Tag Archives: Karen Kleiman

Announcing Karen Kleiman as #PPDChat guest on August 12, 2013

I am THRILLED to be announcing the upcoming guest for #PPDChat!!!

Karen Kleiman is an expert in the field and is also the person who inspired me to start this blog so any time I get to collaborate with her, I get very excited. Read more about Karen’s great work here.

On Monday, August 12, 2013, Karen will be joining us for a discussion about Scary/Intrusive Thoughts. This topic is often at the top of the search terms which lead people to my blog. In fact, I recently made a graphic of all the search terms which led people to my blog relating to this very topic. There were quite a few variations as you can see for yourself:

Postpartum OCD search terms

Also, my top post for the past week was “Do the Thoughts Ever Go Away?

No one really has definitive answers as the thoughts fade, but even as a parent, we all struggle with the “what if’s” of the challenge in raising our kids and keeping them safe.

Join Karen and I as we navigate this important topic on Monday, August 12, 2013 at 8:30pm ET. We look forward to seeing you there!

A Heartfelt Thank You as I Celebrate Six Years of Blogging

Six YearsSix years.

Wow.

Six.

For six years, I’ve been blogging about Postpartum Mood Disorders. I started with my own journey, in an effort to refocus facing pregnancy after two harrowing experiences with Postpartum Mood Disorders myself.

Then I moved on to Sharing the Journey, adding more voices to my own, acknowledging that there is power in the details of ALL our journeys. Through this interview series approach to my blog, I interviewed not only Moms, but experts and authors as well.

Three years ago today, I started #PPDChat and have since met some of the most awesome people to ever grace the Interwebz with their presence.

Being in the belly of hell during my darkest times with Postpartum Depression, OCD, and PTSD sucked. I was alone.

But I’m not alone any longer.

I want to thank Katherine Stone for supporting me as I first got started…for being a powerful and motivating voice which kept me going.

I want to thank Karen Kleiman for her words of wisdom in her book, “What Am I Thinking: Having a Baby After Postpartum Depression” which advises women to re-frame their pregnancies after Postpartum Depression. Her words are the ones which planted the idea of starting a blog to share my journey with others – to make it a real life example of what it’s like to navigate pregnancy after Postpartum Depression.

I want to thank Amber Koter Puline and Ivy Shih Leung for being there with me too as we all navigated this Postpartum Mood Disorder blog thing. Thanks for having my back and for your willingness to listen whenever we had issues. I love you both as if you were sisters. Seriously.

Most of all, I want to thank Wendy Davis of Postpartum Support International. Wendy has encouraged me in my journey of advocacy and helped me think through some very tough questions I had in the early days. She’s been the voice of reason, and never hesitated to talk with me when I needed advice or support. Meeting you in 2010, Wendy, was awesome.

I’d like to thank my Mother too – for her never-ending support through the hell that was my Postpartum Depression journey – for always being just a phone call away and for listening even when she didn’t want to and for letting me just pour my heart out. I can never thank you enough for being there for me when I needed someone to just listen. A huge thanks to my Father for telling me that while hospitalized that what I was experiencing was a completely normal reaction to everything I had been through. More than he’ll ever know, I clung tenaciously to that sentiment as I healed.

I know I’ve forgotten some people but if I thanked every single person, we’d be here forever.

A HUGE thank you to the #PPDChat community as well – without you, women and families wouldn’t have a 24/7 network of support to access on Twitter. Each one of you, yes, you too, are amazing. We exist in every corner of the world, it seems, and someone is always around. Even if you’ve moved on from the depths of hell or are now battling a different diagnoses, you don’t hesitate to refer someone to us. For that, I love you. You are part of this beautiful breathing thing  – this hands across the world cradling new mothers and families as they fight back and fight to see the light in their worlds once again.

I am truly blessed and grateful for the past six years, for all the good, and for all the hard. For if it were not for the hard, I would not be grateful for all the good.

Finally, thank you, dear readers, for reading and interacting for six years, for hanging tough with me when I didn’t have much to say, and for understanding why I needed to pull back. Thank you for welcoming me as I work my way back toward finding My Postpartum Voice once again. It has not gone unnoticed and I am blessed to have some of the best readers on the Internet -all of you so full of love, depth, honesty, support, and best of all – hope. Thank you from the bottom of my heart.

 

Saturday Sundries: 1.29.11: Meds, More babies, When PPD becomes more

Good mornin, y’all. How’s it going?

I love Saturdays. LOVE. There’s something so cozy about Saturday mornings. Round here, we take things slow and easy, enjoy a delicious brunch, and just hang out. This morning we’re having Turkey Sausage, cheesy scrambled eggs, whole grain toast, mango juice, and coffee. NOM.

That’s what we’re doing here. We’re just sitting down for coffee, brunch, and chatting about some serious stuff, girlfriend to girlfriend. Or friend to friend.

So get cozy, grab your coffee, OJ, or tea, oatmeal, danish, waffle, Cocoa Puffs or Honey Smacks, and prop up your feet (yes, that’s allowed here), and enjoy. This is for you.

As always, I am not a doctor. I am a Mom who has lived through the same hell you (or someone you love) is currently or has lived through. I’ve been there. I know what it’s like to be alone and not know where to turn. Please check with your doctor before you do ANYTHING mentioned below. What works for one person may not work for another. This disclaimer is brought to you by Common Sense and Covering my, well, you know.

If you have a question, I’d love to hear it. Email it to me at mypostpartumvoice(@)gmail(dot)com. If you want to stay anonymous, that’s fine. Just tell me in your email. You can also catch me on Twitter via @unxpctdblessing or on Facebook at the My Postpartum Voice Fan Page. With any of these, be sure to mention your question is for the Saturday Sundries feature! I’ll answer just about anything including questions about my personal experience with Postpartum Mood & Anxiety Disorders. What I will NOT do is recommend medications or one form of treatment vs. another form of treatment. That’s for you to discuss with your doctor. I’ll be happy to provide resources and information regarding therapies, etc, but I do not get specific in regards to pharmaceuticals here. It’s an ethical thing.

Now, before your coffee gets cold, let’s get onto the questions!

@walkerKarraa asked: How do moms manage their meds during time in hospital when babies come?

This is really specific from situation to situation. If you are on psychiatric meds during pregnancy and will be on them through delivery and postpartum, this is something you will want to discuss with your provider. Many providers have Mom bring her meds from home. When I delivered my son, I was on medication. I brought it with me and gave the prescription to the nursing staff. They wrote down the information and then gave it back to me. Every morning, they checked with me to make sure I had taken my dose.

I would strongly recommend only bringing as many pills with you as will be needed for your stay in the hospital, if that is where you will be birthing. This way, if there is a misplacement of your prescription, you’re not out an entire month’s supply. This is also a question you can ask at pre-registration. Inquire about hospital policies regarding existing patient prescriptions and how the hospital handles them. Do not assume your hospital will know you need to take Med A at x o’clock and Med B at x o’clock. I cannot emphasize enough how important it is to have this discussion with your caregiver AND the hospital staff where you will be giving birth.

This question came in via email. While the reader did not specify to remain anonymous, I’m going to go ahead and respect her privacy anyway. Given the nature of the question, I immediately emailed an expert on this topic, Karen Kleiman. It was Karen’s book which led me to start this blog, actually. I did not know if I wanted to have another baby after our first one. In fact, we started trying for another one, I totally freaked out, we stopped, and then a few months later, we started up again and bam. Pregnant very quickly. I was on that train. After our second, we were once again on the fence. We had begun to lean toward not when we became pregnant with our son in a very unplanned manner. He’s 3 years old now and the happiest little boy you will ever meet. His happiness is infectious. But I am done. Done done done. I did not have PPD/PPA after his birth. I spent a good bulk of the time during my pregnancy focusing on resources and support for me, not for him. It sounds selfish, I know, but it really paid off. In the end, it WAS for him because the happier I was, the better mother I was able to be for him. Without any further ado, here is the question and the answer from the fabulous Karen Kleiman:

I got PPD/PPA 5 months after my daughter was born and that was 3 years ago. How does a mom like me even consider having another biologically? I read about moms who do it and don’t understand how they get there with the fear, and all. Where are the moms who have had PPD and choose not to have another? Where can I get encouraged from other moms who are like me, and not to feel guilty about not “doing” it again? The guilt is horrible for me.

Karen Kleiman’s answer: The decision to have another baby after experiencing postpartum depression and/or anxiety is complicated by a number of factors:

1) your personal experience

2) your medical history

3) your available support network

4) your course of treatment/recovery and

5) your (and your partner’s) desires, expectations and preferences, just to name a few.

So you can see how complex this decision can be. There are women who decide that having another baby is not worth the anguish of a subsequent pregnancy and unknown postpartum experience. There are women who decide that having another baby after PPD/PPA is worth the risk. It is, to say the least, an extremely personal decision. And one, I might dare say, that is no one’s business, but yours and your partner.

I know there is significant pressure, from society, from friends, from family, etc., but it is perfectly okay for you to determine what course of action is best for you and your family. And the guilt? It can feel overwhelming, to be sure, but guilt can only thrive if you provide the opportunity. You can, with proper support, learn to embrace your decision and more forward with confidence. Find a good therapist, read good books J, find support online, (ppdsupportpage.com, Lauren and her awesome PPD twitterdom, for example). Trust me, there are many many women who struggle with this and there is never one right answer. You will feel better if you can find a therapist who specializes in this area, so you can discuss the pros, the cons, the fear, the guilt, and ultimately make an informed decision that fits your needs the best. Then, take a deep breath, and give yourself permission to stop torturing yourself. All will feel right again soon.

@Zeeke75 asked a question that I’ve been hearing a lot lately. “how do you know when it’s no longer PPD and something else?”

Oh look, a leprachaun – over there! Seriously. Look!

What? You don’t believe m… OOOH! Unicorns! There!

Okay, here’s the deal.

This is a touchy question. This question is really the crux of the current DSM-V debate. It’s very hard to answer. VERY hard.

When I attended the PSI/Marce Conference in Pittsburgh this past October, there was a presenter, Ellen Frank, Ph.D, a volunteer working with the Mood Disorders group. Dr. Frank postulated that due to the lack of research indicating a clear off-set for Postpartum Depression, the current onset of Postpartum Depression and other Postpartum Mood Disorders would continue to show a cut-off date of four weeks. What this means is that according to the new DSM, a woman cannot “officially” have Postpartum Mood Disorder if she presents with symptoms any later than four weeks after birth, something I think is a total crock of BS but hey, what do I know? I’m just someone who did not present with symptoms until 3 months in with my first and was actually told by my physician I didn’t have PPD because I was more than four weeks Postpartum. The DSM’s staff’s argument is that the DSM is merely a reference book and is flexible for interpretation from case to case – well, someone should have told my doc this. He actually pulled out the DSM-IV and read to me.

In the bigger picture, this also means that there is a lack of research in the area of a clear “off-set” of symptoms. This means that it’s really hard to “officially” say that a PMAD has moved from being a PMAD into something else.

Many of us in the field will tell moms that onset for a PMAD is anytime within the first 12 months after birth. We also state that it can take up to 18 months to recover properly. But that doesn’t mean that once your little one turns 18 months you should be running through fields of poppies and floating on clouds.

Recovery time line depends on oh so much. It depends on when you were first PROPERLY diagnosed, when you first received an effective course of treatment/therapy, what kind of support you have, what extenuating circumstances may be present in your life, how cooperative and honest you are in the recovery phase, etc.

How this question is answered from woman to woman varies depending on all of these variables. For some physicians, it’s quite cut and dry. At a certain time, your doctor may consider you no longer Postpartum and into full blown depression, anxiety disorder, etc.

The important thing to remember here is that even if your diagnosis changes, you are still making forward progress even if it doesn’t feel like it. I know it’s overwhelming to go back into that dark place, I do. I went back twice. Each time, it was worse than before. But you know what? I had been there before. I KNEW what I need to do in order to get out. Think of it as playing a video game level. Once you’ve played, even if your character fails and you find yourself at the beginning of the game, you know precisely what to do in order to get through what previously were potholes. So you see, you’re already ahead of the game. You can sides step these really dark holes which trapped you before. Fall into one? Okay. Climb out – you KNOW how to do it. You’ve done it before. You can still do it.

And just because you no longer have the official label of “postpartum depression/anxiety/OCD, etc, doesn’t mean that those of us who have PPD labels, etc, are going to shun you. If anything, we’ll just love you that much more.

Also important to note here is that if you develop a full-blown mental illness, expect your family to struggle with this new diagnosis as well. Many times it is just as hard for them to coped as it is for you. Your loved ones may have previously been accepting, understanding, and supportive. But they may now feel that you are out of the woods and this “relapse” is all in your head. If that happens, send them to me. I’ll set ’em straight.

Those are all the questions we have for today. Don’t forget to submit your questions for next week’s Saturday Sundries. I KNOW you have them!

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.

Therapy and the Postpartum Woman by Karen Kleiman

Karen Kleiman, a wonderfully dedicated therapist to the PPD world,  has authored yet another wonderful book, Therapy & the Postpartum Woman. Available for pre-order now,  this book will release in September and is written for the benefit of both clinicians and women with PPD to maximize the therapy experience on both sides. Click here to pre-order: Therapy & the Postpartum Woman

Here’s an excerpt of what Shari Lusskin, MD says in the foreword of the Therapy & the Postpartum Woman:

Ms. Kleiman presents a theoretical framework in which the therapist “mothers the mother” by acting as the “good” mother, who “must achieve that equilibrium between absolute support and appropriate boundaries.” Using compelling patient narratives, she demonstrates just how to achieve that balance in order to teach the patient how to develop confidence in her own skills as a mother. There is a treasure trove of “clinical pearls” in this eminently readable book, which even the most experienced clinician will be able to use right away. For those new to the field, and for patients and their loved ones, the book offers a wealth of information on the nature of postpartum depression as a medical illness and the psychosocial issues that arise when a woman is faced with caring for a baby. Ms. Kleiman describes how the medical community tends to minimize the complexity of these issues and use a “one size fits all” approach to treating depression. Readers will learn to be more effective advocates for proper treatment of perinatal depression. Therapists will also learn how to draw from their own experiences to facilitate the human connection between therapist and patient at a time when women feel isolated by shame and insecurity. Together, the therapist and the patient can work towards discovering the innate resilience that has allowed women to raise children even in the most extreme circumstances. Ms. Kleiman has developed a humanistic approach to psychotherapy for postpartum mood disorders that gives recognition to psychodynamic theory, but then uses many cognitive–behavioral techniques to reach well-defined goals. Therapy and the Postpartum Woman is an elegantly written book that not only offers practical advice but also does so in a way that will touch the lives of both patients and therapists. It is destined to become a classic for those experiencing or treating perinatal mood disorders.

Sharing the Journey with Karen Kleiman

Yes, I know this month’s interviews are dedicated to moms of women with PPD but I am just so excited about this interview that I just had to put it up!

If you’ve been following this blog from the beginning (and thank you if you have!), you know that Karen’s book, What am I thinking? Having a Baby after Postpartum Depression was what I grabbed immediately after the positive pregnancy test. It was that very book that led to the inspiration for this blog so in a way, this is coming full circle for me because it was about this time last year that I found out I was pregnant.

Karen runs The Postpartum Stress Center in PA and her website and books are the first places I will send a new mom or family member. She’s got her stuff together and in my opinion has some of the best straightforward advice and information for women and their families! I am so honoured to be sharing this with you and even more honoured that Karen agreed to do the interview. Thanks Karen for all your hard work! Keep it up!

 

What led you to specialize in women’s issues?

To steal a line from my new book, “Ever since I was a young child, I wanted to be a mother.”  I remember playing with dolls and always taking on the role of the perfect mother.  I remember proudly asserting to my own mother, “when I grow up, I’m going to be a mother!”  After studying to be a therapist and then, becoming a mother myself, it felt natural to narrow my professional focus to women and their unique needs.

How did the idea for The Postpartum Stress Center come about and what brought it to fruition?

When my children were born, twenty plus years ago, I went back to work part-time as a social worker and trained to be a lactation consultant so I could connect with new mothers when I wasn’t working.  That experience provided one of my earliest exposures to the emotional upheaval of new motherhood.  Women started telling me how bad they were feeling.  (As you can imagine, if you can talk to a stranger about your nipples, you can talk about anything!)  I wasn’t sure if it was because I was a therapist or because they were so overwhelmed, it didn’t matter who was on the other end of the phone, but either way, I became aware of how many women weren’t feeling good after they had their babies.  Some felt bad about their babies, some felt bad about their marriages, some felt bad about them selves.  The common themes were: lack of support, exhaustion, and chronic worry. 

So when I went into private practice, I started studying postpartum depression to better understand what some of these women might be experiencing.   It didn’t take long for me to realize that most of these women were falling through the cracks of the medical community, remember, this was twenty four years ago.  No one was talking about postpartum depression like they do today.  As my practice developed and I started treating more and more women with depression, it was apparent how insufficient the healthcare system was in response to this great need.  This is when my clinical practice evolved into the next phase which included psycho-education, trainings, in-services, and writing, in order to enhance the community’s understanding and promote optimal treatment options.

As a mother yourself, what has been most challenging? Least challenging?

As much as I hate to admit it… this Empty Nest thing… I don’t love it.  It’s funny, I often think to myself how fortunate I am to have such a loving husband (twenty five years with me cannot be easy!), a fabulous career and all kinds of wonderful things to fill my days.  Still, it’s hard not to have the kids here.  Both are close enough to home, but, it’s not the same.

Least challenging?  Laughing with and about my kids.  You know that feeling that a new mother gets when she hears her baby belly laugh for the first time?  It’s like you want to stop the whole world and tell everyone to listen to this exquisite sound, as if no one had ever heard a baby laugh before!  Nothing in the world feels better than hearing your baby belly laugh.  And when the baby is 15 years old, or 21, or 24?  It feels exactly the same way.  It’s magical.

How has becoming a mother changed you?

Motherhood has inspired all that I do, most of what I say, and much of who I am.

What activity refreshes you the most when you’ve had a rough day?

I love coming home and sitting on the deck with my husband after a day’s work; surrounded by flowers, birds, dogs, good food, and lots of laughs.  It is actually essential to my well-being.  I get very cranky if I don’t laugh.

In your opinion, what aspect of motherhood should be celebrated the most?

I don’t think there is any aspect of motherhood that can be singled out to be celebrated.  I truly think all mothers, as well as fathers, always do the best they can at any given moment.   Women need to stop comparing themselves to others; they need to try to quiet the critical voice inside their own heads and believe in themselves.  Mothers need to learn to celebrate their own accomplishments, big and small, and realize the greatness in all that they do.  If they wait for appreciation from others, they will, undoubtedly, be disappointed and disillusioned.

What led you to write The Postpartum Husband?

After working with the postpartum population for some time, I began to realize that husbands were often kept out of the treatment loop.   As more and more partners were joining our sessions, I became aware of their enormous influence on the recovery process.  Not only did they need information and support, but their presence and their connection to the process made a significant difference in how women recovered.

Your book, What Am I Thinking?: Having a Baby After Postpartum Depression, was what I grabbed when I got my positive pregnancy result for Cameron and it really helped me to put a positive spin on my pregnancy – inspired this blog, actually. What went into the authorship of this book and why would you recommend it to women who are facing either a decision about pregnancy or an unexpected pregnancy after experiencing a Postpartum Mood Disorder?

Well as you know, the decision to get pregnant after experiencing a previous postpartum mood disorder is a difficult one.  In my practice, I have seen that women will feel more confident, more in control and less anxious if they have information.  The information gathered from a previous experience of depression can arm a woman with details that can help her learn a great deal about herself.  It has been shown that preparing for the postpartum period by fortifying her resources can reduce the likelihood of a full-blown depression.

  As with all the books I have written, the women I see in my practice have literally led the way.  They tell me what they need to know, which is how I determine what should be addressed.  Postpartum women have taught me what I know and what I need to teach others.  I’m so glad to hear my book helped support you through your pregnancy and postpartum period!  And it inspired this blog?  What a sweet thing to say.  I think this blog is such a fabulous idea and I’m certain it has offered much support to women going through similar circumstances.

 I hope you don’t mind me plugging my newest book which is due out this September.  “Therapy and the Postpartum Woman: Notes on Healing Postpartum Depression for Clinicians and the Women Who Seek their Help” (Routledge, 2008 ) will be a nice companion book for women with PPD who are either in therapy or considering therapy. 

Any sage advice for families currently experiencing issues with a Postpartum Mood disorder? What steps should they take to help Mom get better?  

Talk to her.  Sit with her.  Stay close to her.  Tolerate her anxiety and ambivalence.  Encourage her to contact her healthcare practitioner.  If she doesn’t, make sure she knows you will do that with her or for her.   Do not assume she is fine if she says she is.  Stay connected to the process.  Do what needs to be done to enable her to sleep, eat, rest and get out for fresh air.  Remind her she is loved and no matter how long this takes, you will be there.  Tell her she will not always feel this way. 

If there was one piece of advice you could give to an expectant mother (new or experienced), what would it be and why would this be important for her to hear? 

An expectant mother is at a turning point in her life.  She knows that no matter how things unfold, her life will never be the same.  This can be experienced with great anticipation or with great anxiety.  Either way, it is best to prepare by being mindful and attentive; to her own needs, to those of her partner and to those of her marriage.
 
For women who may be symptomatic during or after their pregnancy, I am reminded of a wonderful quote by Emory Austin:

“Some days there won’t be a song in your heart.  Sing anyway.”