Lunafest in West Orange, NJ on September 13, 2019 Benefit for Postpartum Support International

If you live in New Jersey, please consider attending LUNAFEST proudly presented by the New Jersey Chapter of Postpartum Support International (PSI).

When: Friday, September 13, 2019 at 7:00-10:00 pm

Where: Luna Stage at 555 Valley Rd, West Orange, NJ

Tickets:  $25 includes a complimentary cocktail.  To buy, click here.

About:  Since 2000, LUNAFEST has showcased a collection of short films by, for, and about women. Discover the ground-breaking work of female filmmakers who are changing the industry with this year’s lineup of eight short films.  Your support of Lunafest will not only help flip the script of the 2.13 : 1 ratio of male to female short-film directors in this country, but help raise money for local women’s causes.

Proceeds of this particular screening event will benefit the NJ Chapter of PSI.  PSI’s mission is to promote awareness, prevention and treatment of mental health issues related to childbearing.  The long-term goals of the PSI-NJ chapter is to create, throughout the state of New Jersey, a unified voice for the support, education and care of moms and families with perinatal mood disorders, as well as law enforcement and health care professionals.  support mothers (and even fathers) suffering from it.

If you support women’s causes and want to support mothers (and their families) who suffer from postpartum mood and anxiety disorders (e.g, postpartum depression (PPD), postpartum OCD and postpartum psychosis) to get the help they need, please consider coming to Lunafest and sharing with friends, family members, neighbors, and colleagues and even share widely on social media.

There will be information about PSI, PSI-NJ and other maternal mental health services in NJ at this event.

 

 

 

 

 

A Letter to My Mother on Mother’s Day

Dear Mom,

You brought me into this world.
You raised me.
You taught me to be a caring, polite, honest and hard-working individual.
I have much to thank you for.

You were always a very caring mother.
Even though you always worried so much…..
Too much, in fact.
You worried so much that you drove me and my brothers bonkers.
Your incessant worrying made for a very tough time growing up as your daughter.

You always did tell me, wait until you have your own child(ren), and
Then you will know what it’s like to be a mother.
Looking back, I do realize you were just trying to be the best mother you can be,
Just as I now want to be the best mother I can be too.

I remember how we used to fight a lot.
Much of it was due to no one being able to see things from the perspective of the other.
And dad was a catalyst to our fights.
My unhappy teenage years didn’t help matters.
Things were tough for me growing up.
I hated school and where we lived so much.

But I know things were tough for you too.
You lived far away from your own parents….
So far away that you only saw them a couple times since you came here in the 1950s,
Seeking a better life for yourself and future family.
You always just grinned and trod on,
Focused on ensuring your children did well in life.

Life has not been that fair for you, I know
And I wish I could have changed your experiences and circumstances
So you could’ve had a better life
That you didn’t have to spend so many lonely days at home alone
After my brothers and I moved out and
While dad worked all day, 7 days a week.

I wish I knew then what I know now.
That your heightened anxiety and obsessive behaviors,
Your worst enemies,
Should have been treated so that
After you had your surgery in 2012,
Your anxiety and obsessive behaviors wouldn’t compromise your health.
Your soon-to-be-84-year-old self
Still doesn’t look your age
Despite all the medical issues you’ve faced.
Had it not been for your anxiety and obsessive behaviors,
I could see you living up to 100 years old,
Full of the energy and youthfulness I remember seeing
As a child while you sang and danced in the kitchen.

I will never forget your sadness that you couldn’t spend more time with your family.
It pains me to remember.
I wish I could’ve done more for you earlier….
Like send you back to see your family more,
But money was always an issue.

This regret will hang over my head for the rest of my life.
This regret has taught me that
It’s not about material wealth, size of home, or appearance of wealth that matters
So much as the fact that time goes by and people age too quickly
Moments are all too fleeting,
And before you know it, there are so many lost opportunities
To do things you wanted/meant to do
That are now too late to carry out.
I may now have the means to send you home to visit your family.
But you are now too old and frail to travel.

I don’t want any more regrets.
I don’t want to later look back with regret that I didn’t see you as much as I could.
I don’t want to later look back with regret that I didn’t cook for you.
I don’t want any more regrets.

I want to be there for you as much as I can,
Within my abilities and despite my shortcomings,
As I am far from a perfect daughter.

Today, on Mother’s Day, a dreary, rainy, chilly day,
I reflect on my shortcomings as a daughter.
I could’ve spent more time with you.
I could’ve cooked more for you.

But things are not too late.
I can still see you every week.
I can still cook a little for you,
Even though I suck at cooking.

You inspire me to be a better mother.
And a better daughter too.

Happy Mother’s Day, Mom.

Love always,
Ivy

Parenting is hard

As a follow-up to my July 2018 post about my friend Elly Taylor’s US tour, I would like to help spread the word that PARENTING IS HARD.

 

* * * * * * * *

That’s right, parenting is NOT necessarily instinctive.

Don’t let anyone tell you otherwise.

Parenting is a journey that is traveled by the new mom who learns as she goes.

And one in which the new father (or partner) learns as he goes.

Or as per Elly’s training mantra and title of her book, it’s a journey to Becoming Us.

And you, parents, need to and should take as much help as you can get along the way.

There should be no shame with that.

No one says that you need to go it all alone.

The more help you get, the better your parenting experience will be.

Trust me.

And trust Elly and everyone else that is trying to spread this truth and resources to get you that help.

The more we realize this going into parenthood, the less we are blindsided.

The more we are prepared for the twists in the parenting journey that life throws our way.

For 1 out of 7 new moms, postpartum depression (PPD) is one of the twists that they will come across on their journey.

Minimizing surprises leads to a better parenting experience and less risk of PPD.

We should want this for everyone, no?

So, please help spread the word.

PARENTING IS HARD.

 

* * * * * * * *

Check out Elly’s brand new video.
It is a very important video for all expectant and new mothers and their partners.
I just adore listening to her lovely Australian accent.

Stay tuned to a follow-up post on Elly’s 2019 tour to the United States.

 

Keys to Empowering New/Expectant Moms and Maternal Mental Health

I was talking to someone 2 days ago who mentioned that for millenials, images are the way to go to attract attention to important messages.  In this day and age of limited-word media like Twitter and other social media forums, sound bytes and visuals tend to grab people’s attentions more.  Print media — like magazines and books (like mine) and all the other books I devoured in my quest for knowledge on why postpartum depression (PPD) occurs in certain women — are going more and more by the wayside.  Just today, I stumbled across an email from Karen Kleiman, MSW, LCSW, (founder of The Postpartum Stress Center and author of numerous books on perinatal mood disorders)1 yr and 9 months ago giving me permission to use the below image on my blog.  This image grabbed my attention and I want to help circulate it.   You should too if you care about mothers.  We need images and information like this to reach more expectant mothers.  We need to ensure they are informed before they even give birth so they aren’t blindsided with PPD.

Why do I feel this information is important? My experience with PPD happened back in 2005, and I blogged about the ignorance of my OB/GYN in February 2009, just shy of 10 years ago.  It was one of my first blog posts. Unfortunately, not much has changed between then and now except for the advent of Facebook and other social media to spread the word via organizations such as Postpartum Support International (PSI), PPD survivors/advocates, social workers, therapists and others who treat perinatal mood disorders (PMDs).  I know this from the stories that come across my feed on Facebook.  I know this from talking to others whose job is to care for mothers who struggle with PMDs.  The general population doesn’t know the difference between postpartum blues and PPD because all too many doctors don’t even know the difference.  Karen Kleiman would not have needed to create the above image if she didn’t see the problem still existing with doctors misinforming PPD moms.

The care model for OB/GYNs should be mandated to include:

  1. adequate training in medical schools/residency programs to ensure doctors know how to recognize symptoms of and treat perinatal mood disorders and know the difference between the baby blues versus PPD
  2.  a 15-minute time slot in every hospital baby care/childbirth training session to go over the basics of perinatal mood disorders (PPD, postpartum anxiety, postpartum OCD, and postpartum psychosis), difference between the postpartum blues and PPD, breastfeeding realities, risk factors, importance of lining up practical/social support before baby’s arrival, insomnia as a common first symptom, etc.)
  3. being prepared to offer referrals to organizations like PSI (which has coordinators in every state that can try to help the mother find local help), maternal mental health facilities and mother/baby units (which are starting to pop up more & more around the country), PPD support groups, therapists/social workers who specialize in helping PPD moms, and even websites / blogs / Facebook groups that can provide online support
  4. screening patients for risk of perinatal mood disorders
    • prior to pregnancy – to establish a baseline of hormone levels before pregnancy and determine if the woman has a history of PMDD  or other risk factors for PPD
    • during pregnancy – consultation comprised of questions to try to detect pre-natal depression and review of a standard small booklet with images and bullet points covering the basics of perinatal mood disorders (PPD, postpartum anxiety, postpartum OCD, and postpartum psychosis), difference between the postpartum blues and PPD, breastfeeding realities, risk factors, importance of lining up practical/social support before baby’s arrival, insomnia as a common first symptom, etc.)
    • during 6-week postpartum visit – including blood work to detect iron/thyroid deficiencies and measure hormone/neurotransmitter levels, thyroid panel, Adrenal Stress Index

Click here to see my Onboarding Questionnaire, Pregnancy Questionnaire, and Postpartum Questionnaire.

As you can see, I am continuing to use my PPD experience to come up with ideas to effect change in the reproductive health care arena.  I will continue to find ways to contribute toward public awareness campaigns, as well as resource development and distribution.

New mothers with babies in the NICU are at increased risk of PPD – Part 2

Continuing on the topic I started on January 13th titled “New mothers with babies in the NICU are at increased risk of PPD,” I wanted to add a few points I missed earlier, inspired by a post that came across my feed recently from the Emerald Doulas website titled Preemies Parents and PMADs.  The post was authored by Carrie Banks, an Emerald Doula and one of the North Carolina state coordinators for Postpartum Support International.

Finally home from the NICU with the baby, it is natural for parents to feel anxious, now that they are responsible for their baby’s care and there are no nurses, doctors and machines tending to their baby’s care any longer.  The feeling of being fully responsible and the fear that something may go wrong can cause the parents to feel overwhelmed, especially if there are still medications, feeding and weight gain challenges, as well as physical (e.g., vision, hearing, motor skills) and cognitive development concerns.

I can recall feeling overwhelmed with having to deal with colic, cradle cap and eczema all at once.  My baby was not even a preemie, and my postpartum depression (PPD) starting once the one-week colic period ended.  So, yes, factors that cause stress during the first postpartum weeks while a new mom is still healing from childbirth can indeed lead to PPD.

The Emerald Doulas article contains great tips on addressing:

  • impaired/delayed bonding due to inability to hold the baby/feelings of fear/awkwardness of holding the baby in the NICU
  • transitioning to life at home after the NICU
  • feelings of isolation, guilt and shame
  • why getting help is important

Parents of preemies may also feel ungrateful or even guilty for seeking help for themselves, since everyone’s focus has been on the preemie baby for days, weeks or even months.  While these parents may feel like the only thing that matters is their baby to be okay, they need to remember that they need to stay strong and healthy, both mentally and physically, in order to be there for their baby!  Weeks if not months of having to stay strong for their NICU baby and for other children they may have can chip away until suddenly they find themselves unable to keep it together any longer.  Being anxious and sleep-deprived over an extended period can lead to a postpartum mood and anxiety disorder (PMAD) to set in.

Another contributing factor to the development of a PMAD is the feeling of isolation that occurs from staying home with the baby and keeping visitors away to protect the baby against germs, especially during the winter when colds and the flu abound.  The disappointment that comes from not having friends and family around like they would’ve wanted to have can also contribute toward the development of a PMAD.  Finding a community and support in the form of a NICU support group in-person and/or online can be invaluable, as it can help them feel less alone and more hopeful knowing they are not along in their experience both inside and outside of the NICU having to deal with physical/cognitive development concerns/challenges in addition to the seemingly endless visits with doctors, speech therapists, occupational therapists and/or physical therapists.

There should be no doubt as to whether seeking help is an option.  If you need help, do not hesitate to get it.  Reach out to friends and relatives.  See if you can get a friend and/or relative to help coordinate the search for specific kinds of help.  I’ve seen many situations where a friend sets up a Meal Train account and shares it on social media or email to get friends/relatives/neighbors/colleagues to pitch in money or orders from local restaurants/delis to be sent directly to the family.  If you need help with overnight care and you can afford to hire a postpartum doula, then see if you can locate one through referral from a friend/relative or by searching for one on the Doulas of North America (DONA) website.

You, my dear mother (and father), need to remember self care!

New mothers with babies in the NICU are at increased risk of PPD

The motivation for this blog post is a Huffpost article that popped up in my Facebook feed yesterday titled “NICU Moms Are Struggling With Mental Health Problems–And They Aren’t Getting Help” by Catherine Pearson.  It happens to be from 4/13/2018, but I’m only seeing it now for the first time.

I have blogged about the many risk factors for PPD before.  One of the risk factors happens to be premature births.  Last time I blogged about premature births being one of the risk factors for PPD was 9 years ago.  So, I’m way overdue blogging about this topic again!

A new mother who was pregnant one minute–and expecting several more weeks of pregnancy–and suddenly giving birth and seeing your baby hooked up to machines is an overwhelmingly anxiety-provoking experience.  All new mothers are not only hormonal, exhausted and trying to recover from childbirth, but NICU mothers are also anxious about their babies, unwilling to leave their babies’ sides, and find it hard to eat, sleep or even talk to friends and family members who don’t fully understand what it’s like to have a baby in the NICU. Unable to touch, hold and feed her baby and instead seeing her tiny, precious baby hooked up to so many wires, it is natural for a NICU mother to be consumed with feelings of helplessness, distress and fear.  Each day, the NICU mother spends many hours each day at their baby’s side, pumping every few hours, and on high alert with respect to her baby’s breathing and the noises of the machines keeping her baby alive.

In the daily hustle and bustle of the nurses and doctors in the NICU, having them stop and ask the mother (and/or father) how they are holding up and making sure they are taking care of themselves and getting enough rest are not going to be at the forefront of their priorities, though you’d think it should be second nature for them to do so.  In fact, they are seldom trained to know what to ask.  Even if they did ask, there is an inadequate referral system in place to get help for a mother with a postpartum mood disorder.

“…[Studies have suggested that up to 70 percent of women whose babies spend time in the NICU experience some degree of postpartum depression, while up to one-quarter may experience symptoms of post-traumatic stress disorder.”  Simply put, a new mother’s risk of experiencing a postpartum mood disorder is very high.  And that is not surprising in the least.”

What should the screening entail?

I’ve previously blogged about and will repeat here that mothers should be assessed for postpartum depression (PPD) between 4-12 weeks postpartum.   She should be encouraged to have her six-week follow-up visit with her OB/GYN, provided she doesn’t complain about symptoms up to that point.  If she is symptomatic before the six-week visit, she should be screened right then.  If the 6-week screen doesn’t indicate PPD, she should be assessed once more at the 12-week point and also when she weans and when her period returns, since these events can trigger PPD in some women.

The following—in addition to screening tools like the Edinburgh Postnatal Depression Scale or Cheryl Beck’s Postpartum Depression Screening Scale—should be asked at the six-week follow-up visit with the OB/GYN, which can help diagnose PPD:

1. Have you been feeling any of the following for the past 2 weeks:

  • Persistent and mostly inexplicable sadness/tearfulness and feeling empty inside
  • Loss of interest/pleasure in hobbies/activities you once enjoyed; inability to laugh
  • Overall impaired functioning
  • Sleep difficulties (either insomnia or sleeping too much)
  • Weight loss (usually fairly quick) associated with a decrease in appetite
  • Weight gain associated with an increase in appetite
  • Excessive worrying/anxiety/concern about the baby
  • Restlessness/irritability
  • Difficulty thinking, concentrating or making decisions
  • Onset of panic attacks
  • Sense of despair and/or hopelessness leading to thoughts of death/suicide

2. How have you been feeling physically and emotionally?

3.  How is your appetite?

4.  How are you sleeping?  Have you been able to get at least 4, if not 5, hours of sleep a night?

5.  Have you had any recurring thoughts/images that are disturbing?

 

If local resources for PPD are not readily available (though all hospitals around the country should have a list of local psychologists, psychiatrists, social workers, registered nurses, PPD support groups on hand), the least they can do is provide a pamphlet for Postpartum Support International. Its website lists resources in every state.  And many states have already formed, or are in the process of forming, chapters to focus on state-specific efforts at advocacy, training, and other improvements.

If you are a new mom with a baby in the NICU, please, please, please remember that, though your attention is preoccupied with your baby, if you let your own strength and health go by the wayside, it is possible to succumb to a postpartum mood disorder.  Not everyone will succumb, but just remember the increased risk and higher occurrence among NICU moms.  Don’t forget to take care of yourself.  When your baby comes out of the NICU, you need to be strong and healthy to care for your baby.

 

 

Be the One Person Who Makes a Difference for Someone Else

My first blog post in over 4 months was only 2 days ago.  As you can see, I meant it when I said I would focus more on blogging!

Today’s post is inspired by a Scary Mommy article that appeared in my feed yesterday. The title of the article is “Am I Invisible? One Mom’s Pain-Relieving Response to Being Excluded” by Rachel Macy Stafford.  The title itself triggered my mind to flash back to many experiences of trying to befriend other mothers, only to have my attempts stopped dead in their tracks with the same kind of cold reaction mentioned in the first few paragraphs of this article.   I’ve hated–no, DESPISED– the feeling of being excluded since I was repeatedly excluded as a teen by these 3 C’s:  cliques, classmates and even fellow churchgoers.  Exclusions by teens is one thing.  But exclusions by adults?  Totally unacceptable, unnecessary, immature, inexcusable …..and quite simply, crappy.

As an adult, I have never had any problems striking up conversations with strangers I’ve never met before.  I have done that fairly often during the past 29 years of commuting into the city.  Usually, we are able to have these conversations due to our shared commuting woes.  That is our common bond.

In 2018, I made more new friends in my area in the one year than I have in the past 17 years combined.  As I’ve said in prior posts, I’ve found it challenging making friends in my area.  The friends I made last year arose from shared objectives of ensuring a #BlueWave this past November.  That was our common bond.

In 2016, I made more friends with classmates at my college reunion than when I was in college!  Being alums (without the stress of getting passing grades) was our common bond.

In 2006, I became a member of Postpartum Support International (PSI).  I blogged about our common bond previously in this blog post.

These are just some examples of how a common bond encourages friendships to form and conversations to be had even between strangers.  But that leads me to ask why a common bond of motherhood does not encourage friendships to form and conversations to be had even between strangers?  Why did the author of the Scary Mommy article experience the cold and mean exclusion that she experienced?  Why did I experience numerous cold and mean exclusions of countless mothers, even ADULT mothers of newborns, when we share a common bond of wading through unfamiliar territory together?

Doesn’t matter what the reason is, now does it?  Regardless of the reason–whether it be insecurity, pride or just plain nastiness–I would never do this to someone else.  It’s taken me a long time to piece it all together….the realization that such nasty behavior was actually a favor, as it instantly warned me not to waste any time.  In keeping with my philosophy “Life is too short for BS,” when I see people who–whether they know me or don’t know me yet–behave in a manner that is suggesting exclusion, I won’t waste my valuable time or energy on them.

In keeping with my philosophy of “Love, laugh and live a life with no regrets” I will take my experiences of people turning their backs on me and make sure I DO NOT treat others the way I DO NOT want to be treated myself.   I would NOT turn my back on someone who needed help, a listening ear and/or support.  I am not in the business of being on this earth to earn negative points in the karma area, TYVM.

I would:

  1. Help others who need help because, if the situation were reversed, I would want someone to offer me help
  2. Listen and provide comfort to others who need comforting because, if the situation were reversed, I would want someone to comfort me
  3. Support others who need support because, if the situation were reversed, I would want someone to support me

You know what they say about motherhood?  IT TAKES A VILLAGE.  Do what the Scary Mommy article suggests, which is to be the one person that makes a difference for someone else.  Imagine if everyone did that?  We would truly have a village!

The article urges us to each be the one that makes a difference for another, because all it takes is one person to help, listen/provide comfort to, and support someone else and help them realize they aren’t totally alone in this very-populated-and-yet-quite-lonely-at-times world.  How do we know the other person who’s coming to you for help, comfort or support isn’t in a dire situation?  How would you feel if you found out you could have made a difference by helping them, but was cold to them and there was a tragic outcome?

New mothers who are experiencing, or have experienced, a postpartum mood disorder share a common bond of loneliness, of feeling alone in our experience.  All it takes is one person to help another to not feel alone.  This is why so many new mothers have dedicated their lives to providing help/listening to/providing comfort to/supporting mothers suffering from postpartum mood disorders.  They want to give to someone what they did not receive while they were sick themselves.  Many, like me, did not get help, comfort or support.  Too many new mothers feel alone and for no reason at all.  There is no reason for a new mother to feel alone and at the end of their rope.

I will end with this beautifully-written poem in the Scary Mommy article:

With one invitation, we can take someone
From outsider to insider
From outcast to beloved member
From unknown neighbor to coffee companion
From wallflower to life-of-the-party
From shortened life expectancy to 80 years of joy.

I DO NOT want to have any regrets for not doing something when I had the opportunity.  Do you?

Why Screening of Postpartum Moms is Important and Who Can and Should Do the Screening

Today’s post was inspired by a March 19, 2018 NPR article by April Dembosky titled “Lawmakers Weigh Pros and Cons of Mandatory Screening for Postpartum Depression,” as well as a June 2018 Romper article by Karen Fratti titled “Moms Should be Screened for Postpartum Depression in the ER, New Study Suggests, & It Makes Perfect Sense,” a June 30, 2018 News Medical article titled “Screening mothers for PPD in emergency setting,” and a June 29, 2018 Austin360 article by Nicole Villalpando titled “Who should be screening moms for postpartum depression? More doctors now can.

Screening moms for postpartum depression (PPD) serves multiple purposes.  Screening will help ensure moms get the help they need and avoid suffering unnecessarily.  In case you weren’t aware, screening educates women on what PPD is, why it happens and just how common it is (1 in 7 new moms experience it), and helps them avoid what I and so many other mothers have gone through (PPD makes you feel alone, like you’re losing your mind and will never return to your previous self).  It will ensure fewer moms will ultimately fall through the cracks.  It will ensure fewer tragedies involving mothers and their babies.  And I’ve said this many times before, but a mother who is not well cannot care for her baby the way a healthy mother can.  This is pure logic.  Unfortunately, logic takes a back seat because our capitalist society places more priority on what benefits the pocket over what benefits the people’s well-being.

So…..question is WHO should screen new moms for PPD?

Her OB/GYN?  This should be a given, period, hands down, no questions asked!  In May 2018 the American College of Obstetricians and Gynecologists recommended that, in addition to the standard 6-week postpartum visit, OB/GYNs perform a follow-up visit within the first three weeks postpartum.  This new recommendation is due to the fact that symptoms of PPD often begin before the 6-week appointment.   See second half of my blog post on the issues many OB/GYNs are faced with in terms of screening.

Her baby’s pediatrician (but here the patient is the baby, not the mother)?  The American Academy of Pediatrics (click here and here) recommends doctors screen mothers for PPD when they bring their newborns in for wellness visits, since they occur numerous times in the baby’s first year; whereas, the mother only gets the one wellness check at postpartum week six.  Pediatricians who realize that the baby’s development can be negatively impacted when the mother is ill with PPD will try to screen the mom for PPD.  Problem is, most pediatricians as far as I’m aware are not prepared to screen and refer mothers since the mother is not a patient.

An ER physician?  While you will no doubt raise your eyebrows, doctors like Dr. Lenore Jarvis, an emergency medicine specialist with the Children’s National Emergency Department at United Medical Center in Washington, DC, have been seeing moms bring their babies to the ER, and it turns out the baby is fine but it’s the mother who is highly anxious and feeling overwhelmed.  In these cases, it’s logical to try to determine if it’s the mother who needs help.  In fact, Dr. Jarvis and several colleagues conducted a research study with several colleagues on screening moms for PPD in an ER setting.  A Eureka Alert release dated June 29, 2018 explains the results of the research study. Moms who participated were screened using the Edinburgh Postnatal Depression Scale supplemented by other questions.  The great thing about the research study is that, when moms scored positive for PPD, they received information about PPD and were offered–or if they had a strong positive score from screening, they were required to have–a consultation with a social worker.  Additionally, the researchers followed up with mothers who screened positive one month later to see how they were doing.  This is akin to case management programs we have in place when patients check out of hospitals (I explain all this in my post below). Now THIS is the way it SHOULD be!

Dr. Jarvis refers to the ER as a “safety net  for people who are not routinely accessing regular checkups for themselves and their children. If a mother is having an acute crisis in the middle of the night and feeling anxious and depressed, they often come to the emergency department for help.”  Because American policymakers have been so resistant to instituting policies that would require insurance companies to work with doctors to ensure PPD is caught early through screening and subsequent referrals–researchers/subject matter experts on PPD are left to make recommendations for what Dr. Jarvis referred to as a “safety net” approach of having emergency rooms screen for PPD when moms come in either for their babies (for colic, fevers, etc.) or even for themselves (symptoms of a postpartum mood disorder).

While I agree we need to cover all bases and try to screen a new mother wherever and whenever possible, why do we even need to resort to waiting until a mom comes into the ER to screen them?  Why do we have to have such a safety-net, fall-back, beats-nothing-at-all, better-late-than-never approach in the first place?  Answer:  our society continues to place too much priority on conception and childbirth but once the baby is born, everyone forgets the mother.  Once the baby is born, the mother’s health falls by the wayside.  I’ve blogged about this before, but the attention from that point on will be on the baby from visitors who coo at the baby and treat the mother as invisible.  Same thing with doctor visits; the mother only gets one postpartum wellness check at 6 weeks.  That’s it.  It’s like the mother ceases to exist.  Whereas, other cultures have customs to honor and mother the mother (click here and here for past posts).  The birth of the baby is synonymous in these cultures with the birth of the new mother and they are honored for bringing new life into the world.  This, my friends, is why maternal mental health advocacy is so important.  Until American policymakers institute policies to demonstrate the importance of mothers and their health, we advocates must continue to act as “squeaky wheels to get the grease.”

The following section is an excerpt from my book.

New mothers, especially the ones at high risk for PPD, should be screened during their six-week postpartum visit, provided she doesn’t complain about symptoms up to that point. If she is symptomatic before the six-week visit, she should be screened right then. If the six-week screen doesn’t indicate PPD, she should be assessed once more at the twelve-week point—or when she weans or when her period returns, whichever comes first, since these events can trigger PPD in some women.

The following—in addition to screening tools like the Edinburgh Postnatal Depression Scale or Cheryl Beck’s Postpartum Depression Screening Scale—should be asked at the six-week follow-up visit with the OB/GYN, which can help diagnose PPD:

  1. Have you been feeling any of the following for the past two weeks?
  • Persistent and mostly inexplicable sadness/tearfulness and feeling empty inside
  • Loss of interest/pleasure in hobbies/activities you once enjoyed; inability to laugh
  • Overall impaired functioning
  • Sleep difficulties (either insomnia or sleeping too much)
  • Weight loss (usually fairly quick) associated with a decrease in appetite
  • Weight gain associated with an increase in appetite
  • Excessive anxiety about the baby
  • Restlessness/irritability
  • Detachment from and inability to bond with the baby
  • Difficulty thinking, concentrating or making decisions
  • Feelings of guilt, inadequacy, failure and/or worthlessness
  • Urge to run away
  • Onset of panic attacks
  • Sense of despair and/or hopelessness leading to thoughts of death/suicide
  1. How have you been feeling physically and emotionally?
  2. Are you feeling particularly stressed, and, if so, is it due to a major change you are experiencing, such as marital problems, death of a loved one, financial problems, a recent move, or a job change?
  3. How do you feel about the baby? Are your feelings in line with your expectations of how you’d feel about the baby?
  4. Do you feel you have adequate emotional and practical support from your partner? Do you have any relatives or any other help, like a doula, to help you with the baby during the day?
  5. Are you breast-feeding and, if so, how is it going?
  6. How do you feel the labor and delivery went? Do you feel you experienced any sort of trauma during the delivery?
  7. Do you feel your childbirth and motherhood experience are meeting your expectations?
  8. Do you feel particularly anxious about your baby’s health (colic, SIDS)?
  9. How is your appetite?
  10. How are you sleeping? Have you been able to get at least four, if not five, hours of sleep a night?
  11. Have you had any recurring thoughts/images that are disturbing?
  12. How have you been adapting to motherhood, in general?
  13. Have you returned, or will you return, to work?

I believe these types of questions should be incorporated by all OB/GYNs throughout the country. This all theoretically sounds good and fine, but in most cases, OB/GYNs are not prepared to implement. Why not? At the very least, it would require training on perinatal mood disorders (recognition of symptoms and treatment), as well as ability to provide the right referrals as needed.

This last paragraph from my book excerpt remains true to this day.  Sad because I published my book in 2011.  Seven years later, things have not really changed.

California’s screening bill, AB 2193, has yet to pass the Senate and get signed into law.  Once passed, it would be an exciting development for mothers, as it doesn’t just require screening for PPD.  It requires health insurance companies to set up case management programs (same way my mother was assigned a case manager each time she had to stay overnight at a hospital to ensure she had a plan in place to address the issues that landed her in the hospital–i.e., physical therapy in a rehab center, visiting nurse to change her bandaging, etc.) to help connect moms who screen positive for PPD with a mental health practitioner.

Case management is set up to ensure there is a treatment/referral plan in place.  I sincerely hope that this means health insurance companies are prepared and able to carry out the new requirements.   And I sincerely hope that California will lead the way for other states to follow suit in setting up similar screening bills that will actually require health insurance companies to set up case management programs.

It goes without saying that screening moms for PPD serves no purpose if you can’t help those who test positive for PPD.  So far, as the first state that put mandatory screening in place, New Jersey has not had any reason to be excited ever since its initial groundbreaking “first-state-to-mandate-screening” announcement.  New Jersey, as well as 3 other states— Illinois, Massachusetts, and West Virginia — have tried mandated screening, and it did not result in more women getting treatment, according to a study published in Psychiatric Services in 2015.

A whopping 78% of those who screen positive don’t end up getting mental health treatment per a 2015 research review published in the journal Obstetrics & Gynecology.  Why have women in these states with mandatory screening not been getting treatment?  Well, for starters:

  1. Some obstetricians and pediatricians are afraid to screen for PPD because they are not equipped to refer.  But why is that?   Why is it hard for them to all rely on the resources available via Postpartum Support International?  Its website lists resources in every state.  And many states have already formed, or are in the process of forming, chapters to focus on state-specific efforts at advocacy, training, and other improvements.
  2. The resources to whom doctors (obstetricians, pediatricians, general practitioners, etc.) can refer mothers are limited, especially in more rural areas.  And in more rural areas, it’s harder to find mental health practitioners trained in prescribing meds to pregnant/breastfeeding women, let alone trained in treating moms with PPD.
  3. All too many mental health practitioners don’t take the woman’s insurance or there are significant limitations from an insurance coverage perspective.
  4. There’s a very long wait (several months) to see most mental health practitioners, especially for the first time….a woman in the throes of PPD can’t afford to–both literally (from a cost perspective) and figuratively (from a life & death perspective).
  5. There’s little incentive financially, thanks to insurance companies’ lack of adequate coverage for doctors who do such screening…..in my opinion, screening should be done at the standard 6-week postpartum checkup and therefore covered as part of that checkup.

Attention, American policymakers….our mothers are worth it.  I mean, we make such a big stink about fetuses and unborn babies in this country, let’s start thinking bigger picture, shall we?  Without mothers, there would be no babies to conceive and bring into this world.  Let’s start treating mothers less like second-class citizens and more like human beings who deserve to be able to give birth to and care for their babies without getting sick with PPD and possibly dying in the process!

 

Please Throw Me a Postpartum Party Instead of a Baby Shower, Thanks

and

A truly useful baby shower gift after the baby’s arrival is having relatives, friends, neighbors, etc. chip in funds for hired help [like a postpartum doula] for the first one to two months.

Additionally, as this article suggests, the shower that is thrown should entail a list of family/friends who will help (with watching the baby so the new mom can get some much-needed alone time/rest/shower, picking up groceries, cooking, dishes, laundry, cleaning, etc.) during the first 6 weeks postpartum.  This could include a meal plan via http://www.mealtrain.com deliveries or doing take-out and dropping the food off.

Perhaps if we focused more on ensuring new mothers have the support they need after the new baby arrives, there would be fewer instances of postpartum mood disorders!

 

Join Elly Taylor of Becoming Us on her U.S. tour of training sessions for parents and professionals!

My friend, Elly Taylor, is an Australian relationship counselor, author of the book Becoming Us, and founder of an organization of the same name, which she created to teach professionals and support mothers and their partners.  Both the book and organization’s mission is to help the mother and partner navigate the peaks and valleys of the parenting journey via 8 essential steps that Becoming Us as “map, compass and travel guide all in one.”

Elly is here in the states for her “Seed Planting” workshop tour in Chicago, Beverly (MA), Providence (RI), New York City, Houston and Los Angeles.  For the complete schedule and how to register, click here.

At Darling Harbour, Sydney (2014)

Elly and I have a bunch of things in common.  We are both postpartum depression (PPD) survivors and book authors (though hers is award winning).  We were both blindsided by PPD and the challenges of parenting.  We are both members of Postpartum Support International.  Elly loves NYC (where I’ve spent the last 29 years working) as much as if not more than I love Sydney (where she lives).  She is fortunate enough to be out here in NYC each year for the past 3 years on Becoming Us-related reasons; whereas, I’ve been back to Sydney 3x in the past 21 years (I so wish I could return more often!).  I look forward to seeing Elly during her stay in NYC!

Professionals:

Sign up for Elly’s 2-hour interactive workshop that will teach you key tools to prepare/support expectant/new parent couples to anticipate/cope with the changes–and stay connected through the challenges that come with–early parenthood. You’ll come away with ways for parents to nurture themselves and their partners so the whole family can thrive.  This workshop is designed for couple and family therapists, birth professionals, infant or child mental health professionals, and any others who work with expecting, new or not so new parents.

The transition to parenthood is a major one that consists of numerous transitions.  The training will teach you what the transitions are and how they can negatively impact mothers and their families. You’ll learn how to plant Becoming Us “seeds” that reduce risk for the most common parenthood problems including perinatal mental health issues and relationship distress. Finally, you’ll discover the groundbreaking Becoming Us approach to parenthood and how you can apply the model to your work with parents at any stage of their family life cycle.

Parents:

Sign up for Elly’s 1-hour interactive workshop that will teach you about the transitions that parents normally go through in their first years of family, the steps to navigate each of these transitions and staying connected through the challenges that come with early parenthood. You’ll come away knowing how to nurture yourselves while growing a family that thrives.

 

 

The Robin Study is Looking for New Mothers to Participate in a Research Study

The Robin Study is a research study evaluating an investigational oral medication in women with postpartum depression (PPD).  An investigational medication is a study drug that will be tested during a study to see if it is safe and effective for a specific condition and/or group of people.

To be eligible for the study, you must:
  • Be 18 to 45 years of age
  • Have given birth within the last 6 months
  • Feel any of these symptoms associated with PPD for 2 weeks or longer:  insomnia, crying/sadness, lack of appetite, sudden weight loss, hopelessness, lack of interest in baby, loss of interest in things you used to enjoy, intrusive/disturbing thoughts
  • Have symptoms that began no earlier than the third trimester and no later than the first four weeks following delivery (I know that many mothers don’t develop PPD until 6 weeks or later, but this is a specific requirement for this particular research study)

If you qualify and decide to participate:

  • Your PPD symptoms will be continually monitored by qualified study staff (nurses and clinicians), under the guidance of the study doctor.
  • You will receive study-related medical care and the assigned study drug at no cost.
  • You will be required to take the assigned study drug at home every night for 14 days. You’ll have nightly phone calls with the study coordinator and will come into the study site three times while on the medication and two times as follow-up. Your total participation will last about 76 days.
  • Transportation may be provided for those who require assistance.

To learn more about the study, review frequently asked questions, and see if/how you may qualify, please visit www.TheRobinStudy.com, call (844) 901-0101 to speak with a study representative, or fill out the contact form and a study representative will follow up with you.

Recent PPD Successes and Failures in the Media

I went from blogging once in two months to 8 times so far this month!  With Maternal Mental Health Month a little less than a week away, a lot of fundraising, training and public awareness events are being prepped to happen throughout May.  Another reason to love this time of year….hello spring!

Okay, so the title of my post is “Recent PPD Successes and Failures in the Media.”  There were 2 things in the media that caught my attention on my Facebook feed today that motivated me to blog once again. One is a success and one is a failure.  If you’ve been following my blog for some time, you would know that one of my favorite things to blog about are successful and failed attempts at depicting new mothers suffering from a mood disorder in the media, like my recent post about “Black-ish.”

Let’s start with the SUCCESS……
On this morning’s Megyn Kelly TODAY a postpartum mood and anxiety disorder (PMAD) survivor, Ashley Abeles, shared her experience.  The segment also included brief appearances by Dr. Catherine Birndorf and Paige Bellembaum who are the Medical Director and Program Director, respectively, of The Motherhood Center of New York. The Motherhood Center provides support services for new/expectant moms and treatment for PMADs. I met these ladies from the Motherhood Center at previous Postpartum Support International conferences.  If you missed the show, you can watch it here.  We need more moms sharing their PMAD experiences on shows like this!  Experiences kind of like my own that, as her husband explains, isn’t “headline-grabbing” material involving the tragic death of the mother and/or baby.  Because guess what, the vast majority of PMADs experienced by new mothers are NOT headline-grabbing material.  They’re mothers suffering from anxiety, panic attacks, insomnia, weight loss and/or intrusive/obsessive thoughts who need medication and/or therapy to recover.  Yes, severe postpartum depression (PPD) can cause a mother to feel so depressed that she just wants to disappear or her baby would be better off without her since she can’t feel joyous like a new mother should, but postpartum psychosis is too-often confused with and lumped under PPD (as a catch-all term) by both the general public and doctors alike.  Yes, doctors!  Also, PPD is not the same as the baby blues and even today, doctors still mix up the two!  We’ve come a long way since I had PPD when it comes to information in the news, in publications, on the Internet and in social media.  But we still have a LONG way to go.

And here’s the FAILURE……
The movie “Tully” starring Charlize Theron.  A Motherly post by Diana Spalding titled “We’ve seen Tully– and we’ve got some real concerns” it seems yet another movie director/producer has failed to do their homework about PPD before coming up with the screenplay and releasing it.  What every movie director/producer or TV show director/producer needs to do before even contemplating a movie or TV show about PPD is consult with Postpartum Support International.  This organization is the leading authority on maternal mental health matters and should ALWAYS be consulted to ensure the right information is incorporated into the movie/show plot.  “Tully” attributes the bizarre experiences of Tully (i.e., hallucinations she has of Marlo, frantic baking and cleaning late into the night, impulsive behavior that leads to her car crash, suicidal ideation) to PPD.  However, her behavior is actually attributable to postpartum psychosis, hence this movie spreads misinformation about what PPD really is.  Her talk of suicide is brushed off by her husband, which I can see happening in the real world when loved ones fail to “get it” and ignore the mother’s serious need for help.  While this is a movie and movies don’t necessarily have to educate–after all, this is not a documentary–it should at least get terms right (postpartum psychosis, NOT PPD!)  and it should try to mention at some point that yes, the new mother who’s obviously not well and diagnosed, albeit incorrectly, with PPD needs help!  Maybe put some kind of disclaimer at the beginning or end of the movie like you sometimes see at the beginning or end of a TV show.  Something along the lines of:

“Approximately one out of seven new mothers suffers from a postpartum mood disorder.  If you are a new mother that is experiencing any of the following symptoms: insomnia, crying/sadness for more than 2 weeks, lack of appetite, sudden weight loss, rage, hopelessness, lack of interest in the baby, loss of interest in things you used to enjoy, thoughts of harming the baby or yourself, please know that you are not alone, what you are experiencing is not your fault, and you will recover if you get the right treatment.  Contact Postpartum Support International at 800-944-4773 or visit http://www.postpartum.net

“Mother May I?” – An Important Documentary About Childbirth Trauma

A couple of days ago, a link to the Kickstarter project for the documentary “Mother May I” popped up on my Facebook feed, and it instantly caught my eye (and yes, I am one of the many backers and sincerely hope they meet their financial goal in 30 days, so please consider backing too….even $10 would help!).  Why did it catch my eye?  Because I had a traumatic childbirth experience that was the beginning of an agonizing postpartum depression (PPD) journey.  I didn’t have the awareness needed for me to advocate for myself.  There were no patient advocates anywhere along my PPD journey.  I didn’t have anyone to talk to about my experience.  I didn’t have a means of validating what I experienced.  I was in the dark.  I had to learn the hard way.  This is why I blog, why I wrote my book, and why I look for ways to help others and to try to get the word out and raise awareness so fewer mothers will be blindsided the way I was.

About one-third of new mothers describe their childbirth experiences as traumatic, but you hardly ever hear about negative experiences because everyone wants to be like “everyone else” and happily announce that “mother and baby are doing well.”  No one wants to admit to having a negative childbirth experience, just like no one wants to hear about a negative childbirth experience.  And that is why everyone thinks childbirth experiences aren’t that big a deal.

I had previously blogged about negative childbirth experiences via my blog post titled “Forget the Myths, Here are the Realities of Pregnancy, Childbirth and Postpartum Experiences.” It was one of my first blog posts.   The difference between my traumatic childbirth experience and the ones that are the focus of this film is that the ones in the film, like the one experienced by Caroline Malatesta, involve obstetric assault that resulted in both physical and emotional harm to the mother.  That is much, much worse than what I experienced.

What has been completed thus far is 20 hours of footage of interviews of more than 15 experts (including a birth doula, a labor & delivery nurse and psychologist who specializes in posttraumatic stress disorder (PTSD) and survivors of birth trauma.  My plan is to reach out to the Birth Monopoly Foundation folks behind this documentary–including Caroline Malatesta, President, whose own birth trauma story is the impetus behind and featured in this film–and make sure they include the connection between negative childbirth experiences and maternal mental health disorders like PPD.

If you’ve been following my blog for some time, you know that passion for public awareness is one of my focal points.  I am particularly excited to see that funds from the Kickstarter project will help fund online campaigns to provide free information about birth trauma, resources, and legal rights. It will also help fund college outreach initiatives to help get the film (plus guided discussion) into 1,000 college classrooms around the country.  I believe there is no better time to present such information to teens than in colleges.   Colleges are a great way to reach numerous young people at once.  Speaking of which, I had envisioned doing a book reading of my book at my alma mater when it first came out, but I didn’t get very far.  My school is an all-women’s school and what better place to reach so many women at once about PPD!  But my idea didn’t get much interest.  Perhaps I wasn’t reaching out to the right people.   Perhaps I will try again there….and in other colleges as well.

To follow Birth Monopoly on Facebook: http://www.facebook.com/birthmonopoly 

 

Journey of a PPD Survivor – Q/A Series – #2

Welcome to the second of my Journey of a PPD Survivor Series!

Laura Winters, LCSW, whom I’ve had the pleasure of knowing since we met at this year’s Postpartum Support International conference in Philadelphia, is a therapist specializing in infertility and prenatal/postpartum stress.  We are both members of the recently-established PSI-New Jersey chapter.  Laura is passionate about helping women on their journeys through motherhood, offering individual and group support.  Her practice, Postpartum Health & Harmony, is located in Chatham and Mountain Lakes, NJ.  For more information or to contact Laura, please visit www.postpartumhh.com.

Thank you, Laura, for taking the time to provide my blog readers some insight into your journey as a PPD survivor!

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Question 1:
Can you please describe your journey to becoming a Licensed Clinical Social Worker and what motivated your passion to help women with infertility issues (which I experienced) and mothers suffering from a perinatal mood disorder? How long have you been helping women experiencing infertility and perinatal mood disorder?

 When I was considering careers, I wasn’t totally sure what I wanted to do, but I knew that I wanted a career that would enable me to make a difference in people’s lives.   Social work was suggested to me and it was a perfect fit!  I started out my career working with children and teens and I really enjoyed helping them through various challenges.  In 2007, I started working in private practice, primarily focusing on families.  It wasn’t until about 2011 that I first started seeing some women who were struggling with perinatal mood disorders.  At that time, it wasn’t a specialty of mine, so I only saw a few new mothers.

In 2013, I became a mother and had an entirely new appreciation for parenthood.  It was incredibly difficult in ways I never imagined.  Breastfeeding was not going well, which caused me a lot of anxiety, sadness, and added to my exhaustion.  My husband and I both felt more like roommates and our relationship was strained.  This experience inspired me to make some career changes, most notably acquiring more advanced training in perinatal mood disorders and developing this specialty in my practice.

As I began to work with more pregnant and postpartum moms, I also started getting referrals for women experiencing infertility and postpartum moms who had gone through fertility treatments.  Once again, I felt a need to learn more and was interested in adding this focus to my practice.  I see these times in women’s lives, when you’re trying to conceive or newly postpartum, as being so precious and yet such a vulnerable period.  For the most part, everyone assumes that they will get pregnant easily and that motherhood will be challenging but amazing.  When things don’t go as planned, it can completely turn your world upside down and have you questioning everything about your life.  My personal experience definitely fueled my passion for supporting moms as well as couples trying to conceive.

 

Question 2:
In your practice, have you seen a correlation between infertility and a perinatal mood disorder? Do you treat mothers who you’d also seen while they were struggling with infertility issues and ended up suffering from a perinatal mood disorder?  Have you treated women suffering from infertility issues who ended up not suffering from a perinatal mood disorder?

 Infertility treatment is a risk factor for a perinatal mood disorder and I do see this correlation in my practice, though not across the board.  There are so many factors that influence whether a mother will develop a perinatal mood disorder.  I’ve seen women who have been through infertility treatment and did not end up experiencing any perinatal mood disorders.  Support and early intervention are very helpful in protecting a mom’s mental health.

  

Question 3:
Can you provide an overview of the services you provide? I see that you help patients in person, online, and even in a support group setting. Do you find one way of seeing your patients is more helpful? 

 I offer individual, couples, and group counseling.  I see almost all of my clients in person.  I offer online and phone sessions for times when clients may not be able to come to the office, such as not having child care available or in the first few weeks after childbirth.  Online and phone sessions are a great way of continuing sessions when life gets in the way.  The support group is open, meaning that you don’t have to register and can come as often as you need.  The moms that come to the group tend to be looking for different support than those who come for individual counseling.  The group moms are often looking to connect more with other moms going through similar experiences.

  

Question 4:
In your practice, what kinds of treatments for postpartum depression do you recommend?

In addition to therapy, I will recommend medication for those that are open to it or who have tried other things and are still struggling.  I also encourage my clients to try to incorporate exercise and a healthy diet into their routine.  For clients that are interested, I may recommend meditation or teach them an acupressure technique called Emotional Freedom Technique (EFT).

 

Question 5:
Have any medical healthcare practitioners–like IVF doctors, general practitioners, OB/GYNs or pediatricians–ever refer their patients to you?

 Yes, medical healthcare practitioners are great referral sources.  I definitely get more referrals from those healthcare professionals who take the time to talk to their patients about mental health.

 

Question 6:
What do you think medical health practitioners who come in contact with new mothers, like OB/GYNs, GPs and pediatricians, can do to help prevent, detect and treat perinatal mood disorders?

I would encourage medical health practitioners to take time to talk to moms about mental health.  Ask them about their mood and stress level.  Look their patients in the eyes and ask them how they are really doing.  Normalize how challenging being a mother is.  Making comments such as “motherhood is tough” or “you have a lot on your plate now” can go a long way in helping a mother feel comfortable to open up to you.  And having referral sources on hand when their patients need more support is extremely important.  Don’t leave it up to a new mom to have to find help herself.

 

Question 7:
Is there one key piece of advice you would offer to an expecting or new mom?

For expecting moms, I would tell them to make a postpartum plan that outlines things such as who they can count on for specific types of support (baby/childcare, cooking, advice, etc), how they will protect their sleep, and where they can turn if they need support.  For new moms, I would advise them to take breaks, ask for and accept help, and know that challenges come in phases but do eventually end.

 

Question 8:
What would you want to say to women currently suffering with a postpartum mood disorder?

This is the most common complication of childbirth and not an indication of who you are as a mother.  There is a lot of support available out there including counseling, support groups, and other moms who have been there and are happy to offer encouraging words.  You will feel better once you get the support that’s right for you.  Other moms have recovered and you will too.

 

Question 9:
What advice would you offer to friends/family members of a woman who is currently suffering with a postpartum mood disorder?

Reach out to her often – call, text, stop over.  Be there for her when she’s ready to talk.  Try to listen and validate her feelings.  Consider what support you can offer her—including cooked meals, childcare, cleaning, keeping her company—and rather than asking if she wants that help, tell her that this is how you’d like to help.  Tell her when you’re available to provide that support and then let her decide when you can come over.  Most moms will turn down help initially, but when you are very specific with what you can do and when you can do it, it’s harder to turn that down.  Also, it may help you better understand what she’s going through by researching information on perinatal mood and anxiety disorders.

 

Question 10:
What do you see as the biggest challenge in helping a mother recover from a postpartum mood disorder?

Lack of support and lack of insurance coverage are big obstacles.  It’s hard enough finding a therapist or psychiatrist, let alone when you have an infant and aren’t feeling like yourself.  Whether you have insurance coverage or not can help or hinder the process.   I find that the more support a mother has around her (people who can help with certain tasks and give her breaks), the easier recovery is.  It’s really challenging when you don’t have enough support at home and are expected to do a lot of the childcare and household tasks.  It doesn’t allow enough time for moms to tend to their needs.

Journey of a PPD Survivor – Q/A Series – #1

Welcome to the very first of my Journey of a PPD Survivor Series!

I know many, many survivors whose journeys led them to helping other mothers feel less alone and suffer less than they themselves did.  These women have gone on to become doulas, social workers, psychiatrists, psychologists, psychiatric nurse practitioners, peer support group leaders, founders of not-for-profit groups, bloggers (like myself), book authors (like myself), fundraisers, volunteers (like myself), etc.

Kathy Morelli, whom I’ve had the pleasure of knowing since we met in 2011 at the Postpartum Support International conference in Seattle, has the honor of being my very first interviewee for this series.  Back in 2012, she wrote the most amazing book review for my book.  She herself is a book author in addition to being a licensed professional counselor and licensed massage therapist for pregnant/postpartum women.

Thank you, Kathy, for taking the time to provide my blog readers some insight into your journey as a PPD survivor!

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Question 1:
Can you please describe your journey to becoming a Licensed Professional Counselor and Director of BirthTouch, LLC and what motivated your passion for maternal mental health matters
?

Ivy, lol, this could be a looooong answer! I’ll try to keep it reasonably brief!  I came of age in the 1970s when feminism was just starting to impact our society. I was raised to believe that I could go to college and get a good job, just like the boys. But I was also enculturated to stay home with my children. My mom didn’t work outside the home. There was no Title IX, equal funding of boys’ and girls’ sports, etc. when I was growing up. There was no family leave, no daycare centers included on corporate campuses. So, the tantalizing idea that a woman could work equally as a man was out there, but there were no plans for what to do about motherhood. What to do with a newborn during a career trajectory. These things were not in the public discourse at all. So, I never thought about how the integration of career and family is an enormous life challenge. How would I know?

I was the first-generation Italian American in my family to go to college.   I started my career in my 20s in data processing on Wall Street. I worked my way up to be an AVP at a major international bank. I managed the Database Department there. It was extremely stressful and not really emotionally fulfilling to me. But it was a good job that paid well. I was the only woman of 12 mid-level managers. It was challenging to be the only woman in this peer group. I never felt comfortable in that situation. They talked about things I wasn’t interested in. And sometimes they went to a strip club down the street for lunch. I certainly wasn’t going to do that.

The long commute led to my finding a job at another large data processing facility in New Jersey. My husband and I planned to start a family, and I didn’t want to commute on the subways while pregnant.  I had my son (now 22!) when I was 37 years old. I never changed a diaper or babysat very much at all, as my older sister did all that!  I also didn’t know much about the processes of pregnancy and birth, so it was all big mystery to me.

I actually had negative physical reactions to the idea of putting my son in daycare.  Daycare was a new concept 22 years ago. We made the decision for me to stay home with my son for a few years. I had postpartum depression (PPD) after I had my son. Looking back, it’s obvious that the life changes and the identity shifts were challenging for me. I had always been a high achiever, so shifting to taking care of a baby, which I had never done before, was not easy. I felt isolated. The feelings of depression were difficult to handle and caring for a baby on top of that was just so overwhelming.  In retrospect, I should’ve taken medication. But I wouldn’t, as I was nursing and I was concerned about the effect medication would have on my son.  Back then, there wasn’t the abundant research regarding the relationship of psychotropic medication to breastfeeding that there is now. If I had the information available now on such sites as Mother to Baby , I would’ve been able to make an informed choice with research data as input. I would’ve chosen the medication. Even with counseling, I was depressed for two years. It was a joyful yet painful time.

In short, my journey to becoming a therapist has been founded on my desire to have a career where I could make a difference in the world. From my experience, I also had insight into what it was like to become a mother and go through a lot of biological and psychological shifts all at once.

 

Question 2:
Can you provide an overview of what services you provide?

I’m a Licensed Professional Counselor (LPC) and Licensed Massage Therapist in the State of New Jersey. As an LPC, I work with a broad range of people experiencing everyday family and marriage issues, depression, and anxiety. I have an integrative approach and use both traditional verbal therapies and mind-body therapies.  For many years, I’ve had a special focus on perinatal mood disorders, the transition to parenthood, and birth trauma, but I see a broad range of people.

Currently, I am shifting my focus to using interventions such as eye movement desensitization and reprocessing (EMDR), Somatic Experiencing (SE) and cranial sacral body work to treat post-traumatic stress disorder (PTSD) for single incident and chronic trauma.  Single incident trauma can be birth trauma, trauma from even necessary medical interventions (such as for cancer), a car accident, a rape, etc. Chronic trauma includes childhood sexual, physical, and/or emotional abuse.

So many women talk to me about their pregnancy and birth experiences and how traumatic and medicalized childbirth is. Sometimes the medical trauma is something that is necessary such as when there are true complications and other times the medical trauma is from too many unnecessary, cascading interventions coupled with a general atmosphere that lacks compassion at an individual level.

So, I’m an advocate for woman and family-centered childbirth and have been for 22 years. I’m an advocate for social programs that promote a true family centered focus in our society.

 

Question 3:
You wrote three books, correct? Can you give an overview of what your books are about? 

Yes, I did!  They are all about self help and education for women and families in the childbearing year. They are all available on Amazon!

BirthTouch® Shiatsu and Acupressure for the Childbearing Year is all about education and self-help for the pregnant mom and her family.  There’s information about the difference between infant bonding and attachment, emotional management and safe touch to promote the relaxation response and family bonding during and after pregnancy.  There are numerous studies that conclude that safe massage promotes the relaxation response and family bonding. Safe touch promotes the release of relaxing endorphins and oxytocin and downregulates cortisol, the stress hormone. It’s all about self care in the family unit. Shiatsu is done fully clothed, and it’s a simple shiatsu routine, so even small children can participate, as well as an acupressure routine that is known to promote childbirth. As a massage therapist, I have certifications in shiatsu and acupressure, so the mind body connection is quite relevant to me and how I practice.

BirthTouch® Healing for Parents in the NICU  is a slim volume meant for parents who have a baby in the NICU. The focus in the NICU, is, of course, on the baby, but this slim volume is meant for the parents to help remind them to turn towards each other and support each other through this difficult time. It is a short-seated shiatsu routine that can be done in a waiting room.

BirthTouch® Guide to Perinatal Mood Disorders for Childbirth Educator is a slim volume meant for childbirth professionals, who are often the first line of support for the new mom. This slim volume fully delineates the different perinatal mood disorders and their differential diagnoses for the childbirth educator, so s/he can know what to look for.  It also explains why it’s not always easy to differentiate between the various perinatal mood disorders, because of the overlap and subtlety of symptoms.

 

Question 4:
Can you please explain how shiatsu and acupressure can help a pregnant/new mother? How did you learn these techniques and how did you discover that they can be effective in treating perinatal mood disorders?

I studied shiatsu and Jin Shin Do® Acupressure at the Meridian Shiatsu Institute in Pennsylvania from 1996 – 2000. I became certified in both modalities. The owner of the school retired over a decade ago and closed the school.  I started BirthTouch® around that time, which was a massage and bright hypnosis business for pregnant moms and their families. Women and midwives started to ask me what the acupoints were to begin birthing. I would write them out on a piece of scrap paper at first for my clients, and then eventually I developed a short workbook.  I began studying psychology. I found the intersection of my two fields, touch and psychology, in the seminal work of Dr. Tiffany Field at the Touch Institute in Miami.  Her studies were really the first research examining the effects of touch on mood in pregnant/postpartum women and in infants. Now, it’s a mainstream idea and you can see there are hundreds of studies that validate the use of touch to promote relaxation and mitigate the symptoms of depression and anxiety in pregnant/postpartum women.

After working with many women and families, I realized that people wanted to learn some safe, easy techniques for touch during pregnancy, birth, and postpartum. After teaching these techniques for many years and seeing the clinical benefits, I wrote my BirthTouch® book in 2012.  I hope to run a research project specifically around BirthTouch® techniques in 2019. I will keep you posted on this!

 

Question 5:
I can remember when I first met you at a Postpartum Support International conference a number of years back. How long have you been a member?  What prompted you to become a member?

I think I’ve been a member of Postpartum Support International since 2010.  I was a Warmline Volunteer for about a year on Wednesday evenings, but then it was too difficult to keep it up, as my practice was so busy and Wednesday evening is prime time! I now do some work for the New Jersey Chapter of Postpartum Support International. I wanted to become a member, as I wanted to complete their training and to attend the wonderful conferences and actually meet and be a part of the researchers and clinicians who work in women and family advocacy every day!

 

Question 6:
Is there one key piece of advice you would offer to an expecting or new mom?

Please plan for the Fourth Trimester!  Here’s a link to my website BirthTouch®, with an article about the Fourth Trimester.  Don’t try to do it all yourself or with your partner.  If you don’t have local friends or family who are free to physically help you, then hire some help. It is well worth it! Ask for help, don’t be afraid to tell your doctor how you feel and if you need help, don’t suffer alone. Planning for the Fourth Trimester is key! Have list of resources at ready, in case you need them….friends, family, community resources, food prep, sleep plan, therapist phone number, doctor phone numbers, etc.  Talking to a therapist and taking medication is not shameful!

 

Question 7:
What would you want to say to women currently suffering with a postpartum mood disorder?

Recognize that you have a treatable mood disorder and that taking care of your emotional health is as important as, if not more important than, taking care of your physical body.  Talk to your primary care physician, your obstetrician, a therapist, or a psychiatrist.  Perinatal mood disorders are treated by talking to a therapist and/or taking medication.

Taking care of a baby is hard work. Please get yourself help in many different ways: sleep, food prep, taking time off from baby care by asking family or hiring help, etc. This new dynamic of having an infant to care for sets off feelings where you wonder whether you need to attend to my baby’s needs or my needs? Of course, the baby’s needs must be fulfilled and you need to include your needs in there in some way as well. It’s a new way of being.

To find resources in your area, call Postpartum Support International’s Warmline where you will be connected to someone in your area who can refer you to perinatal mental health resources in your community.

Postpartum Support International Warmline: 1-800-944-4773

 

Question 8:
What advice would you offer to friends/family members of a woman who is currently suffering with a postpartum mood disorder?

Please recognize that your loved one needs support and understanding. Don’t undercut her mothering skills by giving suggestions on how she should manage her baby. If she is struggling, ask her how she feels. Use active listening techniques, ask open-ended questions, and help her get to a therapist and/or doctor to get the help she needs.

And also, as caregiver, try to remember to take care of yourself, although this can be challenging. Caregivers get burned out and depressed as well. Take it easy on yourself and practice lovingkindness towards yourself and others.

 

Question 9:
In your practice, what kinds of treatments for PPD do you recommend? Is there a type of therapy/ies you would recommend?

I think the best treatment is developing a realistic baby-feeding, sleeping and self-care plan that take into account both mom’s and baby’s needs….all of this can be truly overwhelming.

Going to a therapist who has special training in perinatal mood disorders to help process the feelings around the transition to motherhood and the feelings around childbirth events is a good way to manage perinatal mood disorders.

Sometimes talk therapy is not enough. If medication is needed, going to a psychiatric nurse practitioner or psychiatrist is a normal part of treatment.  Feel proud you are taking steps to care for yourself.

In my practice, I take an integrative approach and use a variety of therapies tailored to the individual’s needs. My basis is insight-oriented therapy, combined with some dialectical behavior therapy (DBT), eye movement desensitization and reprocessing (EMDR), and cranial sacral therapy (CST) tools.

 

Question 10:
What do you see as the biggest challenge in helping a mother recover from a postpartum mood disorder?

 The biggest challenge is that people often don’t want to reach out for professional help. They think they can manage okay by toughing it out and ignoring their own needs. This approach isn’t emotionally healthy. You want to learn to optimize your own and your family’s emotional health.  If mama ain’t happy, no one is happy!

 

Question 11:
What do you think medical health practitioners who come in contact with new mothers, like OB/GYNs, GPs and pediatricians, can do to help prevent, detect and treat perinatal mood disorders?

Prevention starts with a solid social safety net, which our society does not provide.

Individual medical practitioners can coach pregnancy moms and their partners about the possibility of the occurrence of perianal mood disorders, and help them recognize this before the mom becomes seriously incapacitated from a mental health issue. If a mom has a previous episode or a family history of perinatal mood disorder, then pre-treatment–with counseling and perhaps medication–is the best way to minimize occurrence.

Medical practitioners who come in contact with new mothers need to be trained to recognize the presence of a perinatal mood disorder and have resources to offer her and her family. Studies show that having the mom complete an abbreviated 3 question version of the Edinburgh Postnatal Scale is as effective as the original 10 question EPDS.

Medical practitioners who treat new mothers for perinatal mood disorders should take specific trainings in these disorders in order to effectively treat their patients. Postpartum Support International has such trainings and also a supportive professional community that shares resources and knowledge.

—————————————————————————-
If you wish to contact Kathy, she has an office Wayne, New Jersey
Her phone number is 973-713-5966
Her websites are: kathymorelli.com  and birthtouch.com

Thank You, Black-Ish, for Your “Mother Nature” Episode on Postpartum Depression

When I saw the announcement on my feed yesterday morning that that evening’s episode of Black-ish was going to be about postpartum depression (PPD)–and on World Mental Health Day, no less–I was so excited.  And skeptical at the same time.  Why skeptical?  Because first of all, this is a sitcom.  As far as I’m aware, a sitcom has never had a show that focused on PPD.   A sitcom is comedy.  PPD isn’t really a laughing matter. I was concerned they would brush off the seriousness of the topic and lose yet another opportunity to properly educate the public about a condition that affects 1 out of 7 new mothers but is still such a hush hush thing.  Because it’s such a hush hush thing, so many mothers continue to suffer from it and not know that what they are suffering from is not their fault, is so common among new mothers, and can be treated but good help and the right meds can be hard to find.  I was concerned with how accurately Bow would portray a new mother with PPD.

I can only recall one other non-documentary show on Prime Time television focused on PPD, which was ABC’s  Private Practice episode back on February 13, 2009.  Boy, did ABC get it all wrong!  And that was mostly due to the fact that they hadn’t considered seeking guidance from any subject matter experts, like Postpartum Support International, before airing the episode.  It wasn’t until after I watched the Black-ish episode, aptly titled “Mother Nature” that I saw a PSI post that said that Disney/ABC had, in fact, contacted PSI prior to airing the episode.  This was after I already saw, to my great relief and excitement, that the writers of Black-ish did a good job with the script and Tracee Ellis Ross did a good job with portraying a mom with PPD. 

For a sitcom, it did a really good job with showing:

  1. That PPD can happen to anyone, even to someone like Bow who is a medical professional and didn’t experience PPD with her 4 other children; every pregnancy and postpartum is different;  not all childbirth experiences are smooth;  Bow never had PPD after having her 4 other children and yet she is experiencing it with this baby after experiencing preeclampsia, premature childbirth (8 weeks early) and emergency c-section.
  2. What it’s like to have PPD….difficulty bonding with the baby, being unable to sleep, feeling anxious and weepy, unable to smile, unable to perform usual activities, unable to appreciate what you would normally appreciate, and not feeling like your usual self for weeks are some of the trademark symptoms
  3. How the family is affected when the mother is suffering from PPD
  4. The views of the older generation on doing what all mothers have done for generations, which is to plow through your temporary emotional period (i.e., postpartum blues) like all mothers manage to do; some of these views cause the new mom (especially one who didn’t have PPD with her other children) to believe she should just power through her feelings without help, since it will go away on its own
  5. How not only practical but emotional support from the significant other–in this case, Bow’s husband, Dre–and the family are crucial
  6. How there is this societal belief that all mothers glow after having a baby; there is much shame and stigma when a mother doesn’t “glow” like a new mother should; in actuality, having a baby is very hard work and is not always a happy/glowing experience for all moms; some moms need help but don’t want to ask for or accept help out of shame that they aren’t experiencing the kind of motherhood they believe all mothers are supposed to have
  7. PPD happens in 1 out of 7 new mothers (yes, they included this in the script!) so if you are feeling this way, get help!

If you missed it, no problem…you can watch it here: http://abc.go.com/shows/blackish/episode-guide/season-04/2-mother-nature.  And you can read a Babble article by Wendy Wisner titled “‘Black-ish’ just boldly went where few sitcoms have gone before: postpartum depression.”

Thank you, Corey Nickerson (writer and executive producer), for taking your own experience with PPD and coming up with the idea to have an episode about PPD.  With a viewership of approximately 5 million, it’s a perfect way to raise awareness!

Two Important PPD Studies

Since my last blog post, I thankfully haven’t been insane with work as I’d been in earlier weeks.  Truthfully, I’ve just been lazy.  It’s like my body is finally letting me be relaxed and not doing much, for once in who knows how long that I’ve honestly lost track.  I am still in the process of transitioning off of the laptop I’ve had for over 8 years, and with this blog post will be closer to my goal, since it will leave me with only 5 more tabs left open to blog about.  My last blog post included 4 stories of moms who died from severe cases of postpartum depression (PPD).  This blog post is about 2 PPD studies.

BREXANALONE / SAGE-547

This past June, I was beyond excited in reading an announcement from the UNC Health Care and UNC School of Medicine Newsroom titled “UNC researchers lead clinical trial evaluating potential treatment for postpartum depression” about a new treatment for PPD called brexanolone (or SAGE-547) currently in clinical trial phase 3.  The results of the clinical trials have been extremely promising thus far, with SAGE-547 providing a fairly rapid onset of relief for the participants, but it still needs to undergo further tests before the FDA would approve it for use by new moms….and how AMAZING would that be!  It would make a huge difference in the lives of so many mothers and their families–with 1 in 7 new moms experiencing PPD–not to mention save lives!

Brexanalone is also known as allopregnanolone, which is a steroid in the brain (neurosteroid) derived from progesterone that helps to regulate mood.  There is an increase before and a sudden decrease after childbirth when it comes to both allopregnanolone and progesterone, and it’s the sudden drop that seems to trigger PPD for some women. There are currently no medications specifically intended to treat PPD. Antidepressants like Paxil, which are supposed to increase levels of the neurotransmitter serotonin, can take several weeks to “kick in” (it took 4 weeks for me), if at all.  For some moms suffering from PPD, multiple antidepressants fail to do anything.  And if you’ve ever been through depression you know how a day spent depressed can feel like an eternity, so can you imagine what weeks, or even months, spent desperate for a relief from symptoms, while caring for a new baby, must be like?

On July 14th, I heard Samantha Meltzer-Brody, M.D., M.P.H., director of the Perinatal Psychiatry Program at the UNC School of Medicine, talk in person about the treatment and the study at the annual Postpartum Support International conference in Philadelphia.

You can participate in testing via the Hummingbird Study. The website includes information on how to find out if you can participate.  On the website, there is also a helpful guide on how to to identify the warning signs of PPD of and provide support to a new mom with PPD.

PPD ACT

In order to better understand why some women suffer from PPD or postpartum psychosis and some do not, what causes PPD, as well as how to detect, treat and even prevent PPD and postpartum psychosis, information from as many women as possible needs to be collected for analysis.  To help collect data from as many participants as possible, an app was created. Thank goodness for technology!

Last year, Dr. Samantha Meltzer-Brody–yes, her again–was part of a team (that included the National Institute of Mental Health, UNC Chapel Hill and Apple) to create the PPD ACT iOS app, which I’d previously blogged about. It is an app that is is free and available to download via iPhone (and now Android phone!) in English and in Spanish in Australia, Canada, and the United States, and is coming soon to the UK and to Denmark.  Any mom who suspects she has experienced symptoms of PPD or postpartum psychosis is encouraged to download the app and join the study.  Even if you think/know you had PPD, you can participate in order to help advance the study to benefit moms in the future.  It only takes 10 minutes of your time.  I just did it myself, and it took less than 10 minutes, including the time to download the app to my iPhone.  Part 1 of the app is a short survey to get feedback on whether you have/had PPD and receive mental health resources if you are currently experiencing PPD. Part 2 involves participation by those who have/had PPD in a DNA study using a spit kit.

Click here for access to articles in the New York Times, Buzzfeed, CNN, Huffington Post, and the Lancet on PPD ACT.

Wake-up call for new moms who feel “off” for days after childbirth (and family members of these moms)

I’m finally blogging again after a slight reprieve from being unbelievably busy for weeks with work and then vacation and then feverishly cleaning my house for guests coming over (if I had more time to clean regularly cleaning wouldn’t be such a big deal).  Also, I am in the process of slowly transitioning off of the laptop I’ve had for over 8 years, so every single tab I’ve had open (which is a lot) need to be closed, obviously.  These tabs have been open for months for me to blog about and/or read but just haven’t had the time to do.  So, here I am trying to get through as many articles as possible.

Many of the tabs had stories about moms who died from severe postpartum depression (PPD), so I decided to blog about the deaths of FOUR moms who suffered from severe postpartum depression (PPD).  These are just four of the deaths from a postpartum mood disorder that have occurred since 2016.  There have been others, but these are the only ones other than the D’Achilles story (which I mentioned back in May) that I have come across in my daily news feeds because loved ones of these women have spoken up  and shared their stories so that others would not suffer such experiences.

In a Good Housekeeping article published on May 19, 2017 by Andrea Stanley titled “The Voice That Said ‘I’m a Bad Mom’ Killed My Wife,” Greg Ludlam opens up about the severe postpartum depression that took the life of his wife Elizabeth on June 1, 2016.  When their second child was around one year old, something about Elizabeth seemed off.  She wasn’t herself.  Little things set her off.  She withdrew from friends and neighbors.  She started saying and believing she was a bad mom.  There was no longer any joy or enthusiasm in things that used to make her happy. She got angry over things at work when she was never previously that way.  These are all trademark symptoms of PPD but Greg had no idea that his wife was suffering from it.  He has had to cope with the guilt of not picking up on what was going on and getting professional help.

Greg Ludlam urges the significant others of new mothers to do the following:

“….[If] you see something not right with your wife or partner, you need to get help right away from a medical professional who specializes in mental health care.  I’m not talking about tomorrow or next week — now.”

He also urges new moms to do the following:

“For anyone who is reading this and you’re feeling overwhelmed or you’re feeling like a bad mom or you’re feeling like a lousy wife, or just feeling unloved and alone — you’re not. You’re not a bad mom. You’re not a lousy wife. You’re not unloved and alone. There’s help. You need to reach out to a qualified mental health doctor right now.”

In a CTV News article published on January 18, 2017 titled “B.C. widower urges moms suffering postpartum depression: ‘Please seek help ‘” Kim Chen opens up about the severe PPD that took the life of his wife, Florence Leung shortly after she gave birth to their son in October 2016.   She had gone missing shortly after giving birth to her son and her body was pulled from the water near an island close to Vancouver, British Columbia.  Florence was being treated for PPD before her disappearance.  Chen urges new moms who feel anxious and/or experiencing low mood to seek help and share their feelings.  He mentions there is a too much pressure and too many misconceptions regarding breastfeeding, as the hospital where they delivered the baby had Breast is Best materials that reiterated over & over how breast milk should be the only food for babies for the first six months.  He realizes the benefits of breast milk but at the same time believes formula is totally fine as either a supplement or replacement for breast milk.  It should be a personal choice and dependent on circumstances.

Chen wants new mothers to know:

“Do not EVER feel bad or guilty about not being able to “exclusively breastfeed”, even though you may feel the pressure to do so based on posters in maternity wards, brochures in prenatal classes, and teachings at breastfeeding classes.”

In a Her View from Home article published in September 2016 titled “New Mom Takes Her Own Life After Silent Battle With Postpartum Depression: Why All of Us Must Share Her Friend’s Plea,” author Julie Anne Waterfield  opens up about the severe PPD that took the life of her friend Allison on June 28, 2016.  Allison leaves behind her husband and daughter.  Julie wants people to know that there is nothing shameful about PPD.  The transition to being a mother can be very difficult and it is important to get help from your husband/partner, friends, relatives (and if you’re not feeling yourself, seek help from a counselor and/or support group).  The road to motherhood is not always smooth or peachy.  For some new mothers (like me), the road is very difficult–not to mention lonely and for first-time moms uncertain, guilt-ridden and downright scary.  For these mothers, not having a birth and postpartum experience as they envisioned it *should* be makes them feel ashamed.

Julie wants new mothers to know:

“To all those mothers out there experiencing some of these same feelings: you are not alone, and you are not a bad mother!  PPD is lying to you.  It is twisting your memories, feelings, and beliefs and reshaping them into an overwhelming falsehood.  You will not be judged, only loved, as you seek help.  To those breast-feeding mothers taking Reglan (metoclopramide) to increase milk supply: stop and do research. Reglan has detrimental side effects such as new or worsening depression, suicidal ideation and suicide.  Supplement with formula if needed.  Your baby will be just as perfect and healthy with or without the breast milk.  Having more breast milk is not worth sacrificing your mental health or possibly your life.”

And finally in a The Hour article published by Kaitlyn Krasselt on September 8, 2017 titled “Norwalk sisters raising awareness about postpartum depression, suicide,” the sisters of Kara Kovlakas open up about the severe PPD that took Kara’s life (one day before she was to turn 33) on October 13, 2016, nine months after giving birth to her 2nd child.  Kara’s family created the Light for Kara website in her memory and to help raise awareness about postpartum mood disorders.  Kara had suffered from depression and anxiety before she had children.  Within 7 months after giving birth, her thoughts started to become jumbled and she couldn’t think clearly. She had doubts that she was a good parent.  A dark cloud followed her everywhere. She couldn’t see the positives, only the negatives each day. She had been seeking outpatient treatment for her depression and anxiety, and kept insisting to her family that she was getting better.  From the outside, she looked fine to everyone.  But taking her own life was something that her family and friends never expected.

Kara’s sister, Lauren Shrage, wants people to know:

“This is a real mental illness. The shame new moms feel about needing to reach out for help is real. As a new mom, you’re expected to have it all together. We’re all new moms too and the only thing anyone ever mentioned to me about postpartum depression was a pamphlet in the folder I took home from the hospital. That’s not enough.”

Please take these experiences to heart. Share them with others. We need to de-stigmatize PPD by being open about it and avoid being judgmental. Remember that not all postpartum experiences are peachy, and that one in seven new mothers experience a postpartum mood disorder. Let’s keep a close eye on the new moms in our lives.  Offer them help, not criticism. Don’t help push a new mom over the edge with Breast is Best or other one-size-fits-all tactics.  ONE SIZE DOES NOT FIT ALL.  Everyone is different.  Everyone’s childbirth and postpartum experiences are different. We want mothers AND babies to thrive, not die.

If you or a loved one doesn’t seem to be herself for days after childbirth, reach out and ask her to share about her postpartum experience with you and/or a health practitioner.  Getting help can mean life or death, as you can see from this blog post.  Postpartum Support International has a warmline (800-944-4773) and a listing of local resources to help with finding local help.  Reach out to me by leaving a comment below and I can respond via email.

Did you know that you can text 741741 when you are feeling really depressed or suicidal? A crisis worker will text you.  It’s a free service by The Crisis Text Hotline! (Only in the US).  Texting has proven to be a more preferred way of reaching out for and getting help.

The National Suicide Prevention Hotline is available 24/7. If you or a loved one needs help right now, call 1-800-273-8255.  It’s confidential and provides a network of over 140 crisis centers nationwide.    You can also visit www.suicidepreventionlifeline.org.

You have to break through the uncomfortable…Why? Because mothers are dying from postpartum mood disorders

You have to break through the uncomfortable…..We are losing a silent battle that no one wants to talk about.

Amen!  These are the words Brian Gaydos utters when people ask what happened to his beloved wife, Shelane, and his answer “She died from a disease called postpartum depression” makes them uncomfortable.  Discomfort from stigma is what keeps suffering mothers quiet and getting the treatment they need and deserve.

When I read the August 4, 2017 article by Michael Alison Chandler in the Washington Post titled “Maternal depression is getting more attention – but still not enough” and I saw Brian’s words at the end of  the article, I decided I needed to blog about these words and about the tragic death of his wife.  Shelane Gaydos, a 35-year-old mother with 3 daughters, lost a baby in utero at 12 weeks and within 3 weeks died by suicide.  Family members did not realize until a while after her death that she had suffered from postpartum psychosis.  The article mentions, and as statistics have always indicated, women are more likely to attempt suicide during the first year after childbirth than during any other time in their lives.  It is important to note that a woman doesn’t need to give birth to experience any one of the various postpartum mood disorders, including postpartum depression (PPD), postpartum OCD and postpartum psychosis.  She can suffer from these disorders after having a miscarriage as well.

The article mentions certain things I’ve mentioned all along in my blog and in my book:

  • 1 in 7 new mothers experience a perinatal (during pregnancy and after birth) mood disorder, and yet these disorders continue to be under-diagnosed and under-treated
  • A relatively small percentage seek professional help either because they don’t know what they are experiencing deserves and needs  professional help and/or they don’t know where to go to get help and/or they are ashamed to seek help
  • More obstetricians and pediatricians lack than possess the training needed to diagnose and treat perinatal mood disorders
  • Certain risk factors are the reason why certain mothers develop PPD and others don’t: genetic predisposition to biological factors (some mothers are affected by hormonal fluctuations during/after childbirth and after weaning more than others) versus environmental factors (poverty, poor/abusive relationships, premature birth or miscarriage, inadequate support, inadequate paid leave from work)
  • It’s thanks to advocates with platforms with a broad reach to members of the government and media that there has been progress in recent years.  Brooke Shields is one of the first of the advocates to start the trend of sharing their own experiences, spreading awareness, and trying to effect change.
  • There are still stubborn societal myths (thank you to the patriarchal and quite misogynistic forces and views still in place here in the 21st century) that only serve to put unnecessary, additional stress on women, encouraging the false notion that all mothers can not only care for their babies without any sleep or support, but also be able to breastfeed without any issues and return to their pre-baby bodies and weight quickly.  Unbeknownst to many of us stateside, societies around the world (and in olden days here in the good ol’ USA) have customs in place that provide new mothers with the support they need to recover from childbirth and care for their newborn baby.  Instead, because we are a strictly capitalistic society, more and more mothers now work and have anywhere between 0-13 weeks of paid leave and are expected to recover and jump right back to their jobs before having babies, as if they’d never given birth in the first place!  If only men who think “Women have been giving birth for centuries should just up and go back to the way they were” can experience childbirth firsthand sometime!

Certain states, like Massachusetts, New Jersey, and Illinois have passed laws that mandate screening for PPD, and thanks to recommendations by the American Congress of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP), healthcare providers are screening for PPD more routinely.  What I would like to know is whether these screenings are even happening (I am dubious):

  • In 2015, ACOG recommended that OB/GYNs screen women for PPD at least once during pregnancy and once after childbirth.
  • In 2010, the AAP recommended that pediatricians screen mothers for PPD at well-baby visits during the first 6 months.

Says Adrienne Griffen, founder and executive director of Postpartum Support Virginia, whom I have the honor of knowing through my affiliation with Postpartum Support International:

Postpartum depression is where breast cancer was 30 years ago.

I truly and sincerely hope and pray that it’s NOT going to be ANOTHER 30 years for us to see a significant change in the way we view PPD as a society and reduce the numbers of women suffering–and even dying–from perinatal mood disorders!

 

 

Colic, Sleep Deprivation, Inadequate Support as Risk Factors for PPD

Just a quick post about colic, sleep deprivation, and inadequate support for the new mom as key risk factors for postpartum depression (PPD). There are many topics I want to blog about, but it’s another case of too many ideas, not enough time.  Since these risk factors make up some of the crucial pieces of the puzzle of my PPD experience, and since the Babble post titled “DR. HARVEY KARP ON WHY HE BELIEVES PPD IS MORE COMMON THAN EVER BEFORE” by Wendy Wisner showed up on my Facebook feed today, I decided to do a quick blog post about it. This blog post joins my previous post about Dr. Karp and his 5S technique “Baby Fussy or Colicky? Try the Amazing 5 S’s!“, a technique that helps babies sleep and parents cope with colic.  Colic causes sleep deprivation and feelings of incompetence from not being able to calm your crying baby (due to lack of prior baby care experience and lack of adequate support/guidance provided by someone with experience).  I basically said the same things in my book.

Dr. Karp also believes the following, which are also points that I mention throughout my book:

  1. Sleep deprivation can change brain physiology in the amygdala by causing it to become more hypervigilant and a triggering of the body’s fight or flight mechanism.  This state can cause a new mother to feel anxious and remain in a constant state of alertness, fearful that something bad may happen to her baby.
  2. Self care is as important as caring for the baby…it takes a village….a health mom means a healthy baby
  3. A mother’s getting enough sleep and support = key to reducing the occurrence of postpartum mood disorders

The bottom line is new mothers MUST get adequate support.  But with many parents struggling financially and not being able to afford help (via resources like doulas) and family members experienced with baby care not living close by and/or are too busy to help, it’s no wonder there are so many cases of PPD.  Please see my past posts about the critical role social support plays in minimizing the occurrence of PPD here and here.