Monthly Archives: September 2008

Perinatal Disorders and Poverty Assessment Training

The Keeler Women’s Center in Kansas City, Kansas,  will be holding a training event on October 1st. The event is entitled Perinatal Disorders and Poverty: Assessment of Resources for Treatment. All professionals who serve women suffering from postpartum depression are welcome to attend. Ministry of the Benedictine Sisters. 1-4 p.m. Oct. 1, Keeler Women’s Center, 2220 Central, Kansas City, Kan. Register. www.mountosb.org/kwc (913-906-8990)

Henna, Childbirth, and the Postpartum Period

"Henna Foot" By Jason. Tabarias @flickr (http://tinyurl.com/35f4yj4)

Here is an excerpt from a wonderful article I located last night regarding this topic. The entire article is absolutely fascinating and DEFINITELY worth the read.

Hennaing a woman after she gives birth is a traditional way to deter the malevolent spirits that cause disease, depression, and poor bonding with her infant. The action of applying henna to a mother after childbirth, particularly to her feet, keeps her from getting up to resume housework! A woman who has henna paste on her feet must let a friend or relative help her care for older children, tend the baby, cook and clean! This allows her to regain her strength and bond with her new baby. She is also comforted by having friends who care about her well-being, and is helped to feel pretty again. It’s a comfort to have feet beautified when you haven’t seen them for several months. The countries that have these traditions have very low rates of postpartum depression.

Friday Soother 09.26.2008

Sooner or later we all discover that the important moments in life are not the advertised ones, not the birthdays, the graduations, the weddings, not the great goals achieved. The real milestones are less prepossessing. They come to the door of memory unannounced, stray dogs that amble in, sniff around a bit and simply never leave. Our lives are measured by these. – Susan B. Anthony

(Today is my birthday but this quote is so right – the important moments in life ARE the little ones!)

Milking cows is cruel; Milking Humans? Not so much!

PETA, the People for Ethical Treatment of Animals has taken it a little too far. Way too far, actually.

Apparently they’ve written a letter to Ben & Jerry’s asking them to use human breast milk in their ice cream because and I quote, “cow’s milk is hazardous and that milking them is cruel.” Yet milking human women isn’t cruel?

As a mother who Exclusively Pumped for seven months, I can attest to how difficult breastmilk is to extract. Not only would it be cruel and unusual to milk women, the price of Ben & Jerry’s would sky-rocket if they were to use breastmilk.

Here’s a link to the PETA site with their side of the story.

I am disgusted with this recommended course of action, even if it is just some sort of attention grabbing ploy. How absolutely disrespecful and misunderstanding of the nursing relationship does one have to be in order to even CONSIDER suggesting such a ludicrous action? Apparently cows rank higher in importance to the folks over at PETA than Nursing Moms.

Sharing the Journey with Dr. Shoshana Bennett

Having started out much like myself as a survivor of PPD, Shoshana Bennett has done more than just dig herself out of a deep dark place – she’s risen far above it and has been reaching back to help others find their way back out and into the bright Clear Sky. In fact, Dr. Shoshana appeared just this past Tuesday on The Doctors to speak about Postpartum Mood Disorders and offered to help currently struggling moms. She serves as a true inspiration and source of caring support for those of us who advocate and are struggling through our own dark path. Thank you, Dr. Shosh, thank you.

Would you share a little bit about yourself with us?

A survivor of two life-threatening, undiagnosed postpartum depressions, now considered a pioneer in the field, I founded Postpartum Assistance for Mothers in 1987, and am a former president of Postpartum Support International. I’ve  helped over 17,000 women worldwide through individual consultations, support groups and tele-classes. As a noted guest lecturer and keynote speaker, I travel throughout the US and abroad, training medical and mental health professionals to assess and treat postpartum depression and related mood disorders. I have earned three teaching credentials, two masters degrees, a Ph.D. and am a licensed as a clinical psychologist. Currently, I am working to pass legislation that helps reduce the incidence and impact of postpartum mood disorders. You can contact me through http://ClearSky-Inc.com.

I’ve written Postpartum Depression For Dummies and co-authored Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression. My latest book Pregnant on Prozac will be available in January of ’09. I’ve also created guided imagery audios that are specifically focused on helping moms take care of themselves.

How did you become focused on Postpartum Mood Disorders? What drew you in to the subject?

Out of personal experience with severe postpartum depressions (along with OCD, panic, and PTSD), it became my mission to educate. There was no help for me back in the ‘80s. When I realized there was a name for what I had gone through, I understood that my family and I didn’t have to suffer like we had. Since then, it’s been my passion to help prevent that pain and isolation in others.

As I look back at my two episodes of Postpartum Depression with OCD tendencies, I see very clearly now how they helped to mold me into the woman I am today and allowed me to develop my tenacity and increase my self-esteem. What are some of the biggest things your experience with PPD allowed you to realize? Through sharing my experience and expertise with clients and colleagues, I experience the deepest, most satisfying feelings. I know my suffering was not in vain – my purpose is to get the word out that there’s hope and that moms will recover with proper help. I get to witness my clients’ lives transforming before my eyes. They often tell me they’re happier than they were even before their postpartum depressions! I am so thankful that out of personal devastation came this glorious path.

As a mom, what have you found to be the most energizing about motherhood? The most challenging?

As many of your readers will agree, our children are our best teachers. My kids always hold up that proverbial mirror so I will be the best person I can be. This is both what’s most energizing and most challenging. It’s not always easy to take an honest look (right?), but I truly love the personal growth involved. I find this challenge stimulating and exciting.

What are some of the biggest challenges you have faced in juggling motherhood and work?

I earned a doctorate degree when my children were quite young. Most of my studying and papers were completed between 3 and 6 in the morning, before my kids woke up, which took some discipline. Also, working from home can be easier in some obvious respects, but more challenging in others. For instance, I needed to learn to keep my work contained in my office , instead of letting it spill into my kitchen and living room. Psychologically and physically it took some practice setting and keeping those boundaries.

We often encourage mothers to remember to take time for themselves. What is it that YOU do to recharge your batteries?

In between writing chapters for my next book Pregnant on Prozac, I take walks, do yoga, and visit with friends. I travel and speak quite a bit, but these are things I can do anywhere. Almost every day I put on some great, upbeat music and I focus on my next steps personally and professionally. I’m also a huge believer in nutrition – I eat really well to support healthy brain chemistry and body functioning. Every month I also receive a wonderful massage. I encourage my clients to take good care of themselves physically, emotionally, psychologically and spiritually, and I do the same for myself.

Postpartum Mood Disorder recognition and acceptance has come a LONG way but we still have miles to go. What do you see as some of the hurdles we still have to cross?

For one, the DSM should recognize the postpartum mood disorders as their very own diagnoses. Right now, there is no actual diagnosis of postpartum depression, so it’s viewed by many well-meaning professionals as no different from any other depression. For any woman who has been depressed before having a baby, and then has ppd, she absolutely knows that ppd feels different. Also, the right questions for moms and dads need to be asked in OB and pediatricians’ offices as a standard practice. It is definitely going in the right direction, and doctors are increasingly “tuning in” to these questions and listening better to the answers given. In addition, medical doctors are also understanding that prescription medicine doesn’t always need to be the first line of treatment. Many of my clients have not needed medication once they receive a solid plan of action with natural healing.

What is your philosophy regarding your approach to Postpartum Depression? How did you develop this philosophy?

I am solution-focused, not problem-focused. I focus on wellness and healing and helping depressed women get “un-stuck” as fast as possible. I learned many years ago that women can recover remarkably quickly when they have very simple and practical steps to help them move forward.

What advice would you give to medical professionals who may come in contact with a mother who is depressed? What are some of the best things they could do for this mom? What should they not do?

Funny – I was just asked to present at a women’s conference on just this topic. It’s important to speak to this mom with care, sensitivity and respect – reassure her that she’s not inadequate, there’s nothing to be ashamed about and handle the topic very matter-of-factly, as gestational diabetes (or any other common perinatal illness) would be approached. A practitioner should not dismiss depression as “normal” or give pat advice such as, “go out on more dates and get your nails done and it should pass.” Depression needs to be taken seriously and a referral to a therapist who specializes in the field should be provided.

And last but not least, if you had a chance to give just one piece of advice to an expectant mother (new or experienced), what would you say?

Pregnant women call me all the time, since they want to prevent depression and anxiety later on in the pregnancy and also postpartum. I help them with a simple plan of setting realistic expectations, sleeping at night, eating/nutrition, and getting emotional and physical support. So much joy and happiness can be experienced (and mood disorders greatly minimized, if not completely avoided), when there’s a solid plan of action in place!

Depression Sucks – One Dad Shares His Story

This morning as I was checking out The Father Life.com, I noticed a link about depression. Well of course I clicked on it – and I was rewarded with one of the best pieces I’ve read in awhile about a personal journey through depression. Click here to read it for yourself. Kudos to the dad who wrote this story – I know the emotions behind putting your journey into words and the power that comes with it. I hope he has found his strength as he moves past depression and onto a new and brighter world!

Grace Awards

Finally! I’m catching up on an entire summer’s worth of stories. I’ve got four good ones here to get us started. Over the course of the next few weeks, I will be going through the remainder of my notifications and posting awards here and there. Enjoy!

Grace Award Badge

“Loss of Loved ones reveals powerful strength”

Jackie Friedman, Star Tribune, Minneapolis, Minnesota

July 11, 2008

Moving and respectful piece about Becky Lavelle, Jennifer Bankston’s twin sister. Jenny Bankston took her life and her son’s life on December 17, 2007 after developing severe postpartum Depression. Becky went on to clinch an alternate spot on the Olympic Triathlon team. Jackie Friedman does an excellent and respectful job of presenting the relationship Becky and Jenny had and also of the grief Becky has endured.

“Book helped mothers deal with problem”

Memory McLeod, The Leader-Post, Toronto, Ontario (Canada)

July 8, 2008

The story behind the book, The Smiling Mask – The Truth behind Postpartum Depression & Parenting. This book tells the story of three mothers and their struggles with Postpartum Depression. My favorite part about the article? One of the authors is quoted as she points out that women with PP OCD are bombarded with negative thoughts but don’t typically do anything about them. THANK YOU Memory, for using that quote.


“Are you ready for your newborn?”

Lisa Martin, special Contributor to Dallas Morning News

August 05, 2008

While this article is not entirely dedicated to Postpartum Depression, the section on PPD is awesome – Lisa includes symptoms, possible treatments, and what really makes me happy is that she mentions PPD can occur anytime during the first year after giving birth. Kudos to you Lisa for not limiting this to just the first six weeks of the postpartum period!

“Birth Trauma: Stress Disorder Afflicts Moms”

Rachel Zimmerman, Wall Street Journal/Health

August 05, 2008

Ms. Zimmerman does an absolutely outstanding job (and what else would be expected from the WSJ?) reporting on Postpartum Post Traumatic Stress Syndrome. Clearly she did her homework, interviewed experts, and the article shows true respect and compassion for moms who struggle with this disorder as a result of challenging childbirth. Thank you, Rachel, for a wonderful piece and shedding light on this rare and often undiscussed complication of childbirth!

Mondays with Pec Part II

Today we finish up last week’s post with Pec by looking at signs and symptoms of various mental health conditions that can occur during the postpartum period. As always, discuss any concerns you may have with your caregiver.

How do I know if I have postpartum depression or anxiety?

Symptoms can vary from woman to woman. Here are some of the most common symptoms:

  • Sadness (sometimes comes in waves-women feel “up and down”)
  • Guilt (often women feel like they aren’t good moms, “maybe I just wasn’t cut out to be a mom”)
  • Irritable, less patient than normal (women often say they are snapping at their partners, or not enjoying their older child/children the way they did before)
  • Sleep problems (often hard to fall and/or stay asleep at night)
  • Appetite changes (may eat more or less than usual), often rapid weight loss
  • Lack of feelings toward baby (“I can bathe her and feed her, but I don’t really feel what I thought I’d feel towards her)
  • Worrying about every little thing (“it feels like my mind won’t shut off”)
  • Lack of fun or pleasure (I often hear things like, “I used to sing in the shower or with the car radio…. I’m not singing anymore”).
  • Overwhelm (“I just can’t cope”)
  • Lack of focus and concentration and difficulty making decisions

Postpartum Obsessive-Compulsive Disorder (OCD)

About 3-5% of new moms get postpartum Obsessive Compulsive Disorder. Women who have a history of OCD or a family history of OCD are at a higher risk. I find that in my practice women who describe themselves as “worriers” or “anal” (have a high need for order and things being “just right”) are at a higher risk.

The word obsessive refers to repetitive thoughts. Compulsions refer to the behaviors people do to avoid or minimize the anxiety produced by the obsessive thought. In the movie As Good As It Gets, Jack Nicholson portrayed a character with severe OCD.

Postpartum, some women get obsessive worry, often about things happening to the baby. Sometimes women get frightening thoughts or even mental pictures of something bad happening to the baby; often the pictures may be about the mom herself hurting the baby. These pictures can seem vivid and horrifying. Unlike women with psychosis, who are not in touch with reality, these women are painfully in touch with reality. These women know they do not want to hurt their babies, and we call these thoughts “ego alien”. Women with postpartum OCD are horrified, “how could I have these thoughts? I love my baby. I would never hurt her. I feel like a monster”.

These thoughts may just pop into her mind- we call them intrusive, and they are repetitive. Sometimes women have behaviors or compulsions that help them feel safer. These are may include things like hiding the kitchen knives or avoiding being alone with the baby.

Postpartum Panic Disorder

About 10% of new moms experience panic disorder. Some of these women have had panic before, sometimes even in pregnancy.

Symptoms of Postpartum Panic include episodes of extreme anxiety or worry, rapid heartbeat, tight chest or shortness of breath, choking feelings, dizziness, restlessness, and irritability. Panic attacks can happen without any specific triggers, even in the middle of the night. Women often feel a sense of doom or that they are going to die. They worry about when the next attack will happen.

Postpartum Posttraumatic Stress Disorder (PTSD)

Posttraumatic Stress Disorder can occur after birth. PTSD is seen in about 1-6% of women. Symptoms of PTSD include recurrent nightmares, extreme anxiety, reliving past traumas, avoidance of reminders of the trauma (for example, the hospital). Women with Postpartum PTSD often feel that they were abandoned, not well cared for, and stripped of their dignity during the birth. Another common feeling is that their voices were not heard and that there was poor communication during the labor and/or delivery. Some women with Postpartum PTSD state their trust was betrayed; they felt a sense of powerlessness and lack of protection by their caregivers.

Postpartum Bipolar Disorder

Bipolar disorder is often incorrectly diagnosed as depression. It is not uncommon for people with bipolar disorder to suffer over 10 years with an incorrect diagnosis, and therefore, inadequate treatment. Women taking medication for bipolar disorder are often told to stop medication before getting pregnant. Some, but not all, medications used for bipolar treatment can cause birth defects. Unfortunately, up to 80% of women who stop medication become ill during the pregnancy. Postpartum, bipolar disorder puts women at risk for a manic or psychotic episode. Women with bipolar disorder need to be working very closely with a psychiatrist trained in reproductive mental health.

Symptoms of postpartum bipolar episode can include

a decreased need for sleep and severe and rapid mood swings. Often there is a family history of bipolar disorder.

Postpartum Psychosis

Postpartum psychosis is considered a medical or psychiatric emergency. There is an increased risk of a woman hurting her self or her infant or children.

Symptoms of postpartum psychosis can include:

  • Difficulty relaxing
  • Incoherence
  • Decreased appetite
  • Paranoia and confusion
  • Hearing or seeing things others do not (hallucinations)
  • Inability to differentiate reality from hallucinations
  • Difficulty sleeping
  • Delusional thinking (lack of touch with reality)
  • Manic behavior (hyperactivity, impulsive behavior)

These symptoms come and go (she may be fine one minute, and acting strangely the next).

All of these postpartum mood disorders can be treated. If a mom is not well, the family is not well. We now know that untreated maternal illness can cause long term consequences for the infant, as well as other children in the home. Postpartum mood disorders also contribute to marital/relationship stress and discord.

Unfortunately, these postpartum mood disorders do not always go away by themselves without treatment.

You are not alone.

You are not to blame

You will be well again.

Seek treatment from someone trained specifically in postpartum depression and postpartum mood disorders. To learn how to screen a potential therapist, go to http://www.pecindman.com.

Important resources:

http://www.MedEdPPD.org (a very informative website)

http://www.postpartum.net Postpartum Support International 1.800.944.4PPD

Beyond the Blues, A Guide to Understanding and Treating Prenatal and Postpartum Depression (2006) by Bennett and Indman

Did You Know?

Here’s a brief section from a research article regarding the Chinese Postpartum or puerperium period and traditions that are commonly practiced. You can read the entire article here.

The postpartum period, or puerperium, starts about an hour after the delivery of the placenta and includes the following six weeks [1]. By six weeks after delivery, most of the changes of pregnancy, labor, and delivery have resolved and the body has reverted to the nonpregnant state [1,2]. The postpartum period is a very special phase in the life of a woman. Her body needs to heal and recover from pregnancy and childbirth. A good postpartum care and well balanced diet during puerperal period is very important for the health of a woman.

According to Chinese traditions, the first 30 or 40 days postpartum is recognized as a special time period for behaviour restrictions and a state for convalescence. This period is called ‘sitting month’ or ‘doing the month’. Based on Chinese traditional medicine, postpartum women are in a ‘weak’ state because of ‘Qi’ deficiency and blood loss [3]. Their body can be easily attacked by ‘heat’ or ‘cold ‘, which may cause some health problems like dizziness, headache, backache and arthragia in the month or in later years. Therefore, Chinese women are advised to follow a specific set of food choices and health care practices. For example, the puerperal women should stay inside and not go outdoors; all windows in the room should be sealed well to avoid wind. Bathing and hair washing should be restricted to prevent possible headache and body pain in later years. Foods such as fruits, vegetables, soybean products and cold drinks which are considered ‘cold’ should be avoided [4,5]. In contrast, foods such as brown sugar, fish, chicken and pig’s trotter which are considered ‘hot’ should be encouraged [5]. It is believed that if a woman does not observe these restrictions, she may suffer a poor health at her later life. These traditional postnatal believes and practices are often passed down from senior females in the family to the younger generations [4].