Category Archives: Antepartum depression

Ohming Postpartum Depression Away

meditation-884687_640The sunlight flowed into the room, bouncing off the parquet floor and spiraling up toward the white walls as women began to stroll in, bedecked in yoga pants, nursing tops, and covered in infants. Soft music played in the background as the waterfall in the front of the room bubbled and sputtered to life.

A woman entered the room once all the mothers were settled and latched their infants. She sat down in the front, her curly hair spilling down her back, nearly reaching the floor. As she adjusted her body into a seated pose, she began to hum as she reached her arms toward the ceiling, which was sprinkled with skylights to invite even more warm rays into the meditation room.

The mothers hummed along with her, deeply breathing in the soothing surroundings and welcoming the excise of the chaos of their lives outside of the room. Breath in, exhale out. Breathe in, ohm out. OHMMMMMMMMM.

For forty five minutes they did this, breathing in, breathing out, letting their minds clear of everything and anything that might possibly distract them from their current state of bliss. OHHHHMMMMMMMM.

Upon closing, the waterfall slowed, the chimes ceased as the water no longer washed over them.  Their guide stood, and made her way to the exit.

The women gathered their things, and went on their way. They’d be back tomorrow, they said to each other. For now, let’s all go to Whole Foods and buy only organic foods and supplements because we absolutely cannot let this motherhood thing get us sad. And then, we’ll meet in the garden at the park to pray fervently to keep the negative feelings away from our hearts.

With a spring in their steps and a clear path ahead of them, they all wished each other Namaste as they meandered away to fulfill their guaranteed destinies of avoiding depression after giving birth…without turning to the evils of medicine or therapy like that one mother over there. She cheated, they said, among themselves, as they unlocked their cars and settled their infants in for the quick drive to the Whole Foods. She’s not Ohm like us.

If only it were THAT easy, right?

Oh, I’ll just eat right. I’ll meditate, I’ll pray, I’ll do everything right and *I* won’t get depression after the birth of a child. And if I do, it’s totally big pharma’s fault because all they want to do is sell me drugs which will get me better.

STOP.

Nope. Hippocrates wrote about postpartum depression way back in the day – (you know, old school.. the father of modern medicine theology/ethics?) so this isn’t some new-fangled disorder created by Big Pharma just to get you to part with your money. 

Marianne WilliamsonThere’s been an irresponsible post by Marianne Williamson on Facebook regarding the recent announcement recommending mothers be screened for depression both during and after pregnancy is like giving stigma a nice fat hug. Follow the money, she says. Meditate more, she says. Pray more, she says. LOVE more. But dear heavens, leave big Pharma out of any possible solution because they prescribe meds like candy.

Know what, Marianne? We tell moms to run like hell from doctors who practice medicine that way. We empower them to rule out physical causes before just popping a pill. We tell them that hormonal changes are normal and what to look for beyond those changes. We follow the research. We follow the stories of the mothers who share them with us. We do not muffle their voices. We do not minimize their pain or magnify their shame.

And yet – in one fell swoop, you’ve managed to do exactly what you did not want to do – muffle voices. Do you have any idea how difficult it is for a new mother to speak up about experiencing anything besides joy and happiness after the arrival of a new little one? It’s incredibly difficult. We fight for it every single day. It’s exhausting. But if it helps one..just ONE mother – it’s worth it.

I do want to clarify that if meditation, nutrition, and prayer worked for you – that’s fantastic. I’m truly happy for you. But. It’s important to remember that not all solutions work for all mothers and to discredit one method of treatment which has helped so many is to do a disservice to those it has helped. It’s like giving Stigma a big fat hug and shaming millions into silence because they dared to take meds that HELPED THEM.

Ohm all you want if it helps. Ohm it away. But.

Be open to other methods. Don’t judge others for their journey to wellness.

Because when we do that?

We hurt all of us.

NIMH Gets Failing Grade for Perinatal Mood & Anxiety Disorder Chat

Last week, a friend of mine tagged me in a link on FB to give me a heads up about a NIMH chat this week about Perinatal Mood Disorders. Of course we were looking forward to it and hoping it would be a worthwhile discussion. I nearly missed it on Friday morning (May 16, 2014)  thanks to a nasty case of food poisoning which knocked me off my feet for the better part of this week. But, I managed to dive in just 10 minutes into the chat.

It was…….awful.

Stilted.

Non-engaging.

Spouting of facts and just the facts, according to the NIMH. (They managed to screw up a few things. Don’t worry, I’ll go there. Oh, yes, yes I will.)

Self-promotion and only self-promotion. No real response to the powerful Perinatal Mood and Anxiety Disorder Advocates who showed up until we started really pushing back. Even then, their response was still stilted.

Just when it seemed it couldn’t get any worse, the NIMH began repeating tweets from the beginning of the chat instead of answering the flurry of questions coming in from those participating.

If NIMH handed this chat in as a graded project, it would have received an F.

When I asked what was being done to encourage medical professionals to become better educated about PMAD’s, this happened:

NIMHChat Congress

Yep.

Congress MANDATED we pay more attention to PMAD’s. In fact, it got shoved in with the ACA. And we all know how well that’s going. After this response, I asked a follow up question asking how that was going – asked for hard numbers. Did I get numbers? Nope. BECAUSE THE ATTENTION MANDATED BY CONGRESS LACKS FUNDING AND THEREFORE ATTENTION.

I’m okay, I’m okay. *deep breath*

There was also this lovely moment in chat:

NIMHChat Snafu

I know, right?

Because we ALL got better by staying in bed thanks to depression, right? Right?

Instead of urging moms to get up, move, and care for themselves, the NIMH  provides them with excuses to stay in bed and well, suffer. Way to go, NIMH. WAY.TO.GO. *slow claps*

While I realize it is difficult to manage a large scale chat with several participants (something I have done myself, when #PPDChat was very well attended), there is absolutely no excuse for the following to happen during your chat:

1) Blatantly state misinformation/misleading facts about your topic. Particularly if said topic is subject to entrenched stigma and misinformation (which is why you are having the chat to begin with, right? Not because it’s a hot topic and you’re using it to draw people in…)

2) Not engage those who are participating – this is SOCIAL media, y’all. SOCIAL. ENGAGE. Like Jean Luc Picard on the bridge of the Enterprise. Even if you’re just going at impulse speed, ENGAGE for the love of ALL that is..well, you know.

3) Don’t repeat yourself word for word. It lets people know you’re unprepared.

4) Share resources other than your own. (see number 2 about social media).

5) Do NOT TREAT those participating with disdain, contempt, or as if they are idiots. They are attending your event which would be nothing without participants. Respond accordingly unless they are clearly bashing you (which we were not) and if they are bashing you, ignore them before you stoop to the level of responding with disdain.
Things to do during a Twitter chat:

1) Engage. Be Social. Greet people. Be happy and upbeat. SMILE through your keyboard.

2) Be knowledgeable and approachable.

3) Treat everyone as if they are your equal. They are there to learn, not to be kicked. Acknowledge their words, their struggle, their questions with the same respect you expect from them. You know, do unto others as you would have them do unto you.

4) Offer insight through connections and share resources from others in addition to your own. The only answer is not yours. Crowd-source and use the media at hand to enhance your chat.

5) Do your best to make everyone be heard, even if it’s through just RT’ing what they’ve said. Again, I realize this is difficult on a LARGE scale but if you have known experts participating, acknowledge them.

I truly hate when things like this go wrong because there is such a tremendous opportunity for exposure when a government agency holds a chat like this. I want to say I’m surprised at how things went but sadly, I am not. Instead of raising awareness and building hope, NIMH decimated the chat with a lot of tweets about nothing, leaving at least one person (and possibly more) with the idea that there is in fact, nothing a mother can do to prevent a PMAD:

NIMHChat PPD cause

And that, dear friends, is NOT the taste you want to leave in the public’s mouth when discussing PMAD’s. Because there is hope. There is help. We are not alone.

Go to Postpartum Progress to find women who are fighting back.

Or Postpartum Stress Center’s website.

Or Beyond Postpartum.

Or find me on Twitter @unxpctdblessing. Or search the hashtag #PPDChat. Message me for the private FB group full of women who KNOW this is hell and yet are fighting back against it with everything they have.

We’re all here for you when you’re ready to reach out for help.

(And THAT is how you end a chat about Postpartum Mood & Anxiety Disorders).

*drops mic and hits publish*

Thoughts about Ebony

I was going to wait to publish this post until after I’d had time to read it through. But given that I just accidentally posted it, freaked out, made it private, I’m realizing that folks who got it through email will be able to read the entire thing anyway. SO. Here ya go. With a temporary title that obviously will be the permanent title – my ramblings and thoughts regarding Ebony Wilkerson, tragically better known as the mom in Daytona who drove  her minivan into the sea.

The public defender’s office said there was a reason she beat her stomach. “She {is} being held in seclusion naked in her cell,” said Craig Byer.

Public defender James Purdey at first asked for Monday’s hearing to get Wilkerson’s 1.2 million bond reduced.

Purdey instead asked his client be transferred from the Volusia County Branch Jail to a psychiatric ward for longer than a typical Baker Act hold, so she can get mental pre-natal care.

The judge did not rule on the request to move Wilkerson because the judge said it’s something that hasn’t been done before. (Source)

According to the Ebony Wilkerson narrative we have thus far, she drove to Central Florida from South Carolina to escape an abusive partner. Her family struggled to get her help but she signed herself out of the hospital and somehow managed to get the keys to the minivan and drive it and all of her children into the ocean despite the family’s efforts to hide the keys from her.

This week, we are told she has been held naked, in seclusion at the local jail and started punching her stomach, causing her defenders to push for her to be moved to a psychiatric ward for “mental pre-natal care.”

What the hell is wrong with this picture?

From an emotional and advocate standpoint, a lot.

From a logical standpoint, I can understand why these measures may need to be taken, particularly if Ebony has been suicidal. Of course you don’t want to give her anything that she could possibly harm herself with but there has to be a way to do that without completely stripping her down and removing all sense of dignity, something she was more than likely running low on if indeed she was escaping an abusive relationship.

The judge’s reluctance to move her may also be grounded in logic as well. Perhaps she did not feel she had enough facts to justify setting a precedence with Ebony’s case. Or perhaps the Volusia County Jail has the capability to be considered as “clinically appropriate” (as is required of examination/treatment in the Baker Act) and therefore the judge did not see moving her as a necessity. Or perhaps there simply wasn’t anywhere to move her to which offered the same level of security the judge felt Ebony requires at the moment.

But when examined from an emotional and advocate point of view, this is absolutely heartbreaking.

A pregnant mother, escaping an alleged abusive relationship, drives her kids into the ocean despite attempts to help her. To me, this screams of absolute desperation. This is beyond sanity. It’s more than a call for help. This type of behaviour requires action.

But is what Volusia County doing enough?

How do we best handle this type of situation in this day and age?

It’s like I tell my kids and my partner – we can’t fix a problem unless we know about it. Unfortunately, women (and men especially) who are in abusive relationships are often quiet about their situations until it’s almost too late, and some until it is too late. Why? Because they are often threatened by the perpetrator that if they don’t remain silent, there will be repercussions.

Silence is also a hallmark of Perinatal Mood & Anxiety Disorders for multiple reasons. Society believes we should be happy when pregnant or in the throes of new parenthood. Thing is, mood disorders have been happening since the dawn of time. Our responses to them over the centuries have varied but even early on, a few folks got it right. Take Asclepiades, for example. According to Thomas Millons Masters Of The Mind, he “argued against dark cells and dungeons for the mentally ill…thought patients should be in settings that were well lit and comfortable.” Asclepiades also proposed that “biological and chemically based treatment would be beneficial” in addition to dividing conditions into acute versus chronic and also distinguished between hallucinations, delusions, and illusions.

The main point of Asclepiades is that even in the early ages (171-110BC, by the way), someone recognized that locking away the mentally ill in dark, dank places was NOT the way to go.

Arataeus believed the “soul was the basis of psychic disturbances” and “mental disorders were exaggerated normal processes”. (Millon)

Then there’s Soranus who posited “consider(ing) culture as a factor in both investigating and treating mental patient.” (Millon, Masters Of The Mind). He also advocated for decent and kind treatment of the mentally ill, asking “his peers to remember who was ill; physicians should not view their patients as disagreeable persons who offended their self-image.” (Millon) It seems to this outside observer that Volusia County is not doing that in Ebony’s case.

Does being an abused woman or a woman at the hands of a Perinatal Mood Disorder excuse the type of behaviour Ebony Wilkerson has exhibited? No. But both are mitigating factors which led to her behaviour and should absolutely be taken into consideration as her case proceeds.

I’ve written extensively about Postpartum Depression as a defense. Cases like these are both fascinating and heartbreaking because all at once, those of us who have experienced a Perinatal Mood & Anxiety Disorder, see fractions of ourselves in the women who make headlines. We collectively gasp and think, my God, what if I had given into all those thoughts racing through my head? I could be her. I could be Ebony. I could be Miriam, I could be Andrea, I could be Otty.

We shudder because we were there, with them, in the dark, in the hell, holding their hands and they fell as we watch in horror. The way their fall is paraded in front of society scares the crap out of us and drives many to silence. Is this healthy for society? Yes and no. We should be outraged when children are subjected to death (or the threat thereof) at the hands of their parents. But at the same time, we need to take steps to prevent this type of situation from occurring in the first place.

How do we do that when every single case, every single situation from mother to mother and from birth to birth is different? How do we catch a falling mother if we don’t know she is falling?

Even if we start by putting measures in place to check for signs of falling, we will still fail if the mother doesn’t admit to having a problem or, as in Ebony’s case, refuses help (for whatever reasons – cultural stigma, fear, etc) which is offered to her because she is far past the breaking point and sees death as the only way out. Do we just throw our hands up in the air and let her do what she may? No. So what do we do then?

I don’t know.

What I do know is this:

  • Mothers (and fathers) do not deserve to be alone in this battle
  • Mothers (and fathers) deserve emotional support
  • Mothers and fathers need a village
  • Perinatal Mood & Anxiety Disorders are not deserving of whispers, they require shouts
  • We need to speak up, every single time, not just when there is a crisis
  • Accept those who are hurting with open arms and provide a safe space for them to fall apart
  • Not judge those who have/are struggling so harshly

So what can we do to improve the situation for struggling parents across the globe with the very real (and often co-occurring) issue of domestic abuse/violence and Perinatal Mood & Anxiety Disorders?

  • Make it okay to reach out for help and ditch the supermom/superwoman/superman/superdad façade
  • Initiate requirements for ALL health professionals who may come in contact with an expecting or new mother to be well-versed in the ins and outs of a Perinatal Mood & Anxiety Disorders (this includes pediatricians, OBGYN’s, GP’s, Family Doctors, IBCLC’s, doulas, midwives, naturopaths, you get my point…)
  • Create local, state, and national referral networks which incorporate above said training on a regular basis
  • Create networks of parents willing to mentor other parents through these tough situations and make it easy to access across the board

Are these solutions going to fix our current problem? No. But they’re a start and sadly, most of it revolves around a tradition which our current technologically advanced society has strayed greatly from – the tight knit expanded family. It takes a village to raise a child but it also takes a village to raise a mother to raise a child right. In my post “On Not Wanting To,” I state the following:

Our village is in peril. Our village? FELL THE FUCK APART AND NO ONE GIVES A DAMN.

In America, we have a pitiful excuse for maternity leave. We are bombarded by stories of celebs who gave birth and look AHMAZING in less than three weeks after giving birth. We are insanely comparing ourselves to women who are a) genetically blessed and b) have crazy access to things like trainers, nutritionists, nannies… and then there are the way we compare ourselves to each other. Stupid idiotic milestones of when we went back to work, how much we manage to get done every day, pushing ourselves to be better than the next mom and still have it all pulled together.

It’s no wonder we are screaming out for help and some of us are doing so through extreme measures.

Let’s keep the “if I were her, I would” out of the conversation. We do not know what she’s going through. Even if we’ve been through hell ourselves, we do not know *her* hell nor should we take her story as one which portends the downfall of ALL women who struggle with domestic violence/abuse and a Perinatal Mood & Anxiety Disorder. Instead, reach out to mothers, to fathers, let them know it is okay to reach out for help. For that matter, teach it to your kids so that when they get older they don’t feel as if reaching for help is in essence, failure to handle something on their own. Yes, independence is a grand thing but there is a time and a place to lean on someone else. Not to lean in, but to lean on, sometimes for dear life.

Our village has forgotten how to do this very simple yet necessary human act. We are now expected to be everything to everyone and dear GOD help us if we are not. Should we assume something is wrong with every mother? No. But instead of oohing and ahhing at her baby, ask how she’s doing. Ask how Dad is doing. Do not dismiss their very real role in their new situation. By acknowledging them, you acknowledge their existence and empower them to express their feelings. And that, my friends, is possibly one of the most powerful things we can ever do for a new parent.

Will it keep more pregnant women from being held in seclusion, naked in a prison cell, after they’ve attempted to kill their older children and themselves? Not all of them, no. But it’s a start.

An even better start would be to continue educating people about Perinatal Mood & Anxiety Disorders, including those in the law enforcement and legal arena. I realize they are bound by the courts and must adhere to the law but if they had a better understanding of the facts behind Perinatal Mood & Anxiety Disorders, perhaps, at least, the treatment of mothers imprisoned for crimes committed whilst experience these disorders would stand a chance of improving.

In the meantime, I genuinely hope that Ebony Wilkerson receives the help she so desperately needs as she awaits trial for her actions on the fateful day she drove her minivan into the sea. We’re watching, Volusia County. Don’t fail us more than you already have failed Ebony.

#PPDChat Topic 03.10.2014: Media Sensationalism & PPD

ppdchat-03-10-14

 

Join me tonight as we explore the issue of media sensationalism and PPD. So often, as I stated in my post “On Not Wanting To”, when a mom hurts herself or her children, we get the sensationalized version of it and the details of her journey to that point (and her journey after the event) are dramatized as well. I hope you’ll join me for a passionate and insightful chat into why this needs to change as well as why we owe it to ourselves and to society to reach out to every new mother dyad with care, compassion, and understanding.

We cannot let the village continue to fail.

On Not Wanting To

I’m tired, y’all.

I’m so damn tired of reading about women splashed across the front page because they’ve done something horrible to themselves or their children.

I’m tired of immediately wondering who let her down. I’m tired of wondering at what point did she fall through the cracks. I’m fed up, to be honest.

It happens way too often, these worst case scenarios splayed across the front page for all to read and shake their heads in disgust or sigh in exasperation because yet another mom has lost her mind.

I’m tired of this bullshit.

I get that drama sells and when it comes to sales or clicks, it’s all about the what will draw people in so OF COURSE LET’S SHARE A STORY ABOUT A MOM WHO FAILED.

Where the hell are the stories about the doctors who failed to screen? Where the hell are the stories about the partners who told these new moms to just suck it up? Where are the stories about their loved ones who didn’t show up to help them when they cried out for help? WHERE THE HELL ARE THESE STORIES?

It takes a damn village, people.

Our village is in peril. Our village? FELL THE FUCK APART AND NO ONE GIVES A DAMN.

In America, we have a pitiful excuse for maternity leave. We are bombarded by stories of celebs who gave birth and look AHMAZING in less than three weeks after giving birth. We are insanely comparing ourselves to women who are a) genetically blessed and b) have crazy access to things like trainers, nutritionists, nannies… and then there are the way we compare ourselves to each other. Stupid idiotic milestones of when we went back to work, how much we manage to get done every day, pushing ourselves to be better than the next mom and still have it all pulled together.

It’s no wonder we are screaming out for help and some of us are doing so through extreme measures.

There was a push for screening but it’s buried in the ACA and we know how well that’s been going with implementation, right?

Then there’s the complication of who will screen. Maternal mental health care crosses so many specialties it’s not even funny. OBGYN, midwives, doulas, Pediatrician, General Practitioner, Lactation Consultants….so who screens? Does the OB? The midwife? The doula? The Pediatrician? The GP? The IBCLC? WHO? Once they screen, what happens? Is the woman informed of her results? Is she successfully referred to the proper care? Is that care knowledgeable about Perinatal Mood Disorders? Will they dismiss her as an exhausted mom instead?

What about the potential physical issues which can masquerade as PPD? Like anemia, thyroid issues, vitamin D deficiencies, etc? Will those be ruled out before she’s put on medication? Or is the doctor just going to toss a script at her and leave her all alone on her skiff in the middle of a hurricane at sea?

Where is this information in childbirth classes? Why are we not informing new moms about this? Why are we not telling them that it can happen, dear caregivers? WHERE ARE YOU? WHY ARE YOU FAILING US? WHY ARE YOU GLOSSING OVER THE DANGER???

Wake up.

Women are dying.

Children are dying.

Families are being destroyed.

And you, you are sitting there claiming “It’s not my place.”

But it is.

Your move.

Get it right.