Tag Archives: Mood disorder

What Is Recovery?

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In glancing through search terms which people have searched to find my blog, questions about Postpartum OCD are the most common.

The biggest question, and the one I dread the most asks, “Do intrusive thoughts go away?”

My heart breaks when I am asked if the thoughts go away because I know where they are – how they’re feeling. How FRUSTRATING it is to want to be with your child and not have any intrusive thoughts flit through your head as they snuggle close to you and  drink in that sweet angelic baby smell in the dusk of the evening.

I know it goes away.

I know it fades.

What stays, and what is difficult for those of us who have OCD to differentiate, are typical parental fears – the nagging fear that something might happen to your child when you’re not watching. THAT stays forever. It’s not intrusive, it’s a normal heightened awareness which comes with parenting. When you have survived OCD, however, it is extremely difficult to keep these normal heightened awareness type thoughts from spiraling into intrusive thoughts. We constantly battle to keep them from growing into giant monsters.

Recovery, at least for me, is not a cut-off date. It’s a constant involvement in awareness of my feelings, reactions, and coping methods in regard to the ever changing world around me. It’s ensuring that in addition to my daily requirements, I’m taking care of myself as well. Recovery is not a discharge notice from a hospital, nor is it the last pill swallowed at the end of a prescription. It’s not the final therapist visit nor is it uttering the words, “I’m okay.”

This is how the dictionary defines recovery:

Recovery Definition

What is recovery in the living world?

Recovery is life.

It’s living and moving forward with a tenacity learned in the depths of hell, a grip on enjoying all the little things and a determination to not go back. It’s knowing that even if I do go back, I have a road map to lead me back out again.

Recovery is self-care, self-compassion, and self-respect.

It is knowing that it is okay to not be okay sometimes. Recovery is celebrating both the ups and the downs. It’s getting to know yourself SO well that you recognize the difference between yourself and depression/mental illness. Recovery is knowing exactly what to do when the ugly beast stirs to keep it from waking completely. It is about arming yourself with a cadre of weapons guaranteed to slay the succubus.

Recovery is acceptance.

It’s being okay with the tough days and providing a soft place to land when they happen. It’s having a support system in place for the bleak days, one that will also be there for the good days. It’s understanding that sometimes, you’re gonna feel angry about your mental health and that’s okay. It’s learning the range of healthy and unhealthy emotions and knowing when to reach out for help.

Recovery is being imperfectly perfectly you.

According to Alexander Pope, “To err is human.” Perfection is a fallacy (so is control). It is an impossibility we set up in our minds, a standard most of us will not reach. Do the best you can with what you have. There’s a special kind of joy (and peace) to be found when you let go of any expectations you, life, or anyone else may have forced upon you. When you are truly yourself, you shine.

Recovery is personal.

We cannot compare our journey to that of others. There are similarities, sure, but we each carry our own luggage and travel our own road. Our stories are as different as we are from each other. Knowing someone else has traveled a similar road helps. But it is absolutely important to remember that just because someone was at point X by a certain point on their Y timeline does not mean you will also be at point X at the same time. There are SO many variables to every story. It is impossible to compare so stop doing just that.

Recovery is…..

Your turn. What is recovery to you? Share below.

Far from perfect

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Tousled whisper thin golden hair fell softly around my face as I pulled a stuffed animal from beneath a toddler-sized shirt. Cradling the stuffed creature delicately in my arms, I leaned down to whisper a promise:

“I’m your Mommy. I’ll love you forever. You’ll see.”

In toddler years? Forever lasts two minutes. If that. I repeated this action over and over again as a child. Motherhood, you see, was my dream. My aspiration. My definition of self.

20 something years later, I grew three real babies over the course of four years under an assortment of plus-sized maternity shirts.

I learned birthing a baby was nowhere near as easy as yanking a stuffed animal from beneath a shirt. It was hard work. It hurt. It was traumatizing. And that love? It’s not always there immediately. Sometimes, it’s confusion. Frustration. Anger. Doubt. Guilt. Apologies. Tears. Overwhelming sense of failure. Depression. Obsessive Compulsive Disorder. Anxiety. Post-Traumatic Mood Disorder.

In short, birth and the aftermath is MESSY.

You can’t turn your back on the aftermath. There’s a creature there requiring attention when you want to sleep. Needing to nurse or feed when all you want to do is cry. Wanting to play when you want to sit. Asking questions when you long for silence. There’s this intrusion on your life, this thing to which you may not know how to relate.

What do you do?

Some rush forward, headlong into the fray, successfully.

Then there are those of us who hate those who rush headlong into the fray successfully. Because we don’t know what the hell we’re doing. We’re frozen by fear. Frozen by anticipated judgment of our decisions. Frozen by the potential for failure. The potential of screwing up our kids. Frozen by selfishness. By not knowing what to do – by not wanting to be a parent. By the loss of ourselves. The loss of our lives. Failing to integrate our lives with the needs of this new intrusion, this tiny helpless being imposed upon us. We retreat. We fall back and wonder what’s wrong with us. We wonder why we’re flawed.

But are we flawed? Is there really something wrong with us deep down? Should we be afraid of these “flaws” or should we embrace them?

Yes, there are parents who suffer from Mental Disorders after the birth of a child. I know, I was one of them after the birth of both my daughters. I apologized to my first daughter when she was 7 days old for not knowing how to talk to her. As if she had already memorized Merriam Webster’s entire dictionary, Mother Goose, and Hans Christian Anderson. I refused to leave the house unless I had to because EVERYONE judged me with just a glance. (They didn’t, but inside my fishbowl head, they absolutely did.) I cried. I screamed. Horrible thoughts zoomed in and out of my head.

But I learned.

When my second daughter arrived, we recognized symptoms sooner. Help arrived quicker. Yes, I was hospitalized but it was necessary. I recovered much faster despite the additional complications of her special needs and NICU stay. I started to heal.

Then her brother dropped in as a surprise. I quickly worked on advocacy and care for myself. I was the complication, not the baby. Already experienced in advocacy for others, advocacy for self came naturally. My doctor worked with me, not against me. He treated me as a trusted partner instead of a subordinate. I developed a Postpartum Plan for myself. Handed it to my everyone involved in my life and in my care. I thrived and had a successful Postpartum experience until three months after his birth when all hell broke loose in another area of my life. But because of my careful planning with my postpartum experience, thankfully, I had everything in place I needed in order to deal with this dam break.

I still failed with the hell which slid my way after his birth though, because instead of diving in to advocate for my own care, I waited for someone to dive in and help me. I didn’t ask for help. I waited. Like a fool. I focused on daily living while I waited. Only the necessary – just enough to get by. I buried my issues with the situation at hand and moved forward without dealing with it. I failed to reach for my scalpel and explore the problem. I didn’t dig around to figure out the landscape. So it festered until it exploded, my marriage along with it.

Instead of accepting responsibility for this explosion, I shifted it to everyone else when in reality, I failed to deal with the issues appropriately. Yes, the source rooted elsewhere, but my failure to deal with the aftermath appropriately is ultimately what caused the explosion. No one is responsible for my actions but myself.

Life is messy. It’s not some neatly wrapped package to be displayed in a store window during the holidays like a Norman Rockwell painting. It’s more like a Jackson Pollock piece in progress. Somewhere, eventually, someone will think it’s fabulous and want to buy it. But most will simply see the mess instead of the passionate art deep within.

Bernard Baruch once stated, “The art of living lies less in eliminating our troubles than in growing with them.” Life is art if you just let go of expectations, of definitions, and learn to LIVE instead of satiate the constant needs of others. Selfish? Yes. But ultimately selfless. How? By letting go and living for YOU, you give more of yourself. You learn what brings you passion, you learn your flaws, you recognize them as beautiful, you recognize that yes, even your weakness is beautiful and not something to be hidden away.

For a very long time, I’ve wrapped my problems in wrapping paper, placed them gently and neatly on a shelf inside my head, then walked away. It worked until the room overflowed and the door burst open, dust, paper, and all my issues flying every which way. I’m sitting in the middle of my brain these days, cleaning house. Step by step. Inch by inch. Face to face with issues I thought I dealt with ages ago.

I don’t know who I am completely these days. I’m not sure where I’m going in life.

But I do know one thing – that room in my head? The one with the shelves? Won’t be rebuilt.

Instead, I’ll be grabbing my scalpels and digging around in my messes in the hopes of understanding them before moving on. Yes, it will be chaotic and unrefined. But it will be resplendent imperfection.

I’m far from perfect. I will make mistakes. I will fail. But I will learn from those mistakes and failures. And that? Makes my life the most beautiful piece of art I will ever have the honour of witnessing.

Go.

Thrive.

Be messy,  imperfect, and blissful.

Make your life Art.

There’s no other way to live.

Dear Abby downplays potential Antepartum depression

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Yesterday, a letter to Dear Abby from a woman seven months pregnant received an alarming response. This mom-to-be states she never wanted to be pregnant. She goes on to share her inability to find any websites for women like her – only websites filled with women cooing over their bellies, etc. Her husband reacted negatively when she shared with him her emotions regarding the pregnancy. Mom-to-be is frustrated, doesn’t want to be pregnant, and flat out asks Dear Abby if there is something wrong with her.

Dear Abby responds:

“No, there’s nothing “wrong” with you. You’re just not particularly maternal.”

Um.

What?

Now, I realize all women are not maternal. It’s okay to not be maternal. However. There’s a difference between non-maternal and a mood disorder. There’s also great potential for this situation to not resolve itself without solid professional help.

To Abby’s credit, she does recommend the mom discuss her emotions with her OB to ensure she’s not suffering from pre-partum depression. But then she goes on to share something very alarming with this new mother. “When your baby arrives, I’m sure you will fall in love with him or her as many other women have.”

Sighs.

Oh Abby.

Not familiar with the research showing Ante-partum depression as a risk factor for Postpartum Mood Disorders?

What about the risk factor of unplanned pregnancies on Ante-partum and Postpartum Mood Disorders?

Not familiar with mothers who do NOT connect with their infants at birth or months afterward?

I’m all for providing hope. But to be unrealistic about it is downright irresponsible. Perhaps this mother will fall in love with her infant. But she may not. And now she, along with millions of other mothers in her situation who read this piece, are pinning their hopes on a potential unrealistic outcome which will only cause their guilt and shame to increase when they DON’T fall in love with their infants. No resources were provided. Nothing other than “Talk to your OB.” What if her OB is an idiot? What if he/she dismisses this mother’s concerns just as you have? This mother, and MILLIONS others like her are now left with only your words and those annoying cooing websites for cheery moms.

Postpartum Support International is a great place to turn to for support for Ante-partum depression. There are also several blogs with invaluable posts and insight into ante-partum depression. There’s also #PPDChat on Twitter for instant support regardless of where you’re at in your pregnancy or postpartum.

Thankfully, we’re talking more and more about this. Not nearly as much as we need to but it’s a burgeoning topic. Pregnancy does not always equal a glowing mama. Sometimes it equals a sad/anxious mama. It’s okay. You’re not alone. There is hope. There is help. If only Dear Abby had been responsible enough to provide some for this mom. Instead, she jots off a quick unresearched response which leaves her out in the cold.

Way to go, Abby. Way to go.

Don’t judge me

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Last night, I asked my #PPDChat Mamas to chime in with suggestions for today’s chat. To the left is a suggestion I received this morning from Amber over at Beyond Postpartum. It got my wheels turning. Judgment, to me, is such a dirty dirty word. The following post is what spilled out as I thought more and more about her suggestion. Read. Share. Comment. Love one another, mamas. And daddies. Love. Don’t hate. Don’t judge. Love. It’s why we’re here.

Why do we judge one another, mamas?

Why?

Aren’t we all in this together?

Don’t we all have the same job when it comes down to it?

Do you know why that mama is giving a bottle?

Do you know why she’s chosen not to co-sleep?

Did you ask? Did you ask if she’s doing okay? Or did you glare? Did you judge? Did you sit on your throne and think better of yourself because you nurse your toddler, have your infant strapped to you 24/7, and only shop in the organic section of the grocery store never stepping foot in the formula or diaper aisle?

Shame on you. Shame on you for judging. For not stopping to ask if this mama is okay. If everything in her world is still right side up. Shame on you for tossing guilt onto her already full pile.

We are all parents. Most of us fight the same battles every day. A child who whines when it’s time to sleep. An infant who screams for hours on end because of digestive issues. A house in which laundry and dishes get laid and multiply more often than we do. We fight through this day in and day out through a fog of exhaustion. We make lifestyle choices based on what we can handle… based on what is best for our families.

Just because my infant isn’t super-glued to my boob doesn’t mean I’m less of a mother.

Just because my toddler stopped nursing before 2 doesn’t mean I love her any less. It doesn’t mean she loves me any less.

Two of my kids have had formula. I feared judgment. But I shouldn’t have been forced to worry about that. I fed my children. They thrived. I thrived. We all thrived. The end. The in between doesn’t matter.

My kids eat non-organic bananas too, by the way. And watch TV. Yes, they LOVE chocolate. And candy. And have eaten at McDonald’s.

I’ve ordered pizza because I didn’t want to cook. Popped open Chef Boyardee for the same reason.

Thank GOD.

Because frankly?

I’m not the kind of mom who can throw myself under the bus on purpose.

No, I’m the kind of mom who’s accidentally stepped in FRONT of the bus and been run over a couple of times.

There’s no full body cast for me but my brain’s a bit loopy still so excuse me if I’m not the Stepford parent I’m supposed to be at the moment. Excuse me if I look a bit more like Roseanne instead of June Cleaver. You see, I’ve been run over by Postpartum Mood Disorders and need to take care of myself in addition to my children because if I don’t, it can get fatal. Seriously. FATAL. As in I might lose my life FATAL. So excuse me while I indulge my child in some Enfamil and pop culture in order to maintain my sanity.

It’s OKAY.

My kids know they’re loved. They’re thriving. They’re using three and four syllable words by the time they hit three.

More importantly?

They already understand mental illness. They know it’s not anyone’s fault. That it just happens. And that it’s okay. Sure, right now they think tickling is an appropriate therapy (it really was in our house, by the way). My kids don’t jump to conclusions. They show compassion. They help. They offer support when someone is sad. They are empathic. They already know the importance of self-care. Our oldest is seven.

The next time you jump to conclusions about another parent in public, remember your children. They are watching you. They are learning from you. Before you even inhale sharply and bite that bottom lip because some mom whips out a bottle to feed her newborn, ask yourself why you’re judging. Ask yourself if it’s your place to judge. Instead of inhaling and glaring, go say hi. Ask that mom how she’s doing. Refrain from judging. Understand we’re all struggling on the same road but need different tools for our own journey.

If we could just show a bit more compassion to each other, the world would be a much better place. Don’t you want to be a part of that world? I know I do.

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Guest Post: The Most Common Complication of Childbirth by Dr. Jessica Zucker, Ph.D.

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Perinatal mood disorders have been called the most common complication associated with childbirth. Mood struggles during the postpartum period run rampant but are consistently quieted by our culture’s focus on the overly idealized “glowing” new mother. Though many women gracefully transition into mothering, many others feel they are riding an emotional, hormonal, and physiological roller coaster- with no seat belt and no way to control the speed. With the glaring statistic of 15-20 % of mothers developing postpartum depression (not to mention all of the other perinatal mood disorders), it seems imperative that this public health crisis be addressed systematically and globally.

Perinatal and Postpartum Mood Disorder Statistics

• Roughly 10-20% of pregnant women experience depression

• One-half to three-quarters of all new mothers are affected by baby blues

• Approximately 15-20% of all mothers will develop postnatal depression

• Approximately 2-5% of new mothers develop obsessive-compulsive disorder

• About 10% of postpartum women are impacted by panic disorder

• 1-2% of post-delivery women experience postpartum mood disorders with psychotic features (30-50% of women have suffered a postpartum depression or psychotic episode in a prior pregnancy)

• Approximately 10% of men are affected by postpartum mood disorders

Postnatal mental disorders can be incredibly detrimental for infant development and attachment formation. “By 6 months, the infant exposed to a mother’s negative affect learns to extrapolate using that behavior with others. By ten months, the emotional responsivity of infants of depressed mothers is already organized differently from that of normal infants.” Determining primary, secondary, and tertiary preventive approaches to perinatal mood disorders will increase the likelihood of generations of healthy baby-mother attachments.

How do we make burgeoning families more of a healthcare priority? Who routinely has the opportunity to discuss maternal psychological and physical transitions with pregnant and parenting mothers? Through the dissemination of maternal mental health information, preventive education, employing diagnostic screenings, and providing additional supportive resources to women and families, the silence and shame that infiltrate postpartum mood disorders may begin to dissipate. Ideally situated, obstetricians and midwives (among other healthcare practitioners) and their unique relationships with pregnant and parenting women, can provide a way to thoughtfully prevent and carefully identify perinatal mood disorders. Here are some initial thoughts on the impact healthcare providers can have on the lives of pregnant and parenting families with the aim of precluding postpartum mood disorders.

Eight Ways the Obstetrician and/or Midwife Can Make Strides Toward Better Serving Pregnant Women and their Burgeoning Families

1. The obstetrician/midwife should be aware of the potential affects of antenatal mood disorders and maternal stress on fetal development and birth outcomes. Getting appropriate training in postpartum mood disorders will allow families to feel safer in their care.

2. Knowledge of the latest research about the efficacy and safety of psychotropic medications during pregnancy and lactation can facilitate authentic discussions about the risks and benefits if medication is indicated.

3. The obstetrician/midwife has countless opportunities throughout pregnancy and at the postpartum visit to talk with patients and their partners about the various risk factors that contribute to postpartum mood disorders, signs to be concerned about, and available local resources. These discussions can be woven seamlessly into routine appointments and allow the patient to feel more deeply understood. Research states that postpartum mood disorder prognoses are best when identified and addressed immediately.

4. Understandably, many women feel confused and conflicted by feelings of maternal ambivalence or outright unhappiness. The obstetrician/midwife can help normalize various feeling states as well as educate patients about perinatal mood issues and possible treatment options. Addressing psychosocial issues increases trust and patient satisfaction.

5. If women with mood disorders are identified at the initial prenatal visit, a consultation with a psychiatrist needs to become part of their care. Women who have experienced previous postpartum mood disorders are at increased risk for reoccurrence.

6. The American College of Obstetricians and Gynecologists (ACOG) recommends a timely screening method- asking the following questions:

(a) Over the past 2 weeks, have you ever felt down, depressed, or hopeless?

(b) Over the past 2 weeks, have you felt little interest or pleasure in doing things?

These simple questions may provide a springboard for exploring mood related concerns and becomes a way to check in about potential psychosocial issues at each prenatal visit.

7. Pregnant and parenting women should feel that all of their physical and psychological concerns are valid and have a place within the patient-doctor/midwife relationship. Fostering an intimate environment through relational sensitivity and candor may increase the likelihood that women will not suffer in silence.

8 . Obstetrician’s and midwives would benefit patients by routinely providing perinatal mood disorder literature as well as local and national therapeutic resources to women and their families.

Sources:

Perinatal and Postpartum Mood Disorders: Perspectives and Treatment Guide for the Health Care Practitioner (2008) edited by Susan Dowd Stone and Alexis E. Menkins

The Pregnancy and Postpartum Anxiety Workbook (2009) by Pamela Wiegartz

Dr. Jessica Zucker is a psychotherapist in Los Angeles specializing in women’s health with a focus on transitions in motherhood, perinatal and postpartum mood disorders, and early parent-child attachment and bonding. Earning a Master’s degree at New York University in Public Health with a focus on international reproductive issues led to working for the Harvard School of Public Health. After years of international public health work, Dr. Zucker pursued a Master’s degree in Psychology and Human Development at Harvard University with the aim of shifting her work from a global perspective to a more interpersonal focus. Dr. Zucker’s research and writing about various aspects of female identity development and women’s health came to fruition in her award-winning dissertation while completing her Ph.D. in Clinical Psychology. Dr. Zucker is currently writing her first book about mother-daughter relationships and issues surrounding the body (Routledge). For more information: www.drjessicazucker.com