Category Archives: Perinatal Mood Disorders

Brown University Researchers Seeking Participants for Postpartum Mood Disorder Study

I met Laura Sockol at the PSI/Marce conference in Pittsburgh, PA in 2010. We had a lively discussion about the DSM-V and Postpartum Mood Disorders in the lobby of the hotel. I still remember sitting and discussing things with her. Laura is a wonderful woman and very dedicated to researching Postpartum Mood Disorders. She’s reached out to me for her upcoming study regarding “The Role of Maternal Attitudes in the Prediction of Symptoms of Depression and Anxiety Among Pregnant and Postpartum Mothers“. Below is the official information Laura sent me. Go check it out and if you’re not eligible to participate, pass it on to someone who is. I’ve been told recruitment closes in the next two weeks.
 
Do you have older children? Are you pregnant again? Or did you have another baby in the past 6 months? Researchers at Brown University are interested in mothers’ experiences when they have more than one child. You may be eligible if you are between the ages of 18 and 45 and live in the United States. Women who complete the full study will be entered into a lottery for a $100 Amazon gift card, the odds of receiving a gift card are 1/50 or better. Interested? Visit www.BrownStudiesMoms.com for more information!

Welcome to #PPDChat Voices!

Hi there!

My hopes for this faded when I hit a tech snafu this past weekend. Granted, I should have recorded earlier than this past weekend but life has been crazy up and down with recovering from a road trip and days full of pain which induce fog-brain so, yeah, I was totally behind. HOWEVER.

I’m having a decent week now, still taking it slowly but I’m thrilled to be introducing this new feature at the blog! We’ll be rolling it out as we get submissions so feel free to send yours in whenever you want. I had grand plans of doing mine first, but recording is just not cooperating over here so I need to get that aspect ironed out.

PPDChatVoicesToday’s #PPDChat Voice is Lindsay, or if you know her on Twitter, @lilloveandluck. She is all sorts of awesome. Her piece is too, despite the fact that she keeps apologizing for all the uh’s and um’s. It’s tough to put yourself out there on camera, yo.

Huge thanks to Lindsay for submitting. (Check your email for your badge for your blog!)

LindsayLindsay’s bio: Powered by espresso and cake, Lindsay is a jill of all trades trying to find her niche in the world. She became a serendipitous advocate after being diagnosed with Postpartum Depression and Anxiety in 2011. She lives and breathes New Orleans with her patient husband, sprightly son, and critters. She blogs at www.withalittleloveandluck.com , and you can find her over-sharing on Twitter @lilloveandluck.

Sticks and Stones Will Break My Bones But Words….

I started this post the other day after a comment was left on a post I promoted on Facebook. Then I had to walk away because I started down a path I did not want to go down. This was a difficult post for me to write as it forces me to revisit a meeting which left me both enraged and shaken. I’ve calmed down quite a bit and the following is a much more polite response than the one I started the other day.

The post is a wonderful interview of Dr. Katherine Wisner by Walker Karraa. The interview, found here, focuses on Postpartum Mood Disorders, of course, but also addresses the challenge and controversy of screening mothers for the presence of Postpartum Mood Disorders.

Screening is a hot topic and has been for quite awhile. There are a lot of unknowns regarding when to screen, how to screen, what happens after a positive screen, liability for care of the patient, when to refer, etc. Bottom line, I feel, is that we need to screen in order to start the dialogue about Postpartum Mood Disorders with care providers in every field that comes in contact with both expecting and new mamas. We also need to work more diligently to create supportive nets of care for women in our communities – coalitions of OB’s, Midwives, Pediatricians, IBCLC’s, Psychiatrists, Psychologists, therapists, doulas, and other various caregivers for pregnant women and young children. It needs to be comprehensive.

Those of us who advocate for the care and support of families battling Postpartum Mood Disorders must be well-versed in all things relating to pregnancy and postpartum. Our scope of knowledge must include a basic grasp on the rights of the expectant woman and as a new mothers. This is in addition to the psychiatric knowledge we also hold and are constantly researching in order to better arm new and expectant mothers.

It is exhausting sometimes, to read all of this information. I myself have suffered from information overload. But, empowering new and expectant mothers to make healthy and better decisions for their care and therefore for their families, is what I have been called to do so read I must.

In the past couple of years I haven’t been reading as much, I’ll admit, but prior to that, I read voraciously. I dove into all things birth related. So when there was a chance to go see Henci Goer at a local get together on August 26, 2010, I went.

Henci, a well-known author and advocate for Lamaze birth and healthier women-empowered births, was someone I admired.

Until the night I met her and discussed my experiences which led to my own advocacy with her.

Henci, after discussing at length, her new project, completely shot down my experience with a very dismissive sentence, the gist of which was left in a comment at Karraa’s interview with Dr. Katherine Wisner I referenced above.

Here was a woman, who seemingly was all about empowering women and improving their birth experiences, failing to even acknowledge the difficulties I experienced after my own. I didn’t experience Postpartum Depression, according to Goer, my experiences were directly related to my birthing experience and therefore weren’t my fault but that of the system’s.

While I agree there are far too many interventions in the modern birthing realm for many mothers and it’s sad that organizations like Solace for Mothers even have to exist, to shoot down the experience of another and how she has worked through it in one dismissive sentence is almost as bad as what my first OB did to me.

PTSD QuoteTrauma is about perception. It’s not about what happened to you, it’s about how you perceive what happened to you. This perception is shaded by our own personal experiences and baggage. These experiences and this baggage also directly affects how we process our experience after our brush with trauma.

No one has the right to question a woman’s perception of her birth experience.

No one has the right to re-frame her experience FOR her. It is hers and hers alone to process. It is hers to share as she feels necessary, with whatever details she deems necessary.

The comment Henci left on Karraa’s interview with Dr. Wisner reads as follows:

I am extremely concerned that the focus on screening for postpartum depression using an instrument solely designed for this purpose will miss diagnosis of childbirth-related post-traumatic stress symptoms and full-blown PTSD altogether or will mislabel women experiencing post-traumatic distress as depressed. PTSD symptoms are fairly common–as New Mothers Speak Out found, 18% of women were experiencing symptoms and 9% met the diagnostic criteria for PTSD–and while some symptoms overlap with depression, the treatment differs.

Furthermore, on-site mental health services would be of little use to women suffering from childbirth-related emotional trauma because one of the prime protective responses is avoidance of environments and personnel that re-trigger traumatic memories.

I have as well a philosophical issue with making depression the preeminent postpartum mood disorder. Depression centers the problem in the woman, and therefore the cure is centered in her as well. PTSD, however, is centered in the system, and therefore its cure depends on systemic reforms. The incidence of emotional trauma can be minimized by reducing the overuse of cesarean surgery and other painful and invasive treatments, by implementing shared decision-making, and by providing physically and emotionally supportive care. So long as postpartum mood disorders are primarily seen as an issue of depression, little or no attention will be paid to the all too common glaring deficiencies of medical model management in this respect.

I have several issues with Henci’s comment.

She seemingly assumes that the Postpartum Mood Disorder community is unaware of the difference between Postpartum Depression and Postpartum Post-traumatic Traumatic Stress Disorder. I can assure her that we are indeed not unaware. Most providers and advocates I know work diligently to go beyond the EPDS to dig deeper for possible birth trauma. The EPDS, while yes, not designed to pick up specifically on PTSD, is a starting point for a conversation about emotional issues during the perinatal period. Henci’s issue with this illustrates exactly why we work to educate providers about the many aspects of Postpartum Mood and Anxiety Disorders.

The discussion with a mother who had a traumatic birth experience is wildly different than with one who did not. Not all mothers who experience a Postpartum Mood Disorder necessarily experience PPTSD. Nor are their issues rooted in an issue with the so-called system. May I remind you, Henci, that PMD’s have existed since the time of Hippocrates. It is not some new fangled “too-many interventions” kind of disorder.

Not all of us are not “victims” at the hand of the system as you would have us believe, Ms. Goer. I’ve held discussions with mothers who had home births or natural births in a birthing center and still gone on to experience a Postpartum Mood Disorder. While it’s certainly not as common and there is a seeming correlation to interventions during the birth experience, there simply isn’t enough evidence to claim interventions (particularly cesarean sections) are the definitive root of all Postpartum Mood & Anxiety Disorders as Henci claims in her comment. (See article “Is there a link between C-sections and Postpartum Mood Disorders?)

We, the advocates for care and empowerment of women who do experience emotional trauma during and after birth, are working diligently to bring to light the additional issues on the Postpartum Spectrum such as Postpartum Post-Traumatic Stress Disorder, Postpartum Obsessive Compulsive Disorder, Postpartum Anxiety, and others. We no longer focus solely on depression. If we do, it is only because Postpartum Depression has been used as a catch-all phrase for so very long.

In the past six years I have been blogging, the term has graduated from Postpartum Depression to Postpartum Mood Disorders to Perinatal Mood Disorders to Postpartum Mood and Anxiety Disorders. In fact, I’m often at a loss as to which one to use. Postpartum Mood and Anxiety Disorders covers it most thoroughly, I believe.

There are researchers who focus on nothing but birth trauma and Post-Traumatic Stress Disorders – such as Cheryl Tatano Beck. I had the pleasure of meeting Cheryl at the 2010 PSI Conference in Pittsburgh. That meeting was so much different than my meeting with Henci. Cheryl was warm, accepting, and thanked me for my work in bringing my experience to light and fighting for others who had been through the same thing.

I do not hide that my first birth was a rough one. I know there are other mothers out there who had even more horrific experiences. But I talk about it because negative birth experiences do happen. I talk about it so that other women will read it, and know that it’s okay to talk about their experiences. If I simply dismissed the experiences of all the women who reached out to me, well, I’d be doing a huge disservice to the community around me. To women in general. In essence, I’d be traumatizing them even further.

With wisdom and knowledge comes power. With that power, comes great responsibility. I hold that responsibility as if it were a fragile ball of glass. My goal is to keep it from shattering. My goal is to create a safe and soft space for it as it grows stronger.

If only Henci Goer saw the birthing world the same way.

The Scorpion Tale of Perinatal Mood Disorders

Last night, I had a rather in-depth discussion with Addye over at Butterfly Confessions. We’ve discussed the same topic before and we’re finally doing something about it because we both think there’s not enough out there about this subject. Her blog post went up last night, discussing the role her antenatal depression, postpartum mood disorders, and other mental health struggles have played in her son’s recent diagnosis of being on the autism spectrum. While our children’s diagnoses are different, our story is the same, and it begins with a long hard look at the stinging guilt with which we now carry along our paths of Motherhood.

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It’s taboo, really, more so than admitting you struggled with a Postpartum Mood Disorder. It’s a secret locked in a trunk hidden in a house deep in the woods where no one will find it. It’s the poison-tipped tail of a scorpion, the thing that gets you after the initial reaction of having a scorpion land in front of you. It’s the nagging feeling you get in your throat every damn time you look at your kid and think, even for a brief second, that you did that to them. It’s YOUR fault.

I’ve been there. I still am, sometimes. Not as much as before, but it’s something that I will always carry with me. A small part of my heart will always be tinged with guilt and a depth of sadness I’ll never shake. I’ve learned to accept it instead of fight it, to give it space to just breathe, knowing I’ll never get rid of it as long as I live. Right next to it though, now, is a space that is filled with a peace I’ve worked very hard to achieve – a peace that cancels out that guilt and sadness…as long as the see-saw is working that day, that is.

I struggled with Postpartum OCD after the birth of my first daughter. I’ve made no secret of that. I sought help but was shot down by my OB, an integral part of this story. I had to fight on my own to heal. Looking back, I didn’t do a great job at healing. What I excelled at was shoving all of the darkness down and faking it until I felt like I made it. Only by the time I got there, I was pregnant again and my hormones became the scorpion.

They flowed into my pregnancy, along with severe morning sickness. There were days I had to choose between eating or my prenatal vitamin. I often chose eating because I knew the vitamin would make me vomit whereas I might be able to keep the food down. One day, I lived on just one powdered donut. Other days, less. I couldn’t tolerate food for almost four months, if memory serves correctly.

I remember thinking I didn’t need the prenatal vitamin. I’d be okay, baby would be fine. Or so my hormone rattled brain said so. I didn’t want to get up, I would lay on the couch as our oldest, just a little under a year and a half, begged me to play with her. I couldn’t move or I’d vomit. So she learned to play by herself.

The pregnancy progressed, everything seemed fine, I didn’t have Gestational Diabetes again, the baby measured fine, all was good.

Until my baby shower. I went into labor that evening. I was 35wks and 6 days pregnant. (Women with untreated antenatal depression are more likely to go into labor early….or so says the research). At the time, I didn’t relate the two. I just knew I wasn’t full term and contracting. I labored at home until the next morning when we finally saw the doctor. I was dilated enough for them to send me to the hospital. Baby was on her way. Instead of happy, I was nervous. What was wrong? Why was she coming early? We were close enough to full term, really, less than a week away. But still, she was early.

After 42 hours of grueling labor, my daughter was born. She looked perfect. 10 fingers. 10 toes, screaming, a perfect squishable pink human all mine. I made her. As I tried to latch her to nurse, she wouldn’t latch. Just kept screaming. I didn’t know why. I tried for 30 minutes. Then we called the Lactation Consultant. I knew what I was doing, damn it, I had nursed our first for 16 months. Why wouldn’t she latch?

The Lactation Consultant swept her mouth as soon as she got to our room.

That’s when shit got real.

My darling perfect little squishable baby was rushed away from me, the word “cleft palate” left hanging in the air.

There I lay, in a hospital room, epidural still wearing off, all alone, no staff, no husband, nothing to show for almost 2 full days of labor except for the echoing of my heart shattering, insidious voices flooding my head with the phrase, “It’s your fault.”

I did that to her. She grew inside of me, imperfectly.

I lost it that night, brushed my hair for 10 minutes in front of the mirror. Ugly cried on the phone a lot that week, so much so that my ex-husband couldn’t even understand me at several points. In front of nurses. I cried a LOT. This? Wasn’t the way things were supposed to go. Why had I failed?

She was in the NICU for 21 days, undergoing one major surgery for her jaw at just 9 days old. Seeing your 9 day old infant on apparatus breathing FOR her… yeah.. um… yeah. “I did that to her.”

The kicker? The geneticist at the hospital asked me if I took my prenatal vitamins. I lied. I didn’t need any more guilt. I really didn’t. In my fog, I failed a lot.

People told us if we made it through the first year….we’d be scot-free.

They lied.

She’s seven now. Is one of the bubbliest personalities you could ever hope to meet. She’s perfect in every possible way. But she’s struggled so much and her struggles are far from over. Because of me.

She fights for every word she says. It could be worse, I tell myself. She could have so many other issues kids with her same condition have – texture issues, an additional syndrome, etc. Aside from her Pierre Robin Sequence at birth, she’s fine. She has speech therapy, and has had additional surgeries to help with her speech. Before she was 2, she’d been through three times as many surgeries as I have in my entire life.

I did that to her.

What if I’d taken my prenatals? Would she have been born this way? What if I’d fought harder for myself in seeking help for my depression after the birth of her sister?

Intellectually, I KNOW it’s not my fault. But still, the sting is there, long after the scorpion has faded out of sight.

It’s there, just a tinge of it, every time we talk. Every time I have to decipher what she’s said to me based on the context of the words I am able to understand because I still can’t understand every single thing she says. I recently won $200 headphones. They help me immensely in understanding her when we Skype. The ear-buds I had before just weren’t high enough quality to do so. Even now, I have to make her slow down and repeat what she’s said because she’s seven and well, seven year olds get excited.

She will need a lot of orthodontic work. She has the risk of giving birth to a child with similar issues. Kids will tease her because of the way she talks. She was born a fighter without having a say in the matter. While I know this will serve her well later in life, it is something with which I struggle.

Some mothers have Postpartum Depression, Anxiety, PTSD, etc, and they heal, with no adverse affect on their children. But there are those out there who experience issues with their children. And because of what we’ve been through, we draw that line from point PPD to point whatever Alphabet Soup DX with our kids. There’s research to back most of it up. There isn’t research (that I’ve found) to back up PPD related to cleft palate but a “Friend” of mine once tried to draw a line to the type of med I may have taken to my daughter’s cleft palate. Punch.IN.THE.GUT.

Moms like me need a gentle hand. We need to be heard, not dismissed. We don’t need to hear that “It’s not your fault” because in our heads? It is. It always will be no matter how much you tell us that it’s not. It just will be. We need you to stand with us, to be there when we need to scream, cry, vent, and shake our fists at the sky. To understand that our truth is a hard truth and sometimes it will break us but we will rebuild, a constant practice in our lives shattered by this spike of unexpected blow-back from our already complex, shame, and stigma-riddled experiences.

We are women made of glass. Under that glass, yes, we are steel, because we have to be, but on the outside, we are glass and we shatter. We need you to be someone who lets us shatter, someone who helps put us back together and take another step forward as we walk toward processing our new truth.

It’s time for us to come out of the darkness and speak up, to be honest about the role we feel we played in the issues affecting our kids, and to find support, REAL support, not dismissive attitudes, in our search for the light both we and our children need to thrive. We seek out the research drawing the lines from Mom to our kid’s issues, whatever they may be. Sometimes, the line tracing back to Mom is real, worth exploring, and worth understanding. Without it, we’re just left wondering why. I, for one, don’t like hanging out in the middle of nowhere with no answers.

Any answer, even a horrible one, is better than no answer at all.

It’s something. A direction in which we can begin to move forward from, a new beginning from which we can start to walk toward solace. Even if we never reach it, walking toward it is often enough. It has to be, right?

 

 

 

Happy Third Birthday, Text4Baby!

partner button_300x250When Text4Baby first came on the scene, I was very excited. Here was a service that offered moms, for free, information about their infants and motherhood which would come straight to their phones. No signing into email or having to go to a website, just sign up for the service and BAM. Valuable information about your baby comes right to your phone. What’s really cool is that Text4Baby includes information about Postpartum Depression as well!

They turn three this month and I am thrilled to wish them a Happy Third Birthday! Text4Baby has grown quite a bit from a small service to a network of over 900 partners.

Here are a few wonderful facts about Text4Baby:

  • Text4baby is a free service that delivers three text messages a week to pregnant women and moms with children up to 1 year old. The text messages are timed to the mother’s due date or the age of her child.
  • A recent study by GW found that moms who used text4baby were “nearly three times more likely to believe that they were prepared to be new mothers”
  • A study by UC San Diego found that 63.1% of women reported that text4baby helped them remember an appointment or immunization that they or their child needed; 75.4% reported that text4baby messages informed them of medical warning signs they did not know; 71.3% reported talking to their doctor about a topic that they read on a text4baby message.
  • Text4baby is a collaboration of 900 partners. A comprehensive list can be found here.
  • 95% of women who use text4baby would refer the service to a friend

I haven’t used Text4Baby as when they began, my youngest was just a little over two years old so I was out of the target audience range.

As the founder of #PPDChat (which also turns 3 this year, incidentally – in May!), I am all for any technology which helps provide solid information and support to moms. Text4Baby does just that!

I hope you’ll join me in wishing an amazing service a Happy Birthday. May Text4Baby continue to grow and make a difference in the lives of mothers & babies!

I did not receive any compensation for this post. @Text4Baby approached me about writing a post and I happily accepted because I believe in what they do for new parents.