Category Archives: postpartum psychosis

NIMH Gets Failing Grade for Perinatal Mood & Anxiety Disorder Chat

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Last week, a friend of mine tagged me in a link on FB to give me a heads up about a NIMH chat this week about Perinatal Mood Disorders. Of course we were looking forward to it and hoping it would be a worthwhile discussion. I nearly missed it on Friday morning (May 16, 2014)  thanks to a nasty case of food poisoning which knocked me off my feet for the better part of this week. But, I managed to dive in just 10 minutes into the chat.

It was…….awful.

Stilted.

Non-engaging.

Spouting of facts and just the facts, according to the NIMH. (They managed to screw up a few things. Don’t worry, I’ll go there. Oh, yes, yes I will.)

Self-promotion and only self-promotion. No real response to the powerful Perinatal Mood and Anxiety Disorder Advocates who showed up until we started really pushing back. Even then, their response was still stilted.

Just when it seemed it couldn’t get any worse, the NIMH began repeating tweets from the beginning of the chat instead of answering the flurry of questions coming in from those participating.

If NIMH handed this chat in as a graded project, it would have received an F.

When I asked what was being done to encourage medical professionals to become better educated about PMAD’s, this happened:

NIMHChat Congress

Yep.

Congress MANDATED we pay more attention to PMAD’s. In fact, it got shoved in with the ACA. And we all know how well that’s going. After this response, I asked a follow up question asking how that was going – asked for hard numbers. Did I get numbers? Nope. BECAUSE THE ATTENTION MANDATED BY CONGRESS LACKS FUNDING AND THEREFORE ATTENTION.

I’m okay, I’m okay. *deep breath*

There was also this lovely moment in chat:

NIMHChat Snafu

I know, right?

Because we ALL got better by staying in bed thanks to depression, right? Right?

Instead of urging moms to get up, move, and care for themselves, the NIMH  provides them with excuses to stay in bed and well, suffer. Way to go, NIMH. WAY.TO.GO. *slow claps*

While I realize it is difficult to manage a large scale chat with several participants (something I have done myself, when #PPDChat was very well attended), there is absolutely no excuse for the following to happen during your chat:

1) Blatantly state misinformation/misleading facts about your topic. Particularly if said topic is subject to entrenched stigma and misinformation (which is why you are having the chat to begin with, right? Not because it’s a hot topic and you’re using it to draw people in…)

2) Not engage those who are participating – this is SOCIAL media, y’all. SOCIAL. ENGAGE. Like Jean Luc Picard on the bridge of the Enterprise. Even if you’re just going at impulse speed, ENGAGE for the love of ALL that is..well, you know.

3) Don’t repeat yourself word for word. It lets people know you’re unprepared.

4) Share resources other than your own. (see number 2 about social media).

5) Do NOT TREAT those participating with disdain, contempt, or as if they are idiots. They are attending your event which would be nothing without participants. Respond accordingly unless they are clearly bashing you (which we were not) and if they are bashing you, ignore them before you stoop to the level of responding with disdain.
Things to do during a Twitter chat:

1) Engage. Be Social. Greet people. Be happy and upbeat. SMILE through your keyboard.

2) Be knowledgeable and approachable.

3) Treat everyone as if they are your equal. They are there to learn, not to be kicked. Acknowledge their words, their struggle, their questions with the same respect you expect from them. You know, do unto others as you would have them do unto you.

4) Offer insight through connections and share resources from others in addition to your own. The only answer is not yours. Crowd-source and use the media at hand to enhance your chat.

5) Do your best to make everyone be heard, even if it’s through just RT’ing what they’ve said. Again, I realize this is difficult on a LARGE scale but if you have known experts participating, acknowledge them.

I truly hate when things like this go wrong because there is such a tremendous opportunity for exposure when a government agency holds a chat like this. I want to say I’m surprised at how things went but sadly, I am not. Instead of raising awareness and building hope, NIMH decimated the chat with a lot of tweets about nothing, leaving at least one person (and possibly more) with the idea that there is in fact, nothing a mother can do to prevent a PMAD:

NIMHChat PPD cause

And that, dear friends, is NOT the taste you want to leave in the public’s mouth when discussing PMAD’s. Because there is hope. There is help. We are not alone.

Go to Postpartum Progress to find women who are fighting back.

Or Postpartum Stress Center’s website.

Or Beyond Postpartum.

Or find me on Twitter @unxpctdblessing. Or search the hashtag #PPDChat. Message me for the private FB group full of women who KNOW this is hell and yet are fighting back against it with everything they have.

We’re all here for you when you’re ready to reach out for help.

(And THAT is how you end a chat about Postpartum Mood & Anxiety Disorders).

*drops mic and hits publish*

#PPDChat Topic 03.10.2014: Media Sensationalism & PPD

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ppdchat-03-10-14

 

Join me tonight as we explore the issue of media sensationalism and PPD. So often, as I stated in my post “On Not Wanting To”, when a mom hurts herself or her children, we get the sensationalized version of it and the details of her journey to that point (and her journey after the event) are dramatized as well. I hope you’ll join me for a passionate and insightful chat into why this needs to change as well as why we owe it to ourselves and to society to reach out to every new mother dyad with care, compassion, and understanding.

We cannot let the village continue to fail.

How the @BostonGlobe got Postpartum Depression Wrong

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With more news stories mentioning Postpartum Depression these days, it is becoming painfully obvious that reporters are scrambling to get their facts straight. Bless them for trying but sometimes, even with the best of intentions, they fall short. Like Karen Weintraub’s article “When the ‘baby blues’ are something more” at the Boston Globe on October 21, 2013.

Karen defends herself in the comments (all two of them at time of writing) about the term “baby blues” by saying that in her researching for this piece, she discovered there is such a thing as baby blues:

Boston Globe Comments

Kudos to Ms. Weintraub for doing enough research to realize that baby blues ARE distinct from depression.

BUT.

There are a multitude of omissions and errors within the article as it stands right now. Let’s go through them:

Ms. Weintraub breaks the Perinatal Mood & Anxiety Disorder experience into only three groups:

  • Baby Blues
  • Postpartum Depression
  • Postpartum Psychosis

Immediately, sirens sound. Particularly because the case study, a Nicole Caligiuri, a first time mother, states she felt “angry and anxious” all the time. While anger/irritability is a sign of depression, anxiety combined with anger is typically (in my non-professional opinion) more closely related to an anxiety disorder. Ms. Caligiuri, however, was diagnosed with Postpartum Depression.

By ignoring the additional facets of the PMAD spectrum, Ms. Weintraub does a severe disservice to those mothers who may be suffering from Postpartum Anxiety, Postpartum Post-traumatic Stress Disorder, or Postpartum OCD.

Weintraub states that 50-85% of new mothers experience baby blues, 14% experience postpartum depression, and a “fraction of 1 percent of new moms” experience Postpartum Psychosis. If you go by those numbers (at the higher levels), nearly 100% of all new mothers experience one of these three phenomena and none experience Postpartum Anxiety, Postpartum Post-traumatic Stress Disorder, or Postpartum OCD.

According to Postpartum Support International’s Get the Facts page:

  • Approximately 6% of pregnant women and 10% of postpartum women develop anxiety. Sometimes they experience anxiety alone, and sometimes they experience it in addition to depression. 
  • Postpartum Obsessive-Compulsive Disorder (OCD) is the most misunderstood and misdiagnosed of the perinatal disorders. It is estimated that as many as 3-5% of new mothers will experience these symptoms.
  • Approximately 1-6% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth.

But in Weintraub’s scenario, there isn’t room for the nearly 20-27% of women who develop these particular Perinatal Mood & Anxiety Disorders. As a survivor of Postpartum OCD, I find this troubling. Particularly because OCD can scare a new mother into thinking she is experiencing a form of Psychosis due to the horrific intrusive thoughts.

As I have mentioned multiple times, it is beyond important to differentiate the varying aspects of a Perinatal Mood & Anxiety Disorder. Why? Because when you lump Postpartum Psychosis sensationalism in with Postpartum Depression, things get murky. You scare new mothers who may be a bit depressed into thinking if they go get help, they will be thought of as potential criminals and have their babes ripped from their arms the instant they admit to feeling anything less than happy.

An additional issue with this article is the strong focus on early motherhood. The logic of this focus is evidenced by the study on which it is centered but a quick mention that PMAD can persist beyond early motherhood would have been a quick fix for this bias.

Why is it important to emphasize that PMAD onset can extend beyond early motherhood?

Often, many mothers do not realize they have issues until they are well into the 6th month or more. I have had mothers contact me at almost a year postpartum to share that they think something has been deeply wrong since the birth of their child but they did not recognize it until now. Many Perinatal Mood & Anxiety Disorders crop up within the first 2-3 months, often immediately after the period of baby blues, but some mothers do not recognize them or even get hit with them until much later. PMAD’s can crop up  within the first 12 months after birth and even then, may not be recognized until much later. But this information is not mentioned anywhere in the article nor are we ever told at what point Ms. Caligiuri sought help.

I deeply appreciate Ms. Weintraub’s effort to reach out to Dr. Katherine Wisner and Dr. Michael O’Hara, respected experts in the research field of Perinatal Mood & Anxiety Disorders, however, I wish she (or her editor) had taken the time to allow this article to be a bit more clear regarding the wide scope of Perinatal Mood & Anxiety Disorders. I also wish a side bar had been included to resources for women and families who are struggling with these issues, particularly given that Ms. Weintraub included this quote from Dr. O’Hara:

Social support is probably the most important thing to provide a new mother, who is at a particularly fragile point in life, said Michael O’Hara, a professor of psychology at the University of Iowa, who has been researching and treating postpartum depression for three decades.

 

Postpartum Support International will connect new mothers with social support. Also, specifically in Hadley, Massachusetts, there is Mother Woman, a fabulous organization who is making fantastic strides toward improving access to support and care for struggling women & families. Advocates in the trenches, such as the volunteers with PSI and Mother Woman, recognize how important it is to have peers support each other so they do not feel all alone in the dark. It is an oversight that neither of these organizations are mentioned anywhere in Ms. Weintraub’s piece.

Overall, Ms. Weintraub, despite making a few blunders, seems to handle the issue at hand with a respectable grace. The study at the heart of the article focuses on the development of depression in children born to mothers who struggled with depression but Ms. Weintraub is fabulous in her handling of this issue, particularly with this paragraph:

But parents shouldn’t feel like they’ve ruined their child’s life if they go through a period of depression, Pearson said. The increased risk of depression in their children is small. Overall, 7 percent of teens are depressed, compared with 11 percent of teens whose mothers were depressed early in their children’s lives.

She side-steps the potential onslaught of guilt and gracefully allows parents to breathe a sigh of relief by including this information from the study’s co-author.

As I stated in the opening, coverage of Perinatal Mood & Anxiety Disorders is greatly improving. But we still have a long way to go to get to fully informed reporting. For the most part, Ms. Weintraub’s article is generally free of sensationalism, includes quotes from respected experts, and manages to allay any potential guilt a new mother with a PMAD may feel in reading it. However, it is still just a few small adjustments away from being truly spectacular and informative.

Dear Sting, Postpartum Depression is No Joking Matter

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Sting played a small venue in Chicago last night to promote ‘Last Ship’, according to this article written by Scott C. Morgan.

The article discusses the process Sting went through to bring ‘Last Ship’, a Broadway musical, to life.

Then at the end, is the kicker.

Though Sting is writing the score for “The Last Ship,” he won’t be appearing in the show. So Seller asked the singer how it will be for him to see other people performing his songs onstage.

 

“I imagine I’m going to have postpartum depression,” Sting joked.

 

Oh, Sting.

I have been a fan since I was a pre-teen and had to sneak off at my grandmother’s house to watch videos on MTV. Yanno, back when MTV actually showed videos.

You’ve been a source of solace for me in my dark times. I used one of your songs in a playlist of mine as I healed from my own bout of severe Postpartum OCD. The rhythm was just right and I liked the emotion it evoked within me.

But now?

I can’t do that.

Because you’ve said this.

In eight words, you have managed to completely undermine the seriousness of what I experienced. What millions of women experience every year. In eight words.

Do you see how easy it is to marginalize someone else’s experience? How easy it is to compare the hell that is a Perinatal Mood Disorder by saying you’ll go through the same thing as you watch other people perform your songs? While it may not be easy to see other people perform your art, I guarantee you that it is a hell of a lot easier than the depths of hell I and millions of other women witness as survivors and warriors in the trenches against PMADs.

We fight, Sting, for our fields of gold, fragile as we are. We fight because maybe, just maybe, tomorrow we’ll see a brand new day filled with hope. We don’t want to be the shadows in the rain, never coming home.

Please, think about what you are saying before you say it. Because when you do not think before you speak, you end up hurting people, minimizing their experiences, and comparing their hell to something which is not even close to their experience.

For now, I am gonna have to do the opposite of Rick Astley and give you up because you let me down.

Thoughts on Miriam in DC

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On October 3, 2013, Miriam Carey tragically lost her life Washington, DC. She was supposed to be in Connecticut, taking her daughter to a doctor’s appointment according to the myriad of articles I have read this morning.

They all seem to have the similar tone to them, these articles. That a woman tragically lost her life because she had Postpartum Depression.

Yet, medication recovered at her Stamford, CT, apartment would indicate that what was going on with Miriam went much deeper than Postpartum Depression.

A woman with Postpartum Depression does not simply break with reality and drive hundreds of miles out of her way to drive into barriers, lead police on a chase, and somehow end up dead, all with her infant daughter in the back seat.

The behaviour of Miriam Carey lends itself to the behaviour of a mother struggling with Postpartum Psychosis, the facts of which can be found at this page on Postpartum Support International’s site. According to this page, symptoms of Postpartum Psychosis can include:

  • Delusions or strange beliefs
  • Hallucinations (seeing or hearing things that aren’t there)
  • Feeling very irritated
  • Hyperactivity
  • Decreased need for or inability to sleep
  • Paranoia and suspiciousness
  • Rapid mood swings
  • Difficulty communicating at times

There are a number of symptoms on that list I have seen discussed this morning. Some of them match up with PPP.

The other things I have seen discussed this morning are heartbreaking. Folks judging Miriam for her actions. Saying she’s a monster. Wondering how she could possibly have driven her vehicle into the barriers and toward a hail of police bullets with her daughter in the back seat.

I have also seen some honest discussion about what it means to struggle with a mood disorder after the birth of a child and how it hurts whenever something like this happens. I feel as if I have been punched in the gut, to be honest. I want to fall to my knees and weep for what happened to Miriam. But instead, I am writing and I am reaching out to those in the community I founded to support women and families struggling with mood disorders after the birth of a child.

Why?

Because this kind of support, on a human level, helps quell the storm. It lets others know they are not alone and there is hope. We help each other find the way in the dark, particularly when a storm like this tragedy looms on our shores. You see, at one time or another, we have all been Miriam. We have had those thoughts, the scary ones about driving our cars into solid objects, about letting go, about just giving up and moving on toward that great white light. Some of us have almost touched that white light. WE KNOW the darkness which drove Miriam to Washington, D.C. intimately. We have sat with it on our shoulders, in our hearts, and felt it try to gain control of our heads. We, however, are the lucky ones because we are still here, fighting.

When the women of the Postpartum Support Community band together, it is a beautiful thing. We are some of the strongest women in the world and we refuse to stand down. In the spirit of standing strong, I will be participating in a Blog Carnival “For Miriam” on World Mental Health Day on October 10th. If you would like to join us, you can find more information here on the FB page.

For now, know that you are not alone, it is absolutely okay to reach out for help, and you are loved.

If you or a loved one are currently struggling with a Perinatal Mood & Anxiety Disorder, reach out to Postpartum Support International at their website or find me on Twitter @unxpctdblessing. There is also 24/7 support available via the hashtag #PPDChat and we have a closed FB group as well. You are never alone.