Category Archives: advocate

My Bloggiversary present to you

Today is my third Bloggiversary. It’s been a very interesting three years filled with Postpartum Mood Disorders, Cleft Palates, drug addiction, laughter, love, a growing family and God.

Three years ago today, I started blogging to re-frame a pregnancy after experiencing a severe Postpartum Mood Disorder which landed me in the hospital.

Since giving birth, my blog has truly grown and expanded. It has provided solace, information, advocacy, and empowerment.

But, like any three year old, my blog been screaming for some independence and growth lately. (And aren’t we all a little too familiar with that screaming – sometimes you just can’t ignore it, can you? Admit it – sometimes you give in just to bathe yourself in the ensuing peaceful silence too!)

So here we are.

Welcome to the re-birth of my blog.

Welcome to My Postpartum Voice.

What does this mean for you?

"holding hands" by annstheclaf @flickr.com

It means a lot for you, actually.

I want this to be an active community filled with empowered strong survivor mamas willing to reach a hand behind, across, or whatever direction is necessary to inspire and provide hope to women currently struggling with Postpartum Mood Disorders.

I want us to take full advantage of the social media landscape, to build a forum filled with compassion for every choice a mother can make in her life. Where mothers will be accepted and not judged. A place where moms can come, kick off their shoes, and not worry about being judged for decisions they make in their everyday life.

I see video, photos, interactions, internet radio shows, audio, poetry, fiction, art, and anything else you can imagine.

This community is YOURS.

Let me know what you want to see here and I will do my best to accommodate your request.

You’ll notice the place is plain right now. We’re missing a couple of things:

A logo

A tagline

If you have talent in these areas or are want to suggest aspects of our logo, please do so in the comments.

I do what I do here for you. I’m looking forward to growing our new community together!

Postpartum Depression formal screening not worth the cost, BMJ study says

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According to a recently published study in the British Medical Journal (BMJ), Postpartum Depression Screening is not…. brace yourselves. Worth the cost.

That’s right.

NOT.WORTH.THE.COST.

In their cost effective analysis, the researchers used “A hypothetical population of women assessed forpostnatal depression either via routine care only or supplementedby use of formal identification methods six weeks postnatally,as recommended in recent guidelines.”

The conclusion was that overall not using a formal screening method was much more cost effective as it eliminated false positives.

So the mental health of a woman which will then affect her child, her family, her community, the world at large, are just not worth it to the National Health System of the UK. The EPDS scored out at about $67,000 per quality adjusted life years while no screening method scored at a price tag of just $20 – $30,000. No value for the money was found to exist when using the formal identification methods.

Did these researchers not read Murray & Cooper’s Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression which explores the effects of postpartum depression treatments on children?

There is SO much more at stake here than the dollar value to the National Health System.

There’s the potential for broken families. The potential for children growing into their own mental health issues, the potential for continued need for mental health treatment due to an undiagnosed episode of postpartum depression, potential for increased incarcerations due to untreated mental illness, continued sadness, the continued stigma, continued and perpetuated lack of education on the part of physicians in regards to Postpartum Mood Disorders.

The most interesting aspect of this study is that it focused on screening for Postpartum Depression in the Primary Care setting. Primary care physicians are not always comfortable or knowledgeable in screening for mental health issues. If a patient were to screen positive, that physician is then morally responsible for referring them to a specialist. Often times, at least here in the states, a Primary Care physician is unaware of where to refer a patient for help with a Postpartum Depression Disorder. Therefore, they become afraid of screening because they fear what will happen if a positive were to occur. What would they do with the patient? Where would they send them? How would they respond? Are they familiar enough with Postpartum Mood Disorders to recognize a false positive?

I think the key to the results of this study is not so much in blaming the high percentage of false positives but in urging that Primary Care physicians receive more training to enable them to recognize a false positive through more in depth questions after a positive is scored via the Edinburgh Postnatal Depression Scale.

original photo/graphic "Hand holding necklace" by K.Sawyer @flickr

A stronger safety net involving a stronger communication between midwives, Obstetricians, Pediatricians, and General Practitioners is so desperately needed to keep women from falling through the very big cracks which currently exist in the system.

Let’s think about this for a moment, shall we?

A woman gets pregnant. She sees a medical physician to get the pregnancy confirmed. Most mothers seek OB or midwife care for their entire pregnancy. Unless they’re depressed – depressed and mentally ill mothers are less likely to take good care of themselves during a pregnancy, making specialized care even more important even when baby is still in utero. Once mothers give birth, they are then shuttled off to the pediatrician’s office for the bulk of their medical contact. One six week or eight week visit to the midwife or OB to ensure mom is healing properly then an annual PAP visit unless something arises in between. Many Pediatricians focus on babies and not mother. But the tide is changing as more and more Pediatricians are taking into account the family lifestyle and well-being. My own Pediatrician does this and I absolutely adore her for it.

But overall, there is typically no continuity of care, no communication between physicians throughout the birth process. There should be. There needs to be. A woman deserves a team of support. She deserves to thrive. So do her children.

No matter what the cost.

Because once you fail woman and her children, you fail society.

Fail society and we fail to exist.

If we fail to exist….

Just Talkin’ Tuesday 03.23.10: How did you find your therapist?

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Original photo: "Everyday Use Items: a couch" by @foka_kytutr @ flickr.com

Congratulations!

You have broken through the fear to make the call for help.

But now what?

Unless you have a therapist tucked away with the burp cloths or shoved in a random diaper bag pocket, chances are you’ll be scrambling to find one after diagnosis with Postpartum Mood Disorder.

There are a lot of questions to be considered when searching for a therapist. Some are financial, some regarding training, and others regarding how experienced the therapist is with your specific diagnosis.

Just as you wouldn’t see an Oncologist for a Pulmonary Embolism, you wouldn’t visit a Substance abuse therapist for a Postpartum Mood Disorder.

But when you are in the throes of Postpartum Mood Disorder, you don’t necessarily have the wherewithal to be going down a checklist of requirements for a Therapist. (That is, unless you get lucky like me and develop Postpartum OCD. Then lists and keeping certain things in a very particular order becomes very very important to you.)

So how can you tell your therapist is going to be a good match or is trained in dealing with Postpartum Mood Disorders?

The first thing you need to know is what degrees to look for when ensuring the therapist you are considering is professionally and properly trained. A therapist will primarily hold a Masters level degree and be either a Licensed Social Worker or Counselor/Therapist depending on your state’s licensing office. A solid counselor should not hesitate to provide evidence of his/her training and current license status if requested. You may also see a Psychologist, who will hold either a Ph.D (research) or a Psy.D (Professional) for therapy.

The second thing to consider is specialized training in Postpartum Mood Disorders. If the therapist is truly focused/familiar with Postpartum Mood Disorder patients, he or she will be aware of Postpartum Support International, Karen Kleiman’s Clinician Training at the Postpartum Stress Center, or Pec Indman’s two day training via Postpartum Support International. If your therapist claims to be intimately involved with treating Postpartum Mood Disorder clients yet has no earthly idea who these people or organizations are, be wary. Ask what specialized training they have completed in the area of Postpartum Mood Disorders (if any) and how long they’ve been treating patients with similar diagnoses to yours.

Third, while your therapist is not meant to be your best friend, you should feel somewhat at ease during the appointment. If you feel uncomfortable or on edge during therapy, you’ll be less likely to disclose as much and therefore hinder your own journey toward wellness. It’s worth the search to find a therapist with philosophies similar to yours.

Do not be afraid to ask what their policy is on admitting to Intrusive thoughts. Many many women worry that if they admit they have thoughts of doing horrible things to their children, the children will be taken away from them. I faced this very same issue and asked my therapist this question before I admitted some pretty dark thoughts to her. Her response was that yes, she was required to report situations which indicated imminent harm to oneself or others but that she understood intrusive thoughts and their involvement in my particular diagnosis. This particular concern goes back to finding out what experience the therapist you are considering has with Postpartum Mood Disorders.

Dr. John Grohol over at PsychCentral has some good advice on how to tell a good therapist from a bad one. I would highly recommend you read it and keep these tips in mind.

Another great link to keep tucked away is “Tips for talking with your doctor” by Karen Kleiman over at the Postpartum Stress Center. She suggests starting with the doctor you feel most at ease with even if it’s your primary care physician. He or she can always refer you to specialists once a consensus is made that further help is indeed needed.

I now hand this post over to you, the reader.

What did you do to find your Postpartum Therapist? Any tips? Suggestions? What to look for? What to avoid?

Let’s get to just talking here!

(Tomorrow we’ll be discussing different types of therapy available for the Postpartum Woman. Stay tuned!)

The reprehensible spammification of Postpartum Mood Disorders

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Something is afoot.

Something strange, disturbing, and downright irresponsible.

Sadly, I am not surprised at this recent development given what a hot topic Postpartum Mood Disorders has become of late in relation to recently (passed!) legislation and the courage of more and more mothers speaking out about their own difficult experiences after the birth of a child.

More and more, I have been receiving very odd links in my Google Alerts for several Postpartum Mood Disorder related search terms. These links lead to websites that have absolutely nothing to do with anything maternal, postpartum, baby, family, or any other related topics. And the information included therein is anything but accurate or reliable.

Even worse, I’ve been seeing a lot of new websites crop up with blanket promises of “Curing” postpartum depression for one low price. (One website even includes a friends and family “coupon” which cuts the price in half just for you!)

My stomach has been churning at the very thought of at-risk women and well-meaning family members finding these sites.

Oh yes, ladies and gentleman, I’m talking about the spammification of Postpartum Mood Disorders.

I can tell the difference between a reliable website and an unreliable website.

Women who blog with me, survivors, experts, and others intimately familiar with the topic can tell the difference.

But what about women and families currently being tossed about on the big nasty Postpartum Sea? Can THEY tell the difference or will they fall prey to these deceptive tactics masquerading as effective life preservers in a hopelessly churlish sea?

Spamming is a disgusting and contemptuous act which has been going on for years. Many of our in-boxes sit full of spam. Some of it makes it through from the spam folder into our in-box making it seem even more reliable. And if one of these links were to make it into the in-box of an at-risk woman or a well-meaning but uninformed family member of a woman struggling with a Postpartum Mood Disorder, the results may prove ghastly.

So what are we to do?

How do we get educated and knowledgeable when it comes to dissecting the authority and reliability of a website?

There are a few steps you can take.

First, is the site’s URL address directly related to the topic you’ve researched?

Chances are that if you’ve researched Postpartum Mood Disorders or Depression and end up on a website for air conditioners, furniture, auto repair, or turf builder, you’re not at a reputable website.

Second, let’s say that the website you’re at DOES correlate to the topic you’ve researched and the word postpartum is in the URL address. That’s gotta be good, right? Well, yes, and no.

Does this website link to known organizations specializing in helping women with this issue? (Think Postpartum Support International) What’s their google page rank? Are they HON Code certified? (Think Postpartum Progress) What’s the story behind the person who put the website together? Are they clear about their training? Do they let you know they’re a Mom/peer supporter, a doctor, provide confirmable evidence of education/degrees/certifications? Can you find anything about them elsewhere? Have other bloggers or websites linked to them and endorsed them or mentioned them? Or are they only published at their specific website and other unreliable websites? (I don’t have a high Google Page Rank or an HONcode certification but I am working to improve my page rank and also toward an HONcode certification as well. I also over-research everything I put up here which is why sometimes I’m a little behind on posting about a hot topic. I’d rather get it right than have it up as soon as it happens)

Third – is the website trying to sell you something? Does the website promise a cure? Are they dismissive of an entire approach to treating Postpartum Mood Disorders?

If the website is really trying to get you to buy something without describing in detail what it is, you need to be wary. There is no one size fits all treatment. There is NO overnight cure for Postpartum Mood Disorders. Just as with all women, all pregnancies, and all deliveries, there are many different types of Postpartum Mood Disorders and they are rooted in different issues dependent on the history of the woman, the type of birth she experienced, her thyroid levels, anemia levels, etc. There are SO many different layers to uncover when it comes to a Postpartum Mood Disorder. It is dangerous to buy into a one size fits all approach. Just as labor is a fluid process subject to change at any moment given any circumstances, so is postpartum recovery. We all approach life with our own individualized chemistry and baggage. Matching sets don’t commonly occur out here in the real world.

The practice of Quackery has been around for eons and will unfortunately continue to exist as long as people are willing to grasp at any answers that may save them from their current condition. That being said, there are legitimate complementary treatments and alternative approaches available for treating postpartum mood disorders. Anyone worth their salt in dedication to helping women with Postpartum Mood Disorder will be open to supporting whatever path you choose to take toward wellness regardless of what type of methods you choose. In the same vein, anyone worth their salt will also strongly encourage you to work with medical professionals as you work toward wellness. Anyone worth their salt will also openly share their training, education, and base of knowledge with you as well. There should be no hidden cloak, no Wizard of Oz mumbo jumbo going on during your journey to wellness with a good provider.

Here are a couple additional links that may help you navigate your way through the 102,000 results you’ll get via Google in .20 seconds for Postpartum Mood Disorders:

Tips on Identifying Reliable Health Information on the Internet

Quackwatch.org

What can you do if you fall victim to one of these websites? First, you can file with the FTC. And if you’ve lost money and care to pursue legal action, you are entitled to do so under something called the Lanham Act. You can also contact the Better Business Bureau’s Online department by clicking here. You can also click here for seven tips on how to keep your email address from getting added to the growing number of spam lists out there.

As more and more voices speak up about their experience with Postpartum Depression, more and more Snake Oil salesmen will crop up to take advantage of the growing searches occurring on the Internet for information. It’s sad and blasphemously tragic but such has been the way for ages with many medical conditions.

Bottom line: If in doubt, throw it OUT. That phrase is handy in the restaurant industry and certainly handy here too. If a link promises too much too fast or reeks of a foul distrusting odor, throw it out.

Tread carefully. Think it through. Talk to a professional. Take care of you.

Tomorrow we’ll be sharing tips on how to tell a good doctor/therapist from a bad doctor/therapist.

Have any tips or insights to share on this? Email me at ppdacceptance(@)gmail.com.

Be sure to check back to see if your tips/experiences were included!

Why I support other Mothers

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I just wrapped up reading a post over at Her Bad Mother, If Prayers were Horses, Grievers would Ride. She’s talking about the recent death of her father and how to cope with her daughter’s questions about death. The post itself doesn’t have a thing to do with Postpartum Mood Disorders. But my reaction to it does.

When I first watched the video montage about Crystal that Joseph Raso sent me, I wept. My children were in the room. And here was mommy, huddled with her laptop, headphones on, tears sliding down my face, my body literally wracked with sobs. Did I know Crystal? No. Do I know Joseph? I do now but I did not then. But I DO know loss. I know the heartache it can bring. I know it all too well. And I suffered from it when I was a child. By the time I was 22, I had lost all four of my grandparents, two cousins, and several other relatives. Most of them succumbed to cancer.

The first death I remember was when my aunt died when I was five. I remember her only a little bit.

My first real brush with a strong emotional reaction was when my step-grandmother died on Thanksgiving in 1987. Imagine getting ready to go to your other grandparent’s house to celebrate and have fun only to have your parents sit you down in their bedroom to explain to you that your grandmother has gone to be with God. I wept. I’m starting to cry again now. Strangely, I just accepted this as part of life. But I had already been through a few other deaths prior to this one so for me, death WAS truly a part of life. We went to her memorial service as she had been cremated. I remember standing at the top of a spiral staircase staring out the windows at the rain. No one was around me, I wanted it that way. My heart hurt. My body hurt. I wanted my grandmother back but I knew she couldn’t come back.

Eleven years later, her husband, my maternal grandfather died. Just a few days before his death, I had a dream. I dreampt his death. I saw him gasping for air, not breathing, calling for help, no one coming to rescue him. A week later, he passed away due to congestive heart failure. This was the first time I had lost someone so suddenly. I became an empty vessel only capable of crying, moaning, thrashing. It was not a beautiful thing. A mere 19 days after this, my other grandfather died. I had nothing left to give. Nothing.

I share all of this to get to my point.

After I watched Crystal’s video, my daughter asked why I was crying. I gulped. Dear Lord, how do I explain this to a child? How do I tell her why this beautiful woman on my computer screen made mommy cry? How?

I grabbed her and held her close. I pointed at the pictures of Crystal sliding across my screen. And I talked to her about what I do. Why mommy is on the computer so much. We’ve talked before but this was different. I told her that this mommy, THIS MOMMY, got very very sad after she had a baby. And no one was there to help her. She didn’t know where to get help. And she made a decision that took her away from her family. That this Mommy’s decision had made her family very sad and now her children didn’t have a Mommy anymore because she’s in heaven. I started to cry again. My daughter looked at me. I looked her in the eyes and said rather emphatically:

“THIS MOMMY is why your Mommy does what she does. Your mommy doesn’t want other kids growing up without a Mommy. YOUR MOMMY wants women to have help and know where to turn.”

We hugged, and a few minutes later, she came back over to me.

“Mommy?”

“Yes dear?”

“I’m sad the Mommy isn’t here anymore.”

“Awww, honey.”

“But it’s ok for you to be on your computer now.”

And you know what, since then, she’s really been okay with me being on my computer.

Kids are resilient like that. Yes, we need to guide them and be careful what they see and hear. But life happens. The more open we are with them about life, the better prepared they will be when they finally step out into that giant pool without us. And if they swim well, we’ve done our job right.