Tag Archives: medication

#PPDChat: 02.29.16: The Great Medication Debate

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PPDChat 2-29-16No, we’re not going to tell you if you should medicate or not. But we will be discussing the various methods women use to treat their Perinatal Mood & Anxiety Disorders. Everything from natural to pharmaceutical medication. The methods vary just as greatly as the women who end up in battle with a Perinatal Mood & Anxiety Disorder. Yet, many of these women still find themselves judged for whatever method they choose. You know what? It’s all about finding what WORKS for you, not what works for those around you and makes them feel better. They’re not the ones inside your heads.

Please join me tomorrow evening for this chat. We’ll let it all hang out – vent away about any judging you have received, how stigma may or may not have kept you away from a certain method, or what kind of surprising support you received – we’ll be there to hear ALL of it. Because in the end, we’re all just moms who want to get back to living and loving our lives.

See you on Twitter at 8pm ET, y’all!

Medication or Therapy?

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In a very insightful piece at the NY Times in the Well section, “To Treat Depression, Drugs or Therapy“,  Dr. Richard Friedman, M.D., explores recent research which examined the manner in which people respond to either medication, therapy, or both.

It’s a question we hear a lot as we support women fighting their way through a Perinatal Mood & Anxiety Disorder. The concern is valid, for a variety of reasons. Breastfeeding mothers worry about what the medicine will do to their children. All mothers worry about the stigma about being on a medication. Therapy provides its own challenges with childcare and financial being the two primary ones.

So how do you choose? Why is it that what works for one doesn’t work for another?

Turns out, according to the research Dr. Friedman examined, it comes down to our brains. The research, led by Dr. Helen Mayburg of Emory University, holds great potential for successful treatment of those of us who struggle with mental health issues.

“Dr. Helen Mayberg, a professor of psychiatry at Emory University, recently published a study in JAMA Psychiatry that identified a potential biomarker in the brain that could predict whether a depressed patient would respond better to psychotherapy or antidepressant medication.”

Read that again. A biomarker. In the brain. This vein of research, which involves imaging the brain, may one day allow us to side step the arduous task of finding the right medication for our own situations.

Go read the article, which also touches briefly toward the end on Dr. Charles Nemeroff’s research regarding the treatment response of those who endured childhood trauma. (This is also very enlightening).

Mental health will always be a challenge. How our brain works affects everything we do, everything we are, everything we hope to be. It’s a fight to get it all done. But it’s a fight worth every single breath.

Meeting Enemies Undaunted

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Last night, when I took to my keyboard to write “Finding Life at the End of My Comfort Zone”, I did not need to write it to complete my 500 words for the day. It was just time to admit what had gone on in my life for the past year and how I was coping. After I hit publish, I exhaled. Finally. It was all out. For me, part of healing is being open and transparent.

Not more than a couple of minutes after hitting publish, the post received a comment from someone who has never commented here. It was held in moderation, and I will not be publishing it as a comment. I am, however, going to publish it here, addressing why it is a highly inappropriate response to my post yesterday.

The entire comment is as follows:

Hi! I think that it’s great you’re taking medications to help yourself but I am so sure that you can do so much more awesome things than taking medicine. I am one of those who don’t step outside my comfort zone as well and you know stepping outside the first couple of steps are the hardest but gradually you’ll become stronger to keep pushing yourself forward. You should try meditation it’s not religious at all too. It’s a practice to obtain peace and can really reduce stress. I believe you can do it, you just have to tell yourself that you’re strong enough! I wish you good luck of your journey! :)

You ready to analyze it? I am.

Let’s start with the greeting and the first sentence:

Hi! I think that it’s great you’re taking medications to help yourself but I am so sure that you can do so much more awesome things than taking medicine.

Notice the cheery greeting, complete with exclamation point. She’s HAPPY! She thinks it’s awesome that I’m taking medications to help myself BUT.. wait…. what’s this? She’s sure I can do so much more awesome things than taking medication? Really? Based on what sound evidence? Is she a physician? Has she discovered some amazing new way to deal with situational depression brought on by an insane amount of stress in a short period of time?

*GASPS* Wait – I know! I should have stuck with just my HappyLight, regular rest and relaxation, supplements, and prayed harder, right? Right? *smacks forehead* I totally failed that one, right?

She then goes for the “I relate to you” sentiment with this line:

I am one of those who don’t step outside my comfort zone as well and you know stepping outside the first couple of steps are the hardest but gradually you’ll become stronger to keep pushing yourself forward.

Oh really? Preach on, sister, preach on. That’s how it works, huh? After two episode of PP OCD, an episode of antepartum depression, post-divorce depression, I had NO clue that the first couple of steps were the hardest. I’ve been through the “gradually you’ll become stronger” thing and know that it’s a hard process. I also know that pushing yourself forward is necessary for progress. Of course, these are all things I thought I addressed in my post which, clearly she read because she commented, right?

Perhaps there’s a solution of which she’s aware that I haven’t thought of yet?

There is!

You should try meditation it’s not religious at all too. It’s a practice to obtain peace and can really reduce stress.

Aaaaaaand here’s where it gets fun, people.

Never mind the call I made to a medical professional after fighting on my own for months against the beast inside me, a beast egged on by the stress of living with very negative neighbors who attacked us verbally or intimidated almost every time we stepped outside and wild children who screamed and yelled outside our condo until the wee hours of the morning, interfering with any chance of sleep at night in addition to an insane amount of anxiety through the day.

Never mind the discussion I had with her during which I stuttered, nervously spilling all the details of the hell in which I found myself, fighting back the urge to completely lose it as I did so.

Never mind the years of school and practice my Nurse Practitioner has under her belt which allowed her to have a very compassionate discussion with me about my current state of mind and what my options were to fix it while calming me down at the same time.

We discussed the possibility of therapy but we cannot afford a weekly therapy session right now because we are not insured. But meds which have worked before were an option. So after two weeks of working my way up to making the call, I walked into a pharmacy and picked up a bottle of pills, feeling as if I were less than a toddler’s forgotten cheerio stuck in a couch cushion.

Apparently, what I should have done instead was head over to YouTube and find a meditation video. Boom. All better, right?

An article in Forbes earlier this month touts the benefits of meditation as rivaling that of anti-depressants. The study in the article specifically focuses on “mindfulness meditation” as the preferred form. If it works for you, fabulous. Kudos. I am a huge fan of doing whatever works for you.

Here’s the thing about depression and mental health issues, however: there are a myriad of treatments available because we are not all built alike nor do we all arrive at our diagnosis via the same path. We also do not find our road to wellness along the same path.

Don’t even get me started on the entire religious aspect of this comment. Let’s leave that out of it because we wouldn’t want to offend anyone, would we? (Which is clearly why she specified that meditation is not religious, right?)

Since my brush with Postpartum Mood Disorders, my life is increasingly mindful. In fact, over the past year, I am healthier mentally than at any time in my life. How can I make that claim despite being on anti-depressants now? Mental health does not always mean happy. To me, what it means is a deep understanding of why things happen and accepting what you need to do in order to move beyond them. It means the capability to examine events in your life and hold a healthy response even if it does not lead to joy. The path back to joy, motivation, and yourself is a personal road and no one beside your physician has the right to tell you how to get there. It is YOUR road map, not anyone else’s.

Of course, blogging about my mental health opens me up to criticism and suggestions like this. Some might say that I “deserve” to have comments like this. No one deserves to be told what to do, not even if they’re asking for advice and particularly not if they are opening up about their choices they have already made.

Telling someone that they SHOULD do something other than what they have chosen to do with the help of a medical professional is beyond reprehensible. Making the decision to reach out for help  – to admit you are not okay to a medical professional is an absolutely nerve-wracking experience.

I cannot help that someone who would dare to judge someone else’s road has never traveled down a similar road. Because if they had traveled down this road, they would know how detrimental it can be to be judged for their decisions as they fight to get well.

She wraps up her comment with a much better outlook:

I believe you can do it, you just have to tell yourself that you’re strong enough! I wish you good luck of your journey! :)

Yay. Cheerleading! RAH RAH SISK OOM BAH!

Had she skipped the whole rigamarole about “more awesome than medication” and “try meditation instead” this would have been a perfectly awesome comment. THIS is a perfectly acceptable response to someone admitting they’ve settled on a method of treatment for a mental health issue. It empowers, supports, and encourages without judging the decisions of the person.

So, after all of this – how do you perfectly respond to someone who is struggling and has settled on a method of treatment? It’s hidden in this very comment.

Like this:

“Hi! I believe you can do it, you just have to tell yourself that you’re strong enough! I am one of those who don’t step outside my comfort zone as well and you know stepping outside the first couple of steps are the hardest but gradually you’ll become stronger to keep pushing yourself forward. I wish you good luck of your journey! :)”

Now this is how you support someone!

You support by offering encouragement, compassion, and empowering the person who is fighting like hell to be themselves again.

If someone proffers judgment on your treatment choices, do not let it deter you from your healing. You are in the driver’s seat and decide what exit is yours on this interstate of life, not anyone else, and definitely not a stranger who knows absolutely nothing about why you’re in the car to begin with.

A friend of mine said it best on FB, typos and all:

“Hugs. Love. I Get Its. And no judgement here. Take your meds. Meditate if it helps ON your meds. But fuck everyone else and their well-meaning yet severely judgmental opinions. Just do what’s fight for you.”

That’s what I’m doing – fighting for me, always.

Anderson Cooper, Meds, Parents, and Responsibility

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Today, in 20 minutes from now, where I live, at least, Anderson Cooper airs. He’s doing a segment about Moms & Medication – Mothers who take medication to be a better parent. Anti-anxiety pills, specifically.

I want to be happy they’re covering this but after last night’s initial tweet which has several people I know up in arms, I just can’t. I’m holding my breath and will be tuning in to watch just to see if they cover things properly and make a clear exception that there ARE parents out there who do need medication for mental health issues just to live, not to be a better parent.

Last night, Anderson’s Twitter account for his show tweeted this gem:

Taking mood stabilizers to be a better parent? What do you think of this new trend? Tweet back: #ALParenting

— Anderson Live (@andersonlive) March 3, 2013

Wow.

If there are parents out there truly doing this, yikes. And if this is just Anderson’s way of spinning the situation into a hype, then shame on them. There are multiple reasons a parent would legitimately need psychiatric medication – not just to be a better parent.

Watch with me, follow along on Twitter (I’m @unxpctdblessing), and follow the hashtag #ALParenting.

I’ll be tuning in and pushing back, using both the #ALParenting hashtag as well as the #ppdchat hashtag. Please join me if you can.

This post will be updated with reactions – and if you write anything or have any comments, please do not hesitate to share them here as well.

Update, after watching the show:

Overall, it went much better than I thought it would. However, as with all discussions about mental health, particularly ones squeezed into short segments and sensationalized for daytime viewing, things did go wrong. Below is a short list of what I was happy to see and then a few things I wasn’t happy to see:

Happy to see:

  • Dr. Michele Borba emphasize the seriousness of maternal depression and getting treatment for it. (Also emphasizing that depressed mothers will and should do anything to get help for their illness)
  • Emphasis, again, by Dr. Borba, that we, as mothers, need to get to know our hot points, learn how to deal with them, and how to deal with winding down as a family so we pass on practical de-stressing techniques to our children.
  • Anderson Cooper emphasize, at the end of the discussion, how important it is that if you have an issue with depression or mental illness, to see a doctor about your issues.

Not happy to see:

  • The anti-med member of the panel ask a member of the audience this question: “If your son were to come up to you and say he had a bad day, would you just tell him to take a pill?” The audience member was stunned. Absolutely stunned. So was I. Just because I took medication after I had my children did not mean I only coped by taking a pill. A pill is merely one part of therapy, there are many facets to caring for yourself. There’s a line you can cross into addiction and yes, that is absolutely unhealthy (the anti-med member’s parents had crossed this line), and it doesn’t allow room for healthy coping methods while in the midst of the addiction, but it doesn’t mean you get to toss a blanket of your experience on everyone else. I am sorry that was your experience, but you absolutely do not get to judge me based on that at all.
  • Failure to mention mental illness in any serious way until halfway through the segment. Most of the discussion involved the emphasis on “taking pills to be a better Mother.” No mention of diagnosis was made, nothing. I understand privacy but if you’re on a national talk show to discuss taking meds, make sure you mention why otherwise you’re just feeding the stigma that Anderson put forth last night which is Moms taking pills to be a better parent as part of a trend. Postpartum Depression and Maternal mental health issues (paternal too) are not part of a TREND. They happen, they are real, and they deserve honest and informed coverage.

On to this afternoon when Katie Couric will have a segment about Moms and mental health as well. Today is gonna be fun, isn’t it?

Share your opinions below!

Just Talkin’ Tuesday: Unhappily Pregnant

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Derniere ligne droite or Pregnancy Last Days

"Derniere ligne droite or Pregnancy Last Days" by f. clerc @ flickr.com

#PPDChat yesterday focused on Pregnancy and Depression. A lot of questions came up and I wanted to continue the conversation today. Welcome to Just Talkin’ Tuesday.

Have you ever tried to find a photo of a pregnant woman in which she is not smiling or glowing?

It’s HARD.

I found one, but it was not easy.

Everywhere you look there are glowing happy pregnant women. Here’s a page from a modeling agency dedicated to providing pregnant models. Every single last one of them is grinning.

Pregnancy, just as postpartum, is supposed to be one of the happiest times of a woman’s life. But what if your mood doesn’t match the one you are supposed to have? The one we are groomed to have? After all, even as young girls, many of us spent hours upon hours playing with baby dolls, fantasizing about having a baby of our own one day. I used to shove stuffed animals under my shirt and “give birth.” Oh, if only it were that easy!

No one mentions the natural mood swings. No one mentions that more women may become depressed during pregnancy than after pregnancy. No one tells us the anxiety pregnancy may rain down upon us. No one tells us the immense guilt waiting to consume us as we are overwhelmed and consumed with thoughts of suicide. No one tells us these things. Instead, we are continually bombarded with pictures of perfection, conflicting advice about everything from how to cope with morning sickness to how get rid of those annoying stretch marks to what to buy for our baby’s bedding to what diapers to buy to how to feed our children. Can you say Information Overload? It’s enough to get a mentally healthy mom super stressed at a time when she is supposed to be avoiding stress to begin with!

A pregnant mother’s depression may be triggered by a number of things. It may be an unexpected pregnancy, her partner or family may not be supportive, she may be experiencing unrelated stresses, she may already have children at home and the physical stress of a pregnancy may have her more than worn down, or she may already struggle with depression or another mental illness. Whatever the cause may be, it’s simply not expected for a mom to be anything but happy during a pregnancy.

So who should mom turn to? Where should she go? How can she tell the difference between pregnancy mood swings and something more serious? Mom can start with her doctor. If he dismisses her and she feels in her gut that something more than pregnancy hormones is causing her issues, she can (and should) seek a second opinion. Ask your original doctor or friends for a referral to another physician. She can also contact Postpartum Support International and speak with a Coordinator in her area who will help her locate a knowledgeable doctor or therapist. Telling the difference between mood swings and something more serious involves paying attention to your weeks rather than your days. If you have weeks filled with more down days, anxiety you just can’t kick, and nothing you do seems to bring you out of your funk, then it’s a very real possibility you may need to speak with a professional about how you’re feeling.

I found myself depressed during my second pregnancy. My first episode of postpartum was not treated. I believe this fed into my depression during my second pregnancy. I had not learned any coping methods or of the importance of taking care of myself. I drifted further and further into the darkness, swallowed whole by morning sickness (all-day sickness for me), the lack of desire to eat, take care of our 16 month old daughter, and no desire to take my prenatal vitamins because they triggered nausea. I even thought at one time what would happen if I didn’t  take my prenatal vitamins. Then my daughter was born nearly 5 weeks early with a cleft palate. Turns out there was nothing I could have done to keep her cleft palate from occurring as it forms within the first 4-6 weeks of pregnancy, well before many women are even aware they are pregnant. Still, I beat myself up about not taking my vitamins. I still do every now and then. But I now enjoy spending time with my daughter.

I also found myself depressed during the first 6 months of my third pregnancy. It was an unplanned pregnancy. I would go to every visit and wish they would not find a heartbeat. If the heartbeat wasn’t there, the baby wasn’t there and this pregnancy would just become a figment of my imagination. It hurts me to type that. As I would lie on the table waiting for the nurse to check the heartbeat with the doppler, I closed my eyes and prayed so hard she wouldn’t find it. Many times she had a hard time finding it and I would get excited. But then she would find it, pronounce it healthy and leave the room. I would cry as I stared blankly out the window, disappointed that once again, the baby had survived another month. I know this sounds horrible. I know it’s harsh and I know there are mothers who try very hard to have children or have angel babies. But there I sat, beyond words filled with heartbreak about this growing gift in my belly. I never talked to anyone about either depression. I wish I had. The difference between the two was that with my son, I was already on medication as I had suffered severe and debilitating Postpartum OCD after the birth of our second daughter (fed, I’m sure, by the depression I suffered during my pregnancy with her).  I was also in counseling. I found therapy very helpful in reframing things. And by the time this pregnancy was underway, I was also blogging here and getting started in Postpartum Advocacy. Things were looking very different indeed. I focused more on preparing for myself and caring for myself which then allowed me to take care of my family and the little one inside my belly. With my son, the fog eventually lifted and once I could feel him moving inside me, things began to look up. I realize I am fortunate the fog lifted. It didn’t magically lift though as it took a lot of hard work on my part and the help of professionals.

Please don’t struggle alone if you are pregnant and suspect you may be depressed. There is help. There is hope. Medication while pregnant is one of the biggest concerns for depressed moms. But there are medications you can take during pregnancy that have a minimal risk to mom and baby. Talk with your doctor about your options in this department.

Have you struggled through depression during pregnancy? Worried you might end up with depression during pregnancy because you’ve had a Postpartum Mood Disorder? Share your concerns, tips, and success stories here. When you comment, you’ll be entered to win a copy of Pregnant on Prozac by Shoshana Bennett. This is one of the best resources out there for mamas when it comes to pregnancy and mental illness. I happen to have an extra copy of the book here and want to pass it on to someone who could really use the information within it’s pages. This give away is not sponsored or endorsed by Shoshana Bennett, just something I’m wanting to give away to a mama in need. If you win the book and don’t need it for yourself, perhaps you could share it with your OB, Midwife, or Therapist so they could pass it on to someone who would find it helpful. All you have to do to enter is leave a comment by Monday, September 13 at 8pm EST. I’ll be choosing the winner that night via Random.org. For an extra entry, please Tweet about this post and then leave an additional comment with a link to your tweet. You can also receive an additional entry by subscribing to My Postpartum Voice via Email and leaving an additional comment telling me you’re subscribed (and if you’re already subscribed, that counts!)

So let’s get to talking about Pregnancy & Depression. It doesn’t deserve to live in the darkness any longer.