Monthly Archives: July 2009

Reflections on San Antonio

I wrote this piece tonight as I thought about what happened this past weekend in Texas. It is a very long piece. Much of the piece is ok to read but there is a paragraph quite a ways down in which I discuss some rather graphic thoughts I had about my own children back when I was in the grips of Postpartum Obsessive Compulsive Disorder. If you are still fragile, you may not want to read the entire piece. And if you need help and are unsure where to find it, please start with Postpartum Support International. They will get you pointed in the right direction. They will not judge, they will not blame, they WILL take good care of you and give you a compassionate shoulder on which to lean as you recover.

In today’s society, news smacks you in the face before it’s even managed to hit the snooze button. By the time an event is fully engaged in the morning commute to the office, many of us have already shared our opinions about what it had for breakfast – how it was prepared, what the choice of bacon v. veggie protein substitute says about it, and why the pinstripe power suit was chosen over sweats for the day. We wax poetic about the potential fall-out of the course taken, what may have led up to the formation of said course, and continue to share these thoughts with each other in a show of solidarity and human curiosity. We do all of this irregardless of our intimate knowledge of said event. Many of us don’t give a second thought to this habit because it’s become so ingrained in our culture, even since elementary school. Remember playing Telephone? What the last person called out almost never was what the first person said, was it?

Every so often there is an event so horrific we’d rather it not be discussed or it gets twisted somewhere along the line. It may start out as the picture of perceived perfection but by the time the tale escapes, it’s got disheveled hair, bloodshot eyes, frayed flannel shirt, stained jeans, ripped shoes and the stench of life wafting over at us from the dusty corner of the room. We’d much rather turn to each other or any other direction but towards this horrible aberration crouching in the vestibule of our day. It sways back and forth as it begs for attention. Many times we rush to judgment. Disgust fills our hearts with judgment quickly following. Often we fail to even attempt to understand or develop compassion. What made her this way? Or worse – could THIS happen to us? Out of fear we explain away her existence. We justify her behavior and experience with ignorance and labels so sensational they could only belong to other people – never to us. Never to us, right?

Never…….

Until it does. Until we awaken one day with disheveled hair, bloodshot eyes and a pile of frayed and filthy clothes in the corner. Suddenly discover we are the aberration in the corner. What then? Where do we turn? What do we do? How do we rejoin society, shed the aberration mask now super-glued to our psyche? How do we help those who find themselves trapped in the same vestibule after us to escape as well?

We slowly build scaffolding around ourselves as we heal. If we are fortunate, we are able to lean on family, qualified and understanding professional caregivers, peers and others. And once we have become strong enough we begin to knock the scaffolding down. Once the dust has cleared after the scaffolding has been removed, we fling open our newly renovated doors to shelter those who are just beginning to realize they too, need scaffolding. We provide the necessary hardware – support, compassion, education. As they begin to heal they find the same empowering passion exists inside themselves as well. So it spreads as they too, break free from their scaffolding to fling open their newly painted doors to shelter others as well, all of us paying forward the compassion and knowledge we received when we were at our worst.

Even with this process there is mourning. Mourning of the loss of innocent souls, mourning those who were not fortunate like us to find shelter in the storm. Mourning that maybe we didn’t do enough to protect those around us.

There is also anger. Anger at the loss of innocent souls, anger that a safe harbor was not provided, anger that not enough was done to protect those we love the most.

Then there is confusion. Confusion over why this happened. Confusion over what went wrong, what could have prevented this horrific tragedy. Confusion as the details are sensationalized as the story is repeated over and over.

And last but not least, there is blame. Blame pointed at the doctors who shouldn’t have let her out of the hospital. Blame pointed at the family for not recognizing the gravity of the situation. Blame, blame, blame.

In the end, we were all failed. We were failed because we are all flawed. We are human. In the throes of tragedy and chaos, we are all tossed about in a rough sea, struggling to find our True North. Each of us has a different True North. Each of us is not equipped to direct others to find their True North. While we may have friends to help us on our journey, there are stretches we must tread alone. These stretches are made easier by the travels of those who have gone before us – especially if they leave comforting words of wisdom behind to guide us.

We may never understand why Otty Sanchez did what she did. We may never fully understand the aberration crouched in the corner. But there is absolutely no reason we can’t reach out to her and show her some compassion. Her family has suffered a tragic loss. An infant brutally murdered by his own mother who then tried to harm herself. I cannot begin to imagine the whirlwind of emotions swirling about this family as they move forward and process the events which unfolded this past Sunday. Events which left even hardened law enforcement officials nearly unable to process the crime scene. Events which left me wanting to to put on blinders. Yet here we are.

Some point. Some judge. Some are eager to throw her to the wolves. Some dissect her situation with an authoritative voice. Others continue on their own journeys, ignoring the aberration in the corner, even if she reaches out desperately for their aid.

Some are willing to reach out to offer compassion, understanding, help.

And each one of us is not wrong in our initial reaction. When an aberration occurs we react from a very visceral and primal place. Our attitudes are deeply rooted in the history of humanity, planted firmly within lessons handed down from generation to generation. We often do not have a choice in our initial reaction. However; we have a choice in what we choose to do with this reaction.

We can choose to let this reaction destroy us and build hatred in our hearts or we can allow this reaction to propel us into compassionate action. Action that will help to prevent this aberration from occurring over and over again. This is the path I have chosen. Many others have also chosen this path. (Or as some of them would tell you – the path CHOSE them!) Regardless, myself and those on this path with me believe deeply in compassion, respecting the journey of others, know the importance of social support and understand the importance of professional education in relation to Postpartum Mood & Anxiety Disorders.

We are not perfect. None of us are. But as we work together we can heal those imperfections. The key is to work tirelessly together towards a common goal encompassing knowledge, awareness, compassion and respect for the journey each and every woman and family embarks upon as they grow our great country. No family deserves to be sent down the dark path of Postpartum Mood & Anxiety Disorders without a road map of support. No family deserves to feel the heartache and horror Otty Sanchez’ family must be feeling right now. NO FAMILY should have to suffer this when there is hope. When there is knowledge. Where there is such a strong potential for light and happy endings.

So I ask – with all the knowledge available today, why are we still stuck here? Stuck in the dark ages of ignorance about Postpartum Disorders? Why are there people still denying that mothers struggle with Postpartum Mood Disorders? Trying to convince the masses that Postpartum Mood Disorders have been cooked up by the Pharmaceutical Industry? Hippocrates first wrote about Mood Disorders and Moms way back in 400 B.C. Yes, 400 B.C., well before any industry had been started. Documented episodes of “Milk fever” and maternal madness continue throughout history – before and after the beginnings of the Pharmaceutical industry.

What will it take for us to wake up? If not now, when?

How many more mothers, infants, and families must be destroyed before we come to our senses? Motherhood has been shamelessly turned into a factory process in this country. Birth is unnecessarily medicalized. Recovery is anticipated to be swift as we expect new moms to rip themselves from their infants at a mere six weeks postpartum. After nine months of tremendous change and all we get is 6 weeks to recover? All is well we expect to hear! But what if all is not well? What if they are guilt ridden? What if they truly are depressed? What if they cannot function? What if they are afraid to share these feelings for fear of the stigma? For fear of judgment? For fear of ignorance or pill shoving physicians who won’t explore the potential of physical underlying causes of these negative emotions such as anemia or hypothyroidism/hyperthyroidism? For fear of shaming their family? For fear of being told to just suck it up or that only the weak cry?

I started to wake up five years ago as I imagined myself stabbing my daughter because I wondered what it would feel like to drive a knife into her tiny body (and no, I was not medicated when I had these thoughts). I fully awoke three years ago as I found myself daydreaming about smothering my daughters, convinced it would all be so much easier if they were just gone. Instead, I crawled into bed and called my husband. I ended up hospitalized. From that point on, my eyes were open. Suddenly my life slid into place much like a solved Rubik’s Cube. I planted my feet, turned, and fought the beast.

Today I stand with arms constantly stretched back to reach out to those who now find themselves desperately struggling to make sense of the negative emotions rushing around them after the birth of a child. I wake each and every day with the goal of empowering at least ONE woman to not allow those around her to mislead her towards believing she is at fault and should just duck her head down as she lives her life in misery.

Please, at the very least, familiarize yourself with the following if you or someone you love is pregnant or postpartum:

KNOW the warning signs of Postpartum Psychosis.

KNOW the signs and symptoms of all the Postpartum Mood & Anxiety Disorders.

DISCUSS what to do if signs and symptoms begin to occur. Recruit family members and friends to be on call to help with childcare, meal preparation and household chores if needed.

TALK with your care provider about actions to be taken once signs and symptoms have been identified.

HAVE a plan in place!

EDUCATE your family and friends about Postpartum Mood & Anxiety Disorders. Knowledge is empowering.

Above all, remember that with the birth of a new baby comes the birth of new parents. Yes, they are grown but now they have suddenly been thrust forth into the hardest job they’ll ever have. The learning curve is vicious. They’re now on-call all the time. These new parents need training. They need 24-7 tech support. They need to know there’s someone there they can rely on when they need it most.

So please, check in with those you know with small children. Ask if there’s anything they need. If there’s anything they need to talk about. Offer to take the kids so they can go to a movie, out to dinner, or just stay in to enjoy some much needed silence or catch up on sleep.

Bring back social support. Share your knowledge. Bring back the village. It’s so desperately needed.

Heartbreaking News out of Houston, TX

I debated about whether or not I should blog about this topic. It’s graphic, it’s disturbing, and it’s deeply saddened me. I finally made the decision to blog about it to clear up a certain point I’ve found in most of the news stories.

Unless you’ve been on a news blackout or under a rock, you’ve undoubtedly heard about the tragedy which occurred in TX this past weekend. I will not be delving into the details here. They are quite graphic and disturbing. I had a hard time reading the news story. I do not wish to trigger any suffering women who regularly read or subscribe to this blog. If you have a stronger stomach and do not feel you would be triggered by the details, you can read the story here.

The news story states the mother was mentally ill, having been previously diagnosed with schizophrenia.(Dad also had been diagnosed with schizophrenia)

Once again though, Postpartum Depression is mentioned in the story. Postpartum Depression is being bandied about as a possible cause of her behaviour.

I’d really like to make something perfectly clear.

Women with Postpartum DEPRESSION do NOT murder their children.

Let me say that again.

WOMEN WITH POSTPARTUM DEPRESSION DO NOT MURDER THEIR CHILDREN!!!!!!!

However, women with Postpartum PSYCHOSIS are much more likely to follow through with these horrific thoughts.

Postpartum Psychosis is a medical emergency. The onset is fast and furious and this particular Postpartum Disorder carries the highest risk of suicide, infanticide, and filicide of ALL the Disorders on the spectrum.Women with Postpartum Psychotic symptoms should absolutely not be left alone with their infants.

According to MedEd PPD, Symptoms of Postpartum Psychosis are:

  • Risk of harm to self (suicidality)
  • Risk of harm to others (homicidality)
  • Inability to provide basic care for self (usually due to psychosis). Psychosis is associated with both suicidality and homicidal ideation toward the infant or others.

Mothers with Psychosis may also show signs of delusional thinking, hear voices, or experience hallucinations.

And what should family members do if they suspect a new mother may be exhibiting signs of Psychosis?

Most importantly, the mother should NOT be left alone with her infant. She should be immediately transported to the ER for professional assessment and treatment. In the above article, it is stated that the mother’s family noticed her decline in mental status just a week prior to her crime. She was hospitalized but signed herself out.

Risk Factors for developing Psychosis include (but are not limited to) family or personal history of bipolar disorder or schizophrenia. In this particular case, the mother had been previously diagnosed and hospitalized for Schizophrenia.

How often does Postpartum Psychosis occur? One per 1000 mothers may experience Psychosis.

If you want to truly understand Postpartum Psychosis, go read my interview with Teresa Twomey, author of Understanding Postpartum Psychosis. Both she and her daughter fortunately survived Postpartum Psychosis. With the publication of her book, she hoped to help remove stigma from this condition which is so very often sensationalized in mainstream media and made to seem more common than it really is.

How many more of these cases do we need to read about? How many more times do we have to confuse Postpartum Depression with Postpartum Psychosis in mainstream media? How many more times do we have to mourn the loss of another infant because a mother was left behind by an uneducated system which failed her? How many more times are we to read about a family destroyed by something which could have been prevented if swift action had been taken?

Why weren’t preventative measures already in place given the mom’s mental health history? Why was this tragedy allowed to occur? And why are moms in TX murdering their infants at such a high rate?

Why?

When will we wake up and realize that we need to reduce stigma, increase awareness, educate, research, and inform medical professionals in ALL fields about the dangers of Postpartum Psychosis? Educate them about the differences between Postpartum Depression, Anxiety, Obsessive Compulsive Disorder, Post-Traumatic Disorder – WHEN?!?!

THE MOTHER’S ACT needs to be passed NOW! Families cannot wait any longer for relief!

Release of Disclaimers, Notices, Policies & Statements

As part of the ongoing growing pains here at Sharing the Journey, I’ve been working tirelessly on some really exciting stuff – Disclaimers, Notices, Policies, and Statements.

You can read them by clicking here or on the Disclaimers page link above.

Please note that these will be updated as necessary so please check back with the policies to ensure full compliance.

Many of these policies have been put into place to ensure quality and a pleasant experience here at Sharing the Journey. We want you to feel safe and among friends here. Thank you for your readership! I look forward to continuing to Sharing the Journey with all of you!

Warmest,

Lauren Hale

Just Talkin’ Tuesday: The MOTHER’S Act

LegislationOn February 23, 2001, Melanie Stokes gave birth to a baby girl. Just three months later, she committed suicide. Melanie’s death gave birth to a very dedicated activist – her mother, Carol Blocker. Frustrated with the failure of physicians to appropriately care for her daughter, Carol worked endlessly to keep Melanie’s tragic death from becoming meaningless. Through Carol’s tireless advocacy and work with Representative Bobby Rush (IL), the Melanie Blocker Stokes Act has now become The MOTHER’S Act.

The MOTHER’S Act as it reads in the current version would provide funds for a public awareness campaign, education campaign for caregivers, increase availability of treatment options and entities as well as require the current Secretary of Health & Human Services to conduct a study regarding the validity of screening for Postpartum Mood & Anxiety Disorders.

More and more research is slowly uncovering potential underlying causes and risks related to Postpartum Mood & Anxiety Disorders. More and more women and caregivers are becoming educated as more of those who have survived a PMAD speak up to share our story.

If passed, The MOTHER’S Act would further reduce the stigma surrounding new mothers not ensconced in the Johnson & Johnson glow of infantdom. If passed, the MOTHER’S Act would increase funding for research and possibly open even more doors to understanding the cause and more importantly, the potential for truly preventing Postpartum Mood & Anxiety Disorders. If passed, the MOTHER’S Act has the potential to prevent tragic deaths like that of Melanie Blocker Stokes.

Much of the debate surrounding the MOTHER’S Act has centered on the word “medication.” Medication does not necessarily mean Anti-depressants. It does not mean this is the ONLY way to treat a PMAD. It is merely listed as an option for treatment. And frankly, if one has a doctor with a quicker draw on his/her prescription pad than Billy the Kidd, I’d run away. I’d run away faster than a cheetah.

Another key point of the opposition has been that the MOTHER’S Act mandates screening. In the current version, there is no mandate for screening. The only mention of screening is to require the Secretary of Health & Human Services to conduct a study regarding the validity of screening for Postpartum Mood & Anxiety Disorders. The current standard for screening is the Edinburgh Postnatal Depression Scale, which you can learn more about here.

You can read a copy of the current bill by clicking here.

Go read it. (Don’t worry – it’ll pop up in a new tab/window – I’m cool like that here)

Seriously. Read. The. Bill.

Then read it again.

And then come back here. Be honest.

Unlike this week’s TIME article which failed to present both sides, I promise to allow unedited comments in support of or opposing the bill as long as they are civil. (Any comments including personal attacks will NOT be allowed!)

So let’s get to Just Talkin’ Tuesday already!

TIME Magazine misfires debate on MOTHER’S Act

Awhile back, I was contacted by Catherine Elton regarding an article which was to examine Postpartum Depression and the Mother’s Act. The email somehow got buried and I did not get a chance to participate in the discussion.

It seems that it would not have mattered if I had been able to discuss my story with her.

Time published the story this week. While the online version has been modified to correct an error with Ms. Amy Philo’s story, you can still see the original version in the hard copy. (Which by the way, I am personally asking you to boycott – even asking if you can take the copy of TIME home from the doctor’s office in order to keep other moms from reading it! And make sure you ASK – because just taking it would be stealing and that’s illegal.)

The original version, entitled “The Melancholy of Motherhood” includes one quote from Carole Blocker, the mother of Melanie Blocker Stokes, a mother who tragically committed suicide after unsuccessful treatment for severe postpartum depression after the birth of her daughter. The quote reflects Ms. Blocker’s confusion as to how someone could oppose the MOTHER’S Act, a bill which is designed to increase public and professional education regarding Postpartum Mood & Anxiety Disorders. Frankly, I’m confused right along with Ms. Blocker.

The only survivor story featured in this article is that of Amy Philo, one of five recipients of an Outstanding Achievement for Mothers’ and Children’s Rights awards from the Citizens Commision on Human Rights or CCHR. CCHR was founded in 1969 by none other than the Church of Scientology, well-known to oppose the entire psychiatric field.

Amy has tirelessly worked against this bill for quite some time now but continues to be tragically misled. Few discussions with her have led to quite the round robin with Amy unable to come up with legitimate research to back up her claims. When asked for said research, Amy refers to her own websites instead of to specific research articles supporting her claims.

I happen to know that Ms. Elton did indeed interview fellow survivors who support the bill. One has to wonder then, why did their stories not make it into the article? Was it length? Was it editing? Or was it intentional? Regardless, the finished piece as published presents a very frightening and deceiptful picture of what new mothers face is this bill is passed. To begin with, the MOTHER’S Act no longer mandates screening. It requires a study to be completed by the Secretary of Health and Human Services (Kathleen Sebelius) as well as funds for an educational campaign for both caregivers and the general public.

I agree that just because a new mother shows emotion she should not immediately be diagnosed as having a PMAD. I also believe that a woman should have free choice when it comes to her treatment decisions and should NOT be judged for those choices. I chose to take Anti-depressants. My first prescription did not work out. But my second one did. Just as with any other medication, sometimes they don’t work so well with your system. So you try another one. You don’t suddenly take your own care into your hands – that’s ridiculous. Would you try to heal a broken leg or diabetes on your own? No? I didn’t think so. So why would you rely solely on self-care when it comes to mental illness? Self-care should be part of the picture but it shouldn’t be the ONLY part of the picture.

I am so tired of being judged and accused of not having informed consent. You know what? When I made my decision to go on Anti-Depressants, I had carried around an informational packet about AD’s & Breastfeeding given to me by the NICU Lactation Consultant with me for a week. I read that thing through and through. I was exclusively pumping for my daughter at the time and did not want to jeopardize her receiving my milk if I ended up having to take something. But I couldn’t function. I couldn’t take care of my family, I couldn’t take care of myself, and a lot of the same thoughts were coming back. Negative, scary thoughts about knives and hurting myself and my family. Yet I wasn’t on anti-depressants. I needed to be able to function. So I made a very informed decision to do so, one I do not regret to this day.

TIME – I am very disappointed in your lack of sharing both sides of this debate. Very very disappointed.

iPhone App Sad Scales includes Edinburgh Postnatal Depression Scale

(Note: This is post does not imply an endorsement or recommendation of this particular application. As with any evaluation, please be sure to see a professional for final diagnosis)

This morning I discovered an iPhone app which includes the Edinburgh Postpartum Depression Scale along with three other depression scales.

While I have not used it myself, it seems like a really neat concept considering how prevalant iPhones are in our society today. Chances are many new moms either have an iPhone or know someone who does. What’s really cool about this app is that it stores the last 30 entries so you can take the results straight to your doctor.

Speaking of doctors – if you’re a professional, you too can get this app for your iPhone as well so if you’re faced with a new mom who doesn’t seem to be doing very well, you can screen on the spot without having to hunt down a screening tool in your office.

Pretty cool, huh?

You can read more about the app here and no, I’m not getting a cut by referring you to the store – it’s just the best description I found of the application.

Just Talking Tuesday 07.07.09: Anti-depressants or Not?

original photo by thegirlsmoma @ flicker

original photo by thegirlsmoma @ flicker

Today’s topic was inspired by a post over at Postpartum Progress: You don’t NEED Anti-depressants, Do You?

In this post, Katherine discusses the lack of stigmatization regarding pharmeceutical treatment for medical conditions in response to a ScienceBlogs post you can find here.

Anti-depressants are stigmatized. Period. Nitro-glycerin or insulin? Not so much. Why? Just as Anti-depressants may work for me, they may not work for you. And if you have the wrong heart condition and take nitro-glycerin, things may not go your way either. But you don’t hear people judging others for being on nitro-glycerin, now do you? And insulin? Many Diabetics require this life-saving medication. Even pain medication after an injury – do you question that prescription? Most don’t and certainly aren’t stigmatized for taking it because let’s face it – a broken leg hurts – something we all understand.

Mental illness hurts too. It hurts the person suffering. It hurts the people around them. And if the right medication is paired with the right therapy, it can make a world of difference. Why then, are we stigmatized or accused of not understanding informed consent for deciding (of our own free will) to take medication as we heal? What makes the scaffolding of Anti-depressants any different than pain medication as a broken leg heals?

So I’m posing a pretty big question today. And I expect there will be a bit of debate about it – which is good…our different opinions are what keep us interesting! Just keep things polite. No hateful, judgemental or fear-centered comments will be approved.

Do/did you or don’t/didn’t you take Anti-depressants? Why? Why not?

And more importantly – IS it your place to tell someone else they absolutely SHOULD not take them if you don’t believe in them or have had a bad experience? Or should you calmly refer them to research that explains the risks vs. benefits and let them make the decision on their own WITH a professional on board?

Let’s get to Just Talkin’!