Just Talkin’ Tuesday: Unhappily Pregnant

Derniere ligne droite or Pregnancy Last Days

"Derniere ligne droite or Pregnancy Last Days" by f. clerc @ flickr.com

#PPDChat yesterday focused on Pregnancy and Depression. A lot of questions came up and I wanted to continue the conversation today. Welcome to Just Talkin’ Tuesday.

Have you ever tried to find a photo of a pregnant woman in which she is not smiling or glowing?

It’s HARD.

I found one, but it was not easy.

Everywhere you look there are glowing happy pregnant women. Here’s a page from a modeling agency dedicated to providing pregnant models. Every single last one of them is grinning.

Pregnancy, just as postpartum, is supposed to be one of the happiest times of a woman’s life. But what if your mood doesn’t match the one you are supposed to have? The one we are groomed to have? After all, even as young girls, many of us spent hours upon hours playing with baby dolls, fantasizing about having a baby of our own one day. I used to shove stuffed animals under my shirt and “give birth.” Oh, if only it were that easy!

No one mentions the natural mood swings. No one mentions that more women may become depressed during pregnancy than after pregnancy. No one tells us the anxiety pregnancy may rain down upon us. No one tells us the immense guilt waiting to consume us as we are overwhelmed and consumed with thoughts of suicide. No one tells us these things. Instead, we are continually bombarded with pictures of perfection, conflicting advice about everything from how to cope with morning sickness to how get rid of those annoying stretch marks to what to buy for our baby’s bedding to what diapers to buy to how to feed our children. Can you say Information Overload? It’s enough to get a mentally healthy mom super stressed at a time when she is supposed to be avoiding stress to begin with!

A pregnant mother’s depression may be triggered by a number of things. It may be an unexpected pregnancy, her partner or family may not be supportive, she may be experiencing unrelated stresses, she may already have children at home and the physical stress of a pregnancy may have her more than worn down, or she may already struggle with depression or another mental illness. Whatever the cause may be, it’s simply not expected for a mom to be anything but happy during a pregnancy.

So who should mom turn to? Where should she go? How can she tell the difference between pregnancy mood swings and something more serious? Mom can start with her doctor. If he dismisses her and she feels in her gut that something more than pregnancy hormones is causing her issues, she can (and should) seek a second opinion. Ask your original doctor or friends for a referral to another physician. She can also contact Postpartum Support International and speak with a Coordinator in her area who will help her locate a knowledgeable doctor or therapist. Telling the difference between mood swings and something more serious involves paying attention to your weeks rather than your days. If you have weeks filled with more down days, anxiety you just can’t kick, and nothing you do seems to bring you out of your funk, then it’s a very real possibility you may need to speak with a professional about how you’re feeling.

I found myself depressed during my second pregnancy. My first episode of postpartum was not treated. I believe this fed into my depression during my second pregnancy. I had not learned any coping methods or of the importance of taking care of myself. I drifted further and further into the darkness, swallowed whole by morning sickness (all-day sickness for me), the lack of desire to eat, take care of our 16 month old daughter, and no desire to take my prenatal vitamins because they triggered nausea. I even thought at one time what would happen if I didn’t  take my prenatal vitamins. Then my daughter was born nearly 5 weeks early with a cleft palate. Turns out there was nothing I could have done to keep her cleft palate from occurring as it forms within the first 4-6 weeks of pregnancy, well before many women are even aware they are pregnant. Still, I beat myself up about not taking my vitamins. I still do every now and then. But I now enjoy spending time with my daughter.

I also found myself depressed during the first 6 months of my third pregnancy. It was an unplanned pregnancy. I would go to every visit and wish they would not find a heartbeat. If the heartbeat wasn’t there, the baby wasn’t there and this pregnancy would just become a figment of my imagination. It hurts me to type that. As I would lie on the table waiting for the nurse to check the heartbeat with the doppler, I closed my eyes and prayed so hard she wouldn’t find it. Many times she had a hard time finding it and I would get excited. But then she would find it, pronounce it healthy and leave the room. I would cry as I stared blankly out the window, disappointed that once again, the baby had survived another month. I know this sounds horrible. I know it’s harsh and I know there are mothers who try very hard to have children or have angel babies. But there I sat, beyond words filled with heartbreak about this growing gift in my belly. I never talked to anyone about either depression. I wish I had. The difference between the two was that with my son, I was already on medication as I had suffered severe and debilitating Postpartum OCD after the birth of our second daughter (fed, I’m sure, by the depression I suffered during my pregnancy with her).  I was also in counseling. I found therapy very helpful in reframing things. And by the time this pregnancy was underway, I was also blogging here and getting started in Postpartum Advocacy. Things were looking very different indeed. I focused more on preparing for myself and caring for myself which then allowed me to take care of my family and the little one inside my belly. With my son, the fog eventually lifted and once I could feel him moving inside me, things began to look up. I realize I am fortunate the fog lifted. It didn’t magically lift though as it took a lot of hard work on my part and the help of professionals.

Please don’t struggle alone if you are pregnant and suspect you may be depressed. There is help. There is hope. Medication while pregnant is one of the biggest concerns for depressed moms. But there are medications you can take during pregnancy that have a minimal risk to mom and baby. Talk with your doctor about your options in this department.

Have you struggled through depression during pregnancy? Worried you might end up with depression during pregnancy because you’ve had a Postpartum Mood Disorder? Share your concerns, tips, and success stories here. When you comment, you’ll be entered to win a copy of Pregnant on Prozac by Shoshana Bennett. This is one of the best resources out there for mamas when it comes to pregnancy and mental illness. I happen to have an extra copy of the book here and want to pass it on to someone who could really use the information within it’s pages. This give away is not sponsored or endorsed by Shoshana Bennett, just something I’m wanting to give away to a mama in need. If you win the book and don’t need it for yourself, perhaps you could share it with your OB, Midwife, or Therapist so they could pass it on to someone who would find it helpful. All you have to do to enter is leave a comment by Monday, September 13 at 8pm EST. I’ll be choosing the winner that night via Random.org. For an extra entry, please Tweet about this post and then leave an additional comment with a link to your tweet. You can also receive an additional entry by subscribing to My Postpartum Voice via Email and leaving an additional comment telling me you’re subscribed (and if you’re already subscribed, that counts!)

So let’s get to talking about Pregnancy & Depression. It doesn’t deserve to live in the darkness any longer.

Violence during pregnancy by intimate partner increases risk of Postnatal Depression

A study included in an early online publication of The Lancet examines the correlation of partner violence against women during pregnancy and the effect this may have on postpartum mental health.

The study took place in Brazil and included women from ages 18-49 years old. 1133 pregnant women were eligible for the study with 1045 included in the analysis. Of those 1045, 270 had postnatal depression. The most common form of partner violence? Psychological. “Women reporting the highest frequency of psychological violence were more likely to have postnatal depression even after adjustment.” while “Women who reported physical or sexual violence in pregnancy were more likely to develop postnatal depression but this association was substantially reduced after adjustment for psychological violence and confounding factors.”

The importance of this study may shift attention to psychological violence and abuse during pregnancy as an increased risk factor for postnatal depression. Physical and sexual violence still warrants attention.

Growing up, we all heard the phrase “Sticks and stones will break my bones but words will never hurt me.” According to this study, words may be even more harmful. The true danger here is that Psychological abuse is often a precursor to physical or sexual violence.

Another recent study also found that “Even After Leaving Abuser, Moms Mental Health Declines.” A mother’s level of depression and anxiety were still high at least two years after escaping an abusive relationship. This research study comes from Ohio State University and included data from 2400 women who were married to, or living with the father of their child at the end of the first year of a three year period. They were broken down into three groups. The women participating were all nearly low income, minority, first time moms and likely experiencing additional stresses. Women who stayed or left a relationship showed higher levels of anxiety and depression, meaning (psychologically) they were no better off than women who stayed. That said, the researchers DID find that “abused mothers who had more social support did better after the end of their relationship than those with less help from family and friend.”

Lesson learned here? Reach out for support. Don’t settle for abuse. You are better than that. You deserve better. Your child deserves better.

If you are an abused mom/woman, you can start by calling a Domestic Violence Hotline. Start here. Start now. Call 1-800-799-SAFE (7233) or visit the National Domestic Violence Hotline’s website for help. You are not alone.

Postpartum Progress call for Nominations for Top 10 Perinatal Writers of 2010

Katherine Stone over at Postpartum Progress is taking nominations for the Top 10 Perinatal Writers of 2010.

I’ll definitely be nominating some of the Postpartum Voices of the week for this award!

If you write about Perinatal Mood Disorders or really like something I have posted here, please nominate yourself (or me!) for the award.

Here’s the down low straight from Katherine:

Entries must have been written/published in 2010.  My criteria?  I look for beautiful writing, compelling stories, creative metaphors, honesty, authenticity, original voice and/or destigmatization.  They can be about any mental illness related to pregnancy and childbirth.  Nominations will close on November 15th.

I love publishing this list as a way of thanking people for their courage, sharing inspiration with those who suffer, and honoring those who are speaking out against stigma.  So get nominating!

I know I can’t wait to see the finalists. The list Katherine put together last year was phenomenal!