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.

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Tri-State Area Resources for New Mothers and Professionals Who Care for Them

I will be adding to this post as I think of other resources…

Postpartum Support International (PSI)

I’ve been a member of PSI since 2006 and have met many wonderful, dedicated and caring social workers, therapists, peer-to-peer support group leaders, etc. at its conferences over the years.  The PSI website, as I’ve mentioned in numerous previous posts, provides a listing of resources by state. There is also a warm line for those who need telephone support.

I’m happy to mention that more and more PSI chapters are forming. For example, in the tri-state area the PSI-CT chapter just recently formed https://psictchapter.com/ and NJ is in the process of forming a PSI-NJ chapter.  Click here for the article  published on February 20th that highlights the purpose of the PSI-CT chapter.  The PSI-NJ chapter is in the early stages of development, but the officers are now in place and ramping up plans with monthly calls to establish committees. The chapter has a Facebook page and a website is in the works as well.

If you would like to get involved with either chapter, please let me know and I can put you in touch with them.

Maternal Mental Healthcare Centers

When it comes to mothers’ centers, there are 2 on my mind in New York City:

Seleni Institute
The Motherhood Center of New York

I will be adding NJ and CT ones in the next few days.

Workshops for Professionals, Peer Support Group Leaders, and Advocates

The Partnership for Maternal & Child Health of Northern New Jersey will be hosting training events featuring Cheryl Tatano Beck, DNSc, CNM, FAAN, Distinguished Professor at the University of Connecticut, School of Nursing.

Click here for more information about the workshop scheduled for April 26th in New Providence.
Click here for information about the workshop scheduled for April 27th in Englewood.

The target audience for these workshops includes physicians, nurses, social workers and others (like peer-to-peer support group leaders) working with perinatal women.  Advocates and others concerned about maternal mental health (like me) are also welcome to sign up.

I will be sure to post information about events intended for new mothers and for those who are dedicating their lives in helping new mothers.

 

 

Steve Bannon’s Ignorance on Mental Health

 *** This post may be triggering if you are suffering from postpartum depression (PPD) and are sensitive to negative news events***

Here I am, posting again….wow, it’s now 3x in one month.  I haven’t posted with such frequency in a long time.  Guess you can say the state of this country is heavy on my mind.  I had said in my last post that I wasn’t going to talk politics since this site is dedicated to maternal mental health.  I was planning to stick to that guideline.  But then I hit a snag in my plans, thanks to a post I read about Bannon, the individual that Trump has selected to be his chief strategist.  Bannon made a comment about mental health that triggered me so much it had me flashing back to the trigger that set me off on a 6-year journey to publish a book about my postpartum depression (PPD) experience.  What trigger is that?  Well, if you’ve been following my blog for some time and/or you read my author bio, you would know that Tom Cruise and his There’s no such thing as a chemical imbalance comment triggered me back in 2005.  But the outcome of the trigger was good, as I have my blog and book as the end result. And yes, I do thank TC in my Acknowledgments.

There’s nothing good about this trigger related to Bannon, though.  TC is just an ignorant actor. But Bannon is an ignorant white supremacist who will have a role in the White House and will have far more negative consequences than TC ever had.  Bannon made a statement that the cure for mental illness is to spank your children more.  Excuse me?  What.The.Fuck. (oops, forgot to use $ or other symbol to fill in for the “u” for the very first time…..there’s a first time for everything, as they say).  I’ve truly had it with this whole election.  I’ve had it with all the hatred, misogyny and bigotry.  With the cheeto about to become our President and the alt right using him as a tool to ensure there are at least 4 years of revenge for the 8 years they had to suffer under President Obama, they have populated the leadership team with known racists (Bannon, Sessions, Flynn) and ensuring that racism becomes the new normal.  My passion for matters related to racism stems from my being bullied as a child for my race.  But I’m not going to digress here (even though anti-bullying is my other passion)……

Note: If you’re a Trump follower trolling this blog post and thinking I’m bullying Bannon or Trump, then think again.  Bullying is DIRECT harassment to them personally.  I’m exerting my 1st amendment right voicing my thoughts on my own blog.  Thank you very much.

<directing myself back on track….>

Bannon, just like I’ve been wishing to tell Tom Cruise in person, I wish I could tell YOU in person, if you’ve never been through mental illness yourself, then:
Shut the f*ck up.  
Shut.Your.Ignorant.Mouth.Up.  

And get educated about mental illness and how it REALLY works.  It’s not mind over matter, you dimwit.  Take a few minutes to read a blog post that may help you see the light when it comes to PPD.  There are plenty of articles from health organizations and blog posts on the Internet for you to learn the TRUTH behind mental illness.  But I’m pretty sure you won’t bother to spend a second to read anything because you think you know it all, don’t you.

Here’s where, if I could be granted 3 genie wishes, one of them would be to make all haters/bigots switch places with the ones being hated and the ones who keep insisting that mental illness is mind over matter to switch places with those who are battling a mental illness (e.g., depression, PTSD, bipolar disorder, etc.).  You will learn in an instant that the logic you’ve been upholding is COMPLETELY WRONG.  See my past post on this titled “All It Takes Is One Day.”  One day to experience a mental illness yourself, firsthand……THAT’S ALL IT TAKES to snap you to reality and stop living in a world based on assumptions (that only make a$$es out of you).

And speaking of backwards, as women, we should not let ourselves be dragged backwards when it comes to our rights. We must stand up for ourselves and for each other.  We must work harder than ever to support organizations that will help us stay on track when it comes to mental health and women’s rights, especially during the time that women are most vulnerable–i.e., before, during and after childbirth.  Please join me in doing this!

If you’re a mom suffering from PPD right now, please be comforted in knowing that there are plenty of people in this country and around the world who care enough to make it a goal to help moms like you.  Please reach out to me, reach out to others with blogs, Facebook pages….we will help you get through this.

You WILL get through this.  I got through it stronger than ever before, and so can you!

Peace to you.

15%-21% of Moms Suffer from a Perinatal Mood Disorder

For the longest time they were saying between 1 out of 8 women suffer from a perinatal (before, during or after childbirth) mood disorder.  Then, they said between 1 out of 7.  And more recently, literature indicates it’s now approximately 15%-21%, which is anywhere between 1 out of 5 and 1 out of 6, with 21% experiencing a postpartum mood disorder.

If you are suffering from a perinatal mood disorder, you can see from these numbers and in many places online–from a multitude of Facebook support pages, blogs and on Twitter–and in newspapers that you are not alone.  For example, in today’s Upworthy, my friend Heidi Koss shares her experience after the birth of her daughters.  She is a PPD survivor and now helps other moms suffering from perinatal mood disorders.  Her story was also mentioned in an NPR article a week ago today.

You need to know when you need to get help from a doctor and/or therapist.  Get it early.  Know the facts.  Know the difference between postpartum blues and postpartum depression (PPD).  Know the difference between PPD, postpartum anxietypostpartum OCD and postpartum psychosis.  Click here for helpful information that can help you.

You need help for you.
You need help for your baby(ies).
You need help for your family as a whole, including your significant other.

I just found out tonight about the fate of Carol Coronado about whom I blogged in May 2014.  She suffered from postpartum psychosis (not PPD as some newspapers allude to), didn’t get the right help and was just sentenced to life in jail.  Carol, her babies, and her husband were failed by the system.  The same system that failed to ensure she got help is punishing her for their failure.  Sound fair to you?  No!  Her case sounds similar to Andrea Yates case nearly 15 years ago.  I pray for Carol and her family.  She has suffered enough and does not need to spend the rest of her life in jail.  I saw a Facebook comment about Carol that triggered me to write this post.  The coldness and lack of understanding are a reflection of just how close-minded people can be.  It amazes me, really.  It’s really hard to beat down stigma when you have such barriers in the way.  But don’t let any of that deter you from getting help.  YOU are important.  Forget these clueless people.  Get the help you need.  Don’t delay!

Whenever you read about these stories in the news, please remember the facts.  Get information from the right resources (links above would be great place to start).  And don’t let stigma and ignorance steer you away from understanding and compassion.  Don’t let stigma, ignorance, and the close-mindedness of people (those who choose not to understand and would rather continue their misogynistic, super hokey, religious extremist mindset in which women are second class citizens) steer you away from getting the help you need to be well again!  Stay strong!  There is help out there!  Reach out to me.  Reach out to the Postpartum Support International Facebook page (closed group) for support.

History in the Making for Maternal Mental Health Advocates

I’ve been super busy at work these days, sometimes having to work at night, which is why I haven’t blogged much lately. But I couldn’t let today go by without mentioning the announcement today about a major step in the right direction….finally!  First thing this morning, I received a text from a friend to check out an article in the NY Times about postpartum depression (PPD), followed immediately by an email from my husband with a link to the same article.

Mental health advocates are excited not just about the news that splashed the headlines of today’s New York Times and NPR about the importance of screening adults for depression.  It’s the acknowledgment–finally–that new and pregnant moms need screening because catching and treating PPD early is crucial to the wellbeing of both the mother and the baby, and to the family unit as a whole.  I’ve blogged in the past about how screening and seeing someone experienced in treating PPD could have prevented my painful experience.  Having the screening recommendation come from the U.S. Preventive Services Task Force is particularly meaningful, as its recommendations have far-reaching impact on things like healthcare (i.e., American College of Obstetricians and Gynecologists, American Academy of Pediatrics, American Academy of Family Physicians) and health insurance in this country.  In fact, its recommendations appear in the current issue of JAMA (Journal of the American Medical Association).

This is a major milestone for maternal mental health advocates in this country.  And it’s about freaking time!  I attribute this milestone to the persistence, hard work, dedication and passion of many, many amazing people either independently acting or as part of organizations formed–too many to list here but foremost on the list is Postpartum Support International (of which I’ve been a member since 2006)–to spread awareness about an all too common condition suffered by mothers that even today people are not aware occurs in 1 out of 7 moms.  Seeing my friends’ names in these articles–Heidi Koss, a survivor/advocate/counselor and Wendy Davis, Executive Director of Postpartum Support International–mentioned makes them all the more meaningful to me.  They are passionate about what they do because they don’t want mothers and their families suffering unnecessarily.

You would think something like screening, which I’ve blogged about numerously in the past, would be mandated by all healthcare professionals who come in contact with expectant/new moms.  In one of my very first blog posts from back in June 2009, I included my suggestions for what screening would entail. Unfortunately, screening has not been embraced because, after all, where there is a positive, there is always a negative.  In this case, there are several negatives, with the biggest being none other than STIGMA, one of the 2 biggest barriers to progress for the battle against PPD.

Stigma–and the ignorance associated with it– comes from resistance to change and attitudes about what screening would mean (“Oh, once a mom is screened positively for PPD, then she will automatically be medicated”).  That, by the way, is totally false.  No one is deliberately trying to medicate every mother and give more business to the pharmaceutical companies.  Again, I have blogged plenty about this in the past, but medication is just one way to treat a perinatal mood disorder and in many cases critical to helping restore the neurochemical imbalance that childbirth has brought about.  Without medication, I might not have survived my PPD.  In most cases, it’s a combination of medication and therapy (like CBT) that is most effective.  In some, less serious cases of PPD, therapy or peer-to-peer support (with a PPD support group led by a survivor) and/or an alternative treatment like meditation or acupuncture is sufficient.

Speaking of which, there is another major barrier, which is what happens once an expectant or new mom screens positively for a perinatal mood disorder….can we find them immediate help?  Although there are more resources now than there were back when I suffered from PPD, we still have a very long way to go.  There is definitely a need for more help among the healthcare, mental healthcare, and peer-to-peer support communities who are experienced in treating perinatal mood disorders.  You’ll all too often hear that there is a long wait to see a psychiatrist (an MD who has the ability to prescribe meds), once you’ve found one that is near you that has experience treating perinatal mood disorders.  Unfortunately, there just aren’t enough mental healthcare practitioners who are experienced in treating perinatal mood disorders.  There aren’t enough mental healthcare practitioners, period.  And among general practitioners, not enough are experienced enough or even have adequate bedside manner to know how to treat/behave toward a mother struggling with a perinatal mood disorder.  I know, because I had seen one of those doctors, and it was a horrible, horrible experience for me.

These are the problems that we need to overcome if we want to truly be able to prevent any more mothers from falling through the cracks.  There are many steps to get where we need to be, but we have attained an important step in the right direction with the recommendation from the U.S. Preventive Services Task Force!

Let’s Hold Failure of the System Accountable for Tragedies Involving Infanticide

 *** This post may be triggering if you are suffering from postpartum depression (PPD) and are sensitive to negative news events***

I stumbled across this headline on my Twitter feed tonight:  “Three years for Edinburgh mum who killed her baby.”   Wasn’t planning on blogging, but when I clicked on the link to read the article, I was so infuriated that it has motivated me to blog.  Here’s yet another tragic loss from system failure and continued societal blindness to the realities of perinatal mood disorders.

I’ve blogged about this previously…that it seems way too common and easy for people to disassociate the baby from the mother.  That a tragedy like this–a mother named Erin Sutherland who suffered from severe postnatal depression (PND) who smothered her baby–occurred should be viewed from a BIG PICTURE perspective as another example of the system failing a mother AND her baby.  Not just the baby, but the mother as well.  Not just the mother, but the baby as well.

The father of the baby, estranged from Erin Sutherland, and his family felt it was unfortunate that the focus seems to have shifted from the real tragedy at hand….the loss of an innocent baby.  No one can/will contest this, but what people continuously forget is that, had the system NOT failed Erin, the baby would be alive because Erin would have received the treatment she desperately needed.  True, I don’t know the full story here, but the mere words coming out of the prosecutor Iain McSporran’s mouth: “generally speaking six months is a point beyond which PND will no longer be considered a factor” is RIDICULOUS.  Spouting such damning untruths is utterly shameful on his part. Had he bothered to get educated about perinatal mood disorders, those words would not have slipped out of his mouth a la angry let’s-lynch-the-mother-she’s-always-guilty-no-matter-what syndrome.  Mr. McSporran, if you had bothered to become educated about perinatal mood disorders, you would know that it is possible for severe PND to be possible up to the end of the 2nd year or whenever a mother decides to wean her baby.

Why would a mother be turned down for help because ludicrous “rules” state that after six months her condition was no longer deemed to be a “problem factor” for new mothers?  Why are such archaic rules still in existence?  They must be updated with scientific facts!   I thought Edinburgh is supposed to be more up-to-speed on perinatal mood disorders than we are in the states, what with the Edinburgh Postnatal Depression Scale (EPDS) originating from none other than….you guessed it, Edinburgh.  But I guess not!

How could anyone refuse treatment for a mother who is clearly suffering from PND and seeking help for it?!  Especially when the mother had previously received hospital treatment following the birth of an older daughter after being diagnosed with PND and becoming so ill that she needed in-patient care when her child was EIGHT months old! Last I looked EIGHT is more than SIX!!!

The system that created such a nonsensical “rule” is culpable for little Chloe’s death.  It left Erin with no treatment and sealed her and Chloe’s fate.  So terrible that I want to smack some sense into these ignorant lawmakers.  Get with the program! Get educated, for crying out loud!  This patriarchal system catering to old fashioned beliefs based on misogynistic, archaic thinking MUST GO NOW!

In a recent post that also involved another tragedy like this, I posted:

Women around the world continue to be viewed as baby incubators and milk machines, and as such, their physical, mental and emotional wellbeing do not matter in the grand scheme of things.  Their needs as new mothers don’t matter.  BUT THEY DO MATTER.

Mothers are more than incubators.  They are living, breathing, humans just like men are.  Just like babies are.  Heck, people seem to be very quick to forget one basic truth:  Without women, you can’t have babies.  Hellllooooo!  I see all the time hateful comments from the extreme right (here in this country) from women, of all things, picking on other women because they were raised brainwashed into believing misogynistic things that do nothing but damn themselves.  Well, I wish women would unbrainwash themselves.  Use their common sense, not have their religious zealotry make them blinder than bats.  It might make a huge difference once women sided with women, don’t you think?

Blue Light and PPD

Just a short blurb today to share an interesting Huffington post article on the connection of blue light with melatonin secretion (the hormone that induces sleep) and thus postpartum depression (PPD).  The title of the article is “The Connection Between Blue Light and Postpartum Depression” by Matt Berical.

I’ve always been fascinated in the biology behind PPD, in particular insomnia as a symptom, hence here I am popping onto my blog this July 4th weekend ever so quickly to blog.  I had previously blogged about blue light in my post from 2 years ago titled “Sleep is So Important, Especially to the New Mom.”  If insomnia is plaguing you on a antepartum (or prenatal) or postpartum (or postnatal) basis, or if you are an expectant mom who just wants to be in the know to reduce the chances of PPD hitting you from left field like it does for so many moms, then please read the Huffington Post article and my previous blog post.

I had not known what depression and insomnia were like before I was hit from left field with both, so I’m always happy when I see information made available to the public to educate people.  An important word I’ve heard used before, just not in conjunction with something like PPD prevention, is prophylactic.   It’s a synonym, after all, for preventive measure, which in the case of pregnancy prevention comes in the form of a condom and/or the pill, but in the context of PPD prevention comes in the form of knowledge of symptoms, where/how to get treatment, lining up adequate social/emotional/practical support, and if you want to avoid disruption of sleep, orange-tinted sunglasses that can be effective in blocking blue light. These sunglasses are recommended for anyone that has to either stay up late on a regular basis, like teenagers studying and being on computers (which emit blue light), to expectant moms who have difficulty sleeping due to having to get up in the middle of the night to go to the bathroom and new moms who have to wake up every 2-3 hours to feed their babies.

Whether it’s the anxiety that comes with new mom challenges or the hormonal fluctuations and decrease in serotonin and/or melatonin–both of which are hormones critical for sleep–sensitivity to circadian rhythm changes are further aggravated by exposure to blue light, a biological trigger to wake up, which means that repeated exposure to it during the night can mess with our circadian rhythms and melatonin production.

And hence, insomnia, which for me was my very first PPD symptom.