Category Archives: Antepartum depression

Just Talkin’ Tuesday 10.27.09: What’s YOUR Postpartum Mood Disorder Story?

Leave a reply
women talking in sunset

Original Photo taken by tranchis @ flickr

This site was started to help me re-frame an unexpected pregnancy after two rather nasty experiences with Postpartum OCD. Turns out that by doing so I not only helped myself but managed to help a lot of other women along the way.

There was a point during my suffering when I dreaded having to retell my story. Looking back I should have just typed the whole thing up and kept copies on hand – kind of like a resume. (Hey – not a bad idea if you end up having to hunt for a decent doctor!) But there came a turning point where my story began to foster a sense of strength and self. Finally I began to bloom.

We’re all at different points on our journey. Some of us are right in the thick of it, some of us a bit further out, others are fully recovered, some have relapsed and are struggling right back out thanks to the path we carved out the last time we fell down. But we are all in it together.

Rather than retype my entire story here (cuz that would take some time!), you can click here to read about “The Day” I was admitted to psych ward. And if you’re brave enough (ie, preferably not in the thick of it or relapsed) you can read another piece I’ve written here about some of the thoughts I had when things were so dark I couldn’t even see my hand in front of my face.

For me and for many others, telling our story or even venting has become a powerful source of personal therapy. It’s a way to just get some of the stress out of our body, our mind, and even possibly work through issues.

So let’s get to just talkin’ here. I want to hear your stories. I want to know what you’ve gone through/are going through. Speak up. We’re here to be supportive, compassionate, and lend our hearts.

I can’t wait to read what you have to share!

Danish research and SSRI use during pregnancy

Leave a reply

An article at medpage.com heralds a new study released September 25, 2009 by Danish researchers. The article carries the sensationalized title “SSRIs in Pregnancy Hike Risk of Heart Defects.”

While the title itself raises eyebrows, the researchers themselves state that they were unable to conclude if the results were because of medication or the underlying depression. Also important to keep in mind is that this research is based on women who had prescriptions filled for SSRIs but does not appear to have checked to see if these women actually took the medication. Instead, they rely on data from a national registry.

“Pedersen and colleagues analyzed national registry data on more than 493,000 births in Denmark from 1996 to 2003. The data included prescriptions filled by mothers-to-be as well as the medical status of their babies at birth.”

And directly from the study:

Our results, however, depend on a correlation between redemptions of prescriptions and drug use. Non-compliance might be a problem for this type of exposure definition and could mask true associations if some of the “exposed” were in fact unexposed.

The most interesting piece to come out of this research is that of the studied SSRI’s, Paxil appeared to have the least risk of septal heart defects. I find this very interesting considering that Paxil is the only SSRI to currently carry a heart defect specific warning.

As with all studies and research, you should always examine all sides and aspects and educate yourself rather than relying on the word of others when making your final decision. Ask yourself if the person presenting the information has your best interest at heart or is merely trying to frighten you with inflated facts and figures. (Click here to read a previous post full of tips on how to find solid medical advice on the web.)

Dr. Shoshana Bennett, author of “Pregnant on Prozac” released this statement regarding this research:

Finally, treatment for the serious and potentially life-threatening illness of prenatal depression (for both mom and therefore baby) is being formally discussed. Fifteen percent of clinically depressed pregnant women try to take their lives – a bit more risky for the baby than mom taking an antidepressant, wouldn’t you say? If the pregnant woman can be non-depressed without a medication, that’s optimal. Some form(s) of treatment, however is essential. If natural and alternative approaches to wellness are not enough, it is regarded by those in the know to be safer for her (and her developing baby) to take an antidepressant than to remain depressed. Depression itself – it is quite clear from the research – crosses the placenta and alters the uterine environment causing negative consequences to the baby. In the latest research there appears to be low (0.9%) chance of a septal heart defect in babies whose mothers had taken certain antidepressants. However, what fear-mongers do not report, is that the researchers themselves could not be sure whether it’s the antidepressant or the underlying depression itself that caused the defect. Women need all relevant information and education about options for treatment during pregnancy so they can make the best decision for themselves and their family. Watch out for alarmists who are not interested in actual data – they are simply invested in promoting fear in women who are at their most vulnerable.

Shoshana Bennett, Ph.D.

http://DrShosh.com

Increased risk was determined by “redemption” of more than one SSRI prescription. Those who redeemed more than one prescription had infants with a higher percentage of septal heart defects. But again this begets the question of whether or not this result lay with the SSRI or the underlying depression/mental illness/stress the mother may have been experiencing in order to receive said prescription.

Bottom line here: Don’t think for a second that becoming a Mom starts at birth. It starts at conception. And we owe ourselves AND our infants the best start possible. This means researching by asking questions and seeking out solid answers. It means finding physicians who will be your co-pilot instead of an uncooperative Auto-Pilot unaware of the pot-holes facing them. It means putting together the best support you can with what you have access to at the time. I happen to agree that a SSRI free pregnancy is absolutely optimal. I also think you should run (not walk) out of any doctor’s office if said doctor is quicker with the script pad than the warm shoulder. But we have to remember that every situation is different. Every person is different and every pregnancy is different. And sometimes we may just have to take medication. It doesn’t make you weaker, it doesn’t make you stupid, and it doesn’t make you a bad mom. And above all, remember that the decision to take or not to take a SSRI during pregnancy is your decision. Make it with an empowered spirit, stick to it, and don’t look back.

PPD Survivor Shares her Story for the first time

Leave a reply

On Tuesday, this was a comment left by a mom who had never shared her story with anyone besides her husband (who lived it with her). I emailed her to ask if she would be comfortable with me giving it a post of it’s very own. Her story begins when she is 34 weeks pregnant and continues through to postpartum. I hope you find it as inspiring and as strong as I did…..

This is my first time to share my story in any capacity…. I don’t know if I’m ready, but here goes nothing…

My depression started around 34 weeks into my pregnancy… I had never heard of PPD and I didn’t know what ante partum depression was… I started to realize something was wrong somewhere between 30 – 34 weeks. I’m not afraid of medication, and think of it as an aspirin would be to a headache.

I have had depression and anxiety before so, I somewhat, recognized the signs. I told my husband that I wasn’t quite feeling right, and he encouraged me to speak with my OBGYN. At my next appointment I told my doc that I was worrying excessively, and not feeling quite right. It was really a whole new type of depression for me.. I never could and still have difficulty describing the way I felt. But worry was a BIG concern. The OBGYN said it wasn’t a big concern, and not to worry lots of new mom’s worry a lot.

My husband is a member of the “mind over matter” club. While he, I’ll say, tolerates, my need for meds to get my depression under control, he definitely is one of those, “Just push through it,” kind of people.

I saw my OBGYN on Tuesday, and she prescribed me Prozac, I ended up going to the E.R. on Sunday because I felt very overwhelmed; with what exactly, I do not know… They gave me an Ativan shot, made sure I calmed down and sent me on my way, with no real information. Or possible expectations. I then saw my OBGYN again on Wednesday, explained what had transpired over the weekend, and she prescribed me some Xanax. I felt so horrible that day, that we went straight to the nearest pharmacy and filled the script so I could take one. That Sunday I woke up and I felt worse than I thought I ever could. I told my husband that he had to take me to the E.R. So they could take the baby out so that no harm would come to her, if I did end up harming myself.

I thought this was a completely rational thought process; and was even more distressed when they told me that instead of delivering my baby early, they were sending me to the Nut House. All of this scared my husband to death, not only was he in fear of losing his wife, but that there was a possibility that he could end up without a wife and a child, or raising a baby on his own. And it was definitely one of the two, because the baby could not stay in me anymore.

I think that is when he realized, after two weeks of doctors and E.R. visits, that something was really wrong and a real threat existed not only to my life but to our unborn daughter’s life as well! I went to the psych. ward at a private hospital, where they were fairly knowledgeable about pregnancy related depression. The one thing that is VERY FRUSTRATING in my case, is that, since I was pregnant I was having a OBGYN come in and check on me daily, and since I was high risk (because of a blood disorder) I had a specialist coming to see me daily as well. They kept telling me it would be okay for me to get some Ativan, which had provided tremendous relief at the E.R. Visits, but the psychiatrist that was assigned to me when I arrived, REFUSED to give me anything other than Benadryl and Celexa, neither of which were providing any immediate relief.

As I have learned over the past year and a half since this all occurred, most psych. Wards have limited visitation, and mine was no different. My husband could come to the evening visitation and spend an hour with me. The first few days all I did was cry the whole time he was there. He was so scared. I was breaking his heart and that just made me feel even worse. I really just wanted to give him the baby and leave (you know d-i-e…) I didn’t want to burden him with all of my problems anymore. The thought of me not being around anymore, was the thing that was really bothering him. He got it in those moments.

I got out of the hospital and managed to hold it together until 38 weeks!!! YAY ME!!! When my OBGYN, asked if I wanted to go ahead and deliver, I practically took myself straight to the hospital right then. Coincidentally, I went into labor on my own the day I was scheduled to deliver. My delivery was easy… But there were some complications with my epidural, which lead to added stress. It is the most horrible feeling in the world to think back onto that day and to look at pictures and to know in those moments there was no joy, no love, and no want, for my beautiful, brand new baby girl. You can see the blankness in my face and the fakeness in my smile in all of the pictures… It breaks my heart to think of it. Will she understand, what was wrong with me then? Will she know how much she has ALWAYS been loved and wanted!

This was my husband’s first baby, but my second. I have a, now 10 y.o., daughter from a previous relationship, so I had been through the nursing and diapering and everything before. I was uncertain of myself because of my depression and anxiety, but I knew what I was doing automatically. My husband second guessed everything I did. He questioned my positioning of the baby while nursing, and was convinced that she was not getting any milk, despite the fact that the nurses had told him multiple times that everything was going fine. As one would assume this only compounded the problem I was dealing with.

A couple of days out of the hospital and other than the epidural complication I thought I was feeling much better! I look back now and think that the depression was just masked by the Vicodin they were giving me for pain after the delivery. I probably had about a weeks worth of Vicodin, and within a few days after that, I was back in the E.R. I won’t go into all of the how I was feeling… But I ended up back in the psych. Ward.

Telling my husband the second time felt easier to me… With the flawed logic of depression, It seemed very simple. I leave (aka die) and then he doesn’t have to worry about me, he now has his child, life will be easier without me… Yada yada yada… The same visitation schedule existed, naturally, I had just been there little less than a month before… My husband came to all the visitations and brought our daughters. (the first time I lied to the oldest about where I was, she still doesn’t really know why I was there either time) again, in the moment, he was understanding, apologetic, and sympathetic. He just wanted me to do what ever I need to do to get better, and come home to our family.

We had tough decisions to make. Since I was nursing, and since I had the same psychiatrist that I had had previously, she was equally unwilling to provide me with any REAL meds, until I agreed to stop nursing ( as I type that, I think I hate her for that!) Up until the point in which I agreed, I pumped and dumped, my milk every few hours in my room there in the ward. That too was heartbreaking, but I was finally at a point mentally where I knew I had to get better and go home, and without me at home, there wouldn’t be breast milk anyway! So I stopped pumping and finally got some relief!!!

When I first came home my husband was great!!!! He did the laundry without being asked, he made sure there were meals for everyone, he helped out with our new daughter a lot. But as time passed and things have gotten better his back to his same old self. Mind over matter. He really does spend a lot of time wondering what the hell is wrong with me.

I’m glad to report, that I’m now doing great, as long and I don’t have to talk about the time around my daughter’s birth, (this post has resulted in the need to take some Ativan!) And you don’t talk to me about having another baby, which my husband definitely wants to do, and I’m not so sure I can handle it… I can’t even type out what happened to me without having a panic attack!!!! But for the most part I’m GREAT! ;o) I’m down to 30 mg of Cymbalta a day, and Ativan as needed (which is rare!). We are working on weaning off the Cymbalta, but I’m in no hurry! I want to be well and I want to be here with my family.

I’m looking forward to sharing this post with my husband. I think I have stated fairly well, what I will need him to do better next time. I have also printed of a “Me First” letter (got it from a post on a PPD site) and will be well armed if we decide to have another baby! I wish my husband had a better understanding of depression. I which he could remember how VERY REAL everything we went through during our daughter’s birth was. Maybe then he would have more compassion for my now fleeting struggles, and be WELL prepared for the next time!

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

Leave a reply

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.

Powered by ScribeFire.

TIME Magazine misfires debate on MOTHER’S Act

Leave a reply

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.