Keys to Empowering New/Expectant Moms and Maternal Mental Health

I was talking to someone 2 days ago who mentioned that for millenials, images are the way to go to attract attention to important messages.  In this day and age of limited-word media like Twitter and other social media forums, sound bytes and visuals tend to grab people’s attentions more.  Print media — like magazines and books (like mine) and all the other books I devoured in my quest for knowledge on why postpartum depression (PPD) occurs in certain women — are going more and more by the wayside.  Just today, I stumbled across an email from Karen Kleiman, MSW, LCSW, (founder of The Postpartum Stress Center and author of numerous books on perinatal mood disorders)1 yr and 9 months ago giving me permission to use the below image on my blog.  This image grabbed my attention and I want to help circulate it.   You should too if you care about mothers.  We need images and information like this to reach more expectant mothers.  We need to ensure they are informed before they even give birth so they aren’t blindsided with PPD.

Why do I feel this information is important? My experience with PPD happened back in 2005, and I blogged about the ignorance of my OB/GYN in February 2009, just shy of 10 years ago.  It was one of my first blog posts. Unfortunately, not much has changed between then and now except for the advent of Facebook and other social media to spread the word via organizations such as Postpartum Support International (PSI), PPD survivors/advocates, social workers, therapists and others who treat perinatal mood disorders (PMDs).  I know this from the stories that come across my feed on Facebook.  I know this from talking to others whose job is to care for mothers who struggle with PMDs.  The general population doesn’t know the difference between postpartum blues and PPD because all too many doctors don’t even know the difference.  Karen Kleiman would not have needed to create the above image if she didn’t see the problem still existing with doctors misinforming PPD moms.

The care model for OB/GYNs should be mandated to include:

  1. adequate training in medical schools/residency programs to ensure doctors know how to recognize symptoms of and treat perinatal mood disorders and know the difference between the baby blues versus PPD
  2.  a 15-minute time slot in every hospital baby care/childbirth training session to go over the basics of perinatal mood disorders (PPD, postpartum anxiety, postpartum OCD, and postpartum psychosis), difference between the postpartum blues and PPD, breastfeeding realities, risk factors, importance of lining up practical/social support before baby’s arrival, insomnia as a common first symptom, etc.)
  3. being prepared to offer referrals to organizations like PSI (which has coordinators in every state that can try to help the mother find local help), maternal mental health facilities and mother/baby units (which are starting to pop up more & more around the country), PPD support groups, therapists/social workers who specialize in helping PPD moms, and even websites / blogs / Facebook groups that can provide online support
  4. screening patients for risk of perinatal mood disorders
    • prior to pregnancy – to establish a baseline of hormone levels before pregnancy and determine if the woman has a history of PMDD  or other risk factors for PPD
    • during pregnancy – consultation comprised of questions to try to detect pre-natal depression and review of a standard small booklet with images and bullet points covering the basics of perinatal mood disorders (PPD, postpartum anxiety, postpartum OCD, and postpartum psychosis), difference between the postpartum blues and PPD, breastfeeding realities, risk factors, importance of lining up practical/social support before baby’s arrival, insomnia as a common first symptom, etc.)
    • during 6-week postpartum visit – including blood work to detect iron/thyroid deficiencies and measure hormone/neurotransmitter levels, thyroid panel, Adrenal Stress Index

Click here to see my Onboarding Questionnaire, Pregnancy Questionnaire, and Postpartum Questionnaire.

As you can see, I am continuing to use my PPD experience to come up with ideas to effect change in the reproductive health care arena.  I will continue to find ways to contribute toward public awareness campaigns, as well as resource development and distribution.

Advertisements

New mothers with babies in the NICU are at increased risk of PPD – Part 2

Continuing on the topic I started on January 13th titled “New mothers with babies in the NICU are at increased risk of PPD,” I wanted to add a few points I missed earlier, inspired by a post that came across my feed recently from the Emerald Doulas website titled Preemies Parents and PMADs.  The post was authored by Carrie Banks, an Emerald Doula and one of the North Carolina state coordinators for Postpartum Support International.

Finally home from the NICU with the baby, it is natural for parents to feel anxious, now that they are responsible for their baby’s care and there are no nurses, doctors and machines tending to their baby’s care any longer.  The feeling of being fully responsible and the fear that something may go wrong can cause the parents to feel overwhelmed, especially if there are still medications, feeding and weight gain challenges, as well as physical (e.g., vision, hearing, motor skills) and cognitive development concerns.

I can recall feeling overwhelmed with having to deal with colic, cradle cap and eczema all at once.  My baby was not even a preemie, and my postpartum depression (PPD) starting once the one-week colic period ended.  So, yes, factors that cause stress during the first postpartum weeks while a new mom is still healing from childbirth can indeed lead to PPD.

The Emerald Doulas article contains great tips on addressing:

  • impaired/delayed bonding due to inability to hold the baby/feelings of fear/awkwardness of holding the baby in the NICU
  • transitioning to life at home after the NICU
  • feelings of isolation, guilt and shame
  • why getting help is important

Parents of preemies may also feel ungrateful or even guilty for seeking help for themselves, since everyone’s focus has been on the preemie baby for days, weeks or even months.  While these parents may feel like the only thing that matters is their baby to be okay, they need to remember that they need to stay strong and healthy, both mentally and physically, in order to be there for their baby!  Weeks if not months of having to stay strong for their NICU baby and for other children they may have can chip away until suddenly they find themselves unable to keep it together any longer.  Being anxious and sleep-deprived over an extended period can lead to a postpartum mood and anxiety disorder (PMAD) to set in.

Another contributing factor to the development of a PMAD is the feeling of isolation that occurs from staying home with the baby and keeping visitors away to protect the baby against germs, especially during the winter when colds and the flu abound.  The disappointment that comes from not having friends and family around like they would’ve wanted to have can also contribute toward the development of a PMAD.  Finding a community and support in the form of a NICU support group in-person and/or online can be invaluable, as it can help them feel less alone and more hopeful knowing they are not along in their experience both inside and outside of the NICU having to deal with physical/cognitive development concerns/challenges in addition to the seemingly endless visits with doctors, speech therapists, occupational therapists and/or physical therapists.

There should be no doubt as to whether seeking help is an option.  If you need help, do not hesitate to get it.  Reach out to friends and relatives.  See if you can get a friend and/or relative to help coordinate the search for specific kinds of help.  I’ve seen many situations where a friend sets up a Meal Train account and shares it on social media or email to get friends/relatives/neighbors/colleagues to pitch in money or orders from local restaurants/delis to be sent directly to the family.  If you need help with overnight care and you can afford to hire a postpartum doula, then see if you can locate one through referral from a friend/relative or by searching for one on the Doulas of North America (DONA) website.

You, my dear mother (and father), need to remember self care!

Traditional Postpartum Practices Workshop – Jan, Feb, Mar 2019

Come check out this special 2-day workshop that will teach you what a holistic after-birth recovery plan–one that is based on Malaysian traditions that have led to the lowest rates of postpartum mood and anxiety disorders (PMAD) in the world at 3%–should look like that is based on the world’s #1 postpartum healing practices.  In the United States PMADs occur in as many as 1 in 7, or 14% of new mothers. By the end of the training, you will know how to create an effective daily plan encompassing specialized nutrition, body massages, abdominal wraps, herbs, and other treatments to help a new mother’s body to recover in a stronger, faster and more balanced manner during the first 6 weeks postpartum.

During her many years living abroad in Malaysia, Valerie Lynn conducted extensive research on postpartum practices via the Ministry of Health, Traditional Complementary Medicine Department of the Malaysian government, as well as via interviews in hospitals and in the field.  She learned that the detailed and thorough care that is provided to new mothers during the first 44-days postpartum is unrivaled.  She witnessed firsthand how quickly mothers recovered from childbirth from the postpartum care they were provided.

Learn for yourself and/or to help other mothers reduce the amount of time needed to recover from childbirth!

A Note to Corporations re: maternity leave and how to maximize employee potential:  Click here for more info.  She can do corporate lunch seminars..just reach out to her via valerie@postpregnacywellness.com for more information on how to coordinate this!

When:
January 24-25, 2019
February 21-22, 2019
March 21-22, 2019
Options are to attend day 1 or both day 1 and day 2 (contact Valerie Lynn at valerie@postpregnacywellness.com for latest rates.

Where:  (Photo ID is required to enter)
Consulate General of Malaysia
313 E 43rd St
New York, New York 10017

To Register:
Please email valerie@postpregnacywellness.com for payment link.  Your full name, company name, address, and telephone are required.  Click here for more info.

About Valerie Lynn:
Author of The Mommy Plan (endorsed by many childbirth educational organizations and is listed as a choice of required reading for Postpartum Doula certification by the Childbirth and Postpartum Professionals Association (CAPPA)Valerie Lynn is an expert on employing a blend of the most effective eastern and western postpartum recovery practices to help new mothers through their physical and hormonal recovery from childbirth.  These practices have been proven to greatly reduce the amount of time needed for new moms to heal.  It was during her own 15-month experience with postpartum anxiety and OCD (obsessive compulsive disorder) after the birth of her son in 2007 that Valerie turned to traditional feminine healthcare to re-balance her post-baby hormones and heal herself naturally through herbs, massage and diet.  She was living in Malaysia at the time. Valerie has held positions such as Executive Director of the American Malaysian Chamber of Commerce and Principal of VLM Consultancy where she was provided strategic consultancy services for foreign companies entering the Malaysian and APEC markets.  She is part of the Board of Directors of the distinguished Malaysian NGO YASNITA, “Women’s Pathway to Success” where she serves as an International Advisor on Postpartum Recovery Practices. She is International Country (PSI) Volunteer Co-coordinator for Malaysia of Postpartum Support International, a global organization in 138 countries. She is a Board Member of the International Maternity Institute and the After Birth Project in the U.S. Valerie regularly contributes to articles, books, and training programs. She aspires to improve the healing-care of new mothers in the United States and globally which, she believes, will reduce the high rates of postpartum depression. She is an approved speaker for Johnson & Johnson.

New mothers with babies in the NICU are at increased risk of PPD

The motivation for this blog post is a Huffpost article that popped up in my Facebook feed yesterday titled “NICU Moms Are Struggling With Mental Health Problems–And They Aren’t Getting Help” by Catherine Pearson.  It happens to be from 4/13/2018, but I’m only seeing it now for the first time.

I have blogged about the many risk factors for PPD before.  One of the risk factors happens to be premature births.  Last time I blogged about premature births being one of the risk factors for PPD was 9 years ago.  So, I’m way overdue blogging about this topic again!

A new mother who was pregnant one minute–and expecting several more weeks of pregnancy–and suddenly giving birth and seeing your baby hooked up to machines is an overwhelmingly anxiety-provoking experience.  All new mothers are not only hormonal, exhausted and trying to recover from childbirth, but NICU mothers are also anxious about their babies, unwilling to leave their babies’ sides, and find it hard to eat, sleep or even talk to friends and family members who don’t fully understand what it’s like to have a baby in the NICU. Unable to touch, hold and feed her baby and instead seeing her tiny, precious baby hooked up to so many wires, it is natural for a NICU mother to be consumed with feelings of helplessness, distress and fear.  Each day, the NICU mother spends many hours each day at their baby’s side, pumping every few hours, and on high alert with respect to her baby’s breathing and the noises of the machines keeping her baby alive.

In the daily hustle and bustle of the nurses and doctors in the NICU, having them stop and ask the mother (and/or father) how they are holding up and making sure they are taking care of themselves and getting enough rest are not going to be at the forefront of their priorities, though you’d think it should be second nature for them to do so.  In fact, they are seldom trained to know what to ask.  Even if they did ask, there is an inadequate referral system in place to get help for a mother with a postpartum mood disorder.

“…[Studies have suggested that up to 70 percent of women whose babies spend time in the NICU experience some degree of postpartum depression, while up to one-quarter may experience symptoms of post-traumatic stress disorder.”  Simply put, a new mother’s risk of experiencing a postpartum mood disorder is very high.  And that is not surprising in the least.”

What should the screening entail?

I’ve previously blogged about and will repeat here that mothers should be assessed for postpartum depression (PPD) between 4-12 weeks postpartum.   She should be encouraged to have her six-week follow-up visit with her OB/GYN, 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 6-week screen doesn’t indicate PPD, she should be assessed once more at the 12-week point and also when she weans and when her period returns, 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 2 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 worrying/anxiety/concern about the baby
  • Restlessness/irritability
  • Difficulty thinking, concentrating or making decisions
  • Onset of panic attacks
  • Sense of despair and/or hopelessness leading to thoughts of death/suicide

2. How have you been feeling physically and emotionally?

3.  How is your appetite?

4.  How are you sleeping?  Have you been able to get at least 4, if not 5, hours of sleep a night?

5.  Have you had any recurring thoughts/images that are disturbing?

 

If local resources for PPD are not readily available (though all hospitals around the country should have a list of local psychologists, psychiatrists, social workers, registered nurses, PPD support groups on hand), the least they can do is provide a pamphlet for 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.

If you are a new mom with a baby in the NICU, please, please, please remember that, though your attention is preoccupied with your baby, if you let your own strength and health go by the wayside, it is possible to succumb to a postpartum mood disorder.  Not everyone will succumb, but just remember the increased risk and higher occurrence among NICU moms.  Don’t forget to take care of yourself.  When your baby comes out of the NICU, you need to be strong and healthy to care for your baby.

 

 

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.

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!