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.

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You have to break through the uncomfortable…Why? Because mothers are dying from postpartum mood disorders

You have to break through the uncomfortable…..We are losing a silent battle that no one wants to talk about.

Amen!  These are the words Brian Gaydos utters when people ask what happened to his beloved wife, Shelane, and his answer “She died from a disease called postpartum depression” makes them uncomfortable.  Discomfort from stigma is what keeps suffering mothers quiet and getting the treatment they need and deserve.

When I read the August 4, 2017 article by Michael Alison Chandler in the Washington Post titled “Maternal depression is getting more attention – but still not enough” and I saw Brian’s words at the end of  the article, I decided I needed to blog about these words and about the tragic death of his wife.  Shelane Gaydos, a 35-year-old mother with 3 daughters, lost a baby in utero at 12 weeks and within 3 weeks died by suicide.  Family members did not realize until a while after her death that she had suffered from postpartum psychosis.  The article mentions, and as statistics have always indicated, women are more likely to attempt suicide during the first year after childbirth than during any other time in their lives.  It is important to note that a woman doesn’t need to give birth to experience any one of the various postpartum mood disorders, including postpartum depression (PPD), postpartum OCD and postpartum psychosis.  She can suffer from these disorders after having a miscarriage as well.

The article mentions certain things I’ve mentioned all along in my blog and in my book:

  • 1 in 7 new mothers experience a perinatal (during pregnancy and after birth) mood disorder, and yet these disorders continue to be under-diagnosed and under-treated
  • A relatively small percentage seek professional help either because they don’t know what they are experiencing deserves and needs  professional help and/or they don’t know where to go to get help and/or they are ashamed to seek help
  • More obstetricians and pediatricians lack than possess the training needed to diagnose and treat perinatal mood disorders
  • Certain risk factors are the reason why certain mothers develop PPD and others don’t: genetic predisposition to biological factors (some mothers are affected by hormonal fluctuations during/after childbirth and after weaning more than others) versus environmental factors (poverty, poor/abusive relationships, premature birth or miscarriage, inadequate support, inadequate paid leave from work)
  • It’s thanks to advocates with platforms with a broad reach to members of the government and media that there has been progress in recent years.  Brooke Shields is one of the first of the advocates to start the trend of sharing their own experiences, spreading awareness, and trying to effect change.
  • There are still stubborn societal myths (thank you to the patriarchal and quite misogynistic forces and views still in place here in the 21st century) that only serve to put unnecessary, additional stress on women, encouraging the false notion that all mothers can not only care for their babies without any sleep or support, but also be able to breastfeed without any issues and return to their pre-baby bodies and weight quickly.  Unbeknownst to many of us stateside, societies around the world (and in olden days here in the good ol’ USA) have customs in place that provide new mothers with the support they need to recover from childbirth and care for their newborn baby.  Instead, because we are a strictly capitalistic society, more and more mothers now work and have anywhere between 0-13 weeks of paid leave and are expected to recover and jump right back to their jobs before having babies, as if they’d never given birth in the first place!  If only men who think “Women have been giving birth for centuries should just up and go back to the way they were” can experience childbirth firsthand sometime!

Certain states, like Massachusetts, New Jersey, and Illinois have passed laws that mandate screening for PPD, and thanks to recommendations by the American Congress of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP), healthcare providers are screening for PPD more routinely.  What I would like to know is whether these screenings are even happening (I am dubious):

  • In 2015, ACOG recommended that OB/GYNs screen women for PPD at least once during pregnancy and once after childbirth.
  • In 2010, the AAP recommended that pediatricians screen mothers for PPD at well-baby visits during the first 6 months.

Says Adrienne Griffen, founder and executive director of Postpartum Support Virginia, whom I have the honor of knowing through my affiliation with Postpartum Support International:

Postpartum depression is where breast cancer was 30 years ago.

I truly and sincerely hope and pray that it’s NOT going to be ANOTHER 30 years for us to see a significant change in the way we view PPD as a society and reduce the numbers of women suffering–and even dying–from perinatal mood disorders!

 

 

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.

~~~~~~~~~~~~~~~

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 .

 

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.

 

Postpartum Bipolar Disorder: The Invisible Postpartum Mood Disorder

In response to my blog post from February 3, 2016 titled “15%-21% of Moms Suffer from a Perinatal Mood Disorder” in which I mention yet another mother who suffered from a postpartum condition that resulted in tragedy, fellow maternal mental health advocate Dyane Leshin-Harwood left me a comment that prompted me to offer her to explain why it’s so crucial to know the difference between postpartum bipolar and postpartum psychosis.  I explained to her that I haven’t seen much out there on a comparison between the two, and of course, the more we speak up about these conditions, the better off we all are!  These are illnesses that are extremely misunderstood, which can result in unnecessary stigma, mothers not getting the help they need because they don’t know who to go to for help, doctors not necessarily knowing how to properly diagnose and/or treat these mothers……and sometimes leading to tragic circumstances.

So, without further ado, I’d like to share Dyane’s story and important information about postpartum bipolar disorder.  Thank you, Dyane, for all the work that you do as a maternal mental heath advocate!

Postpartum Bipolar Disorder: The Invisible Postpartum Mood Disorder

Like father, like daughter: I grew up close to my father, a professional violinist who had bipolar disorder. In this photo I was eight months pregnant, and I never suspected that childbirth would trigger my bipolar disorder.

Like father, like daughter: I grew up close to my father, a professional violinist who had bipolar disorder. In this photo I was eight months pregnant, and I never suspected that childbirth would trigger my bipolar disorder.

By Dyane Leshin-Harwood 

Bipolar disorder, postpartum depression and postpartum psychosis have recently made media headlines. Katie Holmes stars as a lovestruck poet with bipolar disorder in the film Touched With Fire. The British hit television show EastEnders featured a postpartum psychosis storyline that gained national attention. Last January in a landmark decision, the U.S. Preventative Task Force called for screening for depression during and after pregnancy.

While the greater awareness of postpartum mood disorders is promising, postpartum bipolar disorder, the mood disorder I was diagnosed with, is virtually unheard of. Postpartum bipolar is also known as bipolar, peripartum onset, and it’s arguably the least known of the six postpartum mood and anxiety disorders.

It might seem unimportant to publicize an obscure mood disorder, but every mom’s postpartum experience counts. Many medical professionals are unaware that postpartum bipolar exists. Some postpartum and bipolar organizations are unfamiliar with postpartum bipolar or they’re unclear about its definition.

When I was pregnant, my obstetrician didn’t question me about my mental health or my family’s mental health history. My father had bipolar disorder, but before and during my pregnancy I didn’t show any signs of mental illness.

When I went into labor, my life changed overnight.

We went to the hospital and I stayed up all night in pain. When my daughter Marilla was born the next day, I became hypomanic. I was exuberant and talkative (both signs of hypomania), but I appeared relatively normal. My baby attracted most of the attention, and no one noticed that I was in trouble. Exhausted, I sensed something was off, but I kept my fearful feelings inside.

Within forty-eight hours I had hypergraphia, a rare condition in which one compulsively writes. I wrote at every opportunity, even during breastfeeding, when I should’ve been resting and focusing on my baby. I could barely sleep as my mania escalated, and poor Marilla didn’t gain enough weight because I didn’t breastfeed her sufficiently.

A month postpartum, I knew I was manic; after all, I had witnessed mania in my Dad. I frantically searched the internet about postpartum mania, but my search only yielded postpartum psychosis statistics. During Marilla’s six-week checkup, her observant pediatrician heard my racing voice and pressurized speech (symptoms of bipolar) and blurted out “Dyane, I think you’re manic!”

I burst into tears. While I felt ashamed, I was relieved that he realized what was happening. It was clear I needed hospitalization, but leaving my newborn was agonizing. I admitted myself into a hospital’s psychiatric unit where I was diagnosed with postpartum bipolar disorder.

After years of hospitalizations, medication trials, and electroconvulsive (ECT) therapy, I’m stable and doing well. While bipolar disorder ravages many relationships, my husband and I have stayed together, in part, thanks to the guidance of counselors and psychiatrists. Life will always be a challenge, but my two daughters inspire me to take care of myself.

While chances of postpartum bipolar are low, it can affect any mother. Obstetrician and Perinatal Mental Health Lead Dr. Raja Gangopadhyay of West Hertfordshire Hospitals NHS Trust, UK, explains,

“The risk of developing new-onset severe mental illness is higher in early post-childbirth period than any other time in women’s life. Family history, pre-existing mental health conditions, traumatic birth experience and sleep deprivation could be potential risk factors. Bipolar illness can present for the first time during this period. Accurate diagnosis is the key to the recovery.”

Confusion abounds regarding postpartum bipolar and postpartum psychosis. While the two conditions can present together, postpartum bipolar isn’t always accompanied by postpartum psychosis. Perinatal psychologist Shoshana Bennett Ph.D., co-author of the bestselling classic Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression and Anxiety says,

“Many women I’ve worked with had been previously misdiagnosed with postpartum depression. I always make a point of discussing this during my presentations. In addition, postpartum bipolar disorder deserves its own category separate from postpartum psychosis.”

Mental health screening during pregnancy would be of immense value to every mom. Women with a family history of bipolar disorder could be observed postpartum, and if symptoms manifested they’d be treated immediately. It’s imperative that doctors and other caregivers assess women not only for postpartum depression but also bipolar symptoms.

Everyone who lives with a stigmatized illness deserves a chance to find support and empathy from others who understand her experience. Through connecting with those who can relate to our mood disorder, we may not find a magic cure, but virtual support can be profoundly helpful. Postpartum Support International recently created online support groups in English and Spanish led by trained facilitators, while the Postpartum Progress website offers moms a private forum to interact with one another. I’ve never personally met another mom who has postpartum bipolar and I yearn to do so. If you or someone you know is or might be suffering with postpartum bipolar disorder please reach out — I’d love to hear from you!

Kona

My daughters Avonlea, Marilla and husband Craig stood by me through the roughest times.

Dyane’s bio:

Dyane Leshin-Harwood holds a B.A. in English and American Literature from the University of California at Santa Cruz. A freelance writer for over two decades, she has interviewed luminaries including Madeleine L’Engle, Dr. Kay Redfield Jamison and SARK. Dyane was diagnosed with postpartum bipolar disorder (bipolar, peripartum onset) in 2007. Dyane was selected as an International Bipolar Foundation Story of Hope and Recovery, and a PsychCentral Mental Health Hero. She’s raising her daughters Avonlea and Marilla with her husband Craig and serves as women’s postpartum mental health advocate. Dyane founded the Santa Cruz, California chapter of the Depression and Bipolar Support Alliance (DBSA) and facilitates free support groups for moms with mood disorders. She’s a member of the International Society for Bipolar Disorders and Postpartum Support International. Dyane’s memoir Birth of a New Brain – Healing from Postpartum Bipolar Disorder will be published by Post Hill Press in 2017. Dyane is a Huffington Post blogger. Visit Dyane’s blog Birth of a New Brain at: www.proudlybipolar.wordpress.com and find her on Twitter: @birthofnewbrain

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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