Summaries
The March of Dimes is hosting Fight For Preemies Day on November 17. Premature birth is a health crisis that jeopardizes the lives and health of nearly half-million babies each year. It is the #1 killer of newborns and can lead to lifelong disabilities. November 17 is dedicated to raising awareness of the crisis of premature birth. The March of Dimes invites you to get involved. You can:• Learn about premature birth at marchofdimes.com/fightforpreemies• Put a badge on your blog during November, Prematurity Awareness Month®• On November 17, blog for a baby you love and to help others
Premature birth is a concern for women with antepartum depression (depression during pregnancy). Research shows that preterm birth is twice as likely to occur for women who suffer from depression during pregnancy. Studies have also found that antidepressants may cause premature birth. We need more research funding so that we can get a better idea of how to prevent premature birth among pregnant women who suffer from depression, whether they are taking meds or not taking them.
You can join in this event at Bloggers Unite and at the March of Dimes site.
The Des Moines Register reports that Heidi Anfinson, who drowned her 2-week-old child in 1998 while allegedly suffering from postpartum psychosis, is now headed back to jail.
Anfinson had been granted a new trial after being imprisoned for nine years of her original sentence of 50 years for second-degree murder. She had been out for jail for about a year.
"The [Iowa] Supreme Court threw out her conviction at a second trial, held in 2000, because her attorney at the time, Bill Kutmus, failed to raise compelling evidence of severe postpartum depression, or psychosis. Anfinson, and some legal experts nationally, had hoped a new trial would put a spotlight on postpartum psychosis, which has become a more recognized legal defense since her son died."
Her new lawyer had planned to present evidence that she was suffering from postpartum psychosis at the time of the infanticide. Anfinson waived her right to that new trial, however, reportedly out of fear that a jury would again find her guilty. She plead guilty to child endangerment in a plea deal with the prosecutors.
It is still unclear how long her new prison sentence will be. While the judge sentenced her again to 50 years, the Iowa Parole Board could allow her to be released for time served, according to the Register.
"Judge Rosenberg, who presided over Anfinson's post-conviction case, noted that he had no choice under the plea agreement but to sentence Anfinson to prison.'Although this is a tragic incident beyond description ... the court believes (Anfinson) is no further threat to public safety,' he said. 'We often like to think of things in black and white. But often, it is the gray that is the truth.'Many of Anfinson's supporters cried as she was ushered out in handcuffs.Mike Anfinson said he has never stopped loving his wife, or admiring her strength, or thinking she was not to blame for the death of their only child."
Thanks to those of you who visited Organized Wisdom and nominated Postpartum Progress as a top resource for information on postpartum depression. We now have 14 nominations and are leading the pack. You can still nominate Postpartum Progress or any other site you feel is a great resource on perinatal mood and anxiety disorders! I nominated PSI and the MGH Center for Women's Mental Health.
Also, remember last week when I said this?
Just found out Postpartum Progress is listed at #55 of the top 100 Family Blogs on Technorati. Technorati tracks millions of blogs all around the world, so that's pretty awesome. Now we just need to get on the top 100 Health list ...
I spoke too soon. We're on the top 100 Health Blogs list at Technorati now too! As of today we are #14, though that will fluctuate. Weehoo! World of Psychology is on there as well -- go DocJohnG!
I've been busy redoing the Postpartum Progress Blogroll this week. I've taken off blogs that no longer exist or that haven't been updated in quite a while, and tried to add a few more. Since I've added some that weren't on the blogroll before, you should definitely check it out. You'll mainly see blogs written by mommas who are currently going through (or are survivors of) postpartum depression or related illnesses. They include (but are not limited to):
Dooce: this is linked to her posts on depression and postpartum depression
Postpartum Dads Project: for dads whose wives/partners are suffering
Oh, and since my mind is crammed with too much data, I know there are people I've inadvertently left off the list. If you think you are one of those people, let me know at postpartumprogress@gmail.com. Please note that I generally only list writers who've written at least a couple of times about PPD and related topics, as they can serve as a great resource to those who suffer. (Oh, and make sure you check the list first before you fire off an email about how you're not on it!)
Oh, and I hope you'll add Postpartum Progress to your blogroll too! Pweez?! as my daughter would say ...
I finally had a chance to mosey on over to Momversation to see their new video and discussion on overcoming depression. The 6-minute video features bloggers Heather Armstrong of Dooce, Alice Bradley of Finslippy, Mindy Roberts of TheMommyBlog.net and Danny Evans of DadGoneMad. They share their feelings on what it's like to suffer from depression.
The video is fantastic. I love it. Wish there was more of it. I was moved by all of the speakers, particularly by Mindy Roberts, who has been through postpartum depression 4 times.
FOUR TIMES!!!!!! Great Caesar's Ghost! as grandma would say.
Regardless of their specific mental illness I know you will definitely connect with their observations. Those of you currently suffering will benefit most of all. As I stated in my comment on Momversation:
"Despite the progress we've made on public communication to erase stigma and ensure people feel safe reaching out for help, I still hear from women each and every day with a perinatal mood and anxiety disorder who are:
- given erroneous information about postpartum depression and related illnesses (its causes, its symptoms, what to watch for, its treatments, etc.)
- deeply hurt by the reactions of those around them who don't understand what serious illnesses these are (friends, spouses/partners, clergy, employers, doctors)
- made to feel afraid to take medication or seek counseling
- convinced they are alone and there is nowhere to turn
It's just awful and it makes we want to pull my hair out on a daily basis. As the little people in the town of Whoville shout from the tuft in Horton Hears A Who!: We are here! We are here! We are here!"
Okay fine. It wasn't a tuft. It was a small speck of dust. But still ... We are here!!
Over at the Confessions of a First Time Mom blog, the writer shares her very compelling experience with postpartum anxiety. You should read the whole thing, but I wanted to highlight one particular part:
"I honestly didn't realize I was suffering from PPD. I thought I was just nuts. When I was discharged from the hospital after having Josiah, the nurse told me that being emotional was normal. She said most women get the "Baby Blues" and not to worry unless I had thoughts of harming my baby. I never had thoughts of harming Josiah so I figured I was just a terrible mother. Not wanting to admit how I was feeling I kept my mouth shut."
AAAAARRRRRGGGGHHHHHHHH! Can you hear me screaming all the way from Georgia?
Don't worry unless you want to harm your child! If you don't feel the need to pick up some sort of weapon, you're good to go! I'd say you've got 100% mental health! Yay for you! Go get 'em girl!
Newsflash: Not every woman with a postpartum mood or anxiety disorder has thoughts of harming her children.
That's one uninformed nurse. Yikes.
After my bout with postpartum OCD, I decided I would never have another baby. NEVER. NOT. ONE. MORE. EVER.
I am reminded of the choice I made, a choice that would later be reversed out of necessity, by a story on ParentsConnect called "Postpartum Depression: Why I Won't Have Another Baby." This mom writes about how she had always planned to have more than one child, primarily because she so disliked being an only child herself, but has now decided not to after having PPD:
"I am still plagued by anxiety. I am still on medication and in therapy. And one of the most painful things of all is that I am left with no desire to do this again. I fear starting over. Not just fear of possible PPD, but of having another newborn. Worrying about milestones and growth charts. Almost two years later with my son now, I'm still worrying about growth charts. So I can't bear to start over with another child. I fear the fear. I truly feel that if I have another child, I will have two kids with only half of a mother. That seems ludicrous to me. I'd rather focus all my love and attention on the one I have than risk his happiness just so I can say I have two children. Would I be doing it for him or trying to fill my own void?
So this leaves my child an only child. The thing I said I'd never do. The thing that makes other mothers look at me and say, "Oh, you have to have another one! You can't have just one!" (Is he a potato chip or something? I digress.) I'm treated like just wanting one child gives me two heads, and I find this extremely unfair.
So tread lightly on women you come across who feel ill-equipped to have more children. You don't know the pain and guilt that may be underneath."
I do. I know it well.
After taking a year to really get over my postpartum OCD and anxiety, I was not willing to go through that horror for even a second more. I was as done as done could be with having children. No more intrusive thoughts for me. No sobbing. No lack of appetite. No inability to sleep. No overwhelming sadness and guilt. No thank you.
Then I got pregnant. I wasn't trying to, I just did. And given the circumstances, which I will be kind enough not to go into, I really shouldn't have gotten pregnant. At all. It was nearly a miraculous conception. My husband and I were forced to rethink our choice, and in the end we chose to keep the baby (who I would be remiss in not sharing turned out to be our amazing blessing of a daughter Madden). The choice was not without trepidation. You can imagine our fear.
As an empowered patient, I knew this time I would, at the very minimum, put a team of people around me who were specialists and knew what they were doing. I was watched like a hawk throughout my pregnancy. I received counseling. In the interest of full disclosure, I also took medication, a risk I chose to take based on my personal medical history and after very comprehensive consultations with both my psychiatrist and my OB/GYN.
Being a mom to a newborn the second time around was pretty awesome, as I wrote in this piece at the time called "On What It Should Be Like To Be A New Mom". I can't say whether it was the meds, or the therapy, or a good sleep management plan, or the fact that I had more knowledge about postpartum OCD the second time around that prevented me from getting it again. I have no idea. What I do know now that I didn't know before I got pregnant with my second child was that we all have choices. We don't necessarily have to end the growth of our family after having experienced a perinatal mood or anxiety disorder. Not if we don't want to.
Am I saying I think you should have another child? By heavens, no! I'm not advocating that you should continue to have children, and I'm not advocating that you should cease having children after having had PPD or a related illness. I have no opinion on what the size of anyone's family should be (except, I must admit, when it comes to those Duggars. Would they just stop it already?) I'm simply saying that those of us who have had postpartum depression or a related illness have more than one option.
I respect the choice of the mom who wrote the ParentsConnect story. I truly do. I made that same choice. I also respect the choice of moms who choose to press on, despite having a history of perinatal mood or anxiety disorders.
As Karen Kleiman writes in her book "What Am I Thinking? Having A Baby After Postpartum Depression", "The good news is that with proper preparation and planning and a healthcare team that is mobilized on your behalf, we can intervene in ways that will minimize the likelihood that you will experience a depression to the same degree that you did previously. "
You do have a choice.
While it is currently believed that postpartum depression isn't purely a genetic or chemical disease, and that external factors play a part, researchers have been looking more closely at the biological side of things. A new study reported in the American Journal of Psychiatry has found that genetic variations on chromosomes 1q21.3-q32.1 and 9p24.3-p22.3 may increase susceptibility to postpartum mood symptoms.
Damn you, 9p24.3-p22.3. How many times have I told you to BEHAVE?!!??!
For more on this, click here.
Several weeks ago I wrote a post about depression and grief after a miscarriage or loss. To be honest, I was actually surprised by how much reaction it got. Having not had that experience myself, it hadn't really hit me how many women go through it, how deeply affected they are, how it easy it is to say the wrong thing when trying to support them, and how confused they are about where to find the help they need. My eyes were opened.
I just read a piece written by a mom who has already been through postpartum depression and has just recently had a miscarriage. My heart aches for her. Here is a bit of what she wrote:
"I feel like I have this black pit in my insides and it’s slowly consuming more and more of my being. I just want to come out on the other side of this without losing too much of myself. I feel like I’d finally come out of my postpartum issues and I lost a little piece of myself with it, but I also gained. I have Colin. But now I feel like I’m losing all over again and this time I have no reward for survival."
Ugh. I always feel like I don't know exactly what to say. How to show support. How to avoid blowing it by saying the wrong thing. I came across this really helpful post from the Share blog entitled "What Do You Say?", which describes exactly what NOT to say:
"After each of my miscarriages, I was truly shocked and amazed by the words that came from my friends' and loved one’s mouths…things like: 'You’re young, you’ll have more babies!' 'At least it happened early.' 'There was probably something wrong with ‘it,’ you should think of it as a blessing.' (Oh, really? A miscarriage is a blessing? How exactly, I wanted to ask.). My favorite, 'It’s been a MONTH already! You need to get over this!' ...
I am routinely stunned and horrified by what parents who have had later losses tell me…like the mom who was told after her daughter was born still at 20 weeks, 'At least you hadn’t done a nursery yet.' Or the mom who shared with me that her grandmother told her after the full term stillbirth of her third child, 'Oh well…you didn’t need another baby anyway.' Or the many parents who are told 'Count your blessings! You have other children!' as if that makes the death of one okay. Or, 'It wasn’t meant to be.' The 'ors' could go on and on.
Oh gosh. Have I said something like this to someone? Somewhere along the way? To be perfectly honest, I bet I have, or some milder version of it, while fumbling for the right words and trying to put a good spin on a horrible situation. Why do we feel that we have to put a spin on it at all? Why can't we just say "I'm sorry. I'm here for you. I love you."? It's as if we want to make it go away for the person who is hurting, to brush it aside, to lighten the load. As if by saying the magic words she will be set on the speedy superhighway to recovery.
The Silent Grief website offers an article on how to help a friend who has gone through a pregnancy loss. They suggest doing a lot of the same things I'd suggest when trying to help a friend who has postpartum depression.
1. Offer to do errands or bring a fresh and nutritious meal. I've often heard it said that in this situation you shouldn't take no for an answer, since many feel so uncomfortable accepting help and are likely to say they don't need any. Say "I've made this for you and I'm going to bring it. When would be the best time to drop it by?" rather than "Would you like me to bring some food?"
2. Be a good listener, allowing her to share her story and feelings. Don't judge. Don't decide for her when she should get over this or how she should be reacting to it. It's her loss, not yours.
3. Make sure your support is ongoing, not just during the first few weeks. Fight the urge to move away from her because it's so hard to see her suffer and it's so hard to be around such pain. Keep reaching out.
For those of you going through this right now, please check out my piece on the difference between grief and depression after a loss. It includes a list of specific resources that support women who have had miscarriages or stillbirths. Please consider visiting them so that you might be able to interact with those who truly understand what you are going through. You are not alone.
Hey cool! Just found out Postpartum Progress is listed at #55 of the top 100 Family Blogs on Technorati. Technorati tracks millions of blogs all around the world, so that's pretty awesome. Now we just need to get on the top 100 Health list ...
OH, and if you think Postpartum Progress should be among the top 10 resources listed at Organized Wisdom, nominate it here. Pretty please. Just scroll down to the nomination box and enter: http://postpartumprogress.typepad.com. You can also vote for other sites as well, including PSI and the MGH Center for Women's Mental Health, to round out the top 10.
Wish a major TV network would fill a need and create a series that delves into the importance of emotional health, including postpartum mental health? Don't lie. I know the last time you cracked a wishbone or stepped on a crack or blew out some candles this is EXACTLY what you wished for.
Well, your wish is coming true. Wahoo! PBS' "This Emotional Life" will premiere January 4, 2010:
"The Emmy Award-winning team of Vulcan Productions and the producers of NOVA have created a three-part series that explores improving our social relationships, learning to cope with depression and anxiety, and becoming more positive, resilient individuals.The series was produced by Kunhardt McGee Productions.
Harvard psychologist and best-selling author of Stumbling on Happiness, Professor Daniel Gilbert, talks with experts about the latest science on what makes us “tick” and how we can find support for the emotional issues we all face.
Each episode weaves together the compelling personal stories of ordinary people and the latest scientific research along with revealing comments from celebrities like Chevy Chase, Larry David, Alanis Morissette, Robert Kennedy, Jr., and Richard Gere."
Plan on watching it. In addition to covering such topics as attachment, intimacy, autism, forgiveness and meditation, they have included postpartum mood and anxiety disorders. HOORAY!
The TV series is accompanied by a cool website that lists resources, offers blog posts and shares stories from celebrities, experts and everyday people.
I have already checked out the This Emotional Life website. I get the sense they are still working on it, adding more and more resources. In that vein, forthwith I'd like to offer them a little advice:
I was concerned to find that, in the Resource Finder section in the list of topics, postpartum depression isn't listed. Postpartum depression is the most common search term used by women suffering from any type of postpartum mood or anxiety disorder. What is listed is the term "PPMD", which is not commonly used at all. It's an abbreviation for postpartum mood disorders. In fact, I believe most women will scroll down the Resource Finder topic list looking to see if the website has resources for postpartum depression and have no idea what PPMD stands for, or that it is referring to postpartum depression and other related disorders. (And, I could point out that if we were being technically correct it should actually be PMAD or postpartum mood and anxiety disorders, since postpartum anxiety and postpartum OCD are not mood disorders.) I emailed the contact for the This Emotional Life website, but received no response. I have no idea whether they'll change it or not which is very frustrating, because I want women to be able to find the resources they are looking for. If you can hear me PBS, please honk your horn, or blink twice, or nod your head.
If you happen to be in the know and do click on PPMD, the resources listed include NAMI, Mental Health America, DBSA, the Mayo Clinic, Psych Central, the Nurse Family Partnership and then waaaaaay down at the bottom are listed PSI and Postpartum Progress. I think PSI should be the FIRST resource listed. These other organizations, while they are fantastic and should be listed, do not specialize on and focus on women with perinatal mood and anxiety disorders.
In the People & Blogs - Experts section, in addition to Jessica Zucker, I hope they reach out to and add a couple more experts on perinatal mood and anxiety disorders. I would love to see blog postings on the site from Dr. Ruta Nonacs, or Karen Kleiman, or Susan Stone, or Dr. Vivien Burt, or Dr. Lucy Puryear, or Dr. Shari Lusskin, or Birdie Meyer or Diana Lynn Barnes, or Ann Dunnewold, or any of the people who are well-known experts in this field. People who have spent decades treating women with these disorders. I'm giving you some free hints, PBS!!
I'm also hoping they'll add some personal stories from women who have suffered, as currently I don't see any. There are so many great stories out there that would help others.
Oh, and why on earth does the site categorize Postpartum Progress as being about PPMD and eating disorders. Eating disorders? Nope. Not ever. I would hate for women with eating disorders to come to my site and find absolutely no help whatsoever. I only cover perinatal mood and anxiety disorders.
Am I being hard on PBS? GOODNESS NO! I'm EXTREMELY EXCITED about this series (and yes, I am shouting with excitement). I think it has such an ENORMOUS potential to do good, as emotional health is NEVER given enough attention. This series is going to absolutely rock. It's appointment TV as far as I'm concerned. I just want to make sure that, in addition to grief and loss, and addiction and eating disorders and bullying, there are GREAT resources available to women with perinatal mood and anxiety disorders.
Do you have any other suggestions for PBS?
Oh, and also:
Last week, Therese Borchard at Beyond Blue conducted an interview with psychologist Jessica Zucker, PhD. Zucker is among those featured on "This Emotional Life". In the interview, they discuss attachment and bonding. Check it out.
The University of Louisville Women's Mental Health Program, the University of Michigan Perinatal Mood Disorders Program, the Women's Health Consortium program in NYC, the Columbia University Women's Program, the Penn Center for Women's Behavioral Wellness and UT Southwestern's Women's Mental Health Center have all been added.
A big thank you to the hospitals and universities who have recognized women's reproductive psychiatry as a mental health issue important enough to deserve a specialized program with trained individuals who can provide some of the best support and treatment around to the women who need it.
If you know of another program that should be on the list, email me at postpartumprogress@gmail.com and I'll take a look.
There's something new in the world of Medicine 2.0 and it's called the e-patient. I'm still not sure exactly what an e-patient is, but I know that it has to do with regular everyday people like you and me informing ourselves as much as we can about our illnesses and communicating with each other and our healthcare providers as openly as possible about what we are going through. The website e-patients.net describes us as equipped, enabled, empowered and engaged. In that sense, I'd like to think of Postpartum Progress as the ultimate perinatal mood and anxiety disorder e-patient blog, and you the reader, as an ultimate e-patient. You are here because you don't want to sit alone in the darkness hoping someone will come to your rescue.
I just love the idea of e-patients and participatory medicine, because I think collaboration between scientists, healthcare providers, current patients and survivors is key. The more data we share back and forth, the better. We will find out more about the causes, symptoms and treatments of perinatal mood and anxiety disorders. The diverse collaboration will help weed out any undue influence by the pharmaceutical industry or others with an agenda. And the simple practice of sharing itself will help eliminate stigma and create a sense of mutual support.
Several websites have arisen out of the e-patient movement that allow people with similar illnesses or diseases to share thoughts and ideas with each other. I thought you might like to know about them.
Inspire: There are more than 130,000 people on this site, all sharing info about their different illnesses. Inspire is described as a safe place to discuss health and help each other. You can join for free, create a profile, join groups with similar interests, write about your illness in a journal that others can read and more.
Cure Together: If you click the link, it will take you directly to the Cure Together page on depression. You can join for free. Cure Together did not have postpartum depression listed as a specific condition, so I (of course) took the liberty of getting it started. You can add to the list of symptoms, treatments or causes of postpartum depression yourself and the site will track how many people experienced each.
PatientsLikeMe: As they describe it, "PatientsLikeMe is committed to providing a better, more effective way to capture valuable results and share them with patients, healthcare professionals, and industry organizations that are trying to treat diseases." You can join for free, create a profile and add as much or as little information about yourself as you'd like. You can create mood maps, get info on research and read symptom and treatment reports. Here is the Patients Like Me forum on postpartum depression -- there's not a whole lot on this site yet about PPD and related illnesses. I joined the "Mood Community", which has more than 12,000 people in it with whom you can commune.
Wellsphere: This site has millions of readers. You can join free, start your own community or join one, find out about resources near you, watch videos, add your own blog posts and more. Here's the Wellsphere page on postpartum depression.
I'm sure there are others as well. Let me know if you are using these services. And for more on e-patients, visit:
- E-Patients.net
- the Society for Participatory Medicine
Remember, the motto of Postpartum Progress is: Together. Stronger.
Today I got a direct message on Twitter from someone telling me the following:
Postpartum Depression is not a disease. It's a coping strategy.
Ok ... thanks for the info ...
I don't know the therapist who sent me the message. I don't want to malign her thinking. Perhaps she's got a point, perhaps she doesn't. I have no medical training, so how would I know?
What her tweet did bring up in my mind is all of the discussion about whether postpartum depression is real or not, whether it's genetic or not, whether we can help it or not. These discussions tire me. I've seen this illness in myself and I've seen it in other people and I KNOW it's real, regardless of the reason why it's there. Do I understand exactly what causes postpartum depression? Nope. Does anyone else? Nope. Not yet, anyway.
We can get stuck there, arguing over whether it's really an illness or what precise thing brings it about. We can choose to dig in, locked in that dispute forever, quarreling back and forth and accusing each other of being wrong. (It's genetic. No, it's a hormone problem. No, it's dietary. No, it's caused by neurotransmitters. No, it's due to the modern materialistic society of the West. No, it's due to childhood trauma ...) Meanwhile, women will continue to suffer and will still need help. At that moment. They can't wait for the cause to be found.
Thankfully there are a small handful of ways women can be helped, enough of which work effectively enough to get us through the crisis. And there are scientists who are still looking into the causes of depression in general, refusing to get bogged down in the bickering.
"In the second part of the study, Redei found strong indications that depression actually begins further up in the chain of events in the brain. The biochemical events that ultimately result in depression actually start in the development and functioning of neurons.
'The medications have been focusing on the effect, not the cause,' she said. 'That’s why it takes so long for them to work and why they aren’t effective for so many people.'
What does this mean? I have no idea. I'm grateful they're working so hard to figure this all out. I look forward to the day when we will know the cause of postpartum depression for sure. And that day surely will come.
In the meantime, we've got to go with what we've got now, choosing to reach out for help, weighing the risks of various treatments, working with professionals, and getting better. If you want an emotionally healthy family now, you don't have the luxury of waiting for the exact right answer.
One of the people I met at the PSI conference this summer was Gabrielle Kaufman, one of the PSI coordinators for Southern California. One of the things we discussed was dance therapy. I had never heard of dance therapy, and was intrigued to find out more about what it is and how it might be used to help women with perinatal mood and anxiety disorders. Gabrielle was kind enough to write the following article to enlighten us:
"When Rachel was deeply depressed after the birth of her baby girl, she didn't know what to do. In desperation and with her husband's encouragement, she reached out for help. Her OB/GYN referred her to a specialist in postpartum depression. When this specialist spoke to Rachel, she gave monosyllabic answers. Her baby sat alone in the baby carrier and Rachel stated, 'I don't want to be her mother.' When traditional talk therapy didn't seem enough to penetrate her sadness, her doctor thought to refer her to a dance/movement therapist.
Based on the understanding that the body and mind are interrelated, dance/movement therapy is defined as the psychotherapeutic use of movement to further the emotional, cognitive, physical and social integration of an individual. The dance/movement therapist's goal was to help Rachel "move" toward health and connect with her baby girl Sophie.
So what did they do? A dance/movement therapist has training much like a traditional verbal therapist, but has additional tools in her belt. With an understanding of movement assessment, the dance/movement therapist can begin to help the client interpret her behaviors and initiate a shift. The process of bonding with a newborn is a very physical one. By simply encouraging the mother to hold her baby and rock with her, movement can begin a journey toward connection. The rocking rhythm is soothing to both the mother and the baby, and the closeness of touch can be healing for both as well.
The therapist may mirror the client in an effort to meet the mother in her depression, or she may be a model mother by encouraging her client to 'move' her depression. Sometimes the therapist might bring out scarves for her client to use. She might invite the client to 'hide' from her baby and return, 'peek-a-boo'. This process is one in which the mother can regain control and initiate her relationship with her baby. We know that the bond a mother forms with her baby early on makes a profound impact on the lifetime development of her child. As much of this attunement is non-verbal, dance/movement therapy can be an ideal intervention.
These days, Rachel finds herself putting on music and dancing with Sophie. It was through the formation of an intimate bond with her baby that Rachel was able to connect to parenting. At times she still struggles and has moments of sadness, but by continuing to see her dance/movement therapist and her doctor, Rachel feels more prepared to engage in the dance of motherhood. To find out more about dance/movement therapy, visit the American Dance Therapy Association at www.adta.org."
MedEdPPD is conducting a quick, 2-question survey about a potential university-based study of women of childbearing age who have a history of depression. They would like you to take a few moments to answer the survey (Quick & Easy!), and would additionally request that clinician readers of this blog point their patients to this survey.
The survey asks you to help evaluate the idea of a study aimed at preventing, without antidepressant medication, a recurrence of depression in pregnant women with a history of depression. (If this is possible, that would be fantastic!!) They want to see if there is enough interest among childbearing women to take part in the study.
If the study is conducted, women in the program who are on antidepressant medication would taper off of it before trying to become pregnant. Clinicians would monitor study participants during pregnancy and after birth for signs of depression and would be helped with selecting a non-pharmacological treatment if they become depressed.
Women who might want to take part in the study could include:
- women who have had past depression and want to prevent it from recurring while they plan for pregnancy, during the pregnancy, and after the birth
- women who may be taking antidepressant medication and want to discontinue it before getting pregnant
- women who have had one or more episodes of depression and are worried about having it come back when they become pregnant.
Participation is completely anonymous and requires no personal information. Click here to answer the 2-question survey.
<div xmlns="http://www.w3.org/1999/xhtml"><p>Several national mental health advocacy organizations have joined together to support a new campaign to end mental health stigma called "<a href="http://bringchange2mind.org/">Bring Change 2 Mind</a>."</p>
<p>BringChange2Mind.org was created by actress Glenn Close and <a href="http://www.fountainhouse.org/">Fountain House</a>, where Glenn volunteered in order to learn more about mental illness, from which both her sister and nephew suffer.  Their goal is to provide quick and easy access to information that combats stigma to people with misconceptions about mental illness, as well as to provide people with mental illness quick and easy access to information and support.  </p>
<p>The campaign has the support of major mental health organizations, including <a $included="null" href="http://www.activeminds.org/" mce_href="http://www.activeminds.org/" target="_blank"><font color="#0066cc">Active Minds</font></a>, the <a $included="null" href="http://www.afsp.org/" mce_href="http://www.afsp.org/" target="_blank"><font color="#0066cc">American Foundation for Suicide Prevention (AFSP)</font></a>, <a $included="null" href="http://www.imhro.org/" mce_href="http://www.imhro.org/" target="_blank"><font color="#0066cc">International Mental Health Research Organization (IMHRO)</font></a>, the <a $included="null" href="http://www.jedfoundation.org/" mce_href="http://www.jedfoundation.org/" target="_blank"><font color="#0066cc">Jed Foundation</font></a>, <a $included="null" href="http://www.nmha.org/" mce_href="http://www.nmha.org/" target="_blank"><font color="#0066cc">Mental Health America (MHA)</font></a>, <a $included="null" href="http://www.nami.org/" mce_href="http://www.nami.org/" target="_blank"><font color="#0066cc">National Alliance on Mental Health (NAMI)</font></a>, <a $included="null" href="http://www.narsad.org/" mce_href="http://www.narsad.org" target="_blank"><font color="#0066cc">NARSAD</font></a>, <a $included="null" href="http://www.nimh.nih.gov/index.shtml" mce_href="http://www.nimh.nih.gov/index.shtml" target="_blank"><font color="#0066cc">National Institute of Mental Health (NIMH)</font></a>, and the <a $included="null" href="http://www.samhsa.gov/" mce_href="http://www.samhsa.gov/" target="_blank"><font color="#0066cc">Substance Abuse and Mental Health Services Administration (SAMHSA)</font></a>.</p>
<p>One of the things that you can do at the Bring Change 2 Mind website is to <a href="http://bringchange2mind.org/index.php/share-your-story">share your story via video</a>.  As postpartum depression is often the red-headed stepchild of mental illness (and I can say this because I <em>am</em> a red-headed stepchild), I would encourage you to share your story there.  We want the mental health advocacy community to remember that new moms are at risk, that research needs to be devoted to these illnesses and that more resources are needed.</p></div>
Casey, who writes the blog Moosh in Indy, has written a very beautiful piece on her depression and how it may (or may not) affect her child. It is a true love letter to her daughter. The photos she includes of she and Moosh together are just gorgeous, and I found the sentiment of her post really compelling.
"I have always worried about the day you would be old enough to know when I’m not doing well. I’m not the mom you deserve when I’m in the dark. But you are so resilient. You take such good care of me when I’m lost in my own brain. You heal me. But it’s not fair, you’re only four. I sometimes wonder what I would be like if I didn’t have these demons to battle. Would I be very average and boring? I guess it’s not even worth giving any thought to. This is my trial."
Casey has received more than 80 comments on her piece, some of which are from women with or who have had postpartum depression. They are worth reading as well, like this one:
"My own mother went undiagnosed with postpartum depression for about 5 years. It just wasn’t talked about much 'back then.' Those were dark times for her. (and my dad…in med school & residency!) I was about age 2-7 during this time and I can vaguely remember times of hearing her cry in her bedroom and sensing that things weren’t always right but that’s about it. I remember having a happy childhood.
Talking to her after having my last baby, she expressed to me that during her darkest times she would have one goal for her day: That her children could say they had a happy mom. And I can say that."
Some of the women who go through postpartum depression are women who've always suffered depression. Some knew they suffered all along, some have just realized it for the first time through their bout with PPD. Whether you are in a temporary dance with depression, or you are someone with whom it remains, you wonder and worry about your babies. I still worry to this day whether all that crying during his infancy was somehow permanently imprinted on my son somewhere like a tattoo or a scarlet letter. Is it deep down in him somewhere waiting to explode? Will he have depression as well?
I know you think the same things. I know you ask yourself the same questions. We have to remind ourselves that all life, even lives that have never been touched by any form of mental illness, includes suffering. All children see darkness at some point. There are traumas, letdowns, disappointments, deaths, failures ... Our children will have them. Other children will have them. All we can do is give love one day at a time.
For more on this, read What Have I Wrought: Postpartum Depression's Impact on Our Children.
Dr. John Grohol at Psych Central has just published a blog post on the 7 Myths of Depression. All of these would, of course, apply to women with postpartum depression as well. A couple of the key points he makes:
"In depression, time alone doesn’t help, nor does willpower (”Pull yourself up and stop feeling so sorry for yourself!”)."
"While the exact amount of time will vary from person to person based upon the severity of the disorder and how well the various treatments may work for each individual, most people who have depression do not need to be on medications for the rest of their lives (or be in treatment for the rest of their lives)."
He also points out that depression is not just a medical disease. It is actually much more complicated than that, and can include genetic factors, past history, current stressors, coping ability, level of social support and more.
To read the whole piece, click here.
Kudos to reporter Sherry Rauh and the Miami Herald for doing a nicely balanced article on depression during pregnancy and the treatment options. There are risks either way, and it is important to work with your ob/gyn to make the best decision for YOU.
Back from the (freezing) beach and giving thanks to my sweet hubby for the awesome pre-40th birthday celebration with friends! Now let's get back to work ...
Leading Australasian maternity wear company EGG held a fashion show in support of postnatal depression (PND) as reported by Thread:
"After hearing about the suicides of two mothers who suffered from PND, and realizing that there was an urgent need to assist in some way, EGG sponsored the production of a PND leaflet that is circulated to new mums, which aims to give them the information and ways to seek help should they feel they might be at risk, or suffering from, PND. Last night’s event was a further step in the relationship EGG have built with the Mental Health Foundation in supporting PND. Monies raised from a silent auction of sponsor’s products run during the evening will be donated to help the cause."
It's great that EGG is taking the lead on this, because apparently New Zealand provides no government funding to support women with postnatal depression. Thanks EGG!
Are you a fan of Postpartum Progress? If so, join our Facebook Fan page! We will try to have some unique content over there soon -- hopefully a forum and also some surveys/polls now and then! Anyway, hope you'll join the 80 who've already found and joined the Postpartum Progress Facebook Fan Page!!!!!
Joining allows you to see who else is a fan as well, which will hopefully encourage networking!
I'm going to be offline for a few days, but in the meantime I wanted to share with you some good reading:
Sera at Laughing Through the Chaos writes about anger or irritability as a symptom of postpartum depression with "I'll Huff and I'll Puff and I'll Blow This House Down" (I just love that title)
The blogger at Fearless Formula Feeder adds her comments to our piece this week about postpartum depression and the unnecessary stigma of switching to bottle feeding. Amber, at Beyond Postpartum, also weighs in on this subject.
Ivy at Ivy's PPD Blog writes a compelling description of her horrible experience with daycare while suffering from postpartum depression -- I can just feel the anxiety!
I guess Postpartum Progress was automatically nominated for a Blogger's Choice Award for Best Health Blog Award for 2009 since it was nominated in 2008. I had NO IDEA! And I assume you had no idea either, since there are only 2 votes for Postpartum Progress. Dude. Seriously. I know we can do better. Let's get crackin and get more awareness of postpartum depression and other perinatal mood and anxiety disorders.
Click here to vote. It will ask you to sign in and so you'll have to sign up and then go back to the link to vote. Don't complain about registering. That's the deal (not my idea, theirs) if you want to vote for your favorite health blog.
Shall I beg?
The fantastic writer Catherine Connors at the blog Her Bad Mother has taken up the big honkin' subject of breastfeeding with a wonderful new post called "Shame & the Mom: A Boob Story". I know what a HUGE issue this is for Postpartum Progress readers, so I'd like you to read her piece. Catherine ended up quitting breastfeeding one of her children after a long struggle. Here's a bit of the story:
"With no formula-friendly lactation godmother, I was subjected to the repeated assertion that if it hurt, I was doing something wrong (I wasn’t. I know this) and that if I quit, I – and my child – would regret it. It made me crazy – literally. My post-partum depression worsened under the constant pain and intensifying anxiety, even as I reminded myself that someone, at some point, had told me that it would be okay to quit. Even as a few sane voices in the blogosphere quietly urged me (off the record, always) to consider quitting, for my sanity’s sake, I was gripped by the conviction that it would not be okay if I quit. It would be wrong. I should be able to do this. A good mother could do this, would do this. I was a lactivist, for God’s sake. And so I persevered.
It never really stopped being painful, with Jasper. He nursed round the clock, and my nipples bled, and I almost never slept. I was sparing with my PPD meds, for fear of contaminating my milk. But I battled the gathering dark, and persevered. I nursed publicly, and proudly: on planes, in front of TV cameras, standing in front of a crowd while speaking at BlogHer. I nursed another woman’s child. I persevered. For ten months. Ten dark months. And then I quit. Exhausted from the lack of sleep, and the pain, and on the verge of falling headlong into the dark, I quit.
And I felt ashamed."
I can just imagine all the bobblehead-like "uh-huhs" going at this moment. I know I'm nodding up and down furiously. Things started out great with my son in the hospital, but then he started refusing the breast. I found out later the nurses in the hospital nursery had been giving him bottles because of his jaundice. I freaked out. I felt rejected. I tried nipple shields. I tried all those other curious contraptions that you wrap all around your boobs so that you can succeed at doing THE-ONE-THING-EVERY-MOTHER-MUST-DO-NO-MATTER-WHAT! I read the how-tos and followed them step by step. It didn't matter. Plus, what little breastfeeding I was able to eke out had me so worried about how much milk he was getting I practically had anxiety attacks. So I quit. And I felt enormous relief. And I felt guilty that I was so relieved.
I have written about this topic many times before, and shared with you some amazing stories written by women with perinatal mood and anxiety disorders who struggled with breastfeeding -- some who quit, some who kept going. There is NO right answer.
In 2008 I shared a beautiful story written by Lisa Sniderman that I still find very poignant, at least as it relates to those of us who either choose to or have to stop. (I'm frustrated that for some reason the formatting of the piece is all screwy, but read it anyway because it's worth it.) Lisa had always suffered from bipolar disorder and chose not to breastfeed in the end because of the medications she took for that illness. Here's a tibdbit:
"Was bottle-feeding really a 'choice' for me? Only if I could somehow have 'chosen' instead to spend my daughter's first year either in unbearable torment or dead. The rhetoric of personal responsiblity that surrounds breastfeeding, despite the very real barriers so many women still face, disturbs me in general. When it is applied to severely mentally ill mothers who need uninterrupted sleep, mood stabilizers and antipsychotics, it absolutely stops me cold."
“'But what about breast cancer prevention? What about his immune system? What about the lower IQ that he will have because of the formula? What about breast is best!!!' I’d believed all the pregnancy books. I thought the What to Expect When You’re Expecting lady would personally track me down and sear me with an Unfit Mother brand if I failed to provide breast milk."
And from that same event, Therese Borchard from Beyond Blue, wrote about her experiences:
"I tried so hard to do the right thing for everyone else but me. I weaned myself off of my antidepressant because I wanted to breastfeed, to give my infant the best possible start ... the golden stuff right out of the boob. So my lactating breasts and I were on call, with no substitute available, for months and months and more months ... long enough for me to make the walk of shame from the maternity ward to the psych ward."
Ugh. Why do we do this to ourselves? I love that Catherine is so honest about the competing thoughts in her head. When you read the gazillion comments on her post you will see how many women have the same struggles.
Not everyone needs to quit, of course. Some people find breastfeeding is the only thing that helps them hang on to what's left of their sanity. Others, like me, find quitting helps them on the road to sanity. Just make the right choice for you and know that we are on your side, whatever side that is.
More on this topic from Postpartum Progress: Breastfeeding & Postpartum Depression: What Should Moms Do?
Congratulations to Sonia Murdock, executive director and co-founder of the Postpartum Resource Center of New York and past president of Postpartum Support International, who will be inducted into the Suffolk County Women's Hall of Fame on November 18th in Smithtown, NY. Sonia has given so much of her life in complete dedication to women with perinatal mood and anxiety disorders, and is very deserving of every accolade she gets. Way to go Sonia!
If you'd like to attend, call 631-422-2255.
Dr. John Grohol at Psych Central offers up an explanation of anxiety in his discussion of a recent article in the New York Times Magazine. What is it, he asks, then quoting from the Times piece:
"Anxiety is not fear, exactly, because fear is focused on something right in front of you, a real and objective danger. It is instead a kind of fear gone wild, a generalized sense of dread about something out there that seems menacing -- but that in truth is not menacing, and may not even be out there. If you're anxious, you will find it difficult to talk yourself out of this foreboding; you become trapped in an endless loop of what-ifs."
Oh, have I been there.
What if my son never loves me? What if I don't know how to be a mom? What if I never stop crying? What if I harm him by ---------? (fill in the blank with the many terrifying ways I wondered about hurting my son which I won't list here so that I don't make you start thinking the same damn things) What if he doesn't wake up? What if my husband doesn't come home from his trip? What if I can't get my baby to eat? What if I'm not who I thought I was? What if I stay this way forever?
I wonder if I was more exhausted from the lack of sleep or the constant mental gymnastics going on between my ears. My mind never stopped with the worrying and the thinking and the being scared of the thoughts I was thinking. It wouldn't stop. Why won't it stop? MAKE IT STOP.
That's when you want to quit. To run away or give up or maybe something worse. Because the noise in your head is loud and unbearable and hateful and exhausting.
For some reason I didn't quit. I think it was that roly-poly-baby-faced boy looking up at me. I decided I'd try and reach out for help.
There must be somebody somewhere who can help me fix this. This can't be all there is.
There was. And it isn't.
How about this tidbit? Today I found out that "postpartum" is one of the fastest growing topics at Meetup.com. It's #7 overall on the top 10 fasting growing topics. I think that trend will continue. I think that more and more moms will create postpartum support Meetups, or at least list their already existing support groups at Meetup.com.
People ask me how Postpartum Progress has become the most widely-read blog on postpartum depression. What did I do? I don't advertise. I'm certainly not a social media genius -- I have a hard time keeping up. The reality is that it has nothing to do with me. It could be anybody doing this blog. It has continued to gain readers, as have all the other great PPD bloggers, for the same exact reason that "postpartum" is the seventh fastest growing topic at Meetup.com:
Women going through postpartum depression, postpartum anxiety, postpartum OCD, postpartum PTSD or postpartum psychosis WANT AND NEED TO TALK to other women who are just like them. To share. To see they are not alone. To see they will get well.
I sometimes wonder if that's the most powerful treatment method of all.
I say the more postpartum peer support groups meeting in libraries, Starbucks, living rooms, churches, community rooms and hospitals, the better. To join a postpartum meetup or start your own, click here.
I have talked to many healthcare professionals -- pediatricians, nurses, OBs -- who have experienced postpartum depression themselves. Many of them felt particularly surprised at how helpless they felt. Some were very versed in PPD but couldn't recognize it in themselves. They had experience educating patients on what to do if one has the symptoms of a perinatal mood and anxiety disorder, yet now they couldn't even follow the advice they had given countless others.
This happens all the time.
"Flaherty herself followed the advice of a trusted mentor, who reached out to her when she was in the throes of depression and advised her to seek professional care. Now she runs a busy neurology laboratory at Harvard and is director of the movement disorders fellowship program at Massachusetts General Hospital. She is raising healthy twin girls and treats patients, many of them medical professionals. She has no regrets about going public with her bout of mental illness, which is now controlled with medication. She even partly credits her job in the psychiatry department at Harvard to her vocal advocacy of psychiatric treatment. 'Only good things came to me because I talked about it,' she says."
For any clinicians or medical students reading Postpartum Progress who are currently suffering, I hope you will find this helpful.
