A PPD/PPA Survivor’s Experience During the Coronavirus Outbreak

A brief note from Ivy:

Ever since the whole coronavirus thing started impacting us here in the U.S., I’ve been starting my emails and calls to friends, colleagues and clients with “I hope you are doing well.”

For those who read this post, I hope you ARE doing well.  The past couple of weeks have been a period of great uncertainty and adjustment for all of us.  I’ve been trying very hard to go with the flow and not to be overly anxious about what’s going on and the fear that I and members of my family would fall ill with the coronavirus.

It is normal to be anxious.  During this period of uncertainty and anxiety, remember to use your coping skills.  Breathe, listen to music, read a book, connect with people via Facetime, Zoom, Facebook, or any of the other numerous apps out there.  Even churches have been holding online services.

If you are struggling, visit this site to learn some things you can do to take care of your mental health in the face of uncertainty.  You may also call the national Disaster Distress Helpline ( 24/7) at 800-985-5990 for emotional support and crisis counseling if you are experiencing distress or other mental health concerns.  Calls are answered by trained counselors who will listen to your concerns, explore coping and other available supports, and offer referrals to community resources for follow-up care and support.

If you are a new or expectant mom or even a mom who has had a postpartum mood disorder in the past, you know you can rely on the support of Postpartum Support International volunteers and staff to support you if you are feeling anxious. PSI provides support to mothers and their families every day via 800-944-4773 or text 503-894-9453 (Eng) or 971-420-0294 (Español). Additionally, PSI’s free online support groups meet every Tuesday (and now every Thursday as well).  Meet other moms virtually, share your story, build a community and hang out with other moms! Find info on timings and register here.  Please also like the PSI Facebook page for daily updates, including changes to frequency of online support groups.

Stay healthy and safe.

Warmly,
Ivy

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And here is my friend Stacy M’s experience during the coronavirus situation:

Tonight G said something that stopped me in my tracks. I’ve worried so much about regression with him.

At dinner, he announced:”You know I used to do this funny thing where I lined up all my animals on the steps all the time and it was so weird. I don’t know why I would do such a thing.”

I have tons of pictures on our iCloud when he would stim and line his dolls up in his own special way.  We never interfered with what he was doing and just let him run with it. We were always so careful to avoid knocking anything out of place.  We would leave his masterpieces around for days and days.

He has slowly outgrown this behavior. It’s been a while since he has lined things up. I didn’t even realize it….until now.

Now, with the whole coronavirus situation and with schools being closed, life has changed so much these past two weeks.  I have been worrying about what I would do if I had to step in for his teachers and do everything they’ve been doing that have helped him so much.

I was a broken soul his first two little years of life when I suffered terribly with severe postpartum depression (PPD) and postpartum anxiety (PPA).  I was crippled by PPD/PPA for some time.  It’s been 6 years since I felt the kind of despair that I felt when I suffered from PPD/PPA.  PPD/PPA paralyzed me so much that I was even afraid to hold my children (G has a twin sister) for the first year.

Then, when I noticed that G was showing signs of autism around 9 months old, the only way I knew I could help him was to secure as much help as I could with his autism. Even though I felt broken, as long as I had the right help for G, things would be fine.  I have always hated asking for help, but for my sake and for G’s sake, I had to let help in and let help heal us. Once I finally got my feet on the ground, I did better and so did G. We have been making progress and thriving ever since.

However, now with this new way of life of social distancing due to the coronavirus, I have been hit with a wave of feelings that brought me back to the days when I had PPD/PPA. Being a mother during these times is really tough. It’s not the kind of world I ever imagined my family and I would ever have to experience. I have done everything in my strength to be able to function well again.  But now, I’ve been experiencing waves of uncertainty from fear of the unknown, as I (along with everyone else around me) have never experienced what we are now experiencing.  The sudden turn of events requiring everyone to stop going to work, stop going to school, stop getting together with friends and relatives, and even stop going out unless we really had to caught everyone off-guard.  No one could prepare for any of this.

I’ve been having some tears build up for days now.  But I take deep breaths daily.  I’m taking one day at a time.  I have learned that I CAN teach my children from home. I have learned that I CAN manage this.  I HAVE been managing.

The fact that G could reflect on such behavior tonight made me feel so proud of myself and of him that we’ve come so far despite all the obstacles.

What I want to tell other new mothers and mothers to be is to not be afraid to ask for help and to rely on a support system.

It is important to communicate and put one foot in front of the other, one step and one day at a time.

It will all make sense again. It’s okay to be scared, it’s okay to cry right now, and it’s okay to talk about your fears and get them off your chest.

We may be quarantined but there are many online support groups that can help while we still need to maintain social distancing.

You are never alone.

– Stacy M

Hey Doc, Ask Me Why

Happy New Year!  It’s been 17 days since my last post.  Christmas is my favorite holiday, but with Christmas comes a lot of preparation (e.g., shopping, decorating, having people over).  So much goes into preparation for a holiday that lasts as long as any other day.  And *poof* it’s over.  And then the new year comes around.  And I am NOT crazy about celebrating new years.  Nope, not at all.  It’s just another reminder that time is flying by at warp speed.  Speaking of warp speed, here’s a picture that popped up in my Facebook news feed from George Takei of Star Trek fame on New Year’s Day.  It says it all for me.

Well, anyway, I’ve been waiting for that one blog post / news article to inspire me to blog….and I finally found one today.  Today, my inspiration came up on my Facebook newsfeed from two individuals dedicated to the fight against bullying:  Jessica from My Kindness Counts and Mike Urry from His Name Was Steven.

Watch this (*** This video may be triggering if you are suffering from depression***):

The video shows several teens urging on doctors to ask “Why” a young individual is complaining of not being able to sleep and/or having chronic stomach aches and/or headaches and/or experiencing weight loss.  It’s because, as the video states,  “Sometimes what’s bothering your patients isn’t visible to the naked eye.”  Bullying is the cause of all too many missed days of school for kids/teens, both out of fear of being bullied and due to the oftentimes debilitating physical symptoms caused by anxiety and depression.  Doctors shouldn’t merely whip out their script pad and start scribbling out prescriptions for antidepressants and/or medications to relieve physical symptoms, like stomach aches and headaches.  They should ask “Why.  Why are you not able to sleep, have stomach aches and/or have headaches?  What’s going on?  How’s school?  If you feel the need to talk to someone about what is going on, I can recommend someone.  Sometimes, all it takes is for someone who understands what you are going through to help you see that you are not alone and you will get through this.”

All doctors who have young patients need to know the correlation of certain symptoms during certain times in a young person’s life might be tied to teenage angst/depression.  Here’s an excerpt in my book that speaks to all this:

[Depression] is misunderstood not just by the public at large, but by medical professionals as well, and largely because there is no singular cause. Though the word depression implies a mental condition that impacts a person’s thoughts and feelings, its symptoms—caused by a combination of biological and psychosocial factors—are physical, affecting the way a person eats, sleeps, and functions……..Before I experienced PPD, I…..thought feeling sad was the same thing as being depressed. But now I know better. I know that depression not only causes an individual to feel low and hopeless, it can also change sleep and eating patterns and cause a whole host of other physiological symptoms. I seriously think the difference should be taught in school at a young age so kids don’t grow into adults still confusing the two terms with each other. That would be one way to combat the stigma!

[Sleep] and appetite disturbances (including nausea, diarrhea, stomach pain) are physical symptoms of depression, while mood swings, sadness, and restlessness are emotional symptoms of depression.

Those who aren’t aware that these physical and emotional symptoms are due to depression and anxiety will, instead of seeking treatment for those mood disturbances, mistakenly think that the digestive system is to blame for the appetite disturbances, stomach pain, nausea, and diarrhea. The diagnosis may turn out to be irritable bowel syndrome (IBS) that is usually caused by stress, with the goal of treating the irritable bowel, when the underlying cause, which is anxiety in this case, is not properly addressed.

And if you read the following excerpt from my book, you’ll see why this video got my attention so much.  It’s disturbing just how lacking in knowledge of mental health issues (or even teenage issues, in general) doctors were back when I was a teenager….and how it hasn’t changed much, apparently, three decades later.

With PPD, I suffered from lack of appetite and rapid weight loss. I never had that growing up. My teenage weight was always steady and under one hundred pounds. (Wow, those were the good ol’ days!) I was just prone to anxiety, which caused such physical symptoms as dry heaving, nausea, and stomachaches. You would think my doctor back then would have attributed those symptoms to anxiety, but it never came up. He never asked me questions to try to get to the bottom of it. Not much difference in the medical profession from the 1970s and now. What a shame! I can distinctly recall experiencing dry heaves each morning as I was getting ready for school, not having any appetite to eat breakfast but forcing it down anyway because my mother insisted I eat. Upset stomachs and a burning sensation in my gut were a regular occurrence…..ultimately my nervous stomach occurrences slowly but surely stopped after I graduated from high school. If you looked at my photos from my junior high and high school years, you’d see a shell of a person—all skinny, withdrawn, and unhappy looking.

So, are you hearing us, docs?  You go into the medical profession wanting to help others to stay healthy and to treat their health issues.  Well, I sincerely hope medical schools are ensuring that doctors-in-training recognize the symptoms of depression and treat their patients accordingly.  And for general practitioners who currently have young patients, I sincerely hope they are well aware of the issues that youths face and know when they should ask “Why.”

NOTE:  Please refer to my recent blog post for more links on previous posts relating to teen angst, depression, and bullying…and why I write about it so much on this postpartum depression (PPD) blog.

How anyone could think that PPD isn’t real is beyond me

Postpartum depression (PPD), and depression for that matter, is an imaginary, or make-believe illness, a state of mind that can be changed at will, a means to get attention, an excuse to take medication to escape from reality, a sign of weakness or self indulgence, an excuse to avoid the reality of motherhood.

Yeah, get a grip on reality–and get educated while you’re at it–for crying out loud.  These statements couldn’t be further away from the truth.  In this day and age, how anyone can believe any of this BS (especially other women) is beyond me.   Why can’t women be supportive of each other instead of being so critical and competitive with each other?!   That includes being supportive of and contributing toward efforts that will help mothers experiencing PPD rather than impeding those efforts (those people, by the way, should be ashamed of themselves).  Why women have to be so feline (note:  my #2 anger trigger is feline behavior, after my #1 anger trigger of behavior & remarks made out of ignorance/racism/condescension) is beyond me!

Skeptics will claim that, since PPD isn’t necessarily detectable via blood work nor a growth or wound or handicap that is visible to the naked eye, that it must not be real.   And please don’t say this is a recent phenomenon or that women have been giving birth thousands of years and we’ve only seen a rise in PPD awareness–and thank goodness for that–in the past decade, so it must be a new invention made up by women in today’s generation because they can’t cut it like the tougher women of previous generations.  Right.    Anyway, this “recent phenomenon” is thanks to the women out there (you go girls!)–plus celebrities who are finally gaining the courage to speak up more about a condition that has been documented as far back as the days of Hippocrates.  Scientists have not been spending years on research on treatments, detection, determination of risk factors, etc. for lack of anything better to do.

People out there scoff at the idea of PPD and claim to know all about it, when in fact they don’t.  Why?  Because they never suffered it themselves…duh.  They’ll claim that all new mothers experience mood shifts after childbirth.  Hello, you’re thinking of the blues, which happen within the first couple of weeks postpartum and resolve on its own.  They’ll claim that there is no scientific evidence that PPD exists.   They’ll claim that insomnia, a classic symptom of PPD, is merely sleep deprivation and fatigue that all new moms experience.  They’ll also claim that having a panic attack is the same thing as anxiety that comes from difficulties in transitioning to motherhood and being a first-time mom.  Now, had these people actually experienced real PPD, including real insomnia and real panic attacks, they would understand what it’s like to have PPD,  insomnia and panic attacks.   Until then, they should keep their ridiculous claims to themselves.  I’m not going to tell these skeptics to do their reading because no amount of facts will change these peoples’ minds…unless perhaps they experience any of these conditions for themselves.   It’s really a shame, isn’t it, that people insist on maintaining their stubborn beliefs, regardless of how ridiculous they are.

Many of these skeptics of PPD are also skeptical of depression, in general.  They’ll claim that depression is a matter of mind over matter.  They’ll claim that anyone can snap out of depression on their own accord.  Well, wake up!  The ability to will or wish away depression is a myth.  You can’t overcome it by just putting your mind to it.  PPD is a real illness with a biological cause, just like diabetes and heart disease.  You can’t just “snap out of it” any more than you could if you had an ulcer, diabetes or heart disease.  Until I experienced PPD, I thought depression is just a state of mind.  I used to say things like “I’m depressed” whenever I felt sad.  Now, I’m careful to not use the word “depressed” in the context of sadness.  I believe the majority of folks out there mistakenly think that being depressed is the same thing as being sad, feeling down or feeling blue.   People, particularly OB/GYNs,  need to stop getting these two very distinctly different conditions confused with each other because by doing so, they are preventing women with PPD from getting the help they need right at the beginning.  Not to mention, perpetuate the misconceptions about PPD.

With PPD, the longer you wait to seek help, the harder it is to recover from.  But why wouldn’t you get the help that you need to get better and enjoy motherhood sooner?  Why suffer longer than you have to?   There are many possible reasons, though high up at the top of the list would be 1) mistakenly thinking that this is just the way it is with being a first-time mother who is trying to cope but just going through a rough patch (because they don’t know any better due to lack of education about PPD and their doctors’ misdiagnosis as blues) and 2) fear from the stigma associated with mental illnesses and what others would think/say and.    All too many women will unnecessarily struggle with toughing it out or self medicating with alcohol or other substances.

My best piece of advice to you moms out there is to not give a damn what other people think.  Now, if I could take a dose of my own medicine, that would solve one of the biggest habits—or weaknesses, that is—I’ve had so much trouble kicking over the course of my lifetime!  Your priority should be the wellbeing of you and your family.  The best thing you can do for yourself and for your baby—in fact, for your whole family—is to seek help as soon as you experience three of more of the symptoms described in my post “Baby Blues is NOT the Same as PPD!”  Don’t wait until you are crippled by the effects of PPD like I was.    Prolonged and untreated depression can not only negatively affect your marriage and your baby’s cognitive and social development, it can unnecessarily strain your relationship with your partner.  Worse yet, untreated PPD can lead to such feelings of hopelessness that ending your life may seem like the only way out of the pain.  Don’t try to tough it out, thinking what you’re experiencing will pass on its own just as quickly as it developed.  Don’t try to tough it out because others around you are trying to convince you that this is all part of the process of transitioning to motherhood, that every new mom experiences sleep deprivation and anxiety (see previous post on the difference between that and true insomnia, a very common PPD symptom if it is experienced 3 weeks or later after childbirth).

Though the symptoms and their severity may be unique to every woman, PPD is debilitating to all those who suffer from it.  Depression–and there are thousands in this country today that are afflicted with it– affects people physically, not just mentally.  It is a physical illness that is the result of a chemical imbalance.   Hormonal changes are responsible for perinantal (during pregnancy and postpartum)—and even premenstrual dysphoric disorder (PMDD)—mood disorders and an imbalance in brain chemicals called neurotransmitters.  Serotonin is one such neurotransmitter.  Research shows that serotonin dysregulation is a primary cause of PMDD and PPD.  A sudden and huge drop in estrogen levels immediately after childbirth contributes to a decrease in serotonin availability in the brain.  Since serotonin promotes normal mood, a decrease in serotonin availability in the brain is associated with anxiety/depression.  This is why medications such as selective serotonin reuptake inhibitors (SSRIs), which increase serotonin availability in the brain, have in many cases been effective in the treatment of PPD.   An SSRI was effective for me.

Let me explain something here, lest the words “medications” and “SSRIs” trigger a violent reaction among the anti-pharma faction out there.  I am not advocating medication for everyone.  Different treatments will work for different women.  A woman must be informed enough to be able to make a decision that she feels is right for herself.   Being informed means having ready access to information about PPD, its symptoms, where to go for help, what treatments are available, what medications are usually prescribed and their side effects and risk of being passed to the baby via breastfeeding, etc.   It also means having a doctor that is adequately trained to detect, diagnose and treat perinatal mood disorders.  But many doctors are still not adequately qualified to do any of that, plus lack adequate tools and resources.  This is why awareness about PPD and preventive measures (like lining up adequate social support and getting 5 hours of interrupted sleep as much as possible in the first 6-8 weeks postpartum) are so, so critical to everyone who plans on having a baby. 

I’d like to close with this piece of advice to the skeptics.  Without knowing the full story (or without ever experiencing PPD or any other illness directly) one should NEVER pass judgment on the situation of others.   Women with PPD do not need to be scoffed at, doubted and criticized.  They need support and understanding.  If you were in their shoes, would you want to be on the receiving end of these negative or–shall I say–tasteless behaviors?

Benefits of Yoga During IVF and Pregnancy

I know I mentioned my next blog post would be my Part II advice on getting a minimum of 5 hours of uninterrupted sleep, but I had to squeeze this short one in beforehand.  It’s been on my mind ever I saw the recent post over at Postpartum Progress on the benefits of yoga. 

Researchers in Iran provided the results on their study of the benefits of yoga on anxiety and depression in women in the May 2009 issue of Complementary Therapies in Clinical Practice (Volume 15, Issue 2, Pages 102-104).  The conclusion of the abstract reads as follows: 

“Participation in a two-month yoga class can lead to significant reduction in perceived levels of anxiety in women who suffer from anxiety disorders. This study suggests that yoga can be considered as a complementary therapy or an alternative method for medical therapy in the treatment of anxiety disorders.”

 What I forgot to mention in my previous post relating to my IVF experience is that what probably made a huge difference–other than the fact that I had an excellent experience over at RMA of NY–was the fact that I took yoga lessons once a week during the IVF process and I stopped taking the lessons once implantation took place (because I was afraid some of those yoga moves might be too much for the less than handful of eggs that were just implanted inside me).  Believe me, from the time those eggs were implanted and the next 9 months, I took all manner of precaution to avoid mental and physical strain to preserve my pregnancy.   Looking back, I probably should have taken pregnancy yoga classes (or at least followed a pregnancy yoga DVD) to reduce anxiety that would rear its head every now and then when I experienced spotting and pain.  Mind you, I don’t think my anxiety levels were abnormally high during my pregnancy.  I think it was perfectly normal for me to be concerned with spotting and pain after having gone through what I’d gone through to get that far with the pregnancy.   I mean, who wouldn’t feel concerned, given the situation?

Ruta Nonacs, in her book (pg 80) A Deeper Shade of Blue: A Woman’s Guide to Recognizing and Treating Depression in Her Childbearing Years, sums up the reason why infertility is a stressful experience for women as follows: “[Infertility] is one of the most stressful experiences for a woman.  Even the strongest and most resilient may experience depression when forced to ensure such significant demands on their emotional and physical resources…..Several recent research studies indicate that women who suffer from infertility are vulnerable to significant depression or anxiety: among women who undergo infertility treatment, it is estimated that about 25 percent to 30 percent suffer from clinical depression.”   

This is why I would suggest women going through IVF treatments to do everything they can do reduce their anxiety by seeing a therapist experienced with helping IVF patients, as well as giving yoga a try.   And for those who are pregnant–whether through IVF or naturally–you should seriously consider taking pregnancy yoga classes or follow pregnancy yoga DVDs in the privacy of your home.  Yoga will not only benefit you physically, it can help reduce anxiety levels.  After my next post on sleep, I will write on how anxiety levels are also detrimental to the fetus.