–I have ever read.  In reading the article I couldn’t help but be reminded of how I felt after my ectopic pregnancy and when I found out the twin to my daughter didn’t make it past the second month of pregnancy.

UNNECESSARY TABOOS

So, what do pregnancy loss and PPD have in common?  Well, to start with, both seem to have become through the years taboo topics that you rarely hear others bring up on conversation….least of all by those who are in the process of grieving their pregnancy loss and those who are suffering from PPD.   The only people you would be willing to share such a private matter with are certain family members and close friends.   Ironically, it’s at times like this that you need support the most.   Grieving in private, which is what I did when I suffered both my losses, only increases your risk for depression.

THE NUMBERS…YOU WOULD NEVER KNOW

Second, because people don’t talk about their experiences, society as a whole really has no concept of how frequently pregnancy losses and PPD occur.   The author, Jody Pratt, points out:

“An estimated one in seven pregnancies ends in miscarriage. Each year in the U.S. alone, over 700,000 babies don’t survive to be born. Millions of people must be mourning them. So, where are they?  ‘The only tradition our society does have regarding miscarriage is that you’re not supposed to talk about it.’”

As for PPD, an estimated one in eight new mothers experience it.  So, where are they all?  Before I had PPD myself, I hadn’t heard squat about it from anyone I knew.  After I had PPD, I’ve only come across a handful of those I personally know that mentioned their own experiences to me.  Believe me, they are out there.  Thanks to the stigma of mental health and lack of awareness, all too many moms suffering from PPD continue to keep their experiences to themselves, not knowing that what they have is a true illness and there should be no shame associated with feeling the way they do.

ANOTHER CONSEQUENCE OF THE TABOOS

Another consequence of people not talking about their experiences is that people have no real concept–not unless they, of course, have firsthand experience themselves–of what it’s like to lose a baby during pregnancy, regardless of how early in the pregnancy the loss occurred.   Comments that either I or others receive in reaction to the news of pregnancy loss lean in the direction of “Just keep trying….you’ll succeed.”  “At least this happened now rather than later on in the pregnancy, after seeing your belly growing and feeling the baby kicking and moving and feeling your love for the baby growing daily.”  You wouldn’t think that it would be possible to feel an emotional connection within the first few weeks of pregnancy, since there is nothing about an embryo that resembles a baby yet.  For me, even the few weeks during my first pregnancy was more than enough time to become emotionally invested.  When I found out it had to be terminated due to what they referred to as an ectopic pregnancy, I was devastated.   Then, when I lost the twin to my daughter at two months, I cried on and off for a few days but forced myself to move on because I couldn’t risk having my grief jeopardize my pregnancy. 

When it comes to PPD, unless you’ve been through it yourself, it’s hard to really know what the PPD mom is really going through.  All people know is that having a baby is supposed to be a happy time and you only really see happy moms.  So, when a mom who is suffering from PPD isn’t glowingly happy but instead is suffering from PPD, comments she receives may tend to send like the following:  “You have the healthy, beautiful baby that you’ve always wanted.  What more could you want?  How could you not be happy?  Pull yourself together…your baby needs you.  All new moms go through this after having a baby.  It will pass on its own.  You’ll be fine in no time.”

BREAKING THE CYCLE

Parents who grieve should speak up more.  Though, with the reactions they get from even the most well-meaning of family and friends, it’s no wonder people want to keep their grieving to themselves.  It’s also no wonder that most expectant parents do not tell anyone about their pregnancies until the end of the first trimester, because there is a greater likelihood for pregnancy losses to occur during that time.  As a consequence, if you do (God forbid) experience pregnancy loss, you automatically end up suffering in silence because people didn’t even know you were pregnant to begin with.  Being as risk-averse as I am and prone to believing in “jinxes,” you better believe my husband and I didn’t tell anyone at all about my pregnancy until the first trimester was over and I didn’t tell colleagues until I could no longer hide it from them at around 6 months!   I grieved in silence after both of my losses because they occurred before the first trimester was over.

At the same time, family members and friends should learn how to support grieving parents better.  Maybe take some sensitivity training or something.  Learn that keeping what you say to a minimum–in this case, LESS IS MOST DEFINITELY MORE–just your being there for the grieving parents and offering a listening ear (if they ask you) and avoid offering advice especially if you’ve never suffered a loss like this yourself.  Read up on articles such as the one Katherine Stone had previously written up that provide suggestions on how to support someone who is grieving.  Follow the blogs I list under Pregnancy Loss/Infertility Websites & Blogs.  It would also help tremendously for people to know that there are many others who are going through–or have gone through–pregnancy loss (or PPD).  I mean, look at the numbers!   Articles like this one written by Jody Pratt should be accessible via pregnancy books, magazines, and newspapers.  In all forms of media that expectant parents would have easy access to.  As I mention in prior posts, the best place to obtain non-judgmental emotional support is a therapist that specializes in pregnancy loss (or PPD).   Doing so is an investment in your mental health down the road as you embark on future pregnancies that will one day, hopefully, be successful.

PREGNANCY LOSS – A RISK FACTOR FOR PPD

Finally, negative life events related to childbearing–e.g., history of and unresolved grief associated with pregnancy loss (previous stillbirth, abortion, miscarriage) and  multiple failed IVF cycles are a significant risk factor for PPD.  There is a lot at stake emotionally with the baby that is conceived after years of trying, possibly with the help of IVF and after failed attempts/cycles and perhaps even miscarriages.  Click here and here for more info.

Start off 2011 by Saying “No” to Sensationalistic Media

Wishing you a Happy & Healthy 2011!

I was hoping to find inspiration in and blog about something positive to start the new year off on a pleasant foot, but…..Katherine Stone’s blog post today was about one of my all-time favorite topics–media using their spotlight to help spread misconceptions about postpartum mood disorders–and that got me going.  I can’t help but be dismayed, to say the very least, that Time magazine has struck out again as far as editing their content about a postpartum mood disorder (PPMD) before publishing is concerned.  

What did they do this time?  Well, in the article titled “Study: Depression, Fear of Abandonment Can Lead Moms to Kill Babies,” the author Bonnie Rochman uses the words “mad mommies” and “psychotic nut jobs.”  C’mon now….are these words really necessary?  I wish I could tell her and other authors like her to try being realistic rather than trying too hard to grab people’s attention.   There’s simply no need for that.  It’s articles like this that, though the author no doubt thinks she’s doing a huge favor by publishing an article in the health section and educating the public, she’s doing quite the opposite.   Articles like these in a magazine like Time–and we’re not even talking about the National Enquirer or some other gossip mag–only serve to scare new moms out there from getting the help they so desperately need.  It’s this fear of being viewed as “nut jobs” that only contribute to all the moms out there who are falling through the cracks, struggling with a PPMD but going undiagnosed and untreated and sometimes leading to disastrous consequences. 

Thanks, but no thanks for keeping the stigma of mental health going, Ms. Rochman.  Time Magazine, when are you going to help, rather than hinder, progress when it comes to public awareness and education about PPMDs, sticking with the facts and nothing but the facts (i.e., sans sensationalistic terms)?  

For all you PPMD survivor mamas out there–and family members who have seen you suffer and emerge from the dark and desolate tunnel of your experience–please, please, please do your part to help raise awareness.  As I’ve mentioned many times before, be an advocate.  Speak up.  Don’t be afraid to share your stories with your family, friends, neighbors and colleagues.  Don’t be afraid to comment on these articles that incorrectly portray PPMDs, and even submit letters to media outlets that put out articles like this.  If you hear remarks like this being said by those around you, don’t be afraid to provide your honest opinion that comes from experience.  You PPD survivor mamas have what most of these authors and people in the media don’t have…..firsthand experience of what it’s truly like to suffer from a PPMD.  And DON’T YOU FORGET IT!

This Thanksgiving Day…..

I am thankful for many things, but foremost on my list of things to be thankful for are:

  1. My husband who is there for me through the good and the bad….all the things that a marriage is all about (through sickness and health, etc.)…..even though we do drive each other crazy on occasions.  :)
  2. My beautiful and smart little girl who amazes me each and every day.
  3. My life experiences–both good and bad….if it weren’t for them, my eyes wouldn’t be as wide open as they are today, able to empathize with others and be as passionate an advocate when it comes to postpartum depression and anti-bullying matters.
  4. The beauty of nature and wildlife that surrounds all of us….we should never take any of that for granted.
  5. Those around us who have dedicated their lives to helping others and saving lives (e.g.,  postpartum support groups, hospital staff, those who staff hotlines/warmlines, etc.) and those who serve our country (our military).
  6. Last but far from least, I am thankful for the health of my family members.  Life is all too fragile and one’s health should NEVER be taken for granted.  

Have a Happy Thanksgiving!

November is Prematurity Awareness Month – Join in blogging efforts to raise awareness on November 17, 2010

Premature birth is the #1 killer of newborns during the first month of life.  Each year 20 million babies–half of a million of them in the US– are born premature.  A baby that is born too early is not fully developed and thus cannot even suck and/or breathe on his/her own.   It’s simply heartbreaking.  

For those that survive the first year, all too many end up facing serious health challenges and lifelong disabilities.  What is alarming is the fact that the rate of premature birth is increasing (i.e., it has increased > 30% since 1981).  In half the cases, the cause of premature birth is not known, which is why we need to unite in our effort to raise awareness, raise funding and promote research efforts to prevent premature births! 

Here are a couple of things you can do to help promote awareness of this crisis:

1.      November is Prematurity Awareness Month®.  If you are a blogger, please grab a badge and post it on your blog for the month, as well as join other bloggers on November 17th to raise awareness of this crisis.   You can join in this event at Bloggers Unite and at the March of Dimes site.

2.  Ask your U.S. Senators to support the PREEMIE Act (S. 3906), a bill designed to increase research and education on preterm birth, by sending a letter to your Senators and tell them to act quickly on this March of Dimes priority.  To see details of the bill, click here.

3.  Sign up for advocacy alerts, which is a great way to stay informed on legislative developments.

Some of you who have been following my blog for some time and read my blog post last year on the same topic, the following is a reiteration, which I’m including again because I think it’s highly relevant……

What’s premature birth got to do with perinatal mood disorders, you ask?  Well, for starters, approximately 1 out of 10 women experience antepartum (antenatal, prenatal) depression (or depression during pregnancy), though unfortunately many cases go undiagnosed.  Research has shown that preterm births are twice as likely to occur for women suffering from prenatal depression (or depression during pregnancy). To complicate matters, antidepressants to treat prenatal depression have also been shown to contribute to premature births.  And let’s not forget that there is a high risk for postpartum depression (PPD) in women who give birth to premature babies, not only for those with prenatal depression—since depression during pregnancy in most cases will follow into postpartum—but also because the amount of anxiety, stress and exhaustion caused by having a baby in the NICU for an extended period of time can lead to PPD. 

In Deborah Sichel’s and Jeanne Watson Driscoll’s “Women’s Moods: What Every Woman Must Know About Hormones, the Brain, and Emotional Health” (pg 178),  “Anxiety, whether mild or severe, can…..harm the fetus.”  Per Sichel and Driscoll, high levels of anxiety can cause premature births, stillbirths, low birth weight babies, and other complications due to the reduced blood flow, and therefore flow of oxygen and nutrition, to the fetus that results from the constriction of arteries in the uterus when the mother experiences high levels of anxiety.  You need to be aware, if you don’t already know, that the fetus is connected to you via the placenta.  The fetus is basically a part of you.  Just as all the nutrition you get from your food passes between you and the fetus through the placenta, medicine that you take will pass through to the fetus.  Similarly, stress hormones in a woman’s bloodstream from chronic anxiety will flow through the placenta.  In severe cases, stress hormones can cause blood vessels in the placenta to contract so much that it can pull away from the uterine wall, causing hemorrhaging and premature labor.

BOTTOM LINE:  Depression during pregnancy can lead to premature labor and delivery, not to mention low birth weight babies.  Since antepartum depression and antidepressants can cause premature births, more research is URGENTLY needed for the early detection and treatment of prenatal depression, as well as to find ways to treat prenatal depression without harming the developing baby.

American Academy of Pediatrics on the Importance of Screening New Moms for PPD

According to the latest American Academy of Pediatrics report published on November 1st in the journal, Pediatrics, with the over 400,000 infants born to moms with depression each year, perinatal (both antenatal and postpartum) depression is “the most underdiagnosed obstetric complication in America [which untreated and improperly treated] leads to increased costs of medical care,….child abuse and neglect,….family dysfunction and [adverse] affects [on] early brain development.” [1]

As I have said in prior posts, depression in new moms impacts the entire family.  Not only do fathers have an increased risk for developing depression themselves, but babies are at increased risk for insecure attachment, which can lead to developmental (cognitive) delays and behavioral (social, emotional) problems as they grow older.  Children exposed to maternal and/or paternal depression are at much greater risk of developing mood disorders, such as depression.  Hence, to ensure the health and wellbeing of the baby, it is important to ensure the health and wellbeing of the baby’s mother, which is why pediatricians are in a good position to screen new moms for postpartum depression (PPD), as well as help provide referrals for treatment and community resources/support services.

Between the American College of Obstetricians and Gynecologists recommending similar screening earlier this year and now the AAP, I truly hope that this will mean more new moms with perinatal depression being properly diagnosed and treated!  According to this report, although most pediatricians agree that screening for perinatal depression is something that should be included in well-child visits during baby’s first year, they also felt that they didn’t have adequate training to diagnose and treat PPD.  The report also states that the “perceived barriers to implementation [include] lack of time, incomplete training to diagnose/counsel, lack of adequate mental health referral sources, fear that screening means ownership of the problem, and lack of reimbursement.”[2]

There are indications, based on the report, that there have been efforts to move toward inclusion of women’s perinatal health in pediatric practices as demonstrated by programs like the one set up between Dartmouth Medical School and 6 pediatric practices in New Hampshire and Vermont, which show that pediatricians have the ability to effectively screen for PPD.  There is also the ABCD (Assuring Better Child Health and Development) Project, which is comprised of 28 states and their AAP chapters.  It’s wonderful that in Illinois, one of the ABCD states and one of the only states with a postpartum depression law, pediatricians who use the Edinburgh Postpartum Depression Scale to screen new moms for PMDs are actually paid (yes, paid!) by Medicaid for doing so.   Once again, Illinois is setting a positive example for the rest of the country when it comes to looking after new mothers and babies.  For more information on the initiatives going on in the various ABCD states, visit www.abcdresources.org and www.nashp.org.

What we need to do is mandate pediatrician (and OB/GYN) training to recognize PPD symptoms and provide proper referrals to medical/mental health practitioners trained in treating PPD.  The ideal goal would be the establishment of a multi-disciplinary approach (like I mentioned in my last post) wherein doctors–be it OB/GYNs whose patients are the new mom or pediatricians whose patients are the babies of the new mom suffering with PPD—would collaborate with each other and mental health providers in their communities to ensure new moms suffering from a PMD does not fall through the cracks.

I’d like to end this post by pointing out the difference between the AAP’s view of PPD timeframes of occurrence and peak prevalence versus the proposed guidelines I wrote about in my last post with respect to the DSM-5.   The AAP indicates that the peak for a PMD is 6 weeks postpartum, with another peak occurring 6 months postpartum.  It goes on to state in the report:  “Given the peak times for postpartum depression specifically, the Edinburgh scale would be appropriately integrated at the 1-, 2-, 4-, and 6-month visits.” [3]  Hey, American Psychiatric Association, the AAP gets it more than you do!  Please get with the program!

In Conclusion:

From the mere fact that it’s the primary care pediatrician that sees the new mother and her interactions with her baby within the first six weeks (before the postnatal follow-up visit with her OB/GYN at 6 weeks), the pediatrician is in the best position to detect maternal depression early and help prevent adverse outcomes for the baby and the family. “In addition, it is the [pediatrician] who has continuity with the infant and family, and by the nature of this relationship, the [pediatrician] practices with a family perspective [since a healthy functioning family means the healthy development of the child].”[4]  Screening can [and should be] be integrated into the well-child care schedule, as it “has proven successful in practice in several initiatives and locations and is a best practice for [pediatricians] caring for infants and their families.”[5]  The report further clarifies that, since the infant is the pediatrician’s patient, just because the pediatrician screens for PPD does not mean that the pediatrician must treat the mother. It just means that if a PMD is detected during the screening process, the pediatrician would provide information for family support and referrals for therapy and/or medical treatment, as needed.


[1] Earls, Marian F. and The Committee on Psychosocial Aspects of Child and Family. Incorporating Recognition and Management of Perinatal and Postpartum. Pediatrics 2010;126;1032-1039; p. 1032.

[2] Ibid., p. 1034.

[3] Ibid., p. 1035.

[4] Ibid., p. 1035.

[5] Ibid., p. 1037.

24th Annual Postpartum Support International Conference

Last week, I spent 3 days (October 27-30) at the annual Postpartum Support International conference.  This year, it was held in conjunction with the biennial (every 2 year) Marce Society conference, which is traditionally held in the city of the current President of the Marce Society.  With the current President of the Marce Society being Katherine Wisner of the Western Psychiatric Institute & Clinic, University of Pittsburgh Medical Center, this year’s conference took place in Pittsburgh.

Past PSI conferences I attended were in Jersey City, NJ and Kansas City, KS.    With this year’s conference being held in conjunction with the Marce Society, there were over 400 people in attendance, including leading researchers and experts in postpartum depression (PPD).  I was honored to be in the presence of so many individuals who have made such a huge difference on behalf of so many women who have suffered perinatal mood disorders.

Individuals like (note that there are too many to list here, but here are the ones that are most notable to me because I have read their research in the years I have been doing tons of reading on PPD):

  • John Cox, DM, FRCPsych, FRCP, who, along with colleagues J.M. Holden and R. Sagovsky, developed the Edinburgh Postnatal Depression Scale (EPDS) in the 1980s.  Dr. Cox was awarded the Louis Victor Marce Medal in 1986 for his pioneer research and clinical work in perinatal Psychiatry carried out in Uganda, Scotland and Staffordshire.  In 2002 he was elected Secretary General of the World Psychiatric Association.
  • Lee Cohen, MD, director of the Perinatal and Reproductive Psychiatry Clinical Research Program within the Clinical Psychopharmacology Unit of the Massachusetts General Hospital, as well as an associate professor of Psychiatry at Harvard Medical School.  Dr. Cohen is a national and international leader in the field of women’s mental health, and is widely published with over 200 original research articles and book chapters in the area of perinatal and reproductive psychiatry.
  • David Rubinow, MD, Chair of Psychiatry and Professor of Medicine at UNC Chapel Hill.  Dr. Rubinow is currently President of the American Neuroendocrine Society and the Society of Biological Psychiatry, has won numerous awards for his research, his clinical supervision and training, and his scientific administration, and serves on the editorial boards of six journals and has authored more than 300 scientific publications.
  • Cheryl Tatano Beck, DNSc, CNM, FAAN, is a Distinguished Professor at the University of Connecticut School of Nursing.  Dr. Beck serves on the editorial boards of 4 journals and has published over 125 scientific articles as well as 4 books.

I was one of the minority there who was not a mental, medical or public health professional, or social worker.  There were 3 other young ladies there who, like me, are simply moms who want to learn more about perinatal mood disorders and find ways to help spread awareness, as well as to advocate on behalf of and provide support to other mothers.   These young ladies were Katherine Stone, Lauren Hale and Amber Koter-Puline.  This was my 2nd time meeting Katherine and 1st time meeting both Lauren and Amber.  This was the first time all 4 of us PPD bloggers were together in one place.

Here we are:

Amber Koter-Puline, Katherine Stone, Lauren Hale, and me

Another highlight of the conference was the appearance of Former First Lady Mr. Rosalynn Carter as the keynote speaker and book signing of the book “WITHIN OUR REACH: Ending the Mental Health Crisis,”  which she co-authored along with Susan K. Golant and Kathryn E. Cade.

There was so much information provided at the conference, but I was able to take away these 2 really important points that I would like to share with you:

  1. It is critical that we integrate behavioral health with medical care that is provided by those charged with the reproductive health of women.  I learned there is a multi-disciplinary approach to treating women with perinatal depression comprised of a psychiatrist, obstetrician, obstetrical nurse practitioner, and psychiatric social worker at Kaiser Permanente Medical Center in San Francisco.  We REALLY need more of these throughout the country!  In certain other countries, it’s the midwives and early childhood nurses–in addition to GPs–that are the front line of screeners.
  2. There was a presentation about the proposed changes being made regarding the treatment and screening of PPD for the DSM-5 due to be published in May 2013.  During this presentation, the ballroom grew noticeably hotter as one by one members of the audience took to the microphone to state their questions and concerns.  Most of them centered around the announcement that 4 weeks is the cut-off date for onset.  I mean, have you heard of a more ridiculous thing than that?!   That means that any screening that may occur (as not all OB/GYNs or other health professionals screen today) would only occur in the first 4 weeks postpartum, since a postpartum mood disorder (PPMD) would’ve had to rear its ugly head by then.   Why, then, you ask would they propose such an outlandish thing?  Well, it’s because all these years the DSM-IV and all its predecessors are based purely on statistics obtained directly from research.  Not doctor’s offices or hospitals or clinics.  Not from data obtained from the EPDS given to the thousands of moms that give birth each year.   Sounds like typical political, ahem, B.S. if you ask me….

Okay, so what does this all mean?  This means that moms will not only continue to have their OB/GYNs dismiss their PPMD symptoms, but now in addition, there will be a specific cutoff of 4 weeks.  Anything after 4 weeks will risk being shrugged off, as doctors will be referring to the handy dandy DSM-5 as the Bible and complacently inform these moms that they couldn’t have a PPMD because they were more than 4 weeks postpartum.

There is still opportunity to improve on the DSM-5 as it is being proposed.  You can help make a positive difference.  How?  Well, starting in May 2011 and ending midnight of June 30, 2011, the public will be able to submit comments on the draft of the DSM-5 on the American Psychiatric Association’s DSM Development website.   I will be signing up to do so, and I hope you will too.   The more women who do, the better chance we have of convincing the powers that be that they need to extend the onset period to 1 year (or even 3 months would be far better than 4 weeks)!  Voice your concern.  Tell them why.  Share your story.  I know numerous women whose symptoms of PPD didn’t begin until after the 6th week.  Like me, for one.   Other countries who have had ancient social support customs in place for centuries have had 6-8 weeks as the period in which the new mom must be cared for.  There is a reason behind that….just as there is a reason behind the Swedish model of the primary care physician (or general practitioner) performing postnatal screening between 8 and 21 weeks postpartum, with 13 weeks as peak prevalence.

To think that women who are sick with PPD will continue to be shrugged off and go untreated and allowed to suffer unnecessarily angers me to no end.    We are supposed to make progress, but instead, we are more concerned about statistics obtained during very limited studies.   Folks on the DSM-5 committee, this is a blatant example of not being able to see the forest for the trees. 

Last Day of the 21-Day Self-Care Challenge

Well, that was a very quick 21 days!   I’m sure you found how rewarding taking a few minutes each day to do something for yourself truly is.  

As we go about our daily lives, let’s not forget to include taking care of ourselves on our lists of things to do.  Take care of yourself physically, mentally, spiritually.  Eat well.  Exercise.  Get enough sleep.  Meditate.  Do something that you enjoy and feels rewarding to you, like reading, writing, cooking, drawing, singing, or some other hobby.   Treat yourself to an occasional manicure and/or pedicure.  Join a charitable organization that meets once a month and finds ways to give back to your community and raises funds for a worthy cause.

A friend of mine just sent me a short note after seeing my status on LinkedIn that said that I am headed to the annual Postpartum Support International/Marce Society conference taking place in Pittsburgh for the next few days.  He said “Glad to see you’re keeping up with your passion!”    Yes, my passion is learning all there is to learn about postpartum depression (PPD) and sharing that knowledge through my writing.  I am very much looking forward to meeting my fellow bloggers Katherine Stone, Lauren Hale (for the 1st time), and Amber Koter-Puline (also for the 1st time).  I look forward to seeing my other friends from PSI, like Jane Honickman, Wendy Davis, and Birdie Gunyon Meyer.  I also look forward to meeting others who are experts on the subject and heavily involved in postpartum support groups, like Liz Friedman of MotherWoman.

Life is a gift and each one of us should make the most of it.   Find what it takes to be happy and healthy, which includes making time for yourself and finding your passion.

Thank you, Diane Sanford and Anne Dunnewold, for leading this self-care challenge!

Halfway Point of the Self-Care Challenge: Loving Yourself

Today is Day 11 of the self-care challenge, and today’s mantra is:  “I love me, with all my strengths and human faults.”

Why am I tuning in now, after being quiet since my last post, which was day 1 of the self-care challenge?  Well, for one thing, I just got back yesterday from Disney World, having a great dose of time off away the realities of the daily grind made up of the stress of work and the cooling weather–neither of which I care for very much.   Second, we are exactly halfway through the 21-day self-care challenge and I couldn’t not set aside some time today to reach out to my blog readers.  And lastly, today’s mantra has special significance for me.

It is healthy–and actually quite critical–for each and every individual out there to value herself/himself.  Despite what you may have been told while growing up, you are important and you are able to overcome challenges at home, at school, at work, and among peers as long as you put your mind to it.   It all has to do with mindset, which is determined by heredity.  Is your personality more passive than aggressive, more shy than outgoing, more serious than humorous?  It is also determined by environmental factors, such as 1) how much you are nurtured, encouraged and supported by your parents from the time you are an infant through your teenage years, 2) the examples your parents and other elders in your life set for you, and 3) your life experiences.

Remember to focus on your strengths, realizing of course that we all do have shortcomings, as NO ONE IS PERFECT.  I’ve found that discovering your strengths doesn’t stop with the end of your school years.   You will continue to discover and build on your strengths and talents all throughout life.   Life has so much to offer.  So many different things to take interest in.  So many places to see and explore.  So much culture.  So many chances to help and make a difference for others.

I spent the majority (about 30 yrs) of my life disliking myself, not feeling like life was worth living, and incessantly comparing myself to others around me who were more attractive, smart and talented than me.  Well, first of all, remember the age-old saying “Beauty is only skin deep.”   I believe that inner beauty is far more important than physical beauty.  Physical beauty will only last you so long, but inner beauty can only get more vibrant as you become older and more mature.  While it’s very easy and tempting to compare yourself to others, don’t do it.  It’s a total waste of your time.  Every individual is unique.  Every individual has her/his own talents.

While I was in school, I felt so mediocre.  Nothing I did seemed special.  I wasn’t particularly smart enough to score consistent A’s or get scholarships.  I did well in English, but never cared to read the books I was assigned, let alone write papers about them.  I sucked at taking standardized exams, like the PSATs and SATs.  And yet, I got into a good school and am doing okay for myself today.

Aside from singing in choirs, I didn’t have any interest in art (because I suck at drawing and painting) or dancing (which I now regret).  I didn’t play sports–in fact, I hated all team sports.  I have no doubt that things would’ve been different had I not been so shy and withdrawn.  I don’t remember much of my childhood, though I do know that I was reluctant to do much of anything.   I used to think that my parents could’ve tried harder to introduce me to different things (like gymnastics, dancing or soccer) and try to figure out what I liked to do or was good at doing.  Now that I have a daughter that is also shy and withdrawn, I know that it’s not that easy to get such a child to take interest in a whole lot–even if you do your best at supporting and encouraging.    What I’ve learned is that there is a time for everything, and for some people, that time comes later in life.   I broke out of my shy shell of a person gradually through the years, but particularly once I got out of college and started finding out who I really am.  Nowadays, one would never think that I was that shy.  Put me in a roomful of strangers and I can talk to practically everyone as if I’d known them all their lives.  Just don’t put me in front of that roomful of people, and I’ll be just fine.  Yes, like many others out there, I have this fear of public speaking, which I’ve been working on by way of public speaking classes, the latest of which was an absolutely wonderful class at NYU.

As Diane and Anne are encouraging you to do, write down at least 5 things you love about yourself.   Here are my 6 things that I love about myself (and those who know me well know that I am NOT the bragging type):

1.  My ability to empathize with others

2.  My ability to write

3.  My ability to truly see and appreciate the beauty of nature and outdoor settings through photography

4.  My persistence (or shall I say perseverance)

5.  My work ethic…perhaps that is why I’ve been able to survive so many changes and a recession with 1 company for 21 years

6.  My ability to see the positive in my negative experiences, such as my postpartum depression (PPD)

Now, it’s your turn.  Don’t be bashful.

NOTE:  In case you’re wondering if I’ve digressed from the topic of PPD, I haven’t really because self care is key to one’s mental health.  My past posts on the risk factors of PPD and self care during the postpartum months all tie in to how important it is for new moms to be nurtured so they can, in turn, nurture their babies.

Join the Self Care Challenge!

For practical self care tips comprised of really quick (10-15 min) and simple strategies that will hopefully inspire you to lead a healthier lifestyle, visit the Living the Self Care blog starting today, October 6th, through October 26th.  You can sign up for daily reminders to check in for the trip/strategy of the day by subscribing to the Living the Self Care Challenge blog.  Please share your experience and thoughts about the tips/strategies with Drs. Diane Sanford and Anne Dunnewold by leaving a comment on their blog and/or Facebook page and/or tweeting them using #SelfCareChal or @RealMomExperts.

As a Self Care Challenge Champion, I encourage you to share these strategies with friends and family members, and via your own blogs, Facebook and Twitter. 

My last blog post was coincidentally about self care and the importance of new moms taking care of themselves.   Self care is important, in general.  It shouldn’t just be a focus during certain times of your life, as in during pregnancy and postpartum.  It should be programmed into your daily routine.  It should be your way of life.  Exercise, getting enough rest, eating nutritiously, meditation/yoga, pursuing interests that are fulfilling and make you happy (e.g., hobbies, reading, writing, blogging, volunteering, outdoor activities) are but some self care examples.  A happy, healthy person will be less susceptible to physical and mental health issues.   And that’s a fact.

The Myth That Loving Your Baby Means Never Taking a Break

Okay, so you now have a brand-new, completely helpless infant to take care of.  Loving your baby (and your other children if you have any) means never needing to take breaks from her.  Somehow, new mothers all seem to feel guilty at the mere thought of taking a break, convinced that taking time for themselves makes them selfish and bad moms.  C’mon….how ridiculous is that? 

Sure, your priorities have shifted and you need to take care of your new bundle of joy.  But that doesn’t mean you can’t have any time to yourself or time to rest.  You can’t take care of yourself, let alone your baby when you’re completely drained.  You can’t continue on an empty tank, not allowing your body to restore your energy in the form of sleep and adequate nutrition.  You are, after all a human being, not a super-being or the Energizer® bunny that keeps going and going and going.  No one, not even the Energizer® bunny, can run on empty.  The bunny can’t keep on going and going and going without new batteries. If you deprive your body of the sleep, nutrition and rest it needs, there is only so much time before your body will send up a warning flag and succumb to the stressors with which you are faced.  Sure, you put the needs of your baby before yourself.  You make sure she’s fed, cleaned and comforted.  But at the end of the day (figuratively, not literally), you must also be sure to tend to your own needs.  With energy, you can put more energy into mothering.  Can’t be more logical than that!

Mothers should be allowed/allow themselves to take breaks from the baby at least once a day.  If getting more sleep means having someone watch your baby so you can sleep soundly for 4-5 hour blocks and/or take a nap, then so be it.   This may mean arranging for that person to take the baby out while you nap or have the baby stay with them overnight.  Remember, the more well-rested you are, the better off the baby will be. 

If you cannot manage to find a small block of time to nap each day, then the least you can do is close your eyes for a few minutes every couple of hours.  You know you need help when you start to feel like you can’t manage on your own.  You should not wait until you get to that point, especially women at high risk for PPD.  You need to have a postpartum wellness plan lined up and ready to go upon your baby’s arrival.  The plan should include ensuring you have someone to help you each day for the first couple of months so you can get a 4-5 hour block of uninterrupted sleep each day, as well as take breaks from the baby once a day.  In most cases, you won’t be able to rely on your significant other because they need to go to work.  So perhaps your mother, mother-in-law, housekeeper, or nanny.  Someone.  If you don’t already have a cleaning person, hire one to come by once a week, once every other week or once a month. 

 Importance Of Self Care

 “Taking care of yourself is self respect not selfishness.” – Anonymous

What I learned from my PPD experience is the importance of taking care of yourself.  In fact, taking care of yourself is a necessity, NOT a luxury!  Aside from getting as much rest/sleep as possible, here are some tips that I hope you will seriously consider adopting for yourself!

 You’ll be a lot better off if you lower your expectations for yourself:

  • Don’t feel compelled to go to social gatherings or host any parties, particularly if you’re not feeling up to it.  There will be plenty of opportunities down the road for all that. 
  • Don’t expect to keep up with all your chores in addition to caring for the baby, all on your own.  Don’t expect to keep a perfect household in the first months postpartum, unless of course, you can hire a housekeeper.  Don’t push yourself too hard, and don’t feel bad for not being able to do it all.   No new mother can do it all by herself.  It’s simply unrealistic.  Do what you can manage, get your husband or someone else to help with the rest, or just do it later.  This includes making your bed.  There’s no need to make it everyday.  Doesn’t even matter if the clothes you wear are wrinkled or worn several times already that week.  Remember, your priorities are caring for your baby and making sure you get as much rest as possible.  The key is to minimize your stress as much as possible and avoid overexerting yourself.
  • Don’t feel compelled to pick up the phone every time it rings.  Let the answering machine do its job every now and then, especially when you’re busy with the baby or when you’re trying to get some sleep.  In fact, if and when you do try to sleep, you should try to forward the calls to voicemail so you won’t be disturbed.

Nothing Wrong With Doing Something Nice For Yourself…In Fact You Deserve It

  • Do take the time at least once in the first 3 months to treat yourself to a trip to a beauty salon or massage parlor.  Do something you wouldn’t usually think of doing, like get a makeover, a completely new hairdo, a facial or a massage.  Or do something that you simply haven’t had time to do and is long overdue, like get a perm, highlights, hair coloring, pedicure and/or manicure.  It may be something you can do yourself that you simply haven’t been able to find the time or energy to do since the baby’s arrival, like put on makeup, pluck your brows, or put nail polish on your fingernails and toenails.  However, if you are breastfeeding you may want to put off a perm, highlights and hair coloring, since the chemicals can get into the bloodstream and into your milk.  I’ve been getting highlights since before I got married in 2000 and had to put it off from the time I got pregnant until I changed over to formula feedings.  I was feeling unkempt, not having had a haircut in a while and unsightly, with highlights grown out and long grey roots showing.  I can’t tell you what a relief it was to finally get my hair cut and highlighted again.  I felt rejuvenated, a new person!

Importance of a Healthy, Balanced Diet

  • Do maintain a healthy, balanced diet.  Remember, your body has gone through a series of huge biological changes.  It shouldn’t have to be explained that sleeping, eating and staying hydrated are the 3 minimum and essential requirements for a person to stay alive.  Your body requires adequate amounts of all three to recover from childbirth and recharge each day.  Poor nutrition, sleep deprivation and dehydration will make you more vulnerable to illness and stress, putting you at greater risk for PPD. You must be sure to make time to eat (nutritiously).  Make sure you get enough carbs, fiber and protein.  It is never acceptable to not eat because you can’t seem to find the time to do so because of all the new pressures and responsibilities you now have—not to mention you desperately want to return to your pre-pregnancy weight and figure.  Now’s not the time to cut back on the nutrition your body needs to recover and—if you’re breastfeeding—what your baby needs to get from your milk.  If you’re not healthy, it makes taking care of your baby all the more difficult.  Never mind that your body has just undergone huge changes, blood loss and trauma (some more than others).  If you’re like me and suffer from a loss in appetite and weight, you will cause things like vitamin deficiencies, which in turn, can contribute to fatigue and make your PPD worse.  Yes, another vicious cycle to try to avoid! 
    • To repair your body and bring it back to its former condition, as well as develop enough milk and prevent anemia, be sure to eat enough protein.  Tofu, beans, nuts and of course meat are great sources of protein. 
    • To help with constipation, which is common in the first week as your body recovers from childbirth, not to mention a common side effect of antidepressants—eat foods high in fiber, like fruits, veggies and even beans.  There is no prep work needed for pre-cut veggies (e.g., baby carrots), bagged salads, bananas, and grapes.
    • Rather than eating 2-3 large meals a day, you may be better off with small meals throughout the day.
  • Do avoid sugar, including soda and foods high in carbs, since it can cause rapid swings in your blood sugar level that can cause mood changes.  The key to keeping your mood stable is by maintaining your blood sugar at a constant level.  If you’re experiencing a loss of appetite, try to eat small, nutritious meals throughout the day.  Avoid junk foods that are quick and easy ways to satisfy your hunger but have no nutritional value.  If you want something quick and easy to eat, yogurt is a healthier option than Tasty Cakes, Twinkies or candy bars.  Frozen dinners like Weight Watchers and Lean Cuisine or even Subway sandwiches are healthier options than fast-food meals from McD’s, Burger King, Wendy’s, etc.  Despite my lack of appetite, I made sure to stick with my 3 meals by eating oatmeal (carbs) for breakfast, ramen (carbs) and bok choy or a caesar salad with grilled chicken (protein) for lunch, soup with meat and veggies for dinner and yogurt if I got hungry again later in the night.  Temporarily, my husband hat to eat cooked dinners alone because I didn’t have the appetite to eat more than a couple bites of food at any given time. 
  • Do avoid caffeine since it can cause mood changes, an increase in cortisol levels, and even insomnia.  Coffee, tea and soda all have decaffeinated (reduced caffeine) and caffeine free (no caffeine at all) versions. During my PPD, I abstained completely from caffeine.  If you are a regular coffee, tea or soda drinker, it will be especially tough to abstain during the first weeks when you are completely exhausted and want to get a caffeine boost to start off your day and/or keep you awake during the day and/or night.  It was tough for me, but not impossible, to go completely without coffee during my PPD.  Fortunately, I had already weaned myself during pregnancy to only drinking a small cup of decaffeinated coffee per day, which helped me avoid the usual headaches I get from missing my traditional morning cup o’ joe.
  • Do avoid alcohol, since it is a depressant that can cause sleep disruption.  Contrary to popular belief, alcohol is not a sleep aid.  It may cause drowsiness and help you fall asleep, but it doesn’t help keep you asleep and may in fact keep you up the rest of the night.  It is especially important to avoid drinking alcoholic beverages while you are still breastfeeding—even if you are tempted to relieve your stress with a glass of wine or two or to believe advice you may have received about alcohol’s ability to promote milk supply/milk letdown—since alcohol can be carried through breast milk to the baby.

PPD? Nah, It Could Never Happen To Me….Or So I Thought

Do any of these statements sound like you? 

“PPD?  Nah, it could never happen to me.  I’d never let it.  Especially now that I have a baby I’ve always dreamed of having.”

“I’m a strong person.  I’ve overcome many challenges in my life, both on a personal and professional level.  I can handle taking care of a baby.  Plus, I’ve never been depressed before, so how would I get depressed all of a sudden now?”

“I’m busy enough as it is with preparing for the baby’s arrival.  I’ve read all there is to read on infant care, breastfeeding, etc.  I don’t have the time, or need, to read up on PPD.  If it were that big a deal, then why have I never heard anyone I know say they’ve experienced it?  Why don’t you ever see anything in the media about it?  Must not happen a whole lot, so what are the chances I will get it?”

If you look at the Postpartum Support International poster, you’ll see the eye-catching statement that surprised me when I first saw it, as I’m sure it would surprise most people:  “The #1 complication of childbirth is depression.”  Like me, many people have heard of “postpartum depression” but don’t know what it means, at least not until it affects you directly. 

Before I learned about 4-5 months after my daughter was born, 3-4 months after my first symptoms started, and 2-3 months after I learned I had PPD, I didn’t know anyone who has had it (and I’m not counting the likes of Brooke Shields and Marie Osmond either).  In reading up on pregnancy, labor and delivery, I skipped everything that was titled “postpartum depression,” whether it be a pamphlet from the hospital’s childcare class you enrolled in or a chapter in a pregnancy book.  I never thought it would be something that would happen to me.  I thought I had succumbed and overcome many obstacles in my life without ever having depression, I would never let something like PPD happen to me.  I thought it was all a matter of mind over matter. 

The words “Knowledge is Power” have a deeply significant meaning here, because had I known that as many as one out of eight new mothers develop PPD, I would’ve tried to become familiar with what it is, its risk factors, and its symptoms BEFORE having my baby, and I would’ve never traveled that long, lonely and dark road during those dreadful weeks I was sick with PPD.  It hit me suddenly and without warning, and since I didn’t know squat about PPD, my anxiety levels were through the roof.  Insomnia led quickly to panic attacks, quickly debilitating me to the point that I couldn’t sleep, let alone function, without being medicated. 

But I emerged smarter and stronger than I was before my PPD experience.  For that, I am ever so grateful.

The Mental Cost Behind A Nomadic Childhood Experience

Thought you’d never see me post again, eh?   I think this is the longest (2-1/2 wks) I’ve gone without posting since I started this blog up in February ’09.  I just got really, really busy.  One would think that the summer would be all fun and stuff, but nah, not for me.  Work has been crazy busy, and I had to get my house ready for about 30 guests this past Saturday, which meant a week’s worth of cleaning.

I rely in many cases on what my blogging friends post to give me inspiration on what to blog about.  I also rely on tweets.  But since I’ve been out of the loop– as far as the Internet is concerned–for the past 2-1/2 weeks, I don’t have the latest scoop on anything.  So, I am going to blog about something that caught my attention 2 months ago.  It was a NY Times article titled “Does Moving a Child Create Adult Baggage?” by Pamela Paul.  

Without a doubt, the answer to the question is “YES!”  This is from personal experience.  Now, before you think I’m digressing from the topic of postpartum depression, read on…and read on all the way to the end of my post, and you’ll see why I am writing about my nomadic childhood experience.

When people ask me what my home town is, I can’t say North Caldwell, NJ, even though that is where I spent the majority of my life.   Plus the fact that I didn’t care to live there at all…I don’t have any pleasant memories of my 20+ years as a resident there.   Before North Caldwell, I had lived in 7 other places.  That’s 8 homes by the time I was in 7th grade.   For a while, I was moving on average once a year. 

My brothers were basically born and raised there, so all the friends they made in preschool followed them through to elementary school and then onto junior high and senior high.   I, on the other hand, had to make friends from scratch when I started 7th grade for the first time in this school district.   I had to do that at the toughest stage of any person’s life, which is puberty–a roller coaster ride (and boy, do I HATE roller coaster rides) I wanted to get off of so many times but couldn’t.  I really hated life then.  It didn’t help that I was shy and sensitive.  Not sure if I was born that way or that was the consequence of moving so many times.  Plus the fact that I was the only Chinese girl in a class of about 350 students who were primarily of Italian or Jewish descent.   Why else do you think the producers of “The Sopranos” chose to base their show out of N. Caldwell, NJ?  Teenagers can be mean to begin with.  When you put a stranger in their midst, and one who is quiet, probably not the most attractive and definitely not the best dressed, and Chinese to boot, you get P-R-E-J-U-D-I-S-M. 

Now, back to the article.  Up at the top, the author writes “THE GIST: Moves in childhood may do long-term harm.”   I agree wholeheartedly.  The long-term harm it has done to me is a lifelong insecurity in terms of my relationships with others, which is key to my generally low self esteem that I have been fighting to overcome all my life and hasn’t helped my job situation all that much, believe me. 

“PITY the military or academic brat.”  

Everytime I tell people that I used to move a lot, I get the same ol’ question “Oh, is your father in the military?”  It’s gotten to the point that I beat people to the question with the explanation “We weren’t military or anything.  It was due to my father’s job situation.”   He kept moving because he couldn’t find a job that he wanted to stick with.  It wasn’t until he established his own company, which is when we moved to N. Caldwell, that he was content to settle down.  Timing was great for my brothers.  Lousy for me.

“Psychologists, sociologists and epidemiologists have long recognized that children who move often tend to perform worse in school and have more behavioral problems than those with a firmly rooted picket fence.”

I could’ve told people the same thing even without reading this article.  This is the reason why my husband and I intend to stay planted where we are now until our daughter graduates from college. 

“[Findings suggest that] serial movers tended to report fewer ‘quality’ social relationships. The more times people moved as children, the more likely they were to report lower ‘well-being’ and ‘life satisfaction’ as adults (two standard measures used to quantify that ineffable thing called ‘happiness’).”

That first sentence describes me.  I would say that staying rooted in one place is important to enable quality social relationships to develop, which is a key part of most people’s lives.  After all, humans are social beings. 

“[Frequent moves during childhood negatively impact] “certain personality types. Introverts and those [who are deemed] moody, nervous or high strung…..were adversely affected, while extroverts remained blissfully unmoved.  Though this is just one study, Professor Oishi said, ‘Parents who are considering moving need to think about their children’s personalities and the potential risk.’” 

Though this research is too late for me, I now know better as far as my own daughter is concerned.  She is, like me, on the more nervous and high strung side of things.  I know what I need to do is to give her a stable, firmly rooted, non-transient, non-nomadic lifestyle.  The kind of lifestyle I wish I had had while growing up.

“Relocating is much harder on middle schoolers, already wrestling with puberty, than on younger and older children.”

Well, there you have it.  Now that I know what I know now, I am going to make sure my daughter has an easier life than I did when it comes to things that are within my control.  Like moving, for instance.  My husband and I will do our darndest (knock on wood) to have our jobs revolve around where we live.   From experience and knowledge of the impact of decisions we make, we can try our best to pave the way for our children to have less stress during their formidable years, which are basically their school years, and minimize the risk for teenage angst the best we can.    I want to minimize my daughter’s risk for depression…and postpartum depression when she hopefully has her own child(ren), God willing (so I can be a grandma).

Finally, as I’d mentioned in a previous post, the predisposition for depression in many cases is genetic, but whether those genes are expressed, or turned on, depends on the following:

  • your experiences during childhood and adolescence
  • the overall environment in which you live during those years
  • the severity of stressors with which you are confronted early in your life
  • how much nurturing (support, positive role modeling and positive reinforcement) you get from your parents

If we want to keep our children free of depression, along with nurturing, loving, encouraging and spending quality time with them, we need to minimize the stressors that they face within reason, especially as they go through adolescence.  Be aware and supportive of your children’s school experiences and activities, and help them with any challenges they face.   We can help minimize and even help prevent the onset of depression when our children are at their most vulnerable emotionally, which is during their adolescent years.

Massachusetts Postpartum Depression Legislation Signed into Law Today!

Quick post for the purposes of expressing my elation over the fact that the Massachusetts Postpartum Depression legislation has been signed into law today, Thursday, August 19, 2010!  Yep.  The Massachusetts Governor has signed House Bill 4859, otherwise referred to as Chapter 313, An Act Relative to Postpartum Depression.   Click here for more details.

HURRAY FOR PROGRESS!

Similar to the Mother’s Act passed at the Federal level, HB 4859 stipulates a focus on earlier detection of postpartum mood disorders through screenings, improved collaborative efforts among health professionals for the treatment and referral of patients, the training healthcare providers, and public awareness campaigns.  Click here for an excerpt of the bill. 

It’s exciting to see these changes occurring across the country, isn’t it?!  Click here for details on the latest in legislative developments relating to maternal mental health.

Let Oprah Know Your PPD Story!

A real quickie from me today. 

I’ve heard that Oprah is considering airing another show on postpartum depression (PPD), more than likely due to the recent announcement by Twilight actress Bryce Dallas Howard in Gwyneth Paltrow’s recent newsletter where Gwyneth tells her story as well.  Since I believe this opportunity to tell your personal PPD story is only available for a very short time, please be sure to click here to share your straight-from-the heart, as-real-as-it-gets PPD story and try to help other moms.  I just did.  Just be sure it comes out to < 2000 CHARACTERS (not words).  

Hey, you never know if you might be contacted.   I just heard that one of my friends, Marcie Ramirez (Postpartum Support International Coordinator, Middle Tennessee) was contacted by the Oprah show today!

Massachusetts Postpartum Depression Bill Passes Senate!

Today, I received an update–and an excellent one at that–from Katherine Stone regarding the status of the Massachusetts Postpartum Depression Bill.  The Senate passed it this past weekend!   I can’t help but get goose bumps over the excitement I’m feeling over such progress!

So, there you have it.  Approved by both the House and now the Senate.  Does this mean the bill is now law?  Not yet.  The Governor’s signature is but one of the critical steps remaining.   Considering this bill is one of thousands of bills filed this session and only a few hundred have actually been passed by the Senate says a lot about all the work that individuals like Rep. Ellen Story have put in to shedding light on how crucial postpartum depression legislation is for women.  Working in the bill’s favor is the passage of the MOTHERS Act as part of Health Insurance Reform this past spring. 

Ah, forward momentum…let’s keep our fingers crossed it keeps on moving onward! 

I will provide an update once the bill has officially passed.  Stay tuned!

Postpartum Legislation Passes Massachusetts State House!

It’s been a busy, busy, busy month, and I can’t freakin believe it’s the first day of August already!  With daily stomach pain for the past 2 weeks and plenty of stress from work, I’ve managed to fall behind on Twitter and all but forgot my mom’s 75th birthday.   Uh boy!  =(   Then again, I barely tweet to begin with, relatively speaking.  With a full-time job (that monitors employee activity, like tweets) and having to worry about work/life balance, I’m barely keeping up with housework and with the family, let alone Twitter.  And now I’m going to post a record short blog post.

Speaking of Twitter, I was excited to find out through that very informative medium yesterday, through the following @MotherWoman tweet, that postpartum legislation (House Bill 3987) passed the Massachussets State House!  Now it’s on to the Senate:

“Being on TV is exciting but this is the real fun: Postpartum Legislation passed the MA State House yesterday! Now… http://fb.me/sRnfa4Jl

I’m excited to see progress–albeit slow– in research, awareness, and attitudes toward postpartum depression, in general.   I am particularly excited for the state of Massachusetts because I spent four years of college there.  My home state, New Jersey, has had its PPD law in place since 2006.  It seems that people have come to realize that the only way we are going to make quicker and more substantive progress regarding research funding, requirements for healthcare practitioners and hospitals to be more mindful of the mental wellbeing of new moms, and the need to establish postpartum support services is for policy changes to be implemented on a top-down basis (i.e., at the federal and state levels).  

I did a search for more details on the MotherWoman website and on the Internet, but could not find anything.  As soon as I do, I will be sure to share! 

Hope everyone is enjoying their summer–unless of course you are on the other side of the word, like Australia.  We are in the last stretch and fall is around the corner.  I hate it when the days start to get shorter, don’t you?  Bleh.

Celebrity Moms Speaking Up About Postpartum Depression

She’s one of my favorite actresses.  She’s known for her frequent roles with a British accent.  And she lives in England with her husband, Chris Martin (lead sinder of Coldplay), her daughter Apple, and her son Moses.   She was the leading lady in three of my favorite movies:  Sliding Doors, Emma, and Shakespeare in Love.   

Yes, I’m talking about Gwyneth Paltrow.

I’m now more in admiration of her than ever before.  And why is that?  Today, I stumbled across her blog “Goop” where she offers lifestyle advice in the form of weekly newsletters in the following categories: 

  • MAKE:    cooking
  • GO:    travel
  • GET:    gifts – fashion – wine – etc
  • DO:    health – diet – self care – spirituality
  • SEE:    films – events – books
  • BE:     parenting – family – friendships

This week’s newsletter happens to be about her PPD experience after the birth of her son, Moses.  The newsletter also features Dr. Laura Schiller – a NYC-based OB/GYN – who provides a brief overview of PPD;  actress Bryce Dallas Howard; Heather Armstrong, author of dooce.com and author of “It Sucked and Then I Cried;” and psychologist and frequent GOOP contributor Dr. Karen Binder-Brynes.  

Thank you, Gwyneth and Bryce, for your courage in speaking up about your PPD experiences!  Thank you for joining the ranks of celebrities such as Brooke Shields and Marie Osmond who have spoken up about their PPD experiences and have a desire to educate others about PPD.  It’s thanks to these celebrities being open and public about their PPD experiences that PPD is now being discussed more openly among mothers, on blogs, and in the media. 

Celebrities are generally viewed as financially capable of hiring all the household staff that is needed to help around the house and with any babies that come along.  From chauffeurs to maids and nannies, they lead the life the average mom like me can only dream of having.   Celebrity moms are the last ones the public would ever think would experience PPD.   After all, they have all the help they can get around the house, with cooking, laundry, childcare — you name it.    FYI, Gwyneth refused to hire a nanny for her 2 children, even taking time out from acting to focus on motherhood for a number of years, and it was only in the past year that she disclosed that she finally hired one.  

But just as PPD is blind to race and culture, it is blind to socioeconomic status as well.   With an occurrence rate as high as one out of every eight moms, PPD is a serious condition that requires more public awareness and destigmatization…which is why Brooke, Marie, and now Gwyneth and Bryce are speaking up.  PPD surprised them and debilitated them.  Much the same way as PPD surprised me and debilitated me.  PPD can happen to anyone, really.  But there are certain risk factors to be cognizant of.  We need more moms to speak up.  Those who are already in the spotlight have more ready access to the public’s attention, which is why it’s wonderful that these celebrity moms are speaking up!

Gwyneth and Bryce….I just hope you’re not going to stop with this one newsletter.  I hope you can take advantage of that media spotlight of yours and continue to speak and write in different venues about PPD.   Yes, take advantage of your celebrity status and help educate the public about resources that can help mothers get through their PPD experiences.

Anyhoo….one last thing I wanted to point out is that Gwyneth’s PPD experience shows us that just because you didn’t have PPD after your first child doesn’t mean you will be completely immune from having PPD in subsequent births.   And on the flip side, while Brooke suffered from PPD after her first child, she was able to avoid PPD after her second child….and that was due to awareness of her risk factors and minimizing them.  One woman’s pregnancy experience will vary from one pregnancy to the next, just like her childbirth experience will vary from one childbirth to the next.  We can only improve our chances for a good motherhood experience if we are empowered with knowledge about PPD, not caught up in any motherhood myths or thoughts of “PPD?  That can’t happen to me.”

MY ONE AND ONLY

When I spotted the July 19, 2010 edition of TIME magazine sitting on the coffee table at my in-laws’ house this past Saturday, I was instantly drawn to the cover and the title of the feature article “The Only Child: Debunking the Myths.”    The intro lines of the article really grabbed my attention, with the typical setting that for some reason seems to be a common setting that kicks off many articles, both printed and on the web.  The setting is a supermarket.  Sometimes the exchange is between two women standing on line.  Sometimes it’s between the cashier and a customer.  In this case it was the latter–a mom, minding her own business, with her adorable, pink-cheeked baby seated in a grocery cart–and the cashier.   Usually, questions asked at the supermarket pertaining to babies usually have something to do with the age of the baby, and if there are no other children present, whether that is the first baby.  Well, in this article, the cashier starts off the conversation with the latter.  If the answer to that question is “Yes” as it was in this case, then sometimes, the conversation steers toward comments suggesting that she ought to work on the next baby real soon, so that this one isn’t lonely and has a little brother or sister to play with, and to avoid the “single child syndrome” — the belief that single children end up spoiled rotten because their parents lavish all their attention on the one child, lacking social skills and selfish because they don’t have any siblings with whom to interact (and therefore no “sibling rivalry” experiences) and with whom to share their toys.

In all honesty, I didn’t finish the article because I already got what I needed from it, which is inspiration to write a post and share my experience with others who care to listen.   Then, I was inspired even more to make this post a priority when, on Sunday, I saw a tweet from @ArmsOpenGrace where she was saying that she was at a BBQ and couldn’t help but to compare herself with everyone else who all had 2+children, and she’d just had her first child not that long ago.   I tweeted to her: “I can’t help but wonder what it’d be like to have 2 instead of 1. I don’t even compare myself with others anymore. No point.”  So I proceeded to tell her that the TIME article inspired me to write my next post.  And here we are.

For strangers to be prying for this kind of information is a bit much, I have to say.  And it’s all based on this societal pressure to have more than one child, all thanks to Granville Stanley Hall about 120 years ago.   But I’ve learned to come right out with the truth just to cut the exchange short.   That really stops the conversation from getting further than it really has to. 

I can’t tell you how many times I’ve had to experience the following exchange, similar to the one in the TIME article, from the time my daughter was an infant til now (and she is now 5-1/2). 

Acquaintance/Colleague/Stranger  (A/C/S):  “What a beautiful little girl!  How old is she?”

Me:  [I would tell them my daughter's age at the time]

A/C/S:  “Do you have any more children?”

Me:  “No”

A/C/S:  “So, when are you going to have another?”

Me:  “I’m too old.”

A/C/S:   “Nah, you’re not that old.”

Me:  “I’m a lot older than you think.  Did you know I was lucky to have her on my 2nd IVF cycle?”

A/C/S:  “I didn’t know that!  Well, why don’t you give it another try?”

Me:  “I can’t.”

A/C/S:  “Well, you succeeded before….”

Me: “I mean, I really can’t.”

A/C/S: [not wanting to give up]: “But you’re not that old.  Why not?”

Me [just so I can stop this exchange before I start to get nasty]: “Because I’m missing a critical body part.”

A/C/S: [not getting it but curiosity has gotten the better of them]:  “Um, not sure what you mean.”

Me:  “I. Have. No. UTERUS.”

A/C/S: [face falls after a few seconds, realizing finally what I've been trying to say]:  “Oh, I see.  I’m sorry.”

A/C/S: [conversation taking a sudden turn]: “Well, you are blessed with this beautiful girl.  You are really lucky to have her.”

Me:  “Yes, I know.  She’s my one and only.”

A/C/S: “You can always adopt, you know.”

Me:  “Yes, I know. But I am happy with just the one.”

And then, depending on who this person is and how comfortable I am with sharing my postpartum depression (PPD) experience with him/her, I may go on to tell him/her about my childbirth complications that resulted in my lengthened hospital stay, followed by PPD that started 6 weeks later.    A couple of people asked me if they thought that it was the realization that I could no longer have children that led to PPD.  I told them it was one factor, but definitely not the only factor.

Would I have wanted another child?  Absolutely!  When I was younger, I dreamed I would have four children…one more than me and my two brothers.   As I got older, I would have settled for three.    That was, after all, more than two…and two at the time just didn’t seem enough.   But then I got married late because it took me a long time to find “the right one” (and he was worth the wait!).  Not long after we got married,  I had to get surgery to remove a dermoid cyst, which my OB/GYN recommended to prevent pregnancy issues.   We got pregnant after months of trying, but only to have it result in an ectopic pregnancy that had to be terminated.  Then, after many more months of trying to conceive, we were encouraged to undergo IVF treatments.   After our 2nd IVF cycle, which thankfully succeeded, and we were well on our way with the pregnancy, I was praying deep down inside that I would be fortunate enough to succeed just one more time.  I was willing to endure one more, just so I could provide one sibling for my child. 

When I woke up from my emergency partial hysterectomy, I felt so incredibly sad.   I was sad that I could not have another child.  I was sad I couldn’t provide my daughter a sibling.  I felt unwhole.  I was essentially missing an important piece of me.  A piece of me that would enable me to bear children.  It was so final.   Before, I had all my parts but they just weren’t working quite right.  There was a breakdown somewhere in the complex process that occurs behind the scenes–starting with the sperm swimming and finding a good egg to hook up with all the way through the time that there is a viable pregnancy.  And all I needed was some help (in the form of IVF) to prime up the process and improve my chances for a viable pregnancy that would carry to term.  

In the hospital, after hearing the terrible news, I couldn’t help but cry.  But I couldn’t just wallow in my grief.  I now had a baby to take care of.  Since she was my only chance at having a baby, despite my pain and exhaustion, I was determined to do the best I could at breastfeeding her, changing her and holding her.  I was fine until my first PPD symptom, insomnia, appeared during the 6th week.  But in between childbirth and that 6th week, my body and my psyche had to endure so much fatigue and anxiety.  Six weeks of non-stop fatigue and anxiety finally caused my body to shut down.  I’ve endured a lot of challenges and anxiety in the past, but nothing that could compare to such a life-altering experience as childbirth and the weeks of adjustment that go with it.  And I was already starting in the negative, after having gone through what was referred to as a life-threatening procedure in which I hemorraged and lost 4 units of blood, on top of the following chain of events:

  •  traumatic delivery experience that resulted in a partial hysterectomy resulting in loss of ability to have any more children
  • negative experience in the hospital–e.g., constant sleep interruptions in the hospital, constant moving from one room to another and changes in hospital staff, multiple attempts to replace IVs in my arms/hands, food deprivation (I only had about 2 meals the whole week I was there….otherwise what I had were ice cubes for the most part, plus an occasional broth or jello), below-par treatment of certain hospital staff, searing pain (felt like someone was burning me) in my abdomen that came & went for 2 days after the surgery
  • constant sleep interruptions from the noises the baby made throughout the night, plus night feedings
  • baby’s bad case of eczema and cradle cap
  • baby’s one week colic

Blogs Speak to Different People Differently

Feels like ages ago since my last post.  Anyway, I was motivated by Katherine Stone’s post from last week titled “Diverse Voices Are Important to Suffering Mothers” to write this post.   

I agree 100% with Katherine in that “Different people respond to different voices and different experiences.”  That’s why the more women who speak up about their postpartum depression (PPD) experiences, the more people we will reach–not just literally in terms of numbers and geographic locations, but figuratively in terms of being able to get through to all kinds of women.   Katherine’s Postpartum Progress blog has over the years cultivated a huge following worldwide.   She empowers women with knowledge about perinatal mood disorders.   Through the information she shares, she helps women suffering from PPD feel less alone in their experiences. 

Lauren Hale over at My Postpartum Voice and Amber Koter-Puline over at Beyond Postpartum are also wonderful examples of PPD bloggers who share the same goal as Katherine.  I’ve said it before and I’ll say it again….it’s these three inspiring women that have motivated me to devote my blog completely to PPD and other perinatal mood disorders.  We blog with the hope there will be fewer moms out there suffering the way we had suffered.   Though each one of these ladies has their own style and approach, they are all very focused on providing support.   

So, what’s my angle?  I always voice my own opinion on each one of my weekly blog posts.  I also voice my anger in response to ignorant comments made about perinatal mood disorders, or mental health, in general.  As some of my blog followers are already aware, my #1 pet peeve is behavior/remarks made out of ignorance, prejudism, condescension.    This comes about as a result of how I was picked on in high school.   Do I regret those days?  Sure.  But if it hadn’t been for my experience growing up, I probably wouldn’t be the way I am today, trying to tackle ignorant comments whenever they come up.  Whether they are in the form of media attempts to educate people about PPD or blog posts (and let’s not forget comments), I am going to speak my mind and point out incorrect/ignorant statements.  

My style may not be as “warm and fuzzy” as my fellow PPD bloggers, but that’s just me.  I am an analytical/scientific/logical kind of person, which comes from my being a science major in college.   My style or approach to blogging about PPD may not resonate with many of the mommas out there.  My reaction–or shall I say anger–to ignorant comments may scare some mommas away just as easily as it may attract followers.  As Katherine stated in her post:  “You may not like what someone says or how they said it, but if it helps a woman who is suffering and feels alone that’s what is important.  At least, that’s what is important to me.”  Amen, Katherine, Amen!

Not everyone is going to like my blog, as I’m sure no one blog is going to appeal to everyone.  Just like everyone is unique, every blog offers a different voice, a different experience.   Just like Katherine indicated, you can always start up your own blog, if you haven’t done so already and join the growing number of women who are speaking up about their PPD experiences.  Say it in your own way.  After all, that was the original purpose for having a blog–to keep an online diary of your thoughts and experiences.  We’ve come a long way from keeping personal diaries of one’s thoughts and feelings to be kept to yourself versus a blog, which anyone with a PC and Internet access can view in today’s digital way of life.

My latest example of tackling ignorant comments about PPD came about this past Sunday, July 4th.   All I wanted to do was search for the latest news on Georgette Massi, the woman from Mahwah, NJ, who drove drunk with 3 small children in her car less than a couple months ago.  There was this website that came up first when I did a search for her name on Google.  Well, I did what I probably shouldn’t have done, especially on a holiday as we were getting ready to celebrate with friends, which is read the comments.  There was one that had a warning flag of “Beware of possible ignorant comment and angry person behind comment.”  And what did I choose to do?  Reply to the comment with my typical FYI.  My gut was telling me that the link to my post about the possible correlation between PPD and the rise in the number of drunk driving moms (with kids under one) would spark a negative reaction, and boy, did it do that!  But I felt it was contained because the voice behind the person exchanging comments with me (not the one I addressed in my comment) sounded reasonable, relatively speaking.  Then, like 2 days later (today), while writing this post and going to the site to retrieve the title and URL (which I’ve subsequently dropped from this post because that site does NOT deserve any attention whatsoever), I did what I probably shouldn’t have done, which is check to see if there were any new comments.  Lo and behold, there was one.  And boy, was it a doozy.  This one was from the person whose comment I addressed on Sunday.   There was no reason behind it.  Just anger.  And this coming from a PPD survivor!  I couldn’t believe it.   She had blinders on and had no intention of taking them off.  Nah, she was not going to be open-minded, mature or intelligent.  There was only one way of thinking and it was all hers, as wrong as it was.  It was her way or the high way.  

Well, like I said earlier in this post, there are many kinds of people out there.  Some who survive experiences to be stronger, more empathetic people who want to make a positive difference for others.  And there are those who survive their experiences with a crapful of anger directed at everyone else, where there is no room for reasoning.  Just anger.  They don’t care about anyone else.  They don’t want to help anyone else.  Paying it forward doesn’t exist in their vocabulary.  Hey, all I can say to that is, there is such a thing as karma.  What comes around, goes around. 

Am I a masochist?  Maybe.  My friends and husband call me crazy.  What I really believe is that by tackling the comments as I see them, I am in essence tackling the stigma of mental illness.  It’s such a monster to have to tackle.  But where there’s a will, there’s a way.  And I’m hoping that with all our voices speaking up, we will chip away at the stigma so that women don’t have to continue suffering in silence, ashamed, embarrassed and not necessarily knowing what is happening to them.  And unlike what this “PPD survivor” was ranting at me, all belligerent and everything, no, not every woman with PPD is going to know she has PPD.  If that were the case we would be much ahead of where we are today!  The sad truth is that not every woman is going to know  she has PPD since everyone doesn’t know what the symptoms are.  Many women realize there’s this stigma and keep their experience unnecessarily to themselves, hiding behind a facade of smiles when deep down inside they are crying.  They want their motherhood experiences to be joyous and feel ashamed/guilty for not being able to have that experience.   And then to make matters worse, not all doctors diagnose correctly.