Journey of a PPD Survivor – Q/A Series – #1

Welcome to the very first of my Journey of a PPD Survivor Series!

I know many, many survivors whose journeys led them to helping other mothers feel less alone and suffer less than they themselves did.  These women have gone on to become doulas, social workers, psychiatrists, psychologists, psychiatric nurse practitioners, peer support group leaders, founders of not-for-profit groups, bloggers (like myself), book authors (like myself), fundraisers, volunteers (like myself), etc.

Kathy Morelli, whom I’ve had the pleasure of knowing since we met in 2011 at the Postpartum Support International conference in Seattle, has the honor of being my very first interviewee for this series.  Back in 2012, she wrote the most amazing book review for my book.  She herself is a book author in addition to being a licensed professional counselor and licensed massage therapist for pregnant/postpartum women.

Thank you, Kathy, for taking the time to provide my blog readers some insight into your journey as a PPD survivor!

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Question 1:
Can you please describe your journey to becoming a Licensed Professional Counselor and Director of BirthTouch, LLC and what motivated your passion for maternal mental health matters
?

Ivy, lol, this could be a looooong answer! I’ll try to keep it reasonably brief!  I came of age in the 1970s when feminism was just starting to impact our society. I was raised to believe that I could go to college and get a good job, just like the boys. But I was also enculturated to stay home with my children. My mom didn’t work outside the home. There was no Title IX, equal funding of boys’ and girls’ sports, etc. when I was growing up. There was no family leave, no daycare centers included on corporate campuses. So, the tantalizing idea that a woman could work equally as a man was out there, but there were no plans for what to do about motherhood. What to do with a newborn during a career trajectory. These things were not in the public discourse at all. So, I never thought about how the integration of career and family is an enormous life challenge. How would I know?

I was the first-generation Italian American in my family to go to college.   I started my career in my 20s in data processing on Wall Street. I worked my way up to be an AVP at a major international bank. I managed the Database Department there. It was extremely stressful and not really emotionally fulfilling to me. But it was a good job that paid well. I was the only woman of 12 mid-level managers. It was challenging to be the only woman in this peer group. I never felt comfortable in that situation. They talked about things I wasn’t interested in. And sometimes they went to a strip club down the street for lunch. I certainly wasn’t going to do that.

The long commute led to my finding a job at another large data processing facility in New Jersey. My husband and I planned to start a family, and I didn’t want to commute on the subways while pregnant.  I had my son (now 22!) when I was 37 years old. I never changed a diaper or babysat very much at all, as my older sister did all that!  I also didn’t know much about the processes of pregnancy and birth, so it was all big mystery to me.

I actually had negative physical reactions to the idea of putting my son in daycare.  Daycare was a new concept 22 years ago. We made the decision for me to stay home with my son for a few years. I had postpartum depression (PPD) after I had my son. Looking back, it’s obvious that the life changes and the identity shifts were challenging for me. I had always been a high achiever, so shifting to taking care of a baby, which I had never done before, was not easy. I felt isolated. The feelings of depression were difficult to handle and caring for a baby on top of that was just so overwhelming.  In retrospect, I should’ve taken medication. But I wouldn’t, as I was nursing and I was concerned about the effect medication would have on my son.  Back then, there wasn’t the abundant research regarding the relationship of psychotropic medication to breastfeeding that there is now. If I had the information available now on such sites as Mother to Baby , I would’ve been able to make an informed choice with research data as input. I would’ve chosen the medication. Even with counseling, I was depressed for two years. It was a joyful yet painful time.

In short, my journey to becoming a therapist has been founded on my desire to have a career where I could make a difference in the world. From my experience, I also had insight into what it was like to become a mother and go through a lot of biological and psychological shifts all at once.

 

Question 2:
Can you provide an overview of what services you provide?

I’m a Licensed Professional Counselor (LPC) and Licensed Massage Therapist in the State of New Jersey. As an LPC, I work with a broad range of people experiencing everyday family and marriage issues, depression, and anxiety. I have an integrative approach and use both traditional verbal therapies and mind-body therapies.  For many years, I’ve had a special focus on perinatal mood disorders, the transition to parenthood, and birth trauma, but I see a broad range of people.

Currently, I am shifting my focus to using interventions such as eye movement desensitization and reprocessing (EMDR), Somatic Experiencing (SE) and cranial sacral body work to treat post-traumatic stress disorder (PTSD) for single incident and chronic trauma.  Single incident trauma can be birth trauma, trauma from even necessary medical interventions (such as for cancer), a car accident, a rape, etc. Chronic trauma includes childhood sexual, physical, and/or emotional abuse.

So many women talk to me about their pregnancy and birth experiences and how traumatic and medicalized childbirth is. Sometimes the medical trauma is something that is necessary such as when there are true complications and other times the medical trauma is from too many unnecessary, cascading interventions coupled with a general atmosphere that lacks compassion at an individual level.

So, I’m an advocate for woman and family-centered childbirth and have been for 22 years. I’m an advocate for social programs that promote a true family centered focus in our society.

 

Question 3:
You wrote three books, correct? Can you give an overview of what your books are about? 

Yes, I did!  They are all about self help and education for women and families in the childbearing year. They are all available on Amazon!

BirthTouch® Shiatsu and Acupressure for the Childbearing Year is all about education and self-help for the pregnant mom and her family.  There’s information about the difference between infant bonding and attachment, emotional management and safe touch to promote the relaxation response and family bonding during and after pregnancy.  There are numerous studies that conclude that safe massage promotes the relaxation response and family bonding. Safe touch promotes the release of relaxing endorphins and oxytocin and downregulates cortisol, the stress hormone. It’s all about self care in the family unit. Shiatsu is done fully clothed, and it’s a simple shiatsu routine, so even small children can participate, as well as an acupressure routine that is known to promote childbirth. As a massage therapist, I have certifications in shiatsu and acupressure, so the mind body connection is quite relevant to me and how I practice.

BirthTouch® Healing for Parents in the NICU  is a slim volume meant for parents who have a baby in the NICU. The focus in the NICU, is, of course, on the baby, but this slim volume is meant for the parents to help remind them to turn towards each other and support each other through this difficult time. It is a short-seated shiatsu routine that can be done in a waiting room.

BirthTouch® Guide to Perinatal Mood Disorders for Childbirth Educator is a slim volume meant for childbirth professionals, who are often the first line of support for the new mom. This slim volume fully delineates the different perinatal mood disorders and their differential diagnoses for the childbirth educator, so s/he can know what to look for.  It also explains why it’s not always easy to differentiate between the various perinatal mood disorders, because of the overlap and subtlety of symptoms.

 

Question 4:
Can you please explain how shiatsu and acupressure can help a pregnant/new mother? How did you learn these techniques and how did you discover that they can be effective in treating perinatal mood disorders?

I studied shiatsu and Jin Shin Do® Acupressure at the Meridian Shiatsu Institute in Pennsylvania from 1996 – 2000. I became certified in both modalities. The owner of the school retired over a decade ago and closed the school.  I started BirthTouch® around that time, which was a massage and bright hypnosis business for pregnant moms and their families. Women and midwives started to ask me what the acupoints were to begin birthing. I would write them out on a piece of scrap paper at first for my clients, and then eventually I developed a short workbook.  I began studying psychology. I found the intersection of my two fields, touch and psychology, in the seminal work of Dr. Tiffany Field at the Touch Institute in Miami.  Her studies were really the first research examining the effects of touch on mood in pregnant/postpartum women and in infants. Now, it’s a mainstream idea and you can see there are hundreds of studies that validate the use of touch to promote relaxation and mitigate the symptoms of depression and anxiety in pregnant/postpartum women.

After working with many women and families, I realized that people wanted to learn some safe, easy techniques for touch during pregnancy, birth, and postpartum. After teaching these techniques for many years and seeing the clinical benefits, I wrote my BirthTouch® book in 2012.  I hope to run a research project specifically around BirthTouch® techniques in 2019. I will keep you posted on this!

 

Question 5:
I can remember when I first met you at a Postpartum Support International conference a number of years back. How long have you been a member?  What prompted you to become a member?

I think I’ve been a member of Postpartum Support International since 2010.  I was a Warmline Volunteer for about a year on Wednesday evenings, but then it was too difficult to keep it up, as my practice was so busy and Wednesday evening is prime time! I now do some work for the New Jersey Chapter of Postpartum Support International. I wanted to become a member, as I wanted to complete their training and to attend the wonderful conferences and actually meet and be a part of the researchers and clinicians who work in women and family advocacy every day!

 

Question 6:
Is there one key piece of advice you would offer to an expecting or new mom?

Please plan for the Fourth Trimester!  Here’s a link to my website BirthTouch®, with an article about the Fourth Trimester.  Don’t try to do it all yourself or with your partner.  If you don’t have local friends or family who are free to physically help you, then hire some help. It is well worth it! Ask for help, don’t be afraid to tell your doctor how you feel and if you need help, don’t suffer alone. Planning for the Fourth Trimester is key! Have list of resources at ready, in case you need them….friends, family, community resources, food prep, sleep plan, therapist phone number, doctor phone numbers, etc.  Talking to a therapist and taking medication is not shameful!

 

Question 7:
What would you want to say to women currently suffering with a postpartum mood disorder?

Recognize that you have a treatable mood disorder and that taking care of your emotional health is as important as, if not more important than, taking care of your physical body.  Talk to your primary care physician, your obstetrician, a therapist, or a psychiatrist.  Perinatal mood disorders are treated by talking to a therapist and/or taking medication.

Taking care of a baby is hard work. Please get yourself help in many different ways: sleep, food prep, taking time off from baby care by asking family or hiring help, etc. This new dynamic of having an infant to care for sets off feelings where you wonder whether you need to attend to my baby’s needs or my needs? Of course, the baby’s needs must be fulfilled and you need to include your needs in there in some way as well. It’s a new way of being.

To find resources in your area, call Postpartum Support International’s Warmline where you will be connected to someone in your area who can refer you to perinatal mental health resources in your community.

Postpartum Support International Warmline: 1-800-944-4773

 

Question 8:
What advice would you offer to friends/family members of a woman who is currently suffering with a postpartum mood disorder?

Please recognize that your loved one needs support and understanding. Don’t undercut her mothering skills by giving suggestions on how she should manage her baby. If she is struggling, ask her how she feels. Use active listening techniques, ask open-ended questions, and help her get to a therapist and/or doctor to get the help she needs.

And also, as caregiver, try to remember to take care of yourself, although this can be challenging. Caregivers get burned out and depressed as well. Take it easy on yourself and practice lovingkindness towards yourself and others.

 

Question 9:
In your practice, what kinds of treatments for PPD do you recommend? Is there a type of therapy/ies you would recommend?

I think the best treatment is developing a realistic baby-feeding, sleeping and self-care plan that take into account both mom’s and baby’s needs….all of this can be truly overwhelming.

Going to a therapist who has special training in perinatal mood disorders to help process the feelings around the transition to motherhood and the feelings around childbirth events is a good way to manage perinatal mood disorders.

Sometimes talk therapy is not enough. If medication is needed, going to a psychiatric nurse practitioner or psychiatrist is a normal part of treatment.  Feel proud you are taking steps to care for yourself.

In my practice, I take an integrative approach and use a variety of therapies tailored to the individual’s needs. My basis is insight-oriented therapy, combined with some dialectical behavior therapy (DBT), eye movement desensitization and reprocessing (EMDR), and cranial sacral therapy (CST) tools.

 

Question 10:
What do you see as the biggest challenge in helping a mother recover from a postpartum mood disorder?

 The biggest challenge is that people often don’t want to reach out for professional help. They think they can manage okay by toughing it out and ignoring their own needs. This approach isn’t emotionally healthy. You want to learn to optimize your own and your family’s emotional health.  If mama ain’t happy, no one is happy!

 

Question 11:
What do you think medical health practitioners who come in contact with new mothers, like OB/GYNs, GPs and pediatricians, can do to help prevent, detect and treat perinatal mood disorders?

Prevention starts with a solid social safety net, which our society does not provide.

Individual medical practitioners can coach pregnancy moms and their partners about the possibility of the occurrence of perianal mood disorders, and help them recognize this before the mom becomes seriously incapacitated from a mental health issue. If a mom has a previous episode or a family history of perinatal mood disorder, then pre-treatment–with counseling and perhaps medication–is the best way to minimize occurrence.

Medical practitioners who come in contact with new mothers need to be trained to recognize the presence of a perinatal mood disorder and have resources to offer her and her family. Studies show that having the mom complete an abbreviated 3 question version of the Edinburgh Postnatal Scale is as effective as the original 10 question EPDS.

Medical practitioners who treat new mothers for perinatal mood disorders should take specific trainings in these disorders in order to effectively treat their patients. Postpartum Support International has such trainings and also a supportive professional community that shares resources and knowledge.

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If you wish to contact Kathy, she has an office Wayne, New Jersey
Her phone number is 973-713-5966
Her websites are: kathymorelli.com  and birthtouch.com

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Thank You, Black-Ish, for Your “Mother Nature” Episode on Postpartum Depression

When I saw the announcement on my feed yesterday morning that that evening’s episode of Black-ish was going to be about postpartum depression (PPD)–and on World Mental Health Day, no less–I was so excited.  And skeptical at the same time.  Why skeptical?  Because first of all, this is a sitcom.  As far as I’m aware, a sitcom has never had a show that focused on PPD.   A sitcom is comedy.  PPD isn’t really a laughing matter. I was concerned they would brush off the seriousness of the topic and lose yet another opportunity to properly educate the public about a condition that affects 1 out of 7 new mothers but is still such a hush hush thing.  Because it’s such a hush hush thing, so many mothers continue to suffer from it and not know that what they are suffering from is not their fault, is so common among new mothers, and can be treated but good help and the right meds can be hard to find.  I was concerned with how accurately Bow would portray a new mother with PPD.

I can only recall one other non-documentary show on Prime Time television focused on PPD, which was ABC’s  Private Practice episode back on February 13, 2009.  Boy, did ABC get it all wrong!  And that was mostly due to the fact that they hadn’t considered seeking guidance from any subject matter experts, like Postpartum Support International, before airing the episode.  It wasn’t until after I watched the Black-ish episode, aptly titled “Mother Nature” that I saw a PSI post that said that Disney/ABC had, in fact, contacted PSI prior to airing the episode.  This was after I already saw, to my great relief and excitement, that the writers of Black-ish did a good job with the script and Tracee Ellis Ross did a good job with portraying a mom with PPD. 

For a sitcom, it did a really good job with showing:

  1. That PPD can happen to anyone, even to someone like Bow who is a medical professional and didn’t experience PPD with her 4 other children; every pregnancy and postpartum is different;  not all childbirth experiences are smooth;  Bow never had PPD after having her 4 other children and yet she is experiencing it with this baby after experiencing preeclampsia, premature childbirth (8 weeks early) and emergency c-section.
  2. What it’s like to have PPD….difficulty bonding with the baby, being unable to sleep, feeling anxious and weepy, unable to smile, unable to perform usual activities, unable to appreciate what you would normally appreciate, and not feeling like your usual self for weeks are some of the trademark symptoms
  3. How the family is affected when the mother is suffering from PPD
  4. The views of the older generation on doing what all mothers have done for generations, which is to plow through your temporary emotional period (i.e., postpartum blues) like all mothers manage to do; some of these views cause the new mom (especially one who didn’t have PPD with her other children) to believe she should just power through her feelings without help, since it will go away on its own
  5. How not only practical but emotional support from the significant other–in this case, Bow’s husband, Dre–and the family are crucial
  6. How there is this societal belief that all mothers glow after having a baby; there is much shame and stigma when a mother doesn’t “glow” like a new mother should; in actuality, having a baby is very hard work and is not always a happy/glowing experience for all moms; some moms need help but don’t want to ask for or accept help out of shame that they aren’t experiencing the kind of motherhood they believe all mothers are supposed to have
  7. PPD happens in 1 out of 7 new mothers (yes, they included this in the script!) so if you are feeling this way, get help!

If you missed it, no problem…you can watch it here: http://abc.go.com/shows/blackish/episode-guide/season-04/2-mother-nature.  And you can read a Babble article by Wendy Wisner titled “‘Black-ish’ just boldly went where few sitcoms have gone before: postpartum depression.”

Thank you, Corey Nickerson (writer and executive producer), for taking your own experience with PPD and coming up with the idea to have an episode about PPD.  With a viewership of approximately 5 million, it’s a perfect way to raise awareness!

Wake-up call for new moms who feel “off” for days after childbirth (and family members of these moms)

I’m finally blogging again after a slight reprieve from being unbelievably busy for weeks with work and then vacation and then feverishly cleaning my house for guests coming over (if I had more time to clean regularly cleaning wouldn’t be such a big deal).  Also, I am in the process of slowly transitioning off of the laptop I’ve had for over 8 years, so every single tab I’ve had open (which is a lot) need to be closed, obviously.  These tabs have been open for months for me to blog about and/or read but just haven’t had the time to do.  So, here I am trying to get through as many articles as possible.

Many of the tabs had stories about moms who died from severe postpartum depression (PPD), so I decided to blog about the deaths of FOUR moms who suffered from severe postpartum depression (PPD).  These are just four of the deaths from a postpartum mood disorder that have occurred since 2016.  There have been others, but these are the only ones other than the D’Achilles story (which I mentioned back in May) that I have come across in my daily news feeds because loved ones of these women have spoken up  and shared their stories so that others would not suffer such experiences.

In a Good Housekeeping article published on May 19, 2017 by Andrea Stanley titled “The Voice That Said ‘I’m a Bad Mom’ Killed My Wife,” Greg Ludlam opens up about the severe postpartum depression that took the life of his wife Elizabeth on June 1, 2016.  When their second child was around one year old, something about Elizabeth seemed off.  She wasn’t herself.  Little things set her off.  She withdrew from friends and neighbors.  She started saying and believing she was a bad mom.  There was no longer any joy or enthusiasm in things that used to make her happy. She got angry over things at work when she was never previously that way.  These are all trademark symptoms of PPD but Greg had no idea that his wife was suffering from it.  He has had to cope with the guilt of not picking up on what was going on and getting professional help.

Greg Ludlam urges the significant others of new mothers to do the following:

“….[If] you see something not right with your wife or partner, you need to get help right away from a medical professional who specializes in mental health care.  I’m not talking about tomorrow or next week — now.”

He also urges new moms to do the following:

“For anyone who is reading this and you’re feeling overwhelmed or you’re feeling like a bad mom or you’re feeling like a lousy wife, or just feeling unloved and alone — you’re not. You’re not a bad mom. You’re not a lousy wife. You’re not unloved and alone. There’s help. You need to reach out to a qualified mental health doctor right now.”

In a CTV News article published on January 18, 2017 titled “B.C. widower urges moms suffering postpartum depression: ‘Please seek help ‘” Kim Chen opens up about the severe PPD that took the life of his wife, Florence Leung shortly after she gave birth to their son in October 2016.   She had gone missing shortly after giving birth to her son and her body was pulled from the water near an island close to Vancouver, British Columbia.  Florence was being treated for PPD before her disappearance.  Chen urges new moms who feel anxious and/or experiencing low mood to seek help and share their feelings.  He mentions there is a too much pressure and too many misconceptions regarding breastfeeding, as the hospital where they delivered the baby had Breast is Best materials that reiterated over & over how breast milk should be the only food for babies for the first six months.  He realizes the benefits of breast milk but at the same time believes formula is totally fine as either a supplement or replacement for breast milk.  It should be a personal choice and dependent on circumstances.

Chen wants new mothers to know:

“Do not EVER feel bad or guilty about not being able to “exclusively breastfeed”, even though you may feel the pressure to do so based on posters in maternity wards, brochures in prenatal classes, and teachings at breastfeeding classes.”

In a Her View from Home article published in September 2016 titled “New Mom Takes Her Own Life After Silent Battle With Postpartum Depression: Why All of Us Must Share Her Friend’s Plea,” author Julie Anne Waterfield  opens up about the severe PPD that took the life of her friend Allison on June 28, 2016.  Allison leaves behind her husband and daughter.  Julie wants people to know that there is nothing shameful about PPD.  The transition to being a mother can be very difficult and it is important to get help from your husband/partner, friends, relatives (and if you’re not feeling yourself, seek help from a counselor and/or support group).  The road to motherhood is not always smooth or peachy.  For some new mothers (like me), the road is very difficult–not to mention lonely and for first-time moms uncertain, guilt-ridden and downright scary.  For these mothers, not having a birth and postpartum experience as they envisioned it *should* be makes them feel ashamed.

Julie wants new mothers to know:

“To all those mothers out there experiencing some of these same feelings: you are not alone, and you are not a bad mother!  PPD is lying to you.  It is twisting your memories, feelings, and beliefs and reshaping them into an overwhelming falsehood.  You will not be judged, only loved, as you seek help.  To those breast-feeding mothers taking Reglan (metoclopramide) to increase milk supply: stop and do research. Reglan has detrimental side effects such as new or worsening depression, suicidal ideation and suicide.  Supplement with formula if needed.  Your baby will be just as perfect and healthy with or without the breast milk.  Having more breast milk is not worth sacrificing your mental health or possibly your life.”

And finally in a The Hour article published by Kaitlyn Krasselt on September 8, 2017 titled “Norwalk sisters raising awareness about postpartum depression, suicide,” the sisters of Kara Kovlakas open up about the severe PPD that took Kara’s life (one day before she was to turn 33) on October 13, 2016, nine months after giving birth to her 2nd child.  Kara’s family created the Light for Kara website in her memory and to help raise awareness about postpartum mood disorders.  Kara had suffered from depression and anxiety before she had children.  Within 7 months after giving birth, her thoughts started to become jumbled and she couldn’t think clearly. She had doubts that she was a good parent.  A dark cloud followed her everywhere. She couldn’t see the positives, only the negatives each day. She had been seeking outpatient treatment for her depression and anxiety, and kept insisting to her family that she was getting better.  From the outside, she looked fine to everyone.  But taking her own life was something that her family and friends never expected.

Kara’s sister, Lauren Shrage, wants people to know:

“This is a real mental illness. The shame new moms feel about needing to reach out for help is real. As a new mom, you’re expected to have it all together. We’re all new moms too and the only thing anyone ever mentioned to me about postpartum depression was a pamphlet in the folder I took home from the hospital. That’s not enough.”

Please take these experiences to heart. Share them with others. We need to de-stigmatize PPD by being open about it and avoid being judgmental. Remember that not all postpartum experiences are peachy, and that one in seven new mothers experience a postpartum mood disorder. Let’s keep a close eye on the new moms in our lives.  Offer them help, not criticism. Don’t help push a new mom over the edge with Breast is Best or other one-size-fits-all tactics.  ONE SIZE DOES NOT FIT ALL.  Everyone is different.  Everyone’s childbirth and postpartum experiences are different. We want mothers AND babies to thrive, not die.

If you or a loved one doesn’t seem to be herself for days after childbirth, reach out and ask her to share about her postpartum experience with you and/or a health practitioner.  Getting help can mean life or death, as you can see from this blog post.  Postpartum Support International has a warmline (800-944-4773) and a listing of local resources to help with finding local help.  Reach out to me by leaving a comment below and I can respond via email.

Did you know that you can text 741741 when you are feeling really depressed or suicidal? A crisis worker will text you.  It’s a free service by The Crisis Text Hotline! (Only in the US).  Texting has proven to be a more preferred way of reaching out for and getting help.

The National Suicide Prevention Hotline is available 24/7. If you or a loved one needs help right now, call 1-800-273-8255.  It’s confidential and provides a network of over 140 crisis centers nationwide.    You can also visit www.suicidepreventionlifeline.org.

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!

 

 

Why is it still so damn hard for moms to find help for postpartum mood disorders?

We are in the 21st century.  It is now 2017.  We have someone leading the country and the GOPs in trying to make it even harder for people to get access to healthcare, and in particular, mental healthcare.  Check out the articles “How Trumpcare Will Affect Moms Fighting Postpartum Depression” and Psychology Today’s “How Trumpcare Will Affect Mental Health Care.”  But we mustn’t let such ignorant, selfish and typically capitalist initiatives impede progress.  We must never stop resisting any initiative to make conditions worse, to stop forward momentum!

It is 2017 and I am asking the question so many of the other attendees of last week’s Postpartum Support International (PSI) conference are asking: Why is it still so damn hard for moms to find help to treat their postpartum mood disorders, like postpartum depression (PPD), postpartum psychosis (PPP) and postpartum OCD?  A common theme across the training sessions offered at the PSI conference, and a common topic of my blog, is the fact that there are mothers seeking help across the country daily, and we may have names of therapists or social workers, but in many cases, these professionals aren’t anywhere near where the mothers are located.  Or there’s the issue of affordability.  Or when the professionals can see a new patient (could be weeks).  Or how about there just aren’t enough professionals who can see new mothers suffering from postpartum mood disorders, period.

A recent article by Crystal Edler Schiller, PhD, assistant professor in the Center for Women’s Mood Disorders and Department of Psychiatry at the University of North Carolina at Chapel Hill, titled “Maternity mental health care should be accessible” highlights the issues.

Although the numbers of professionals is increasing slowly over time, there is just not enough of them to treat the actual numbers of mothers needing care.  Many PSI members are social workers, registered nurses, peer group supporters, psychologists and psychiatrists, which is great.  But the numbers of people in these roles throughout the country fall pitifully short of the help that’s actually needed.   So many mothers suffer in silence, and you only really hear about the ones who openly discuss their experiences via social media (like me) or other articles or in the news.  Or you hear about the mothers in the news who weren’t able to get the right help and their illnesses led to their deaths and/or death of their babies.

I’m fortunate that I’m in New Jersey, a state that mandates screening for PPD and has a state initiative called “Speak Up When You’re Down.”  We also have The Perinatal Mood and Anxiety Disorder Center at Monmouth Medical Center, the very first center dedicated to maternal mental healthcare in the state, which I blogged about previously.  A group of PSI members in New Jersey have come together to form a PSI-New Jersey chapter.  These members meet monthly and we discuss the support they provide mothers via their own practices and/or via the Partnership for Maternal & Child Health of Northern New Jersey, Central Jersey Family Health Consortium, and the Southern New Jersey Perinatal Cooperative. My own experience with PPD pre-dates all of these initiatives, and needless to say, there was a whole lot more ignorance back in 2005.  It’s truly satisfying to see these initiatives take root, with more in the works.  However, this is just New Jersey and as far as I’m aware, only California, Massachusetts and Illinois have similar screening and care initiatives in place and/or in development.  There are 47 other states who are extremely behind when it comes to maternal mental healthcare.

The slow change I’ve seen just in New Jersey alone over the past 12 years since I suffered from PPD is unacceptable.  You would think that all therapists know how to diagnose and treat mothers suffering from a postpartum mood disorder.  Unfortunately, they don’t.

How do we speed up progress?  We need funding to make the printing of pamphlets/flyers available in ALL doctor’s offices that could potentially see new mothers (i.e., OB/GYNs, family doctors, general practitioners, pediatricians).  Medical schools must mandate that all training programs for all healthcare professionals (i.e., doctors, nurses, social workers, therapists) include a minimum of a semester in maternal mental health conditions and are led by PSI educators, and without these programs people cannot obtain their degrees/licenses.  Unless we start putting these measures in place, we are not going to see any significant improvement in addressing the scores of mothers needing help in our lifetime.

I’m going to leave you with the last sentences of Dr. Schiller’s article, which makes the common sense statement that, thanks to ignorance due to stigma, is all too often taken for granted by all too many people, healthcare professionals included:

Let’s dispense with the outdated idea that the body and mind are separate, which is at the foundation of decisions to pay for physical but not mental health care. Mental health is physical health, and our bodies and our babies are only as healthy as our minds.

 

 

 

Happy Mother’s Day 2017

Dear Mama-

If you’re visiting my blog, I just want to let you know that you are not alone in your postpartum experience.

You may feel like you are alone.  But you aren’t.

I am a PPD survivor.  There are MANY PPD survivors.  I am here for you.  There are many PPD survivors out there for you.

I love analogies, and I’m going to use one here.  I have pansies outside on the deck that I never expected to make it all winter with the cold, snow and ice, but it DID make it.  I covered the plant with a plastic food container to prevent it from getting crushed by snow/ice and to protect it from the below-freezing temps and wind.  I visited it, touched the one or 2 flowers that endured during the winter, and spoke to them (never thought I’d ever be a flower whisperer, but here I am) as much as I could.

Here are the persistent pansies that failed to let the elements prevent them from standing tall.

And here are the pansies today!  

You will get through the sleepless nights due to your anxiety, insomnia, feelings of helplessness.  Just like the pansies surviving was doubtful, they were able to persist because they received care and support.

I made it, without even knowing that what I had was PPD.

I made it through with crappy bedside manner from both my OB and doctor.

I made it with no support from anyone else around me except for my husband. I’d never heard of anyone having PPD before.

I didn’t know about Postpartum Support International (PSI).

I wasn’t on the Internet much back then.  It was 2005. I wasn’t on Facebook or Twitter.

I wasn’t referred to any therapists who specialize in PPD.  I didn’t have a support group, either.

But I made it.  And YOU WILL TOO.

If you are reading this and you are suffering and don’t have any idea how to get help, please leave me a comment.  I will respond and try to help you find resources to help you get through this.  You can also go to the PSI website for phone and local resources.

There was a blog post from fellow PPD survivor, Andrea Bates, author of the blog “Good Girl Gone Redneck” featured on the PSI website on World Maternal Mental Health Day this past week that I want you to visit if you haven’t seen it already.  Please check it out.  She’s a wonderful writer.  I wish I could write like her.  She also wrote 3 blog posts leading up to Mother’s Day this past week that you should also check out.

Happy Mother’s Day, Mama!

Love,
Ivy
❤ ❤ ❤

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.