#PPDChat Topic 02.25.13: Outta Steam – Coping on the Hard Days


ppdchat-02-25-13Motherhood, heck, parenthood period, doesn’t come loaded with sick days or days off when the going gets tough. No, we have to steel ourselves to push through it. Sometimes we soar right on through whatever is flung in our direction and then there are times when we feel we fail miserably.

It’s not easy.

With a Postpartum Mood Disorder on board, it gets even muckier. We barely have the energy to fight that in addition to taking care of our children, let alone tossing anything else on top of the flames. So how do you handle it when a tough day (or days) hits when you’re struggling? What if you get sick? What if everyone is sick? Or there’s an emergency family situation? Or..the list could go on.

Today’s chat will focus on these situations. Feel free to join us to vent, share tips, or just hang out. We don’t promise to instantly cheer you up or fix all the tough in your life, but after today’s chats over on Twitter, you’ll know you aren’t alone.

See you there!

 

 

Just Talkin’ Tuesday 06.08.10: How do you talk with your kids about Postpartum Depression?


First, apologies for this being late. Summer break, a new family schedule, a blah day yesterday and then Internet connectivity issues today have all come into play. Starting next month, I’m going to work on planning a whole month’s worth of posts focused on one topic. So if there are any specific questions you’d like to have answered, send them to ppdacceptance(@)gmail.com. Maybe YOUR question will be a Just Talkin’ Tuesday post soon!

Looking back, I have realized our older daughter experienced a lot of things at 23 months old no child should ever experience. My husband and I yelling and screaming at each other because we were not communicating, Mommy collapsing in the floor as she wailed because something minor set me off, snapping at her for nothing at all, trapped in the house because we could never leave it, feeling abandoned as we went to Atlanta to be with Charlotte (don’t worry y’all – we had family members caring for her – not like we tossed her some cookies in her bed and wished her the best of luck!), and just the overall instability a Postpartum Mood Disorder drags with it into the household.

When we discovered our third pregnancy we decided things had to have a different focus. Instead of preparing things for the baby, we would need to prepare ourselves for the baby. By this time I had been doing advocacy work for just a few months and running a support group for nearly 4 months. I read, researched, picked a local OB known for his attention to women after delivery, and poured my heart and soul into the development of a personalized Postpartum Mental Health Plan.

Our girls, then nearly 4 and 2, sat in the middle of this potential storm. How could we best prepare them for the firestorm?

We waited until 8 months or so into the pregnancy. At every meal we would bring up Postpartum Mood Disorders. Yes, they got sick of hearing about it. But what we did worked well for us.

The conversation went something like this:

“Mommy wants to talk to you about something.”

Daughter 1: “Yes, mama?”

Daughter 2: plays with her food

“You know how you’re getting a new baby brother?”

Daughter 1: “Ahuh. And he’s gonna be so much fun and…”

Daughter 2: shoves food to one side of her plate.

“Well, sometimes, after mommies have babies, they get really super duper sad. And it’s not anyone’s fault.”

Daughter 1: “Sad? Why sad?”

Daughter 2: working on moving food back to the OTHER side of her plate.

“Well, no one really knows why yet. They just do. And like I said, it’s not anyone’s fault. Not the Mama’s, not the daddy’s, not the children’s fault, and not the baby’s fault. Got it?”

Daughter 1: “Got it.”

Daughter 2: is now parting her food as if it were the Red Sea.

“So who’s fault is it if a Mommy gets sad after she has a baby?”

Daughter 1: “The Mommy’s.”

*sigh* “No… it’s not anybody’s fault! It just happens.”

Daughter 1: “Oh. Not anybody’s fault?”

Daughter 2: Contemplating a spoonful of food at eye level.

“That’s right! Not anybody’s fault!!!”

“So – if that happens to Mommy and she gets sad, let’s think of some ways you can help mommy cheer up.”

Daughter 1: “Okay. I can tickle you. That will make you smile!”

Daughter 2: Attempting to eat said food. Instead creating a river of oatmeal down her chin.

“I like that! So if you see mommy sad or upset you can come tickle me, okay pumpkin?”

Daughter 1: “Really? I can? Yay!!!” cue really big goofy toddler grin.

Daughter 2: now smearing river of oatmeal on table. I’ve given up.

“So who’s fault is it?”

Daughter 1: “NOBODY’S!”

“And what are you going to do to help mommy if she gets sad?”

Daughter 1: “TICKLE YOU!”

And off we giggled into the sunset as a river of oatmeal flooded the plains.

But seriously – see what we did? We had a completely age appropriate discussion about Postpartum Depression. It really sunk in because if I looked sad after our son was born, my daughter really DID tickle me. So totally adorable.

As for the flip side – telling your children about your own experience with Postpartum Depression you had with them is a completely different ball game. Sure, I have share with them some of it but again, it’s in an age appropriate manner. They know mommy spends so much time on the computer because she helps women who are sad after they have babies. They have seen me cry when I’ve been touched by a story or a tragedy. And my oldest knows enough to know that if she ever has Postpartum Depression, she needs to talk to mommy cuz mommy knows what she’s doing. I hope and pray neither one of them experience this hell but with my experience, their risk goes up. So I feel I owe it to them to educate myself as much as possible, be as open as possible, and let them know beyond a shadow of a doubt they are NOT alone.

SO let’s get to Just Talkin’ here. Did you have older kids when you experienced your Postpartum Mood Disorder? Were you able to prepare them? If not, how did they react to your Postpartum experience? How did you talk with them about what was going on with Mommy? And here’s a doozy – will you ever tell your child the full unfiltered and uncensored story about what happened? Or will you continue to tell them in general terms about Postpartum Mood Disorders? (I’m still on the fence about whether or not I’ll share full details with them – if I ever write a book I suppose there’s no turning back then, right?)

I can’t wait to discuss this with y’all!

Postpartum Depression formal screening not worth the cost, BMJ study says


According to a recently published study in the British Medical Journal (BMJ), Postpartum Depression Screening is not…. brace yourselves. Worth the cost.

That’s right.

NOT.WORTH.THE.COST.

In their cost effective analysis, the researchers used “A hypothetical population of women assessed for postnatal depression either via routine care only or supplemented by use of formal identification methods six weeks postnatally, as recommended in recent guidelines.”

The conclusion was that overall not using a formal screening method was much more cost effective as it eliminated false positives.

So the mental health of a woman which will then affect her child, her family, her community, the world at large, are just not worth it to the National Health System of the UK. The EPDS scored out at about $67,000 per quality adjusted life years while no screening method scored at a price tag of just $20 – $30,000. No value for the money was found to exist when using the formal identification methods.

Did these researchers not read Murray & Cooper’s Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression which explores the effects of postpartum depression treatments on children?

There is SO much more at stake here than the dollar value to the National Health System.

There’s the potential for broken families. The potential for children growing into their own mental health issues, the potential for continued need for mental health treatment due to an undiagnosed episode of postpartum depression, potential for increased incarcerations due to untreated mental illness, continued sadness, the continued stigma, continued and perpetuated lack of education on the part of physicians in regards to Postpartum Mood Disorders.

The most interesting aspect of this study is that it focused on screening for Postpartum Depression in the Primary Care setting. Primary care physicians are not always comfortable or knowledgeable in screening for mental health issues. If a patient were to screen positive, that physician is then morally responsible for referring them to a specialist. Often times, at least here in the states, a Primary Care physician is unaware of where to refer a patient for help with a Postpartum Depression Disorder. Therefore, they become afraid of screening because they fear what will happen if a positive were to occur. What would they do with the patient? Where would they send them? How would they respond? Are they familiar enough with Postpartum Mood Disorders to recognize a false positive?

I think the key to the results of this study is not so much in blaming the high percentage of false positives but in urging that Primary Care physicians receive more training to enable them to recognize a false positive through more in depth questions after a positive is scored via the Edinburgh Postnatal Depression Scale.

original photo/graphic "Hand holding necklace" by K.Sawyer @flickr

A stronger safety net involving a stronger communication between midwives, Obstetricians, Pediatricians, and General Practitioners is so desperately needed to keep women from falling through the very big cracks which currently exist in the system.

Let’s think about this for a moment, shall we?

A woman gets pregnant. She sees a medical physician to get the pregnancy confirmed. Most mothers seek OB or midwife care for their entire pregnancy. Unless they’re depressed – depressed and mentally ill mothers are less likely to take good care of themselves during a pregnancy, making specialized care even more important even when baby is still in utero. Once mothers give birth, they are then shuttled off to the pediatrician’s office for the bulk of their medical contact. One six week or eight week visit to the midwife or OB to ensure mom is healing properly then an annual PAP visit unless something arises in between. Many Pediatricians focus on babies and not mother. But the tide is changing as more and more Pediatricians are taking into account the family lifestyle and well-being. My own Pediatrician does this and I absolutely adore her for it.

But overall, there is typically no continuity of care, no communication between physicians throughout the birth process. There should be. There needs to be. A woman deserves a team of support. She deserves to thrive. So do her children.

No matter what the cost.

Because once you fail woman and her children, you fail society.

Fail society and we fail to exist.

If we fail to exist….

Rainy Days


Today was one of those dreary rainy days complete with darkened gray skies, thunder, and lightning.

We arose with the intention of going to church but alas, we did not make it. Charlotte had a minor issue with diarrhea and ended up having to pop in the shower twice this morning prior to us even getting them ready. We had also run out of formula for Cameron and did not have enough to give him his morning bottle. By this time it was 9a and we would have to be out the door to go to church by 945. This would have included getting dressed, getting Cameron some formula, and Chris getting a shower. Just wasn’t going to happen. So we stayed home and listened to our pastor on the radio through the screams and squeals of toddlers and the babbles of Cameron. (Translation: We didn’t hear much!)

The rest of the day was pretty much a wash – neither Chris nor myself could keep our eyes open long enough for it to count for anything and of course, the thunderstorm started right as we would have been putting the girls down for nap. Chris and the girls curled up in the recliner in the living room as I gave Cameron a bottle. Once he was done, I put him down for a nap of his own in his crib, returning to the living room for one of my own. I curled up on the couch and quickly fell asleep only to be roused awake by Alli shouting MOMMY! at me a short while later.

It’s nearly 1030p here and I am exhausted. I also seem to have caught a nasty case of the blahs. Perhaps some serious rest will cure me. Off to bed with me….tomorrow is a new day and I intend to make it a good one.