Category Archives: Perinatal Mood Disorders

Just Talking Tuesday: Wrangling the Guilt Monster Postpartum built

“I’m a bad mom because I have Postpartum.”

If I had a dollar for every time I’ve heard that since I started reaching out to other new moms struggling with Postpartum, I swear I would be richer than Donald Trump.

Thing is, we are NOT bad moms because we have Postpartum.

Postpartum is not like a breakfast cereal. It’s not like we woke up one day, went to the cabinet and chose the Postpartum Flakes with Insomnia nuggets sprinkled with a bit of Anxiety for good measure.

HELL NO.

It chose us.

That bastard came trouncing into our homes, jumped into our beds with glee and announced it had no immediate plans for departure, grinning all the while, daring us to do something about it’s very presence.

Some may spring into action immediately. Others wait to see if it will disappear on it’s own. Still others wait to see if things will get worse before seeking out help.

We may hold our babies closer. We may push them away. We may yell. We may crawl into bed with Postpartum and cuddle close.

Rest assured though that Postpartum mamas are NOT BAD MOMS.

In fact, Postpartum Mamas are some of the most ferociously protective and strong mothers on the face of this planet.

Before our children are one, we have fought to protect them, to keep them safe. We beat ourselves up for yelling at them at 1 week, 1 month, 3 months, 6 months, whenever it was we lost our minds and could not tolerate another second of motherhood because we were literally unable to do so. We defend our relationship with them, redefine our relationship with them – our bond with them, however fragile or deconstructed has truly been born of fire and forged iron strong. We may not see it that first year. In fact, it may be the second, third, or fourth year before we realize just how strong our bond is with our Postpartum child.

More than anything, the lingering monster with which we wrangle on a daily basis is the Guilt Monster. He’s a slippery little devil.

We wrestle with him when our children cry. We wrestle with him when we leave our children, when our children misbehave and we discipline them. We wonder if our Postpartum affected our ability to parent. Are we bad parents because we had Postpartum? Are we harming our children because we can’t “snap out of it”? Guilt asks these questions. Guilt makes us second guess every decision. Guilt is the last monster to leave the nest. Frankly, guilt stays around in some aspect or another as long as we are parents. What changes is how we cope with the questions guilt attempts to force in our direction.

Spill your confessions here. Has Guilt sabotaged your recovery? Your parenting? Your relationship with others? Your job? Your decision to stay home as a parent?

Let’s get to just talkin!

Just Talking Tuesday 11.23.10: Husbands, Wives & Postpartum Mood & Anxiety Disorders, Oh My

"Argue" by jk+too @flickr

“I wish my husband understood that I’m not just trying to get out of Motherhood.”

“How can I admit to struggling when he seems so happy? I’d hate to rain on his parade.”

“He doesn’t believe in mental illness. Neither does his family. So I fake it.”

“I can’t take medication. He won’t let me.”

“My wife won’t admit she is struggling. What can I do?”

“Everything I do is wrong. I’m scared I’ll lose my wife and my child.”

“She’s awesome with the baby. Me? I suck. I’m failing at fatherhood.”

“I’m the Dad. I have to be the rock. I can’t be depressed.”

“I drink/do drugs to hide/numb just how bad I’m feeling from her.”

Every single one of these statements are real things parents who have reached out to me have expressed. These statements are extremely telling. What do they tell, you ask? They tell just how much communication has broken down within the relationship. The breakdown may have occurred before baby. Or it may be a new thing. Until now, everything within their relationship may have been picture perfect. They were the perfect couple. Never had to work hard at their relationship. They may have been “THAT” couple. But now that everything is dashed to hell, smashed to pieces by an innocent new life, their relationship struggles to stay afloat. Everything they thought they knew about each other is also up in the air. They wait with bated breath for it all to crash back down, hopefully back into the right place.

We did just that six years ago.

Things are still falling back into place.

We met at work. Yes, we were like Pam & Jim. We met the weekend after Thanksgiving in 2000 after our Supervisors relocated us to adjoining cubicles. Our first date? A flirtatious invite to a non-existent steak dinner as I bragged to him about my evening. I dashed like a mad woman to the grocery store to turn this imaginary meal into a reality. We’ve been inseparable ever since. In 2002, we got married.

In 2003, we got pregnant.

In 2004, we officially became parents and I went off the deep end.

Suddenly he couldn’t do anything right. I knew everything, he knew nothing. I snapped at him because, well, I could. He got frustrated. We stopped talking. If he did talk or get upset about something, it was automatically my fault. My self-esteem took a nose-dive. I did not think I was verbally abusive, irritable, angry, or crazy. Turns out I was. This continued well into my second pregnancy.

Then our second daughter was born. She spent time in the NICU. I was hospitalized 56 days postpartum after a near-psychotic break. Think we weren’t communicating before? Now we really weren’t on the same page. He had been medicating with marijuana along with the same anti-depressant I ended up on after my hospitalization. We yelled. We screamed, we fought, I cried, I begged him to tell me he wasn’t okay about all of this – that he was hurting too. He lied and said he was fine because that’s what he thought he was supposed to do – he was the man. The rock. He was supposed to be okay.

Turns out he wasn’t okay after all.

After the birth of our third child, I was involved in a car accident at just 3 months postpartum. I went to jail. Why? Because my husband had been spending money on marijuana instead of on important things like vehicle registration and car insurance. Again, failure to communicate.

He’ll be 3 years into recovery this coming March. So will I. Wait – did you say  – I did. I’m no longer a co-dependent. I’m no longer enabling his habit. Believe me, you didn’t want to be in this house the day after my accident. It was not pretty.

Our fallout from PMAD’s and Paternal Postnatal Depression took nearly four years to explode. It’s taken close to seven years to claw our way back to where we are now – a place very closely resembling normal and healthy. Even here though we have our issues. I suspect we always will. To assume perfection is to ignore the flaws in front of you. Flaws are not always a bad thing. Sometimes they are just what we need to learn and move forward.

We have mistakes in our past. We have learned from them. Moved on. Trusting in God and His enduring support as we grow to trust in Him for everything. Our journey has been full of hell. But it’s also been obviously filled with grace and tenacity. On our part and on God’s part.

There are times within the past almost seven years at which I could have walked away and no one would have faulted me. I chose to stay and fight. Certainly not the easiest path but definitely the right path – especially as I sit here in the glow of a Christmas tree, a fireplace, and my husband beside me.

For us, our brush with Perinatal Mood & Anxiety Disorders ripped the band-aids off situations we may not have otherwise faced head-on. We were thrust headlong into trauma, grief, mental illness, and forced to decide how to move forward. I am thankful we clung to each other and made the decision to move forward together. I know many other couples who are not as fortunate for whatever reason. Each situation, each person, each Perinatal Mood & Anxiety Disorder is different. Therefore, the results will be assuredly different as well.

What challenges have you faced as part of your PMAD? Has your husband axed certain avenues of treatment? Has that affected your recovery? Your marriage? Did your PMAD ultimately lead to divorce? Or is your marriage stronger as a result of coming through the fiery storm that is a PMAD?

Let’s get to just talking about Husbands, Wives, and Postpartum Mood & Anxiety Disorders. Oh My.

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Prematurity Awareness Day: Remembering to Breathe

[youtube=http://www.youtube.com/watch?v=jPz3YaIJkjQ&fs=1&hl=en_US&rel=0]

2 AM and she calls me ’cause I’m still awake

~Anna Nalick, Breathe~

I couldn’t sleep. It was time to pump again. If I did not pump, I stood to lose the precious supply of breastmilk I struggled to establish. Every three hours I hooked myself up to a yellow hospital grade Medela pump. The plastic horns were cold. Hard. Definitely not the warm natural manner in which I expected to be providing milk to my new baby girl. Never-mind she was in Atlanta about an hour away.

I sat on the couch, in the dark, hooked up to a whirring machine via tubes. 70+ miles away, my daughter was doing the same thing, hooked up to machines, whirring and straining to keep her alive.

‘Cause you can’t jump the track, we’re like cars on a cable
And life’s like an hourglass, glued to the table
No one can find the rewind button, girl.
So cradle your head in your hands
And breathe… just breathe,
Oh breathe, just breathe

~Anna Nalick, Breathe~

She was a little over 4 weeks early, my second daughter. A late-term preemie but a preemie none the less.

We had no idea she had a cleft palate. Or a recessed jaw. Or a compromised airway. Or a floppy tongue.

No idea she would be in an ambulance less than 24 hours after birth heading toward a NICU in the nearest large city.

No idea we were about to get a crash course in medically fragile infant care.

No idea of the plan to take our lives and turn everything completely upside down.

The plan was to have a baby. Go to the hospital, give birth to a healthy baby, nurse, go home.

Our plan failed. I failed. I wailed. I cleaned. I screamed. I cried. I wanted to leave her at the hospital. She was not mine. The hospital had made a mistake. They could keep her. I could not do this. I couldn’t. I just… I…. I was delusional. In shock. Processing but yet…. not.

Detached. Clinging to a series of routines. Clean, brush, wash, change, pump, meds, yell, scream, argue, repeat.

Stuck at home.

What I wouldn’t have given to have had her stay inside for a few more weeks.

To have known before we had her of the issues we would face.

But we did not.

I do not know if knowing would have changed a damn thing. I think it would have sometimes. But then I realize I cannot change what has been. Only what will be.

There’s a light at each end of this tunnel,
You shout ’cause you’re just as far in as you’ll ever be out
And these mistakes you’ve made, you’ll just make them again
If you only try turning around.

~Anna Nalick, Breathe~

The day we were to learn how to place an NG tube, I sprained my ankle as I got up from pumping on the couch. My husband freaked out along with me. Then I instructed him to bring me an ankle brace and ace bandage, bag up some ibuprofen and tylenol, and grab an ice pack. There was a grown up hospital across from Children’s. If things got worse, I would go, I promised. I never went. The nurses asked why I was limping. When I told them, they chided me. I did not care. I had limped around since arrival. 42 hours of labor wracked my body. I had the shakes, fever, signs of trauma. I kept going. I burned and re-tore. I should have slowed down. Rested. But I could not. My daughter needed me so I threw myself gleefully under the bus, a Cindy Crawford Pepsi ad smile glued to my face.

Why?

Because this is what a Mother does. Right? Right?

Everyone told us just get through the first year. The first year is the worst.

What they didn’t mention was the follow up appointments. The speech therapy. The potential for behavioral disorders. Allergies. Orthodontia. Additional surgeries. Ear Tubes. Feeding Tubes. Depression. Developmental delays. Hell.

They also did not mention the joy we would feel when our daughter, at four years old, finally blew out candles on her birthday cake all by herself. I cried.

Or the joy when she finally started talking and could TELL us in her voice instead of with her hands how much she loved us.

Or how much joy would spread across her face as she blew up a balloon after surgery #6 which created a pharyngeal flap to close off excess nasal emission of air previously preventing her from blowing up a balloon.

Or her giggles when she first blew bubbles.

Or how big we would grin as we listened to her teach her 2 year old brother talk.

How good it would feel to as she finally made progress.

How good it would feel to understand 80-95% of her speech instead of 25-50% of her speech.

How good it felt as we both recovered from depression and felt the sun’s warmth on our faces and in our hearts.

How grateful we would eventually be to God for carrying us through such a huge storm.

2 AM and I’m still awake, writing a song
If I get it all down on paper, it’s no longer inside of me,
Threatening the life it belongs to
And I feel like I’m naked in front of the crowd
Cause these words are my diary, screaming out loud
And I know that you’ll use them, however you want to

~Anna Nalick, Breathe~

When I became pregnant with her brother, I began to blog here. Not so much for others at first, but for me. I needed the support. I needed to vent. I needed to know I was not alone. Writing became a solace for me.

I know I am not alone.

You are not alone.

We are together.

There are thousands of us scattered across the world, just as scared as the next one. But we are not alone. We are not alone.

But you can’t jump the track, we’re like cars on a cable,
And life’s like an hourglass, glued to the table
No one can find the rewind button now
Sing it if you understand.
and breathe, just breathe
woah breathe, just breathe,
Oh breathe, just breathe,
Oh breathe, just breathe.

~Anna Nalick, Breathe~

Today I breathe. In. Out. Just as before.

But everything around me, in me,  has changed.

I have changed. For the better, I think.

Today I am stronger. I am braver. I am not stuck in that moment. I move forward. Not because I have to but because I want to do so. Because I choose to do so.

I am far from perfect. Far from June Cleaver.

I am me. Unapologetically me and unapologetically me as a mom. I do not worry about what I am doing right or wrong according to others. I don’t worry about what she says or she says or she says. What she says does not matter. All that matters is if my daughter has laughed with me today. Has she felt loved? Has she been hugged? Is she warm? Clothed? Fed?

Our house is a wreck. My kids watch TV. My kids eat junk food occasionally. I do too. We are imperfectly perfectly us.

And for that?

I am grateful.

So I breathe. I exhale. I move forward as an empowered unapologetically me.

The day I gave birth to my daughter four and a half weeks early was the same day I gave birth to a stronger me.

It just took me nearly five years to really figure that part out.

(This post is part of the March of Dimes Blogger’s Unite to Fight for Preemies event. You can learn more about Prematurity Awareness at the March of Dimes website.)

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Off the Blog: The breath of life (via Self-CareTips for Women)

When Diane Sanford emailed me the other day to ask if I would write a brief piece about their self-care challenge, I said yes. I love this project. It has really forced me to focus more on taking care of myself which is something I had not been doing a very good job of lately.

I hope you will go check it out and get inspired to join the self-care challenge with me!

The breath of life Today's post is by Lauren Hale. As you read this I want you to focus on the absolute most basic function of life. You are doing it right now. Breathing. Notice how your chest rises and falls, your stomach moves up and down, the air in and out of your nose and mouth. If it is cold, you may even be able to see your breath today. When we take time to be aware of our actions, even the most basic, we tune with what is going on within ourselves and aro … Read More

via Self-CareTips for Women

The Great Divide: Researchers, Clinicians, Medical Professionals, Peer Support Advocates, Struggling Patients

All across the globe, there are Researchers dedicating their lives to exploring all aspects of Postpartum Mood Disorders. Many of these researchers work in clinics, some are purely academic, and others review the research of others and present a compilation to conclude results.

Clinicians (for our purposes here) are trained in a variety of professions from therapists to psychiatrists to psychologists. These are the professionals on the front line. Some may be trained specifically in Postpartum Mood & Anxiety Disorders while others may be largely unware of the nuances of these conditions.

Medical Professionals often see Postpartum Women prior to a Clinician is involved. These are General Pracitioners, Family Practice doctors, Pediatricians, Obstetricians, Midwives in some areas, ER doctors, nurses, etc. These professionals again, may or may not have additional specific training in Postpartum Mood & Anxiety Disorders yet it is highly unlikely they are familiar at all with the nuances involved.

Peer Support Advocates are in the trenches. These may be made up of survivors, passionate and informed Clinicians, nurses, pediatricians, IBCLC’s, doulas, and a number of other people various walks of life. They become Peer Support Advocates for various reasons but largely due to personal experience from either a lived experience or the experience of a loved one.

Struggling Patients are in the thick of a Postpartum Mood & Anxiety Disorder, often navigating the system for the very first time. Many of them have never had a mental illness before giving birth or pregnancy. They are not familiar with their rights, the issue of medication, diagnosis, follow-through, or where to turn for help. They are filled with guilt, shame, and fear. These families and patients are often afraid to speak up and reach out for help. But their voices are increasing. Yet they are still echoing into an empty cavern as they scream out for the help they so desperately need.

Peer Support Advocates often are the first to hear the cry of the struggling patients. We work with them to find knowledgeable support in their locale. While the possibility of connecting these patients with knowledgeable or compassionate care is increasing, often times, we find ourselves up against a brick wall riddled with barriers to treatment. The biggest barrier is lack of knowledgeable local referrals. Primary referral in many areas is often to an uninformed or untrained Medical Professional.

An uninformed Medical Professional may do more harm than good with a Postpartum patient. He or she may erroneously take the DSM guidelines to heart, refusing to acknowledge a Postpartum Mood Disorder if the patient had her baby more than four weeks prior to presenting with symptoms. Nevermind that the APA itself admonishes the usage of the DSM in such a manner. If the non-mental health trained Medical Professional is informed, then the patient may find herself ushered higher up the ladder into the office of a professional Clinician trained to deal with psychiatric illness and disorders.

Clinicians are not always trained in Postpartum Mood & Anxiety Disorders. Therefore, it’s important for the patient to know what questions to ask when making an appointment with a specialist in the psychiatric field when seeking help for a PMAD. Questions like “Have you been trained in Perinatal Mood Disorders?” or “By whom have you been trained?” or “How long has it been since you were trained?” or “What is your approach to treating PMADs?” are all excellent questions someone who has been trained in Perinatal Mood Disorders would be comfortable in answering. A good clinician will answer honestly that he/she has not been trained but is willing to learn. He/She should offer her viewpoint on treatment and not force you into accepting their way or the highway. A good (and informed) clinician will also keep up with the latest research regarding PMADs.

Researchers are often not in the field with patients. On rare occasion they are clinicians themselves. Many are academic researchers. These researchers study everything from epidmeology to treatment to type of Perintal Mood Disorder, to risk factors, to contributing factors, birth trauma, etc. The issue with Researchers comes in when their research is manipulated, funded by Pharmaceutical companies, involves retro-data, a small data group, or a limited field in which some factors are not viable simply because the size of the group or source of the group is inherently flawed or for some other various reason. This is not to say that all research should be thrown out the window. It shouldn’t be at all. BUT it is important to be able to distill the research with a keen eye and apply some common sense to the outcome.

This is where Clinicians, Medical Professionals, and Peer Suppport Advocates come into play. Anyone trained or in contact with experts in the field of Perinatal Mood Disorders will be able to help you recover. Even those not well-trained but well-meaning and open-minded will be able to help you. If your Clinician, Medical Professional and Peer Support Advocate is willing to help formulate (or find) help which fits your personal lifestyle and belief system, your chances of recovery increase. But if you have a Clinician, Medical Professional or Peer Support Advocate who is closed off to certain avenues of treatment due to a certain aspect of your own life such as breastfeeding, other children, pregnancy, etc, then you may want to continue looking for help elsewhere.

In light of the new guidelines in the DSM-5 which will keep the Postpartun Depression Identifier at 4 weeks, we need to work to get those involved in care for Postpartum Women struggling with disorders talking with each other instead of at each other or indirectly with each other via research, peer support survivors, and trainers, etc. But how do we do this?

How do we get the researcher to share with the Clinician their goals, interests, and conclusions? How do we then get the Clincian to spark interest in the Medical non-specialist Practioner to learn about Perinatal Mood & Anxiety Disorders? Then how do we plug in the Peer Advocate and the patient? How do we open the discussion between Professional, Peer Advocate, and patient? How do we keep the communication going once it’s started? What will it take? How many more tragedies must we endure before everyone involved is ready to talk and on the same page?

Enough is enough. We need to stop talking at each other, around each other, to each other and instead talk WITH each other. Until we do, innocent women, children, and families will continue to struggle, suffer, and possibly even die. I am not willing to let that happen. Are you?

Speak up. Say something. EVERY Word makes a difference. Every.Word.

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