Category Archives: sleep

KevinMD guest post misses the mark about Mothers

This evening I happened upon a guest post over at KevinMD by Dr. Srini Pillay, MD, an author and an Assistant Clinical Professor at Harvard Medical School. KevinMD has been a site I read more and more these days. I enjoy the insight offered by his knowledgeable guests. Today’s post, however, has me shaking in anger.

Dr. Sirini Pillay’s post is entitled “What a psychiatrist learned in therapy sessions with mothers.” It’s also posted at Pillay’s other blog, Debunking Myths of the Mind under the title “I love my children but hate my life: Solutions to Dilemmas Mothers Face” with the subtitle of “A balm for all guilty mothers.”

(Please note: All text below in italics and bold is directly from Dr. Pillay’s article)

 

Dr. Pillay pontificates a few reasons for the psychological issues/stress mothers experience during their lives. With every one of them, his explanation (in my opinion) places even more guilt upon the already exhausted and stressed out mother rather than offer true solutions for her success as a mother. Perhaps most glaring  in his examination of the trials and tribulations of motherhood is the omission of any mention of a Postpartum Mood Disorder as the source for the points upon which he offers his expert insight. I find it impossible to believe, given the statistics of Postpartum Mood Disorders (1 in 8 new mothers), Dr. Pillay has never seen a mother with a Postpartum Mood Disorder or is unaware of the additional issues a Postpartum Mood Disorder brings to the dynamic of Motherhood, especially if said Postpartum Mood Disorder goes untreated. It is both appalling and irresponsible to me for a Psychiatrist to fail to mention such a glaring issue in the face of addressing issues faced by Mothers.

First up, Dr. Pillay mentions Perfectionism. “New mothers often expect to be perfect rather than the best that they can be,” Why does the mother expect to be perfect, Dr. Pillay? Is it because SHE has placed those ideals in her head? No. It is because society has placed these ideals in her head. We are absolutely expected to be pristinely Stepford in our execution in the assigned task of Motherhood while Fathers are expected (also unfairly) to be aloof idiots. What Dr. Pillay fails to mention is that those of us who are obsessive perfectionists are at a higher risk for developing a Postpartum Mood & Anxiety Disorder. What he fails to mention is that, in order to overcome this “Peril of Perfection” society must also change their view of Motherhood. Instead, Dr. Pillay perpetuates the stigma and tells Mothers “you can always strive to be better by making small changes. Holding yourself to a standard of perfection can lead to burnout in all areas of life, because you are constantly striving for something that does not exist.” I agree, Dr. Pillay. But the same society fails us when they perpetually hold us to a standard of perfection, for which when not reached, we are then automatically judged and crucified.

Next up, burnout. Burnout is a direct result of perfectionism. It’s also the direct relation of attempting to care for an infant while struggling with the depths of a Mood Disorder. Study after study has proven the adverse effect of Postpartum Mood Disorders on sleep. Have a Postpartum Mood Disorder? You won’t sleep as well when you do sleep. Sleeping less and lower quality of sleep are both symptoms of a Postpartum Mood Disorder. Yes, everyone knows new mothers don’t sleep much. But moms with a Postpartum Mood Disorder sleep even less and achieve a lower quality of sleep when we DO sleep. Another kicker? Our children sleep less and at a lower quality as well. So now you have an exhausted dyad attempting to live up to an impossibly high societal standard which is now even further out of our grasp. Need more ammunition here? We’re also told to snap out of it if we seek help. Stigmatized. Made to feel guilty. Not allowed to have the “time” to be depressed because by God we have an infant to raise which is what we were bred to do. Failure is not an option. So we stay silent, we suffer, we weep, we wail, we dry our eyes in the face of the public realm because we’re not allowed to have emotions other than those seen in Johnson & Johnson or Pamper’s commercials. Everything is to be picture perfect. If it’s not, we’ve failed. Dr. Pillay’s suggestion here? “So rather than force themselves to think and feel differently, addressing the burnout can help many problems all at once.” I would have loved to have addressed the issue of burnout. I attempted to address the issue of burnout with each one of my children. I asked for help. I begged for a night nurse from the pediatrician once our second daughter came home after nearly a month in the NICU after being born with a cleft palate. His response? “Why do you need a night nurse?” I had a toddler. Two dogs. A husband who worked 70+ hours a week. I was exclusively pumping every three hours and running a Kangaroo pump on the same schedule. I had to clean my daughter’s PEG site and jaw distraction sites a total of 4-6 times a day on TOP of everything else. Sleeping would have been a gift from the Gods. Yet I was denied and landed in a Psych Ward less than two months after my daughter’s birth through no fault of my own. No amount of forcing myself to think and feel differently would have helped. But I tried to address the burnout. That too, failed.

Now we move into “The best balance.” This paragraph’s opening sentence really captures judgment of mothers across the world: “When women feel overwhelmed, they essentially need to ask themselves why they expect something impossible from themselves.” Again, he’s absolutely right. Yet again, it’s society which has trained us to expect the impossible from ourselves. Dr. Pillay goes on to suggest “The reality is that if a woman has a need to work and have a baby, she needs to find a best balance that is right for her and her family.” Again, I agree. But if a woman has a Postpartum Mood & Anxiety disorder, she is already wracked with guilt. Attempting to find balance in her life is not achievable until she has begun to heal from her fragile mental state. A woman with a Postpartum Mood & Anxiety disorder can barely survive her day let alone find balance in her life until her mental health issues are addressed. Any health professional or anyone I knew mentioning to me all I needed to do to improve was to “find a best balance” in my life when I was in my darkest days would have heard an earful. We’re barely able to keep our own heads above the fray – how are we expected to balance too?

“There is no one-size-fits-all type of mother, and different types of mothering produce different positive and negative outcomes.” Amen. And yet, society expects Sally to parent like Suzie and Suzie to parent like Bethany and Bethany to parent like Rebecca and Rebecca to parent like Jody and Jody to parent like.. well.. you get my drift. It’s the whole Stepford thing. Again, society does not allow for this sort of flexibility. Mothers with Postpartum Mood Disorders parent far differently than any other mother on the planet. We realize the value of self-care because it’s necessary for our survival. For some of us, it’s necessary for our children’s survival. We are judged for how we parent. How we HAVE to parent. We are judged for expressing our frustrations, for choosing to formula feed, for choosing not to go the attachment parenting route, for letting our little ones watch TV because we’ve had a tough day. Yes, we heal from a Postpartum Mood Disorder but when you’re in the thick of it and family members or random people in public are judging us, we have a harder time letting it go and then BAM. Hello guilt. Hello Xanax. I love the idea, I love the theory of “no one -size-fits-all type of mother,” I do. But it doesn’t work in the real world and certainly doesn’t work when the public thinks of mothers with Postpartum Mood Disorders. A mother with a Postpartum Mood Disorder is a horrible mother to most – we’re stigmatized and in addition to overcoming the every day normal judgmental issues which accompany motherhood – we must also overcome the additional perception of our “bad mother” rep.

The final paragraph recognizes that “It’s not all you.” It’s not. It’s genes. It’s how our child is wired to react. But guess what? Kids of depressed parents are more at risk for issues like ADHD. They sleep less. Their quality of sleep is less. Dr. Pillay says, “Parents who take on all the responsibility of this often distort this, feeling as though they are fully responsible for how a child turns out.” Wait a second. Aren’t we? What about Parents who are arrested for the behavior of their children? Parents who are judged because their child isn’t yet sleeping through the night or wets the bed or isn’t getting good grades in school? Or Parents who have infants who are not yet eating solid foods even though they keep trying? Yet, Dr. Pillay’s solution is for PARENTS not to blame themselves when their child doesn’t “lean on their own sense of responsibility.” He also goes on to add this gem: “Also, mothers who are alarmed by their own mistakes set a challenging standard for their children who may grow up to learn that mistakes are “bad” rather than inevitable but not a reason to give up.” Let’s say a mother has a doctor for her Postpartum Mood Disorder who keeps telling her she’ll get better with every therapy they try. Instead, she continues to worsen. Eventually she’s convinced the fault lies within her. That SHE is the problem. Some of these mothers may even give up and just live out the rest of their lives without trying any more therapy because they are the issue, not the therapy. So of course she will raise a child to believe mistakes are bad as opposed to inevitable. Of course she will raise her child to believe once a mistake is made more than once that giving up is the proper course of action. Or even worse yet, let’s say mom doesn’t get treatment at all (which is the case with most mothers struggling with a Postpartum Mood Disorder, by the way), this issue will spill over into how she raises her child and no amount of pulling herself up by the boot straps will change her thinking. She’s leaned on her own distorted sense of responsibility and it didn’t work for her. Why should she then expect it to work for her child? Why would she not consider herself fully responsible for her child’s behavior when society does just that on a daily basis?

My absolute favorite part of Dr. Pillay’s piece is the closing paragraph:

“Thus, when mothers find their relationships thrown into disarray, they may want to re-examine their own standards and relax their judgments toward themselves as they allow themselves to be more human and the very best that they can be without needing to be perfect.”

Sighs.

If only society would let us, Dr. Pillay. If only society would let us.

I’d like to add though should a mother finds her relationships thrown into disarray, she should not immediately blame herself for the fault of the disarray. Yes, she may truly be at fault but the other party may be at fault. She may be struggling with a Perinatal Mood Disorder or another type of mental illness. There are many additional reasons for the fault of relationships to be at fault other than the internal (yet societal driven) standards imposed on Mothers today. Perfectionism is imposed, not perceived. Failure to achieve perfection is perceived yes, but the standards we fail to reach were, at some point, imposed upon us by society. If we truly want to help mothers overcome the perception of succeeding by not being perfect, we need to first change society’s view of mothers, not mother’s view of themselves. The standards we try to reach our not our own… they are the fences between which we are forced to live. Until these barriers are removed, we will never succeed.

Just Talkin’ Tuesday: Let’s talk about sleep

"Sleeping Like a Baby" by NoVa Hokie @ Flickr

The person who coined the phrase, “Sleep like a baby,” clearly never had one. Granted, when babies DO sleep, they are peaceful. For all of what seems like two seconds. And then bam. Right when you hit the couch, they’re up again. Diaper. Feed. Burp. Walk. Rock. Glare at the pile of laundry skulking off to Vegas and wondering how you can hitch a ride without anyone calling CPS. Yeah, I think we’ve all been there a time or two.

I remember the early days. Blurring together, feeling like I had just closed my eyes only to have hubs waking me to inform me of Babe’s infinitely empty stomach. But I JUST nursed! No, it was about two hours ago. What the… really? So I’d jump roll slowly creep out of bed as I cursed the boob monster responsible for ripping me from my nest.

Sleep. My best friend in college. The reason I had no classes before noon my senior year. The reason my last quarter of college only had me in one class well after noon and only twice a week. I mean, really. Whole days of sleeping in – who is going to begrudge you that in college?

Once the kids are in school, I tell myself, I will take the first day off. I will put all three of the children on a bus at 635 a.m. because that’s what time it gets here, I will smile and wave. And then? Then I will Irish Jig ALL the way up the damned driveway, happily skip into my bedroom, reset my alarm for 2pm, and close my eyes. Think I’m kidding? August 5, 2012. I.WILL.SPEND.THE.ENTIRE.DAY.IN.BED. It’s on my calendar.

They say you can’t catch up on sleep. Once you miss it, it’s gone. No sleeping in on the weekend will recapture the sleep you missed out on because Junior decided 345am was an awesome time to wake up and play with trains. Or because Princess decided that 213am was the new 7am. Nope, you’re so screwed out of that time. I don’t know that I believe that. I always feel better after sleeping in on a Saturday.

So let’s get to just talking – how are you sleeping? Falling asleep easy? Feel rested when you wake up? Or are you struggling to fall asleep? Waking up feeling like you never quite got the rest you should have in the hours you were sleeping? Or are you not sleeping at all? Sleep deprivation does feed into Postpartum Depression. And Postpartum Depression? Yeh, it decreases your quality of sleep. Lovely. Oh, the havoc of sleep deprivation!

I will say this – prior to becoming a parent, coffee was not my best friend. It is now my holy grail. For without it, I would never survive.

How do you survive your sleeping issues? What works for you? Any tips for moms with PPD currently struggling with sleep issues? Toss ’em out there into Comment Land. I’m sure there are some Moms in need of suggestions!

The havoc of sleep deprivation

Let’s face it – if Alice were a new mother, it wouldn’t have been a rabbit after which she tumbled down a dark hole. No, it would have been the spiraling mental anguish of a sheer lack of sleep due to the sudden presence of a very small creature unable to communicate in any other way but with a loud piercing shriek. The way I see it, Alice is walking through the daisy covered field, singing happily or humming a light-hearted tune and then WHAM! A loud shriek fills the air and down she tumbles, clawing at the sides of the dirt encased tunnel to keep from falling any further.

Sleep deprivation is a serious issue for anyone. But toss in a new mother with hormones bouncing in every direction topped off with a new little being to care for, and a zillion people babbling advice at her all at once, it’s enough to tip the scales in the wrong direction. To add to this negative balance, turns out Postpartum Depression can aggravate already impaired sleep quality.

According to the APA, a person who does not get enough sleep can experience issues with the following: apathy, slowed speech and flattened emotional responses, impaired memory and an inability to be novel or multitask. Hmmmm. Flattened emotional response? Impaired memory? (When DID I feed the baby last?) Multitask? (Ever tried to care for more than 1 kid at a time on next to no sleep? It’s not pretty people, not pretty at all!)

There are a few reasons you may not be getting decent sleep as a new mom. Depression is one of them. Two other conditions that can wreak havoc with your sleep are Thyroiditis and Anemia. Both of these conditions can leave you exhausted even if you are sleeping the required 6-8 hours a night. Be sure to ask your doctor to screen for both. It’s a simple blood test. The results will make a world of difference if  positive. Anti-depressants will not treat thyroiditis or Anemia. You’ll need a different approach altogether. Treatment for thyroiditis or anemia may include hormonal or iron therapy to get things moving in the right direction.

It’s been almost two years since I have been  a brand new mom but recently I received a stark reminder of what sleep deprivation will do to someone.

Our oldest daughter has been sick repeatedly since January. The most recent bout really took it out of me. One evening, I gathered fresh sheets to make up one of the kid’s beds. I carried them straight into the living room and almost made up the space heater instead. Thankfully I realized what I was about to do and turned myself around before placing sheets on the heater.  I was shocked I had let myself get to that point. I remember when the kids were still nursing. I’d finish up nursing them, crawl into bed, only to be woken up by my husband in what seemed just five minutes later to nurse again. With just one kid, it was easy to recover during the day. Recovering from the same scenario with two toddlers and a newborn who just doesn’t want to quit is even harder. Lack of sleep is a debt which adds up quickly. According to recent research, sleep loss is not something we can ever make up. That’s right – sleeping in on the weekends doesn’t really help.

As mothers, we often forget to mother the most important person in our lives – OURSELVES. If we are not healthy, we are then not able to take care of those around us. If we cannot take care of those around us, they become grumpy, unhappy, and unhealthy, giving birth to a very vicious circle which is difficult to escape. However, if we take care of ourselves by making sure we eat right, sleep right, exercise, and feed our souls, those around us will be happier and our kids will have a positive role model on which to base their own behavior.

I know telling a new mother to simply get some rest is so much easier said than done. Talk with your support people prior to delivery. Make sure that sleep is high on the list. First, actually. Before the dishes, before laundry, before anything. In fact, British researchers recently concluded that women need 20 more minutes of sleep than their male counterparts. Why? Because we do more “jobs” with our minds. For instance, right now? I’m blogging, researching, listening to the movie my kids are watching, keeping up with where my kids are in the room (on the couch relaxing right now, thank goodness!), praying the trash truck doesn’t set off too much of a barking event with the dogs, and thinking about what I’m going to make for dinner. I’m also reminding myself about several tasks I need to complete today. Women, by nature, are multi-taskers. Our minds race ahead of themselves at a very fast pace all day long. The extra 20 minutes of sleep allows our minds to rest just enough to be able to get up and do it all over again the next day.

A new mom is struggling to figure out how she’ll get the chores done, feed the baby, soothe the baby, get a shower, breathe, cook, and fit everything else she used to do into her now controlled by a tiny creature life. It’s not easy. Eventually routine happens. One little thing at a time.

Start small. In the morning, make yourself a cup of tea. Sure, it’s not the dishes, but it’s for YOU. If you’re nursing, the more relaxed you are, the easier it will be for your child to get your breast milk flowing. Then, when you are done, take a few seconds to clean your tea cup/mug/glass. See? One dish done. My great-great grandmother once shared a piece of advice with my mother she never forgot and then thankfully passed down to me. If you’re in a room doing something, take a few seconds to clean. In the bathroom? Clean the sink. Heading to the kitchen? Take any dirty dishes with you and rinse them out if needed. If you get in the habit of cleaning up after yourself bit by bit, there is no large task looming ahead of you. Just tiny little ones here and there. And this is how developing a routine begins. It may not happen overnight, but it will happen. And once it does, I bet some of the anxiety about housework fades and your sleep starts to improve.

Going back to the topic of sleep, it’s important to develop a routine there. In the first few weeks after giving birth it will be hard to have a dedicated routine and frankly, you’ll probably be asleep before your head even hits the pillow when you have a chance to clamber (ok, race) to bed. But once you’re through the first few weeks and baby starts to sleep better, start with just one activity to initiate your bedtime. Some common things to do are: read a book, take a shower or hot bath, drink soothing tea (not caffeinated is important here!), warm milk, a favorite TV show, pray or meditate. As time moves on you can combine these things – take a shower, read a book and have some soothing tea. Or watch a TV show and drink some warm milk.

Napping has also been shown to help with mental acuity. Albert Einstein and Thomas Edison allegedly never slept for long periods of time. They napped here and there. A fifteen to twenty minute power nap can do amazing things. Recent research showed that people who took a 90 minute power nap after lunch scored up to 10 percent higher on a cognitive test than those who did not. Stages of sleep affect our body and minds differently. To understand the different stages a bit better, check out this piece by Diana L. Walcutt, Ph.D at Psych Central.

You must sleep sometime between lunch and dinner, and no halfway measures. Take off your clothes and get into bed. That’s what I always do. Don’t think you will be doing less work because you sleep during the day. That’s a foolish notion held by people who have no imaginations. You will be able to accomplish more. You get two days in one — well, at least one and a half.”

~Winston Churchill~

The keys to recovering a good night’s sleep after giving birth to a baby is to slowly incorporate routine back into your life, asking for help and support, and remembering to Mother the most important person in the house. YOURSELF.

Just Talkin’ Tuesday 06.30.09

With last week’s debut so full of seriousness, I thought it’d be best to balance things out a bit with a lighter topic.

Sleep!

sleeping mamaAs parents, we all know how meaningful sleep can be – it’s precious lifeblood which lets us function – and when we don’t get it, World watch out! Unfortunately, those of us who struggle with a Postpartum Mood Disorder on top of the common parental experience of dazed consciousness are really in trouble. You see, it’s been proven over and over in research that sleep has something to do with our psyche. And guess what – lack of sleep can exacerbate symptoms of Postpartum Mood or Anxiety Disorders! Great, you say? Yeah, well, that was my reaction too when I first read the research. I mean, really, why did they even bother researching this topic? Isn’t it common knowledge? BUT… they did research it… and now we have something concrete to point to when our beloved partners are befuddled at our new-found obsession with sleep.

So here’s today’s topic:

Share with us what effect (if any) sleepless nights had on your Postpartum Experience. Did you sleep? Did you not sleep? When you woke up, were you rested or did you wish you could go back to sleep? What strategies did you use to help regulate your sleep? Did you read? Watch TV? Play on the Internet?

Here are some basic suggestions for those who are STILL struggling with sleep.

Get into a routine. At a certain point in the evening (if you can – we all know how unpredictable babies can be!), start a certain chain of events that will lead to you crawling er, collapsing into bed.

Once in bed, if you lay there awake, GET back up and go somewhere else. Watch TV or read for 30 minutes. Bathe, shower, drink some hot milk. Then get back in bed. Don’t stay in bed if you’re awake. This will cause you not to associate bed with just sleep. (which completely defeats the purpose!)

Have your partner take a night feeding and let you sleep for at least 5-6 hours at night. (Even if you’re nursing DO this – and have your partner get baby ready for nursing by changing diaper, etc, so you can get a few extra minutes!)

Remember – if you are not sleeping and/or have difficulty sleeping for more than a week, call your doctor. This is not the time to hold off on getting relief!

You can read more at this website about sleep disorders and difficulties.

Sharing the Journey with Diane Ashton

Diane Ashton is the PSI Co-Coordinator for the state of Hawaii. Sasha Williams serves as the other Coordinator for the state of Hawaii. Diane is awesome. I’ve really gotten to know her via email and facebook (we’re both on Facebook WAY more than we should be). Diane is funny, honest, and a wonderful woman. I am thrilled she agreed to a very last minute interview (sorry diane! but thanks!) To learn more about the support Diane offers in Hawaii, visit her website, PPD Support Hawaii. Now here’s Diane’s story in her own words.

Tell us about Diane. Who is she when she’s not providing support to women with PPD?

Hi Lauren!  It’s kind of funny how self-identified with postpartum issues a person can become!  I know I’m singing to the choir here to say that PPD advocates are a passionate bunch!  Along with my obsession, avocation, I am the mom to two older children–they’re 15 & 20 now, although I have no idea how they grew up so fast.  You know how that is.  And all my cherished skills I learned from and with the two of them. We grew up together, in many ways. We’re all a bunch of computer nuts, and are sitting in a 10 x 10 room on our own computers right this minute.  It’s more fun than housework.


You’ve experienced PPD and describe it at the PSI website as a mystery/horror movie. Share with us your journey through this strange place.

It’s been over 14 years, so I tend to be a bit removed from the experience now.  Maybe that’s encouraging to moms going through it now–knowing that eventually PPD won’t feel like something you live and breathe every. single. day.  Why I described it as a mystery/horror movie was that, even though I’d probably been depressed in the past, I’d never been to the depths like I was with PPD.  I’d also never been so sleep deprived.  It was a sleep deprivation due to depression, not because my kids weren’t sleeping through the night.  They were.  I was too anxious to sleep; it was that kind of anxious/depression.  And that was part of why it made it so hard to figure out what was going on with me.  I didn’t feel “depressed”.  I felt, like so many other moms have described, like I was “going crazy”.  It was a mystery to me what was wrong.  With all that came intrusive thoughts that were very gory.  And they weren’t thoughts so much as very vivid images.  They scared me and made me think someone would take my kids away from me, and me away from society forever–pretty much a horror.

What made you realize your moods after giving birth were not quite right? How were you treated when you sought help?

I…actually, …I waited until my daughter was around eight months old before I started sliding into that PPD pit.  It was partly due to her big brother going off to kindergarten with all his little friends we’d seen every week for …4+ years.  But kindergarten is somehow a big shift anyway, and can put moms off-balance for a bit.  Or maybe it’s just us moms who’ve been on the PPD ride are more sensitive to changes.  Anyway, by mid-October (6, 7 weeks into kindergarten) I was losing it.  But no way was I admitting to it.  Although I tried to look stuff up (1994–not much of an internet to surf then) I couldn’t find anything that described what I was experiencing.

Finally my husband took me for “a Sunday drive” to the ER, where they kept and observed me for a while.  I stayed at the hospital for a bit and, well, my peers there were very interesting.  The main thing was though that I finally got on a medication (Zoloft) and it started working.  I began to feel a lot like myself again within a couple of weeks.


How did your family help you during this difficult time?

They were great.  My in-laws had dd while I was in the hospital.  Dh had ds at home, and took him to school each day.  Afterwards, I stayed with my in-laws for more support and to get up to some kind of speed again.  There were other times they stepped in in BIG ways over the next year too–I don’t know what we would have done without them.


Name three things that made you laugh today.

  • A video the kids pointed me to, on youtube had us all cracking up.  A bit on the potty humor side, but we laughed.
  • Talking with a couple of my girlfriends about calling, texting, to American Idol–like we’re a bunch of tweenagers–how many phones each person uses to vote.
  • Swapping stories with my fellow former classmates tonight at dinner.
What do you find the most challenging about parenting? The least?

Still occasionally wondering if we bonded well, if I messed the kids up for life, etc.  But I imagine other moms who didn’t go through PPD wonder this as well.  Also challenging… the age of 13.  EEYuh…challenging.  The least challenging–the easiest–is loving my beautiful, vibrant kids every day!


As fellow PSI Coordinators, we’ve had the concept of self-care proven to us time and again. What do YOU do for yourself that is not a need and soothes your soul?

The beach soothes me.  Body boarding especially, but just getting in the ocean water balances me in emotional and visceral ways.

You work with women struggling with PPD all the time. Tell us a bit about what made you decide to turn your experience into advocacy and support. How empowering is it to do what you do?

It is partly because I didn’t get the name for the exciting journey I had until five or so years later–Oprah had Marie Osmond on, talking about her book about some illness called “postpartum depression”.  I sat there pointing at the TV again and again. “That was ME! That was ME!!”  I finally had a name for it.  I Googled and found online information and bulletin boards where I then made myself at home.  It was because I could find nothing here to help with PPD, and with my experience on the boards that I decided to become an Area Coordinator with Postpartum Support International.  Might as well make some lemonade from the PPD lemons.

How empowering is doing what I do?  What I’ve done for 5 years now is telephone support, email support, a weekly support group, and some speaking.  –the support calls, email and the group empower the parents and are validating for both of us.  Speaking to groups still feels empowering; our recovered moms/volunteers get a chance to speak at various events. I remember my first time too–it was empowering.  People, providers, wanted to know what it is like, what could be done, how would you know.  And they listened.  There’s a threshold you cross when you speak publicly about your experience.  What a great question Lauren.  I have to tell my therapist how much it meant to me that she asked me to speak a number of times. It allowed me to step out of my shame and into myself.


Now that your children are older, have you spoken with them about your experience? If so, how did they handle the information? How do they feel about your current work with women?

They are around when I’ve been on phone calls with moms or providers, so they do hear my end of conversations occasionally.  It’s just a part of our lives.  I weave information in to our conversations when opportunities arrive, much like I have with sex education.  Dd just had one of those “pretend baby” exercises where she had to care for a hard-boiled egg for 2 weeks as if it were her baby.  Of course I wove in some PPD talk!


Last but not least, let’s say you have an opportunity to speak with an expectant mother (new or experienced) about Postpartum Mood Disorders. What would your advice be?

It would really depend on the situation.  I used to be tempted to pass out information to every new parent I saw, just so they could avoid the journey I endured.  Barring accosting new parents in the grocery aisles, what I would say though is that you’re not alone if you have a PMD, they are very treatable, they are not your fault and that honestly, I found a gift in my experience, eventually.  Maybe it was my biggest experience of “whatever doesn’t kill you outright makes you stronger.”  And in the case of PPD, as many mothers say, it loosens your judgments, revealing compassion.

Aloha!

Sleep patterns of infants with depressed Mothers differs

"sleep like a baby" by peasap @ flickr

"sleep like a baby" by peasap @ flickr

According to a study published today in the May 1 issue of the journal SLEEP, the patterns of sleep differ depending on Mom’s depression or lack there of. The overall amount of sleep seems to be the same but infants with non-depressed mothers sleep longer at night (up to 97 minutes to be precise) and also seem to sleep for longer periods during the day.

Infants of depressed moms seem to wake more often .

Researchers hypothesize that this is related to the stress hormone, cortisol. When mom is pregnant and stressed, more cortisol crosses the placenta. And if you’re depressed postpartum, that plays a role as well.

Now before you freak out and think that your child’s sleep patterns are wrecked for life here, the lead author, Roseanne Armitage, MD, has news for you. The “damage” may be reversible.

“We do think that we could develop a behavioral and environmental intervention to improve entrainment of sleep and circadian rhythms in the high risk infants,” said Armitage. “However, whether it is maternal hormones that “cause” the sleep problems in infants is not yet known. It could genetic, hormonal, or both. Regardless of the cause, they may still be modifiable since brain regulation is very plastic and responsive in childhood.”

If you’d like to read more about this study, click here.

Now, breathe a little sigh of relief. See? the fact that baby isn’t sleeping ISN’T because you’re not doing something right or wrong. It’s not because there’s something wrong with your baby. It’s hormonal. Totally out of your control. I don’t know about you, but I am always able to put things into a better perspective when I understand the explanation behind them.

Frankly, this explains a LOT.

It explains why my first daughter never wanted to sleep for very long and why she wouldn’t sleep a lot at night. It also explains why our second daughter did the same thing. And last but not least, because I did not have PPD with our third, it explains why he’s such an amazing sleeper and has been from the start. Thank GOD it wasn’t me (or baby)! Phew!

What a week!

Monday was Charlotte’s cleft repair, pharyngoplasty surgery, and ear tubes.

Tuesday morning she got the nasal tube they put in to aid in breathing removed. Then she ate. And ate some more. And drank.

So we were discharged Tuesday afternoon.

She stopped eating Wednesday morning. Stopped talking by the middle of the day. She was also refusing all medication and foods.

We were instructed to return to the hospital.

So we did.

And there we stayed until yesterday morning when her appetite and fluid intake finally picked up enough to make me feel comfortable with bringing her back home.

Our stay was riddled with issues.

The first issue was failure to get written consent for her ear tube surgery. The surgeon took the time to track down where the breakdown in communication happened and did apologize to us but then just a few sentences later admitted that post-consent happens quite a bit in her practice with her adults. Yeah. We’re SO not going back to see her.

Second issue arose during our return to the hospital. The ER had a hard time getting ahold of Charlotte’s doctor to approve admission even though we had been instructed to return by them. We arrived at the ER at 830p but did not get a room until nearly 2a Thursday morning.

Third issue was our day nurse on Thursday. She was a bit flighty and had a propensity for over-explaining things and failed to be prompt in her attention to us. My daughter’s med pump went off repeatedly as did her fluid pump with no response from her whatsoever. She was apologetic and spent some time trying to kiss Charlotte’s behind but I had the nurse replaced. It’s not my kid you have to impress, lady.

Fourth and fifth issue happened on Friday.

Fourth: A tech walked into our room and asked if I wanted to give Charlotte a bath. I said that I did. So she got everything ready and decided we needed to give Charlotte a sponge bath in bed. We had Charlotte lean back over a bowl of water and wiped her hair down. The tech realized she didn’t have water to rinse with so she went and got some while I tried to keep Charlotte calm and still. The tech returned with the water and began to pour it on Charlotte’s head. Charlotte screamed. I reached up and felt the water. It was absolutely scalding. I immediately told the tech to stop and get out of our room. The water she had gotten was entirely too hot! She acted surprised and I had to ask her several times to leave the room. I asked our nurse to make sure she was not allowed back in our room. I didn’t see her again during our stay.

Fifth: At about 1p the phone in our room rang. I answered. It was a prank call. I hung up. They of course, redialed. I was very unsettled (they said horribly mean and rude things to me) and called our nurse. He came right away and handled the situation beautifully. Unplugged our phone and had our phone number changed. A report was filed.

I don’t tell you all of this to complain. I’m telling you all of this to stand strong. I got flustered only twice during our stays. The first was immediately after surgery when we had to hold Charlotte down as the anestethia worked its way out of her system. She was angry, confused, and frustrated. Kept pulling at her IV, her nose, and wanted to be done with all of the pain. I admit that I cried. It took four hours for her to finally calm down.

The second time was when we got prank called. I was very very scared. I didn’t know if it was someone from inside the hospital or outside. I felt very vulnerable and afraid. I even had a plan in place if someone we did not know were to burst into our room. But nothing came of it and I was able to get back to sleep within the hour.

I am glad this past week is behind us.

On a positive note, Charlotte’s speech is ALREADY improved. She’s saying words that we can now understand a lot more often. There are sounds she struggled with before that she is now making with seemingly no effort. We still have quite a bit of work ahead of us but for now, we’re miles away from where we were this time last week.

Last night was rough but I have hopes tonight won’t be as bad. I think she’s got some night terrors and trauma residuals going on as a result of spending the week at the hospital. Teething tablets and a night light finally helped her go to sleep on her own last night but she spent the bulk of the evening in the living room with me. We’re going to have her return to school so her mind will have other things to focus on as well to help leave the memories of this past week behind.

Sharing the Journey with Tara Mock

Tara has been a true source of inspiration for me through my advocacy journey. Her strength, faith, and dedication to supporting other women has made me examine my own work and my increasing awareness of the role my faith and God held in my experience with Postpartum OCD and my subsequent passion for advocacy. I often refer women to her website when they are in need of faith-based support. I’ve thoroughly enjoyed getting to know her and have connected with another wonderful Christian PPD supporter – Sue McRoberts – through Tara. Thank you, Tara for all you do for Moms who are still on that dark path. Thank you for showing them the way Out of the Valley.

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Share a little bit of yourself with us. Who IS Tara Mock as a woman?

I am a formerly-shy-now-outspoken woman who loves Jesus dearly, my husband 0428whole-heartedly, and my children with everything I have.  I am a pianist and an avid reader.  I can have a sarcastic sense of humor, but I love to laugh and believe the best memories are those with lots of laughter and smiles.  I hate pickles with a deep and abiding passion, but will eat chocolate with anything.  I love to have dinner and/or coffee (I prefer hot chocolate) with my girlfriends.  They are so precious to me, so encouraging and wise, and as a mom of young children, I love that.  I’m not sure what I would do without them!

You’ve walked the dark path of Postpartum Depression. Share with us what that was like.

In one word –  horrid.  I would not wish what I went through on my worst enemies. PPD hit me hard and fast in the week after my son’s birth.  I was in a lot of physical pain to begin with and then my emotions began to snowball, running the gamut:  sadness, anger, apathy, despair, hopelessness, frustration, to eventually suicidal.  That terrified me and it was then, and through the encouragement of my pastor’s wife, that I told my doctor.  Even after that, those crisis days were not over and I still had another couple of weeks to trudge through – including a hospitalization, suicide watch, meds, 24-hour care by a nurse-friend, and lots of sleep.  In the subsequent days and weeks and months, I gradually learned how to care for my son and gain new confidence as a mother, with my eyes towards hope for the future. There were good days and there were bad days, but when the good started outnumbering the bad, I knew I was getting better.  It was about nine or ten months from the time of his birth before I really felt like I had my feet on solid ground and out of that valley.
How did your faith affect your experience and recovery?

Greatly.  My Christian faith is who I am, but with this experience I initially felt like I had been “kicked while down.”  We had gone through infertility treatments to even conceive this baby, my husband had been laid off on the very day we found out I was pregnant, and I was very angry that PPD was happening to me after all that.  I repeatedly asked God “Why?  Isn’t it enough what I’ve been through already?”  But I learned that I also could not get through it without Him.  I clung to encouraging Scriptures with everything I had, even taping them on note cards around my house.   Unfortunately, there were Christian friends who said well-meaning but hurtful things (pray more, just be grateful, etc.), but working past that and learning what the Bible really says helped me grow so much.  I hated going through PPD, but I can also say that I am grateful for the experience and for who it made me today.  (Please know that it is ok if you do not feel the same way!)
At what point did you decide to become an advocate and source of support for other women who are struggling with a Postpartum Mood Disorder?

There were a series of events that solidified my resolve to become an advocate for women going through what I went through.  First, on my first Mother’s Day, the one I had longed for for quite a few years, I went to a local bookstore to purchase Brooke Shields’ new book, Down Came the Rain – it had just been released.  The lady behind the counter started commenting on my son, mentioned she had a baby the same age then started to tell me how she could not understand how anyone who had had a baby could be sad.  I was stunned.  Here I was purchasing a book about PPD and she could not put two and two together that I might be hurting?  I mumbled something about that it had happened to me and thankyouverymuchgoodbye.  I cried all the way home.   (Not to worry, I went back the next day and spoke with the manager about that employee.)  Second, the argument between Brooke Shields and Tom Cruise was a highlight in the news sometime around then and I was angry at the sheer ignorance that some people had about this illness as well as the fact that this Hollywood figure was spreading so much misinformation.  Third, I was part of an online Christian group and some lady (or two, I do not recall) had a discussion about the Brooke Shields book and began degrading her and what she went through.  I took it very personally because I was going through it as well – and these were fellow Christians.  Ouch!  The misinformation out there was stunning – I had just encountered it three times in a short time span.  I decided then and there to not be ashamed of my story, to share it and not hide it, and to encourage other women also sick with PPD.  That was the beginning….  I then began to search for Christian resources for this illness and at the time, there were none.  (Now, there are a few and the number is growing quite quickly, yea!!!)  After my son’s first birthday, I felt led to fill the gap – to provide a non-denominational Christian ministry for women, their families, and churches to know how to deal with Postpartum Mood Disorders.  Thus was born the (currently) online ministry, Out of the Valley Ministries, Inc.

You have two beautiful children. Did you experience PPD with both? If not, what do you think made the difference?

Thank you!  With my daughter, I experienced a small amount of anxiety, but overall the experience was remarkably better with no real recurrence of PPD.  We planned very, very carefully for her birth.  The planning itself was therapy, helping me feel like I had some control, whereas I felt I had none when I had PPD with my son. Medications were discussed with my doctor.  I had a therapist I could call if needed.  I had a schedule of family and friends to be here with me for at least six weeks.  My husband was insistent that sleep be my first priority (sleep deprivation being a huge trigger for me) and he was so wonderful in making sure that I got that.  I had a self-care plan in place for my return home to minimize anxiety.  I had the same doctor as I did for my son’s birth and amazingly, the same nurse who was there for our childbirth education classes, my son’s delivery, and who cared for me when I had PPD  – she was standing there when I walked into the birth center in labor with my daughter.  What a blessing!! She knew me and exactly how to take care of me.  As much as I had it under control, that told me that God had it in His hands as well.  I believe prayer and the pro-active approach we took to minimize/prevent a recurrence of PPD was really key.
Self-care is of the utmost importance on this road called Motherhood. What do you do to make sure you are taken care of on a daily basis?

Not enough! I make sure to always put the kids in their rooms for quiet time/nap time in the middle of the day – whether they sleep or play.  This gives me the mental break and quiet moment I need to get through the rest of the day. I treat myself to a cup of tea and either a book, my favorite blogs, or catch up on a favorite TV show. The days that I am able to have a quiet moment to read my Bible and pray are definitely my better days, but doing that consistently, especially when kids like to get up at 6am is difficult!   Staying in touch with the rest of the world is important for me as well – the internet is a wonderful thing to a mom with young children!  Being a pianist, music is ingrained in my soul.  If things are getting stressful around here, I know I can put on some music and my mood can change that quickly.  I love that!
List three things that made you laugh today.

Ah, great question!  I laughed when my son came up to me and said, “I love you wotsa-wotsa-wotsa-wotsa!”  (Translation:  I love you lots and lots and lots and lots!)   And my little girl makes me laugh all the time – especially when she grins and says “I did it!” for something she shouldn’t have done.  I have to hide my laugh then!
What have you found to be the most challenging about parenting? The least challenging?

The least challenging?  When the kids are actually asleep.  The most challenging?  When they are awake.  Some days we just have no idea how to handle this or that behavior, and other days we are just amazed at what great kids they are.
Tell us a little about Out of The Valley and how it has continued to grow. When you started out, did you envision it growing as much as it has?

Out of the Valley Ministries is primarily an online ministry – I share articles and Scriptures to encourage ladies who are hurting, help churches and loved ones help those who are sick, as well as list a wealth of resources.  On my blog, I try to list practical self-care tips, include music that encouraged me, and write devotional-type pieces to encourage the hurting mom, and have recently begun to feature stories and testimonies of survivors.  Periodically, I may share my story on the blog or other information that is of the utmost importance in the PPD world.  Yours (Sharing the Journey) and Katherine Stone’s (Postpartum Progress) among others do such a great job at keeping us updated on the news that I feel no need to duplicate the information, but to rather write from a self-care perspective.  That growth has come as I have learned about and gotten to know the many wonderful people advocating for postpartum mood disorders, as well as gotten better at managing my website and finding a niche that fits me as a person.  I love seeing how God has used this ministry to touch women’s lives – and women that I had no idea that it helped until recently.  That blesses my socks off!  It made what I went through worth every second.
And last but not least, if you had the opportunity to share one piece of advice about PMD’s with an expectant mother, (new or experienced), what would you tell them?

Just one?  Gosh, Lauren, you know how to ask the hard questions!  Some days you will need to take it one breath at a time, and others five minutes at a time, but eventually the whole day will be beautiful and full of hope.  You WILL walk out of this valley, and know that God is with you the entire time!

Sharing the Journey with Michael Puline

A couple of weeks ago, we shared the journey with Amber Koter-Puline. Today we’ll get her husband’s point of view. It’s important to include dad in the postpartum experience because his support is invaluable to recovery. I want to thank Michael from the depths of my heart for sharing his story so openly and for supporting Amber so wonderfully during such a difficult experience. I hope this provides invaluable insight for new or expecting fathers who may either find themselves in a similar situation or know someone who is already there.

What makes you tick? Tell us a little bit about who you are!

I enjoy business – specifically the retail real estate business.  I enjoy all aspects of my business.  I spend a good portion of my time dedicated to being successful in my work so that I can provide for my family.  I also enjoy spending time training Gracie jiu jitsu; its something that I have always wanted to get into before but didn’t have the opportunity.  When we moved to Atlanta and I found a place to train and I immediately began.  I am a morning person!  I like to get up very early before others to accomplish things.  I am generally waiting for the gym to open at 4:45am when I arrive.   Sometimes they let us in early.  On nights that I am not at jiu jitsu, I play the guitar and enjoy spending time with my family.

You’ve walked the dark path of Postpartum Depression with your wife. Share with us what it was like to watch the woman you loved seemingly slip away into a dark shell.

It was awful.  I saw a highly motivated and capable person become so helpless and undergo such a radical change.  It is almost as if you no longer know the person.  They are someone else.  It was very difficult for me because I didn’t really believe it was happening.  I thought that it would go away on its own.  But, when Amber came to me and recognized that she was in need of professional help I knew that it was serious.  It was  very difficult to deal with.  I had to change my work schedule and Amber had to even come with me to work some days.  It was almost as if she had regressed mentally to a 4 year old.  She had to be at my side almost 24-7.  You can’t believe it until you experience it.

How did your faith support you through Amber’s recovery?

It helped in many ways.  One of the biggest was seeing the outpouring of help from our church community.  Even people who we did not expect to come through for us came and truly tried to make a difference in our lives and help us with this difficult situation.  As a result of having gone through this, my faith has grown stronger and I can now see why God chose this to happen to my wife.

What has it been like to see your wife take something so painful and turn it into such a point of strength and grace?

It has been really nice. I know she enjoys it. Anytime you go through a challenge and are able to transform it into a positive aspect of others lives I believe it is the ultimate blessing you can receive.  Amber has done this.  She has put her heart and soul into a blog, website, communicating with others, and constantly trying to reach out and help others. It is very commendable. I love her for it. It feels really good to know that she wants to help others. She took the situation, transformed it, and is giving it back to God by helping others. It’s the only way to live.

Did PPD affect your marriage? If so, how?

Yes, in many ways. It has changed our plans for future children (we had previously wanted a larger family.) We had to change our schedules and had to change the dynamics of our child-rearing than we had previously planned. You see, Amber and I had initially thought about having several children, however when she went through such a severe PPMD it really changed her desire and made her feel as if she could never handle more than one child, as she could barely physically and emotionally handle this one. As she had continued to get better, I believe her opinion continues to change slightly. For the first 3 or 4 months I had to do the lion’s share of the night-time wakings, because she needed to rest. At first I think I resented her for it, but now I think it helped me to build an irreplaceable bond with my son. While it was difficult at the time, I am very much thankful for the opportunity to do that because the benefits clearly outweigh the sacrifice I made. Hey, whats a few hours sleep for a guy who gets up at 4:30am anyways? I think as a result we take specific time in our day to better ourselves- praying together, reading and discussing books together, etc. We truly want each other to grow and develop everyday as individuals and parents. We are much more committed to each other. Not just to having our marriage be ok or something we endure, but to flourish. It also changed how we now interact. We have a different relationship. It’s much stronger.
Fathers need to remember not to lose themselves in the process of parenting. What is it that you do to just hang out and be a “guy”?

Jiu Jitsu.  I train.  For me, jiu jitsu offers me the opportunity to escape.  Going to the gym is similar, but jiu jitsu provides me the one on one competition that drives me to do better every day.  I think one of the reasons I like it so much is that I wrestled as a child.  I always enjoyed wrestling and jiu jitsu is similar, but you wear a gi instead and the object is to submit an opponent vs. pin them.  Outside of that, I really like to watch football.  College, NFL, it doesn’t matter!  My wife will watch “our teams,” but can’t understand at all why I would watch other games.  For me, this is how I relax…sitting on the couch or in my chair, with a cold beer Sweetwater 420 (shameless local beer plug!) in my hand.  That’s my release.

3 things that made me laugh…

Telling others a story about how a rock hit my windshield.
My son saying “mango” as one of his first words.
Remembering when my wife saw a coyote walking down the middle of our street when she had PPD.  I asked her if it was real.  She replied, “I am crazy, but not THAT crazy!”  The next day we got a notice about a neighborhood coyote spotting.  :)

What do you find the most and least challenging about fatherhood?

Having patience with my son has been challenging.  I sell things…I am a salesman.  I have absolutely NO patience for anything and I don’t care to.  For me, patience was not important at all.  But now, with my son, I start to realize that there are times where it is needed.  I think that because my love for him is so strong I am able to be more patient and give him the attention that he needs.

I think just having fun with my son comes easily and naturally to me.  Ball, guitar, piano, wrestling, etc.  If there is one thing that I know how to do, it’s how to have fun!  I have spent my whole life enjoying every moment.  Get the fullest out of life.  I want to look back and say I wouldn’t have done anything differently.  It’s the only way to live.

Amber’s PPD Support means…

Alot to me because it means a lot to her.  I think it is important to her.  It helps her grow as a person and move past this terrible part of her life that occurred.

Advice…

This is REAL.  It can happen to anyone.  Don’t feel badly.  Don’t try to hide it.  Don’t ignore it.  Seek professional help right away.  Be more proactive in finding out how your spouse is feeling postpartum.  Ask her- Are you feeling overwhelmed?  Are you feeling depressed?  Can we go for a walk and talk?  Observe her.  Is she getting enough rest?  She is human, too.  She needs more than 2 hours of sleep a day.  Is she getting it?  You are much better off taking the necessary time off in the beginning to try to avoid a PPMD getting worse than to let it evolve untreated.  It will get worse before better.  In closing you’ll note that in the beginning it may be harder to detect, but easier to cure.  While left untreated, it will become VERY apparent and much more difficult to cure.  My suggestion is to be proactive.  It really can happen to your family.

Two Hours to finish a Smoothie?

My attempt at hiding Alli’s medicine in a smoothie failed miserably.

It took nearly two hours for her to finish the thing and if I had recorded the sounds she was making the entire time, you’d expect me to be announcing the birth of a child after it was all over. Seriously!

What the heck is going on here??? Why won’t my kid take her medicine? Chris says it’s because she’s got his discerning palate which means she’ll be a chef someday. I don’t care about someday, I told him. All I care about is that she take her medicine now so she can go back to school.

I just got off the phone with a very unfortunate nurse at my pediatrician’s office who’s first suggestion was to hid the medicine in some yogurt or pudding. Were you NOT listening to what I just told you about the friggin smoothie???  The medicine was hidden in blended layers of frozen blueberries, yogurt, banana, and blueberry juice. AND SHE KNEW IT WAS THERE!!!! Then the nurse brilliantly told me to hide it in some Sunny D. Listen here sweetheart, my kid’s got strep. I’m not giving her something as acidic as Sunny D. Correct me if I’m wrong but I believe that’d be a bit like rubbing salt in an open wound. And then Brilliant Nurse Idiot suggested I not let Alli see me put the medicine in whatever I’m hiding it in. Really? Oh My God. Thank YOU for that brilliant tip. I HADN’T THOUGHT OF THAT ONE!!!! The pediatrician is supposed to call me back. I think I got a bit too belligerent on the phone but I’m at my wit’s end, can ya blame me?

I want to go curl up in our bed and go to sleep.  I think I will right after the ped calls me back.

Anyone have a tracking number for that Cuervo?