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.

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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

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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.

If Only I Had Known – Part II

Today, I decided to continue with the “If Only I Had Known” theme from my first post 5-1/2 years ago in which I had blogged about a prior abdominal procedure to remove a dermoid cyst as a likely cause of infertility due to scar tissue formation.  What prompted me to write another If Only I Had Known post is an article on my feed a couple of days ago.  I’m writing about the same darn dermoid cyst removal procedure and scar tissue formation, but this time as the likely cause of the placenta accreta that ended up setting the stage for the postpartum depression (PPD) that hit me from left field 6 weeks after my daughter was born.  Earlier on in my blogging days, I had shared my less-than-perfect childbirth experience– the “Childbirth Complications” part of the trifecta of conditions in the subtitle of my book “One Mom’s Journey to Motherhood”–that led to the PPD rearing its ugly head.  In that blog post, I shared what happened after the perfectly normal vaginal delivery.

The title of the NPR article that I stumbled across a couple days ago titled “If You Hemorrhage, Don’t Clean Up: Advice from Mothers Who Almost Died” is, needless to say, very attention-grabbing.  The article, written by Adriana Gallardo and Nina Martin of ProPublica and Renee Montagne of NPR, starts off with the life-threatening situation that occurred to Marie McCausland after she gave birth.  The article then shares the advice of other survivors of traumatic and life-threatening childbirth experiences in several categories: choosing a provider, preparing for an emergency, getting your provider to listen, paying attention to your symptoms, after the delivery, and grappling with the emotional fallout.  This is why I love the article so much.  Although it contains frightening scenarios of possible complications that can occur during childbirth, it was written not to scare folks already anxious about having babies but to provide advice.  After all, KNOWLEDGE IS POWER.  Every mother should read it because if, God forbid, a complication does occur, she’ll be prepared.  As they say, hope for the best BUT EXPECT THE WORST.  This is not pessimism.  It’s reality.  In reality, complications can and do happen.  And we cannot and should not rely solely on our healthcare providers.  If you read the NPR article in its entirety, you’ll see how healthcare providers repeatedly fail their patients.

I absolutely love these types of KNOWLEDGE IS POWER articles!  Chapter 3 in my book is titled “Knowledge is Power” and is broken up into “What to know and do before the baby arrives” and “What to know and do if PPD hits.”  The sole purpose of my book was to raise awareness so others would not go down that dark, lonely, hopeless road I traveled after having a baby.  There is so much covered in my book, that I laughingly refer to my book as “an encyclopedia” purely due to the girth (i.e., 429 pgs)….yes, I had a lot to say!  In fact, that’s how I referred to it when I posted to my Facebook page a pic of my books on the Postpartum Support International table at their annual conference I attended a few weeks ago in Philadelphia.   Following is an outline of how I wanted my book to educate readers.

Chapter 1: The Statistics: A Wake-up Call

Chapter 2: Sharing My PPD Experience

  • Insomnia Sets In
  • Next Came the Panic Attacks
  • The Dark Abyss

Chapter 3: Knowledge Is Power

  • What to Know and Do Before the Baby Arrives
  • What to Know and Do if PPD Hits

Chapter 4: Environment vs. Heredity, Nature vs. Nurture

  • Role of Genetics/Nature
  • Role of Environment/Nurture
  • Role of Reproductive Events
  • My Story: Environmental and Genetic Factors Wreaking Havoc on My Life
  • What You Can Do to Make a Difference for the Next Generation

Chapter 5: Know Your Risk: Risk Factors

  • Biological Factors
  • Psychological Factors
  • Social Factors
  • Infertility
  • Coming Up With a Prevention Plan

Chapter 6:  My Postpartum Period – Exhausting, Anxious, Uncertain

  • Interrupted Sleep/Sleep Deprivation
  • Startle/Moro Reflex
  • Colic
  • Nasty Eczema and Cradle Cap
  • My Hair Loss
  • Returning to Work

Chapter 7: Ignorance and Stigma: Barriers to Progress

  • The Stigma of PPD
  • Silo Approach to Health Care and Ignorance among Medical Community

Chapter 8: Those Darned Myths

  • Myth #1: Pregnancy Is Always a Smooth, Easy and Blissful Experience
  • Myth #2: Baby Blues Is the Same Thing As PPD
  • Myth #3: PPD Is a Make-Believe Illness
  • Myth #4: Loving Your Baby Means Never Taking a Break
  • Myth #5: Motherhood Is Instinctive and Can Be Handled Solo: The Supermom Myth
  • Myth #6: All Mothers Fall Instantly in Love with and Bond with Their Babies
  • Myth #7: Breast-feeding Is Instinctive

Chapter 9: Trend Away from Social Support

  • First Few Days at Home … Now What?
  • New Moms Need Nurturing Too
  • What Is Social Support?
  • Support of Husband
  • Other Sources of Support (in the U.S.)
  • Postpartum Practices in Other Cultures
  • Tips for Establishing a Support Network

 Chapter 10: Postpartum Depression 101

  • Defining Postpartum Depression
  • PPD Symptoms
  • Insomnia
  • The Spectrum of Perinatal Mood Disorders
  • Reproductive Hormones and Mood
  • The Brain, Neurotransmitters and Stress

Chapter 11: PPD Impacts the Whole Family

  • Effect of PPD on the Baby
  • Effect of PPD on the Dad/Husband

Chapter 12: Passing on Lessons Learned

  • Tips for the Dad/Husband
  • Tips for the Mom Regarding the Dad/Husband
  • Tips for Friends and Family

Chapter 13: Steps to Recovery and Wellness

  • Health-Care Practitioners
  • Treatment Options

Well, like I said, the goal of the book was to help others, but who wants to read an encyclopedia nowadays when you’ve got the Internet, lol…..guess you can say it’s the thought that counts.  Hopefully, folks are finding my posts because the intent of this blog post, as with all my other blog posts and my book, is to try to educate women and their loved ones (and even health professionals too) so they can know enough to advocate for themselves, much like the intent of the NPR article.   I am not doing this for me.  I’ve already survived PPD.  I’m doing it for those who do have access to the Internet, find my blog and read my posts to learn how to prevent/survive PPD.

Jumping back to the NPR article…..
It’s a link in the post that led me to a Wall Street Journal article titled “The Quest to Untangle Why Pregnancy Can Turn Deadly,” written by Daniela Hernandez about Kristin Terlezzi’s experience with placenta accreta.  This article contains the most info on the topic I’ve seen in all my years of blogging (since 2009). Kristin Terlezzi recently, along with Alisha Keller Berry and Jill Arnold (two other survivors of placenta accreta), established the National Accreta Foundation  in April 2017 to work towards reducing the incidences of placenta accreta by partnering with other federal, state and local organizations.

Another link in the article led to the ProPublica article “Do You Know Someone Who Died or Nearly Died in Childbirth? Help Us Investigate Maternal Health” published on February 10, 2017 by Adriana Gallardo and Nina Martin, which asks for those who know someone who died or nearly died in pregnancy, childbirth, or within a year after delivery to share their stories.  The hope is that this information can be used to help researchers come up with ways to reduce the occurrence of and deaths from placenta accreta.

The only problem with these articles on NPR and other similar media is that they are only accessible to those who read such articles in the first place.  As I’ve realized in these past few months since T took over as President and split the nation into two factions, there is a whole T-supporting, alternative facts supporting faction claiming everything but Breitbart, Fox News and now Trump TV as #fakenews.  So, how is this information going to reach everyone?  It’s not like these misogynistic media are going to share scientific articles dedicated to improving the experience of mothers, because all these media only care about is the fetus, the health/well-being of the mother be damned….but then again, I digress.  But I won’t apologize for raising this critical point.  It’s definitely food for thought as to how we can get this information to EVERYONE.