Monthly Archives: October 2008

A Peek into the Darkness

Instead of posting an interview today, I want to share a piece of me with you. Yes, I know I’ve been doing that already but this is deeper and darker. You see, I found my journal from my first Postpartum experience. I shared a brief piece of this with a mom who contacted me the other day and it resonated so strongly with her and made me realize I need to share this openly. Keep in mind that I sought and was refused help at the three month mark – the first entry I share is from her 3 month birthday. So here goes.

July 26, 2004

Today is Allison’s 3 month birthday. I can’t believe we’ve made it 3 months. 1/4 of the way to a year. I’m still exclusively breastfeeding her. I’ve had to give her formula twice – once, the night she came home because she just wouldn’t take the breast, the second time she was being extremely fussy and wouldn’t eat. I couldn’t let my baby starve.

Wow. 3 months of life with a baby. And I am still feeling like I’ve been hit over the head with a frying pan. Sure there are glorious glimpses of normalcy and happiness but mostly I stare at the clutter, worry about our bills, get upset at the dogs for waiting until Alli has latched on to let me know they need to go O-U-T and they gotta go NOW. And Chris has had this kidney stone problem since she was about a month old. That’s been fun. He’ll be having surgery on Wednesday so now I’m worrying about that bill too.

In case you can’t tell, today was one of those days. I called my mom this morning. She answers the phone and asks if she can call me back. But the way she asks sounds like she’s crying. So I freak out and think something horrid has happened to my kid brother who’s in jail. Turns out it was just a laugh that I misinterpreted.

Then later today I’ve attempted to put Alli in her crib for a nap but she’s not napping – no – she’s screaming. And Chris flippantly comments (and I quote) “Geez, you’d think someone was killing her!” THANKS! I’m already having a hard enough time listening to her cry and now you go and put the very image I struggle every day to keep out at the very forefront of my mind. I rush through the rest of the dishes and go to comfort my crying daughter. She did eventually nap – in her swing for about 30 minutes. It gave me enough time to get caught up with Thank You notes. I had gotten just a little behind. Now we just need stamps. Gotta wait until we have a spare $7.40 though. Maybe next week.

Allison did get a couple of presents in the mail today. She got a cute little outfit from her great-aunt’s friend and two books from my deceased step-mother’s sister. There was a very touching note in the card stating that Grandpa Cam & Grandma Helen would have loved having a great grandaughter. I’m sure they know. This little girl has quite an army of angels looking out for her.

My hand is hurting from writing so much. I’d better go. Don’t know how much longer I’ll be awake for. I’m exhausted and my neck & shoulders are killing me. I’ll write again when I can. Thanks for listening.

July 30, 2004

I put my underwear on inside out this morning. Should have paid attention to that sign. It was a really shitty day emotionally. Alli and I did just fine for the most part – until lunch. We met Chris’ parents at Golden Dragon – and Greg & Cindy were there. GRRRRR. I was not in social butterfly mode and really not up to faking it. We sat down and then Mom offered to watch Alli while we got our food. I came back, set my blate down and went to get some soup. Mom’s sitting there talking to some friend of the family in my seat and doesn’t move so I can sit down and friggin eat. So she finally moves and I sit down. Of course Alli immediately starts to fuss and I have to soothe her with my right hand and try to eat with my left. ARGH. She got fussier and fussier. I had to leave after about 4 forkfuls. So I drive her home (she of course, FALLS ASLEEP halfway home) On the way home I was both relieved and pissed off. Relieved because she saved me from having to be social; pissed off because I didn’t get to eat. She woke up as soon as we got home and I fed her. Called my mom and cried. I was/am so completely emotionally exhausted that the prospect of a busy afternoon was absolutely overwhelming. Oh, and the doctor’s office called to reschedule my appt yet again on monday with the psychologist. So  told them that I just wanted to cancel the appt. Obviously they aren’t a reliable source of help for this sort of thing.

After I finished feeding Alli, Grandmama showed up. Once Chris and Mom got home, I just collasped. I ate, then I came into the bedroom and layed down.  I remember staring at the wall – just laying there trying to feel something – anything. I didn’t even go say goodbye to Grandmama. I didn’t have the strength. I think Chris is really starting realize how much of a toll all of this is taking on me. He let me sleep from 3-345p and then Alli needed to nurse.

The good part of this day was that once we put Alli to bed, we went and saw Spiderman II with Greg & Cindy. Was nice to get out and do something with other adults, even if it was just sitting in a dark theatre and watching a movie.

Chris is asleep next to me at the moment and our legs are intertwined. Well, they were. He just moved. I love him so much. I hate that he has to see me go through this but I’m also glad he’s the one I’m with – I know he will do anything to help and I really need that right now.

I’m pretty tired and my back and neck are still pretty sore. I better go to sleep – it’s the only time I don’t feel the pain.

Maternal & Child Comprehensive Center: My Dream

As I have grown and continue to grow in my knowledge and support of women and families struggling with Postpartum Mood Disorders, so has a dream of mine. And right now, it is just that – a dream. One day I hope it will become reality. This dream would be realized in the founding of an all inclusive Maternal and Child Services Center.

The Center would be non-profit to allow for sliding scale fees so that no woman or family would have to be turned away. Women of childbearing age would be accepted – intake would consist of consultation with a Nutritionist, a Case Manager to aid in Mental Health, and of course, an OB or Nurse Midwife. Once pregnant, monthly visits with the OB or NM would continue until the eighth month of pregnancy with special appointments with the Nutritionist and Case Manager scheduled every three months or more often as needed. Doulas would also be available. Childcare would also be provided on site to remove the stress of finding child-care for appointments from the mother or family’s life. We would have on-site birthing and recovery as well as Postpartum Cottages for in-patient psychiatric care – homes where a Postpartum Doula and nurses would work round the clock as the family stayed together to recover – rather than being torn apart. Days for Postpartum Care would include therapy for both mom and dad as well as joint parenting classes. At night, Dinner would be a joint effort amongst all patients – creating socialization opportunities for confidence to bloom again in this area.

We would also offer on-site Pediatric Care with Pediatricians trained to recognize signs and symptoms in both mother and child of Postpartum Mood Disorders. Children would be eligible for this care until age twelve.

Regular support for breastfeeding, formula feeding, loss of breastfeeding relationship, infant loss, miscarriage, special needs infants, Postpartum Mood Disorders in both mothers and fathers as well as classes on infant massage, yoga, and other alternative treatment options for soothing stress in families with young children would also be available.

Overall, the primary staff would consist of a Center Director, Social Workers, Psychiatrist, OBs, Nurse Midwives, Lactation Consultants and Counselors, Doulas, Nurses, Nutritionists, Peer Support Specialists, Pediatricians and Childcare Specialists.

During the Childbearing years, it is of utmost importance women take care of themselves, their bodies, and their families. This Center would enable them to do so by informing and empowering them of their options as well as providing quality comprehensive care for every aspect of their lives during this time, something all women deserve to have access to, no matter what their social or financial standing.

Exhaustion

In the past six weeks, we have all been sick.

Two trips to the hospital (with two different kids for two entirely different reasons), one rushed trip to the pediatrician due to a seriously swollen and red bug bite, a head cold that won’t quit for all of us girls, and that’s just all the stuff besides normal every day life.

I’m tired.

In fact, I’ve gone to bed before eight pm twice this week. Yes, twice. This week. And it just started!

The house is a wreck.

Days are crazy again due to the whole one vehicle thing – my schedule is insane. I feel like I should just set up shop in the car. I’m up and out the door by 715 every morning (this means waking up at 530 so I can have the girls showered, fed, and dressed) to take Alli to school – then home. Chris gets ready for work and then we pack Charlotte and Cameron up around 9 and take him to work. Then home. Then lunch and nap. Up and out the door by 215 to go pick up Alli. Then home for an hour and a half and then off with all three kids to pick up Chris. No wonder I’m asleep before my head even hits the pillow most nights.

I’m not resentful at all – this is just what we have to do right now so we do it. Life is so full of everyday challenges. If it wasn’t, I’d be bored. We’d all be bored without the daily drama regardless of how much we may moan about it.

Hopefully we’ll get the other truck working soon. We think the starter needs to be replaced but man that’ll be nice.

Another nice thing is the falling gas prices. I never thought I’d be ready to throw a party just because gas is actually less than three dollars/gallon.

Sharing the Journey with Ruta Nonacs, M.D.

Dr. Ruta Nonacs M.D., author of A Deeper Shade of Blue, also serves as Associate Director of the Center for Women’s Health at Massachusetts General Hospital and an Instructor in Psychiatry at Harvard Medical School. She received her MD from Cornell University Medical School and her Ph.D from Rockefeller University in New York.

She is very dedicated to ensuring women, families, and professionals have accurate information regarding depression during a woman’s childbearing years. In fact, her inspiration for her book, A Deeper Shade of Blue, lies within a strong desire to provide a carefully researched resource for women and their families that lays bare the myths and facts of symptoms, treatment, and recovery. Thank you Dr. Nonacs for your pioneering efforts in this area and I look forward to your continued work!

I sincerely appreciate her willingness to share her journey here and hope you enjoy her words!

Who IS Ruta Nonacs? What do you do when you’re not teaching or doing research?

I am trained as a psychiatrist and have spent my professional life doing a combination of research and clinical practice, working mostly with women during their reproductive years. I have recently been devoting more time to Postpartum Support International; it is one of my most important professional goals to increase awareness of postpartum depression. To this end, I spend a fair amount of time writing for both medical and lay audiences. Since having kids, I started working part-time and that has worked well for me. I have two daughters, ages 3 and 8, and I feel fortunate to be able to spend a lot of time with them.

How did you come to be interested in Postpartum Mood Disorders? Was there a particular experience or situation that drew you into the topic?

During my residency, the first patient I took care of was a young woman who was in the first trimester of her pregnancy, and I had the privilege of following her for the next three years. As a single mother, it was a difficult time in her life, and I felt that I was really able to help her a great deal. I can’t help feeling that this experience had something to do with my choices later on. I also had the good fortune of doing my residency at Massachusetts General Hospital, where they have a phenomenal perinatal psychiatry program.

As we both know, motherhood is a life-changing experience. How has motherhood changed you?

It has changed me in so many ways. For one, it has permitted me to slow down and enjoy all the little small pleasures in life.

Postpartum Mood Disorder recognition and treatment options have come quite a long way, even since my first episode a little over four years ago. How much further do we have to go and in your opinion, what can we do to facilitate the furthering of positive change regarding these conditions?

Depression in all shapes and forms carries a real stigma, and I think we still have a long way to go here. I think one of the things that has helped women with postpartum depression to get treatment is hearing about other women’s experiences with the disorder.

Moms need to take time for themselves in order to recharge their batteries. What is it that you do to relax and recharge?

I wish I could say that I am good at following the advice I give to my patients. I probably don’t relax as much as I should, but I do love bicycling, being outdoors, and photography.

Of all the research you have done in the Postpartum Depression area, were there any results you were particularly surprised to obtain? If so, what were they and why were you surprised? If not, would you mind sharing a brief overview of one of your favorite research projects with us?

I think one of the things I have enjoyed about my research (and my clinical work) has been the chance to make things better. Let me clarify this a bit. We have done a great deal of research on identifying risk factors for postpartum depression. Probably the strongest risk factor is having a history of depression or anxiety before pregnancy. By identifying women at highest risk for postpartum depression, we have been able to implement certain interventions that decrease the risk of postpartum illness. That means we can actually prevent postpartum depression, and that is a truly wonderful thing.

Tell us a bit about your book, A Deeper Shade of Blue and the related blog. What inspired these projects?

A Deeper Shade of Blue is a book for the lay public that provides reliable information on the spectrum of mood and anxiety disorders that affect women during their childbearing years. In this book there is information about postpartum depression and also about mood disorders that occur during pregnancy, as well as the psychological issues surrounding infertility and pregnancy loss.

I wrote the book because there is so little accurate information out there on these topics. While there has been increasing awareness of postpartum mood disorders, most women knew very little about mood and anxiety disorders that occur during pregnancy. There is also so much misinformation in this area; for example, many women assume that they can’t take medications during pregnancy or while they are breastfeeding, and that simply isn’t true. I wanted to give women a carefully researched resource, a guide that would help them to be better informed and to get the help they need.

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

My general philosophy is that we can never afford to ignore postpartum depression. Even when it is relatively mild, depression takes a toll on a mother and on her family. This philosophy derives from my clinical experience — seeing way to many women who have not been able to enjoy or participate in important aspects of their lives because they were depressed and did not receive any treatment.

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?

I think the first thing to do is to educate the mother. Many women don’t know a lot about depression; they do not know that this is a biological illness. They don’t know what treatments are effective. Depression still carries a significant stigma, and so many women are horribly ashamed about being depressed. Medical professionals need to help to enlighten women and help them to see depression as any other type of illness that requires attention. Medical professionals need to help women access the help they need, whether it is support from the family, talk therapy, or treatment with medications. These resources are sometimes difficult to find, and we need to make sure that women get the help they need.

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

As hard as it may be, you need to take care of yourself first. If you aren’t taking care of yourself, you can’t be the mother you want to be.

Say a Prayer

This past Monday, my mom called to ask if I had received an email from my brother. When I said no, she took a deep breath.

A friend of the family was killed suddenly on October 11, 2008 at two a.m. in an auto accident. Just two years older than myself, he died at the scene after a two vehicle accident. Jason and his mother welcomed my family when we moved to Virginia. The first summer we spent there involved a LOT of swimming in their pool and hanging out with him at church. Open, friendly, warm, and funny, Jason really made the adjustment to the rural country a little bit easier for us “Yankees.” I still can’t believe he’s gone even though I had not really thought of him in quite some time as life has moved on for myself and for all of us.

Jason went on to become a member of the National Guard and served an 18 month tour in Kosovo just this past year. He was also a highly decorated member of the local PD where my parents live. His funeral is this coming Sunday at 2p.m. If you can, at that time, please pause and just take a moment of silence for this fallen friend of mine. He was happiest helping others, something that is near and dear to my own heart. I truly do not have any words left to express how deeply saddened I am at the loss of Jason.

The One Flaw In Women

A good friend of mine sent this to me today. Good thing she did because I really needed to read it. Enjoy.

By the time the Lord made woman,
He was into his sixth day of working overtime.
An angel appeared and said,
‘Why are you spending so much time on this one?’
And the Lord answered, ‘Have you seen my spec sheet on her?
She has to be completely washable, but not plastic,
have over 200 movable parts, all replaceable
and able to run on diet coke and leftovers,
have a lap that can hold four children at one time,
have a kiss that can cure anything from a scraped knee to a broken heart
-and she will do everything
with only two hands.’

The angel was astounded at the requirements.
‘Only two hands!? No way!
And that’s just on the standard model?
That’s too much work for one day.
Wait until tomorrow to finish.’

‘But I won’t, ‘ the Lord protested.
‘I am so close to finishing this creation that is so close to my own heart.
She already heals herself when she is sick
AND can work 18 hour days.’

The angel moved closer and touched the woman.
‘But you have made her so soft, Lord.’
‘She is soft,’ the Lord agreed,
‘but I have also made her tough.
You have no idea what she can endure or accomplish.’

‘Will she be able to think?’, asked the angel.
The Lord replied,
‘Not only will she be able to think,
she will be able to reason and negotiate.’

The angel then noticed something,
and reaching out, touched the woman’s cheek.
‘Oops, it looks like you have a leak in this model.
I told you that you were trying to put too much into this one.’

‘That’s not a leak,’
the Lord corrected,
‘that’s a tear!’
‘What’s the tear for?’ the angel asked.

The Lord said, ‘The tear is her way of expressing her joy,
her sorrow, her pain, her disappointment, her love,
her loneliness, her grief and her pride.’
The angel was impressed.
‘You are a genius, Lord.
You thought of everything!
Woman is truly amazing.’

And she is!
Women have strengths that amaze men.
They bear hardships and they carry burdens,
but they hold happiness,
love and joy.
They smile when they want to scream.
They sing when they want to cry.
They cry when they are happy
and laugh when they are nervous.
They fight for what they believe in.
They stand up to injustice.
They don’t take ‘no’ for an answer when they believe there is a better solution.
They go without so their family can have.
They go to the doctor with a frightened friend.
They love unconditionally.
They cry when their children excel
and cheer when their friends get awards.
They are happy when they hear about
a birth or a wedding.
Their hearts break when a friend dies.
They grieve at the loss of a family member,
yet they are strong when they think there is no strength left.
They know that a hug and a kiss
can heal a broken heart.
Women come in all shapes, sizes and colors.
They’ll drive, fly, walk, run or e-mail you
to show how much they care about you.
The heart of a woman is what makes the world keep turning.
They bring joy, hope and love.
They have compassion and ideals.
They give moral support to their family and friends.
Women have vital things to say and everything to give

HOWEVER, IF THERE IS ONE TINY FLAW IN WOMEN,

IT IS THAT THEY FORGET THEIR WORTH.