Category Archives: Perinatal Mood Disorders

Just Talkin’ Tuesday 09.29.09: What does self-care look like for you?

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In my pre-kid days, I took good care of myself. Got my nails done, did my make-up, spent hours on my hair and paid attention to detail. These days I’m lucky if I manage to throw a shirt on without baby food stains, have make-up left over from Sunday church and really lucky if I’ve managed a shower. Point is, I could be doing more. But with three kids it is really hard to get even basics taken care of sometimes.

But I do try to make sure to take time for myself each day and breathe. It may be as small as going to a favorite website or listening to some great music. It may even be as little as a bite of chocolate or some awesome tea.

Motherhood is hard work! Through my bouts with Postpartum Depression I learned that self-care is the most important care. So while my priorities have changed from having awesome nails to making sure I’ve managed to put on stain-free clothes, I still work pretty hard at taking time for myself.

So let’s get to Just Talkin’! What does self-care look like for you? What are some of your favorite “I’m just being me and not a mom or a wife at the moment” things? Tell us!

Danish research and SSRI use during pregnancy

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An article at medpage.com heralds a new study released September 25, 2009 by Danish researchers. The article carries the sensationalized title “SSRIs in Pregnancy Hike Risk of Heart Defects.”

While the title itself raises eyebrows, the researchers themselves state that they were unable to conclude if the results were because of medication or the underlying depression. Also important to keep in mind is that this research is based on women who had prescriptions filled for SSRIs but does not appear to have checked to see if these women actually took the medication. Instead, they rely on data from a national registry.

“Pedersen and colleagues analyzed national registry data on more than 493,000 births in Denmark from 1996 to 2003. The data included prescriptions filled by mothers-to-be as well as the medical status of their babies at birth.”

And directly from the study:

Our results, however, depend on a correlation between redemptions of prescriptions and drug use. Non-compliance might be a problem for this type of exposure definition and could mask true associations if some of the “exposed” were in fact unexposed.

The most interesting piece to come out of this research is that of the studied SSRI’s, Paxil appeared to have the least risk of septal heart defects. I find this very interesting considering that Paxil is the only SSRI to currently carry a heart defect specific warning.

As with all studies and research, you should always examine all sides and aspects and educate yourself rather than relying on the word of others when making your final decision. Ask yourself if the person presenting the information has your best interest at heart or is merely trying to frighten you with inflated facts and figures. (Click here to read a previous post full of tips on how to find solid medical advice on the web.)

Dr. Shoshana Bennett, author of “Pregnant on Prozac” released this statement regarding this research:

Finally, treatment for the serious and potentially life-threatening illness of prenatal depression (for both mom and therefore baby) is being formally discussed. Fifteen percent of clinically depressed pregnant women try to take their lives – a bit more risky for the baby than mom taking an antidepressant, wouldn’t you say? If the pregnant woman can be non-depressed without a medication, that’s optimal. Some form(s) of treatment, however is essential. If natural and alternative approaches to wellness are not enough, it is regarded by those in the know to be safer for her (and her developing baby) to take an antidepressant than to remain depressed. Depression itself – it is quite clear from the research – crosses the placenta and alters the uterine environment causing negative consequences to the baby. In the latest research there appears to be low (0.9%) chance of a septal heart defect in babies whose mothers had taken certain antidepressants. However, what fear-mongers do not report, is that the researchers themselves could not be sure whether it’s the antidepressant or the underlying depression itself that caused the defect. Women need all relevant information and education about options for treatment during pregnancy so they can make the best decision for themselves and their family. Watch out for alarmists who are not interested in actual data – they are simply invested in promoting fear in women who are at their most vulnerable.

Shoshana Bennett, Ph.D.

http://DrShosh.com

Increased risk was determined by “redemption” of more than one SSRI prescription. Those who redeemed more than one prescription had infants with a higher percentage of septal heart defects. But again this begets the question of whether or not this result lay with the SSRI or the underlying depression/mental illness/stress the mother may have been experiencing in order to receive said prescription.

Bottom line here: Don’t think for a second that becoming a Mom starts at birth. It starts at conception. And we owe ourselves AND our infants the best start possible. This means researching by asking questions and seeking out solid answers. It means finding physicians who will be your co-pilot instead of an uncooperative Auto-Pilot unaware of the pot-holes facing them. It means putting together the best support you can with what you have access to at the time. I happen to agree that a SSRI free pregnancy is absolutely optimal. I also think you should run (not walk) out of any doctor’s office if said doctor is quicker with the script pad than the warm shoulder. But we have to remember that every situation is different. Every person is different and every pregnancy is different. And sometimes we may just have to take medication. It doesn’t make you weaker, it doesn’t make you stupid, and it doesn’t make you a bad mom. And above all, remember that the decision to take or not to take a SSRI during pregnancy is your decision. Make it with an empowered spirit, stick to it, and don’t look back.

Guanabee: “What Otty Sanchez’s story can teach us about Latinas & mental health”

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I’m always in awe of how this works for me. Earlier today I was thinking about how we could learn about the effect of postpartum depression on latinas as a result of Otty Sanchez’s story. Then BAM. Into my inbox flies a link to an amazing article over at a beta site, Guanabee. (Click here to read the article for yourself. Be warned that it does mention what Sanchez did in a rather graphic manner)

Alex Alvarez really hits the nail on the head when he asks what could have been done to prevent this tragedy. Alvarez cites misinformation of family members, pracititioners, and others surrounding Sanchez. He also points out that latinas are more likely to seek help from a general practitioner or a clergy member. Language is also mentioned as a barrier to treatment.

One of the best books I’ve found out there for latinas is a book called “The Seven Beliefs.” This book empowers the latina woman to confront and face her depression. While it does not specifically address postpartum depression, it is indeed a powerful tool which speaks the latina’s language.

Postpartum Support International also provides support in Spanish. For more information on their support for the spanish speaking loved ones in your life, please click here for a list.

The importance of Kangaroo Mother Care

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"Day 6" by samwebster @ flickr

"Day 6" by samwebster @ flickr

Kanga-what?

Kangaroo Mother Care is when a human mother and her infant snuggle skin to skin with the infant lying prone on mom’s chest. It’s a term coined after the Kangaroo’s close relationship with her little joey who doesn’t come out of mom’s pouch for four months after birth. Instead, joey relies on mom’s warmth, nutrition, and support for his “fourth” trimester. Research has concluded over and over again that this care is invaluable for both human moms and babies as well.

In 2007 a study published in the Oxford Tropical Pediatrics from researchers at the Instituto Materno Infantil in Brazil concluded that Kangaroo Mother Care may prove helpful in warding off postpartum depression. Researchers evaluated mothers at the beginning of NICU care and at the end of their Kangaroo Mother Care. NO mother developed depression during their Kangaroo stay. Let me say that again. NO MOTHER developed depression during their Kangaroo stay.

WHO, the World Health Organization, also offers an article regarding Kangaroo Care in the early months of infancy. Their article focuses on the bonding and encouragement of breastfeeding that Kangaroo Care provides. Many of the after-birth procedures and examinations can take place while baby is on Mom’s stomach in the prone position thereby improving chances of maternal and infant bonding.

There’s also another personal story proving the very value of Kangaroo Mother Care. Carolyn Isbister, a mom out of Edinburgh, saved her infant’s life with a Kangaroo Cuddle. Her little one had been given up on by doctors. Carolyn cuddled with her infant to say goodbye. She and her husband watched as their daughter’s breathing and heart beats regulated. They watched as she went from grey to pink. Carolyn’s little girl is now healthy and home, thanks to Kangaroo Mother Care.

One of the calmest moments I had in the midst of my own downward spiral was as I sat with Charlotte snuggled up on my chest. We were in the middle of the NICU, beeps and boops all around us. The fragility of life hung heavy in the air. Her many wires, tubes, and other non-baby items draped across me as well. But all that mattered was her soft warm head resting peacefully under my chin, her breath caressing my chest. I wrapped my arms as tightly as I dared around her tiny body and closed my eyes. This was a moment in which I wanted to get lost. I wasn’t experiencing many of those at the time. Time stopped as we stepped out of the NICU and into our own little world for a bit. Even as I type this I can still smell her fresh baby scent and feel the weight of her little body curled up on my chest. It is a moment I will always cherish and never forget. My eye in the midst of a hurricane from hell.

If you’re a new mom struggling with bonding with your new infant, please try Kangaroo Mother Care. It’s free, it’s easy (mostly naked baby, mostly topless parent) and it does wonders.

There is a website dedicated to the promotion of Kangaroo Mother Care as the standard of care for all newborns. They do sell products there which I am not endorsing in any way shape or form. But the website is very informative and something worth checking out if you’re interested in trying Kangaroo Care, know or work with a population who may benefit from this option. You can reach Kangaroo Mother Care by clicking here.

Just Talkin’ Tuesday 08.25.09: Sharing the PPD news with your parents

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Communication today is often done via email, text, twitter, facebook status updates. It’s become much less personal and much less formal. For some, this is good. For others, not so good. Some things get lost in translation. It’s easy to type something and hit send without thinking. It’s also easy to apply this short communication style to every day life, leading to quick judgments, misunderstandings, and worse, the planting of grudges and beginnings of the end of relationships. The art of the thoughtful conversation seems to be drifting by the wayside.

Many women and families with whom I’ve worked have expressed to me that the biggest challenge they face is enabling those around them to understand what is going on without increasing stigma or losing their formerly close relationships. It’s a struggle to go through a Postpartum Mood & Anxiety Disorder let alone try to explain the complexity of it to a loved one from whom you need support.

When I spoke with my parents about PPD, they were understanding, compassionate, and actually did their own informative research. The one thing that stood out to me when I was hospitalized came from a phone call with my dad. He said something simple yet profound (my dad is full of those – I LOVE him for it). My father told me not to let anyone tell me I was “crazy” for the way I was feeling given my situation. My situation was that two months prior I had given birth to our second daughter who was then subsequently diagnosed with a cleft palate and by then had undergone two surgeries, one major to help lengthen her jaw in order to allow her to breathe safely. I held it together as long as I could but finally collapsed on day 56. Turns out for me, falling apart was precisely what I needed in order to pull it back together.

I’ve spoken with Mothers and their Parents alike who are frustrated and upset by the lack of information, communication, and the subsequent misunderstandings that follow all too often in the wake of a Postpartum Mood & Anxiety Disorder. Often these very issues only serve to compound a family’s recovery.

Today, I would like to take the opportunity to check in and see how (or if) you told your parents (or in-laws) or kept up appearances with them. Did you let them see inside the dusty window or did you keep the shade pulled down and pray no one would accidentally flip it up?

Let’s get to Just Talkin’!