Tag Archives: Perinatal Mood & Anxiety Disorders

#PPDChat Topic 02.10.14: Love In The Time of Perinatal Mood Disorders

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When you are struck with a Perinatal Mood & Anxiety Disorder, as with any illness, you focus on healing yourself. It’s perfectly okay to do this but it is also important to remember that this experience extends to those you love as well. If you are in a positive environment, the people around you should be diving in to provide the safe cocoon you need to heal. Even in the most supportive environments, however, chaos still may thrive and after the initial crisis mode fades away and the sun appears on the horizon, a storm may be brewing just behind you.

It is beyond imperative for all of us, not just the one struggling against the beast, to focus on the form the relationship between our most intimate partner takes during the Perinatal episode. If we let it slide too much, the relationship may be irreparable.

Tonight’s chat will focus on how to deal with several types of relationships, a brief discussion of signs of dangerous types of relationships (and how to get help) as well as little things you can do to keep the romance alive in your marriage/partnership as you also navigate the waters of your Perinatal Mood & Anxiety Disorder.

There won’t be a worksheet go go along with tonight’s chat but there will be a resource sheet as well as some coupons/certificates you can share with someone you love who may be depressed (or, if you’re the one who’s depressed, share with someone you love as something that they can do for you to help you out). I sincerely hope you won’t miss tonight’s chat. It’s gonna be invaluable.

See y’all on Twitter at 830pm ET!

#PPDChat Topic 02.03.14: The Five Senses Challenge

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Life is lived through the senses, isn’t it? Memories are not just thoughts put on shelves in our brains, they are remembered best through sights, sounds, tastes, touch, and scents, right?

I remember my grandmother’s perfume. I could not, for the life of you tell you the name of it (I want to say Charlie, but I think I am horribly wrong) but whenever I briefly smell something similar, I think of her. Well, that and bouillabaisse but perfume is far more common.

The scent of ink takes me back to my childhood spent in the family print shop. That’s a cascade of memories – the sound of the presses whirring, the cutter chopping stacks of paper, the cement in the alley outside, the giant cardboard boxes and pallets of paper we would hide behind. Or the darkroom filled with massive amounts of chemicals I’m sure weren’t safe for me to be around but bring a dizzying memory of darkness glowing in the bath of a red light to the forefront of my mind.

Ocean waves crashing make me smell the salt spray drifting through the air, I hear the seagulls overhead, and the warm sun slowly baking me into a loaf of human bread. If I focus just enough, I hear the chatter of other people playing at the beach over the humdrum of the ocean waves.

The wafting scent of a cigar reminds me of my grandfather. He always had one chomped in his mouth as he puttered around outside, it seemed. Mix that with the scent of wet leaves in the fall and the memory of my grandfather is complete. Weird, yes, but that’s him.

Don’t even get me started on the deliciousness that is Entenmann’s or an Eggplant Parmesan sub because YUM. Oh, and delicious saltwater Taffy. OH the memories as it would melt in my mouth and stick to my teeth. Gah, I miss being a kid.

Right now, there is snow falling outside, floating and dancing as it drifts to the ground where it has collected en masse to add up to a minimum of 7 inches for now. It is a good healthy wet snow which means we get to make a snowman at some point. But for now, it is quite peaceful to just sit here and watch it silently and gracefully cover the entire landscape as if it were a bride preparing for her groom. Everything is draped in white, laden with heavy snow.

This week’s #PPDChat will focus on the senses and how living life mindfully helps you navigate your view away from the negative toward the positive. There is beauty in everything, it just takes a few extra minutes to tune in to the heart of it all. Once you do, you will find, however, that you can’t possibly miss the beauty in even the smallest of things.

I hope you will join me at 830pm ET tonight for this fabulous chat. Stay tuned for the worksheet to go along with tonight’s chat – I think you’re gonna love it!

How the @BostonGlobe got Postpartum Depression Wrong

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With more news stories mentioning Postpartum Depression these days, it is becoming painfully obvious that reporters are scrambling to get their facts straight. Bless them for trying but sometimes, even with the best of intentions, they fall short. Like Karen Weintraub’s article “When the ‘baby blues’ are something more” at the Boston Globe on October 21, 2013.

Karen defends herself in the comments (all two of them at time of writing) about the term “baby blues” by saying that in her researching for this piece, she discovered there is such a thing as baby blues:

Boston Globe Comments

Kudos to Ms. Weintraub for doing enough research to realize that baby blues ARE distinct from depression.

BUT.

There are a multitude of omissions and errors within the article as it stands right now. Let’s go through them:

Ms. Weintraub breaks the Perinatal Mood & Anxiety Disorder experience into only three groups:

  • Baby Blues
  • Postpartum Depression
  • Postpartum Psychosis

Immediately, sirens sound. Particularly because the case study, a Nicole Caligiuri, a first time mother, states she felt “angry and anxious” all the time. While anger/irritability is a sign of depression, anxiety combined with anger is typically (in my non-professional opinion) more closely related to an anxiety disorder. Ms. Caligiuri, however, was diagnosed with Postpartum Depression.

By ignoring the additional facets of the PMAD spectrum, Ms. Weintraub does a severe disservice to those mothers who may be suffering from Postpartum Anxiety, Postpartum Post-traumatic Stress Disorder, or Postpartum OCD.

Weintraub states that 50-85% of new mothers experience baby blues, 14% experience postpartum depression, and a “fraction of 1 percent of new moms” experience Postpartum Psychosis. If you go by those numbers (at the higher levels), nearly 100% of all new mothers experience one of these three phenomena and none experience Postpartum Anxiety, Postpartum Post-traumatic Stress Disorder, or Postpartum OCD.

According to Postpartum Support International’s Get the Facts page:

  • Approximately 6% of pregnant women and 10% of postpartum women develop anxiety. Sometimes they experience anxiety alone, and sometimes they experience it in addition to depression. 
  • Postpartum Obsessive-Compulsive Disorder (OCD) is the most misunderstood and misdiagnosed of the perinatal disorders. It is estimated that as many as 3-5% of new mothers will experience these symptoms.
  • Approximately 1-6% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth.

But in Weintraub’s scenario, there isn’t room for the nearly 20-27% of women who develop these particular Perinatal Mood & Anxiety Disorders. As a survivor of Postpartum OCD, I find this troubling. Particularly because OCD can scare a new mother into thinking she is experiencing a form of Psychosis due to the horrific intrusive thoughts.

As I have mentioned multiple times, it is beyond important to differentiate the varying aspects of a Perinatal Mood & Anxiety Disorder. Why? Because when you lump Postpartum Psychosis sensationalism in with Postpartum Depression, things get murky. You scare new mothers who may be a bit depressed into thinking if they go get help, they will be thought of as potential criminals and have their babes ripped from their arms the instant they admit to feeling anything less than happy.

An additional issue with this article is the strong focus on early motherhood. The logic of this focus is evidenced by the study on which it is centered but a quick mention that PMAD can persist beyond early motherhood would have been a quick fix for this bias.

Why is it important to emphasize that PMAD onset can extend beyond early motherhood?

Often, many mothers do not realize they have issues until they are well into the 6th month or more. I have had mothers contact me at almost a year postpartum to share that they think something has been deeply wrong since the birth of their child but they did not recognize it until now. Many Perinatal Mood & Anxiety Disorders crop up within the first 2-3 months, often immediately after the period of baby blues, but some mothers do not recognize them or even get hit with them until much later. PMAD’s can crop up  within the first 12 months after birth and even then, may not be recognized until much later. But this information is not mentioned anywhere in the article nor are we ever told at what point Ms. Caligiuri sought help.

I deeply appreciate Ms. Weintraub’s effort to reach out to Dr. Katherine Wisner and Dr. Michael O’Hara, respected experts in the research field of Perinatal Mood & Anxiety Disorders, however, I wish she (or her editor) had taken the time to allow this article to be a bit more clear regarding the wide scope of Perinatal Mood & Anxiety Disorders. I also wish a side bar had been included to resources for women and families who are struggling with these issues, particularly given that Ms. Weintraub included this quote from Dr. O’Hara:

Social support is probably the most important thing to provide a new mother, who is at a particularly fragile point in life, said Michael O’Hara, a professor of psychology at the University of Iowa, who has been researching and treating postpartum depression for three decades.

 

Postpartum Support International will connect new mothers with social support. Also, specifically in Hadley, Massachusetts, there is Mother Woman, a fabulous organization who is making fantastic strides toward improving access to support and care for struggling women & families. Advocates in the trenches, such as the volunteers with PSI and Mother Woman, recognize how important it is to have peers support each other so they do not feel all alone in the dark. It is an oversight that neither of these organizations are mentioned anywhere in Ms. Weintraub’s piece.

Overall, Ms. Weintraub, despite making a few blunders, seems to handle the issue at hand with a respectable grace. The study at the heart of the article focuses on the development of depression in children born to mothers who struggled with depression but Ms. Weintraub is fabulous in her handling of this issue, particularly with this paragraph:

But parents shouldn’t feel like they’ve ruined their child’s life if they go through a period of depression, Pearson said. The increased risk of depression in their children is small. Overall, 7 percent of teens are depressed, compared with 11 percent of teens whose mothers were depressed early in their children’s lives.

She side-steps the potential onslaught of guilt and gracefully allows parents to breathe a sigh of relief by including this information from the study’s co-author.

As I stated in the opening, coverage of Perinatal Mood & Anxiety Disorders is greatly improving. But we still have a long way to go to get to fully informed reporting. For the most part, Ms. Weintraub’s article is generally free of sensationalism, includes quotes from respected experts, and manages to allay any potential guilt a new mother with a PMAD may feel in reading it. However, it is still just a few small adjustments away from being truly spectacular and informative.

"Chest" by Flood G. at Flickr.com (http://www.flickr.com/photos/_flood_/7750480094/)

Wishing Upon a Magic Wand

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Once upon a time, there was a little girl who lived in a modern house at the edge of suburbia.

"Chest" by Flood G. at Flickr.com (http://www.flickr.com/photos/_flood_/7750480094/)

“Chest” by Flood G. at Flickr.com (http://www.flickr.com/photos/_flood_/7750480094/)

One of her favorite things was a trunk filled with dolls and stuffed animals from far away lands. She would open the trunk slowly, and carefully select a few toys with which to have tea.

Her favorite was a stuffed panda bear from China. There was nothing shiny or sparkly about it but the panda bear fit just so in the crook of her arm. When she wrapped it in a blanket, the bear transformed into a baby. She would rock it for hours after tea, whispering sweet nothings into its ear and smoothing the fur in between its ears.

Then, at night, just before bed, she would tuck the bear back inside the chest, telling it good night and wishing it happy dreams.

The little girl would clamber into bed for a night full of happy dreams about things she could do the following day with all her perfect toys tucked ever so neatly into the fancy trunk at the end of her bed.

As she grew older, she had different dreams. Dreams of a real baby of her own. The trunk grew dusty and the panda bear stayed inside, asleep for years and years.

Eventually, the little girl had a child of her very own. She wanted very much to hold it, rock it, and whisper sweet nothings into its ears. Kiss the sweet innocent cheeks and tuck it away for the night as she slept too.

But it did not work that way, the now-grown girl discovered. The sweet nothings were trapped deep in her heart, quelled from bubbling to the surface. The now grown-girl was sad, depressed, and anxious instead of being happy and carefree. What was this? How could she make this go away?

Then she remembered a story her father told her – about an enchantress in a forest far, far away. This enchantress turned sadness into happiness with the mere flick of a wand, something her father showed her every time she cried, imitating the enchantress’s wand with his finger as he carefully wiped her tears from her cheeks. So the now-grown girl decided to make the journey. She set about making preparations. Food, check, baby strapped to her chest, check. Unicorn to ride, check.

As she rode away from the castle, an uneasiness settled over her heart as she wondered if she would be able to make the journey all alone, with no help to care for her child. But she pressed on because she did not know where else to turn.

She rode for days until she saw the edge of the forest in the distance. As she settled in for the night, she snuggled her child close to her and stroked its hair. In the morning, she whispered, things will be better. You’ll see.

As the sun rose, so did she. She gathered up the things spread out from camp the night before and once again, strapped her wee one to her chest before flinging herself upon her unicorn. They galloped toward the forest. After a short while, she heard more hooves on the road behind her. Glancing back, she saw hundreds of other mothers, all with infants strapped to their chests, riding on unicorns. They too, were headed to see the great magical enchantress for the were exhausted with fighting against wave after wave of emotion.

Surely, one wave of a magic wand and they would be whole again.

They grew closer to the forest by the end of the day but could not quite seem to reach it as the sun sank in the sky behind the towering trees. So all the women dismounted and set up a great big camp not too far from the edge of the woods.

Together, they prepared dinner, they sang, they laughed, they shared caring for the babies they held. Then, at long last, they slept peacefully for the first time in months as volunteers took turns tending to the babes at the mothers’ sides. In the morning, breakfast was prepared and shared amongst the camp.

As the sun rose higher, the women, having been lost in their camaraderie, finally realized the forest had again shifted even farther away. But no one made a move to pack up and ride onward. Instead, they went about their business, laughing, crying, sharing, and helping where they could in the camp.

For you see, you do not need a magic enchantress with a magic wand when you have the support and compassion of those around you.

While peer support has been proven to heal women faster as well as prevent severe cases of Perinatal Mood & Anxiety Disorders, it is not often the only tool one needs to fight back. You may also need to see a health care professional to discuss more serious and intensive care methods such as therapy or a variety of medicine approaches – whether it be pharmaceutical or homeopathic. If you or a loved one are struggling with a Perinatal Mood & Anxiety Disorder, know that you are not alone. Reach out to Postpartum Support International to help locate resources near you.

Why Stigma is Not Like a Band-Aid

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Stigma sucks.

So does Stigmata but that’s a whole ‘nother topic.

Thing is, band-aids would do a better job of healing stigmata, as horrific as it is, than it they would to heal the misconceptions about mental illness.

For centuries, people have developed their own fears and prejudices in regards to those of us who struggle with mental illness.

We’re scary.

We’re violent.

We’re stupid.

We can’t function.

We should be locked away.

We are to be feared.

We are to be hidden.

We are to be whispered about.

We are not to be talked about at all.

We are to hide our illness the best we can.

We are an embarrassment to our families.

We can’t have friends.

We can’t have children.

We can make our illness go away.

We choose to be crazy, nuts, insane, loco.

We use mental illness as an excuse to not contribute to society.

We are lazy.

Meet stigma.

Stigma is a heavy blanket which covers all of us who struggle with mental illness. Not only do we fight against whatever illness it is we are diagnosed with, but we fight the blanket too. It’s a thick and heavy blanket society has flung over us to hide us as we try to function within their world. It’s hiding us. Just as a band-aid hides a wound.

Band-aids don’t always heal wounds. Sometimes a wound needs to breathe, to gulp in fresh air, scab over, and continue to grow new skin in order to heal. Fresh air is the equivalent of open conversation of mental illness not laced with stigma. Until we, as a society, are able to sit down at a table together to discuss mental illness without resorting to judging or stigmatizing those who struggle with it, we will never heal.

Stigma is not something which can be pulled off quickly like a band-aid either.

It requires a slow removal because stigma is a wound which has been festering for eons. Lots of tender care is required in order to aid in the wound reaching fresh air. Several layers need to be removed, slowly and carefully. Bold conversations, intense honesty, patience, compassion, and a dedicated desire to convey the truth about mental health are requirements.

It is possible to peel back the layers and allow the wounds to heal. Start with one person and you might be surprised where your ripple of truth ends up. But if you never start that conversation? Stigma will continue to thrive. Don’t hesitate to do something because you believe just one voice doesn’t make a difference. Because your voice, no matter how small, matters.