Monthly Archives: October 2008

Sharing the Journey with Ruta Nonacs, M.D.

Dr. Ruta Nonacs M.D., author of A Deeper Shade of Blue, also serves as Associate Director of the Center for Women’s Health at Massachusetts General Hospital and an Instructor in Psychiatry at Harvard Medical School. She received her MD from Cornell University Medical School and her Ph.D from Rockefeller University in New York.

She is very dedicated to ensuring women, families, and professionals have accurate information regarding depression during a woman’s childbearing years. In fact, her inspiration for her book, A Deeper Shade of Blue, lies within a strong desire to provide a carefully researched resource for women and their families that lays bare the myths and facts of symptoms, treatment, and recovery. Thank you Dr. Nonacs for your pioneering efforts in this area and I look forward to your continued work!

I sincerely appreciate her willingness to share her journey here and hope you enjoy her words!

Who IS Ruta Nonacs? What do you do when you’re not teaching or doing research?

I am trained as a psychiatrist and have spent my professional life doing a combination of research and clinical practice, working mostly with women during their reproductive years. I have recently been devoting more time to Postpartum Support International; it is one of my most important professional goals to increase awareness of postpartum depression. To this end, I spend a fair amount of time writing for both medical and lay audiences. Since having kids, I started working part-time and that has worked well for me. I have two daughters, ages 3 and 8, and I feel fortunate to be able to spend a lot of time with them.

How did you come to be interested in Postpartum Mood Disorders? Was there a particular experience or situation that drew you into the topic?

During my residency, the first patient I took care of was a young woman who was in the first trimester of her pregnancy, and I had the privilege of following her for the next three years. As a single mother, it was a difficult time in her life, and I felt that I was really able to help her a great deal. I can’t help feeling that this experience had something to do with my choices later on. I also had the good fortune of doing my residency at Massachusetts General Hospital, where they have a phenomenal perinatal psychiatry program.

As we both know, motherhood is a life-changing experience. How has motherhood changed you?

It has changed me in so many ways. For one, it has permitted me to slow down and enjoy all the little small pleasures in life.

Postpartum Mood Disorder recognition and treatment options have come quite a long way, even since my first episode a little over four years ago. How much further do we have to go and in your opinion, what can we do to facilitate the furthering of positive change regarding these conditions?

Depression in all shapes and forms carries a real stigma, and I think we still have a long way to go here. I think one of the things that has helped women with postpartum depression to get treatment is hearing about other women’s experiences with the disorder.

Moms need to take time for themselves in order to recharge their batteries. What is it that you do to relax and recharge?

I wish I could say that I am good at following the advice I give to my patients. I probably don’t relax as much as I should, but I do love bicycling, being outdoors, and photography.

Of all the research you have done in the Postpartum Depression area, were there any results you were particularly surprised to obtain? If so, what were they and why were you surprised? If not, would you mind sharing a brief overview of one of your favorite research projects with us?

I think one of the things I have enjoyed about my research (and my clinical work) has been the chance to make things better. Let me clarify this a bit. We have done a great deal of research on identifying risk factors for postpartum depression. Probably the strongest risk factor is having a history of depression or anxiety before pregnancy. By identifying women at highest risk for postpartum depression, we have been able to implement certain interventions that decrease the risk of postpartum illness. That means we can actually prevent postpartum depression, and that is a truly wonderful thing.

Tell us a bit about your book, A Deeper Shade of Blue and the related blog. What inspired these projects?

A Deeper Shade of Blue is a book for the lay public that provides reliable information on the spectrum of mood and anxiety disorders that affect women during their childbearing years. In this book there is information about postpartum depression and also about mood disorders that occur during pregnancy, as well as the psychological issues surrounding infertility and pregnancy loss.

I wrote the book because there is so little accurate information out there on these topics. While there has been increasing awareness of postpartum mood disorders, most women knew very little about mood and anxiety disorders that occur during pregnancy. There is also so much misinformation in this area; for example, many women assume that they can’t take medications during pregnancy or while they are breastfeeding, and that simply isn’t true. I wanted to give women a carefully researched resource, a guide that would help them to be better informed and to get the help they need.

What is your philosophy regarding your approach to Postpartum Depression? How did you develop this philosophy?

My general philosophy is that we can never afford to ignore postpartum depression. Even when it is relatively mild, depression takes a toll on a mother and on her family. This philosophy derives from my clinical experience — seeing way to many women who have not been able to enjoy or participate in important aspects of their lives because they were depressed and did not receive any treatment.

What advice would you give to medical professionals who may come in contact with a mother who is depressed? What are some of the best things they could do for this mom? What should they not do?

I think the first thing to do is to educate the mother. Many women don’t know a lot about depression; they do not know that this is a biological illness. They don’t know what treatments are effective. Depression still carries a significant stigma, and so many women are horribly ashamed about being depressed. Medical professionals need to help to enlighten women and help them to see depression as any other type of illness that requires attention. Medical professionals need to help women access the help they need, whether it is support from the family, talk therapy, or treatment with medications. These resources are sometimes difficult to find, and we need to make sure that women get the help they need.

And last but not least, if you had a chance to give an expectant mother (new or experienced) one piece of advice, what would you tell her?

As hard as it may be, you need to take care of yourself first. If you aren’t taking care of yourself, you can’t be the mother you want to be.

Say a Prayer

This past Monday, my mom called to ask if I had received an email from my brother. When I said no, she took a deep breath.

A friend of the family was killed suddenly on October 11, 2008 at two a.m. in an auto accident. Just two years older than myself, he died at the scene after a two vehicle accident. Jason and his mother welcomed my family when we moved to Virginia. The first summer we spent there involved a LOT of swimming in their pool and hanging out with him at church. Open, friendly, warm, and funny, Jason really made the adjustment to the rural country a little bit easier for us “Yankees.” I still can’t believe he’s gone even though I had not really thought of him in quite some time as life has moved on for myself and for all of us.

Jason went on to become a member of the National Guard and served an 18 month tour in Kosovo just this past year. He was also a highly decorated member of the local PD where my parents live. His funeral is this coming Sunday at 2p.m. If you can, at that time, please pause and just take a moment of silence for this fallen friend of mine. He was happiest helping others, something that is near and dear to my own heart. I truly do not have any words left to express how deeply saddened I am at the loss of Jason.

The One Flaw In Women

A good friend of mine sent this to me today. Good thing she did because I really needed to read it. Enjoy.

By the time the Lord made woman,
He was into his sixth day of working overtime.
An angel appeared and said,
‘Why are you spending so much time on this one?’
And the Lord answered, ‘Have you seen my spec sheet on her?
She has to be completely washable, but not plastic,
have over 200 movable parts, all replaceable
and able to run on diet coke and leftovers,
have a lap that can hold four children at one time,
have a kiss that can cure anything from a scraped knee to a broken heart
-and she will do everything
with only two hands.’

The angel was astounded at the requirements.
‘Only two hands!? No way!
And that’s just on the standard model?
That’s too much work for one day.
Wait until tomorrow to finish.’

‘But I won’t, ‘ the Lord protested.
‘I am so close to finishing this creation that is so close to my own heart.
She already heals herself when she is sick
AND can work 18 hour days.’

The angel moved closer and touched the woman.
‘But you have made her so soft, Lord.’
‘She is soft,’ the Lord agreed,
‘but I have also made her tough.
You have no idea what she can endure or accomplish.’

‘Will she be able to think?’, asked the angel.
The Lord replied,
‘Not only will she be able to think,
she will be able to reason and negotiate.’

The angel then noticed something,
and reaching out, touched the woman’s cheek.
‘Oops, it looks like you have a leak in this model.
I told you that you were trying to put too much into this one.’

‘That’s not a leak,’
the Lord corrected,
‘that’s a tear!’
‘What’s the tear for?’ the angel asked.

The Lord said, ‘The tear is her way of expressing her joy,
her sorrow, her pain, her disappointment, her love,
her loneliness, her grief and her pride.’
The angel was impressed.
‘You are a genius, Lord.
You thought of everything!
Woman is truly amazing.’

And she is!
Women have strengths that amaze men.
They bear hardships and they carry burdens,
but they hold happiness,
love and joy.
They smile when they want to scream.
They sing when they want to cry.
They cry when they are happy
and laugh when they are nervous.
They fight for what they believe in.
They stand up to injustice.
They don’t take ‘no’ for an answer when they believe there is a better solution.
They go without so their family can have.
They go to the doctor with a frightened friend.
They love unconditionally.
They cry when their children excel
and cheer when their friends get awards.
They are happy when they hear about
a birth or a wedding.
Their hearts break when a friend dies.
They grieve at the loss of a family member,
yet they are strong when they think there is no strength left.
They know that a hug and a kiss
can heal a broken heart.
Women come in all shapes, sizes and colors.
They’ll drive, fly, walk, run or e-mail you
to show how much they care about you.
The heart of a woman is what makes the world keep turning.
They bring joy, hope and love.
They have compassion and ideals.
They give moral support to their family and friends.
Women have vital things to say and everything to give

HOWEVER, IF THERE IS ONE TINY FLAW IN WOMEN,

IT IS THAT THEY FORGET THEIR WORTH.