Category Archives: postpartum depression

On Helping Others

“How do you help all the women you do and not carry their pain with you?” asked my therapist as we sat in her office a little over two years ago.

“I don’t know. I just do.” I fidgeted slightly as I readjusted in the chair, popping my neck and a few vertebrae as I did so.

“But day in and day out, you are seeing people at their worst and helping them solve their problems. How do you manage to do that without internalizing it?” she rephrased, pushing me to answer.

“How do you do it?” I answered her push with a question.

“Nice try. You’re good at deflecting, aren’t you?”

I smiled and recrossed my legs, staring back at her.

“It’s an art, really. As for how I don’t carry their pain and issues with me, I just don’t. Their issues are not mine. I have fought my battles, I am fighting my battles, and I leave their battles to them. I learned, from fighting my own battles, that I cannot fight anyone else’s battles for them. They have to fight them. All I can do is point them in the right direction and hand them the right tools. That’s my job. That’s where it ends.”

“So you have never had a situation that shook you?”

“Of course. Haven’t you?”

“Yes. The difference is that….”

“You’re a trained professional and I am not?”

“Well, no. Perhaps. It is just that it takes a lot to be able to listen to issues day in and day out and not get worn down by that. Given that you are here and still helping other people, it is my job to make sure you are taking care of yourself.”

“I am. I know when to step away. I have people I can hand things off to if they get too intense and I know that I am not equipped to handle crises. I also have people I debrief with after any situation which involves a crisis – people check on me which is wonderful. I am peer support only, something I make very clear to anyone who reaches out to me.”

We wrapped things up shortly thereafter, this particular session not nearly as rough as the one where she pushed me to consider whether or not I had ever shown my true self to anyone at all including myself. But this session left me deep in thought too, which is what a therapy session is supposed to leave you doing – thinking about your issues in a constructive manner instead of just wallowing & ruminating.

Sometimes I would go hiking after my sessions. Other times, I would go for a long drive, music blasting, the windows down. I wish I could say I remembered what I did after this session but I don’t because frankly, the after sessions blurred together.

The discussion in this session though, is one that we can all learn from. While not everyone is actively helping stranger after stranger through what some consider to be the worst time of their lives (most of us who have been through a Perinatal Mood Disorder kindly call it hell), it is important to remember that when we are helping others to not allow their pain to become our own. It is possible to be compassionate without tucking someone else’s pain into a pocket in your own heart. Difficult, but possible. It is also important to know your own emotional limits. Do not ever sacrifice your own emotional well-being for someone else if you can help it. (Remember the whole your glass must be full in order to give to others rule here.)

My goal, when someone reaches out to me for help, is to empower them to deal with their issues on their own with help that is much closer (and far more professional). This should be your goal as well if you are a fellow advocate or a non-professional. Educate, empower, release. I follow up, of course, and some of the folks end up being pretty good friends, but most of the time, it is a catch and release sort of contact. It’s something I’ve grown to expect.

With each person I help, my own personal hell loses just a little more of its darkness, shoving me further into the light, allowing me to help even more people.

No woman or family should ever have to struggle through a Perinatal Mood Disorder alone. This is why I do what I do and why I will never stop.

Because every single one of us matters to someone out there.

Turning Writer’s Block into Ruby Slippers

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Ever sit in front of your computer, arched like a cat, ready to strike at the keyboard, ideas at the ready and then…they sprout wings and fly out of your head as if they have been summoned by the Wicked Witch of the West to go fight Dorothy and friends as they cross Oz on their journey to see the Wizard?

I am so there. *screams at the fleeing monkeys*

In the past couple of months, I had a brief conversation with @schmutzie on Twitter about poetry and writer’s block. She casually mentioned she did not believe in writer’s block which struck me as interesting as it is something I have struggled with from time to time – heck, all of us writers have, have we not?

Then I seriously considered her idea. Why would we willingly believe in something which only serves as a roadblock to something we so desperately want to do? By doing so, are we giving ourselves permission to daydream instead of dive into the task at hand? The only thing blocking the writer is well, the writer.

What if we refused to believe in writer’s block? Mind over matter and all that. For example, right now? I’m channeling my inner Charles Bukowski and putting his words “writing about writer’s block is better than not writing at all” into practice.

Let’s say you go into the kitchen to cook a batch of muffins. You want these muffins more than anything in the world. You preheat the oven, gather your equipment, and put all the ingredients on the counter. But you realize you are out of eggs, a very necessary ingredient. Do you give up on making the muffins? No. If you’re like me, you Google for egg substitutions or you run to the store for eggs. You mix up the recipe, accepting that while it may not be exactly right, it’s better than no muffins at all.

The same is true for writing.

Even if you sit there and write about not being able to write, it is better than not writing at all. For that matter, you could simply copy another text. The method is to get you thinking and following the patterns of language and imaginative thinking. Granted, what you are currently writing may not be the most allegorically amazing thing to ever hit the page but it is writing nonetheless.

I am currently on Day 11 of author Jeff Goins’ My 500 Words Challenge. Some days I have put the keyboard to the metal and zoomed by 500 words (like yesterday when I wrote over 1k words) and other days, I have barely managed to crank out the 500 minimum words. Right now, I am eying the word count because frankly, I would rather be doing anything other than writing. Sleep sounds good, actually.

One of the things I have really appreciated about the FB group for Jeff’s challenge is the motivation. Particularly Jeff’s motivation. He has constantly encouraged us every day through example and challenges. Just yesterday he told all of us to stop doubting ourselves – that we were indeed, enough. If I am stuck, I pop into the group and scan through some of the threads for inspiration. Sometimes it works, other times, it doesn’t.

I am noticing, however, that my brain is working differently. Instead of just experiencing things and dismissing them, the most mundane things are turning into potential pieces. In fact, my most liked post from the past week was about the dinner I cooked that evening. Until I cooked that dinner, I had no idea what I would write about that day. Then, boom.

Being a writer is not about contracts. It is not about publication. It is not about writing a perfect piece every time your fingers hit the keyboard or wrap themselves around a pen hovering over paper. Being a writer is about writing when you just don’t want to but you have a deadline to meet or a challenge to fulfill. Being a writer is about seeing everything around you as a potential story. It is about digging deeper and challenging yourself to fill in the gaps.

Tonight, and always, I am a writer. A sleepy writer, but a writer. Are you a writer?

Even though we are 11 days in, you can still join Jeff’s challenge. Go here for more information. If you decide to join, I’m going to toss in an extra challenge (which is implied in Jeff’s challenge but not explicitly stated, I dare you to say to hell with Writer’s Block and write whether you feel like it or not. Use this awesome quote as inspiration:

“Discipline allows magic. To be a writer is to be the very best of assassins. You do not sit down and write every day to force the Muse to show up. You get into the habit of writing every day so that when she shows up, you have the maximum chance of catching her, bashing her on the head, and squeezing every last drop out of that bitch.”
― Lili St. Crow

Go forth and squeeze every single drop out of your Muse. Drain her dry. What you find inside may just surprise the hell out of you. Remember, according to Hemingway, ““There is nothing to writing. All you do is sit down at a typewriter and bleed.”

At the end of The Wizard of Oz, Dorothy realizes that all she has to do is click her ruby red slippers together and say, “There’s no place like home” in order to get back to Kansas. All you have to do as a writer is click your keyboard and whisper “There’s nothing like writing” to defeat your writer’s block. (Even if it’s angry pecking and frustrated whispers or shouting). You got this, right? Good.

Now write.

How the @BostonGlobe got Postpartum Depression Wrong

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With more news stories mentioning Postpartum Depression these days, it is becoming painfully obvious that reporters are scrambling to get their facts straight. Bless them for trying but sometimes, even with the best of intentions, they fall short. Like Karen Weintraub’s article “When the ‘baby blues’ are something more” at the Boston Globe on October 21, 2013.

Karen defends herself in the comments (all two of them at time of writing) about the term “baby blues” by saying that in her researching for this piece, she discovered there is such a thing as baby blues:

Boston Globe Comments

Kudos to Ms. Weintraub for doing enough research to realize that baby blues ARE distinct from depression.

BUT.

There are a multitude of omissions and errors within the article as it stands right now. Let’s go through them:

Ms. Weintraub breaks the Perinatal Mood & Anxiety Disorder experience into only three groups:

Baby Blues
Postpartum Depression
Postpartum Psychosis

Immediately, sirens sound. Particularly because the case study, a Nicole Caligiuri, a first time mother, states she felt “angry and anxious” all the time. While anger/irritability is a sign of depression, anxiety combined with anger is typically (in my non-professional opinion) more closely related to an anxiety disorder. Ms. Caligiuri, however, was diagnosed with Postpartum Depression.

By ignoring the additional facets of the PMAD spectrum, Ms. Weintraub does a severe disservice to those mothers who may be suffering from Postpartum Anxiety, Postpartum Post-traumatic Stress Disorder, or Postpartum OCD.

Weintraub states that 50-85% of new mothers experience baby blues, 14% experience postpartum depression, and a “fraction of 1 percent of new moms” experience Postpartum Psychosis. If you go by those numbers (at the higher levels), nearly 100% of all new mothers experience one of these three phenomena and none experience Postpartum Anxiety, Postpartum Post-traumatic Stress Disorder, or Postpartum OCD.

According to Postpartum Support International’s Get the Facts page:

Approximately 6% of pregnant women and 10% of postpartum women develop anxiety. Sometimes they experience anxiety alone, and sometimes they experience it in addition to depression.

Postpartum Obsessive-Compulsive Disorder (OCD) is the most misunderstood and misdiagnosed of the perinatal disorders. It is estimated that as many as 3-5% of new mothers will experience these symptoms.

Approximately 1-6% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth.

But in Weintraub’s scenario, there isn’t room for the nearly 20-27% of women who develop these particular Perinatal Mood & Anxiety Disorders. As a survivor of Postpartum OCD, I find this troubling. Particularly because OCD can scare a new mother into thinking she is experiencing a form of Psychosis due to the horrific intrusive thoughts.

As I have mentioned multiple times, it is beyond important to differentiate the varying aspects of a Perinatal Mood & Anxiety Disorder. Why? Because when you lump Postpartum Psychosis sensationalism in with Postpartum Depression, things get murky. You scare new mothers who may be a bit depressed into thinking if they go get help, they will be thought of as potential criminals and have their babes ripped from their arms the instant they admit to feeling anything less than happy.

An additional issue with this article is the strong focus on early motherhood. The logic of this focus is evidenced by the study on which it is centered but a quick mention that PMAD can persist beyond early motherhood would have been a quick fix for this bias.

Why is it important to emphasize that PMAD onset can extend beyond early motherhood?

Often, many mothers do not realize they have issues until they are well into the 6th month or more. I have had mothers contact me at almost a year postpartum to share that they think something has been deeply wrong since the birth of their child but they did not recognize it until now. Many Perinatal Mood & Anxiety Disorders crop up within the first 2-3 months, often immediately after the period of baby blues, but some mothers do not recognize them or even get hit with them until much later. PMAD’s can crop up within the first 12 months after birth and even then, may not be recognized until much later. But this information is not mentioned anywhere in the article nor are we ever told at what point Ms. Caligiuri sought help.

I deeply appreciate Ms. Weintraub’s effort to reach out to Dr. Katherine Wisner and Dr. Michael O’Hara, respected experts in the research field of Perinatal Mood & Anxiety Disorders, however, I wish she (or her editor) had taken the time to allow this article to be a bit more clear regarding the wide scope of Perinatal Mood & Anxiety Disorders. I also wish a side bar had been included to resources for women and families who are struggling with these issues, particularly given that Ms. Weintraub included this quote from Dr. O’Hara:

Social support is probably the most important thing to provide a new mother, who is at a particularly fragile point in life, said Michael O’Hara, a professor of psychology at the University of Iowa, who has been researching and treating postpartum depression for three decades.

Postpartum Support International will connect new mothers with social support. Also, specifically in Hadley, Massachusetts, there is Mother Woman, a fabulous organization who is making fantastic strides toward improving access to support and care for struggling women & families. Advocates in the trenches, such as the volunteers with PSI and Mother Woman, recognize how important it is to have peers support each other so they do not feel all alone in the dark. It is an oversight that neither of these organizations are mentioned anywhere in Ms. Weintraub’s piece.

Overall, Ms. Weintraub, despite making a few blunders, seems to handle the issue at hand with a respectable grace. The study at the heart of the article focuses on the development of depression in children born to mothers who struggled with depression but Ms. Weintraub is fabulous in her handling of this issue, particularly with this paragraph:

But parents shouldn’t feel like they’ve ruined their child’s life if they go through a period of depression, Pearson said. The increased risk of depression in their children is small. Overall, 7 percent of teens are depressed, compared with 11 percent of teens whose mothers were depressed early in their children’s lives.

She side-steps the potential onslaught of guilt and gracefully allows parents to breathe a sigh of relief by including this information from the study’s co-author.

As I stated in the opening, coverage of Perinatal Mood & Anxiety Disorders is greatly improving. But we still have a long way to go to get to fully informed reporting. For the most part, Ms. Weintraub’s article is generally free of sensationalism, includes quotes from respected experts, and manages to allay any potential guilt a new mother with a PMAD may feel in reading it. However, it is still just a few small adjustments away from being truly spectacular and informative.

Wishing Upon a Magic Wand

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Once upon a time, there was a little girl who lived in a modern house at the edge of suburbia.

“Chest” by Flood G. at Flickr.com (http://www.flickr.com/photos/_flood_/7750480094/)

One of her favorite things was a trunk filled with dolls and stuffed animals from far away lands. She would open the trunk slowly, and carefully select a few toys with which to have tea.

Her favorite was a stuffed panda bear from China. There was nothing shiny or sparkly about it but the panda bear fit just so in the crook of her arm. When she wrapped it in a blanket, the bear transformed into a baby. She would rock it for hours after tea, whispering sweet nothings into its ear and smoothing the fur in between its ears.

Then, at night, just before bed, she would tuck the bear back inside the chest, telling it good night and wishing it happy dreams.

The little girl would clamber into bed for a night full of happy dreams about things she could do the following day with all her perfect toys tucked ever so neatly into the fancy trunk at the end of her bed.

As she grew older, she had different dreams. Dreams of a real baby of her own. The trunk grew dusty and the panda bear stayed inside, asleep for years and years.

Eventually, the little girl had a child of her very own. She wanted very much to hold it, rock it, and whisper sweet nothings into its ears. Kiss the sweet innocent cheeks and tuck it away for the night as she slept too.

But it did not work that way, the now-grown girl discovered. The sweet nothings were trapped deep in her heart, quelled from bubbling to the surface. The now grown-girl was sad, depressed, and anxious instead of being happy and carefree. What was this? How could she make this go away?

Then she remembered a story her father told her – about an enchantress in a forest far, far away. This enchantress turned sadness into happiness with the mere flick of a wand, something her father showed her every time she cried, imitating the enchantress’s wand with his finger as he carefully wiped her tears from her cheeks. So the now-grown girl decided to make the journey. She set about making preparations. Food, check, baby strapped to her chest, check. Unicorn to ride, check.

As she rode away from the castle, an uneasiness settled over her heart as she wondered if she would be able to make the journey all alone, with no help to care for her child. But she pressed on because she did not know where else to turn.

She rode for days until she saw the edge of the forest in the distance. As she settled in for the night, she snuggled her child close to her and stroked its hair. In the morning, she whispered, things will be better. You’ll see.

As the sun rose, so did she. She gathered up the things spread out from camp the night before and once again, strapped her wee one to her chest before flinging herself upon her unicorn. They galloped toward the forest. After a short while, she heard more hooves on the road behind her. Glancing back, she saw hundreds of other mothers, all with infants strapped to their chests, riding on unicorns. They too, were headed to see the great magical enchantress for the were exhausted with fighting against wave after wave of emotion.

Surely, one wave of a magic wand and they would be whole again.

They grew closer to the forest by the end of the day but could not quite seem to reach it as the sun sank in the sky behind the towering trees. So all the women dismounted and set up a great big camp not too far from the edge of the woods.

Together, they prepared dinner, they sang, they laughed, they shared caring for the babies they held. Then, at long last, they slept peacefully for the first time in months as volunteers took turns tending to the babes at the mothers’ sides. In the morning, breakfast was prepared and shared amongst the camp.

As the sun rose higher, the women, having been lost in their camaraderie, finally realized the forest had again shifted even farther away. But no one made a move to pack up and ride onward. Instead, they went about their business, laughing, crying, sharing, and helping where they could in the camp.

For you see, you do not need a magic enchantress with a magic wand when you have the support and compassion of those around you.

While peer support has been proven to heal women faster as well as prevent severe cases of Perinatal Mood & Anxiety Disorders, it is not often the only tool one needs to fight back. You may also need to see a health care professional to discuss more serious and intensive care methods such as therapy or a variety of medicine approaches – whether it be pharmaceutical or homeopathic. If you or a loved one are struggling with a Perinatal Mood & Anxiety Disorder, know that you are not alone. Reach out to Postpartum Support International to help locate resources near you.