Category Archives: Therapy

Tips on Identifying Reliable Health Information on the Internet

If you’ve landed here as a result of a Google, Yahoo,  Bing, or other search engine, you already know how many results you can get in mere seconds and even sometimes nano-seconds. Thousands! So you wade through the results hoping for reliable and trustworthy information. Unfortunately, not everything out there is reliable and trustworthy. And even if it is reliable and trustworthy, you should ALWAYS check with a professional prior to implementing or stopping any treatment.

Here are some general tips to help you tell the good from the bad (source: Medical Library Association):

1. Sponsorship
  • Can you easily identify the site sponsor? Sponsorship is important because it helps establish the site as respected and dependable. Does the site list advisory board members or consultants? This may give you further insights on the credibility of information published on the site.
  • The web address itself can provide additional information about the nature of the site and the sponsor’s intent.
    • A government agency has .gov in the address.
    • An educational institution is indicated by .edu in the address.
    • A professional organization such as a scientific or research society will be identified as .org. For example, the American Cancer Society’s website is http://www.cancer.org/.
    • Commercial sites identified by .com will most often identify the sponsor as a company, for example Merck & Co., the pharmaceutical firm.
  • What should you know about .com health sites? Commercial sites may represent a specific company or be sponsored by a company using the web for commercial reasons—to sell products. At the same time, many commercial websites have valuable and credible information. Many hospitals have .com in their address. The site should fully disclose the sponsor of the site, including the identities of commercial and noncommercial organizations that have contributed funding, services, or material to the site.
2. Currency
  • The site should be updated frequently. Health information changes constantly as new information is learned about diseases and treatments through research and patient care. websites should reflect the most up-to-date information.
  • The website should be consistently available, with the date of the latest revision clearly posted. This usually appears at the bottom of the page.
3. Factual information
  • Information should be presented in a clear manner. It should be factual (not opinion) and capable of being verified from a primary information source such as the professional literature, abstracts, or links to other web pages.
  • Information represented as an opinion should be clearly stated and the source should be identified as a qualified professional or organization.
4. Audience
  • The website should clearly state whether the information is intended for the consumer or the health professional.
  • Many health information websites have two different areas – one for consumers, one for professionals. The design of the site should make selection of one area over the other clear to the user.

MLA’s guidelines are an excellent starting point and should be used by anyone searching for Medical information on the internet. Many caregivers will also tell you to not search the web for information, especially if you have a Postpartum Mood Disorder. If you have a question and feel overwhelmed with doing research on your own, get in touch with a Postpartum Support International Coordinator, your midwife, or your doctor, and ask for help in doing research. Sometimes you may come across research or news stories that are not applicable to your situation that may cause triggering thoughts or increase your fear and anxiety without justification.

Another great way to check the reliability of a website is to do so through HONcode. HONcode, Health on the Net certifies websites with healthcare information. Their standards are pretty high and they certify on a random basis once a website has been accepted. (I’m currently working on acheiving this certification for this blog myself). Through HONcode, as a patient/consumer, you can download a toolbar or search directly from their site and will only be given websites that have been approved by them. Click here to learn more about the safety process at HONcode.

I also want to take a moment to mention that a good doctor or advocate will be compassionate, understanding, and work with you regarding your desired route of treatment. Good Caregivers and Advocates are able to stay objective and not allow personal experience to cloud their aid to those who seek their help. This does not dismiss advocates who have specialized knowledge of certain types of treatment however – what I mean by this statement is that if you approach and advocate with a question regarding an Anti-Depressant, they should direct you to research regarding that particular medication and encourage you to also speak with your caregiver. They should NOT bash said medication because they’ve had a bad experience with it. If the caregiver or advocate is not compassionate but instead dismisses or attacks your desired treatment methods, it’s time to find another caregiver or advocate for support.

As a Postpartum Support International Coordinator myself, I work very hard to support the journey the mother is on and the treatment route that best fits with her personal philosophy. I encourage the involvement of professionals – including her OB or midwife, a psychiatrist, and a therapist. I also encourage Mom to take time for herself, something we all forget to do from time to time, but is very important for our mental well-being.

So please remember to:

Thoroughly check the source of the information you are reading online using the above guidelines from the Medical Library Association as well as searching via HONcode for your information.

Double-check any information regarding starting treatment or stopping treatment with your professional caregiver prior to implementation.

Make sure your caregiver respects your opinion regarding your body. (You are of course, your #1 expert in this area!) If he/she fails to respect you, although it may be difficult, find another caregiver who DOES respect you!

Take time for yourself as you heal.

Thoughts on exploring a “Pregnant Pause”

An article in May’s issue of Vogue entitled “Pregnant Pause” by Alexis Jetter attempts to provide insight into the very confusing world of the pharmacological treatment of depression or mental illness during pregnancy. Ms. Jetter seems to have done her homework. She brings up some very valid points, includes supportive research, referring to specific studies all framed within a heart-tugging story of a boy born with a heart defect as a result of his Mom taking Paxil during her pregnancy. Yet Ms. Jetter forgets to tell both sides of the story. Here’s my take on the article.

In no way am I belittling this Mom’s experience by rebutting some of Ms. Jetter’s claims. As a Mom of a special needs child, I know first-hand how difficult life becomes as you work with and around your child’s needs. I also understand the enveloping guilt which rages inside you every time you see your child suffer or struggle and wonder “Did I do that? Was it my fault?”

You see, I didn’t take my pre-natal vitamins during my second pregnancy. At first it was because of the wretched morning sickness. Then I just didn’t want to take them. I even pondered what would happen if I didn’t take them, thinking it would be a neat little “experiment” to find out.

When my daughter was born with Pierre Robin Sequence which included a complete and bilateral cleft of her hard and soft palate, I felt a guilt that cannot begin to be described by any words known to mankind. It took me nearly two years to admit this to anyone. I lied at the hospital when I was asked if I had taken my prenatal vitamins. Why? Because I knew from my mom’s quick research about PRS that lack of folic acid in the maternal diet increases the risk for this particular condition. The last thing I needed was for the doctors to also blame me for my monumentally bad judgment. Looking back, I’m pretty sure this erratic behavior was directly related to my untreated issues with Postpartum OCD/Depression after the birth of our first daughter.

To this day as my daughter struggles with speech, socialization, and a myriad of other challenges, I still blame myself somewhat. Intellectually I know her problems are not my fault. I have accepted this on that level. But a small part of me will always wonder if she would have these problems if I had just taken my vitamins. So I get it. I get the guilt, I get the hind-sight. I get the anger and outrage. And I definitely get the need for education and informed consent.

What I don’t get is the desire to limit treatment options for other people. Instead of limiting, let’s encourage the development and shared knowledge of non-pharmacological therapies for mild cases of depression during pregnancy such as altering your diet, increasing exercise, natural supplements, psychotherapy, to name a few. Instead of judging, let’s allow women to make their own decisions regarding their mental health treatment. (you can read more on my thoughts regarding the ante-partum medication conundrum here)

Just as with those who are passionate for home-birth and those who are passionate for breastfeeding, there is a caution to be heeded here. We cannot convince a woman who is determined to have a caesarean section to have home-birth just as we cannot convince a woman who is convinced that a pill will solve her problems to try other therapies. All we can do is provide the education, statistics, and support. Then we need to step out of the way and let the woman make the decision with her medical professional team.

We can only fix ourselves, not those around us.

Now, onto the meat of the article, if you will.

After we meet Gina Fromm and hear of her difficult experience as a result of taking Paxil during her pregnancy, we are introduced to Dr. Anick Berard, PhD and Professor of Pharmacy at the University of Montreal. He discusses his study on Paxil, concluding that “..now other people have done the studies, too. And I’m much more comfortable saying that Paxil is a bad drug to take during pregnancy.”

Really, Dr. Berard?

I found a more recent study undertaken by none other than Dr. Anick Berard which concludes that unless the dose of Paxil is above 25mg during the first trimester, Paxil usage is not associated with an increase in congenital cardiac malformations when compared with non-SSRI usage. (Typical therapeutic dosage for Paxil can range anywhere from 10mg to 40mg.) When researching it’s not difficult to find studies to contradict one another but when you find them from the same researcher it’s a bit odd.

Next we meet Carol Louik, Sc.D, author of one of the two studies released in June of 2007 extolling the small risk SSRI’s posed to the human fetus. Turns out Carol’s study was partially funded by GlaxoSmithKline, Sanofi Aventis, and another Pharmaceutical Company. However, at the same time Carol’s study was published in the New England Journal of Medicine, another study was also published. This study was coordinated by the CDC out of Atlanta and did not have any financial disclosures to the Pharmaceutical Companies. Sura Alwan, MSc, and Jennita Reefhuis, RN, were first and senior authors respectively. Their study concluded the absolute risk of exposure vs. non-exposure not to be much different than the standard baseline risk for defects in any healthy pregnancy.

But the Alwan/Reffhuis study results are not present in the Vogue article.

Then we’re tossed this golden nugget – “….SSRI usage dramatically increases the chances that a baby may be miscarried, born prematurely or too small, suffer erratic heartbeats, and have trouble breathing.” The author further states that “Taken together the NEW research caught many experts by surprise.” Yet most of the research articles I located by the researchers quoted were from 2006 or earlier. This is hardly NEW research. In fact, the NEW research contradicts many of the studies referenced in the Vogue Article.

For instance, we’re informed through a quote from Dr. Adam Urato, M.D. That “these antidepressants are portrayed almost like prenatal vitamins that will level out their mood and lead to a healthier baby. But antidepressants have not been shown to decrease rates of miscarriage or birth defects or low birth weight. On the contrary, they’ve been shown to increase those problems.” Then directly after this quote, Ms. Jetters states pregnant women are routinely excluded from clinical tests of new drugs. But she fails to ask a very important question.

Why?

A solid answer can be found in the February 2009 Carlat Psychiatry Report, an unbiased report regarding all things psychiatry related, including medication. According to an article entitled “Psychotropics and Pregnancy: An Update,” the Carlat Psychiatry Report states “the gold standard study will never occur. It will never be ethically permissible to enroll pregnant women into a randomized, placebo controlled trial designed to determine if a drug causes birth defects. For this reason, we are left with less than ideal methods of determining risk.”

To seemingly substantiate Dr. Urato’s quote regarding miscarriage, birth defects, or low birth weight, a study performed by Developmental Pediatrician Tim Oberlander, M.D. At the University of British Columbia is briefly examined. This study concluded after tracking the birth outcomes of 120,000 women that infants exposed to SSRI’s prenatally were born too small and have trouble breathing. Oberlander’s quoted conclusion for the article? “It’s not the mother’s mood,” Oberlander says. “It’s the medication.”

Yet Oberlander’s study is negated by Einarson’s study, “Evaluation of the Risk of Congenital Cardiovascular Defects Associated With Use of Paroxetine During Pregnancy” Einarson also writes a letter to the American Journal of Psychiatry, (located in Vol. 64, No. 7, July 2007) which states the conclusions made by Oberlander and others is not supported by the data presented. Einarson points out that low birth weight was not stated as an investigated outcome and that only average weight of newborns and proportion falling lower than the 10th percentile (ie, small for gestational age but NOT low birth weight. Low birth weight is technically defined as >2500g2.

Einarson’s study combined both prospective and retrospective methodology to examine a large number of women specifically on Paxil. Their conclusion? “Paroxetine does not appear to be associated with an increased risk of cardiovascular defects following use in early pregnancy, as the incidence in more than 3,000 infants was well within the population incidence of approximately 1%.”

Just in case you’re wondering, no, their study was not funded by GlaxoSmithKline. The Carlat Psychiatry Report is quick to point out that seven of the nine authors received no funding from GSK or any other drug company but two have received funding for drug research from other drug companies but not GSK.

The Carlat Report also address what one should do with conflicting information regarding medicating during pregnancy. The best one can do from a “medico-legal perspective is to avoid paroxetine. But the data does suggest that paroxetine – and perhaps by extension, all SSRI’s – may be safer than what has been suggested by other smaller studies.”

Going back to the issue of pre-term delivery as well as low birth weight and their relation to mood or medication, a recent study released by Dr. Katherine Wisner examines this very topic. The study looked at 238 women with no, partial, or continuous exposure to either SSRI treatment or depression and compared infant outcomes. Dr. Wisner’s study found that exposure to SSRI’s did not increase birth defects or affect infant birth weight but the importance of this study lies within the finding that the pre-term delivery rates were the same with depression exclusive of SSRI treatment, leading the researchers to state that it is “possible that underlying depressive disorder is a factor in pre-term birth among women taking SSRI’s.” Dr. Wisner also encourages further research into this topic even though her study was just released this year. You can read more about this study by clicking here.

Rita Suri, M.D. from UCLA also studied this very situation, publishing her research in August 2007 in the American Journal of Psychiatry. Not surprisingly, Suri’s study is quoted in the Vogue article. Her results found that infants born to women taking SSRI’s were three times more likely to be born prematurely (although most were only 1 week early) She also found that the higher the antidepressant dose, the higher the risk of early delivery. However, her results did not show that untreated mild depression had an effect on prematurity. I’d like to add a personal digression here. My second daughter was born at 36 weeks. While not officially diagnosed, I would say that I suffered from untreated depression during that pregnancy. Sure it’s not an official research study but it’s very hard to discount personal experience especially when it agrees with current research.

At this point in the article, we’re introduced to one of the more well-known disorders associated with paroxetine usage, Persistent Pulmonary Hypertension of the newborn. Tina Chambers, Ph.d, a birth-defects researcher from University of California at San Diego is the chosen expert for this topic. She states that this condition normally strikes only one or two infants in 1,000. But Chambers found that rates jumped between six and twelve per 1,000 for mothers who take SSRI’s. In contrast, a recent prospective study by Susan Andrade, ScD, concluded no relationship between SSRI usage and PPHN but did admit that given limitations of the study and small number of confirmed cases, further study in this area may be warranted. In Andrade’s study, 1104 mothers were followed with only 5 confirmed cases of PPHN reported.

Alexis McLaughlin’s story about her daughter’s struggle with PPHN is striking, especially for me, because I’ve seen my daughter struggle for breath immediately after birth. Her quote, “It’s difficult because you need good mental health and a healthy baby,” is very reminiscent. You do indeed need good mental health and a healthy baby. When I was pregnant with Charlotte, we told people we didn’t care about gender, all we cared about was health. But if that doesn’t happen? You do your best to get through it because there is nothing you can do to go back and change what was done in the past. We can only move forward, changing what we can, and if we can’t change it, we change the way we think about it. Even with a normal pregnancy given no SSRI exposure or depressive exposure, a mother faces a 3% risk of giving birth to a child with a birth defect of some kind.

We are then moved into the science behind the affect of an anti-depressant on the human fetus. It’s hypothesized that serotonin is responsible for sending “crucial developmental signals to the fetal heart, lung, and brain….[and that]…SSRI’s, which prevent the body’s natural absorption of serotonin, could be tampering with essential cell growth.” A study by Francine Cote concludes that maternal serotonin is indeed involved in fetal development, precedes the appearance of sertogenic neurons, and is critical for development. The latter hypothesis regarding the interference of SSRI with essential cell growth has been and I’m sure will be studied for quite some time.

Shortly after this, the article winds down by warning of the “small coterie of influential doctors who…underplay the dangers of antidepressants,” again, a quote from Dr. Adam Urato. I do agree whole-heartedly with the latter part of his quote: “We want and need expert opinion that’s free from industry influence and from the appearance of bias,” Urato says. “It’s just outrageous that doctors have to work with that.”

Any of the several women I’ve come across who work with the Perinatal Population will be some of the first to admit that yes, there are risks to taking medications while pregnant or nursing. We even inform women we support to not only weigh the benefits against the risks by researching their options but let the professionals determine if the situation is severe enough to warrant medication.

Dr. Katherine Wisner examined this Risk-Benefit relationship in a study back in 2000. In this study, Dr. Wisner encourages physician and patient communication through the use of informed consent, provided the patient meets the legal definition of competent. She also recommends a family member or friend of the patient be present to help alleviate any anxiety and to ask questions the patient may not think of asking regarding any medication decision.

Many of the recommendations Dr. Wisner sets forth should be commonly used by a competent physician. Unfortunately there are physicians who do not follow informed consent and instead pay attention to the perks offered by Pharmaceutical Companies. However; these perks are slowly disappearing as the medical community awakens to the ethical dangers they pose as a result of increased consumer advocacy for fair and informed treatment when it comes to mental illness. If you should find yourself with a physician who prescribes SSRI’s like m&m’s or refuses to listen to your situation, it is time to find a new doctor for your care. A good doctor will listen, research, and collaborate with you.

I want to close with a quote directly from the Vogue article by Gina Fromm, Mother to Mark Fromm, the little boy with the heart defect as a result of his mother’s usage of Paxil. I couldn’t say it any better than this.

“It is easier to take a pill,” Gina says. “But over the long run, that’s not the best solution. It certainly hasn’t been for my life.”

I agree Gina, I agree whole-heartedly.

In my opinion, society today has gotten in the habit of quick fixes instead of sustaining solutions. I personally think it’s time we change that. But let’s do so in a logical, evidence based, and bias-free manner. Otherwise we’ll all just end up stuck right where we are screaming at each other so loud we can no longer hear ourselves think.

The Confusion of Ante-Partum Depression: To Medicate or Not?

Finding yourself faced with depression during pregnancy is a confusing prospect indeed. How do you treat it? Do you tough it out and hope there is no effect on your pregnancy? Or do you risk medication and the potential effects that course may have on your baby as well? In addition, many care-givers are hesitant to medicate a pregnant mother for depression or even worse, are not familiar with ante-partum depression and negate the mother’s concerns over her mental health. If your caregiver brushes aside your concerns as normal pregnancy ups and downs yet you know in your gut it’s more, get a second opinion or ask for a referral to a therapist at the very least.

A recent study by Dr. Katherine Wisner, M.D., M.S., found that continuous exposure to either SSRI or Depression during pregnancy results in pre-term delivery rates in excess of twenty percent while mothers with no exposure to either depression or SSRI over the course of their pregnancy experienced rates of pre-term delivery at six percent or lower. The study looked at 238 women with no, partial, or continuous exposure to either SSRI treatment or depression and compared infant outcomes. They found that exposure to SSRI’s did not increase birth defects or affect infant birth weight but the importance of this study lies within the finding that the pre-term delivery rates were the same with depression exclusive of SSRI treatment, leading the researchers to state that it is “possible that underlying depressive disorder is a factor in preterm birth among women taking SSRIs.” You can read more about this study by clicking here.

“This study adds evidence that depression in pregnancy can negatively affect birth outcome. Although women treated with SSRI’s throughout the pregnancy may experience pre-term birth, the factor causing the problem may in fact be the depression and not the SSRI. More research is needed to tease out what is causing the changes in the uterine environment. As research comes forth, what continues to be clear is that treatment for depression in pregnancy is important. ‘Treatment’ doesn’t necessarily mean medication, but for everyone’s sake the pregnant woman needs to receive a plan for wellness.” Dr. Shoshana Bennett shares when asked about her take on Dr. Wisner’s research.

You may recall a recent study posted also regarding birth weight of infants. The study concluded that Prenatal Depression restricted the fetal growth rate. This study concluded that depressed women had a 13% rate of pre-term delivery as well as a 15% greater incidence of lower birth weight. This study’s results examined cortisol levels to determine risk of pre-term delivery and birth weight prediction, which leads us to another study examining the reliability of cortisol to predict short gestation and low birth weights. The study concluded cortisol levels were indeed a reliable manner in which to predict both.

So what’s a pregnant depressed mama to do?

Throw her hands up in the air?

Scream?

Cry?

Tough it out?

None of the above – she should work in partnership with her doctors to weigh the risks. There are other treatments available for depression and anxiety during pregnancy besides SSRI’s. Therapy is always an option. (Yes, more studies to be quoted ahead) A study examining the effectiveness of a Mindfulness based intervention for pregnant mothers found women receiving the intervention experienced less stress and anxiety during their third trimester and postpartum period. There was no data collected regarding pre-term delivery or birth weight in relation to this particular study.

There’s also a wonderful article at wellpostpartum.com that discusses how cortisol impacts mothers. Included in this article are some terrific (and natural) suggestions on how to keep cortisol at bay.

Alrighty now. You’ve shared your precious studies with us. What about some real life advice? What did YOU do when faced with the Hamlet conundrum of medicating during pregnancy?

I read.

Voraciously.

The two biggest sources of help for me were Karen Kleiman’s What Am I Thinking? Having a Baby After Postpartum Depression and Kornstein/Clayton’s Women’s Mental Health. Karen’s book allowed me to realize my emotions were right on target for a woman facing pregnancy (expected or not) after surviving a PMD episode while Women’s Mental Health laid out the risk factors in a no-nonsense manner. I was convinced to stay on medication after I read my risk for relapse went up by 50% if I discontinued my medication during pregnancy. With my risk factor already 50% higher than women having never experienced a PMD, there was no way I was giving myself a 100% risk of traveling down that road.

I stayed on my medication. I stayed in therapy. I talked to my family and developed a postpartum action plan, spending more time on preparing for my possible fall than for my son’s arrival. And you know what, it paid off big time. I did not experience a PMD the third time around, even though (yes, more studies) having a boy may put you at a higher risk for developing a PMD and the risk for experiencing a PMD after two episodes is almost 100%. I beat the odds and don’t think a day doesn’t go by that I don’t give thanks to God for carrying me through.

I always encourage women I come in contact with to weigh their options with their caregivers. To educate themselves and make the best decision possible with the information at hand. Your doctor is on your team and should be willing to listen to your plan and at least consider your requests. If he/she does not respect your wishes, it may be time to find another physician for care during the prenatal period.

I would also encourage you to get a couple of books, the first being Dr. Shosh’s Pregnant on Prozac, in which she examines the relationship of psychiatric medications to pregnancy. It’s a must have resource for mothers facing the decision of psychiatric medication for an existing condition or a newly diagnosed condition. Also pick up a copy of Karen Kleiman’s Therapy & The Postpartum Woman. While this book is ultimately aimed at clinicians and the postpartum woman, pregnant women facing a mood disorder would glean quite a bit from this book as well and may consider gifting it to their caregiver as well, a paying it forward action if you will.

And if you’re interested in complementary or alternative treatment methods that don’t include SSRI’s, a great place to start researching is over at Well Postpartum. Run by Cheryl Jazzar, this blog has just about everything you could ever want to know about alternative care during the Perinatal Period.

The final thought on all of this? Do your homework. Don’t be afraid to ask questions or stand up for yourself (and your child). Above all, make the decision and agree not to second guess yourself or blame any outcome on yourself. As long as you make the best decision with the best information at your fingertips at the time, there is no blame. (And hey, the fact that you’re reading this article right now speaks pretty highly of your motivation to educate yourself!)

No matter how alone you may feel in that dark pit of depression during pregnancy or postpartum, you’re not. There are plenty of other women there with you and there are lots of us reaching our hands down to help you out. All you have to do is reach out and grab.

New PPD Help for Middle TN

SAINT THOMAS HEALTH SERVICES PARTNERS WITH HOPE CLINIC FOR WOMEN TO PROVIDE POSTPARTUM DEPRESSION COUNSELING AND EDUCATION

NASHVILLE, Tenn. – Jan. 23, 2009 – Saint Thomas Health Services has developed a partnership with Hope Clinic for Women to provide better counseling and educational resources for Middle Tennessee women suffering postpartum depression.

Baptist Hospital in Nashville and Middle Tennessee Medical Center (MTMC) in Murfreesboro, Tenn., which are part of Saint Thomas Health Services, make follow up calls to new moms once they return home. Some of the questions asked are related to postpartum depression and the women can be connected to the Hope Clinic for Women for a full phone assessment or to set up counseling, if necessary. In addition, physicians at Baptist Hospital and MTMC can refer patients who might benefit from the treatment services offered and the program is open to any women in the Middle Tennessee community who may be experiencing postpartum depression.

Resources available from Hope Clinic for Women include screening and diagnostic assessment, individual or couples therapy, support groups, support services for fathers or referral for psychiatric  evaluation and follow up. Services are offered on a sliding scale, based on the ability to pay.

“Our hospitals deliver nearly 10,000 babies combined per year and based on input from our obstetricians, mental health – especially postpartum depression – is very under-served in Middle Tennessee,” said Amanda Cecconi, women’s health service line executive for Saint Thomas Health Services. “Part of the patient experience we provide is to ensure new moms have what they need when they return home. Unfortunately, postpartum depression is often a ‘silent topic.’ We want to be proactive by helping identify women who may be suffering from it and to offer additional resources. Hope Clinic for Women, also a faith-based organization, was a natural fit to develop a partnership.”

As many as 80 percent of women experience some mood disturbances after pregnancy. Many suffer the “baby blues,” which can last from several days up to two weeks after delivery and are characterized by mood swings, crying, feelings of doubt or being overwhelmed. These feelings subside as hormone levels begin to stabilize.

One in seven women will experience postpartum depression, which usually occurs within a few months of delivery and should be treated by a health professional. It is more serious and a major form of depression that usually occurs within a few months of delivery and can last up to a year. Its peak onset usually occurs between two and 12 weeks postpartum. Symptoms can include drastic changes in motivation, appetite or mood, severe disruptions in sleep, excessive crying without cause or provocation and difficulty concentration.

“Postpartum struggles are common and the symptoms are treatable,” said Kristi Marshall, director of client programs for Hope Clinic for Women and a counselor for the program. “Our hope is that new moms won’t let feelings of shame or embarrassment get in the way. Seeking treatment doesn’t mean admitting failure; it is the first step in the road to relief. We’re here to help answer questions or provide treatment. We’re proud to be partnered with these hospitals.”

Saint Thomas Health Services assisted Hope Clinic for Women in obtaining postpartum depression training for two of its staff members.

Hope Clinic for Women has locations in Nashville at 1810 Hayes Street and in Spring Hill at The Garden, 2620 Thompson Station Road East. Another location in Rutherford County will be added in the near future.

For more information, call Saint Thomas Health Services at (615) 284-PINK (7465) or Hope Clinic for Women at (615) 321-0005 or visit www.hopeclinicforwomen.org.

Saint Thomas Health Services is a faith-based ministry with more than 8,000 associates serving Middle Tennessee. Saint Thomas Health Services’ regional health system consists of four hospitals – Baptist and Saint Thomas in Nashville, Middle Tennessee Medical Center in Murfreesboro and Hickman Community Hospital in Centerville – and a comprehensive network of affiliated joint ventures in diagnostics, cardiac services and ambulatory surgery as well as medical practices, the Center for Spinal Surgery, clinics and rehabilitation facilities. STHS is a member of Ascension Health, a Catholic organization that is the largest not-for-profit health system in the United States. For more information, visit http://www.sths.com.

Blogs as Peer Support for PPD

With the recent release of the study regarding how helpful peer support is for women with Postpartum Depression, I thought it would be interesting to take a look at blogging as a form of peer support. The source of inspiration for this piece? An article by Kristin Schorsch over at the South Town Star about blogging and PPD in which yours truly is featured along with Natalie Dombrowski.

Many of the women I know who have blogs and have recovered from Postpartum Depression have found their blogging habit to be a powerful source of support. Those who read them undoubtedly feel the same way, finding strength and hope in the words that part ways with those of us who have been through the very dark in which they now find themselves enrobed.

For me, there was relief in knowing I had my blog to lean on and that through my blog I was potentially helping other families survive the very same thing I struggled against. I credit my blogging as a tremendous part of not experiencing PPD the third time around. After all, I had numerous risk factors according to several different studies and statistics.

My first risk factor lied within being a two time survivor. A third episode lies in a nearly 100% risk range. Studies have also shown that women who give birth to boys are more likely to experience Postpartum Depression than mothers who give birth to girls. My third child? A boy. I also had extenuating stressors – a marriage that was dashed onto the rocks at just 3 months postpartum after giving birth to Cameron and financial stressors to boot. Last but not least, women who experience severe pelvic pain during pregnancy are also more likely to suffer from Postpartum Depression. And guess what? I had severe pelvic pain with all three but it was the worst with Cameron. Relying solely on numbers, I should have suffered from Postpartum Depression with Cameron. Yet I didn’t.

Why?

I had peer support, social support, medication, education, blogging, meetings, advocacy, and preparation on my side.

But hey, I had all that too you say. And I still ended up suffering. Unfortunately this is where it gets tricky. What works for one woman in one situation may not work for another woman in her situation.

Why? We don’t necessarily know. What we do know is that communication with other women and TRAINED medical professionals is key to recovery. This is where I get on my soapbox.

The MOTHER’S Act would allow for research funding so we might be able to find these things out. It would also allow funding for additional social and community support programs to be implemented across the country so that no family would have to suffer silently. It would allow for women to speak up without fear about their intrusive thoughts, to admit they are not happy at a time when they feel they should be. It would educate caregivers so no more women would have to be fear being dismissed when they do speak up, as I was. It would decrease potentially lethal cases of untreated Postpartum Depression and catch episodes of Postpartum Psychosis before they reached the breaking point.

The MOTHER’S Act would finally allow for the recognition of Postpartum Mood Disorders as a true illness, allowing for the flow of ideas and treatment options between patients and clinicians to open up. It would allow us to finally create treatment networks between Pediatricians, OB’s, Therapist, Psychologists, and Psychiatrists, keeping women from slipping through the cracks and confused about which medical professional to talk with regarding their emotions.

The passage of the MOTHER’S Act would allow those of us who have survived and those of us who are still struggling to finally begin to live over the rainbow, where we deserve to live. Where there is finally acceptance, happiness, and true hope instead of disapproval, sadness, and despair that permeates the lives of so many women and families fighting to rid themselves of the beast of Postpartum Depression.

Off the soapbox now.

I blog to provide the land over the rainbow for myself and for others. We’ve fought hard enough against the rain on our own. Nothing more, nothing less. Providing hope to those who struggle behind me, those deserving of a helping hand as they claw furiously against the muddy wall of the hole they now find themselves lost inside.

We all deserve the rainbow.