Category Archives: Complementary Treatment

Postpartum Voice of the Week: Meds, Placentophagia, and Mamas! Oh My!

To take meds or not to take meds. THAT is the question so many moms with a Perinatal Mood Disorder face with a heavy heart. I hope it is a decision you take seriously, educating yourself about the risks, the benefits, talking with your doctor before changing a dosage level if you do decide to take medicine, and involving your pediatrician as well if you are nursing and decide to take medicine. Pharmacological treatment of a Postpartum Mood Disorder should involve a team of professionals – and the most important person on that team is YOU.

Stacey over at Maternal Ramblings wrote a wonderful post simply entitled “PPD” in which she opens up from a mom’s point of view about a severe case of PPD that led her to take medicine. She didn’t want to take medicine at first as she feared it would control her life. Stacey came to realize that a good day on meds was better than a bad day without. She’s enjoying feeling normal again and looks forward to the day when she won’t need the medicine anymore.

Kate Kripke, a fellow Postpartum Support International Coordinator in Colorado, wrote a great post from a professional standpoint entitled “What if I have PPD and I don’t want to take meds?” It’s well worth the read as she offers some invaluable insight when it comes to alternative or complementary approaches.

Ruta Nonacs, MD, Ph.D over at the Massachusetts General Hospital Center for Women’s Health offers a Quick Review of Non-Pharmacologic Options¬† for the Treatment of Antenatal Depression. Understandably, a pregnant mother may want to avoid meds on a personal level even more so than a postpartum mother. Ruta quickly sums up several options but does caution that all of the studies associated with these methods only reviewed their effectiveness with mild to moderate depression. If you have severe depression, these options may not work for you. Remember, your health and mood is paramount. Depression crosses that placenta too.

Finally, Kate Kripke also offers a great piece on Placentophagia. If you are not quite sure what that is, it’s the ingestion of the placenta after birth. Many mothers have begun to encapsulate this after birth. To read more about a mom who did just that and how she did it, a great post is offered up by Emma Kwasnica, a passionate natural birth advocate in Canada. (There ARE pictures.) If a mom wants to ingest her placenta after birth, I feel she has the right to do so. Where I run into a problem is with the promotion of Placentophagia as a prevention for PPD. As laid out by Pec Indman as part of Kate’s post, much of the research quoted by those who practice Placentophagia is outdated and much of it does not focus on actual placenta ingestion but instead on the depletion of iron after birth. To date, no known human study has been completed which specifically focuses on Maternal Mental Health and the practice of Placentophagia. If you happen to know of one, please share it with me. I, and other PSI Coordinators, would love to read it.

In the end though, we are all on our own paths and so must our journey to wellness reflect our own hearts. I believe whole-heartedly in supporting a mama in whatever decision she may make as long as it is a well-informed decision reflecting her true sense of self and her family philosophy. No mother should ever be judged for her decisions when it comes to her mental health or the well-being of her family.

Therapy Choices for the Postpartum Woman

Once diagnosed with a Postpartum Mood Disorder, you are then faced with a literal bevy of choices regarding your path to wellness.

Some doctors may toss pills at you. If that happens, run. Run very fast and very far away from any physician who shoves anti-depressants your way before you’ve even finished describing what’s wrong. A good prescribing doctor will sit down with you and hear you out before grabbing for his pen and pad (or these days, keyboard and internet connection). A good physician should also run a couple of simple blood tests first to rule out thyroid disorders or anemia which need completely different types of medication to show improvement.

Some doctors may suggest psychotherapy. And that is where things start to get a little sticky. What kind of talk therapy? Will there be a couch? Will it be comfy? Will I have to talk about how my Great Aunt Edna used to kiss me on the cheeks and leave funny lipstick stains? Will I have to talk about things not related at all to my current state of mind? Will I be hypnotized? Or any other strange mumbo jumbo I’ve seen happen on TV or in the movies or from my best friend who found this website and…

Hold the phone there.

Cognitive Behavioral Therapy proved to be the best option out there for me. There was a couch but I didn’t lay down on it. I sat cross-legged on it as I drank coffee and chatted with my therapist. She sat in a really cool rocking chair with a foot stool. I got along fabulously with my therapist. That’s not to say we were bestest of buds but she knew what she was doing, just let me talk and work a lot of my issues out. I did occasionally talk about things in my past but it wasn’t at all like “So, you were born… let’s start there.” She met me where I was and let things fall where they fell. Or at least she seemed to. She did ask questions to get me to think about issues and how I was reacting to them. I had not planned on staying in therapy for long but once I became pregnant again, I made the decision to stay in through my pregnancy. Therapy gradually stopped at about 6 months postpartum of that pregnancy as we scaled our sessions back.

While I will not be covering every single last type of therapy out there, my goal is to provide some basic information for the most common therapies  used with Postpartum women.

At the top of the list is Cognitive Behavioral Therapy which is actually a blanket term for several types of therapies with similar traits. Primarily Cognitive Behavior Therapy (CBT) promotes that WE have power over our moods through our thoughts. You can read more about it by clicking here. A great resource now available for women and clinicians alike when it comes to treating Postpartum Depression is Karen Kleiman’s Therapy and the Postpartum Woman. You can read more about it by clicking here. (In the interest of full disclosure now required by the FTC, I have not been compensated at all for including this link. I sincerely believe it’s a good resource.)

EMDR or Eye movement desensitization and reprocessing is gaining popularity as an option. EMDR is most effective with Post Traumatic Stress Syndrome. You can read more about this approach by clicking here.

Peer Support/Group therapy is also an option. The primary benefit of this option is the realization it provides to women of not being alone. They really aren’t the only ones having a panic attack when they get in a car or experiencing frightening thoughts prancing through their mind at the most inopportune moments. Many times this option is a cost-effective option as well because many groups do not charge. A group led by a therapist may only charge a small fee such as $10-15 for attending. While peer support should absolutely not replace professional medical care for Postpartum Mood Disorders, it is an important aspect to add to recovery. If your area does not have a local peer group, you can find help online. The Online PPD Support Page has a very active forum for postpartum women. You can also visit the iVillage Postpartum or the Pregnant & Depressed/Mental Illness Boards. (Shameless plug on the iVillage boards, I am the Community Leader for both.) Another bonus of peer support? It reduces the recovery time.

Pharmaceutical therapy is also an available option. Some women are against taking medication and that’s perfectly okay. No one should ever be forced to take medication. Typically, pharmaceutical therapy is paired with another type of therapy. In fact, combining pharmaceutical therapy with a type of Cognitive Behavioral Therapy has proven to be one of the most successful approaches for the Postpartum Woman. Sinead O’Connor really put it best during an appearance on Oprah in regards to the function of psychiatric medications. They are the scaffolding holding you up as you revamp yourself. There are risks involved with taking medications and you should absolutely educate yourself, talk with your doctor, and if you end up deciding to take medication, be sure to inform your child’s pediatrician if you are nursing so they can be involved in monitoring for any potential issues.You should also familiarize yourself with the symptoms of Serotonin Syndrome, a fast-acting reaction which occurs for some people when they do not metabolize medication quickly enough. The build up results in a severe toxic situation. You should also avoid stopping any pharmaceutical therapy without consulting with a physician. Stopping suddenly can cause very negative symptoms similar to Serotonin Syndrome. If you have any signs or symptoms of Serotonin Syndrome, get medical help immediately.

For more serious cases of Postpartum Depression that do not respond to medication, Electroconvulsive Therapy may be suggested. ECT has come a long way since the 50’s and is a viable choice for many women who do not respond to medication. Now, I am not saying that if you choose not to take medication, you’ll be given ECT. This is for women with severe depression who cannot metabolize or do not respond at all to medication. Choosing not to take medication does not buy you an ECT ticket at all.

For women who want to use a more natural approach, there are a lot of choices. Again though, I have to urge you to make sure you are seeing a professional during your recovery. Don’t take something because it worked well for Aunt Martha. Check with your doctor and make sure it’s applicable to your situation and okay for you to take in combination with any other medication you may already be taking. Be sure your naturalist or herbalist is licensed and trained. You’ll also want to make sure that any herbs/natural supplements you are taking are compatible with breastfeeding if you are doing so. You can visit the blog over at Rebuild from Depression for a food/diet based approach.

Note: I had a reader, Steve, from Noblu.org leave a comment regarding IPT or Interpersonal Therapy. You can click here to read his comment. Thanks, Steve, for stopping by and sharing your knowledge with us!

As you can see, there are a lot of options available if you are diagnosed with a Postpartum Mood Disorder. More and more practitioners are becoming familiar with these disorders. More help is available today than even 6 years ago when I was first diagnosed. Remember to ask questions when choosing a therapist, advocate for yourself and what best fits your personal lifestyle philosophy. Don’t settle just because you want to heal. You have the power to say no. It’s your body, your mind, your say.

Tomorrow we’ll be discussing some things you can do on your own to help your recovery along. Stay tuned!

The reprehensible spammification of Postpartum Mood Disorders

Something is afoot.

Something strange, disturbing, and downright irresponsible.

Sadly, I am not surprised at this recent development given what a hot topic Postpartum Mood Disorders has become of late in relation to recently (passed!) legislation and the courage of more and more mothers speaking out about their own difficult experiences after the birth of a child.

More and more, I have been receiving very odd links in my Google Alerts for several Postpartum Mood Disorder related search terms. These links lead to websites that have absolutely nothing to do with anything maternal, postpartum, baby, family, or any other related topics. And the information included therein is anything but accurate or reliable.

Even worse, I’ve been seeing a lot of new websites crop up with blanket promises of “Curing” postpartum depression for one low price. (One website even includes a friends and family “coupon” which cuts the price in half just for you!)

My stomach has been churning at the very thought of at-risk women and well-meaning family members finding these sites.

Oh yes, ladies and gentleman, I’m talking about the spammification of Postpartum Mood Disorders.

I can tell the difference between a reliable website and an unreliable website.

Women who blog with me, survivors, experts, and others intimately familiar with the topic can tell the difference.

But what about women and families currently being tossed about on the big nasty Postpartum Sea? Can THEY tell the difference or will they fall prey to these deceptive tactics masquerading as effective life preservers in a hopelessly churlish sea?

Spamming is a disgusting and contemptuous act which has been going on for years. Many of our in-boxes sit full of spam. Some of it makes it through from the spam folder into our in-box making it seem even more reliable. And if one of these links were to make it into the in-box of an at-risk woman or a well-meaning but uninformed family member of a woman struggling with a Postpartum Mood Disorder, the results may prove ghastly.

So what are we to do?

How do we get educated and knowledgeable when it comes to dissecting the authority and reliability of a website?

There are a few steps you can take.

First, is the site’s URL address directly related to the topic you’ve researched?

Chances are that if you’ve researched Postpartum Mood Disorders or Depression and end up on a website for air conditioners, furniture, auto repair, or turf builder, you’re not at a reputable website.

Second, let’s say that the website you’re at DOES correlate to the topic you’ve researched and the word postpartum is in the URL address. That’s gotta be good, right? Well, yes, and no.

Does this website link to known organizations specializing in helping women with this issue? (Think Postpartum Support International) What’s their google page rank? Are they HON Code certified? (Think Postpartum Progress) What’s the story behind the person who put the website together? Are they clear about their training? Do they let you know they’re a Mom/peer supporter, a doctor, provide confirmable evidence of education/degrees/certifications? Can you find anything about them elsewhere? Have other bloggers or websites linked to them and endorsed them or mentioned them? Or are they only published at their specific website and other unreliable websites? (I don’t have a high Google Page Rank or an HONcode certification but I am working to improve my page rank and also toward an HONcode certification as well. I also over-research everything I put up here which is why sometimes I’m a little behind on posting about a hot topic. I’d rather get it right than have it up as soon as it happens)

Third – is the website trying to sell you something? Does the website promise a cure? Are they dismissive of an entire approach to treating Postpartum Mood Disorders?

If the website is really trying to get you to buy something without describing in detail what it is, you need to be wary. There is no one size fits all treatment. There is NO overnight cure for Postpartum Mood Disorders. Just as with all women, all pregnancies, and all deliveries, there are many different types of Postpartum Mood Disorders and they are rooted in different issues dependent on the history of the woman, the type of birth she experienced, her thyroid levels, anemia levels, etc. There are SO many different layers to uncover when it comes to a Postpartum Mood Disorder. It is dangerous to buy into a one size fits all approach. Just as labor is a fluid process subject to change at any moment given any circumstances, so is postpartum recovery. We all approach life with our own individualized chemistry and baggage. Matching sets don’t commonly occur out here in the real world.

The practice of Quackery has been around for eons and will unfortunately continue to exist as long as people are willing to grasp at any answers that may save them from their current condition. That being said, there are legitimate complementary treatments and alternative approaches available for treating postpartum mood disorders. Anyone worth their salt in dedication to helping women with Postpartum Mood Disorder will be open to supporting whatever path you choose to take toward wellness regardless of what type of methods you choose. In the same vein, anyone worth their salt will also strongly encourage you to work with medical professionals as you work toward wellness. Anyone worth their salt will also openly share their training, education, and base of knowledge with you as well. There should be no hidden cloak, no Wizard of Oz mumbo jumbo going on during your journey to wellness with a good provider.

Here are a couple additional links that may help you navigate your way through the 102,000 results you’ll get via Google in .20 seconds for Postpartum Mood Disorders:

Tips on Identifying Reliable Health Information on the Internet

Quackwatch.org

What can you do if you fall victim to one of these websites? First, you can file with the FTC. And if you’ve lost money and care to pursue legal action, you are entitled to do so under something called the Lanham Act. You can also contact the Better Business Bureau’s Online department by clicking here. You can also click here for seven tips on how to keep your email address from getting added to the growing number of spam lists out there.

As more and more voices speak up about their experience with Postpartum Depression, more and more Snake Oil salesmen will crop up to take advantage of the growing searches occurring on the Internet for information. It’s sad and blasphemously tragic but such has been the way for ages with many medical conditions.

Bottom line: If in doubt, throw it OUT. That phrase is handy in the restaurant industry and certainly handy here too. If a link promises too much too fast or reeks of a foul distrusting odor, throw it out.

Tread carefully. Think it through. Talk to a professional. Take care of you.

Tomorrow we’ll be sharing tips on how to tell a good doctor/therapist from a bad doctor/therapist.

Have any tips or insights to share on this? Email me at ppdacceptance(@)gmail.com.

Be sure to check back to see if your tips/experiences were included!

Low Omega-3 Fatty Acid Intake from Fish correlates with High Levels of Depressive Symptoms in Pregnancy

Published in the July issue of the Journal Epidemiology, researchers put to the test the relationship between fish intake and depression based on the observation that “Although common in western countries, depression appears to be virtually absent in countries with high seafood intake.” (Abstract, High Levels of Depressive Symptoms in Pregnancy with Low Omega-3 Fatty Acid Intake from Fish)

The researchers collected data from women as they progressed in their pregnancy during 1991-1992. At 32 weeks, the women then completed a questionnaire which included symptoms of depression as well as a food frequency questionnaire from which the amount of Omega-3 Fatty acid from fish was calculated.

The results? Both adjusted and unadjusted analyses showed that lower maternal intake of omega-3 from fish was associated with high levels of depressive symptoms.

So just how much fish do you have to eat in order to achieve these results? Women consuming more than 1.5g of Omega-3 from seafood vs. those consuming none were less likely to have depressive symptoms. And how much fish equals 1.5g of Omega-3 fatty acids? FDA guidelines suggest women and children eat up to 12 oz of fish per week. Some of the healthier fish to eat (in order to avoid mercury build-up) are: Anchovies, Catfish, Crab, Herring, Mackerel, Mussels, Wild Salmon (Alaskan), Sardines, and Whitefish (source: Fish Intake During Pregnancy, Dietriffic.com)

What if you don’t like fish? You can take a supplement and there are non-fish sources of Omega 3 such as walnut, kiwi-fruit, flax seeds, pecans, hempseed, hazel nuts, and butternuts. Eggs and milk from grass fed chickens and cows are also higher in levels of Omega-3 fatty acids than other eggs and milk. But remember this particular study dealt specifically with Omega-3 from fish.

You can also check out the following blog, Rebuild from Depression, for additional sources and information regarding Omega-3 fatty acid sources.

I have been taking Omega 3/6/9 for quite some time now as part of my regular routine. I can tell when I forget to take my supplement as well. (So can my husband!) Make sure you talk to your physician before adding a supplement to your routine though. Also discuss adding more fish to your diet as well to make sure it fits with your particular situation.

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