Tag Archives: Mood disorder

What Is Recovery?

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

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

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

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.

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

Seeking guest contributors

Due to a personal situation, I am currently unable to blog here at the moment. I am hoping to get back to blogging soon.

In the meanwhile, I would like to continue sharing stories and experiences of Postpartum Mothers (and fathers) here at My Postpartum Voice. Over the past four years, I have worked tirelessly to reach out to those who are struggling in an effort to help them feel as if they are not alone. While there is four years of material here, new stories and new perspectives are always welcome and may reach someone I may not be able to reach myself.

If you are interested in writing for My Postpartum Voice, please email me at mypostpartumvoice(@)gmail.com. I never edit for content, only for grammar and spelling. I believe when you are writing about your Postpartum experience, it should be in your voice, your words. I also never limit the length but prefer most pieces to be not much longer than 800 words. If your story is longer than that, it’s fine, we can certainly post it in sections. Topic is completely up to you but absolutely must relate to the Postpartum Mood & Anxiety experience in some way. Tips, personal stories, research, opinion, etc. – all welcome. Humor too – I’m a big fan of laughing your way through the darkness.

Also, you are more than welcome to submit anonymously. I realize that the Postpartum journey can be frightening and you may need to share but not wish to do so publicly. I will absolutely respect your wishes in this area and work with you to ensure your privacy is protected.

I look forward to hearing from you and hope that even if you are not ready or able to share a story, you’ll pass this on to someone who may be able to or ready to share theirs.

Thank you for reading, for supporting, and for sharing.

Postpartum Voice of the Week: 02.03.11: Searching for Hope

The following piece is an original story which was submitted for consideration. The author takes you from one of the darkest places she has ever been in to a place in which she offers hope to others. She’s still struggling in the midst of it all but thankfully has hope on her team these days. Without further ado, I give you this week’s Postpartum Voice of the Week:

 

I didn’t have a “mom” growing up. I had no one to teach me right from wrong, no one to talk to, no one to look up to. My mom was physically there, just enough to scrape by with the title of “mom.” When I needed her to get through some of the darkest times of my life, she wasn’t around. I was so miserable having someone who was supposed to be there, but who wasn’t. I had promised myself that I would be the mother to my kids that I never had.

The time came for me to be mom when my first child was born in 2008. I was overjoyed, ecstatic, blessed to have such a title and to give everything I had to this little baby. We welcomed his younger sister into our family in early 2010, and with that, our family was complete. I was ready to raise these children in a family full of love and be the best mom I could possibly be. I was meant to be a mom, it was the only aspiration I ever had.

Having had a difficult childhood myself, I knew the face of depression. I understood feelings of being worthless, hopeless, and simply not good enough. What I didn’t know was that these feelings could accompany the birth of a child. After my daughter was born, things gradually started getting worse. I would become irritable with every cry, angry every time a bottle wouldn’t soothe my crying little one, and just hostile when things weren’t going the way I had planned. Six months had gone by; I had brushed the feelings off my shoulder as if they were “normal.” I had 2 kids under 2, things were supposed to be hectic, right? Running on very little sleep, being needed by two kids simultaneously with only 2 hands was enough to make any mom a little discouraged when things were rough and there was no help in sight.

Six months postpartum, I had noticed I wasn’t getting better. The irritability was at its worst, I had those same feelings of worthlessness that I had once experienced, I had no desire to take care of my kids, I had no desire to even take care of myself at this point. I let all the housework go, I cried at the drop of a hat even when I had no logical reason for crying, I started spending more time in bed, and nothing seemed worth it anymore. I had awful thoughts of leaving my children, my family, and never looking back. I just didn’t want anything. I felt like a failure; I wasn’t even good at what I wanted to be for so long…a mom. My children didn’t deserve me anymore. I kept thinking of my mom, and how there were times I wished she weren’t around-that she weren’t my mom. I didn’t want my kids to grow up wishing I wasn’t their mom or that I wasn’t around because I was a spitting image of my own mother. I thought taking myself out of the equation was the best decision for my family. I whole-heartedly believed someone could do my job better.

No matter how much I wanted to in that moment, I couldn’t ever leave my children. Ever. I knew something was wrong, and I needed help immediately before such irrational thoughts became my reality. I asked my husband to drive me to the hospital, that it was an emergency. He really had no idea what was going on, my feelings were kept to myself because I didn’t want anyone to think bad of me or that I was a bad mom for having such thoughts. After being evaluated for an hour, I wanted to walk right back out the doors I walked in. I was scared; there was no way I belonged there. Seeing other patients walk the halls with their head down, the screams that came from rooms down the hall that warranted a handful of doctors to hurry off, I knew this was a mistake. My anxiety was too much for me to handle at this point. The evaluating nurse asked me many questions that left me with feelings of shame. How could I have such deep, dark feelings when I have two beautiful children at home needing me? Needless to say, I was admitted. There was no turning back, I was there and there was no way out. Although I knew this wasn’t the right place for me, I made the decision to get everything I possibly could out of this hospital stay. I told the numerous psychiatrists and therapists I saw on a daily basis exactly how I felt, why I was there, and let them in on my life (which is something I don’t do until I have full trust in a person). Against medication from the beginning, I openly tried whatever meds they wanted to put me on because I was desperate to get better. I was diagnosed with PPD/PPA/PPOCD. What was that? I had no clue there was such a diagnosis. I was never talked to about this. After nearly a week of being there, I was released…sent on my way. I had the number to a psychiatrist and a therapist whom I was instructed to follow up with. I did just that. The psychiatrist changed my meds completely, and it was only weeks before I started to really see an improvement in my behavior. I’m still working on finding the right combination of meds to keep me stable, and we’ll go from there.

What I can tell you is that I now have hope that things will get better. If someone would have told me something, anything, about PPD ten months ago, I wouldn’t have hit rock bottom before reaching out for help. I wouldn’t have gone through four months of absolute misery thinking of how bad a parent I was and how guilty I felt that I couldn’t take care of my own children. I saw multiple healthcare professionals during my months postpartum- the OBGYN, my family doctor, my children’s doctor, nurses at hospitals when my kids were sick, yet no one ever asked me how I felt emotionally. I was too afraid to bring up my feelings, fearing they would tell me it was all normal and I was worrying too much. I almost took my life because I thought I had ruined not only myself, but my children. I almost walked out on the two most important people in my life because I thought I was crazy. The fear of admitting the awful thoughts I had was bizarre. I believed people would immediately think I was “crazy” or “undeserving” of my children. But I reached out. I took control of my own behavior. I waited too long hoping that someone would help me. I waited too long thinking I would eventually get better on my own. I waited too long to take this illness by the horns and control my own destiny. I wanted to get better so bad for my children, for my family. However, it took me wanting to get better for MYSELF before I had the courage to do so, to reach out and put myself and my feelings out there into the hands of people who have the control and the knowledge to help me. My biggest motivation was the thought of having to live the next day as miserable as the day before. Things needed to change.

These postpartum mood disorders have me in check. Every time a thought passes through my head that I have conquered this beast, I am made aware that I am still on my journey to recovery. I am, by no means, fully recovered from PPD/PPA/PPOCD, but it no longer controls me. I control it.

As awful as this journey has been, I have become a better person because of it. I have learned to cherish every moment with my children, from the sleepless nights to the temper tantrums. I have learned to appreciate things for what they are, rather than what I want them to be. Most importantly, I have learned that even in the late hours of the night, or on my darkest days, I am stronger than I think I am. I can get through the bad things, and things will get better. There is hope, and that’s what keeps me going…

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Postpartum Depression is not just tears

Postpartum Depression is not just tears.

It can be anger. It can be irritability, frustration, insomnia, obsessive compulsive, or anxiety.

Postpartum Mood Disorders can manifest in mothers in so many different ways.

Not only do we fight against the stigma of struggling with a mental illness and/or not being thrilled about our newfound motherhood, we also fight against the stigma of what a mom with Postpartum Mood Disorder must be like. So many moms don’t reach out for the help they so desperately need because they don’t “have the typical symptoms” of Postpartum Mood Disorder.

It’s not all tears.

I found a blog post which speaks to this precise issue. Written by a mother of three currently expecting her fourth, she bravely shares her experience and admits that she would never have classified herself as having Postpartum Depression because she “wasn’t sad, I didn’t cry, I took care of my children.  My house was clean, my responsibilities taken care of. I didn’t sleep a lot, or wallow in my own misery.”

Go read the entire post here. Leave her some love and let her know she’s not alone!

After hitting publish, another mama left her blog post about the VERY SAME topic in the comments. Rather than leave it hidden down there, I want to encourage you to read her post too. Entitled Postpartum Disorders, this mama, Sarah, over at Dandelion Roars writes a great piece about how Postpartum Mood Disorders were not all she thought they were supposed to be – she even states she had never heard of Postpartum Depression. Most importantly, she points out that there is a myriad of disorders between Postpartum Depression and Psychosis.

Go read Sarah’s post too.

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Saturday Sundries 01.22.11: Stigma, Meds, Relapse, Pregnancy

Saturday Sundries: A Postpartum Q&A Series (Original Graphic created by Lauren Hale for MPV Copyright 2011)

Welcome to Saturday Sundries, A Postpartum Q&A Series. This series will be dedicated to answering questions asked by you, the readers of My Postpartum Voice and Twitter friends of @unxpctdblessing. Ask away. I will answer, to the best of my ability, any question. Sometimes the best answer I will be able to provide will involve discussing the issue with your physician. I am not a doctor, I am not a therapist, I’m just a Mom turned advocate after experiencing Postpartum Mood Disorder twice. I provide peer support and nothing more.

In the interest of furthering discussion about Postpartum Depression and tearing down the walls of Stigma, I hope you will ask questions. Don’t make them easy. Ask the hard questions. If you want to ask a question and stay anonymous, that’s cool too. You can email me at mypostpartumvoice(@)gmail(dot)com with your questions. Just specify you would like it answered anonymously. There’s no shame in not wanting to reveal yourself or your struggles. I get that. But you still deserve to have your questions answered. Someone else out there may need to have that exact question answered but they may not be able to ask it at all.

This week’s questions come straight from Twitter. There are only four this week (the most I’ll take each week is five) but they are excellent questions.

Let’s get to answering them!

 

First up: @MamaRobinJ asks: How would you recommend making a decision about another pregnancy when still dealing with #PPD & on meds?

Awesome question. The simplest answer I could give to this one can be summed up in one word: Carefully. But you didn’t ask me this question to get an ambiguous one word answer, did you?

There are a two books I  highly recommend to any mother considering this very issue. The first book is Karen Kleiman’s What Am I Thinking? Having a Baby After Postpartum Depression. It proved to be very helpful for me. (That book is why I started this blog!) The second must-have book for any mother considering this issue would be Pregnant on Prozac by Shoshana Bennett.

One of the most important things Karen addresses is the level of fear a mother should have when faced with another pregnancy after PPD. Karen states that a healthy fear of relapse, etc, worries her less than a mother who is convinced she can breeze right through a pregnancy and postpartum after a Postpartum Mood Disorder experience. She’s right. She also talks about reframing the experience in a positive manner. (Hence, my blog.)

If you are already on meds, hopefully you are already in therapy as well. I would strongly recommend discussing this choice with your caregivers, your therapist, etc. Assemble your team, focus on your care, and prepare for the possibility of a relapse after giving birth if you decide to go ahead with getting pregnant. You’ve done the baby care thing before. You’ve done the PPD thing before. Think like a Boy Scout here and Always be Prepared!

It’s important to note here that no one should ever EVER EVER EVER EVER go cold turkey off their meds. Again, I am not a doctor. But if your doctor tries to tell you that you need to immediately drop any psych meds, run, don’t walk, to another caregiver who is willing to work with your own personal beliefs and needs. The issue of medication during pregnancy is very well covered in Pregnant on Prozac. Shosh even covers how to handle uncooperative doctors. Seriously. If you’re on meds and thinking about pregnancy, or you might end up back on meds, GET THIS BOOK. Make your husband/partner read it too. Make him read the Karen Kleiman book too, if he will. Reading both of these books will profoundly influence your experience.

I should mention that some women do relapse no matter what level of prevention they take. But if you assemble your team, have everyone ready to go before hand, even if you relapse, it will be caught quicker and your healing time should be less than if you take no prevention at all. The key here really is to be as pro-active as possible. Halle Berry once said during an interview with Oprah that when you fall back into the valley of depression again, the journey out is quicker than the first visit. Why? Because this time you have a road map. You know yourself, what works, and how to move through that valley better than you did the first time.

 

Second Question: @WalkerKarraa: Why is there so much stigma re: #PPD?

Wow, Walker. I could write a very long post about just that question.

Since Hippocrates, there has been stigma about PPD. These days, there is a silence around the issue of Postpartum Mood Disorders which infects almost every walk of life.

Every time you see an infant product commercial, regardless of the product, the Mom and baby are together, smiling, happy. Cuddling, bonding, cooing, grinning, etc. Don’t get me started on Baby Showers, the biggest sham this side of the Atlantic. Instead, we all smile and grin at each other, eat cucumber finger sandwiches, drink tea, all while ooohing and ahhhing over tiny baby clothes and annoying toys you may one day want to heave through the window of your home because Junior won’t stop screaming for the zillionth hour in a row and you’ve not slept in nearly a billion hours. Your eyes are crossed, your hair looks like you stuck your finger in a socket, and you’ve long forgotten what a shower is or even where the shower is in your home. Hot food? Distant memory. You can pee in 1 second flat, change a diaper even faster, and yet still you find yourself trapped on the couch or pacing the floor with a grumpy infant.

No one tells us about the hell we might face. No one opens up until we fall apart. Our society has built up such a high expectation of perfection – at this time the level of perfection is so high it is virtually unattainable. And when moms go to extreme lengths to reach those goals set by society and fall short, they blame themselves. We begin the Mommy guilt game earlier and earlier with each generation. We begin the Judge the Mommy game even earlier. The instant someone finds out another woman is pregnant, they feel they have a right to “inform” her of all her decisions and then expect her to choose to be pregnant and/or give birth THEIR way instead of HER way. So many choices, so much pressure, so many things which can go wrong. When things do go wrong, the mother is judged. She didn’t birth at home. She had a c/s. She had an epidural so… She didn’t breastfeed, she didn’t, she didn’t, she didn’t, she didn’t, she didn’t, she isn’t, she isn’t… she isn’t happy because….

Fact is, any Mom can get a Postpartum Mood Disorder. It’s the most common complication of childbirth. 1 in 8. But we’re not talking about it in the birthing or breastfeeding communities. We’re not talking about it in childbirth classes. We’re not talking about it at prenatal appointments. At 6 week check up appointments. At pediatric appointments. We’re just not talking about it.

Because if we don’t talk about it?

It’s not real.

And that’s why there is so much stigma.

Because if we just shut up about it, it’ll go away and we can pretend it doesn’t exist. It’s a shadow in the corner of the room and if we move just right, it will disappear. It’s the monster under the bed we convince ourselves isn’t really there.

It does exist. It IS an issue. And I refuse to shut up about it. I will get LOUD about Postpartum Mood Disorders until I am physically unable to do so any longer. Why? Because no one got LOUD with me and I nearly lost my life because of them.

If you think I’m going to let that happen to another mom on my watch, you, sir, or madam, are seriously mistaken.

 

Third question: @thewilsoncrowd asked: Is it possible to relapse in the middle of treatment? Suddenly back to feeling like I’m at square one this week. #PPD

Oh dear, yes. Yes indeed. Especially if something has triggered you.

But it’s so very important to put this in perspective – you say this week. Has this “relapse” feeling lasted all week? Longer than all week? Or has it just been a few days?

Again, not a medical professional, but relapse is usually more than just a few days here and there. For me, relapse would have to be a good solid week or more of just horrible bad days in a row during which I felt no motivation to try and heal through the methods that worked before.

If you feel you are relapsing, definitely get in touch with your doctors. It’s important to note here that any change in med dosage, sleep habits, PMS, or an increase in stress can make it feel like a relapse. Regardless of the root cause, you need to discuss this issue with your physician so the two of you can formulate a plan to help you stay out of this rut and continue on your journey toward recovery. Make it a pot hole instead of a sink hole.  You can do this!

 

Fourth question: @Preparing4Birth What medications are safe for breastfeeding… why is rapid weaning not a good idea?

I wish I could answer the meds question. I do. I don’t recommend specific medications over other medications. It’s really for a physician to do after discussing a patient’s situation with them. Your doctor should have a copy of Thomas Hale’s Medication & Mother’s milk for reference. If he doesn’t, get them one. Or encourage them to get one for themselves. You can also call your local IBCLC or talk with a La Leche League leader. Another great place for you to get information re: meds during breastfeeding is from OTIS Pregnancy. They even have handy fact sheets available at their website for specific medications. Go check to see if a med you have a question about is there.

Rapid weaning is not a good idea as it can cause several issue with both you and your infant. If you are talking about rapid weaning from nursing, that alone can cause severe issues with both the mother and infant dyad. The mother may experience engorged breasts as her system is absorbing the shock of no longer nursing the way to which it had become accustomed. Engorgement can lead to mastitis and infection. Mastitis is very painful and is considered an urgent medical condition. The infant is suddenly switched over to formula and his/her young and immature digestive situation is flung to the wind as those in “charge” wait to see what will happen. You may end up with a mother who may want to nurse, despite the risks of whatever med she is on. It is of the utmost importance for a physician to be sensitive to the nursing desires of a new mom. Nursing is either not working out at all or it is the ONE thing she is doing right. To take nursing away from the latter mom is to remove a positive left in her very dark world which is a bad idea.

Rapid weaning of any psychiatry medication is strongly advised against as it can cause some severe and even worse issues than being on the meds. Not only will you go through withdrawal, but your infant may go through this as well. And that’s just not good for anyone. If you are nursing and on medication, it is important to let your child’s pediatrician know what medication you are on and at what dosage so they can monitor your infant for any possible side-effects. Primary side effects with psychiatric medications with infants are sleepiness and weight gain. If your infant seems to sleep a lot or is struggling to gain weight, it’s important for your pediatrician to know you are on medication that might be causing these issues. Again, Thomas Hale’s Medication & Mother’s Milk is a very solid resource for this information.

Another important thing to note here is that, as with question one, preparation here really is key. Find out what meds you can take. Let your doctor know what your issues are, honestly. Also know what the risks are to both you and to your infant. It is also important to know the characteristics of the medicine you are prescribed, if you are prescribed one. Some meds may dry up your breastfeeding supply. Others make make you more annoyed than ever. It’s important to work with your doctors to find the approach which fits your philosophy the best. You are advocating for yourself AND for your infant here. Don’t be afraid to question things. Ask why. There is no line when you are protecting yourself and your infant. Question everything.

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On the First Day of PPD Dismissmas: A Wailing Mess in a Pear Tree

On the first day of Dismissmas,

Postpartum sent to me

A wailing mess in a pear tree.

 

Many mothers struggling with Postpartum Depression are not weeping, wailing, messes. Instead they may find themselves struggling with anxiety, irritability, insomnia, intrusive thoughts, jealousy of the other parent, a loss of desire for previously held hobbies or interests, etc. Also important to note here that a mom with a Postpartum Mood Disorder may be perfectly capable of putting on a mask to fool others (and herself) into thinking she is perfectly normal.

The baby blues may cause random bouts of crying or mood swings for the first two to four weeks after delivery for some new moms. If these symptoms get worse during or do not dissipate after the first month after giving birth, please reach out for help. 1 in 8 new moms go on to develop a full blown Postpartum Mood & Anxiety Disorder. You can get in touch with an ever growing network of knowledgeable moms and professionals through Postpartum Support International. PSI can be reached via their website or their warmline at 1-800-944-4PPD.

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