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

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

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

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

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

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

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

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

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

The following section is an excerpt from my book.

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

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

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

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

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

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

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

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

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

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

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

 

I Can Understand How the Despair from PPD Can Cause a Mother to Want to End Her Life

As a preface to this post, I’d like to share an excerpt from my book that reflects how the pain from postpartum depression (PPD) can fill a mother with so much despair and hopelessness–especially when she doesn’t know what is happening and why, and that there is a cure for whatever it was that is causing her to feel/behave/think the way she is feeling/behaving/thinking–that she would want to end her life.

One too many times, I gave Ed a miserable look and told him how scared I was that I didn’t know what was going on with me and I was afraid that I’d never get better. There would be tears in my eyes but I couldn’t cry. Most of the time, he didn’t know what to say. It was way after I had fully recovered from PPD that Ed finally admitted that he had feared I would never get well, never return to my old self, and never appreciate watching [our daughter] grow up.

Each day, I’d stand by a window, staring out at the snow and pleading for God to help me get through all this. I’d say over and over again, “Please, God, please help me get through this. My baby and husband need me … help me to be strong!” It was difficult for me to focus on any tasks. Often I’d sit there in the kitchen by myself or stand in the middle of a room, unsure of what to do next or not wanting to do anything at all. I felt like staying in bed all day long or in a tight ball hiding in a corner, rocking myself for comfort, but I couldn’t because I had to take care of [my baby]. During that time, I tried my best to interact with [my baby], to play with her, and talk to her.

…….. I thought I was never going to get better, I wasn’t going to be able to go back to work, and I wasn’t going to ever be well enough to take care of the baby. I just wanted to shrivel up into a tiny ball and disappear. I couldn’t bear the thought I was going to be like this for the rest of my life.

Although I never thought about actually ending my life, I constantly thought about disappearing because I just wanted all the misery to end.  And I most certainly couldn’t imagine staying in my PPD state for the rest of my life.  So it’s a good thing my PPD was cured when it was, as I’m not sure how much longer I would have lasted.  I have heard many other mothers who suffered from PPD that thought about disappearing as well.  I have also heard a few instances of mothers thinking about taking their own lives and/or actually attempting suicide.  Each time I hear these stories, it makes me feel more committed than ever to continue blogging and trying to reach people who are struggling with PPD.

I’ve been wanting to share a couple of important articles about suicide as the second leading cause of death for women in the postpartum period….one article is from last June and the other is from 3 months ago.

The one from 3 months ago (5/2/2018) was written by Catherine Pearson on Huffington Post titled “Suicide is a leading cause of suicide for new moms but awareness is low.”  The article focuses on the story of Kari who died by suicide back June 2010.  Kari’s sister, Karla, shared the story to try to educate other mothers on how deadly PPD can be. Like some of the other stories I’ve shared on this blog, Kari’s family was unaware of how bad her PPD was until it was too late.  Her family was getting her ready to move in with them to help her out until she felt better, but never had a chance to do so.   Within 4 weeks of giving birth, she died by suicide.  Her condition had quickly gone from giving birth to not being able to sleep (what happened to me) to feeling super anxious to wanting to harm herself.  The day before she was going to see a doctor about her condition, she died by suicide.

The one from last June (6/5/2017) was written by Gina Louis for Medium titled “The Night Postpartum Depression Almost Killed Me.” This is the story of a new mother who, after struggling with feelings of inadequacy and feeling a failure of a mother and wife that her children and husband would be better off without, she planned to take her own life one night.  She was going to let the dark hole of despair swallow her up.  But she thankfully didn’t carry it out that night.  She got help.  She is now, like me, a survivor speaking up and trying to help others realize that PPD can be overcome with the right help.  As my experience has made me feel stronger and more confident than before, her experience has made her feel stronger and more confident than before.

What Kari’s sister and Gina Louis are trying to do by sharing these stories is to educate folks on how deadly PPD can be and how quickly things can become deadly.  PPD is a serious condition that can lead to tragic consequences quickly.  If you or someone you know is suffering from PPD, please seek/get them to seek treatment asap.

For a country that is so advanced in medicine and technology, we must ask ourselves why American mothers don’t have enough access to, or education about, maternal mental health treatment and why American policy makers can’t do more to address the stubbornly high rates of pregnancy-related death and pregnancy-related suicides, which account for one in five postpartum deaths.

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline.
You can also text HOME to 741-741 for free, 
24-hour support from the Crisis Text Line.
Outside of the U.S., please 
visit the International Association for Suicide Prevention for a database of resources.

Dads Do Get PPD Too

I haven’t blogged about this important topic–of dads getting postpartum depression (PPD) too–since 2012, so it’s high time I do so now as I’m catching up during my stay-cation!

My previous posts are:
Fathers and Postpartum Depression
A Father’s Day Post: The Effect of PPD on the Dad
Shame on You, The Guardian, for Perpetuating Negative Notions on Mental Health Issues and Denigrating Men at the Same Time

In today’s post, I have a bunch of articles, and even a recent Today Show segment about PPD in dads, that I’d like to share.  PPD in dads is not a topic that you see much of because, after all, it’s the new mother whose body goes through a lot of physical changes before, during and after pregnancy.  After all, she’s the one who carries the child for months and after giving birth experiences roller coaster emotions, thanks to all the hormonal changes.  It’s bad enough that PPD is still so misunderstood (and what comes with lack of knowledge/understanding is stigma) in women, but the scoffing that men face when they find themselves suffering from PPD is even worse.

Men can and do experience depression after a child’s birth.  Risk factors include a personal history of depression, a wife that has PPD, a baby with health issues, colicky baby, first-time fatherhood and uncertainties due to inexperience, stress at work, etc. I personally know someone who experienced it briefly after the birth of his first daughter, and he was fortunately able to avoid it after his second daughter was born.

The Today Show that aired on August 3rd focused on the story of Dr. David Levine, a pediatrician who also happened to be a new father who suffered from PPD.  Dr. Levine, who talks about his experience with PPD, is accompanied by subject matter expert, Dr. Catherine Birndorf (psychiatrist and co-founder of The Motherhood Center) whom I’ve met previously at a Postpartum Support International conference, and Erika Cheng (assistant professor of pediatrics at Indiana University School of Medicine).

 

This is not, by the way, the first time the Today Show has focused on PPD in men.  On July 1, 2015, there was a very good article on it titled “Not just moms: postpartum depression affects 1 in 10 new fathers.” The article features the experience of Mark Williams, founder of  Fathers Reaching Out and Dads Matter UK.  The article also features information about PPD in fathers by subject matter expert Dr. Will Courtenay, who founded Postpartum Men.

On August 11, 2018, I spotted a CBC (Canada) article about PPD in men titled “New dads show signs of postpartum depression too, experts say.”

On May 19, 2017, I spotted a Deadspin article titled “A Q&A with Tony Reali About Postpartum Depression and Anxiety in Dads.” I know this article is a bit old….I have had this article up for the past 15 months!  I told you I had a lot of catching up to do!  Tony Reali is the host of ESPN’s Around the Horn.

 

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

and

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

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

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

 

A Must for All New Jersey Medical/Mental Maternal Healthcare Practitioners, Doulas, Midwives, etc.

After a two-month dry spell in posting on my blog due to lots going on at home and at work, here I am briefly to help spread the word for the Postpartum Support International 2-day training on November 15-16, 2018 in Fort Lee, New Jersey:  Perinatal Mood Disorders: Components of Care. 

Led by PSI’s very own Birdie Gunyon Meyer, RN, MA (whom I’ve known since I became a member in 2006), Lisa Tremayne, RN, CPPD, CBC, and Joanna Cole, PHD, it is a critical training intended not just for mental health care practitioners but anyone and everyone who would ever need to care for an expectant or new mother.  That includes obstetricians/gynecologists, general practitioners, pediatricians, doulas, midwives, nurses, ER doctors and their staff, etc.

You can visit the site that goes over the training objectives, location, and cost via the above link, but the training will cover the basics in identifying/treating perinatal mood and anxiety disorders (PMADs)–which include antepartum depression, postpartum depression, postpartum anxiety, postpartum panic disorder, postpartum OCD, postpartum PTSD, and postpartum psychosis–as well as understanding risk factors, treatment options, breastfeeding, consequences of untreated conditions, impact on loved ones, importance of social support, cultural differences, spirituality, etc.

Please attend and/or help spread the word about this training.  It is so, so critical that we ensure as many people as possible are trained so that fewer mothers suffer unnecessarily (like I did) and even worse, fall through the cracks and become another tragic outcome of a perinatal mood disorder.

 

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

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

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

At Darling Harbour, Sydney (2014)

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

Professionals:

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

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

Parents:

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

 

 

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

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

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

If you qualify and decide to participate:

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

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

In the Wake of the Recent Celebrity Suicides of Kate Spade and Anthony Bourdain

I am shaken by the suicides of Anthony Bourdain and Kate Spade.  Very shaken.  Although I was never much of a fan of Kate Spade’s hand bags, shoes, clothing and jewelry, I was a pretty big fan of Anthony Bourdain’s for the simple fact that he brought very different people together around the world through an appreciation, respect, and curiosity of the vast array of cuisines and cultures.

These very successful individuals that you never once heard had any issues with depression or other mental health issues are suddenly taking their own lives.  I’ve seen comments that there are so many veteran suicides each day.  Don’t they matter?  Well, everyone matters……

Veterans matter.
Celebrities matter.
Mothers matter.
Fathers matter.
Young people matter.
Old people matter.

Why are we making such a big deal out of these celebrities?  For one, you see them on television, in newspapers, on the news, etc.  When you see them, do you ever see them depressed?  Unhappy?  Nope.  Do you ever hear about them being depressed?  Unhappy?  In Kate’s and Anthony’s situations, I do not believe there has ever been any mention of any struggles with depression.  I truly hope that the good that comes from these recent, high profile suicides that took place one after another–all in less than a week’s time–is a greater understanding that you can’t base the well-being of a person on looks, societal status, race, and religion alone.  People may have a history of mental illness and you would never know by looking at them.

Poor people have mental health issues.
Rich people have mental health issues.
Outgoing people have mental health issues.
Shy people have mental health issues.
Self confident people have mental health issues.
People lacking self confidence have mental health issues.
People of every race have mental health issues.
People of every religion have mental health issues.
[Don’t kid yourself if you believe the above statements are not true.]

The other thing I keep seeing is something that totally pisses me off.  People bad-mouthing the deceased with “Suicide is selfish.”  How the heck would you even know what they were going through?  They could have been battling so much pain for so many years, but how would you know?  Tell me, because I would love to know.  Are you like an alien and can take over the person’s body so you can know exactly how that person is feeling?  This reminds me of a previous post that I want to bring up again here.  All it takes is one day for you to know the extent of suffering that a person experiences.  I wish the haters and people passing judgment could walk in the shoes of a person battling bipolar disorder, PTSD, and depression.  After you go through that experience, then let’s talk.  Until then….SHUT. UP.

What’s truly behind the surface can only be determined if we sit down and spend time with them.  So, think about your circle of friends–not all thousand people that may be in your FB circle cuz, let’s face it, not everyone in that circle is truly a friend–and create a list of people you haven’t spoken to, heard from and/or seen in a while.  And arrange to meet them over a meal, and if not a meal, then coffee.  Or invite them over to your house.  Or visit them at their home.  Whatever you do should facilitate a conversation.  A real conversation.  A good ol’ fashioned in-person chat.  No social media.  No texting.  No emails.   The way it was in the good ol’ days before all this “social media” got in the way of forging true relationships.  That’s what we need more of.

Which brings me to this….as it seems society has degenerated thanks to social media that we now need people to create places like Sip of Hope, just to have a place where people can (truly) talk.

I saw a video on my Facebook feed, posted by a Facebook page called Well-Rounded Life a couple days ago about the brand new  coffee shop, Sip of Hope, that opened  at Logan Square, Chicago, last month during mental health awareness month.  Sip of Hope is run by Hope for the Day, founded by Jonny Boucher.  Here’s the link to the Chicago Tribune article that talks about what the coffee shop hopes to accomplish.  Hope for the Day is a Chicago not for profit that aims to raise awareness around suicide prevention and mental illness.  All proceeds will go to Hope for the Day.  It presents a unique approach of opening up a coffee shop for the purpose of allowing people to come in and talk, as well as eliminate stigma of mental health issues.  Baristas double as mental health aides.  There are pamphlets/flyers containing info on local mental health resources.

Good on ya, Jonny Boucher, for coming up with this idea and having it come true.  I sincerely hope this coffee shop stays open for a very long time, and other Sip of Hopes will open across the country until every major city has one!

Below is the video that was on CBS News before the grand opening:

 

Go See Tully, and Let’s Talk

Just a quick post tonight with a movie review of “Tully” written by a friend of mine, Mrs. W.

Initially, Mrs. W was annoyed like I was about the movie’s apparent failures based on a couple of negative movie reviews she and I both read this past weekend.  Like me, she did not want to see the movie.  That is, until I sent her the review from a postpartum psychosis survivor, Melissa Bangs, who happens to be the star of her own one-woman show “Playing Monopoly with God” that’s been on tour for the past couple of years and is headed to New York City next week!  Reading this positive review of someone who is a PPP survivor peaked Mrs. W’s interest, and so she went to see “Tully” yesterday.  Please take a moment to read Melissa’s personal thoughts from the perspective of an actual PPP survivor!

Without further ado, here’s Mrs. W’s movie review:

“Ok. So I saw it tonight………….

  1. There are a couple triggering scenes.  One of them was in the first half of the movie, which almost caused me to leave because my whole body got amped up like I was going to have an anxiety attack.  But I calmed myself down and was able to sit through the last half of the movie, which was less emotionally jarring.
  2. I don’t want to spoil the movie, but I will say that the main character definitely has postpartum psychosis but no one ever says it outright.  There are a few things said (like when her husband told the doc she was depressed with their second child) that might mislead people to think she has postpartum depression (PPD), but I think the movie left out the actual diagnosis on purpose because it wants the audience to figure it out on their own.  However, I do think the movie shines a light on postpartum mental health and how a struggling mother could slip through the cracks …to the point that even a husband who doesn’t pay close attention would fail to notice his wife’s condition.
  3. It is a shame that the doctor in the movie doesn’t say it outright that she has PPP.  It was definitely a missed opportunity to shed light on the subject no one talks about.
  4. Also, Charlize Theron played the heck out of that role.”

Hmmmm, it’s interesting that Mrs. W thinks the film makers deliberately left out the diagnosis of PPP to cause the audience to want to figure it out on their own.  I, on the other hand, don’t have such an optimistic perspective and in this case would not give the film makers such credit for the reasons stated in my blog post about Tully.  What the movie and the subsequent posts on social media has done, at least in the maternal mental health circle, is promote discussion about maternal mental health.  But that’s within the already existing circles of advocates, mental healthcare practitioners, and survivors.  I haven’t really heard much about discussions going on among the general public, which is why first and foremost we must capture the proper message about maternal mental health conditions (and bust stigmas associated with them) to educate people, share widely and DISCUSS!  THIS is why I am still annoyed about the lost opportunity to educate the public.  The film makers could have easily inserted a diagnosis into the screenplay.  But they didn’t.

Anyway, the whole point of this post is to weigh different perspectives and not let a couple of negative movie reviews completely shut off all interest in seeing a movie.  Just as Mrs. W had done, she started out with an opinion that was formed based on a couple of negative reviews of people (not really clear if they themselves were PPD or PPP survivors) who did see the movie.  Because of these negative reviews, she was annoyed and had zero interest in seeing the movie.  After I showed her Melissa’s review, she went to see it and was able to form her own opinion after seeing it.  Then she shared with me her thoughts about the movie.

Mrs. W did confirm that the movie:

  1. Puts a light on maternal mental health in terms of mothers’ struggles being real and women like Tully falling through the cracks due to lack of awareness and lack of support from significant others and loved ones.  Motherhood is not easy.  A mother who is struggling will fall through the cracks if she doesn’t get the help she needs.  New mothers need practical/emotional help during the first couple of months.  Forget about the whole supermom thing.
  2. Falls short in raising awareness that postpartum mood disorders are experienced by 1 out of 7 mothers and definitely not anything to be ashamed of.  They are very real, serious, painful to experience, and life-changing.

And yes, Charlize Theron plays the heck out of ANY role she plays.  But for me, even if Charlize earns an Oscar nom, I still can’t set aside my annoyance (that I blogged about previously) to see it.  As a person of principle, I would not want to pay even $1 to watch a movie that fails an opportunity to educate the population properly by sending unclear signals on the condition Tully really suffered from.  To each his/her own, as they say…..

 

World Maternal Mental Health Day: May 2, 2018

With just a few minutes left to World Maternal Mental Health Day, I wanted to do check one more thing off my TO DO list: Taking a picture with The Blue Dot Project sign with a very important message on it to do my part in spreading awareness about the statistics (1 in 7 new moms), common symptoms, who to call for support/where to find resources & info (Postpartum Support International or PSI), a positive message (the PSI mantra: You’re not alone, this is not your fault, you will get better with the right treatment), and the hashtag #RocktheBlueDot.

 

 

 

 

 

 

 

Earlier in the week, I did the whole Twibbon thing with the #WorldMMHDay on social media, I have been sharing the daily Facebook posts of The Blue Dot Project on both my personal and my author page, and I figured I would wrap up today with this blog post.

With May as Maternal Mental Health Month, keep your eyes open for all sorts of social media campaigns, fundraisers, news articles, and blog posts.  The wealth of information is satisfying to see, as it is 100 times–to say the very least–more than what I had when I found myself stuck all alone and scared on the very difficult postpartum depression (PPD) path I found myself forced to take over 13 years ago!   We need to keep the public awareness going to continue to chip away at the stigma and ignorance that still prevent moms suffering from PPD (and their loved ones) from knowing what to look out for, knowing how to get help, having all medical/mental healthcare professionals that work with moms knowing how to detect/diagnose/refer moms who need help.

Please, please, please do your part to spread awareness.

Click here to find out how you can take your very own #RocktheBlueDot picture with your own message, and share it with the ladies over at The Blue Dot Project so they can share it on their end as well.

Share Postpartum Support International, The Blue Dot Project, and posts by other maternal mental health organizations across the globe.

Join the movement!

 

Recent PPD Successes and Failures in the Media

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

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

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

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

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

Free Webinar: Bringing Light to Postpartum Depression and PMAD

ATTENTION:
OB/GYNs and their staff, general/family practitioners, therapists, social workers – basically, everyone who would ever treat a new mother. Also, new/expectant mothers and their loved ones!

Once again, I’m piggybacking off of my last 2 posts about the Postpartum Resource Center of New York by sharing this great opportunity I learned from this post I just spotted on my Facebook feed for all who care for / about new mothers and their postpartum well being to learn about PMADs, treatments, resources, and how loved ones can help.

PMADs are experienced by 1 in 5 mothers.  What better way to spread awareness than this FREE webinar!  We need more of these opportunities to combat stigma and ensure as many people are educated as possible, as there are still way too many people whose job it is to care for mothers that don’t accurately identify PMADs and get them the help they need.  With more awareness, we will chip away at stigma.  We will ensure fewer mothers suffer alone and in silence.  We will ensure fewer mothers and children suffer the consequences of undiagnosed/untreated PMADs.

When:  Wednesday, May 2, 2018 from 8:00pm – 9:00 pm
Who:  Sonia Murdock (Exec. Director of the Postpartum Resource Center of New York) and Bridget Croteau (St. Joseph’s College NY alumna; Mrs. Suffolk County America 2017-18)
Cost:  It’s absolutely free, and open to the public!
Registration:  Click here to sign up. If you can’t make it to the live session, no problem!  You can access a recording, provided you register.
For more info:  Contact Taryn Kutujian at tkutujian@sjcny.edu

Please spread the word about this!  Share WIDELY on social media!

 

Sounds of Silence 10th Annual Run/Walk – May 12, 2018

Piggybacking off my last post from 4 days ago in which I blogged about the Lisa Mary Reilly Visioning Education Series, today I would like to invite folks who live in the Tri-State area to join the Sounds of Silence, Friends of the Postpartum Resource Center of New York’s 10th annual run/walk in memory and celebration of Lisa Mary Reilly and help raise funds in the effort to increase awareness of perinatal mood disorders, such as postpartum depression (PPD), postpartum OCD, and postpartum psychosis.  Not only is this for an excellent cause, it will be a nice opportunity to race (or walk) a beautiful 5K boardwalk along the Atlantic Ocean.

I have posted about this annual run/walk every year since the first fundraiser back in 2009.  That year, I was one of the two top fundraisers, bringing in over $1,000 (as an individual).  This annual fundraiser was started back in 2009 by sisters Erin Mascaro and Lisa Reilly. It was Lisa’s experience with PPD after the birth of her daughter–an experience so deeply painful and full of suffering (a suffering that many others like her feel forced to endure in silence) that was witnessed by Erin and other loved ones–that motivated Erin and Lisa to break the silence of PPD with the Sounds of Silence annual run/walk .

Please help spread the word about this fundraiser by blogging or sharing the flyer on Facebook/Twitter.

Sponsors Needed:  They are looking for sponsors, so companies looking for opportunities to support a wonderful cause that benefits mothers and their families should seriously consider this opportunity!  Click here for more info.

Date:  Saturday, May 12, 2018

Time:  Registration from 8:00-9:00; race/walk begins at 9:30 AM.  There will be a Kids Fun Run, Raffles, Food and more.

Place:   Jones Beach State Park, Wantagh, Long Island (Field 5)

Registration:  $25 (adults); $15 (ages 11-18); $5 (ages 10 and under); register here.  Registration price increases after May 5th.

Virtual Participation:  For those of you who can’t make it in person, you can participate virtually by registering via this link.

What first 250 entrants and first 500 registrants will receive:  First 250 entrants will receive commemorative t-shirts, and first 500 registrants (on day of) will receive race swag bags.  There will be a post-race raffle for prizes that include gift baskets, gift certificates, etc.  All who raise $200+ will receive a Sounds of Silence beach towel.

50/50 Fundraiser:  For the first time, there will be a 50/50 Fundraiser to benefit the Postpartum Resource Center of New York.  The drawing will take place during the After Party at Fatfish Wine Bar and Bistro, Bay Shore, NY.  Only 300 raffle tickets will be sold.   All proceeds from this raffle will be shared equally between the winner of each prize and the Postpartum Resource Center of New York, Inc.  Click here for more info. 

All proceeds will go towards supporting the important services the Postpartum Resource Center of New York, Inc., a 501(c)3 non-profit organization (tax ID #11-3449880), provides to new mothers and their families.  To learn more about its services, go to:  http://postpartumny.org.

Traumatic Childbirth: The Ever-Widening Ripple Effect

Piggybacking off of my last blog post “Mother May I?” – An Important Documentary About Childbirth Trauma 2 days ago, I wanted to make folks aware about a childbirth-trauma-related event that I spotted on my Facebook feed today.

LMR Visioning Educational Series 2017

Sonia Murdoch, Jane Honikman, and me

The Lisa Mary Reilly Visioning Educational Series hosts an annual event in collaboration with the Postpartum Resource Center of New York.  Last year, I attended the event that took place in Manhattan and featured Jane Honikman, founder of Postpartum Support International.

This year’s event will be co-hosted by The Rochester Postpartum Wellness Coalition and will take place on Thursday, May 3, 2018, from 11:00 am-2:00 pm, at the Rochester Academy of Medicine, Rochester, NY.  The guest speaker of this event will be Cheryl Tatano Beck, DNSc, CNM, FAAN. She a Distinguished Professor at the University of Connecticut School of Nursing.  Dr. Beck serves on the editorial boards of 4 journals and has published over 150 scientific articles as well as 4 books.  The title of her presentation is Traumatic Childbirth: The Ever Widening Ripple Effect.   Click here to find out more about the event and to buy tickets, which are $50 each and includes lunch.

My wish is for every medical professional that treats mothers–from OB/GYN doctors and their staff to maternity ward staff, emergency room staff, midwives, doulas, and family doctors/general practitioners, as well as mental healthcare practitioners–were required to take this kind of training regardless of where they are located. This means this kind of training should be replicated and hosted in every major city in every state.  Until then, we are going to continue to have medical/mental healthcare professionals fail to realize the connection between traumatic childbirth and postpartum mood disorders.

We need to emphasize the importance of care for mothers just as much as people emphasize the importance of care for babies.  As I’ve said before, it just seems so obvious that, once a mother gives birth to a baby, all the attention goes to the baby and its care and the mother falls by the wayside.  Hello, she just carried a child for 9 months and had to give birth! Her body goes through extreme physical changes, including hormonal upheaval.   Any complications that occur during childbirth can increase the chance of a postpartum mood disorder to occur.  The ONLY view that matters on how a childbirth went should be is the new mother’s view on her childbirth experience.  If she feels like it was a God-awful experience, we need to respect, acknowledge and try to understand her feelings.  We should never pooh pooh her experience.  We should never assume her feelings are what you think they ought to be.  A new mother’s experience is her experience, period.

Let’s care more about how a mother views her childbirth experiences.
Let’s care about the kind of care she receives during childbirth.
Let’s care about how she envisions her childbirth to go.
Let’s care about how she feels about breastfeeding.
Let’s care about how anxious she feels about taking care of the baby.
Let’s care about her enough that when she seems to not be herself, we get her the help she needs.
Let’s care enough to realize that about 20% of new mothers experience a postpartum mood disorder that usually starts within the first 4-6 weeks postpartum but can happen up to a year and may be triggered by weaning.
Let’s care about her feelings, bottom line.

 

 

 

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

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

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

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

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

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

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

 

Playing Monopoly with God – New York City Performances!

I am super excited to share the news that “Playing Monopoly With God” is coming to New York City! (Unfortunately, I won’t be able to make it due to prior commitments).

“Playing Monopoly With God” is an amazing, one-woman play.  Melissa Bangs is the talented and passionate actress behind this play.

Her mission is to share her experience and in so doing, spread awareness on what it’s like to be one of the 20% of new mothers who suffer from postpartum mood disorders and encourage mothers to share their experiences.

Melissa has been touring for 4 years putting on 37 shows—including sold-out shows in Seattle and Los Angeles– reaching nearly 5000 people

♦♦♦♦♦♦♦♦♦♦♦♦♦

Postpartum Support International presents:

Playing Monopoly with God & Other True Stories
Hilarious. Heart-wrenching. Human. 
A true tale of childbirth, madness and the journey home.
LIVE. NONFICTION. STORYTELLING. PERFORMANCE.
 
TICKETS ON SALE NOW!!! MAY 17th – 20th

Evening
 Performances – 6PM Doors – 7PM Performance
THE RATTLESTICK THEATRE @ 224 Waverly Place, New York, New York
Thursday, May 17th – Live Performance followed by a PSI Gala Event at Bobo NYC ($175)
Friday, May 18th – Live Performance w Wine, Cheese and Panel Discussion ($75)
Saturday, May 19th – Live Performance (also to be webcast) ($45 in-person)
and a Mimosa Matinee…
Sunday, May 20th – 1PM Doors/2PM Show ($45)
 
In September 2012, at 40 years old, Melissa Bangs gave birth to her beautiful daughter Adelaide.  A month later, dramatically hormone depleted and sleep deprived, Melissa is admitted to the Providence Psychiatric Facilities in a complete manic state.  After nearly a month, she is sent home with a bipolar diagnosis and on lithium.  What comes next is an extraordinary journey.
 
On her path back to wholeness, one of the things Bangs did was read her entire 100 plus page hospital record.  Somewhere, around page 87, there is a nurse’s note that looks as if it were scribbled late at night after a long shift.  It reads, “Patient says she will do comedy on this experience.”  Upon reading this, Bangs laughed out loud.  
 
The psych team couldn’t have possibly known that Bangs has been a storyteller her entire life and did comedy for a stint, as a student, at the Upright Citizens’ Brigade in New York City.  They couldn’t have known that transforming details from the most painful experience of her life into a room full of laughter would prove healing for so many.
 

Join Postpartum Support International for an evening of storytelling full of bewilderment, chaos and hilarity.  Bangs has a knack for telling true stories that cut to the bone of our shared, vulnerable human condition. Her true gift, however, comes in the moments in which she’s able to strip away the shame or agony of an experience and transform the room into an uproar of laughter.

Postpartum Pain – by Stacy M.

Thank you, Stacy, for once again sharing your gift of poetry on my blog.

Just eight months old
Lost and confused
Mommy had to go

As tears flowed
From tired eyes
I drove

Clenched the wheel
Held on tight
The most important
Ride of my life

Surrendered all my
Postpartum pain
I told them all
To please go on
Without me

I just couldn’t
Breathe
Or eat
Or see
Anything
In front of me
I felt like
Disappearing

I wasn’t sure
If I could go on
I was drifting
So far
And sinking
So fast

Fearing
Everything
And everyone
Blindsided
By the panic
And the pain
I thought for sure
The old me
Was gone
Long gone and
For good

All the fear
Abruptly
Turned my world
Pitch black

I wasn’t sure
If I could
Ever find
My way back
Or my old self
I was desperate
For help

Postpartum pain
Makes you lose
Your way
And your grip
Makes reality
Start to slip

It can rob you
Of your dreams
It’s deceiving
Gets you believing
That nobody
Not even yourself
Or your new baby
Or this life
Needs you

In all the darkness
That surrounded me
I was a tiny shadow
Of myself
Not even

Did anyone see
I was not okay
Did I really hide it
All too well
Who was in denial more
Me or my community
Why do we pretend
It will never make
Any sense

Just those few years ago
I stood at the edge
Ready to give up
The fight
Of a life I worked
So hard for
I had a home
With a husband
And children I adore
In a moment
I could have lost it all

My knees were buckling
In a flash I suddenly
Could not understand
What it was I was living for

Prisoner of my own mind
Paranoid of the judgment
Overwhelmed
Run down
Unsteady from
The incision that
Still felt so raw
Stitches barely
Holding me together
The healing felt like
Forever

Postpartum pain
Postpartum pain

Oh how thankful
Of where we are now
My little girl sleeping on me
All snugly and sound
As I still pick up all the pieces
Of that horrific transition

Postpartum pain
Postpartum pain

Will make you never the same

Postpartum Depression Doesn’t Look the Same Across the Board

I always try to keep up with the multitude of articles that feature Karen Kleiman, MSW, LCSW, founder of The Postpartum Stress Center and author of numerous books on perinatal mood disorders.  This particular article from October 4, 2017, titled “Postpartum Depression May Look More Like Anxiety Than Sadness” that appeared on Well and Good, by Annaliese Griffin,  caught my attention.  It caught my attention because it’s because when my doctor told me 13 years ago that I had postpartum depression (PPD), I didn’t believe him.  I thought “How could I be depressed if I’m not even sad?”  He explained that depression could manifest as anxiety, but did I understand that at the time?  Nope. Little did I know that I was about to embark on a journey to discovering what PPD really was….that it’s a catch-all term that encompasses all postpartum mood disorders, which includes postpartum anxiety, postpartum OCD, and postpartum psychosis.  That my PPD caused insomnia, weight loss, loss of appetite, and being a shell of a person unable to enjoy anything, and unable to pretty much do anything.  I was so concerned about my baby’s cradle cap and eczema and her bowel movement/feeding schedules that, by the time her colic came and went at my 6th week postpartum, PPD set in and I had no idea what was happening to me.

This article is very important because the number of women suffering from postpartum mood and anxiety disorders (PMADs) is pretty common.  And I should know because of the number of hits I get on my blog for the symptoms that I experienced.  So, if it’s been over 3-4 weeks since you had your baby and if you are feeling anxious, unable to sleep even when the baby sleeps and unable to function and enjoy things you’re normally able to enjoy (like listening to music), having moments of rage, having panic attacks, and/or having obsessive and even scary thoughts, please go the Postpartum Support International (PSI) website to seek help near you.  You are not alone, there is nothing to feel ashamed of, and you will get better with the right help.  Do not be afraid to ask for and accept help.

Jessica Porten’s story went viral a week ago because she admitted to the nurse at her OB/GYN office that she was experiencing feelings of anger, and that admission was unfortunately not handled correctly.  This, my friends, is why I have been blogging for the past nearly 9 years.  My mission is to help spread awareness and in so doing dissipate the stubborn stigma that refuses to go away because there is still so much ignorance about PPD.  My mission is to also help mothers as much as I can to get the help they need.  Anger/rage is another way that PPD can manifest for some mothers.  Everyone’s PPD experience is unique to that person because we are all complex people that– when emotions, temperaments, hormones, heredity, childbirth experience, and history come together–symptoms manifest differently from one person to the next.  Symptoms can range from feelings of sadness to anxiety, anger and even rage to insomnia, sleeping too much, lack of appetite, eating too much, obsessive/intrusive thoughts, etc.  As such, treatment of these moms will vary from one mother to the next.  Some moms need medication. Some moms need therapy.  Some moms need a combination of medication and therapy.  The duration of treatment will vary as well.  But there is one thing in common among all mothers suffering from PPD:  they need help.  They don’t need to be treated the way Jessica Porten was treated.  They don’t need to be treated like I was treated 13 years ago.

Erica Chidi Cohen, a doula and co-founder and CEO of  Loom in Los Angeles attributes postpartum anxiety to first-time mothers feeling uncertain and anxious about going through childbirth and taking care of a baby for the first time. It is more common than you think for first-time mother to feel anxious but when the anxiety morphs beyond worry to insomnia, lack of appetite, etc. is when medical attention is needed.  A traumatic childbirth experience increases the chances for a new mother to experience PPD.

Click here to visit Kleiman’s The Postpartum Pact. It is an important postpartum toolkit for expectant mothers and their partners and loved ones to review before baby’s arrival.  It truly pays to be prepared, regardless of whether you think you may be at risk for PPD or not.  One never knows, as I have said in prior blog posts and in my book, whether something may happen during pregnancy/childbirth that could lead to PPD.  It can’t hurt to review the pact and prepare to have folks lined up to help once baby arrives to ensure the new mother has adequate practical support, especially if this is her first baby or if she has another little one(s) to take care of already.

Speaking of adequate support, it’s organizations like Loom in Los Angeles and Whole Mother Village  in W. Orange, NJ — two examples of many childbirth, pregnancy, and reproductive wellness communities that have sprouted around the country to provide support, information, referrals and services from preconception to parenthood– that are critical because it takes a village when it comes to a family’s well-being.  Going it alone is not a viable option nowadays, especially when the significant other needs to work to support the family and the new mother is not well and family members are not close by and/or are too busy to provide emotional and practical support.  It really is no wonder there are so many cases of PPD.  Please see my past posts about the importance of mothering the mother and how it takes a village to minimize the occurrence of PPD here and here.

 

 

Is This the Way A Doctor’s Office Should Treat a New Mom with PPD? Heck No!

Before you read this post, please read this: 
If either you or a loved one gave birth in the last few weeks or months and you are having problems with insomnia, don’t feel like yourself, experiencing a great deal of anxiety and/or rage and/or are scary thoughts, please call Postpartum Support International (PSI) at 800-944-4773 where trained individuals (many of whom are survivors themselves) will listen to you and connect you with informed providers.

Note that the story you are about to read is an example of what may happen if you and your loved ones are not informed about mood disorders that occur during pregnancy and after childbirth, and your OB/GYN and staff are not properly trained to detect, diagnose, treat and/or refer patients with perinatal mood disorders.  It does not mean that the same thing will happen to you.  If you have any concerns about your own situation, please leave me a message and I will get back to you asap.  Or give that PSI number a call.

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This is the Facebook post that went viral right after it was posted this past Friday, January 19, 2018. Instead of taking legal action (which I most certainly would have done), Jessica is paying it forward by sharing her story so the public can see how broken the healthcare system is when it comes to postpartum care for new mothers.  She also turned down the numerous offers for help she has received since her post went viral and instead asks that everyone who has reached out to her offer their service for a woman of color.

Following is her experience in a nutshell.

  1. Usually, new moms have their first postpartum visit with their OB at 6 weeks. Her first appointment wasn’t scheduled until the 3rd Her OB kept cancelling her appointments for a month, so by the time she went she was 4 months postpartum. That’s not good.
  2. At the doctor’s office, Jessica told the nurse practitioner that she had postpartum depression, which included fits of anger and violent thoughts. She also said she wanted to discuss medication options, needed medication and therapy to get through this, had a strong support system at home, and she would never hurt herself or her baby.  If she’d spoken to me or anyone with experience diagnosing and treating PPD, I would think “Okay, this is a woman who is informed and knows what she is talking about. I have no reason to doubt that she knows what she’s saying, so I will have the doctor see her now so they can talk about treatment options and/or referral to someone experienced with treating PPD.”
  3. But instead of telling the doctor so he could properly assess her condition and discuss treatment and/or referral options, they called the police! In exchange for her honesty and being knowledgeable enough about PPD to advocate for herself, she was treated like a criminal!   A grueling 10-hour ordeal ensued, with her infant in tow.  No medication. Never once speaking with a doctor. No follow-up appointment. She drove with her baby to the ER with 2 police cars escorting them. They took her blood and she had to give a urine sample.  A security guard stood guard.  She had to remove all her clothes, which they took away and locked up.

Like Jessica, I would want to effect change but I would want to give the nurse practitioner and doctor a piece of my mind.  I would’ve been so pissed by this overreaction to a mother knowledgeably informing her doctor’s office of her PPD and the ensuing humiliating experience that ensued, plus I don’t forget bad experiences that easily and who would?  When a mother is suffering from PPD, she is already in an emotionally vulnerable state and this kind overreaction can be the tip of an already unstable iceberg.

Everyone who comes in contact with new mothers should ABSOLUTELY be trained to recognize symptoms of a perinatal mood disorder, to understand that a new mother with a perinatal mood disorder needs support and treatment.  This would apply to nurses, OB/GYNs, general practitioners, pediatricians, doulas, and midwives.  At this point, there shouldn’t be a single OB/GYN doctor and nurse that doesn’t know how to recognize symptoms of a perinatal mood disorder and either treat her or refer her right away to someone who can.  This kind of training should not be optional.   IT MUST BE MANDATORY….i.e., you can’t practice as an OB/GYN doctor or nurse without the mandatory training that Postpartum Support International offers. Let’s advocate for change at the American College of Obstetrics and Gynecology (ACOG) and American Board of Obstetrics and Gynecology (ABOG) level, as I’ve been saying for years.

At the end of her post, Jessica proposes crowd sourcing as a way of coming up with solutions to fix this broken healthcare system. She poses very thoughtful and key questions that should prompt immediate discussions among everyone who has anything to do with maternal mental health (e.g., advocates, mental healthcare practitioners, doctors, nurses).  These are her questions, which I’m putting here to help get the word out, as not everyone is on Facebook.

  • Why is the way I was treated standard procedure?
  • What can we do to improve standard procedures for all postpartum mothers, but also specifically those at higher risk for developing PPD and presenting with signs of PPD.
  • Who is most qualified to make suggestions for improvements?
  • Who is actually capable of making the changes to standard procedures, and how can we can contact them?
  • Why was I let go, when so many others would have been put on a mandatory 72 hour psychiatric hold, and had their children taken away?
  • Why do a disproportionate number of women of color who have PPD not receive the services they need, even when they initiate treatment?
  • Why are a disproportionate number of women of color who have PPD misdiagnosed?
  • Why are black women half as likely to receive mental health treatment and counseling as white women?
  • What can we do as a community to lift up our marginalized members and make sure they receive the quality care that we ALL have a right to?!?

I am hopeful that we will make some headway, since this post has gone viral as she’d hope it would be.  I am already hearing that advocacy groups like 2020Mom reach out to Jessica, who is going to join 2020Mom in a rally in Sacramento, California state capital, which just so happens to be where Jessica’s story took place.  2020Mom is in the process of introducing 4 bills in California.

I have previously shared how my PPD experience was a critical steppingstone to becoming the person I am today, and do not regret it except for the time that I lost during the weeks I was not myself. My PPD experience changed the course of my life.  I believe I had PPD for a reason, as it has given me the courage to speak up, blog, publish a book, and change my career path.

I somehow get this feeling that Jessica’s PPD experience is a steppingstone to advocacy and change when it comes to maternal mental health matters.  I am pretty sure this is just the beginning of her involvement in maternal mental health advocacy.

Thank you, Jessica, for sharing your experience!

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Update to post: 
Jessica Porten’s story has gone viral and made it into various news media, which is what I’d hoped would happen.  The more ways her story gets shared, the more people she reaches (including folks in the medical field). Here are just some of the places her story has popped up:

Sacramento CBS news: “Mom Shocked After Doctor’s Visit For Postpartum Depression Leads To Police Escort To ER” by Steve Large.

NowThis Her video

Medium: “Address Postpartum Depression with Training and Treatment, Not Police” by Ann Smith, current President of PSI.

Slate: “She Asked for Help for Postpartum Depression. The Nurse Called the Cops.” by Darby Saxbe.

Upworthy: “A mom told her OB she might have postpartum depression. Then they called the cops.” by Evan Porter.

Romper: “This Mom Had The Cops Called On Her After Seeking Help For PPD, & Her Story Is A Must-Read” by Karen Fratti.

Romper: “Why Are We Letting Our Mothers Die?” A Conversation About Postpartum Treatment” by Ashley Stoney.

Research4Moms: “No More Excuses: Providers Are Accountable for Their Lack of Knowledge About Moms’ Mental Health” by Shannon Hennig.

Dearly: “Mom Says She Needs Help for Postpartum Depression. Nurse Leaves the Room…to Call the Police” by Prudence Hill.

Huffpo Canada: “A Mom With Postpartum Depression Asked For Help. Her Nurse Called The Cops” by Patricia Tomasi.

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.