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

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

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

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

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

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

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

History in the Making for Maternal Mental Health Advocates

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

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

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

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

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

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

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

Naomi

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

candle

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

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

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

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

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

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

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

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

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

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

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

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

Thank You, New York Times, for Your Recent Coverage on Maternal Mental Health

These past couple of weeks have been a blur of work and plans for celebrating a couple of milestones in my life.

A little behind, as I usually don’t blog about such meaningful news relating to maternal mental health a couple weeks after they occur, here I am today, taking a quick break from what I am working on right now to applaud the two-part New York Times focus on maternal mental health, the first of which was titled “Thinking of Ways to Harm Her: New Findings on Timing and Range of Maternal Mental Illness” and appeared on June 15, 2014 on the front page and the second part titled “After Baby, an Unraveling:A Case Study in Maternal Mental Illness” appeared the very next day.

Kudos to Pam Belluck, the reporter who wrote the articles and ensured they received such prime spots in such a major newspaper.   Ms. Belluck interviewed three mothers for the first article, and the second article featured the story of Cindy Wachtenheim, who after battling postpartum psychosis, ended her life on March 13, 2013.  Both articles mention Postpartum Support International (PSI), the organization I joined back in 2006 in my search for answers and information as I endeavored to write a book about my own experience with postpartum depression (PPD), which began in January 2005 and ended a few months prior to the first PSI conference I attended in June 2006.

A week ago, on June 23, 2014, an article appeared on HuffPost Parents titled “What the New York Times Got Right and Wrong About Maternal Mental Health” in response to the NY Times articles.  Very good points made by  Christiane Manzella, PhD, FT, supervision director and senior psychologist at the Seleni Institute including how, even though this two-part series in the NY Times was a step in the right direction, it was still a missed opportunity to educate the public on the common misconceptions of postpartum mood disorders.  For example, many cases of postpartum mood disorders actually begin during pregnancy (i.e., antenatal or antepartum depression) or up to a year after and is not strictly limited to the first weeks postpartum.  Also, the spectrum of postpartum mood disorders covers not only PPD, but postpartum psychosis as well, which is still not being diagnosed/treated correctly in all too many cases today…and unfortunately the disastrous outcome hits the news, like in the case of Cindy Wachtenheim.

I also wanted to highlight the June 21, 2014 Letters to the Editor submitted in reaction to the two-part series on maternal mental health.  Note the first letter written by Karen Kleiman, MSW, LCSW, founder of The Postpartum Stress Center.

Thank you, Pam Belluck and the NY Times for making these articles happen and putting them in the spotlight to bring more awareness about perinatal mood disorders to the public.  For too long perinatal mood disorders have been lingering in the shadows, remaining a topic that has evaded the understanding by medical/mental health practitioners and the public alike.

Every mother deserves to understand what perinatal mood disorders are, as well as how to know when to get help and who to go to for help without fear.  Fear of stigma.  Fear of any potential repercussions. People need to put aside these fears because things can get very bad very quickly if a mother does not seek help in a timely fashion, or gets the wrong diagnosis and/or treatment.

Every mother deserves to receive the right treatment and not be afraid to seek it.  As in my case and in all too many other mothers’ cases, time is of the essence in getting the correct treatment.  If I had gone much longer with my insomnia and panic attacks without the right combination of medications to treat them, I am not certain what would have happened.  I was in a very bad place for a few weeks, and I am ever so grateful for only losing a few weeks of precious time with my baby.  The outcome could have been so much worse.

Things Your OB/GYN Won’t Tell You But Should

Lately, I’ve been having a hard time picking what topic to blog about in the little time that I have to blog.  Nowadays, something I read in my Facebook feed has to really spark my interest in a big way.  Today, I stumbled across this HuffPo article “6 Things Your Ob-Gyn Won’t Tell You But Should.”  The article is meant to provide guidance to women who are thinking about becoming ,or are already, pregnant and need to find an OB/GYN that is right for them.

Here’s the comment I left:

I can tell you what my OB/GYN didn’t tell me about….postpartum depression…or treat me in an understanding/sympathetic fashion….or know who to refer me to for help. It’s pitiful and inexcusable that they are supposed to be charged for the care of women’s reproductive health matters, and yet perinatal mood disorders are still so far off their radars! They must get up to speed and be prepared to inform, detect (this includes screening pregnant and new moms with basic questions), and treat and/or refer to a specialist for treatment!

Here’s my advice for you that is coming from someone who has been down the road of having to find an OB/GYN (because I had just moved to the area) and was merely relying on the fact that so many women in town have the same one, without really feeling the doctor out ahead of time by asking questions and really determining if he was the right fit for me.  I didn’t allow any chance for my gut instinct–usually very fine-tuned–to really kick in.  How was I supposed to know he was going to have such poor bedside manner at the first hint of things not going as planned, and then drop kick me when he realized I had PPD?

In addition to the questions the Huffpo article lists, be sure to ask the following:

  1. How much about PPD and other perinatal mood disorders do you know, and can you tell me about them?
  2. Do you screen all your patients during, at minimum, the postpartum period for any postpartum mood disorder (PMD)–both via basic questions asked (see sample questions here) and via bloodwork?
  3. Do you treat PMDs, and if not, do you have referrals to healthcare providers who specialize in treating PMDs?

Please note that I am not limiting this advice to those with a history of depression.  I never had depression prior to my pregnancy and yet managed to get hit from left field with PPD and was thus left feeling sad, scared, alone, helpless and hopeless.

Please do not follow in my footsteps.

Be in the know and choose your OB/GYN wisely.

Lovely Book Review Over at Resplendent by Design

A friend of a friend, Bobbi Parish, therapist and author of the blog Resplendent by Design and book “Create Your Own Sacred Text” has written a very lovely book review of my book “One Mom’s Journey to Motherhood.”  Thank you, from the bottom of my heart, Bobbi, for taking the time out of your very busy schedule to read my book and write a book review.

One of the many rewards for writing my book–aside from the personal satisfaction of seeing the fruit of your six years of labor result an attractive book with content that can help make a positive difference for others–is making new connections, especially ones who would go out of their way to spread the word about a fellow mom’s book intended to help other moms.  Another reward is knowing that you are contributing in some small measure toward reaching mothers and their families with information that can help empower them to recognize when they are suffering from a perinatal mood disorder, where to go for help, what the treatment options are….not to mention, realize that what they are going through is experienced by more women than they will ever know, they have no need to feel guilty, and they will be well again with the right help.

The best part of Bobbi’s review is the fact that she is recommending my book for patients of obstetricians, midwives and doulas:

In my opinion, this is a book that should be on every Obstetrician, Midwife and Doula’s shelf and in their waiting room. It should also be on a list of resources about Postpartum Disorders handed out to every pregnant woman by their health care professional. It will absolutely help women battle this insidious mental health disorder and thereby enable them to have a healthier, happier postpartum period with the full capacity to care for and bond with their newborn.

Please go over to her blog and read the rest of her book review.

If you are an obstetrician, midwife or doula, please consider following Bobbi’s recommendation of 1) keeping a copy of my book in your waiting room and 2) including my book on a list of resources which I hope you already have (and if not, please consider putting one together now) about perinatal mood disorders handed out to your pregnant patients.

If you have stumbled across my blog and want to read more about my motherhood journey and what I learned from it, please consider buying a copy.  My book is available at Amazon via Kindle and both paperback and hard cover format.

If you know a mom who has found herself as blindsided and scared as I found myself when I was hit hard by postpartum depression, please consider buying her, or recommending she buy, a copy of my book.

Thank you, from the bottom of my heart.