Hats off to Chicago Med

I just watched my 3rd episode of “Chicago Med”….yet another brilliant TV show created by Dick Wolf of “Law & Order” fame. My only regret was not discovering this show sooner! This show has a thoughtfully-written script and characters realistically portrayed by a great cast in a way that–much like “House” in its first season–draws you into each episode.  Oliver Platt plays the Chief of Psychiatry at Chicago Med, and I think he’s doing an awesome job!  The best part about “Chicago Med,” IMO,  is the fact that it’s the only show, as far I’m aware, that affords a weekly story line delving into the realm of mental health.  Yes, MENTAL HEALTH.  There are multiple story lines happening concurrently with the cast, but from I’ve seen from the 3 episodes I’ve watched, the focus of each week’s episode is primarily about a situation involving mental health.  Not just an occasional acknowledgment here and there during a whole television season that yes, there are health issues that aren’t entirely medical in nature (think Dr. House and his addiction to vicodin for his “pain”) but a FULL story line each and every week dedicated to at least one person struggling with a mental health issue.

Finally, prime time television is taking a serious stab at shedding light on mental health!  For that, I am grateful.  You know why? Because we need to talk more about mental health conditions.


Depression…..PTSD…….Suicide……Obsessive Compulsive Disorder…..Bipolar Disorder….Self Harm….Eating Disorders…..Postpartum Depression…..Sociopathy……Borderline Personality Disorder…..Schizophrenia……etc.


 

Every single person out there knows someone who has experienced one or more of these mental health issues.  You wouldn’t know that, though, because the tendency is for people to hide these things thanks to misconceptions spawned by the very little that we do know about them.

Thank you, “Chicago Med,” for shining a light on mental health.  I look forward to future episodes, and hope that more and more people will start watching the show.  My hope is that “Chicago Med” will prompt other show producers/directors to create more shows like this, realizing the need to make mental health a part of our daily discourse and encourage discussions and curiosity about these conditions and create a mentality that “Hey, a mental health condition deserves to be diagnosed and treated the same way as, say, diabetes or a heart condition.”

Keeping mental health conditions swept under a rug and a mystery from the public create a taboo mentality that mental health conditions don’t deserve to be treated and you should just “snap out of it” or stop imagining that you even have any kind of condition in the first place.  Part of the problem is that mental health conditions are, as quoted in the episode tonight, “invisible.” In tonight’s episode, Dr. Ethan Choi (played by Brian Tee) continues to battle the effects of his PTSD from serving in the military.  His girlfriend Vicki makes a reference to mental health conditions as being difficult to diagnose/treat because they don’t necessarily exhibit any physical symptoms and/or there doesn’t appear to be a medical explanation for those symptoms.  Modern medicine and technologies are making headway–albeit slowly- in assisting doctors and psychiatrists to confirm and/or make diagnoses via brain scans.  The patient under Dr. Choi’s care in tonight’s episode appeared to also be a victim of PTSD from being in combat, but it was through Dr. Choi’s keen observations that they ultimately determined the patient had excessive scar tissues near his heart that caused the sound of his heart beating to echo loudly in the poor guy’s head.  So, he wasn’t imagining things and he most certainly wasn’t suffering from PTSD like he was insisting from the beginning!  And of course, no one believed him!  This is where I applaud the writers for writing a script that shows that, even though someone may appear to be suffering from a mental health condition, you can’t assume that there isn’t a physical or medical explanation for what the person is experiencing until you take the time to determine the root cause for a patient’s experience.  Just like depression has a scientific explanation, like a hormonal and/or neurotransmitter imbalance, there is a biological explanation behind every mental health disorder. And it’s the task of research scientists to figure that all out, and I pray they hurry the heck up because we are losing too many people each year to mental illnesses!  But I digress…..

I end this blog post with a call for “Chicago Med” to include an episode or two on postpartum depression. We desperately need an episode that informs the public of the difference between postpartum depression and other postpartum conditions like postpartum OCD, postpartum psychosis and postpartum bipolar.  Please, please, please, Dick Wolf and team of writers: please reach out to Postpartum Support International today and collaborate together on a series of episodes on postpartum mood disorders.

If you look at the statistics, how can people NOT produce more shows on a topic that touches so many lives?

 

 

Postpartum Bipolar Disorder: The Invisible Postpartum Mood Disorder

In response to my blog post from February 3, 2016 titled “15%-21% of Moms Suffer from a Perinatal Mood Disorder” in which I mention yet another mother who suffered from a postpartum condition that resulted in tragedy, fellow maternal mental health advocate Dyane Leshin-Harwood left me a comment that prompted me to offer her to explain why it’s so crucial to know the difference between postpartum bipolar and postpartum psychosis.  I explained to her that I haven’t seen much out there on a comparison between the two, and of course, the more we speak up about these conditions, the better off we all are!  These are illnesses that are extremely misunderstood, which can result in unnecessary stigma, mothers not getting the help they need because they don’t know who to go to for help, doctors not necessarily knowing how to properly diagnose and/or treat these mothers……and sometimes leading to tragic circumstances.

So, without further ado, I’d like to share Dyane’s story and important information about postpartum bipolar disorder.  Thank you, Dyane, for all the work that you do as a maternal mental heath advocate!

Postpartum Bipolar Disorder: The Invisible Postpartum Mood Disorder

Like father, like daughter: I grew up close to my father, a professional violinist who had bipolar disorder. In this photo I was eight months pregnant, and I never suspected that childbirth would trigger my bipolar disorder.

Like father, like daughter: I grew up close to my father, a professional violinist who had bipolar disorder. In this photo I was eight months pregnant, and I never suspected that childbirth would trigger my bipolar disorder.

By Dyane Leshin-Harwood 

Bipolar disorder, postpartum depression and postpartum psychosis have recently made media headlines. Katie Holmes stars as a lovestruck poet with bipolar disorder in the film Touched With Fire. The British hit television show EastEnders featured a postpartum psychosis storyline that gained national attention. Last January in a landmark decision, the U.S. Preventative Task Force called for screening for depression during and after pregnancy.

While the greater awareness of postpartum mood disorders is promising, postpartum bipolar disorder, the mood disorder I was diagnosed with, is virtually unheard of. Postpartum bipolar is also known as bipolar, peripartum onset, and it’s arguably the least known of the six postpartum mood and anxiety disorders.

It might seem unimportant to publicize an obscure mood disorder, but every mom’s postpartum experience counts. Many medical professionals are unaware that postpartum bipolar exists. Some postpartum and bipolar organizations are unfamiliar with postpartum bipolar or they’re unclear about its definition.

When I was pregnant, my obstetrician didn’t question me about my mental health or my family’s mental health history. My father had bipolar disorder, but before and during my pregnancy I didn’t show any signs of mental illness.

When I went into labor, my life changed overnight.

We went to the hospital and I stayed up all night in pain. When my daughter Marilla was born the next day, I became hypomanic. I was exuberant and talkative (both signs of hypomania), but I appeared relatively normal. My baby attracted most of the attention, and no one noticed that I was in trouble. Exhausted, I sensed something was off, but I kept my fearful feelings inside.

Within forty-eight hours I had hypergraphia, a rare condition in which one compulsively writes. I wrote at every opportunity, even during breastfeeding, when I should’ve been resting and focusing on my baby. I could barely sleep as my mania escalated, and poor Marilla didn’t gain enough weight because I didn’t breastfeed her sufficiently.

A month postpartum, I knew I was manic; after all, I had witnessed mania in my Dad. I frantically searched the internet about postpartum mania, but my search only yielded postpartum psychosis statistics. During Marilla’s six-week checkup, her observant pediatrician heard my racing voice and pressurized speech (symptoms of bipolar) and blurted out “Dyane, I think you’re manic!”

I burst into tears. While I felt ashamed, I was relieved that he realized what was happening. It was clear I needed hospitalization, but leaving my newborn was agonizing. I admitted myself into a hospital’s psychiatric unit where I was diagnosed with postpartum bipolar disorder.

After years of hospitalizations, medication trials, and electroconvulsive (ECT) therapy, I’m stable and doing well. While bipolar disorder ravages many relationships, my husband and I have stayed together, in part, thanks to the guidance of counselors and psychiatrists. Life will always be a challenge, but my two daughters inspire me to take care of myself.

While chances of postpartum bipolar are low, it can affect any mother. Obstetrician and Perinatal Mental Health Lead Dr. Raja Gangopadhyay of West Hertfordshire Hospitals NHS Trust, UK, explains,

“The risk of developing new-onset severe mental illness is higher in early post-childbirth period than any other time in women’s life. Family history, pre-existing mental health conditions, traumatic birth experience and sleep deprivation could be potential risk factors. Bipolar illness can present for the first time during this period. Accurate diagnosis is the key to the recovery.”

Confusion abounds regarding postpartum bipolar and postpartum psychosis. While the two conditions can present together, postpartum bipolar isn’t always accompanied by postpartum psychosis. Perinatal psychologist Shoshana Bennett Ph.D., co-author of the bestselling classic Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression and Anxiety says,

“Many women I’ve worked with had been previously misdiagnosed with postpartum depression. I always make a point of discussing this during my presentations. In addition, postpartum bipolar disorder deserves its own category separate from postpartum psychosis.”

Mental health screening during pregnancy would be of immense value to every mom. Women with a family history of bipolar disorder could be observed postpartum, and if symptoms manifested they’d be treated immediately. It’s imperative that doctors and other caregivers assess women not only for postpartum depression but also bipolar symptoms.

Everyone who lives with a stigmatized illness deserves a chance to find support and empathy from others who understand her experience. Through connecting with those who can relate to our mood disorder, we may not find a magic cure, but virtual support can be profoundly helpful. Postpartum Support International recently created online support groups in English and Spanish led by trained facilitators, while the Postpartum Progress website offers moms a private forum to interact with one another. I’ve never personally met another mom who has postpartum bipolar and I yearn to do so. If you or someone you know is or might be suffering with postpartum bipolar disorder please reach out — I’d love to hear from you!

Kona

My daughters Avonlea, Marilla and husband Craig stood by me through the roughest times.

Dyane’s bio:

Dyane Leshin-Harwood holds a B.A. in English and American Literature from the University of California at Santa Cruz. A freelance writer for over two decades, she has interviewed luminaries including Madeleine L’Engle, Dr. Kay Redfield Jamison and SARK. Dyane was diagnosed with postpartum bipolar disorder (bipolar, peripartum onset) in 2007. Dyane was selected as an International Bipolar Foundation Story of Hope and Recovery, and a PsychCentral Mental Health Hero. She’s raising her daughters Avonlea and Marilla with her husband Craig and serves as women’s postpartum mental health advocate. Dyane founded the Santa Cruz, California chapter of the Depression and Bipolar Support Alliance (DBSA) and facilitates free support groups for moms with mood disorders. She’s a member of the International Society for Bipolar Disorders and Postpartum Support International. Dyane’s memoir Birth of a New Brain – Healing from Postpartum Bipolar Disorder will be published by Post Hill Press in 2017. Dyane is a Huffington Post blogger. Visit Dyane’s blog Birth of a New Brain at: www.proudlybipolar.wordpress.com and find her on Twitter: @birthofnewbrain

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!

Naomi

Please visit the Postpartum Support International post about Naomi.
Please read and share that post, and let us really try our best to spread awareness about perinatal mood disorders.
We need to do all we can to ensure that everyone who works with maternal mental health in the medical and judicial systems truly understands and is able to identify symptoms and knows how to react and treat a woman who is suffering from a perinatal mood disorder. These encounters can mean life and death, ultimately, for the mother and her child.

candle

Naomi, on this day of your memorial service
With tears in my eyes and a lump in my throat,
I write this.
Though I did not know you personally,
I do know that you suffered greatly
And experienced unimaginable loss
During your time on this earth.
And I am so, so sorry that you did.
What a terrible loss to the community
Of fellow postpartum mood disorder survivors.
Words cannot adequately express
How sorry I am that your pain was so great.
I feel so guilty for not being able to help you
While you were among us.
Society has once again failed another mother
Through its ignorance and lack of adequate support services.
I cry over our loss of you.
I promise you that I will continue to work with the community
Of maternal mental health advocates and survivors
To carry on your advocacy
And your passionate desire
To prevent other mothers from experiencing
The pain and loss you suffered.
Yes, I will continue to work with others to spread the word
With your spirit in us and
With you looking down upon us
That mothers suffering from postpartum mood disorders are
Far from alone,
They are not to blame for their postpartum illness,
And they WILL recover with the right treatment and support.
Rest in peace, Naomi

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?

Help Me Finish the Sentence: Just Because She Doesn’t Look Depressed…..

A super duper quick post tonight, as I have had too many windows open on my PC and need to shut it down to give my PC a break…not to mention install some updates.  Before I shut my PC down tonight I need to briefly jump onto my soapbox and put my thoughts out into cyberspace about not making assumptions and not judging books by their covers.  These 2 thoughts combined and in the context of new mothers produces the following:

Don’t assume that a new mom wearing makeup and a smile is happy.  

How would you know better, then, you ask?  Well, the only way you’re going to know for sure is if you care enough to ask how a new mom is doing.  Take the time to have a chat with her and show you care. Look into her eyes when speaking.  Being the empath that I am, I can usually sense when something is a bit off with someone.  But I would most certainly confirm what my gut is telling me by talking to them.

I’ve also blogged about this previously (click here to read), but I do want to make sure you go over to Eve Canavan’s blog Small Time Mum and check out her blog post titled “You Can’t Be Depressed Dear, the Forestry Commission Don’t Have to Be Called to Trim Your Bush.” It’s a great post.

So, just because she (a new mom) doesn’t look depressed does NOT mean she is NOT depressed, and the only way you’re going to know is if you stop and ask how she’s doing and look her in the eyes.

A New Mom’s Needs Matter Just As Much As the Baby’s Needs

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

Nothing recently has truly sparked my desire to blog…that is, until tonight.  One of my Facebook friends had commented on an article on a public page, so it popped up on my Facebook feed on my commute home from work.  The post was titled “Charlotte Bevan’s death: an indictment of a breastfeeding culture that ignores the needs of women,” written by Amy Tuteur, MD.

One of my biggest peeves is an extremist, misguided, self-serving, selfish, hateful and highly narrow-minded viewpoint, whether it be about politics, guns, religion, bigotry, misogynism, women’s reproductive rights…..or in this case, breastfeeding.  I’ve previously blogged about how breastfeeding zealotry led to the deaths of a mother and her baby, and here I am again, blogging about another PREVENTABLE AND SENSELESS DEATH of a new mother and her baby.

WHEN IS IT GOING TO STOP?

If you are in the medical healthcare profession, you MUST place your patients’ wellbeing BEFORE your religious and biased viewpoints, which have NO PLACE in a profession in which lives are at stake. And should you NOT know the appropriate protocols for specific conditions, drug interactions, consequences of taking someone off medications, etc., then you have NO BUSINESS being in your profession.  PERIOD.

Sure, breast is best if it’s best for baby AND MOM.  BUT DO NOT EVER FORGET ABOUT THE MOTHER.  If she is healthy and wants to/can breastfeed, then great.  If she is healthy and does not for whatever reason want to breastfeed, she shouldn’t be forced to/guilted into doing so.  If she is not healthy and cannot breastfeed, then stop guilting her into doing so.  Let her formula feed in peace.

If she has a mental health condition (as in Charlotte’s case) that requires her to continue taking medication, then she MUST do so.  If she has a mental health condition and wants to breastfeed, then have her continue breastfeeding if–as in this case with risperidone–the medication she is taking is compatible with doing so based on research.  If she prefers to feed her baby formula because she is uncertain about breastfeeding while on the medication, then let her feed her baby formula.  Let her formula feed in peace.

Whoever let Charlotte go off her anti-psychotic medications without monitoring her to be sure both she and her baby were okay are directly responsible for her death.  Here again, we have the insidious belief that a baby deserves to be fed “liquid gold,” the life of her mother be damned.  Bottom line, those whom she entrusted her care might as well have just pushed her off the cliff themselves.  Death by negligence. I believe they call it negligent homicide here.

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.

I had to quote an excerpt out of the post written by Dr. Amy Tuteur here, as it’s perfectly on point:

For most of human history, women have been reduced to three body parts: uterus, vagina and breasts. Their intellect was irrelevant; their talents were irrelevant; their wants and needs were irrelevant. For a while it appeared that we had moved beyond this deeply sexist and retrograde view of women, but now it’s back in a new guise: natural parenting, specifically natural childbirth, lactivism and attachment parenting. These movements place the (purported) needs of babies front and center. They ignore the needs of women.

I firmly believe that extremist thinking is in and of itself an illness.  It is delusional, obsessive and destructive behavior that MUST BE STOPPED.   This tragedy wasn’t just a wake-up call.  There have been all too many wake-up calls.  IT IS TIME FOR US TO WAKE THE F*CK UP.

Women are more than baby incubators and milk machines.