Category Archives: public awareness

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.

 

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.

#PPDChat Topic 03.10.2014: Media Sensationalism & PPD

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.

veteran-infographic

When You Thank A Vet

Today marks Veteran’s Day here in the United States. It’s a day we set aside to honor those who have fought so valiantly for our country.

With the advent of technology, reaching out to Veterans to declare your support is easier than ever before. Businesses, organizations, individuals – everyone is sending a shout out to Vets today. It is amazing to see the support flowing forth.

But.

I think there is an aspect we often forget about as we reach out to give our thanks to the vets who have fought for us through service in various branches of our military.

It is important to remember they are human too. They have emotions, reactions, and they too, are remembering their journey in their own way as we lavish them with praise and appreciation.

Some may struggle with PTSD. Others are lost in thoughts of brothers in arms lost to battle. Others contend with the idea that those who thank them for all they have taught them are themselves the teachers and worthy of praise.

We forget, all too often, I think, the intense emotional aspect of war. The toll it takes on all of us. Perhaps this is because best summed up by this quote:

“Humankind cannot bear very much reality.”

T.S. Eliot, Four Quartets

Is war something we are unable to closely associate with human emotion because of the very nature of it? Is battle too fierce? The fighting too gruesome? Do our psyches not allow us to carry the traumatic alongside the sensitivity? Is this our brain’s way of protecting us from an emotional overload? Or is it because the majority of soldiers for so long have been men and therefore not allowed to operate as anything less than robotic, keeping them from processing the emotions battle swells within them?

We do not broadcast our losses on the evening news as often as we should, a point made in this deeply moving post about a citizen sharing a last flight home by a soldier. Instead, we relegate ourselves to separation from the tremendous loss and focus instead on the reunions of soldiers with loved ones. We are not acknowledging, in my humble opinion, the steep and tragic cost associated with prolonged battle. The loss, the heartache, the raw emotions steeped in battle and drenched in blood shed against tyrants who dare to threaten our freedoms, are far too great for humanity to bear.

We, for whatever reason, do not often equate humanity with soldiering. Empathy and compassion fails to mesh well with the ferocity of battle. So when soldiering and emotion intersects, as it often does on Veteran’s Day for so many, it can be triggering. It may leave some feeling overwhelmed and not knowing quite how to deal with the gratitude flowing their way.

It is not like Christmas or Thanksgiving. We are not celebrating, we are honoring. There are no gifts or celebratory meals. Instead, there is quiet recognition and thoughtful consideration of all that our veterans have sacrificed. Like anything else, we all choose to do this differently for it is intensely personal for those of us who have a veteran in our lives. Whether they be friends, brothers, sisters, fathers, mothers, grandfathers, or grandmothers, how we choose to honor their service and their memories is as unique as a snowflake which falls with the first snow.

We may choose to honor them quietly or we may make a public statement. For me, today, I am wearing my grandfather’s tag and will probably at some point watch Mister Roberts, a movie I used to watch with my grandfather quite often. Both of my grandfathers served in the Navy in WWII and although they never spoke of it with me, I knew they carried their experiences with them, as all veterans do. Military service is a part of their souls and the very fiber of their beings. Once you have served, there is rarely a time when you can untangle soldier from human. Therein, in my opinion, lies the challenge in coming to grips with the flow of gratitude on Veteran’s Day.

I only saw my grandfather cry once – when we were at a play meant to raise funds for the WWII D-Day Monument. As the telegraph notifications came in reporting the deaths of the soldiers in Bedford, Virginia, the hall went completely silent. Deeper than an audible silence; the kind of silence which envelops a room when there is great respect for what is occurring. I glanced over at my grandfather at this point to see his cheeks soaked in tears. I quickly looked away and struggled to hide my own flooded cheeks shortly thereafter. We never spoke of these tears but I never forgot them for they symbolized the emotional depths of war for me and always will.

For many, in particular those who have seen war since 2001, today is different. The memories are recent, the pain is ongoing, and they have joined the Greatest Generation in knowing the pain of war. Yes, the pain. War is not some glorified wonderful thing. It is not the Hollywood version where there is a rise to action, action, and then a conclusion. It’s messy, it rips families apart, it pushes soldiers to their limits and back again, and if they’re lucky, they get to come home, alive and still intact both physically and mentally. For all too many, this is not the case, and their wounds may not be visible to the eye.

veteran-infographicSuicide rates among soldiers, for the first time ever, outnumbers the deaths occurring in active combat. There is PTSD, and number of additional other issues which, again, because of technology and advancements in mental health awareness & medicine, are now at the forefront of the adverse affects of war. Women who are deployed face a higher risk of Postpartum Depression which in turn, affects an entire generation. War truly leaves a mark on every one of us, both on and off the battlefield.

So today, when you thank a veteran, particularly a younger veteran, take the time to embrace that they may be filled with emotions they may not be ready for today as a result of the onslaught of gratitude. Take the time to realize that these brave men and women have lost loved ones, brothers in arms, and they are replaying this in their heads as you thank them for their service. Respect their journey but also take the time to check in with them and ask them how they are doing.

For they are soldiers, they are brave men and women, but beneath it all, they have a heart, a soul, and they have bled for us, some more than others. They deserve nothing less than our greatest compassion and understanding for the hell they witnessed on the battlefield as they fought for freedom from tyranny in our great country’s name.