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"Imagine the terror of it - all of a sudden realizing that you’re a shattered mirror. I couldn’t watch television. Every pregnant woman screaming for an epidural on a sitcom made me want to smash the TV. A commercial for the local hospital’s “birth center” made me want to chew my own limb off to escape. I couldn’t stay in the same room with women who began discussing their births ..."
I wanted to share with you some nice videos on the web today about postpartum depression.
The first comes from the BBC in the United Kingdom, and features a doctor discussing the basics of postnatal depression, as the Brits call it, quite nicely. Check it out here.
This next one is from a mom named Heidi Howes. This is part one of three videos she's created to share her experience with postpartum depression. In this one, I really like how she describes what it feels like as I think many of you will relate. Check it out here.
And get ready for video from Postpartum Progress as well -- my Mother's Day present was a Flip Mino Ultra videocamera. I'm getting the hang of it right now but excited to be able to share some video with you very soon!
The magazine esperanza, which recently featured a story on postpartum depression, as well as pieces on Mary Jo Codey, Amy Sky and yours truly, is seeking feedback on those articles. If you would like to send a letter for the Summer 2009 Letters to the Editor, click here.
The practice of confinement involves comprehensive social support and has been though to protect new moms from PPD. The new mother is confined to her home for the first month after chidlbirth and someone cares for both her and the baby's needs during that period, sometimes the mother-in-law and sometimes a paid pui-yuet or "confinement lady".
The study authors, from the University of Melbourne in Australia, state that "confinement cannot be presumed to be available to, welcomed by or effective for all Chinese women or to be a substitute for health service provision."
Postpartum Support International and the Los Angeles County Perinatal Mental health Task Force will be hosting a Casino Night on Saturday, July 18th at 7:30pm at the Braemar Country Club in Tarzana, CA. They'd like you to join them for casino gaming, prizes, live entertainment, dinner and dancing to support their work helping women who are suffering from mood and anxiety disorders related to childbirth. They ask for a charitable donation of $100 at the door from those who attend. This event is sponsored by Score Gaming and Binions Hotel & Gambling Hall Las Vegas. If you have questions or would like to donate an item to the evening's silent auction, please call Dr. Diana Barnes at 818-887-1312. Please RSVP by July 10th if you plan to attend.
In a follow up to my story last week on Emory psychiatrist Zachary Stowe's conflict of interest situation, wanted to let you know that, according to the Carlat Psychiatry blog, Emory University now has a new ethics policy that bans its faculty from accepting gifts or money for speaking engagments for drug companies.
This week I spent about 10 hours trying to go through the last 5 years' (yes, on July 17th Postpartum Progress will be 5 years old!) worth of posts on Postpartum Progress to make sure they were categorized correctly. Of course, many of them weren't. So I recategorized quite a few so that you could use the Categories sidebar (scroll down and watch the left side of your screen to find it) to look up specific topics and see what I've written about that topic.
For instance, if you click on the category "Hispanic & Latina" you'll see posts about research on postpartum depression and Latinas, as well as info on Spanish-speaking volunteers who help moms who speak Spanish only. If you click on the category "Obstetricians" you'll be able to scroll through posts applicable to the obstetric community, including research on doctors' views of PPD and a link to ACOG's guidelines on the use of psychiatric drugs during pregnancy.
I hope these categories help you. As always, you can also use the Search function, which is also in the left sidebar directly underneath the subscription box and is provided by Lijit.
Richard Shaw, MD, a child psychiatrist at Lucile Packard Children's Hospital and an associate professor at the Stanford University School of Medicine, is studying post-traumatic stress disorder among moms and dads whose infants stayed in a NICU.
We've known that moms whose children spend time in the NICU, or whose children are born with birth defects, are at a greater risk of suffering from postpartum depression. Dr. Shaw's research focuses on post-traumatic stress disorder, and he looks at the impact of premature births on both mothers and fathers.
The University of Nevada Las Vegas Maternal Health Lab is currently conducting an internet-based survey on postpartum mental health and is seeking 500 postpartum women who have had a child within the last year and are at least 18 years old to participate. The survey is completely anonymous and takes approximately 30 minutes to complete. If you meet the criteria and would like to participate, please go to www.maternalhealthlab.com and click the Postpartum Moms link.
Time's John Cloud has a piece today on preventing mental illness. Here's a tidbit:
"Earlier this year, the National Academies — an organization of experts who investigate science for the Federal Government — released a 500-page report, nearly two years in the making, on how to prevent mental, emotional and behavioral disorders. The report concludes that pre-empting such disorders requires two kinds of interventions: first, because genes play so important a role in mental illness, we need to ensure that close relatives (particularly children) of those with mental disorders have access to rigorous screening programs. Second, we must offer treatment to people who have already shown symptoms of illness (say, a tendency to brood and see the world without optimism) but don't meet the diagnostic criteria for a full-scale mental illness (in this case, depression)."
To read the rest of the story, click on the link above. (Thanks Dr. John Grohol for pointing this out.)
I've had several Postpartum Progress readers contact me in the last few months about the topic of breastfeeding-related feelings of depression. These moms feel just fine all the time EXCEPT right when they're about to breastfeed or are breastfeeding. This is a condition I must admit I hadn't heard of, but after a preponderance of emails about it, I thought I should look into it more. It doesn't surprise me that women who have this experience would worry that it is related to postpartum depression.
Kathleen Kendall-Tackett was kind enough to point me in the right direction by telling me about Dysphoric Milk Ejection Reflex, also called D-MER. According to D-MER.org, Dysphoric Milk Ejection Reflex is a newly recognized condition affecting lactating women which causes a surge of negative emotions to occur just before milk release. These emotions usually don't last more than a few minutes. They explain that D-MER is not postpartum depression, nor is it a postpartum mood disorder.
Moms with D-MER often experience a hollow feeling or emotional churning in the stomach, and a feeling of dread, guilt, anxiety or anger prior to letdown. They state that a key experience of D-MER is that the mom feels fine except right before her milk starts to flow, with the feeling lasting only as much as 2 minutes, though some moms with closely spaced letdowns may have these feelings throughout the nursing period.
Some resources for those of who you experience this:
She writes that, according to the Vitamin D Council's website, there is epidemiological evidence that associates vitamin D deficiency with mental illness. Two small reports studied the association of low 25(OH)D levels with mental illness and both were positive. Additionally, depression has significant co-morbidity with illnesses associated with hypovitaminosis D such as osteoporosis, diabetes, heart disease, hypertension, multiple sclerosis, and rheumatoid arthritis.
For Therese's full story on vitamin D, click the link above.
Also, Cheryl Jazzar shares a piece from Natural News on 8 ways to naturally boost serotonin and mood. None of them should surprise you, and all of them are important.
For anyone with postpartum depression or psychosis who needs inpatient psychiatric care, Psych Central has just published the helpful "Inpatient Psychiatric Questions & Tips". This is great, because I know when I was hospitalized briefly I had no idea what to expect or how to plan for it.
One helpful tidbit: Find out what criteria you need to meet to be released.
Check it out!
From the Healthy Mothers, Healthy Babies Newsletter: A study in the June 2009 edition of the journal Pediatrics examines the feasibility of screening for maternal depression as a standard part of well-child care, and looks at the prevalence and incidence of maternal depression at well-child visits during the first six months of life. Providers in an adolescent-oriented maternity program were cued electronically to screen the mothers for postpartum depression when they opened electronic medical records of 0 to 6-month-old infants. The study found that electronic cueing improved providers' compliance with screening for depression. In addition, screening two months after delivery detects most mothers who become depressed during the first six months postpartum.
A mom on the website MomLogic has written a very poignant post called "I Am a Mom and I Am an Alcoholic". There is no name of the author listed, nor is the article open to comments, which is disappointing because I'd like to thank her for her honesty.
The woman who writes happens to be a psychotherapist. In her youth she becomes an addict, but gets sober at the age of 20 and remains that way for more than a decade. Her mother-in-law dies when she is pregnant with her first child, and she suffers a terrible bout of postpartum depression and anxiety, and begins drinking again. Her own mother dies 2 weeks before her second child is born, and her anxiety, and thus her addiction, gets worse.
"At 8 months pregnant, my husband's mom died suddenly, and it took much of his time and energy to process his shock and grief over this loss. After I had my son, my mom's cancer (which had been in remission for several years) returned full force and she was given 2 years to live. I was flattened by postpartum depression and anxiety, which despite my clinical background, totally pulled the rug out from under me ..."
I spent the next few years battling alcoholism and addiction. I stayed sober during my second pregnancy and controlled my drinking while nursing. At 7 months pregnant my mom's cancer took a major turn for the worse. She died exactly two weeks before my daughter was born. After I brought my baby girl home from the hospital, the grief, pain, sadness and anxiety I felt was indescribable."
The author finally went to get treatment and is now 17 months sober.
This is a very important subject to me as I know women who have become alcoholics to blunt the pain of postpartum depression. Some became that way a long time ago, back when there were no toll-free numbers or support groups and nowhere to turn to get help. Some become that way in this day and age because they are afraid to or don't want to seek professional help and they don't know any other way to make themselves feel better. The negative impact of mothers who drink alcohol and take drugs while pregnant or breastfeeding or raising infants is rarely discussed, but this is another reason why identifying women with postpartum depression and anxiety is so important.
I have great empathy for women like this author. It is a difficult and destructive road. As the author writes in the conclusion of her article, "If you are reading this and finding yourself relating to parts of my story, please know that there is a way out of this destructive cycle. You are not alone."
If you have postpartum depression or anxiety, you are NOT alone. You can get help and get better.
Women who have experienced sexual abuse are at a higher risk for experiencing postpartum post-traumatic stress disorder. I was recently asked about resources for these women, and I came upon a blog called "Survivor Moms Speak Out", created by the authors of the book "Survivor Moms: Women's Stories of Birthing, Mothering & Healing After Sexual Abuse." If you are someone you know falls into this category, this site and book may be of help to you.
Other resources for you to consider:
TABS - Trauma & Birth Stress, an organization based in New Zealand.
PTSD After Childbirth - A Guide for Survivors of Child Sexual Abuse
An article about remembering sexual abuse in childbirth
Nice story from the St. Petersburg Times on the University Community Hospital in Tampa and what they're doing to help moms with postpartum depression. This includes having moms fill out questionnaires to identify risk factors and then having high-risk moms see a postpartum support specialist before discharge. Great job UCH!
A new study presented at the annual meeting of the Endocrine Society shows that postpartum anxiety can lead to a delayed onset of puberty in daughters.
The study, conducted on mice by researchers in New Zealand, found that low levels of prolactin in early pregnancy causes postpartum anxiety. (Maybe that's what was wrong with me.) Puberty was delayed in the daughters even if they weren't raised by their birth mothers.
According to Newswise, late puberty in humans is linked to shortened height and psychological problems that can persist into adulthood.
Apparently Stowe made approximately $250,000 from his relationship with Glaxo. The paper reports that Stowe has been reprimanded and told he must eliminate all conflicts related to current federal grants. "In a statement, the school said Stowe had informed it of 'previously unreported activities and has disclosed his failure to abide by Emory policies.'"
This is very disappointing. It calls into question his research, regardless of whether it was or was not affected by this relationship. Is it possible to separate church and state and have federally-funded research that completely bars any additional funding from pharmaceutical companies? What is the issue with the cost of research or the amount that researchers are getting paid that makes them seek additional funding from sources that could compromise their work? Can't we ensure that people are paid well enough in their jobs that they don't need to seek this kind of questionable funding elsewhere? Ugh.
No matter how many he times he may say that this didn't affect his research results, it won't help because this damages his credibility, at least in the public arena. No matter how much good work he may have done. That is why this is so awful.
For more on this, check out the Carlat Psychiatry Blog here.
It seems I may have missed National Women's Health Week back in May. I didn't notice any big celebrations or news or parades or million women marches -- did you? And may I ask, IS THAT ALL WE GET?! A measly week?!!!
Nonetheless, in honor of our health, the US Department of Health & Human Services' Office on Women's Health released two women's mental health publications that are available to you free. You can either download them or order free copies through the Substance Abuse and Mental Health Services Administration's Health Information Network (SHIN) or call 1-877-SAMHSA-7.
The first is called "Action Steps for Improving Women's Mental Health" and was created for healthcare pros. This is a report that brings together the most recent research, resources, products and tools on mental health issues in women and explores the role gender plays in diagnosing, treating and coping with mental illness. It outlines specific action steps for policy-makers, health care providers, researchers and others to take. The item number for this report is OWH09-PROFESSIONAL. To view it, click here.
The second is called "Women's Mental Health: What it Means to You" and is for consumers. It is a 22-page booklet addressing the stigma associated with mental health, with information on the signs and symptoms of mental illness. It also provides suggestions for support and solutions for preventing and coping with mental illness. The item number for this report is OWH09-CONSUMER. To view it click here.
I listened in on the press conference today by the National Academies on a new report from the National Research Council and Institute of Medicine on parents with depression. Very exciting to hear the level of understanding about how depression impacts families and how important it is to address it.
From today's news release (to read the entire news release, click here):
"Effective tools and strategies exist to treat and prevent depression, but only one-third of adult sufferers get treatment. Although many factors affect children's development, parental depression can increase the chances for health, emotional and behavioral problems in children. The report does not suggest that every parent with depression will inadvertently or deliberately cause harm to their children, but rather than parental depression increases the risks for spillover consequences during critical periods of child and adolescent development.
"'To break the vicious circle of depression, we need to refocus our view of this illness through a broader lens that sees the whole family, not just the individual with depression,' said committee chair and psychiatrist Mary Jane England, president, Regis College. "Our report describes a new vision for depression care that would provide comprehensive services not just to adults, but to their children as well. It will take significant policy changes to make this vision a reality, but the benefits warrant the effort.'"
Couldn't agree more. Highlights:
Also, a few facts from the press conference, most of which you probably know if you are a regular Postpartum Progress reader:
I asked the panel to respond to the fears of those who worry that universal screening will just "overmedicalize" depression. Their response was that screening will be effective if it is attached to treatment, so availability of services and follow through is important. They also said they emphasize giving parents a choice among treatments by offering a variety of options. (The same EXACT things I might point out that those in the perinatal mood and anxiety disorder community believe.)
As Dr. William Beardslee, Professor of Child Psychiatry, Children's Hospital in Boston, stated during the conference, "The first two years of life are crucial and we need very intensive interventions at that time for depressed parents."
To order the full report, click here.
Here's a section from the highly-respected Mayo Clinic on the issue of antidepressants and safety during pregnancy. (Note: there are two pages, so don't miss the second page.) It is a well-balanced piece that discusses the pros and cons. Here's their conclusion, which is exactly what I've tried to put forth here at Postpartum Progress:
"If you have depression and are pregnant or thinking about getting pregnant, consult your doctor. Sometimes mild depression can be managed with support groups, counseling or other therapies. If your depression is severe or you have a recent history of depression, the risk of relapse may be greater than the risks associated with antidepressants.
It's not an easy decision. As researchers continue to learn more about antidepressants, the risks and benefits of taking the drugs during pregnancy must be weighed carefully on a case-by-case basis. Work with your doctor to make an informed choice that gives you -- and your baby -- the best chance for long-term health."
The Tree of Hope Foundation is holding its annual 5K Run, Walk & Stroll, called "Step Up for Hope", on Saturday, June 21, at Metro Beach Metropark in the Detroit area to raise awareness of postpartum depression, or PPD.
The Tree of Hope raises awareness about perinatal mood and anxiety disorders and provides support and education for families. The Foundation also provides information for medical professionals who may have patients dealing with the disorder.
Click here for a walk registration form.
"About 13 percent of women suffer from the anxiety, hopelessness, desolation, and fatigue of postpartum depression (PPD) for the first 3 to 12 months of their children's lives. Yet, primary care physicians fail to recognize more than half of PPD cases, despite the availability of depression screening tools that can expedite diagnosis and treatment. Some women and clinicians may confuse PPD with "baby blues," which occur in more than 80 percent of mothers. However, baby blues begin within hours or days of delivery, are characterized by major mood swings rather than consistent depressive symptoms, and typically disappear 2 to 4 weeks postpartum.
While baby blues and minor depressive symptoms often clear spontaneously, PPD is a persistent form of major depression that develops within the first 2 to 6 months postpartum. Untreated PPD can devastate the mother (who loses her energy or joy in parenting), her child (who often has delayed psychological and cognitive development), and her family (with twice the risk of divorce within 2 years postpartum). In extreme cases, PPD can result in suicide and infanticide. Timely diagnosis and treatment of PPD can interrupt these cycles before damage to mother, child, and family become irreparable, explains Barbara P. Yawn, M.D., M.Sc., of the Olmsted Medical Center and University of Minnesota."
Don't forget ... if you have questions, Postpartum Support International can help. This Wednesday PSI is offering its weekly free, open phone session called "Chat with the Expert". You can join the call to talk or just to listen to others discuss resources, symptoms, options and general information with an experienced member of Postpartum Support International. You can talk from the privacy of your own home and there is no need to pre-register or give your name. Sessions are informational only and open to anyone with questions and concerns about themselves, a loved one, friend or family member. To get information on how to participate in Wednesday's call, or any of the other phone sessions offered, visit http://www.postpartum.net/info-sessions/
The National Research Council and Institute of Medicine of the National Academies are releasing a report at a public briefing on Wednesday, June 10 called "Depression in Parents, Parenting and Children: Opportunities to Improve Identification, Treatment and Prevention". The report will be released via a press conference at 1pm EST at the National Press Club in Washington DC.
It explores the interaction of depressed parents, parenting practices and its impact on children as well as strategies to promote effective interventions for widespread implementation in different service settings for diverse populations of families. The briefing will include the committee's recommendations for improving the quality of care for depressed adults and their children. The study was funded by the Annie E. Casey Foundation, the California Endowment, the Robert Wood Johnson Foundation, the U.S. Health Resources and Services Administration, and the U.S. Substance Abuse and Mental Health Services Administration.
Participants in the press conference will include William Beardslee of Children's Hospital in Boston, Frank Putnam of Cincinnati Children's Hospital Medical Center and Mareasa Isaacs of the National Alliance of Multi-Ethnic Behavioral Health Associations.
The briefing will be audiowebcast for those who cannot attend. Both the webcast link and the form for submitting questions via email will become available at the time of the event at http://national-academies.org.
I wonder whether this report will just reinforce the need for the Melanie Blocker Stokes MOTHERS Act ...
Warrior Moms and other Postpartum Progress readers ...
PLEASE bear with me now that the summer has arrived. My children are out of school, and AT THE SAME TIME, we're preparing to move about an hour away to the other side of Atlanta in July. I'm getting lots of great emails and I have lots of story ideas, but in the months of June and July it takes me a whole lot longer to get things done since I'm "cruise director" and can't work during the day. I just wanted you to know that even though things are a little bit slower around here right now it's not because of anything more than mommyhood! Hang with me ...
If you have experienced any serious adverse affects from taking medication of any kind, there is a reporting process you can use offered by the FDA called MedWatch. You can submit a report to them here and you can read about other general information on medications from the FDA here.
Each month, the European search engine Wikio allows a different health blogger to give his or her readers a sneak peek at their new rankings of health blogs. This month Postpartum Progress is getting the preview, so here you go -- you get this info before anybody else! By the way, Postpartum Progress is ranked #32. How exciting is that?
On Thursday, August 6th, the PSI Annual Conference's Banquet will be held at the Millenium Biltmore Hotel in downtown LA. This special event will include a cocktail reception, keynote speaker, musical entertainment and a silent auction. The auction is an important fundraising event for Postpartum Support International. PSI is asking for items valued at or great than $100.00. If you have something to donate, or you know of local merchants or friends that would be interested, please contact Linda Klempner at lklempner@verizon.net or 201-692-9496.
I've shared Depressed (But Not Unhappy) Mormon Mommy's posts here before. This one is just so gorgeous I have to share it with you. Laura writes about a panic attack she experiences while reading the book "Ecology of a Cracker Childhood" as the author describes her father's mania.
She then shares the text of a letter the book's author Janisse Ray receives from her father later in life -- this is one of the most beautiful things I've EVER READ on the topic of mental illness. It is such a wonderful summation of how I feel about the invaluable gifts I've received since experiencing postpartum OCD.
I know ... if you're currently suffering, you will read the letter and think his sentiments are outrageous. They couldn't be further from the truth of how you feel. But you will reach out for professional help, and then one day you will get better, and then one day life will return to your version of normal, and then one day you just might feel the same way. His letter is a lovely bit of hope.
Thank you, Laura, for sharing this with us.
If you are interested in being an exhibitor at the upcoming Postpartum Support International annual conference in Los Angeles (Aug 6-7), here's what you need to know:
The conference attracts professional care providers, such as obstetricians, gynecologists, pediatricians, psychiatrists, social workers, psychologists, nurses, women who have experienced postpartum mood and anxiety disorders and their families, and support volunteers from across the country and abroad. Attendance is expected to be approximately 300 healthcare providers plus members of the general public.
Exhibitors will be able to display their materials and sell books on site. All other merchandise may be purchased via order forms. Each exhibitor will be able to display their materials using a 6-foot table. Prices are $850 for exhibitors and $450 for 501(c)(3) non-profit exhibitors. Non-profit exhibitors are limited to the first 7 organizations who apply. To participate or to ask questions, please contact Kimberly Wong at 213-974-2888 or kwong@pubdef.lacounty.gov.
If you'd like to learn more about the conference, visit the conference registration site at http://psi.eventbrite.com.
Also, sponsorships are available for this great conference. For a $5000 sponsorship, the sponsor receives one half-page ad in the conference program, one exhibitor table and two free registrations to the main conference. If interested, please contact Kimberly Wong.
There are lots of interesting articles, tidbits and posts online by the cast of characters I like to read, and I want to share some of them with you here:
Therese Borchard at Beyond Blue: Do Antidepressants Dull Emotions?
Therese Borchard at Beyond Blue: How Would the Dalai Lama Treat A Mood Disorder?
Lauren Hale at Sharing the Journey: Adrienne Einarson Responds to Vogue's "Pregnant Pause" Article
John Grohol at Psych Central: No Significant Relationship Between Violent Crime & Mental Illness
John Grohol at Psych Central: Online Treatment for Depression
Today I'm adding to our "Six Things" series with the "Six Things You Should Avoid If You Have Postpartum Depression" or any related illness. (Note: To see the other Six Things articles, look to the left of your screen underneath my picture.)
SIX THINGS YOU SHOULD AVOID IF YOU HAVE POSTPARTUM DEPRESSION
1. Scary Stuff
Women with perinatal mood and anxiety disorders can be very suggestible. What does that mean? It means you can hear or see something disturbing and then suddenly be convinced it relates directly to you. You can get a scary idea in your head and then not be able to get rid of it -- it can sometimes get stuck in there and endlessly terrorize you. It's best to surround yourself as much as possible with positive images so that upsetting thoughts don't get the chance to enter your mind.
Avoid horror movies and scary books. Don't watch too much news, and don't surf the internet carelessly. Be very choosy about which websites you go to and which discussion forums you join. Some "mommy websites" don't have trained moderators running their PPD forums, and you'll run into well-meaning women telling you exactly what you need to do, and not do, to get better. They don't know you and they don't know exactly what you need. Each person responds differently to treatment. Some take meds and some don't. Some have side effects and some don't. Some have a great doctor and some don't. Some get better quickly and some don't. If you spend all day comparing yourself to what women on the internet have done you can drive yourself crazy. Try to go to safer sites, where trained peer support and/or research-based information are offered, like Postpartum Support International, the Online PPD Support Group, MedEdPPD, Postpartum Progress or your state's local support organization.
2. An Overscheduled Life
Does it all need to get done right now? Really? Or is your health more important? A spotless house, empty laundry basket and dishwasher, three-course meal and five different mom and baby classes aren't necessary. The more you give yourself to do, the more you're likely to beat yourself up when you can't do it all perfectly. And trust me, you can't do it all.
3. Thought Monkeys
The fabulous blogger at Sophie in the Moonlight calls the negative thoughts that most of us with perinatal mood and anxiety disorders experience "thought monkeys". Many of us unwittingly lend a hand to our illness by accepting these negative thoughts; by telling ourselves we are bad people and defective mothers. I love how Sophie has brought this to life:
"Thought Monkeys [are] my name for those incredibly destructive, deeply internalized, mischievous thoughts that jump and screech inside my mind, demanding attention, demanding action NOW. Look at us NOW ... The Thought Monkeys even have names. In no particular order they introduce themselves as follows: "I'm Not Enough of, at or for Anything", "I'm A Big Burden"; "I'm Unlovable"; "My name is "The World Would Be Better Off Without Me" and her close cousin "I'm Not Worthy to Breathe In This Air Shared By My Friends and Family"; and my least favorite says "I'm To Blame For Every Abusive Thing That Has Ever Been Done to Me My Entire Life". Aren't they sweet? Each one is uglier than the last and they each think they are the most important one. Hateful little creatures."
Sophie challenges each thought monkey. She avoids believing they are true. She fights back with her own mind, argues with herself that these thoughts are wrong. We have to do the same. We can't contribute to and even further our suffering by accepting that these thoughts are reality. They aren't. They are part of the temporary disease.
4. Unsupportive People
It may help to temporarily avoid or limit your time with people who blame you for your illness or don't try to understand, as well as people who are judgmental or don't support your treatment and recovery path. You need positive and supportive people on your side, so spend as much time with those people as possible. And even if you don't find them among your friends and family, you will find them among the women who have been through these illnesses, so try and find a support group in your area.
5. Procrastination
Many recent studies show that both the physical and emotional health of untreated women and their children can be negatively impacted over the long term. Babies whose mothers have untreated depression during pregnancy, for instance, are twice as likely to be born prematurely. Prematurity can lead to health problems and developmental delays.
There is just no good reason to wait it out if you are ill, either during pregnancy or postpartum. Avoid procrastination. I know you're scared, but it's important to reach out to a doctor and let him or her know what's going on. As Karen Kleiman, author of "This Isn't What I Expected: Overcoming Postpartum Depression," wrote in a comment on Postpartum Progress:
"Sometimes people feel that a risk is greater if they 'do' something or take action, as opposed to just letting things be. Life, 'If I get on that airplane during the storm, the risk will be greater than if I don't go.' That seems pretty clear.
Conversely, there are times when the risk is in fact higher when no action is taken, such as the decision not to do anything in response to having chest pains.
This is the case with women who are pregnant or postpartum. Women who are deciding whether or not to take medication are understandable unsettled by having to make this decision. Often they feel if they 'take' the medication they are taking an action or engaging in behavior, or making a choice that increases the risk, or so they believe. Thus, they feel it would be better to do nothing.
But we know that in many of these cases, it is NOT better to do nothing and NOT TAKING ACTION can be detrimental; it can significantly increase the risk potential, particularly for women who are severely ill. So it's a perception thing. We perceive the risk to be greater if we take action. If I put this pill in my mouth I will be hurting myself or my baby. But it's a faulty perception. Sometimes the risk is much greater when we do not act."
This doesn't just apply to the issue of medication, of course, because not every woman needs medication. It's simply a great illustration of how procrastination can hurt you in the end. And, by the way, did you know that difficulty making decisions is a symptom of postpartum depression? You may have to push yourself a little bit harder to take that step of reaching out for help.
6. Acting Like You Have A Medical Degree
Unless you graduated from medical school and have completed your residency, you shouldn't be diagnosing yourself. If you think you might have a perinatal mood or anxiety disorder, seek a trained a professional to tell you whether you simply have the baby blues or something more. And for goodness sake, if you're taking medication, you don't get to decide to stop it cold turkey or reduce the dose without discussing it with your doctor first. Doing that to yourself could do more harm than good.
I'm pleased to share with you that in the spring issue of Esperanza, a magazine for anxiety and depression sufferers, I've been chosen as an "Everday Hero" along with Canadian singer Amy Sky and former first lady of New Jersey Mary Jo Codey. Very cool! I'm honored to be in such company, and glad the magazine chose to cover the topic of postpartum depression.
Thank you, Esperanza, and thanks to Tom Davis for such a nice write-up of all three of us!!
One of my mothers (I have two) works at the Mississippi State Mental Hospital. She told me they have some sort of museum or archives there, and in it there is an admitting book that shows, among other patients, the women who were admitted shortly after childbirth and committed to the mental institution for the rest of their lives. Checked in and never checked out. This was not unusual in an era where there were no toll-free numbers, support groups and patient brochures about postpartum depression. Only the belief that these women were "hysterical" and probably weren't coming back from wherever their minds had gone.
I just came upon this poem from a blog called Life At Willow Manor. I don't know Willow, the author, personally, but her poem is so poignant and beautiful. It makes me long to hug all the women who were in her great grandmother's exact situation. I'm so glad we've come a long way from that. She has given me permission to reprint it here.
Emma
Shadows of my family
hang from this stranger’s pensive smile,
like the locket and chain pinned
to her clean Victorian blouse.
Galena Kansas, branded
on the faded cabinet photo,
tags her face
as cattle marked for market.
She was committed, they told me;
endless days of silence,
absently pulling the chain of her shackle,
fenced in a dark corral.
I tell myself her smile
was tucked away,
resting in the hope chest
with her locket, chain and ruby slippers--
waiting for her tin man
and scarecrow to
link arms and steer her
along that yellow brick road to the sky.
I haven't quite gotten into the podcast/blog video thing yet. It's on my list for this year. But I did do an Ohio public radio interview on WOUB-AM recently and I thought I'd share the audio here. I talk about perinatal mood and anxiety disorders, my experience with postpartum OCD and Postpartum Support International. It lasts 30 minutes.
So ... if you'd rather hear me talk about all of these things than read, click here for the mp3. It will take a few minutes to download, and will then start playing immediately.
There are currently few resources in middle Tennessee to help women with perinatal mood and anxiety disorders. Marcie Ramirez is putting together a taskforce to meet this need. Please join her and others on Monday, June 22, at 7pm at the Fellowship Church in Murfreesboro, TN, for a brainstorming session to assess the mental health needs and resources fro new families in Middle Tennessee. Professionals and consumer advocates are welcome.
If you are able to attend, please RSVP to Marcie at 615-439-8414 or email her at ppdhelp@ymail.com. If you are unable to attend but would like to stay up-to-date on the happenings of the group, please let her know that too.
Marcie is a survivor of postpartum depression and anxiety and serves as a PSI coordinator in Tennessee.
If I could, I would thank Kirstie Alley personally. Hug her, even. Her over-the-top Twittering this week (@kirstiealley) has finally started to bring attention to the widely-spread false and misleading statements that have been made for months now about the Melanie Blocker Stokes MOTHERS Act.
Some of Kirstie's statements on Twitter this week have included that the bill is "backed 100% by big pharma" and that "The goal is to pre-screen pregnant mothers for depression. If they fit the bill, it is mandated treatment which is drugs. And for her baby."
I've always been a fan of Kirstie Alley, so this came as a disappointment to me. But I'd like to hope that she was just being misled, and didn't realize that the facts she was sharing with her 22,000-plus followers on Twitters were not, in fact, facts.
Websites that have taken notice and spoken up include About.com and the Daily Kos.
Daily Kos: "Kirstie Alley & Scientology Vs the MOTHERS Act"
"Nowhere does this bill suggest that women or their children will be forcibly drugged, but this is one of the fearmongering 'factual statements' put forth by Scientology, CCHR, and its celebrity mouthpieces like Kirstie Alley."
About.com: "No Mercy for Those Who Invent Facts"
"Kirstie Alley and Scientology's Citizens Commission on Human Rights are protesting The MOTHERS Act, which is meant to provide more information about postpartum depression to new and expectant mothers. It also pushes for greater research into the condition ... This isn't an issue of mere misunderstanding. This is, at best, passing along rampant, unfounded, and unresearched rumor; at worst, deliberate misrepresentation."
Another site that I must admit I hadn't been aware of, until now, called Celebitchy, reported this:
"Alley is Twittering about all the bad things she believes will happen if the Mother’s Act is passed. This includes things like FORCING women and babies to take psychiatric drugs and squirting Prozac in babies’ eyes. Yes, she really said that."
I might point out that several people who tweeted Ms. Alley back this week to disagree with her, including myself, Amber Koter, and Ivy Shih-Leung, noticed that our tweets were blocked. I'm sad that doesn't want to have a reasoned discussion about this.
Let's all repeat:
1. The MOTHERS Act does not mandate that women be screened for postpartum depression. It actually funds research to look into how effective screening is in indentifying women who have it.
2. The MOTHERS Act does not mandate women to take drugs for postpartum depression. It doesn't take any stance whatsoever on treatment, other than to fund research into what effective treatments may be and into what causes this illness so that perhaps more targeted treatments can be developed in the future.
3. The MOTHERS Act is not sponsored by the pharmaceutical industry. Its only sponsors are the Senators (Menendez) and Representatives (Rush) who created it and brought it to a vote, thanks to the unending insistence of Carol Blocker, the mother of Melanie Blocker Stokes, who committed suicide while suffering from postpartum psychosis. Its endorsers, I might point out, include the American College of Obstetricians & Gynecologists, the March of Dimes, the National Healthy Mothers Healthy Babies Coalition, the Children's Defense Fund and NOW. And, I'm excited to say, as of this week the National Perinatal Foundation has added its voice to those organizations that support this legislation.
4. I know plenty of women who have screened positive for postpartum depression because they were, in fact, suffering from postpartum depression. These women have been able to make their own choices about whether they wanted treatment or not, and if so, what type. I know women who've done therapy only, women who've used alternative methods, women who've taken meds. It's still a free country, thankfully, and will continue to be after the MOTHERS Act is passed.
5. Nobody will be squirting anything into babies' eyes or into any other orifices of any other person.
Tomorrow, Jen Stoll, the executive director of the Postpartum Resource Center of Kansas, and her family will take 8,707 steps to combat postpartum depression. Four people will each walk two miles to represent the number of women who experience PPD in the Kansas City metro area. If you want to support their walk, which will help fund the staff and volunteers at the Postpartum Resource Center of Kansas, you can help in one of three ways:
Registration is now open for the Postpartum Support International Annual Conference, held this year in sunny Los Angeles. The event is August 4-7, with the pre-conference on the 4th and 5th, and the main conference on the 6th and 7th. It is co-hosted this year by PSI and the Perinatal Mental Health Task Force of LA County and will be held at the California Endowment. To register, click here!
The conference hotel is the Millenium Biltmore. A discounted room rate of $145 per night has been reserved for conference attendees. Please request the group rate for "Postpartum Support International Conference". To book online with group discount please go to: https://reservations.synxis.com/lbe/rez.aspx?hotel=11535&arrive=08%2F03%2F2009&nights=4&adult=1&group=PSIAUG2009&promo=&iata=&step=1
Another actress adds her name to the list of celebrities who have suffered a perinatal mood and anxiety disorder --Lisa Rinna.
Rinna was a star of the show "Melrose Place" and has also appeared on "Dancing With the Stars".
The 45-year-old mother-of-two tells all about her dark past in her new book Rinnivation: Getting Your Best Life Ever.
Rinna admits she set out to write about diet and fitness, but she found herself haunted by visions of killing her actor husband Harry Hamlin and their daughters, Delilah, 10, and Amelia, seven.
And the project soon became a way for the actress to reach out to other women who have suffered in a similar way.
She says, "I set out to write a diet and fitness book period and that was about it. That isn't exactly who I am, I'm much more than that. I just started to open up and it became this cathartic event... People don't talk about this. It's very, very scary and vulnerable. I had visions of knives and guns. I made Harry hide all the sharp knives and take the gun out of the house because I had visions of killing everybody. Now how horrific is that? I wanted share it because I think women are so shamed by this and feel so horrible... I found help and got through it."
First of all, Starpulse, PLEASE NOTE that having suffered from a perinatal mood and anxiety disorder is not a "dark past," thank you very much.
Also, it sounds like Rinna suffered from postpartum OCD actually. I made my husband take the gun out of the house as well. I'm glad that she found help to get through it and that she was willing to share her experience.
Have you joined the Surviving & Thriving Mothers Photo Album here on Postpartum Progress yet? HAVE YOU?!!! We now have more than 60 moms who are great examples of how you can recover and thrive after postpartum depression and related illnesses.
If you are a survivor of postpartum depression, postpartum psychosis, antepartum depression, postpartum OCD/anxiety, antepartum anxiety or postpartum PTSD, you can serve as an inspiration to the thousands of moms reading Postpartum Progress who may be suffering right now. They are thinking the same thing you did: I will NEVER get better. I will NEVER be the same again. You know that's not true, because you recovered. So show them what it feels like to be a mom now.
SEND ME YOUR PICTURE, like the moms below did, of you and your children so I can add it to the photo album. It doesn't matter how long ago you suffered, or how long it took you to get better -- the point is that you're better. Just send a jpeg, your first name and last initial, the state you live in, and which illness you suffered and when to stonecallis@msn.com.
Have you ever been parasailing? I have.
As described by Wikipedia, Parasailing, also known as parascending, is a recreational activity where a person is towed behind a vehicle (usually a boat) while attached to a specially designed parachute. known as a parasail. The boat then drives off, carrying the parascender into the air.
I went once when I was on vacation in Lake Tahoe. This was when I was in college and was willing to risk life and limb just because a cute guy ran the parasailing boat.
After the fright and thrill of going up into the air harnessed to a parachute, something immediately grabs your attention. Silence. You can't hear ANYTHING, except perhaps the air blowing past your ears. You can see all the people down below, driving around in boats, waterskiing, wave running, frolicking. At ground level, the beach is a noisy place. Then up you go and the sound disappears completely. You suddenly feel strangely separated from the world. You know what's going on down there, you can see them and you understand what they're doing, but you get the clear sense that you could yell and scream and no one would hear you. You're there, but then again, you're not.
I was thinking about that experience the other day and it reminded me so much of how I felt when I suffered postpartum OCD. It was like an out-of-body experience; I was floating above my life watching all the people go about their day and I couldn't successfully communicate with them. I couldn't connect to them. I was still there, but in a different place, and I didn't know how to come down out of that place by myself. Like the boat that eventually pulls the parasailer back down to earth, it took professional help to bring me back to myself, my friends and my family. I got it, of course, and mercifully returned to the shore of my life.
For more on this, read "Profoundly Alone: The Disconnection of Postpartum Depression".
Diana Lynn Barnes, PsyD, is one of this year's five Welcome Back Award honorees who have overcome innumerable obstacles to make a profound difference in the lives of others. She received the Lifetime Achievement Award. Congratulations Diana!!!!!
As they describe her so impressively: Diana Lynn Barnes, Psy.D., is an internationally recognized expert on the assessment and treatment of perinatal mood disorders who has used her own three-year struggle with postpartum depression to help educate others through media interviews, speaking engagements and as an author. In addition to her private practice, she is a nationally known forensic expert in women's reproductive mental health and works with defense counsels in cases of infanticide, pregnancy denial and neonaticide. She is a past president of Postpartum Support International and continues to work with the group to raise awareness of postpartum depression. In 2007, she wrote her first book "The Journey to Parenthood: Myths, Reality and What Really Matters." Additionally, Dr. Barnes has been involved with the
Diana is a great lady and I'm happy that she's being honored in this way!
Eli Lilly and Company will be honoring all of the winners at the Eleventh Annual Welcome Back Awards ceremony in
And, no ... Eli Lilly did not pay me to write this. ;-)
If you have a friend or loved one who is suffering from a mental illness, be it a perinatal mood or anxiety disorder or something else, you might be interested in checking out the website "What A Difference". They offer tips on how to best support people you care about who have been diagnosed with a mental illness, including an interactive video.
Also, Paige Hemmis from ABC's "Extreme Makeover: Home Edition" has kicked off Blueprint for Hope, talking about her own experience with depression. Full disclosure: her partner for this site is Wyeth Pharmaceuticals, manufacturer of antidepressant medications.
"Not only can postpartum depression interfere with a new mother's ability to care for her newborn, it can be confusing and misunderstood by the woman and her family," Rupp said. "My colleagues and I will be investigating whether oxytocin, a hormone that reduces the physiological stress response and promotes social bonding, buffers new mothers against depression through its influences on their neural responsiveness to stress, and whether this process is disrupted in some way in women suffering from postpartum depression."
The mechanism for altered neural responsiveness in the postpartum period may involve oxytocin, which also occurs at higher levels in new mothers. It is hypothesized that this makes the new mother less affected, generally, by negative stressors from the outside world, but more responsive to her infant.
The study will involve three groups of women -- new mothers who are not depressed, new mothers with PPD, and women who have never given birth. Using fMRI technology, Rupp and her colleagues will compare brain activity in the three groups in response to a series of images. Some of the women will also receive an oxytocin nasal spray. The study results will provide a better understanding of brain activity in women with postpartum depression, and the role of oxytocin in the early stages of motherhood.
Adrienne Griffin pointed out to me a recent article in the Atlantic called "The Case Against Breastfeeding". I think the title goes a little far, as breastfeeding is of course just fine. The title should have read "The Case Against Acting Like Breastfeeding Is the Only Way to Be a Good Mom". Author Hannah Rosin compares the medical literature on breastfeeding with the pop culture view on breastfeeding and finds out how much the two differ, after discussing her potential plans to stop breastfeeding her baby:
"One afternoon at the playground last summer, shortly after the birth of my third child, I made the mistake of idly musing about breast-feeding to a group of new mothers I’d just met. This time around, I said, I was considering cutting it off after a month or so. At this remark, the air of insta-friendship we had established cooled into an icy politeness, and the mothers shortly wandered away to chase little Emma or Liam onto the slide. Just to be perverse, over the next few weeks I tried this experiment again several more times. The reaction was always the same: circles were redrawn such that I ended up in the class of mom who, in a pinch, might feed her baby mashed-up Chicken McNuggets."
This from a mom who didn't suffer postpartum depression. Adrienne, the founder of Postpartum Support Virginia, pointed out that breastfeeding is often the #1 topic of discussion in some of the PPD support groups in which she has been involved, as this issue often causes such pain for moms, especially those with postpartum depression or anxiety. Some moms want to breastfeed but can't due to low supply, or because baby can't suck, or perhaps because they're on medication contraindicated in breastfeeding. Some moms refuse get treated for postpartum depression or anxiety because they don't want to be on medication while breastfeeding, all the while often unaware of the potential dangers of untreated postpartum depression for both mother and child. Some moms don't want to breastfeed, whether they are or aren't depressed, but do it while miserable to keep up with the Joneses. For other moms who are depressed, breastfeeding is the only thing that helps them feel close to their child and they continue on while getting treated at the same time. There is no one-size-fits all story around whether moms should or shouldn't breastfeed.
It's too bad the Atlantic article didn't point out the effect the breastfeeding mystique has on women with postpartum depression and related illnesses. It would have been a great supporting point to her piece. If you read any of the stories on the Mother's Day Rally for Mom's Mental Health -- such as this one from Sophie in the Moonlight -- you can see how much moms are affected by the expectation that they will and should breastfeed if they truly love their babies. You can find another great story on the issue of breastfeeding and postpartum depression -- A Mother Without A Breast -- here, written by Lisa Sniderman. And still another great piece, which references the same Atlantic article, by Morra Aarons Mele on BlogHer about the breastfeeding debate in general, with lots of comments from readers.
Interestingly enough, Therese Borchard just wrote about this very subject today on Beyond Blue after receiving some negative comments on her post for the Mother's Day Rally for Moms' Mental Health, like this one:
Dear New Mothers,
Don’t make the same mistake this writer did. Learn the real facts about breastfeeding and depression medication. Know that there are options that can both treat your completely legitimate mental health needs and preserve your breastfeeding relationship. Know that your needs and your baby’s needs are not always in conflict. Breastfeeding need not be a soul-crushing, life-stealing endeavor. Indeed, you might find (as many do, as I do) that it is a life preserver, that it sustains and nurtures you and your baby through the good times and the bad.
Actually, the only thing new mothers need to know is that some moms can breastfeed and some moms can't -- for some it's a life preserver and for some it's an anchor -- yet all can have loving, healthy relationships with their babies regardless.
I couldn't breastfeed, even though I was being treated for my postpartum OCD. Breastfeeding exacerbated my anxiety, as I was constantly and consistently FREAKED OUT over how much milk my son was getting. My breast did not have ounce markings on it, and that was enough to cause me unrelenting worry. This was all made worse by the fact that the nurses in the hospital nursery chose to supplement him with formula to help his jaundice, without my knowledge, causing horrible nipple confusion and a refusal to latch on. For me, stopping breastfeeding in the end was one thing, among others, that allowed me to calm down and focus on getting better while at the same time not being hysterical when it came to the feeding of my child.
Women must support each other in their choices, including breastfeeding. We all travel down different roads.
I missed out on telling you about a lot of study results and articles that have come out in the last several weeks while I was getting ready for the Mother's Day Rally for Moms' Mental Health. So here goes ...
An editorial from the May 2009 issue of the American Journal of Psychiatry entitled "Assessing Risk & Benefit: To Treat or Not to Treat Major Depression During Pregnancy with Antidepressant Medication." Here's the article's conclusion:
"Thus, all things considered, on the basis of the findings from the methodologically sound and rigorous study of Wisner et al. and the evidence available from long-term studies, this author thinks that the risk of untreated major depression outweighs the risk of effects of SSRI treatment on neonatal outcomes."
An article on breastfeeding and postpartum depression from Advance for Physicians Assistants.
And get ready for the big one ... women with postpartum depression who are treated with antidepressants often see their sexual problems resolve as well, per a new study in the Journal of Clinical Psychiatry.
Karen Kleiman: This Isn't What I Expected: Overcoming Postpartum Depression
Karen Kleiman: What Am I Thinking? Having a Baby After Postpartum Depression
Sandra Poulin: The Mother-to-Mother Postpartum Depression Support Book
Susan McRoberts: The Lifter of My Head: How God Sustained Me During Postpartum Depression
Tracy Thompson: The Ghost in the House: Motherhood, Raising Children, and Struggling with Depression
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