I decided to take questions from Twitter today. Only the first 5 responses though so as not to overwhelm myself. In no particular order, here are the questions and their answers.

1) @ksluiter asked: I want to know about succesfully weening to get pregnant or staying on meds while pregnant.

Staying on meds while pregnant was a decision I struggled with when I became pregnant with our son. The pregnancy was not planned so I skipped over the whole “weaning to get pregnant” concern and skipped straight into the “should I stay on my meds while pregnant” arena. This is most definitely a decision which should be made with the help of a medical professional. There were a few things which helped me make my decision a little easier:

a) Moms on meds when pregnant and then go off their meds during pregnancy face a higher relapse rate for mental health issues (specifically Postpartum) after delivering.

b) Baby has already been exposed to medication for 4-6 weeks by the time you realize you are still pregnant (unless you weaned beforehand) Going off meds cold turkey will affect baby as well as you.

c) High levels of stress/depression cross the placenta as well and can inhibit fetal growth and spur premature delivery. Given that my 2nd daughter had indeed been born nearly 5 weeks early, I was not interested in going that route again.

Bottom line here: This decision is an intensely personal decision. Talk with your doctor. Research. Know what you are comfortable with doing.

Couple of great resources for this are: Pregnant on Prozac by Shoshana Bennett and also Otis Pregnancy (also has a Twitter presence: @OtisPregnancy) Check them out.

2) @invisibledaddy asked: what’s the closest experience you’ve had to ppd besides ppd itself, to help us get a sense?

Wow. I had to really think for this question. I think the closest experience I have had to PPD happened my junior year of college. Within 19 days between February and March, I lost both of my grandfathers. This left me with no grandparents. The subsequent grieving process I went through was extremely similar emotionally to how I felt during Postpartum Depression. My grief was a very physical grief and that’s where it differed from my Postpartum. It also differed in that I wailed. A lot. Quite often I would wail and scream myself to sleep. I struggled with anxiety attacks as well, something I did not experience during Postpartum. I also thrashed and hit. It took me a very long time to recover.

The most important difference here is that people expect you to grieve when you lose a close family member or friend. When you have Postpartum, there is an element of guilt and shame accompany the disorder with which you struggle. Why? Because you have a baby. You SHOULD be happy. Even those who experience the grief of miscarriage or losing an infant within the first months of life experience this as many around them will tell them awful things such as “Well, it was never a REAL baby” (miscarriage) or “He/she wasn’t here very long so the pain will fade quickly because you didn’t have a lot of time to bond.” Acerbic comments such as this are extremely unhelpful and only serve to expose the ignorance of those offering them. (FYI, for a great website about miscarriage and infant loss, I highly recommend the folks over at Grieve Out Loud.)

Another thing I experienced with Postpartum that not many associate with it was intense anger and increased irritability. Many associate crying as one of the major symptoms. While it is a symptom, it is not one that every mom will experience. Many moms instead become very overwhelmed and as a result, develop what I term “explosive” personalities, blowing up over the smallest perceived injustice or high expectation.

3) @MamaRobinJ asked: How about blogging about PPD. How much detail do you think people should offer? What’s too personal?

I have a few personal rules I stick to when blogging about PPD. The primary goal is to keep from endorsing specific medications as I feel that is a discussion best left between physician and patient and to keep from triggering others.

Sharing details is good to an extent. That said, if you have a piece you are posting to your blog that a new mom may visit, always ALWAYS warn at the very beginning of the piece that if someone is in a fragile state, they should probably skip the post and come back when they’re feeling a bit healthier. I’ve taken to posting music videos via YouTube at the beginning of posts I think may trigger someone. Katherine Stone, author over at Postpartum Progress, has a symbol she posts at the beginning of potentially triggering posts. We all have our own methods but we all keep in mind the fact that the people reading our blog may not be in the same mindframe we are now.

Another thing aspect of sharing details is that in writing your own story, you may feel drained. It may drag up some of the same emotions you had when you experienced while in the depths of PPD. Be prepared to deal with this. Sharing is therapeutic. But it can also be exhausting. Share at a pace which is healthy for you. Your mental health is far more important than indulging the curiosity of your readers.

Too personal for me is:

• Naming the Psych Hospital I spent time in
• Naming any of my Physicians
• Naming any of my medications

Even with HIPAA, for me this is a privacy issue and one that I will not disclose under most circumstances.

If I do disclose my medication, I am very careful to say that it is what worked (or didn’t work) for me. All treatments/therapies work differently for different people. It is important for us to respect the journey of others toward wellness.

4) The good folks over at @bandbacktogether asked: “why did you start to blog?”

The best answer to this question is back at my very first post in May 2007. But, for the sake of posterity and saving you a click and a ton of reading (and the horrificness of my first ever blog post), my husband and I found ourselves quite unexpectedly pregnant after a very nasty episode of Postpartum OCD (and probably PTSD due to my daughter’s NICU stay). Once the pregnancy test lines turned pink and I dug myself out of bed after reading Karen Kleiman’s “What Am I Thinking: Having a Baby After Postpartum Depression,” I decided to start a blog in order to “reframe” my pregnancy as Karen suggested. Little did I know something I started for just for me would still be around nearly four years later and evolved into what it has today – including #PPDChat at Twitter every Monday at 1p & 830p ET.

5) @TouchstoneAZ asked: “Have you seen any correlation between when period returns pp even while bfing and PPD?”

When I asked for further clarification, she stated she was asking about mood and period. If I’ve understood her question correctly, I think she’s asking about increased issues with mood during PMS after an episode of Postpartum. SO many mothers (including myself) struggle for a long time with increased mood issues during PMS after a Postpartum episode. I get increasingly irritable, cranky, and just all around grumpy. I was on medication for PMS prior to pregnancy for my PMS. In fact, I remember reading research stating that women with PMDD (or severe emotional issues during PMS) are at a slightly higher risk for developing PPD. I can’t find the link at the moment though as my kids are on day 3 home from school for snow and frankly, my brain is fried. I’m also defending my laptop from my three year old as I type this so .. when I find the link, I’ll update this answer with it, I promise.

This was fun! I may have to do this again next week! If you liked this feature and have a question about my experience or anything Postpartum related, please either @ me on Twitter (I’m @unxpctdblessing) or email it to me at mypostpartumvoice(@)gmail(dot)com with “Q&A submission” as the subject line. I look forward to hearing from you!