Wrapping up Maternal Mental Health Awareness Month: Interview with Lindsay Lipton Gerszt on the Documentary “When the Bough Breaks”

Introduction:

When the Bough Breaks follows the journey to recovery for Lindsay Lipton Gerszt.  It also includes interviews of celebrity mothers (i.e., co-producer Tanya Newbould, Carnie Wilson of Wilson Phillips, celebrity chef Aarti Sequeira, Peggy Tanous of The Real Housewives of Orange County), interviews with other mothers, subject matter expects on postpartum mood disorders (like Diana Lynn Barnes, whom I know), and those who helped Lindsay during her recovery (including her doula, her therapist, her acupuncturist, her OB/GYN).

The film is educational in that it touches on the statistics of postpartum mood disorders and what they are, importance of social support, risk factors, importance of screening new mothers, treatment methods, and the stigma/shame surrounding such disorders…..fundamentally, the same elements that are covered in my book.

The film encourages mothers to speak up and share their experiences, and seek help as soon as they feel something isn’t right.  There should be no shame in being sick with a postpartum mood disorder.  It is not your fault.  It is your body’s physical reaction to your childbirth experience.  The more mothers share their experiences, the less stigma there will be.

I smiled when I saw my lovely friends, Jane Honikman, founder of Postpartum Support International and Postpartum Education for Parents (PEP) and Walker Karraa.  Tears flowed when I listened to the tragic stories, one of which I had blogged about previously (Naomi Knoles). One of my favorite lines from the film referred to PPD as a “sickness of the brain, which is an organ of the body.”  If the public and healthcare folks all treated PPD this way, we would be leaps and bounds ahead of where we are today.  My hope is that one day, the diagnosing and treating of PPD will be as routine as diabetes.  The film ends very much like how my book ends.  There is hope, as there is progress thanks to efforts of many of the folks mentioned in the film.

I know what it’s like to be impassioned to share your experience so that other mothers don’t feel as alone, hopeless and caught off guard as you do.  My 429-page book has no doubt scared a lot of people away from buying and reading it, and I haven’t done a whole lot to market it.  But at least I have my blog, which reaches people via Internet all over the world.  For many people, images and movies have a greater impact.  You just sit back and take it all in.  Now that it’s available on Netflix, the film is available among all the other movies that could potentially be seen by the 94 million subscribers, which is a really huge deal.  And with Brooke, Carnie, Aarti and Peggy’s names attached, the film will surely draw in many, and hopefully, many more people will now have an awareness of postpartum mood disorders and as a result, more mothers with PPD will recognize when it’s not the blues and seek help sooner.  And hopefully, the film will help decrease the stigma associated with maternal mental health conditions like PPD, postpartum psychosis, postpartum OCD, etc.

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Lindsay, I’m sure you have heard repeatedly about how wonderful this film is.  It is ground breaking.  It is educational.  It is chock full of information that is so important to share with the public.  Thank you for taking the time to participate in this Q&A on my blog!

Question 1:

When did the idea of filming your experience with PPD first come up? Was there a light bulb moment for you?  What was the pivotal moment that turned your desire to write your story into reality?  For me, there was a specific what I refer to as “light bulb moment.”  Tom Cruise’s words “There’s no such thing as a chemical imbalance” in 2005 was my light bulb moment to write a book about my PPD experience. Incidentally, seeing him included in When the Bough Breaks flashed me back to how I felt when he uttered those infamous words. It was my experience with PPD, combined with childcare complications and lack of social and practical support, that motivated me to write my book One Mom’s Journey to Motherhood.  My mission was to help other mothers realize they were not alone in what they were experiencing and not the only ones seeking practical tips in dealing with childcare complications (e.g., colic, eczema, cradle cap, which I had no idea how to address as a first-time parent), so new moms wouldn’t be as anxious and in the dark as I was on how to cope with these types of issues.

Answer 1:

Director and Producer, Jamielyn Lippman, and Producer, Tanya Newbould, had the idea to make a documentary about PPD.  They put an ad in a mommy blog and I responded, as I felt ready to share my story.  At the time, my son was only a few years old and I was still suffering greatly.  After my interview, Jamielyn reached out to meet with me.  We decided to continue the journey of making When the Bough Breaks with the three of us, and I came on as a producer.

We knew that, in order for this film to really resonate with the audience, we needed to follow someone on her journey.  We needed someone that people could root for and connect with.  When we first started talking about who we wanted this person to be we didn’t have to think further than myself.  I craved to feel better and I realized that I was so far from recovery.  It was also the perfect opportunity for me to seek out different treatment options and to further educate myself on perinatal mood disorders.

What I did not know at the time was how big of an impact making this film would have on me.  The emotions I felt while filming were real, raw and intense.  I had anticipated to “hurt” while sharing my journey but what I experienced through filming was life changing.

 

Question 2:

Can you give a brief overview of what the film is about ?

Answer 2:

When the Bough Breaks is a feature-length documentary about PPD and postpartum psychosis.  Narrated and executive produced by Brooke Shields, this shocking film uncovers this very public health issue that affects one in five new mothers after childbirth.  The film follows Lindsay Gerszt, a mother who has been suffering from PPD, for six years. Lindsay agrees to let the cameras document her and give us an in-depth look at her path to recovery. We meet women who have committed infanticide and families who have lost loved ones to suicide.  Babies are dying, women aren’t speaking out, and the signs are being missed.  When the Bough Breaks takes us on a journey to find answers and break the silence.

 

Question 3:

Is there anything in particular you’ve learned as a consequence of capturing your story and these other people’s stories on film?

Answer 3:

I have never learned more about myself, human nature, pain and love as I have with making When the Bough Breaks. I have always suffered from depression but to suffer while having to take care of a baby made me realize how strong I am and what I am capable of.  I also learned that you cannot judge anyone!  Everyone has a story to tell and we must learn from each story no matter how painful it is to listen.  As hard as it was to make this film, it was life changing and I would not take it back for anything in the world.

 

Question 4:

Who should watch the film, and why?

Answer 4:

When the Bough Breaks is not just a film for mental health professionals.  It is a film for everyone.  Since up to 1 in 5 new mothers will suffer from a perinatal mood disorder, everyone will know someone at some point who is suffering.  We need to know what signs to look out for and how to give the support that those whom are suffering so desperately need.  We need to know what treatment options there are and how those treatments work.  Most importantly, we need to keep talking about this very serious illness and fight the stigma that is attached to it.  With When the Bough Breaks being available in 64 countries, now we have a big opportunity to work with other advocates to keep this important conversation going and reach a huge audience that otherwise does not know anything about PPD.

 

Question 5:

What was the most challenging part in the process of filming this documentary?

Answer 5:

For me, filming the interviews that dealt with postpartum psychosis were the most challenging part of filming When the Bough Breaks.  As producers, you are there to tell a story.  However, when you meet and get to know the many people being interviewed in the film, you start to care for them on the deepest of levels because we are sharing this experience and journey together.  To see their pain in telling their stories–whether it was a mom who suffered from postpartum psychosis, her partner or the children who were affected by it–was very intense and heartbreaking for me.  I personally became very close to Naomi Knoles and her family.  When we lost her, we were devastated but it also made us work even harder to make sure the film reached as many people as possible so her story could be heard and help others.

 

Question 6:

Do you plan to screen this movie in major cities, and if so, is there a schedule?  Is there a plan to get OB/GYNs to watch this movie?

Answer 6:

We have just signed two educational deals that will help get the film out in markets to which we would not normally be able to reach out on our own.  We have also set up a screening license on our website so that organizations and communities can screen and share the film. We need the film to reach as many hospitals, OB/GYNs, pediatricians and any other organizations that work with new mothers, and I am and will continue to work hard to make sure that happens. The screening license can be found here https://www.whentheboughbreaksfilm.com .

 

The First Center of its Kind in New Jersey

As I mentioned a few days ago, I took the day off because  I needed to witness the grand opening of the very first center of its kind in my home state: The Perinatal Mood and Anxiety Disorder Center at Monmouth Medical Center.

 

 

 

 

 

After paying this center a visit personally and hearing about the immensely positive impact it has had the past 6 years since Lisa Tremayne first endeavored to provide a place for mothers suffering from postpartum depression (PPD) to go to for help, I am just so, so amazed and have such tremendous respect for Lisa and for the staff.

 

 

 

 

There were many mothers/babies there that were there to celebrate with Lisa and the amazing staff.

 

 

 

 

 

Robert Graebe, MD (Chairman of the OB/GYN Dept) kicked off the ceremony.

 

 

 

 

 

Followed by Mary Jo Codey who recounted her personal experience with PPD so long ago.  I’ve heard her speak what must be a dozen times by now, but hearing her wrenching experience from when she suffered from severe PPD in the 1980s and a second time in the 1990s always serves as a reminder of how far we’ve come and yet how much further we still need to go when it comes to helping new mothers realize when and how to get help, helping doctors correctly diagnose and treat PPD.  She wrapped up her speech with a statement about how grateful she is for the existence of this center and how we need to make sure more centers like this open up in New Jersey.  Click here  and here for articles posted earlier today that include pictures and video clips.

After the former First Lady’s speech came Lisa Tremayne who gave a brief history of the center and how it has been helping mothers since 2011 and then introduced PPD survivors Meg Santonacita, Luciana Mangyik, and Carolyn Stack, each of whom shared their experiences and how the center helped each of them to recover.

 

 

 

 

 

After the speeches came the ribbon cutting ceremony!

Maternal Mental Health Awareness Month – 2017

Just like this time last year, I’ve come across so many things on my Facebook feed in the past few days–all in anticipation of Maternal Mental Health Awareness Month– that I’m just going to highlight all the exciting work, developments, other mothers’ experiences, and upcoming events all in one post.  It’s just a shame that these exciting developments, including articles to boost awareness, don’t happen all year round!  Think about how much more progress there would be if that were to happen!

As I stumble across more articles this month, I will add them to this blog post.

 

House Bill 1764 in Illinois

I saw an exciting announcement today on my Facebook feed from my friend Dr. Susan Benjamin Feingold, a nationally renowned expert on perinatal (pregnancy and postpartum) disorders and the author of Happy Endings, New Beginnings: Navigating Postpartum Disorders.  She testified yesterday in the Illinois Senate Criminal Committee.  HB 1764 just passed the Senate Committee and must next pass the full Senate.  Once the Governor signs off on it, it becomes Illinois law, making Illinois the first state to pass such a law!  Such a law has existed in the UK since 1922 when the Infanticide Act was put in place to ensure mothers receive psychiatric treatment and rehabilitation, rather than a death sentence or life in prison. Canada and several other European countries have also adopted similar laws.  It’s about time the US did too!

It’s due in large part to the following individuals that HB 1764 has made it thus far:  Dr. Feingold and Lita Simanis, LCSW who provided critical testimony, Bill Ryan (retired Assistant Deputy Director at the Illinois Department of Family and Child Services who regularly visited the Lincoln Correctional Center in Logan County, IL and heard the stories of numerous women serving long or lifetime prison sentences for crimes committed while sick with a postpartum disorder) who proposed the law and brought it to State Representative Linda Chapa LaVia (83rd District) who sponsored it, and Barry Lewis (Chicago Criminal Defense Attorney) who provided a written brief and expert testimony as to why this law is constitutional (in response to opposition from the State Attorney).

Click here for more information about postpartum psychosis and why this news is of such significance and a major stepping stone to what will hopefully be the passing of similar legislation throughout the U.S.   Cases of postpartum psychosis are rare and cases of ones leading to infanticide are even rarer.  But as the article states, all cases of postpartum psychosis are neurochemically caused.  Usually, women who are sick with postpartum psychosis don’t even know that’s what was wrong with them and their conditions go untreated, undiagnosed or diagnosed but not properly treated.  During trial, these women are not allowed to talk about their conditions or have them considered as mitigating factors in sentencing.  Although the idea of infanticide is truly tragic and unfathomable, try donning your empathy hat and imagine what it would be like if it were you (be sure to read up on what postpartum psychosis is and what it does to a person first) that was being controlled by  neurochemistry gone completely out of whack until tragedy strikes with an act you commit–one that you could not prevent or control due to your illness–that you will pay for dearly for the rest of your life enduring painful, unrelenting regret, many years or life in jail (or even face the death sentence), and with your illness never addressed or treated.

 

PPD Screening in NYC and Texas:
On May 18th, First Lady of NYC, Chirlane McCray, announced that NYC Health + Hospitals will screen EVERY new mother for maternal depression.  NYC Health & Hospitals provides healthcare services to more than 1.4 million New Yorkers in more than 70 patient care locations and in their homes throughout New York City.  Click here for the link to her Facebook page announcement.  Click here for more about NYC Health & Hospitals.

On my Facebook feed on May 23rd, I saw a link to an article that made my eyes pop wide open!  How exciting was it for me to read that, over in Texas, House Bill 2466 was passed for new mothers participating in federally-backed health care programs (for low-income families) like Medicaid to be screened for PPD when they bring their babies to see their pediatricians.  Yes, mothers who bring their babies in for their checkups can get screened for PPD by their babies’ pediatricians, and the screening would be covered under their children’s plan, like the Children’s Health Insurance Program. Research has shown that PPD is less likely to be identified and treated among low-income mothers, and this bill seeks to detect PPD through newborn checkups.  The rationale is–which I’ve blogged about previously and even wrote about it in my book–since mothers are not required to see their OB/GYN after childbirth unless there’s a medical issue that needs treatment, there is the opportunity at their babies’ 1-month checkup for the pediatrician to screen the mother.

 

Alexis Joy D’Achille Center for Women’s Behavioral Health:
In my Facebook feed today, I spotted an article about a new center like The Perinatal Mood and Anxiety Disorder Center at Monmouth Medical Center, which celebrated its grand opening on May 5th.  Click here for my blog post about this first of a kind center in New Jersey.  Due to open this fall, the the Alexis Joy D’Achille Center for Women’s Behavioral Health will offer comprehensive maternal mental health care at West Penn Hospital in Bloomfield, PA, in partnership between Allegheny Health Network and the Alexis Joy D’Achille Foundation.  This new facility will offer a wide range of treatment, including weekly therapy, an intensive outpatient program and partial hospitalization for women with more severe forms of PPD.  The Alexis Joy D’Achille Foundation was founded by Steven D’Achille in memory of his late wife who at the age of 30 lost her battle against the severe PPD that hit her after she had her daughter in August 2013.  The article about this new center talks about the work it has done to benefit new mothers since 2015, and the work it plans to do once the facility is completed.

 

Personal Success Story: If You Only Ask – by Jordan Reid
Being your own advocate by being informed about postpartum mood disorders, knowing your risk, and being prepared for the possibility – unfortunately, you have to for self-preservation purposes because there aren’t enough resources to catch the moms who fall through the cracks of doctors failing to diagnose, treat or even refer maternal mood disorders. The post reflects the main steps I suggest in chapter 5 of my book, which delves into risk factors and coming up with a prevention plan.  I also touch on being prepared in a previous blog post by having a therapist lined up, just in case, if you think you are at high risk for postpartum depression (PPD).  I’ve also blogged about risk factors for PPD.

 

Postpartum Support International (PSI):
The annual PSI conference is coming up in Philadelphia!  Register by May 8th to take advantage of early bird rates for its PMD certificate course from 7/12-13, as well as for the regular 2-day conference from 7/14-15).

Additionally, PSI has just announced its partnership with the University of North Carolina-Chapel Hill (UNC-Chapel Hill) School of Medicine to expand the PPD ACT.  The PPD ACT is an iPhone app previously released in the U.S. and Australia to study PPD, which is now expanding its reach to iPhones in Canada and to Android phones in the U.S. and Australia.  The app was designed to help understand why some women suffer from PPD and others don’t, in the hope of improving the ability to minimize risk and find more effective treatments.  Women with the app can participate in surveys and DNA testing to study the genes of those suffering from PPD.  This study is the first of its kind.  Last year, approximately 14,000 women enrolled in the study.  Many women who participated were successfully treated for PPD. Ultimately, the hope is to be able to expand the study across the globe.  To download the app or learn more about the study or PPD, click here. For more information about the PPD ACT, click here to access the UNC-Chapel Hill announcemen, here for a HuffPost Canada post announcement, and here for a Mom.me post titled “Find Out If You Have Postpartum Depression Without Leaving Home” by Claudiya Martinez on May 15, 2017.

 

National Coalition of Maternal Mental Health (NCMMH):
And last and most definitely not least, please have a look at how you can participate in Maternal Mental Health Awareness Week (May 1-7) led by the National Coalition of Maternal Mental Health (NCMMH).  Click here to see how you can partner along with other organizations, blogs, authors, mental healthcare providers, etc. in the awareness initiative by becoming a social media partner (like me) to NCMMH.  Help spread the word about the #1 complication of childbirth on Facebook and Twitter by changing your profile pictures and cover pictures, as well as re-tweeeting/re-posting digital messages from the NCMMH’s Twitter and Facebook accounts from May 1-7.

 

The Perinatal Mood and Anxiety Disorder Center at Monmouth Medical Center – Grand Opening on May 4, 2017

Announcing the Grand Opening of The Perinatal Mood and Anxiety Disorder Center at Monmouth Medical Center (MMC)!  This is such an exciting development for New Jersey that I’m taking the day off from work to attend this grand opening to meet the program’s multi-disciplinary team of experts and clinicians certified by Postpartum Support International.

When:  Thursday, May 4 at 1:00 p.m. (ribbon cutting starts then)
Where:  Maysie Stroock Pavilion (Pavilion & Second Avenue, Long Branch)
RSVP:  Email teamlink@rwjbh.org or call 888.724.7123
Agenda:  Speakers will include Mary Jo Codey (former NJ First Lady who will share her personal experience with postpartum depression (PPD), Lisa Tremayne, Robert Graebe, MD (Chairman of the OB/GYN Dept), and several PPD survivors who are former patients of the center.

Thank you to Lisa Tremayne, RN, CPPD, CBC, CCE — maternal child health nurse at MMC — for graciously providing the details of how New Jersey’s VERY FIRST perinatal mood and anxiety center of its kind has evolved under her persistent efforts.

After the birth of her triplets (after 6 years of not being able to conceive naturally and one round of IVF) in 1998, Lisa suffered from what she later learned was postpartum anxiety/postpartum OCD, which greatly affected her life as a new mom.  She experienced racing thoughts and living in a constant state of anxiety.  She never received help, no one ever questioned if she was okay, and it took years for her to fully recover.

It wasn’t until 2007 when she was at a mandated lunch and learn with the Central Jersey Family Health Consortium that she learned she had what they referred to as postpartum depression (PPD).  Not telling anyone about her experience, she started volunteering for the consortium, and helped patients find resources and help. In 2011 she became the MMC Childbirth Education Manager. As facilitator for a new moms support group she quickly realized many mothers were suffering from PPD.  She then received permission to start a PPD support group, which was instantly well received and attended by large numbers of mothers.  It was at that point she broke her silence and shared her experience with others. She presented her plan to start a PPD program to new business development, but it wasn’t until April 2015 that the plan was accepted and the program was started with the support of the chairperson of OB.  The program consisted of Lisa, a therapist and a psychiatric nurse practitioner on a part-time basis. Since then, the program has grown.  It is now a mother/baby program in which babies are not only allowed but encouraged to attend with their mothers so the staff can assess mother/baby attachment at all times.  Many classes/workshops are designed specifically for the mother/baby.

Lisa and the other dedicated members of the program are excited about the grand opening that is finally going to take place on May 4th!  To date there have been intakes of over 800 women, and 500 women have received medical evaluation, treatment and referrals to appropriate services through the program.  On average, there are 30 new patients a month.  Lisa hopes the program will evolve into a partial day stay program by 2018.  The program is interdisciplinary and every member is completely passionate about helping moms/babies, normalizing this temporary and treatable illness and educating the public that this is the #1 complication of childbirth.

Postpartum Insomnia Series – Part 5: VAN

I want to thank Van for sharing her postpartum insomnia experience with us.  She reached out to me via my blog back in January and we’ve corresponded via email since then.  She is nearing the end of her postpartum depression (PPD) journey.

From the time she first reached out to me, I realized her symptoms were very similar to mine.  Every time she reached out to me, I felt like I was experiencing PPD once again. I empathized with her so much, I just wanted to give her a hug and try to do more for her.  But she was very far away.  Thankfully, we were able to exchange emails.  The primary difference between her experience and mine was that she gained weight and craved food, while I lost weight quickly and had no appetite.

Like me, she had a traumatic childbirth experience, hemorrhaging, and a 1-week stay in the hospital.
Like me, she was caught blindsided by insomnia and panic attacks within a few weeks of giving birth.
Like me, she was frightened and had no idea what was wrong with her.
Like me, she was desperate for answers and understanding.

Her frightening experience has resulted in a desire to help other mothers going through PPD.  I figured what better way to start doing so by sharing her own experience on my blog!

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QUESTION:
When/what was the first indication that something wasn’t right, and how long after childbirth did the first sign occur?

ANSWER:
Looking back in hindsight, I felt something wasn’t right shortly after I gave birth but I didn’t think much of it. I attributed it to a traumatic birth (I haemorrhaged and lost 1.5 litres of blood), no sleep, and exhaustion. I remember feeling overwhelmed and very scared. I kept on thinking “What have I done? I don’t want this baby. How am I going to look after this person?” All I wanted to do was get away from this little person, but knew I couldn’t.

Due to my blood loss, infection and complications with the baby, we had to stay in hospital for a week. It was a day after I gave birth and during my hospital stay that the panic attacks started. I remember pacing up and down the ward, not knowing what was happening to me.  I felt an overwhelming surge of adrenalin that made my heart race and made me feel like I was going to die.  It didn’t register that something was wrong.  I just attributed it all to exhaustion, and staying in a busy ward with no sleep.  I thought things would be okay once I was home. I spoke to the midwives about it and they said that what I was going through was normal.  Since they dismissed it, I did too.  It wasn’t until after I was home and the insomnia and panic attacks continued and worsened that I finally acknowledged that something was really wrong.

QUESTION:
Did you suffer from insomnia? What other symptoms did you experience, if any?

ANSWER:
Yes, I suffered from severe post-partum insomnia. I have suffered bouts of insomnia in the past, but didn’t really have trouble falling asleep and staying asleep. My past insomnia experiences weren’t as prolonged or severe as my post-partum insomnia. I am not too sure whether it was the anxiety and panic attacks that caused the insomnia or the insomnia that resulted in the panic attacks. For the first four months, my life was pretty much a living hell. I’d have panic attacks 3 times a day, sometimes lasting 2 hours at a time. I was very hysterical and desperate.  Aside from the insomnia and panic attacks, I had a huge appetite and ate 7-8 meals a day. Every 2 hours I’d feel hungry and I didn’t know when to stop.  I would eat throughout the night too. I gained a lot of weight during the first 4 months post-birth. I later found out that sleep deprivation causes changes in the digestive hormones.

I constantly had a dry mouth. I also felt like I had a constant lump stuck in my throat and that my windpipe was closing up. I couldn’t feel my body.  It felt like my nerve endings weren’t working properly.  If you pinched my cheeks or arm I couldn’t fully feel the sensations. I couldn’t feel heat either. My heart would palpitate so much it felt like I was having a heart attack. I felt nauseous pretty much every day.  I couldn’t feel my legs, and felt this constant pins-and-needles sensation on the soles of my feet.  I didn’t know whether that had anything to do with the epidural. I later learnt that all these sensations were symptoms of anxiety. Every time I closed my eyes to try and sleep, all I could feel was the surge of adrenalin through my body.  It felt as though there was a battle between my sleep hormones and adrenalin.  It was a very horrible feeling. I could never relax and I was constantly alert. I developed a fear of sleeping because of all this.  Every night I would get scared about sleeping, wondering whether I would be able to sleep or not. I became very paranoid. I was scared to go out. I became slightly obsessed with certain things. I had certain rituals that if I didn’t/ did do them I thought I wouldn’t get better. I was very desperate to get better and I was so afraid that I wouldn’t. I feared that this would be my life forever. Every day was a battle. I felt I was dying every day. Since I wasn’t sleeping, my mind was very foggy like there was cotton wool in my head.  At the same time, I was very alert and wired. I constantly felt dizzy. Ten months after giving birth I still feel dizzy sometimes.


QUESTION:

Did you see a doctor right away, and was he/she able to help you?  What course of treatment did he/she prescribe? Did he/she diagnose you with a postpartum mood disorder?

ANSWER:
I didn’t see my GP until 10 days after I gave birth. I didn’t sleep at all during those 10 days. I have vivid memories of the day I saw my GP.  I walked into my GP’s office and broke down.  I was hysterical. Tears streamed down my face as I begged in desperation for someone to help me.

My GP wasn’t much help, and he certainly wasn’t reassuring. He prescribed me Zoplicone to help with sleeping and Propanolol for the panic attacks. He said he has never seen anyone like me before and never heard of post-partum insomnia. I wasn’t given a formal diagnosis, but I was referred to the peri-natal team. They did some assessments and concluded that I was very depressed. But I kept saying I wasn’t depressed….. what I needed was sleep. The peri-natal team referred me to a psychiatrist who only wanted to give me anti-depressants, which I didn’t want to take. I was prescribed Paroxetine.  I had to wait 2.5 months post partum until I had my first CBT session. I had 6 sessions in total, once a week. After the 6th session they released me, as they decided I was well enough and didn’t need to continue. If I had a relapse at any point I was suppoed to contact the peri-natal team. So far, I haven’t had to.

 

QUESTION:
If you had to take meds, what was it/what were they and how long did you have to take it/them?

ANSWER:
I took Zoplicone for my sleep and took that for 2-3 month. On some nights I was able to sleep for 2.5 hours with Zoplicone.  On some nights, though, it didn’t help me sleep. I took Propranolol only for a week because I felt it was making my anxiety worse. I was also prescribed Paroxetine, but I never took it because I was so scared of the side effects it’s been known to cause.

 

QUESTION:
Did you have enough resources to help you with your recovery?  What kind of resources did you have (e.g., support group, postpartum doula, psychiatrist, partner reduced work hours/worked from home)? Did you have enough practical help (e.g., late night feedings) with the baby?

ANSWER:
Fortunately, I had a very good support network of family and friends. My mum stayed with me for 5 weeks. She was brilliant and looked after me, my husband and my baby. I remember one night, in particular. I was having a panic attack, and my mum held and rocked me and sung me a lullaby. That night occurred during the lowest point of my experience with my post-partum disorder. My husband was also very supportive.  He did all the night feeds for about 3 months until I felt I was able to do them.  During that time, he still went to work every morning. He was amazing.   He supported both me and the baby. The focus was for me to sleep and get better, so I slept in a separate room from my baby and husband so I wouldn’t be disturbed. My mother-in-law also came to help with the baby while I was recovering.  My friends visited regularly.  l called my friends whenever I had a panic attack, as I found talking to others helped me through my panic attacks.  Although I had a brilliant support network, nobody really understood what I was going through. I remember one afternoon when I was having a panic attack. I was alone upstairs in my bedroom crying, and my heart was beating so much that I thought I was going to die from a heart attack. I remember feeling so alone and terrified, and crying and praying for all this to end. It wasn’t until I found Ivy’s blog about post-partum insomnia and disorders that I felt less scared.  Reading her blog and other people’s experiences helped me realize that post-partum depression really does exist and it wasn’t just me.  This realization helped with my recovery.

My peri-natal team was very good.  Someone came to visit me every week for 3 months to check up on me. My CBT therapist, Annie, explained to me that my body had gone into survival mode after a traumatic birth, which could be one of the reasons why I was having panic attacks and experiencing chronic insomnia.

I was so desperate to find answers to what was wrong with me that I was constantly on the Internet trying to find answers. I became a bit of a hypochondriac, thinking that I suffered from everything I read about. I thought I had diabetes, thyroiditis, and adrenal fatigue. I consulted a nutritionist and explained what I was going through. I did an adrenal fatigue saliva test and my cortisol level was very high, especially at night. No wonder I couldn’t sleep! He designed a food plan for me to lower my cortisol levels and told me to take certain vitamins and minerals. To my surprise, I was able to sleep better after being on his food plan. Since I was very reluctant to take medication, I sought alternative therapies. I found crystal healing helped with my recovery. Although the crystals may very well be just a placebo, I still sleep with them. On nights I feel a little anxious, I hold my crystals and I’d fall asleep.

 

QUESTION:
When was the first sign of light at the end of the tunnel and you were starting your recovery?

ANSWER:
I can’t really pinpoint when I started to feel better.  It was a gradual process. I took it one day at a time. Slowly, I got out of the house more, I obsessed less over what I ate and when I ate, and I stopped obsessing about my heart rate and Googling my symptoms. The panic attacks became less frequent. I got more solid hours of sleep. I didn’t ruminate as much about how I felt and how my mind was fuzzy. But recovery was such a long process. Sometime it felt like I was taking one step forward and two steps back. I remember emailing Ivy on one of my low days asking her “Will I get better?” She reassured me and said yes. I always looked forward to Ivy’s emails as they made me feel like I wasn’t going crazy.  Slowly but surely I recovered and began to enjoy motherhood and being with my son.

 

QUESTION:
Did you have any more children after this PPD experience, and if so, did you do anything to prepare yourself and were you able to ward off PPD the subsequent time(s)?

ANSWER:
The whole experience did put me off having another baby initially, as I didn’t think I could go through the whole ordeal again. But now, 10 months after giving birth, I think I could do it again because I now know what to expect if I were to have another baby. If I were to suffer from PPD again, I wouldn’t be so afraid and I know it would only be temporary and things will get better.

 

QUESTION:
If you could go back in time what advice would you give yourself before you got pregnant?

ANSWER:
I would advise myself to read up on PPD. I don’t think there is enough awareness on PPD. If you are a first- time mother suffering from it, it’s a very scary situation to be in if you don’t know what is happening to your body and mind.  Throughout my pregnancy no one mentioned PPD. Healthcare providers emphasized pregnancy, labour and giving birth but never once talked about the post-partum period or possible complications during pregnancy and childbirth.  If I had known about PPD, I wouldn’t have felt so scared and isolated. I would also look into hypnobirthing and/or active birthing to have a better and more natural childbirth experience. I would hire a doula to help with childbirth and the first few weeks post-birth.

 

QUESTION:
Did anything positive come out of your PPD experience?

ANSWER:
My experience has had a huge impact on me. I really want to help women going through PPD. I think I’ve grown as a person. I’ve learnt to appreciate the small things. I’m more compassionate and less judgemental and generally happier than I was before my pregnancy.

 

QUESTION:
What would you want to say to women currently suffering with PPD?

ANSWER:
What you are going through is horrible, your hormones are trying to find a balance, and sleep deprivation is beyond awful.  At times you will feel like you are going crazy, but you aren’t. You have hormones that are making you depressed, angry, anxious and/or unable to sleep.

Every day is a battle. Take each day at a time, and do things you think will help you get by each day.  If you think having acupuncture will help, do it.  If you think going shopping will help you get through the day, do it. Do whatever it takes to get through the day.

Get help and support. Get your partner to look after the baby. At the moment, self care is important, so don’t put too much pressure on yourself. Get medical, practical and emotional support if you haven’t done so already.

I know it doesn’t seem like you will get better, but you will! Slowly but surely you will see snippets of your old self come back and you will be laughing again soon. This is only temporary.

Help Her Get the Help She Needs

My first almost wordless blog post, ever. The words in this image say it all. It is an important message that we, as family members, friends, neighbors or even colleagues of new mothers, should take very seriously.  Permission to use this image granted by Karen Kleiman, MSW, LCSW, founder of The Postpartum Stress Center and author of numerous books on perinatal mood disorders.

Postpartum Insomnia Series – Part 3: BRYN

This is the third of my series of blog posts about postpartum insomnia.

I met Bryn recently via the closed Facebook group for Postpartum Support International.  Thank you, Bryn, for sharing your experience on my blog.  I am very glad that the process of reflecting back to the time you suffered from postpartum depression (PPD)/postpartum anxiety (PPA) and putting your thoughts down was cathartic.  I’ve always found blogging to be a therapeutic process, and I encourage all my readers to consider writing/blogging about your experiences. It will truly make a difference and help you process/validate what you went through.

Now, without further ado, here are Bryn’s 10 Q&A…..

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

QUESTION:
When/what was the first indication that something wasn’t right, and how long after childbirth did the first sign occur?

ANSWER:
My first sign was probably before I even left the hospital. I had a regular check-up at 38w6d and had low amniotic fluid, so I was induced that evening, Friday. Delivered Saturday morning and went home Monday late afternoon. During that whole time, I maybe slept a handful of hours total. Early Monday morning I was a wreck, sobbing about putting baby girl in the nursery so we could sleep and sobbing because I couldn’t sleep. But that just registered to me as Very Emotional First Time Mom. My first official indication that something wasn’t right was trying to sleep at home Monday night and free falling into my first-ever panic attack. I felt very, very dangerous. I remember looking at some scissors and making some very disorienting, strong connections to my panic and danger and those scissors. I actually picked them up and will never forget my husband saying, “Bryn, put down the scissors.” I made DH drive us (me and the three-day-old, poor girl) right back to the ER, where I had another panic attack. My folks had visited earlier that morning, had already driven home (80 miles away) and then drove back to be with me at the hospital. DH’s mom drove to our house to set up helping out with baby girl (So, so grateful to have one grandma who’s a Labor & Delivery Nurse and one grandma who’s a Licensed Professional Counselor Mental Health Professional). I finally got some Ativan and went home to try sleeping with Unisom. This was around 2am. DH’s mom woke me up around 6am to nurse. So, I maybe got four hours of sleep. I remember feeling so incredulous that, even after everything that had happened the previous night, she would actually wake me up. But, um, duh, I do have a baby now. Four hours was generous! I was very much in denial. So, short answer, my first sign that something wasn’t right happened 2-3 days postpartum.

QUESTION:
Did you suffer from insomnia? What other symptoms did you experience, if any?

ANSWER:
Yes. Monday night I got a few hours of sleep after Ativan and Unisom. Tuesday night, I tried melatonin and didn’t sleep. Wednesday late afternoon, I tried to go to bed early and took Unisom since that worked okay Monday night. I didn’t sleep and was also so whacked out with constant anxiety and mini-panic attacks that I pleaded to go back to the hospital. I begged and begged the ER to sedate me. I was out of my ever-loving mind, clinging to DH and just losing it. At 8pm, after a lot of doc consults and one psych consult (and the number to the local crisis stabilization unit), I finally got a cocktail of Benadryl, Ativan and Haldol. I slept for 10 hours, waking up at 6am and went right back to high-strung anxiety and all-day panic. Thursday night, I tried Ambien and woke up after an hour. Made a deal with DH that I would go to baby girl’s first doc appointment Friday morning and then we would check me in somewhere. We’d spent a week trying to figure out what the hell to do with me and how to get me better, and now it was the professionals’ turn.

QUESTION:
Now, just out of curiosity, do you have a personal history of depression and/or anxiety or other mood disorder?

ANSWER:
I had a brief period of depression in high school after moving cross country my junior year, but that experience didn’t lead to anything that truly interfered with my life the way my PPD/PPA did after I had my baby.  The sadness during my junior year definitely felt different than other times in my life. I remember functioning like a zombie, numb for a few months until I got into the swing of things. My mom says I barely ate for a few weeks, but I don’t really remember that.  I didn’t have any treatment beyond the school counselor getting me involved in the basketball team as a scorekeeper. It wasn’t until after I gave birth that I experienced a mood disorder that prevented me from sleeping, functioning and enjoying the baby that I gave birth to after a very stressful IVF cycle so much so that I truly needed medication to help with recovery.

QUESTION:
Did you see a doctor right away, and was he/she able to help you?  What course of treatment did he/she prescribe? Did he/she diagnose you with a postpartum mood disorder?

ANSWER:
Tuesday, after my first panic attacks, we went back to my midwife to check in with her about all this. They prescribed Xanax, which turned out to not really agree with me. I don’t remember them diagnosing me with a mood disorder of any kind. And I don’t remember PPD/PPA being mentioned. Just that I was having difficulty getting back on track. But I did take the Edinburgh and remembering scoring off the charts, so maybe we had that discussion? I really don’t remember.

QUESTION:
If you had to take meds, what was it/what were they and how long did you have to take it/them?  Did you have enough resources to help you with your recovery?  What kind of resources did you have (e.g., support group, postpartum doula, psychiatrist, partner reduced work hours/worked from home)? Did you have enough practical help (e.g., late night feedings) with the baby?

ANSWER:
I started with Xanax (anti-anxiety) from my midwife, which just gave me jitters and put me out of sorts. I first checked in to a local, free, crisis stabilization unit Friday morning (one week postpartum) in Cookeville, TN where we were living at the time, but once I got fully checked in and started assessing the place (with my vast knowledge of psychiatric help facilities [sarcasm]), I started freaking out that they weren’t going to be able to help me because the doctor had already gone home for the day and I had zero confidence they could get me to sleep that night. I went into panic mode again. The nurse got authorization to give me some Ativan (anti-anxiety). I called my family to come get me, and we headed to Vanderbilt Psychiatric Hospital instead. The Ativan really helped keep me calm for about an hour or two. I kind of wish I had had that all that first week, but of course, that wouldn’t have addressed any underlying issues.

Vandy Psych checked me in via the ER and a Patient Transfer Unit. That place. I will always remember that place as the lowest of my low points. It was a perfectly fine unit with perfectly great, professional people. That was just where it all came to the point of no return for me. My folks were with me while DH and his mom were with baby girl. We just waited and waited, on furniture that was bolted to the ground, I might add. We had intake and consult after intake and consult. And there were a handful of other folks in the other rooms waiting, just like me, for a bed to open up. Knowing what I know now about the process, they had mercy and definitely pushed me ahead of other folks. I was pacing and freaking out and then pumping and trying to lie down and changing my diaper because I was still only a week postpartum, and pacing and freaking out on repeat. I was so beyond exhausted, my dad paced behind me so I wouldn’t fall over. I pleaded with the staff to get me in so I could just go to sleep. I remember telling anyone who would listen I was this close to just banging my head against the wall to knock myself out. I was VERY aware of feeling this “line” just right there in front of me. I very easily could go ahead and bang my head against the wall. But I knew if I crossed that line, there would be no coming back, not for a long time or without a lot of repercussions. That willpower to not beat my head against the wall or go flailing out of control, letting loose all the fucked-up crazy that was pent up inside me, that was the strongest I have ever been. Ever. I am in awe of myself for not letting go. I guess I come by my control issues and anxiety honestly.

At one point I got pretty worked up and they gave me Atarax (anti-anxiety) to calm down. Man, those -axes do not agree with me. I felt like my soul was trying to come out through my skin and my skin was trying to dissolve off me at the same time. So horrible.

When I finally got to the psych unit, I was given a brief tour and another intake and then some sleep meds. I know Zyprexa (anti-psychotic) was one of them, and I think melatonin (supplement) or Benadryl (antihistamine), or both, were in there, too. This was a bit after midnight and I slept until about 7am. The staff had been told not to wake me and seemed pretty surprised to see me lining up for breakfast.

For whatever reason, I did not have my anxiety and insomnia symptoms during my long weekend stay Inpatient. They switched me from Xanax to Zoloft (anti-depressant) because I wanted to keep trying breastfeeding/pumping. I stepped down on the Zyprexa for sleep and the last two nights switched to melatonin. After three days, I felt ready to go home, against doc’s advice. I didn’t even sign up to attend Outpatient the next day. I felt great. (My discharge papers diagnosed me with “major depression with postpartum onset.”) DH picked me up, and we drove to his mom’s where they had moved during this time to be closer to where I was. When we arrived, I immediately held my baby girl and immediately went straight back into panic and despair. My doc team and family had decided I wouldn’t sleep in the same room as the baby just yet, so I battled through panic (that I hadn’t felt in four days) in another room and somehow slept fairly well. I RAN back up to the hospital the next morning and begged them to let me in the Outpatient program. I participated in that program for the rest of that week (two weeks postpartum) and had no new meds, but did step up my Zoloft.

At the end of that week, we were going to drive back to Cookeville for baby girl’s two-week pediatric appointment and I was pretty worked up about going back to that house, that bedroom, that no-sleep zone. Doc gave me some super low dose Klonopin (anti-anxiety) and I managed to make it to Sunday without taking any. Sunday night I slept in the same room with DH and baby girl, and actually did a night feeding shift (formula) around 2am, I think. We went to her appointment, refreshed some clothing and stuff and drove back to Nashville so I could finish the Outpatient program that week.

That weekend back home in Cookeville started a set-back. I made the hard, but relieving decision to stop pumping and switch to formula. Pumping/breastfeeding sent me into panic every time and I just couldn’t take it anymore. I went back to Outpatient Tuesday (sobbing to my mom on the drive up there, sobbing so hard she made me drive to her place so she could drive me the rest of the way) and Tuesday night confessed to DH that I was having thoughts of cutting myself. Just something to distract me from this misery that I could not escape. I just wanted it all to go away and there was no magic pill for that. Mom drove me to Outpatient again Wednesday morning and I confessed the same to her. With her therapist hat on, she asked me if I had considered checking myself back in. I just sobbed more. I actually really wanted to go back Inpatient. In there, I was safe and taken care of and structured and understood. If I could just pause Life, and if they could just fix me, then I could go be a mom and a wife and Life would be doable again.

So, a week after being discharged, I checked myself back in. This time, I stayed just over a week. I had all my anxiety symptoms, but was at least sleeping fine. The doc team added Risperidone (anti-psychotic) to my meds and Pindolol (beta blocker). When I was discharged, I was scared. I didn’t feel confident this time going back to Life. I gladly went to Outpatient and continued to sleep apart from DH and baby girl. I did okay over my first weekend back (no Outpatient and no structure made weekends scary) and finished out the whole next week.

After being away for two years, we had already planned to move from Cookeville back to Nashville over this summer. So, after this second attempt at Inpatient and Outpatient, I was four weeks postpartum and we needed to be out of our apartment two weeks later.

Luckily, yes, we had resources. We had a ton of resources. Both our families lived in the area and were a HUGE help. We got moved back, DH started a new job, and I had two more months maternity leave. I no longer felt in crisis, but I also did not see the light at the end of the tunnel just yet.

QUESTION:
When was the first sign of light at the end of the tunnel and you were starting your recovery?

ANSWER:
The light at the end of the tunnel probably came around six months postpartum. I posted on Facebook that “it suddenly dawned on me that I hadn’t cried or felt miserable and had, in fact, been feeling rather “up” for almost one whole glorious week.” Going back to work was ROUGH. Finally feeling love for baby girl and then leaving her at home with Grandma was ROUGH. I weaned off Risperidone and Pindolol, but stayed on Zoloft. I continued my Psych follow-ups. I tried different counselors, but didn’t find a good fit until almost a year later. Unfortunately, what helped me most, I think, was giving myself permission to be bad at everything except surviving; I was subpar at my job, a crappy wife, I let go of chores and cleaning, and gave up and went to bed around 8pm most nights.

QUESTION:
Did you have any more children after this PPD experience, and if so, did you do anything to prepare yourself and were you able to ward off PPD the subsequent time(s)?

ANSWER:
I am 16 months postpartum and just starting to think about more kids. This time last year, even thinking about more kids was a big Hell No. But, here we are. Baby girl was such an easy baby and is seriously a delightful toddler. Surely, we’re setting ourselves up for a colicky next kid! I will say, we battled through infertility for a few years before conceiving via IVF, and if we didn’t have frozen embryos already, we’d be one and done. We just don’t have the funds or energy for a fresh cycle, and, clearly, the old-fashioned way just doesn’t work for us.

To those ends, I have been reading What Am I Thinking? by Karen Kleiman. Her book This Isn’t What I Expected was a bible for me during Inpatient and those first several weeks. DH and I want to find some counseling so that we’ve strengthened “us” the best we can before a second potential crazystorm. I will likely stay on my Zoloft, maybe step down a bit, but stay on.

QUESTION:
If you could go back in time what advice would you give yourself before you got pregnant?

ANSWER:
Advice for pre-crazy Bryn? I don’t know. Unfortunately, I tend to be a “go through the mess myself” kind of person instead of believing the person who says, “Don’t go that way, it’s a mess.” I got pregnant via a never unstressful cycle. I was commuting 80 miles one way for work a few times a week and staying with my folks (away from DH) a few nights a week (thus not having to commute every day). I had Factor V Leiden which meant I gave myself shots of Lovenox in my belly twice a day during the entire pregnancy until six weeks AFTER delivering. I had an ER scare with severe abdominal pain mid-pregnancy (inconclusive, but definitely not pre-labor/BH). And I was eventually induced a week early because of repeated low amniotic fluid. Whew. I think my advice would be Pay Attention and Take It The F Easy. It’s so easy to look back and see the massive amount of stress I was managing and living with. When the swirling hormone stew that is postpartum became a reality, the control I thought I had of everything that I had been dealing with just fell apart.

QUESTION:
Did anything positive come out of your PPD experience?

ANSWER:
I remember feeling incredibly raw and vulnerable during those first several crisis weeks. And that actually felt good. To just be so real and open and honest and bare with those around me. Everyone knew what was what and I just didn’t care what folks thought of me. I was in crisis. I was a mess. I was fighting for my life. And I REACHED OUT. I RAN to help. Maybe it’s because of growing up with a therapist for a mother, but I had zero shame in seeking help. I had shame about failing my daughter, my husband, burdening my in-laws, scaring the hell out of my parents. But I didn’t have shame about sharing the hell I was going through and hoping someone could reach down and help pull me out. I see that as a positive.

QUESTION:
What would you want to say to women currently suffering with PPD?

ANSWER:
I have no idea what to say to others going through this. I don’t know that anyone could have said anything to me. I babbled and raged and folks listened and I started meds and I kind of feel like I just waited it out. I just kept putting one foot in front of the other. I made sure I felt safe with the folks around me in case I fell, and then just gritted my teeth and kept going. It REALLY sucked. But it doesn’t now. That’s probably not very inspiring or life-affirming, but maybe that will resonate with someone.