LUNAFEST® Screening on November 4, 2022 presented by Postpartum Support International-NJ

Tickets are available now for the 4th annual LUNAFEST®proudly presented by the New Jersey Chapter of Postpartum Support International (PSI).

Once again, the event will be hybrid.  If you are in New Jersey, you can participate  in person.  If you don’t live in the New Jersey and/or would prefer to participate from the comfort of your home, you can participate virtually!  Please consider buying a ticket to support a wonderful cause!

IN-PERSON:
When: Friday, November 4, 2022; Meet & Greet Reception @ 7:30 pm; Films begin @ 8:00 pm
Where: The Woodland, 60 Woodland Road, Maplewood, NJ
Tickets:  $50 includes a complimentary cocktail.  To buy, click here.

VIRTUAL:
When
: Log in anytime between Friday, Nov 4 @ 8 PM EST – Sunday, Nov 6 @ 8 PM EST.  The festival of 8 short films has a total running time of 80 minutes.
Where: A streaming link will be emailed to you the morning of November 4, 2022.
Tickets:  Just $25!  To buy, click here.

Proceeds of this particular screening event will benefit the NJ Chapter of PSI.  PSI’s mission is to promote awareness, prevention and treatment of mental health issues related to childbearing.  The long-term goals of the PSI-NJ chapter is to create, throughout the state of New Jersey, a unified voice for the support, education and care of moms and families with perinatal mood disorders, as well as law enforcement and health care professionals.  support mothers (and even fathers) suffering from it.

If you support women’s causes and want to support mothers (and their families) who suffer from postpartum mood and anxiety disorders (e.g, postpartum depression (PPD), postpartum OCD and postpartum psychosis) to get the help they need, please consider coming to Lunafest and sharing with friends, family members, neighbors, and colleagues and even share widely on social media.

There will be information about PSI, PSI-NJ and other maternal mental health services in NJ at this event.

The Realities of Postpartum

I just realized I was supposed to blog again in September (my Sept post was meant for Aug), as I’d promised I would blog at least once a month from October 2020-October 2021.  So, this blog post is to make up for September, and I will be posting again for World Mental Health Day 2021.

Today, I’m going to blog about the importance of ALL information relevant to a new mother’s well-being.  I was pleased to see Good Morning America’s piece titled “Moms get real about what it’s like postpartum: ‘I felt like I got hit by a bus.'”  dated September 30, 2021.  I love that there is “real” talk about the realities of postpartum.  That is essentially the motivation and focus of my book, which I’d published back in 2011 because not enough people were talking about the realities of postpartum.  While my book uses the terms “hit from left field with PPD” and “PPD hits you like a ton of bricks” in Chapter 3 (Knowledge is Power), the general idea is the same, and it wouldn’t be so bad if more people talk about the realities of postpartum.  The 2 mothers in the article (Maria Alcoke and Jenny Laroche) share my desire to help educate other women so they can avoid the kind of negative experiences we had.  I mean, with knowledge, we have the the power to minimize fears and anxieties that come with first-time motherhood, as well as to get help EARLY.

Just like my book, the article mentions that there is plenty of information out there about preparing to become a mother, about pregnancy, and about baby care, but there isn’t a whole lot about the realities of the postpartum period, like hair loss, recovery from childbirth, anxiety with caring for a baby for the first time, societal expectation that the postpartum period is just for physical recovery from childbirth, and difficulties with breastfeeding–just to name a few.  For Laroche, who experienced heavy hair loss (“I had no idea that you lose so much hair. No one warned me,” said Laroche, who said she felt “like a passenger in my own body” postpartum) and was concerned about even the most basic of body functions, like bowel movements, these completely normal experiences wouldn’t have been so traumatizing and isolating had she known what to expect by talking about it with other mothers or reading about it.  Why are people so afraid to talk about their real experiences?  Is it fear of being shamed?  Judged by others? Not living up to their dream of being a perfect mother?  Wanting to maintain the notion that pregnancy and motherhood are always blissful experiences?  What I want to know is why people insist on keeping up these false notions.

Alcoke shares:

When talking [in] women’s circles and just talking with your friends and sharing experiences, you never want to scare someone away, right? People don’t necessarily want to hear that, like, ‘Oh did you hear about the vaginal tear that I had?’ but it’s part of the process. It happens. It’s super common.

These are things I touch on in my book in my Chapter 6 (My Postpartum Period – An Exhausting and Uncertain Experience) where I talk about Interrupted Sleep/Sleep Deprivation, Startle/Moro Reflex, Colic, Nasty Eczema and Cradle Cap, My Hair Loss, and Returning to Work.  I also talk about the realities of pregnancy, childbirth and the fact that breastfeeding isn’t always instinctive in Chapter 8.  Here’s an excerpt from my Knowledge is Power chapter:

It’s only natural for you to not want to hear about anything that could go wrong during the postpartum period. You may have enough pregnancy-related concerns as it is, with things like nausea, difficulty sleeping, getting everything ready for the baby’s arrival, spotting, cramping, bloating, preeclampsia, etc. I mean, who wants to look forward to her baby’s birth with anything other than positive thoughts? And who wants to think about something you’re convinced won’t happen to you? It’s natural to deal with concerns as they arise rather than worry about something that more than likely would not happen anyway. But remember that a cross-that-bridge-when-you-get-to-it mentality won’t help you if, once you cross that bridge, PPD hits you like a ton of bricks—suddenly and quite mercilessly.

and

From seeing the happy moms around you to those on the television and in magazines, you look forward to your future with your baby with joyful anticipation, thinking that, with happy thoughts, there will only be happy days ahead. And just because you never hear anyone you know talk about having PPD, it doesn’t mean no one you know has ever suffered from it. A friend, relative, colleague, or neighbor may one day suffer—or at this moment could be suffering—from PPD, and you may never even know it because she doesn’t know what is wrong with her and is ashamed to let anyone know that she is unable to enjoy her baby as she’d dreamed she would. No woman is completely immune from PPD after having a baby. With the right combination of risk factors and stressors, any woman—even you—could end up suffering from it.

The Good Morning America piece also touches on the fact that a woman’s body goes through huge changes that–besides the size of the belly–aren’t necessarily visible to an observer.  These changes are hormonal and even neurochemical.  And yet women are sent home from the hospital a couple days after childbirth to recover and with a newborn to take care of (in addition to possibly other kids)!  Everyone recovers in different ways, lengths of time, etc.  Most mothers experience postpartum blues (not the same thing as postpartum depression – which I talk about in Chapter 8 of my book) due to the huge hormonal changes that come with childbirth.  But a percentage (up to 20%) of new mothers experience postpartum depression (PPD), which is a general term for when there is a postpartum mood disorder.  What the article doesn’t mention is that there is also postpartum anxiety, postpartum obsessive compulsive disorder, and postpartum psychosis.

The piece also touches on the fact that new mothers are setting themselves up for huge disappointment if they assume that, when it comes to pregnancy, childbirth and postpartum, things will turn out the way they plan.  No amount of books/information and staying on top of details is going to fully prepare you for all the variables that include the way a woman’s body responds to childbirth, the huge hormonal swings from pregnancy and childbirth, and the baby’s personality and development…..just to name a few.  When it comes to having a baby, the more you want control of a situation, the greater your struggle will be if the results are not what you expect.

This is an excerpt from my book:

Being a first-time mother, you learn the ropes as you go. Practice makes perfect. But mothers with perfectionist or control-freak tendencies find it particularly hard to adapt to the fact that much of their motherhood experience is one in which mistakes will be made and it isn’t possible to have complete control of your life when you have an infant. Those who set high expectations and have specific thoughts of how their childbirth and motherhood experiences should be are setting themselves up for disappointment when their expectations are not met.

The article also touches on the fact that postpartum care in the U.S. is lacking.  Once the baby is born, all the attention turns to the baby, and it seems everyone forgets about the mother.  The article mentions that, in 2018, the American College of Obstetricians and Gynecologists (ACOG) released new guidelines to help encourage more postpartum care.  Six weeks used to be the standard for the first new mother visit with her OB-GYN.  ACOG now recommends that new mothers contact their OB-GYN within the first 3 weeks after delivery, and that care should continue on an ongoing basis, ending with a “comprehensive postpartum visit no later than 12 weeks after birth.”  I believe the reason for this is for OB-GYN’s to assess if the new mother has any symptoms of a postpartum mood disorder.

Postpartum care for the new mother has been completely lacking in the U.S.  I discuss this in detail in Chapter 9 of my book.  Chapter 9 sections include these sections:
  • First Few Days at Home … Now What?
  • New Moms Need Nurturing Too
  • What Is Social Support?

I’ve blogged about social support in great detail previously here and here.  Hugely ignored is the importance of emotional and practical support during the first four to six weeks postpartum to enable the new mother to get the rest she needs while she is recovering from childbirth and at her most vulnerable, thereby minimizing her risk for PPD. A support network should be set up before the baby arrives. Be prepared to have support with how to soothe a crying baby, how to cope with reflux and colic, how to identify and deal with eczema and cradle cap, and how to deal with food allergies, etc. Not being prepared for these challenges and having to figure out how to deal with them via pure trial and error can cause anxiety levels to skyrocket.

LUNAFEST® Screening on October 15-16, 2021 presented by Postpartum Support International-NJ

Tickets are available now for the 3rd annual LUNAFEST®proudly presented by the New Jersey Chapter of Postpartum Support International (PSI).

This year, the event will be hybrid.  If you are in New Jersey, you can participate  in person.  If you don’t live in the New Jersey and/or would prefer to participate from the comfort of your home, you can participate virtually!  Please consider buying a ticket to support a wonderful cause!

IN-PERSON:
When: Friday, October15, 2021; Meet & Greet Reception @ 7:30 pm; Films begin @ 8:00 pm
Where: The Woodland, 60 Woodland Road, Maplewood, NJ
Tickets:  $40 includes a complimentary cocktail.  To buy, click here.

VIRTUAL:
When
: Log in anytime between Friday, Oct 15 @ 8 PM EST – Saturday, Oct 16 @ 8 PM EST.  The festival of 7 short films has a total running time of 86 minutes.
Where: A Vimeo streaming link and passcode will be emailed to you the morning of October 15, 2021.
Tickets:  Just $20!  What a deal!  To buy, click here.

Proceeds of this particular screening event will benefit the NJ Chapter of PSI.  PSI’s mission is to promote awareness, prevention and treatment of mental health issues related to childbearing.  The long-term goals of the PSI-NJ chapter is to create, throughout the state of New Jersey, a unified voice for the support, education and care of moms and families with perinatal mood disorders, as well as law enforcement and health care professionals.  support mothers (and even fathers) suffering from it.

If you support women’s causes and want to support mothers (and their families) who suffer from postpartum mood and anxiety disorders (e.g, postpartum depression (PPD), postpartum OCD and postpartum psychosis) to get the help they need, please consider coming to Lunafest and sharing with friends, family members, neighbors, and colleagues and even share widely on social media.

There will be information about PSI, PSI-NJ and other maternal mental health services in NJ at this event.

The Good, the Bad, and the Ugly of COVID

I didn’t even realize I failed to post for June, so will post at least twice this month!  For all who read this post, I sincerely hope you are well.  If you need to reach out to me for help regarding insomnia after having a baby and postpartum depression or other related mood disorder, please do not hesitate to leave me a comment.  It may have been 16 years since I survived my experience, but I am always looking to help new moms!

Now, with today’s post.  Let me start with the ugly and work my way to the good.  As with everything, I try to see everything as REALISTICALLY as possible.  And try to appreciate silver linings.

The Ugly:

-I learned that people who felt inconvenienced with mask wearing, lost their jobs and/or lost loved ones harbor so much anger that they look to take their anger out on someone, and that someone is Chinese-looking people that live everywhere outside of China – that includes Chinese Americans who’ve never been to China (like me), Taiwanese, Koreans, Japanese, Malaysians, Filipinos, Singaporians, Vietnamese, Thai, Cambodians, Indonesians….you get the picture, right?
-I learned that there is still much to be done with respect to Anti-Asian sentiment and racism in this country; and much for people to learn with respect to Asian Americans and Pacific Islanders (AAPI)
-I learned that the so-called leader of this country deliberately caused the ramp-up of Anti-Asian sentiment and racism in this country by constantly referencing COVID as the “Kung Flu” and “Chinese Virus”….and it didn’t stop there…..his divisive rhetoric made people all the more hateful of people who aren’t white and the “perpetual foreigner” that legally-immigrated Chinese Americans (like all other legally-immigrated people of European descent, etc.) have been viewed as since they first came to this country in the 1700s

The Bad:

-I learned that COVID was not the only reason to be fearful of returning to NYC if you look Chinese, since physical and verbal attacks on Asians are occurring at an alarming rate
-I learned that COVID is ruthless with certain people regardless of underlying conditions or perfect health
-I learned that front line health workers have sacrificed so much, including their own lives
-I learned that many people were furloughed until their employers asked them to return or lost their jobs because so many small businesses around the country were impacted by the shut-down
-I learned that COVID has kept families from gathering in large numbers (well, at least the ones who believe COVID is a real issue) to celebrate and to grieve (when death takes a toll on a loved one)
-I learned that COVID can make people prone to depression even more so because people prone to depression should not be staying inside and being unable to have in-person social interactions for prolonged periods of time
-I learned that rates of postpartum mood disorders (e.g., postpartum depression, postpartum anxiety, postpartum OCD, postpartum psychosis) went up during lockdown:

The Good (yes, there are a few silver linings in the mix!):

-I learned that working remotely can have benefits, like getting more work done and getting more sleep, and being able to pick your kids up from school
-I learned that one can save a lot of money by not having to commute; I save upward of $500 a month from not having to commute to NYC and spend money on breakfasts & lunches
-I learned that one can get hours back by not spending time commuting – that for me means 3 hrs commuting on average each day, something I claimed I didn’t mind doing for almost 31 years leading up to March 2020
-I learned that another silver lining to staying at home is focusing on de-cluttering my life’s belongings, a thing I’ve been putting off for years
-I learned the importance of staying close to nature by tending to our garden, going on daily walks, and visiting the abundance of gardens in NJ, NY and PA
-I learned that technologies such as Zoom can work wonders to keep people connected when in-person gatherings are not possible
-I learned that true friendships pick up where they left off before the lockdown

Shout Out About Doulas in The Good Doctor….Can We Now Get One for PPD???

A brief post from me today, as it’s almost the end of April and I promised (for Amber) I would post at least once monthly for a year starting last October. Of course, I always start off saying it will be brief, but by the time I’m through, it’s not the short post I thought I was going to write, lol! Once I get my thoughts going, I could go on and on!

I’ve watched The Good Doctor since ep 1, and have absolutely LOVED the show for the way it’s written, cast, and directed. I was thrilled when doulas got a shout-out in a recent episode! I saw this on my Facebook feed a few days ago from a post by Raising Flowers Birth Services in Utah, which gave me the idea to blog about this. I bet more than half the people who watched the ep were like, hmmmm, what are doulas? I’ve mentioned them a bunch of times in my blog, but did blog about doulas specifically here.

I just wish they would do a show on postpartum mood disorders, as we desperately need a primetime TV show brave enough to get the message out that postpartum mood disorders are experienced by mothers (1 out of 7 in this country), and yet how all too often cases are missed, misdiagnosed, mistreated and have potentially fatal consequences for the mother and/or baby. I wish I could get a hold of Daniel Dae Kim on this (I did message him on Facebook yesterday but don’t expect a response), since he is a producer of the show, to see if he can work with Postpartum Support International. I don’t recall a primetime TV show ever having had postpartum mood disorders a focus of an episode. There might have been a shout-out or two or three these past years, but either I missed them or they were not substantive enough for me to recall.

Over the past few years, depression has been getting more attention, since Chicago Med and New Amsterdam have a mental healthcare practitioner on staff and they do have almost weekly examples of someone needing help from them. It’s a tremendous step in the right direction, and I am forever grateful. But…..WE NEED A POSTPARTUM MOOD DISORDER EPISODE!

Please, please, please, producers/directors of Chicago Med, New Amsterdam, Good Doctor….doesn’t matter which show. Please consider the importance of getting the message out because mothers around the country (and world, actually) are suffering and the public needs awareness about it because of the popular belief that, once people hear after a child is born that “mother and baby are doing well,” then all must be hunky dory and let’s all just focus on the baby. But…the baby will not thrive well UNLESS THE NEW MOTHER IS TRULY OKAY. And too many mothers suffer needlessly and painfully when they develop a postpartum mood disorder from out of the blue. Too many mothers feel shame because they don’t want others to know they can’t feel the joy that they “should” be feeling after the birth of their babies. The experience causes unnecessary feelings of despair and hopelessness, as what happened to me back in 2005. I got slammed with PPD from out of the blue. One day I was fine, the next day I wasn’t sleeping or eating, lost all my pregnancy weight and more in a few days, had anxiety attacks morning and night, and I thought I was not going to make it.

I would provide sample links to re-highlight why postpartum mood disorders like postpartum depression (PPD), postpartum anxiety, postpartum obsessive compulsive disorder, and postpartum psychosis are missed, misdiagnosed, mistreated and have potentially fatal consequences for the mother and/or baby, but I would be providing almost every link to every blog post I’ve ever written since 2009. And that’s an awful lot.

2nd Edition of Transformed by Postpartum Depression by Walker Ladd, PhD

Over nine years ago, my dear friend Walker Ladd, MFA, MA, Perinatal Mental Health Contributor for Science and Sensibility, Giving Birth With Confidence, and Midwife Connection, told me she was conducting a dissertation research study exploring transformational dimensions of postpartum depression (PPD). The study was part of the criteria to assist Walker in meeting the requirements of the Global Doctoral Psychology program at Sofia University.  She asked me if I wanted to participate.  She explained that participation would be a valuable contribution to a deeper understanding of the topic of personal transformation through the experience of PPD. 

By December 2014, Walker turned her dissertation into a published book titled “Transformed by Postpartum Depression.”  Just as the title suggests, this book focuses on the transformative power that women suffering from a postpartum mood disorder like PPD possess. It is a critical book that women suffering from PPD must have a chance to read. This book is exactly what I wish I could’ve found when I was sick with PPD and was desperately seeking other people’s stories but only found those written by celebrities, not of regular folks like myself.

It’s been nearly 16 years since I came out of that dark tunnel, but despite the number of years, the number of people treating women in a medical capacity that are uneducated about PPD still greatly outnumber those who are educated about PPD. This book should be mandatory reading for all individuals in the medical and mental health occupations who need to treat expectant and new mothers at any given point of their careers.  It should absolutely be on the required reading list for medical/nursing schools!!!

I remember when I received a copy of “Transformed by Postpartum Depression” back on December 13, 2014 (12/13/14!).  I was beyond thrilled for Walker.  And I was deeply honored Walker had chosen to include me in her book. 

Now, six years later, her second edition of the book is out! 

I will never be able to fully convey how honored I truly feel for her choosing me (of all people!) to write a foreword for this new edition. I will also never be able to fully express just how much respect I have for Walker and gratitude for the amazing gift of a book–so intelligently-written, informative, inspirational, and fact- and research-filled– to help new mothers and their families.  She worked so hard on the interviews and research to write this book, so let’s make sure people read it!  

This book isn’t just one survivor’s story. It’s the stories of 25 survivors (5 new ones added to this edition). Twenty-six, actually, if you count Walker’s! Go get your copy today!  At the very least, please be sure to share information about this book with others!  Thank you!

 

In Memory of Amber

On October 26th, I found out that a friend and wonderfully passionate and caring postpartum depression (PPD) advocate and blogger passed away over the weekend.

Her name was Amber Koter Puline.

I was shocked. Heartbroken. I haven’t really been able to process this over the past 5 days. I’ve only blogged 4 times since last August, but I felt the need to blog about this, to pay tribute to her.

I’m having a hard time conveying my feelings right now. I don’t think anything I write will adequately convey what this loss really means to me and so many people who were fortunate to have known her, loved her, befriended her, and been helped by her. Although my words don’t flow as beautifully as they do for those who are naturally gifted in writing, my intentions and feelings are genuine.

I met Amber almost exactly 10 years ago today at the annual Postpartum Support International (PSI) conference, which took place from October 27-30, 2010 in Pittsburgh. I remember feeling so excited to meet her and 2 other fellow PPD bloggers–Lauren Hale and Katherine Stone–at that conference. I greatly admired them all. Amber for her Beyond Postpartum blog and her work facilitating postpartum support groups and helping connect mothers with resources in the Atlanta area. Lauren for her My Postpartum Voice blog and her work with PPDChat on Twitter. And Katherine Stone for her very well-known blog Postpartum Progress. Between the time I first started blogging in February 2009 and for a year or two after that, we were the only individual bloggers whose blogs were focused specifically on PPD and other postpartum mood disorders (e.g., postpartum psychosis, postpartum OCD, postpartum anxiety). We used to run ideas by each other. The three of them inspired me.

Anger from my PPD experience helped my words flow freely, which is why I used to write frequent blog posts. Words used to flow from my head, out through my fingertips, onto the keyboard, and onto the computer screen whenever something fired me up that was PPD-related. That process helped promote healing. Ever since my anger dissipated in 2018, I’ve been at a loss for words and the desire to blog. This sudden loss of Amber, after not really being in touch with her much for the past few years, fills me with much regret. I’ve decided to channel this regret into positive action. So, just as Amber inspired me to blog 11 years ago, she is now inspiring me to take up blogging again.

Starting now and ending next October, I will write a blog post at least once a month in dedication to you, Amber, my friend and fellow PPD survivor mama. You helped so many mamas over the years that there is so much good karma because of you! Even though you are not physically with us, we know your spirit will continue to be with us as we find ways to keep that positive momentum going in your memory, like helping a new mother who is struggling, spreading awareness about PPD and/or donating to one of the following 2 organizations in your name:

Mental Health America of Georgia https://www.mhageorgia.org/donate/
Postpartum Support Internationalhttps://www.postpartum.net/donate/

Yes, I will do this in your memory, Amber.

Elly Taylor of Becoming Us and her 2019 Seed Planting Workshop U.S. Tour

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 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 30 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 4 years on Becoming Us-related reasons; whereas, I’ve been back to Sydney 3x in the past 22 years (I so wish I could return more often!).

Elly will be here in the states for her “Seed Planting” workshop tour in Los Angeles, Denver, Chicago, and New York City.  For the complete schedule and how to register, click here.  If you live near those areas and are a couple or family therapist, birth professional, infant or child mental health professional, and anyone else who works with expecting, new or not so new parent, sign up for Elly’s 2-hour interactive seed-planting workshop.

The training will teach you:

  1. how the groundbreaking research- and evidence-based Becoming Us approach can support you to work with mothers/fathers/partners to navigate the different transitions to parenthood, reduce risks for postpartum mood disorders, and support families to thrive
  2. what the transitions are (there are more than 8!), how they can negatively impact mothers and their families
  3. how to plant Becoming Us “seeds” that reduce risk for the most common parenthood problems including perinatal mental health issues and relationship distress
  4. how you can apply the model to your work with parents at any stage of their family life cycle

Then, in Atlanta, Elly will also hold a breakout session/seminar at the CAPPA Conference taking place from June 21-23.  See the CAPPA website for more info and to register.

Additionally, she will hold a breakout session/seminar at this year’s Postpartum Support International conference in Portland, Oregon.  It will take place on June 30th from 9am-noon.  See the PSI Conference website for more details about the conference and how to register.

Maria’s Letter to Her Younger Self

Maria’s younger self in 2009

A note of thanks to my friend and fellow PPD survivor/advocate, Maria, who was gracious in letting me share this letter she wrote last week during Maternal Mental Health Week, and I happened to see it on my feed and totally loved it.  This letter has inspired me to write my own letter to my younger self, which I hope to share soon.

If you are suffering from a postpartum mood disorder right now, please be comforted in knowing there are so many more moms like Maria and me that have suffered and overcome PPD only to become much stronger and empowered women.  You will down the road be able to write–and perhaps even share–your own letters to your younger selves as well.

*  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *

Dear Younger Maria (2009):

You are going to be okay.

You’re in hell now,
but you’re going to plug along
and find your way out.

It isn’t going to be easy
and it isn’t going to be pretty,
but soon after this photo was taken
you will summon the courage to reach out for help.

You will call the nurse manager in your obstetrician’s office
and in between sobs and heaving breaths,
you will slowly and fully tell her how you think something is wrong.

How you feel nothing when you hold your daughter
and you cry all the time.
How you only want to hide in a locked closet or a locked bathroom,
and in fact that is often what you do
once the kids are asleep or with a babysitter.

You are barely functioning but you are doing it.
You are doing it mama.

And those babies love you.
And you are an amazing mother.
And you are going to shine so brightly.

I promise.

Just hold on,
trust in yourself,
lean on your trusted friends,
and always remember that
you are worthy of more than this feeling.

More than this heart-wrenching,
gut-punching pain
and stifling loneliness.

This emptiness that consumes you will subside,
and soon you will find
a version of yourself that will set you free.

Be brave sweet mama.
I am so proud you.

Love,
Older Maria (2019)

Free Screening of Not Carol and Panel Discussion – Scotch Plains, NJ on May 29, 2019

If you live in New Jersey, please consider attending this screening of Not Carol, a feature-length documentary about the Carol Coronado case from 2014.  I’d blogged about it here and here.  And in searching for her current status just now (I was hoping there’d be news that would be more positive than that she was spending the rest of her life in prison without parole), I found this article featuring Joy Burkhard of 2020Mom  and her advocacy for Carol and other moms.  Carol’s case is another example of a tragic loss resulting from a postpartum mood disorder, in this case postpartum psychosis.

What:  Free Screening of Not Carol

Why:  Learn about postpartum depression (PPD), its symptoms and how to support mothers (and even fathers) suffering from it.  Public awareness initiatives like this one can help reduce stigma and ensure mothers suffering from a postpartum mood disorder, like PPD or postpartum psychosis, get the help they need.  We must ensure future cases like Carol’s will never happen again.  Note: this screening is not just intended for doctors/psychiatrists/social workers that work with new moms.  You can be a survivor, advocate, or simply a concerned citizen who may or may not know someone in your life that has suffered/is currently suffering from a postpartum mood disorder.

When: Wednesday, May 29 at 7:30 p.m.

Where: Scotch Plains JCC, 1391 Martine Avenue, Scotch Plains, NJ 07076

RSVP: Courtney Teicher via cteicher@jccng.org or 908-889-8800 x227

After the film there will be a panel discussion comprised of the following individuals (note that Dr Birndorf and Dr. Levine were on The Today Show on August 3, 2018, which focused on Dr. Levine’s experience as a new father with PPD.  Click here for my blog post about that):

  • Film Executive Producers: Eamon Harrington and Veronica Brady
  • David Levine, MD:  Summit Medical Group physician
  • Catherine Birndorf, MD – Clinical Associate Professor of Psychiatry and Obstetrics/Gynecology and founding director of the Payne Whitney Women’s Program at The New York Presbyterian Hospital – Weill Cornell Medical Center in Manhattan.  She is also a co-founder of The Motherhood Center).  I’d met her previously at a Postpartum Support International (PSI) conference.

Speaking of PSI, there will be information and individuals on-hand to provide information about the non-profit international organization.

 

 

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.

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.

 

 

Be the One Person Who Makes a Difference for Someone Else

My first blog post in over 4 months was only 2 days ago.  As you can see, I meant it when I said I would focus more on blogging!

Today’s post is inspired by a Scary Mommy article that appeared in my feed yesterday. The title of the article is “Am I Invisible? One Mom’s Pain-Relieving Response to Being Excluded” by Rachel Macy Stafford.  The title itself triggered my mind to flash back to many experiences of trying to befriend other mothers, only to have my attempts stopped dead in their tracks with the same kind of cold reaction mentioned in the first few paragraphs of this article.   I’ve hated–no, DESPISED– the feeling of being excluded since I was repeatedly excluded as a teen by these 3 C’s:  cliques, classmates and even fellow churchgoers.  Exclusions by teens is one thing.  But exclusions by adults?  Totally unacceptable, unnecessary, immature, inexcusable …..and quite simply, crappy.

As an adult, I have never had any problems striking up conversations with strangers I’ve never met before.  I have done that fairly often during the past 29 years of commuting into the city.  Usually, we are able to have these conversations due to our shared commuting woes.  That is our common bond.

In 2018, I made more new friends in my area in the one year than I have in the past 17 years combined.  As I’ve said in prior posts, I’ve found it challenging making friends in my area.  The friends I made last year arose from shared objectives of ensuring a #BlueWave this past November.  That was our common bond.

In 2016, I made more friends with classmates at my college reunion than when I was in college!  Being alums (without the stress of getting passing grades) was our common bond.

In 2006, I became a member of Postpartum Support International (PSI).  I blogged about our common bond previously in this blog post.

These are just some examples of how a common bond encourages friendships to form and conversations to be had even between strangers.  But that leads me to ask why a common bond of motherhood does not encourage friendships to form and conversations to be had even between strangers?  Why did the author of the Scary Mommy article experience the cold and mean exclusion that she experienced?  Why did I experience numerous cold and mean exclusions of countless mothers, even ADULT mothers of newborns, when we share a common bond of wading through unfamiliar territory together?

Doesn’t matter what the reason is, now does it?  Regardless of the reason–whether it be insecurity, pride or just plain nastiness–I would never do this to someone else.  It’s taken me a long time to piece it all together….the realization that such nasty behavior was actually a favor, as it instantly warned me not to waste any time.  In keeping with my philosophy “Life is too short for BS,” when I see people who–whether they know me or don’t know me yet–behave in a manner that is suggesting exclusion, I won’t waste my valuable time or energy on them.

In keeping with my philosophy of “Love, laugh and live a life with no regrets” I will take my experiences of people turning their backs on me and make sure I DO NOT treat others the way I DO NOT want to be treated myself.   I would NOT turn my back on someone who needed help, a listening ear and/or support.  I am not in the business of being on this earth to earn negative points in the karma area, TYVM.

I would:

  1. Help others who need help because, if the situation were reversed, I would want someone to offer me help
  2. Listen and provide comfort to others who need comforting because, if the situation were reversed, I would want someone to comfort me
  3. Support others who need support because, if the situation were reversed, I would want someone to support me

You know what they say about motherhood?  IT TAKES A VILLAGE.  Do what the Scary Mommy article suggests, which is to be the one person that makes a difference for someone else.  Imagine if everyone did that?  We would truly have a village!

The article urges us to each be the one that makes a difference for another, because all it takes is one person to help, listen/provide comfort to, and support someone else and help them realize they aren’t totally alone in this very-populated-and-yet-quite-lonely-at-times world.  How do we know the other person who’s coming to you for help, comfort or support isn’t in a dire situation?  How would you feel if you found out you could have made a difference by helping them, but was cold to them and there was a tragic outcome?

New mothers who are experiencing, or have experienced, a postpartum mood disorder share a common bond of loneliness, of feeling alone in our experience.  All it takes is one person to help another to not feel alone.  This is why so many new mothers have dedicated their lives to providing help/listening to/providing comfort to/supporting mothers suffering from postpartum mood disorders.  They want to give to someone what they did not receive while they were sick themselves.  Many, like me, did not get help, comfort or support.  Too many new mothers feel alone and for no reason at all.  There is no reason for a new mother to feel alone and at the end of their rope.

I will end with this beautifully-written poem in the Scary Mommy article:

With one invitation, we can take someone
From outsider to insider
From outcast to beloved member
From unknown neighbor to coffee companion
From wallflower to life-of-the-party
From shortened life expectancy to 80 years of joy.

I DO NOT want to have any regrets for not doing something when I had the opportunity.  Do you?

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.

 

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!

 

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.

*********************************************************************************

 

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.

Two Important PPD Studies

Since my last blog post, I thankfully haven’t been insane with work as I’d been in earlier weeks.  Truthfully, I’ve just been lazy.  It’s like my body is finally letting me be relaxed and not doing much, for once in who knows how long that I’ve honestly lost track.  I am still in the process of transitioning off of the laptop I’ve had for over 8 years, and with this blog post will be closer to my goal, since it will leave me with only 5 more tabs left open to blog about.  My last blog post included 4 stories of moms who died from severe cases of postpartum depression (PPD).  This blog post is about 2 PPD studies.

BREXANALONE / SAGE-547

This past June, I was beyond excited in reading an announcement from the UNC Health Care and UNC School of Medicine Newsroom titled “UNC researchers lead clinical trial evaluating potential treatment for postpartum depression” about a new treatment for PPD called brexanolone (or SAGE-547) currently in clinical trial phase 3.  The results of the clinical trials have been extremely promising thus far, with SAGE-547 providing a fairly rapid onset of relief for the participants, but it still needs to undergo further tests before the FDA would approve it for use by new moms….and how AMAZING would that be!  It would make a huge difference in the lives of so many mothers and their families–with 1 in 7 new moms experiencing PPD–not to mention save lives!

Brexanalone is also known as allopregnanolone, which is a steroid in the brain (neurosteroid) derived from progesterone that helps to regulate mood.  There is an increase before and a sudden decrease after childbirth when it comes to both allopregnanolone and progesterone, and it’s the sudden drop that seems to trigger PPD for some women. There are currently no medications specifically intended to treat PPD. Antidepressants like Paxil, which are supposed to increase levels of the neurotransmitter serotonin, can take several weeks to “kick in” (it took 4 weeks for me), if at all.  For some moms suffering from PPD, multiple antidepressants fail to do anything.  And if you’ve ever been through depression you know how a day spent depressed can feel like an eternity, so can you imagine what weeks, or even months, spent desperate for a relief from symptoms, while caring for a new baby, must be like?

On July 14th, I heard Samantha Meltzer-Brody, M.D., M.P.H., director of the Perinatal Psychiatry Program at the UNC School of Medicine, talk in person about the treatment and the study at the annual Postpartum Support International conference in Philadelphia.

You can participate in testing via the Hummingbird Study. The website includes information on how to find out if you can participate.  On the website, there is also a helpful guide on how to to identify the warning signs of PPD of and provide support to a new mom with PPD.

PPD ACT

In order to better understand why some women suffer from PPD or postpartum psychosis and some do not, what causes PPD, as well as how to detect, treat and even prevent PPD and postpartum psychosis, information from as many women as possible needs to be collected for analysis.  To help collect data from as many participants as possible, an app was created. Thank goodness for technology!

Last year, Dr. Samantha Meltzer-Brody–yes, her again–was part of a team (that included the National Institute of Mental Health, UNC Chapel Hill and Apple) to create the PPD ACT iOS app, which I’d previously blogged about. It is an app that is is free and available to download via iPhone (and now Android phone!) in English and in Spanish in Australia, Canada, and the United States, and is coming soon to the UK and to Denmark.  Any mom who suspects she has experienced symptoms of PPD or postpartum psychosis is encouraged to download the app and join the study.  Even if you think/know you had PPD, you can participate in order to help advance the study to benefit moms in the future.  It only takes 10 minutes of your time.  I just did it myself, and it took less than 10 minutes, including the time to download the app to my iPhone.  Part 1 of the app is a short survey to get feedback on whether you have/had PPD and receive mental health resources if you are currently experiencing PPD. Part 2 involves participation by those who have/had PPD in a DNA study using a spit kit.

Click here for access to articles in the New York Times, Buzzfeed, CNN, Huffington Post, and the Lancet on PPD ACT.