#PPDChat Topic: Using Stigma to Start a Discussion

Image


Just Talkin’ Tuesday: Unhappily Pregnant


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.

Speaking up for depressed Dads


So unless you’ve been hiking the Himalayas this past week, you’re aware that a study about dads with prenatal and postnatal depression and it’s correlation to maternal depression was released. Published today, actually in JAMA.

Twitter’s been aflitter with this study. Tons of media outlets are jumping on the story. Almost every Google Alert I’ve received this week has had a ton of links for variation after variation on this new study involving dads and depression.

And then…

And then.

I got an email this morning. It included several tweets doubting the possibility of men having depression. I wanted to cry.

People on Twitter were saying awful, awful, awful things. Did I mention the awful things? AWFUL.

Here are a few of the ones I’m comfortable with posting. Even though they make me cringe. And want to grab every single Tweeter and have a little Homer Simpson/Bart Simpson moment with them.

“Post Partum Depression for dad’s? Really? Already a name for that. Called “Llife got tougher. Deal.” Judges also would accept, “Parenthood.”

“CNN: “Dads get post-partum depression too.” Oh, come on. It’s called sleep- and sex-deprivation.”

“I’m sorry. I just cant see a man suffering from postpartum depression. No one is cutting his man hole & sewing it up to bring out a baby”

“A man suffering from postpartum depression is a girly man.”

“Lol @ “postpartum depression can strike new dads”. Yeah, no. Until they have to have an episiotomy…no”

Wow.

Mmmmmmk.

Let’s see here.

You want to know WHY it’s so important that we know this about men and depression after they become expectant or new fathers? Because men, when depressed are:

Less likely to seek help

More likely to complete suicide

More likely to take their depression/rage out on their families

Depressed men will exhibit the same symptoms as women to a certain extent but there are some differences. Men may begin to abuse alcohol or other substances, dive into work, put up a wall with friends and make up excuses to avoid his family.

I’ve lived with a depressed dad. I’ve suffered the consequences of a depressed dad’s attempts at self-medicating his moods away. It is not pretty people, it is not pretty. It hurts. It opens long-healed wounds if left untreated. Turns things upside down and inside out. Depression destroys lives. It rips out hearts, infects every aspect of your life. It’s not much different than cancer in that sense… left to it’s own it runs rampant and has the potential to kill you. Depression is DEADLY. The only difference between cancer and Depression is that Depression can kill others even if they’re not infected. Doesn’t that make Depression more deadly and dangerous? I certainly think so.

Owning up to a depression bigger than you, a monster that’s been hard at work destroying your life takes a helluva lot of courage. It takes guts to step out from behind the facade of normalcy to admit things are not okay. It takes a helluva lot of guts to completely break down and cry in front of other people. It takes courage to then get up the next morning and the next and the next with the goal of rebuilding yourself. It takes a REAL MAN to own up to depression and seek help.

I applaud the Dads who are owning up to being depressed during their partner’s pregnancies and as they navigate life as a new father. Thank you, Joel Schwartzburg. Thank you Dr. Will Courtenay for providing a safe place for Dads to come to and find help.

Thank you.

Men often hide their depression during the pregnancy of their partner or after the child’s birth because they feel they’re expected to be strong. Even though I begged my husband to tell me he was struggling too after the birth of our second daughter, he repeatedly told me he was fine. All I wanted to hear was that I wasn’t alone. Instead he kept it inside as he began to abuse marijuana on top of the anti-depressants he had been prescribed. In fact, I just discovered last night that he didn’t even want to hold her while she was in the NICU. Our daughter is now four years old.

Depression can happen to anyone, at anytime, with no warning of onset.

If any of the above people were to ever experience a mental illness, I would hope they would not encounter comments like the ones they just made. Instead, I would hope they would find compassion, knowledgeable resources, and be able to surround themselves with people able to empower them as they journey toward recovery.

No one deserves to be kicked when they’re down. No one deserves to be doubted when they dare to speak up. No one deserves such harsh words.

Would you tell a male cancer patient they’re a girly man for getting breast cancer? Cuz men have breasts too and yes, they get breast cancer.

Would you tell a man to tough out a heart attack? To man up and fight the pain? Skip the nitro and the aspirin – you’ll be fine. It’s just tough right now.

Would you tell a man who just broke his leg that he’s not justified in complaining just because his break isn’t the worst break on the planet?

Nobody would dare say those things to such patients.

Then pray tell, why, why do you feel comfortable saying them about mental health patients? Please tell me because I truly do not understand.

And to the ladies who commented about surgery and birth – there are plenty of women who have given birth naturally or vaginally without episiotomies and gone on to experience postpartum depression.  But I suppose that’s not allowed either because clearly surgery and episiotomies are pre-requisites for depression after childbirth.

I leave you with something my parents raised me to believe.

If you can’t say something nice……

Just Talkin’ Tuesday 05.18.10: How did you first share your Postpartum Mood Disorder story?


Today is a mash-up of posts.

It’s the APA’s Mental Health Blog Party day and my weekly installment of Just Talkin’ Tuesday. (If you’re interested in reading other entries for today’s Blog Party, the APA is rounding them up here.)

Today, the APA is asking all mental health (and not) bloggers to raise our voices in order to shatter the stigma which surrounds mental illness and disorders. In that spirit, I had to give quite a bit of thought to the topic for today’s Just Talkin’ Tuesday post. It had to be a topic we had not covered recently as well as one that fit the blog party spirit. And wouldn’t ya know it, inspiration strikes right as I am seriously craving some time with my bed. This topic has been meandering about upstairs for a few days but decided to wait until the last second to make a mad dash for the door, er, keyboard. So here I sit, at 1215am EST, words pouring onto my blog. I make no promises as to the length of this ramble. Proceed at your own caution and time restraints.

It started with a simple phrase uttered to me while at psych ward on a suicidal/harm to others hold during my second postpartum experience.

“You don’t have to tell anyone where you were this weekend.”

Why?

Why would I want to keep this experience a secret? What reason would I have for not wanting to share my struggle?

My mother raised me to keep the communication lines open no matter how deep the trauma. And my father taught me to always, ALWAYS think before I spoke. So you see, I strive to keep a balance between the two. Sometimes this means holding my tongue or my thoughts for a bit longer than I should and missing out on opportunities to speak up. But then I figure maybe it is for the best I didn’t say anything in the first place.

"Raffles Resort Beach"by fpugirl @flick

More than anything though, I believe strongly in both values. And these values are what caused me to question why on earth the nurse told me I didn’t have to tell anyone about my visit to the psychiatric wing. And what pray tell, would I have told them? That I had won a trip to the Carribean? Been waited on hand and foot? Slept the weekend away on pillows flatter than ironed Martha Stewart Linens? C’mon, people!

From the very beginning of my downfall, I was vocal about my experience. I asked questions. I sought answers. I wanted to talk to other mothers. I needed, desperately, to know that I was not alone in this new pitch black rough and tumble sea.

There was something I clung to as a lifesaver in the midst of my temporary insanity. And I don’t think I have ever properly thanked him for saying it to me right when I needed to hear these words the most.

“You are reacting no differently than anyone else in your shoes would be. Don’t let them tell you any different!”

My father spoke those words to me during a phone call from the hospital. I clung to that phone like a lifeline. My father’s words echo through my mind every so often but back then, when I needed to hear them most, they were a shiny buoy of hope in my dark dark sea. I never let go. Thank you Dad, thank you for knowing just what to say right when I needed to hear it. I am sorry if I have not thanked you before now but THANK YOU. From the very depth of my very healed heart.

If I could be on the phone, by golly, I was on the phone. Talking. Sharing. Being HONEST about where I was and how I had gotten there. And every last person on the other end accepted me, loved me, did not judge me. I know how fortunate I am to have that kind of support. Believe me, I am above and beyond grateful for the support which exists in my world. There are others who exist and fight with no support, no place to turn, alone in their dark sea upon which they are now sailing. Sailing with no compass, no supplies, lost.

There are mothers out there who struggle in the darkness for a very long time. So long, in fact, that Dr. Arlene Huysman coined a term, Progressive Postpartum Depression, an undiagnosed Postpartum Depression which gets darker and darker as time marches forward, dragging the darkness along for the ride. So long that there’s an entire Scientific American article dedicated to the topic and a ton of research on the impact of untreated Maternal Depression if you should care to go looking for it via Google or med journals. Why do they stay quiet? Why do they not seek help? It does not make sense. If your throat is sore, you see the doctor. Heart attack, ER. So why not this? Is it not the same? It should be treated as such.

But it is not.

Many believe you should be able to snap out of a depression. That Happiness is a choice. That somehow, we are choosing to be sad, insane, or conjure up these intrusive thoughts to get out of being a mother. That it’s all a conspiracy. But it’s not. Oh, it is SO not a conspiracy. There’s no dark back room to which we all retreat in the middle of the night and agree on what symptoms to exhibit the next day to escape the humdrum of domesticity. We don’t choose straws to see who gets to be the happy housewife and who gets to curl up in a ball muttering to herself. There are no auditions for this. IT.JUST.HAPPENS. And guess what? We don’t like going through it anymore than you enjoy watching us go through it.

A Postpartum Mood Disorder is sheer hell. First, there’s the myriad of symptoms from anxiety, to depression, to not eating to not sleeping to obsessing, to thinking horrific thoughts about what might happen to baby, what we might do to baby, etc, so on and so forth. And then there’s the guilt. OH the guilt. The guilt of not wanting to have anything to do with our baby. The guilt over not gushing over baby or not snapping back as quickly as celebrities or not coping like the suave women in the Johnson & Johnson commercials. The suave women who invade our homes every day as we sit in front of the TV with a screaming infant as our hair becomes ratty and our bathrobes and slippers wear thin because we haven’t changed our clothes in over a week. And then, there’s the judgment. We are supposed to be happy. Anything less than happiness is unacceptable in most families. Suck it up. Get over it. Yeah, motherhood is hard but I just did it. I didn’t get sad. I didn’t curl up in a ball. I don’t remember.

We are all different.

We are ALL beautiful.

And there is a quiet power in each and every one of our stories. An important power. One we must protect and share so that others will listen, learn, and understand.

"Stormy Sea" by Xeubix @flickr

When I was in the thick of my Postpartum sea with waves crashing all around me, I dreaded sharing my story. I hated having to explain to yet another person what had brought me to my knees. I hated answering questions.  At some point, that changed. At some point, it became liberating to tell others how I had managed to escape and heal. The mode of transportation whether it be natural, pharmaceutical, physical, spiritual – does not matter. All that matters is that you find what works for you, for your personal philosophy and situation. And damn anyone who dares to judge your choices. YOU are in charge of you – don’t ever forget that. It is your path to wellness and not that of anyone else. Take command of your decisions and let no man judge you for them.

When I first shared my postpartum story with power behind my words, it was with Wendy Davis of Postpartum Support International as I applied to be a Coordinator here in the state of Georgia. At the time, there was only one other Coordinator. There are now four of us, a statewide support network, and two support groups in operation according to the PSI Georgia webpage. That’s a lot of growth in just three years. Since then, I’ve operated my own support group (which has stopped meeting due to lack of local interest and support), began blogging to reframe a third pregnancy, and also become the Community Leader for two iVillage message boards dedicated to helping both Postpartum and Pregnant women who are depressed or struggling with mental illness. I’ve also recently started a #PPDChat at Twitter. Turnout there is still small but it has been powerful. I believe in quality vs. quantity when it comes to peer support. Every time I share a piece of my story, I empower another woman, another family. I continue to empower myself through my sharing. I am always healing, a work in progress.

There are power in your words. Share them but share them wisely and carefully.

How did you finally share your Postpartum Story? What made you decide to share your story? Was it with a loved one? With a colleague? A complete stranger? In person? Online? Or have you held it in for years, filled with shame because there was no one to tell who wouldn’t judge you?

Let’s finally get to just talking – and beat the crap out of PMD stigma while we’re at it, ladies and gents!