Category Archives: postpartum 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.

On Shonda Rhimes, Race, & Postpartum Depression

Last night’s episode of Grey’s Anatomy has some folks flurrying around, claiming it stigmatizes mental illness and does some serious damage to women who struggle with Perinatal Mood & Anxiety Disorders. (Click here to read more about this battle moms are taking to Shonda’s alleged shaming of Perinatal Mood & Anxiety Disorders.)

I’d like to take a view that is the polar opposite of being infuriated.

Shonda Rhimes did everything right last night.

Everything.

(This is where you go elsewhere if you haven’t seen the episode yet and don’t want spoilers – in fact, go get Happy with Pharrell!)

We start the episode out coming back from winter break – we last found out that Kepner & Jackson’s baby has serious issues and Derrick is leaving for DC after a fight with Meredith.

HELLLOOOO STRESS and high tensions.

The opening scene involves Meredith discussing the hiring of a nanny with Callie. The conversation is interrupted by the incoming trauma of a mom who drove off a bridge with her two kids in the car. At this stage, we do not know the ages of the children and I don’t recall if they mention mom is pregnant at this time (ie, no need to jump to the PMAD hopscotch square yet). Meredith remarks, as everyone starts to walk, “Maybe she needed a nanny.”

Doesn’t every mom need a nanny at some point or other? Why does this imply a mental illness? It doesn’t. It implies motherhood is fucking difficult and sometimes, mom just needs some help (which we do).

Then, we fast forward to another scene where Dad arrives at the hospital after Mom has, only armed with the knowledge that there was an accident and believes someone has pushed his wife’s car off a bridge. He’s dumbfounded to find out it was his wife who was the driver – and rightfully so. Would you truly believe that your spouse were capable of driving off a bridge?

Stephanie interviews the husband as doctors and nurses prep his wife in a room, asking him if there’s anything he had noticed about her that – he interrupts, and says “You mean do I think she’s crazy? No! Absolutely not!” He then sits down and starts to list signs he’d noticed – fatigue, forgetting things, stressed, etc. Admits he’s been working a lot of hours and perhaps hadn’t been paying attention like he should have been.

Meredith, meanwhile, becomes the woman’s advocate and pushes back against any judgement implying the patient is, for lack of a better word, crazy. In fact, Meredith is the one to push for a physical diagnosis of her behaviour instead of a psychiatric one.

In the second half of the episode, the husband breaks down with Jackson, weeping, asking how on earth he could have missed this and how could he have been prepared for something like this to happen? Of course this hits Jackson hard as he is facing the birth of a child with serious health issues.

April, in her own personal hell after learning the situation with her own unborn child, goes on the most glaring rant against the patient’s behaviour.   Callie attempts to calm her down but doesn’t really get anywhere. April’s reaction, to me, was completely justified because she’s reacting from a place of hurt and is projecting.

Here’s how I saw the episode go down, in bullet points:

  • Situation/stigma presented (start in the messy)
  • Situation/stigma delved into
  • Situation/stigma pushed back against

How often do we see a show that deals with a Perinatal Mood & Anxiety Disorder by introducing the stigma, toying with it, but not dealing with it and instead treating it like the elephant in the room?

Grey’s didn’t do that last night.

No.

In fact, they brought the stigma in, expanded it by using a woman and family of colour, and then they smashed right through every single damn stigma aspect they introduced.

And yet, that’s still not enough.

A groundbreaking episode presented to us on a popular television show run by the ONLY woman of colour in TV running things right now and that’s STILL NOT GOOD ENOUGH.

What the actual hell?

I watched the episode, waiting for the horror to unveil itself. Instead, I found myself agreeing with every single situation I had seen bashed as being handled poorly. Every single situation in this episode seen as “stigmatizing” simply WAS NOT STIGMATIZING. AT ALL.

I expected one of the children to be an infant. But nope. Well out of toddler years for both children.

There was simply no reason to fly off the handle for this episode. None. Except wait, the line where someone mutters “crazy moms who…” We push back against this as hard as we can with facts, with exposure of what it’s really like to live with a Perinatal Mood & Anxiety Disorder. Guess what? Even though last night’s mom didn’t have a PMAD? They pushed back. They had a solid grasp on reality and they exposed it. Reality is, this is where we are as a culture – and that isn’t going to change over night. I, for one, welcome a show which is willing to push the boundaries of stigma and what exists there but also be willing to yank it back. Because in reality? Not everything is neatly tied up and beautiful replete with facts and details.

Shonda Rhimes starts where it’s messy. Then she wades through it and brings it to conclusion. Does it end up where we want it to? No. But you know what? It starts with what we recognize as a CULTURE. Is that right? Not yet. But we’re getting there and last night’s episode of Grey’s acknowledged that in a big way because it:

  • introduced a woman of colour who did something unspeakable
  • had the husband deal with it appropriately
  • involved the staff reacting in an appropriate medical manner without judging mom

In my book, that’s GROUNDBREAKING, not shameful. Not at all.

Thank you, Shonda Rhimes, for putting this episode together and doing so in a respectful and mindful manner. Keep that up.

 

When the Awareness Month Ends

Where does the awareness go?

Does it get tossed in the trashcan? Do we save it and recycle it for next year’s shindig?

Or do we raise the banner and keep it waving for the entire year?

Awareness months are fabulous things.

But there’s a fault with them – they last only 28, 30, or 31 days.

Everything has an awareness month these days, it seems. We are all screaming about them from the social media rooftops. Pay attention to this, do that, say this, share that, use this hashtag, find this picture on Instagram, enter this, like this, donate here, etc.

It can all lead so very quickly to donor fatigue or the inability to comprehend anything regarding any of the topics we are supposed to give our all to because well, it’s the topic du mois.

Do you go home when it’s the first of the next month?

Or are you still there, in the stands, in the midst of the mess, yelling at anyone who will listen that this is something we should still give a damn about?

We need people who will stay and fight. People who will give their all for more than 28, 30, or 31 days. The people who scream and shout even when there’s nothing left – the people who sacrifice their entire heart and soul to save those around them – those are the people who make the difference. THOSE are the people I want to surround myself with as I move forward in life.

We all matter. Do we need to be ramped up even when it’s not THE MONTH for our cause? Yes and no. Advocacy is a shout in the sunshine but it’s also a quiet whisper in the dark. Sometimes it’s as simple as sharing your story. Other times, it’s far more complex and exhausting.

Whatever the form your advocacy takes, don’t drop it just because it’s no longer the right month.

Carry that flag with you throughout the year. Hold your head high, be a shining example and move others toward your cause by exemplifying the type of person you are inside – a fierce warrior capable of surviving anything life may throw your way.

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.