Category Archives: Postpartum Obsessive-Compulsive Disorder

NIMH Gets Failing Grade for Perinatal Mood & Anxiety Disorder Chat

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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*

#PPDChat Topic 03.10.2014: Media Sensationalism & PPD

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ppdchat-03-10-14

 

Join me tonight as we explore the issue of media sensationalism and PPD. So often, as I stated in my post “On Not Wanting To”, when a mom hurts herself or her children, we get the sensationalized version of it and the details of her journey to that point (and her journey after the event) are dramatized as well. I hope you’ll join me for a passionate and insightful chat into why this needs to change as well as why we owe it to ourselves and to society to reach out to every new mother dyad with care, compassion, and understanding.

We cannot let the village continue to fail.

On Walking Through Life as a Postpartum Mood Disorder Survivor

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I had a very interesting discussion yesterday as part of an interview with a woman who is putting together a proposal for a book about Perinatal Mood Disorders. Both of us struggled with PP OCD and for the first time, I think we nailed it when we discussed how Postpartum becomes part of your life, even after the initial “crisis” phase passes.

You see, struggling with a Perinatal Mood & Anxiety Disorder affects your entire life. It affects how you function, how you relate to everyone and everything around you, and it ultimately changes your outlook on life. This change, this transformation, at least for me, is directly related to know just how far down I slid when it struck me from out of the blue the first time around.

Diagnosis is one of the first steps toward healing. Diagnosis leads you to help and regaining your footing on the proper path. We all walk different paths and for some of us, our diagnosis becomes our mask. For others, it becomes just one part of us. Or for others, it becomes the very definition of who we are as a person, a mother, and whatever else we are…some become the personification of a PMAD. One of the things we hit on is how women who do not define themselves completely as their diagnosis find it easier to heal because for them, it’s essentially a broken leg instead of a full body cast if that makes sense. It doesn’t take as long to heal just one part vs. the whole thing. Even then, there are always mitigating factors affecting the pace of individual healing.

When you fight back, you develop coping mechanisms to pull yourself through. These look different for everyone and depend on how defined you allow your sense of self to be by the diagnosis of a Perinatal Mood & Anxiety Disorder. It is also important to note that these coping mechanisms may continue to be part of your life for the remainder of your days. It takes 21 days to develop a new habit. Therefore, it makes sense that if you continue something for longer than 21 days, it will become a habit. Whether this habit is healthy or not is up to you and your physician to decide. If it’s minor, no worries. But if it affects your normal day-to-day functioning, it might be time to evaluate things and consider breaking this “habit” as it isn’t healthy.

Do I still carry some of my OCD habits with me from my Postpartum days? Absolutely. But I know they are not a sign that I am still fighting the beast. They are there because they were a part of who I was for a very long time. There are still signals that speak to me and let me know that I am spiraling down the dark path once again, however. My habits tend to increase and begin to interfere with my day to day living when this happens. For instance, I will obsessively brush my hair, stop listening to music, and start looking for things to be upset about if I start to feel overly stressed. Learning to recognize these is a huge leap forward and learning to accept that little quirks you developed with Postpartum are just that, quirks, is also a huge leap forward.

Today was a huge milestone for me. I cleaned and organized the entire first floor of our town house because it needed it, not because I needed to do it. Yes, the clutter was bugging me but not to the point that it made me twitchy. To clean and not “need” to clean felt fantastic. In fact, I’m sitting here, basking more in the accomplishment of having cleaned NOT because of my OCD and because it needed it than in the fact that the downstairs (including the front closet) is completely spotless.

Our habits stay with us after Postpartum because we have immersed ourselves in them for so long as a coping mechanism. Sometimes we have thoughts that carry us back to those dark days and it is important to recognize them as such – just thoughts, not an actual fall back into the dark hole (unless they persist for more than a week or two – then you may want to seek help). Some of us may move on to a deeper, lifelong diagnosis of a daily fight against mental health. But the thing to remember is that you are YOU. You are not your diagnosis, you are not your habits. You are YOU and YOU are amazing, even when it is darkest.

Changing Your Stars

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I am watching A Knight’s Tale, one of many movies I could watch several times over. As I start to write, this scene is in the background:

“He’s a real Knight, William. Watch him and learn all that you can. Now go, and change your stars!”

“But father, I’m afraid.”

“Afraid of what?”

“Afraid I won’t be able to find my way home.”

“Don’t be afraid William, you’ll just follow your feet.”

Life is full of changes and situations which evoke fear in our hearts. “Courage is being scared but saddling up anyway,” according to John Wayne. It is knowing not knowing what is around the bend but peeking just beyond despite this unknown, is it not?

For me, that bend was motherhood, and waiting around that bend was one an awful monster I had no desire to meet. But we came face to face anyway, the monster and I, not too long after my first daughter graced my arms. The monster, he breathed heavily in my face, the moisture from his open, drooling mouth specking my face as if it were drizzling. He growled at me as he snatched me, taking me back to his lair just beyond the edge of town.

This monster, he shoved me down a hole in the floor of his shack, a hole so deep there was no light. I crawled into a corner and wailed helplessly until I fell asleep. This monster, he fed me, when he could, but left me there to wallow and ruminate, lost forever from the world, away from my child, my partner, everything. Until one day, a hand reached into the hole and helped me out. The light, it burned. The leaves were greener than I remembered, the dew sparkled on them as the sunlight bounced off the fresh rain collected just on the surfaces of the just born foliage.

The face of my rescuer blurred into many faces for it was not just one person, it was many, working together, which brought me back to the land of the living. One of those faces was my own for I had to fight to accept the help I so desperately needed to escape from the deep dark hole under the monster’s house.

As I left the monsters house, I of course, had to follow my feet home. For me, they led me to a new place in life, some of it familiar, some of it brand new. But alas, it was the home where my heart belonged.

In A Knight’s Tale, as Oreck travels to Cheapside, he encounters a little girl to find out where his father lives. She tells him, and he discovers his father is now blind, unable to see. So he goes up to see him, telling him that he is well without identifying himself, and that he has indeed managed to change his stars. Then there is this exchange:

“Has he followed his feet? Has he found his way home at last?”

“Yes.”

“Oh, Oh William! Oh my boy!”

Then, they sit, they talk, they eat, they laugh as if time has never passed. This is how it should be when a prodigal son returns. A celebration of return to self, or return to an improved self, rather.

Then the story goes dour again as the Adhemar, the knight opposing Oreck (William), exposes him as not being of noble birth. This is much like a relapse, as if the monster had hunted us down again and shoved us back in the hole.

But this time, this time he has people willing to fight with him, beside him, and most importantly, someone willing to truly change his stars. This is what I wish for all of us fighting a Perinatal Mood & Anxiety Disorder – a warrior willing to tilt full speed ahead with a lance against anything and anyone daring to rip us off our horses as we heal. This is what I work to be for all women who contact me – a fighting spirit who will not only go to bat for them but will do whatever I can to instill the same spirit within themselves.

Prince Edward then dubs Oreck, now William Thatcher, as a knight, asking him if he is fit to compete. He is, of course, and he wins against his enemy, the villainous Adhemar.

This is what those of us who fight against a mental illness want – we not only want to win our battles, but we want to be acknowledged as someone who matters. We are human, longing to be counted among those who surround us.

Every day may be a battle, every day may be exhausting, but we get up the next day, and do it all over again, hoping that today, just maybe, we will change our stars a little bit more than the day before, inching ever so much closer to the person we long to be deep inside our hearts.

Go. Change your stars. Don’t be found weighed, measured, and found wanting. Push yourself toward constantly changing your stars for the better. Defeat your monster, make him look up at you from the flat of his back after you have knocked him off his horse.

If you don’t need to change your stars, help someone else change theirs.

To you, it might just be a random act of kindness. To them? It might just change their entire life.

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.