Thoughts about Ebony


I was going to wait to publish this post until after I’d had time to read it through. But given that I just accidentally posted it, freaked out, made it private, I’m realizing that folks who got it through email will be able to read the entire thing anyway. SO. Here ya go. With a temporary title that obviously will be the permanent title – my ramblings and thoughts regarding Ebony Wilkerson, tragically better known as the mom in Daytona who drove  her minivan into the sea.

The public defender’s office said there was a reason she beat her stomach. “She {is} being held in seclusion naked in her cell,” said Craig Byer.

Public defender James Purdey at first asked for Monday’s hearing to get Wilkerson’s 1.2 million bond reduced.

Purdey instead asked his client be transferred from the Volusia County Branch Jail to a psychiatric ward for longer than a typical Baker Act hold, so she can get mental pre-natal care.

The judge did not rule on the request to move Wilkerson because the judge said it’s something that hasn’t been done before. (Source)

According to the Ebony Wilkerson narrative we have thus far, she drove to Central Florida from South Carolina to escape an abusive partner. Her family struggled to get her help but she signed herself out of the hospital and somehow managed to get the keys to the minivan and drive it and all of her children into the ocean despite the family’s efforts to hide the keys from her.

This week, we are told she has been held naked, in seclusion at the local jail and started punching her stomach, causing her defenders to push for her to be moved to a psychiatric ward for “mental pre-natal care.”

What the hell is wrong with this picture?

From an emotional and advocate standpoint, a lot.

From a logical standpoint, I can understand why these measures may need to be taken, particularly if Ebony has been suicidal. Of course you don’t want to give her anything that she could possibly harm herself with but there has to be a way to do that without completely stripping her down and removing all sense of dignity, something she was more than likely running low on if indeed she was escaping an abusive relationship.

The judge’s reluctance to move her may also be grounded in logic as well. Perhaps she did not feel she had enough facts to justify setting a precedence with Ebony’s case. Or perhaps the Volusia County Jail has the capability to be considered as “clinically appropriate” (as is required of examination/treatment in the Baker Act) and therefore the judge did not see moving her as a necessity. Or perhaps there simply wasn’t anywhere to move her to which offered the same level of security the judge felt Ebony requires at the moment.

But when examined from an emotional and advocate point of view, this is absolutely heartbreaking.

A pregnant mother, escaping an alleged abusive relationship, drives her kids into the ocean despite attempts to help her. To me, this screams of absolute desperation. This is beyond sanity. It’s more than a call for help. This type of behaviour requires action.

But is what Volusia County doing enough?

How do we best handle this type of situation in this day and age?

It’s like I tell my kids and my partner – we can’t fix a problem unless we know about it. Unfortunately, women (and men especially) who are in abusive relationships are often quiet about their situations until it’s almost too late, and some until it is too late. Why? Because they are often threatened by the perpetrator that if they don’t remain silent, there will be repercussions.

Silence is also a hallmark of Perinatal Mood & Anxiety Disorders for multiple reasons. Society believes we should be happy when pregnant or in the throes of new parenthood. Thing is, mood disorders have been happening since the dawn of time. Our responses to them over the centuries have varied but even early on, a few folks got it right. Take Asclepiades, for example. According to Thomas Millons Masters Of The Mind, he “argued against dark cells and dungeons for the mentally ill…thought patients should be in settings that were well lit and comfortable.” Asclepiades also proposed that “biological and chemically based treatment would be beneficial” in addition to dividing conditions into acute versus chronic and also distinguished between hallucinations, delusions, and illusions.

The main point of Asclepiades is that even in the early ages (171-110BC, by the way), someone recognized that locking away the mentally ill in dark, dank places was NOT the way to go.

Arataeus believed the “soul was the basis of psychic disturbances” and “mental disorders were exaggerated normal processes”. (Millon)

Then there’s Soranus who posited “consider(ing) culture as a factor in both investigating and treating mental patient.” (Millon, Masters Of The Mind). He also advocated for decent and kind treatment of the mentally ill, asking “his peers to remember who was ill; physicians should not view their patients as disagreeable persons who offended their self-image.” (Millon) It seems to this outside observer that Volusia County is not doing that in Ebony’s case.

Does being an abused woman or a woman at the hands of a Perinatal Mood Disorder excuse the type of behaviour Ebony Wilkerson has exhibited? No. But both are mitigating factors which led to her behaviour and should absolutely be taken into consideration as her case proceeds.

I’ve written extensively about Postpartum Depression as a defense. Cases like these are both fascinating and heartbreaking because all at once, those of us who have experienced a Perinatal Mood & Anxiety Disorder, see fractions of ourselves in the women who make headlines. We collectively gasp and think, my God, what if I had given into all those thoughts racing through my head? I could be her. I could be Ebony. I could be Miriam, I could be Andrea, I could be Otty.

We shudder because we were there, with them, in the dark, in the hell, holding their hands and they fell as we watch in horror. The way their fall is paraded in front of society scares the crap out of us and drives many to silence. Is this healthy for society? Yes and no. We should be outraged when children are subjected to death (or the threat thereof) at the hands of their parents. But at the same time, we need to take steps to prevent this type of situation from occurring in the first place.

How do we do that when every single case, every single situation from mother to mother and from birth to birth is different? How do we catch a falling mother if we don’t know she is falling?

Even if we start by putting measures in place to check for signs of falling, we will still fail if the mother doesn’t admit to having a problem or, as in Ebony’s case, refuses help (for whatever reasons – cultural stigma, fear, etc) which is offered to her because she is far past the breaking point and sees death as the only way out. Do we just throw our hands up in the air and let her do what she may? No. So what do we do then?

I don’t know.

What I do know is this:

  • Mothers (and fathers) do not deserve to be alone in this battle
  • Mothers (and fathers) deserve emotional support
  • Mothers and fathers need a village
  • Perinatal Mood & Anxiety Disorders are not deserving of whispers, they require shouts
  • We need to speak up, every single time, not just when there is a crisis
  • Accept those who are hurting with open arms and provide a safe space for them to fall apart
  • Not judge those who have/are struggling so harshly

So what can we do to improve the situation for struggling parents across the globe with the very real (and often co-occurring) issue of domestic abuse/violence and Perinatal Mood & Anxiety Disorders?

  • Make it okay to reach out for help and ditch the supermom/superwoman/superman/superdad façade
  • Initiate requirements for ALL health professionals who may come in contact with an expecting or new mother to be well-versed in the ins and outs of a Perinatal Mood & Anxiety Disorders (this includes pediatricians, OBGYN’s, GP’s, Family Doctors, IBCLC’s, doulas, midwives, naturopaths, you get my point…)
  • Create local, state, and national referral networks which incorporate above said training on a regular basis
  • Create networks of parents willing to mentor other parents through these tough situations and make it easy to access across the board

Are these solutions going to fix our current problem? No. But they’re a start and sadly, most of it revolves around a tradition which our current technologically advanced society has strayed greatly from – the tight knit expanded family. It takes a village to raise a child but it also takes a village to raise a mother to raise a child right. In my post “On Not Wanting To,” I state the following:

Our village is in peril. Our village? FELL THE FUCK APART AND NO ONE GIVES A DAMN.

In America, we have a pitiful excuse for maternity leave. We are bombarded by stories of celebs who gave birth and look AHMAZING in less than three weeks after giving birth. We are insanely comparing ourselves to women who are a) genetically blessed and b) have crazy access to things like trainers, nutritionists, nannies… and then there are the way we compare ourselves to each other. Stupid idiotic milestones of when we went back to work, how much we manage to get done every day, pushing ourselves to be better than the next mom and still have it all pulled together.

It’s no wonder we are screaming out for help and some of us are doing so through extreme measures.

Let’s keep the “if I were her, I would” out of the conversation. We do not know what she’s going through. Even if we’ve been through hell ourselves, we do not know *her* hell nor should we take her story as one which portends the downfall of ALL women who struggle with domestic violence/abuse and a Perinatal Mood & Anxiety Disorder. Instead, reach out to mothers, to fathers, let them know it is okay to reach out for help. For that matter, teach it to your kids so that when they get older they don’t feel as if reaching for help is in essence, failure to handle something on their own. Yes, independence is a grand thing but there is a time and a place to lean on someone else. Not to lean in, but to lean on, sometimes for dear life.

Our village has forgotten how to do this very simple yet necessary human act. We are now expected to be everything to everyone and dear GOD help us if we are not. Should we assume something is wrong with every mother? No. But instead of oohing and ahhing at her baby, ask how she’s doing. Ask how Dad is doing. Do not dismiss their very real role in their new situation. By acknowledging them, you acknowledge their existence and empower them to express their feelings. And that, my friends, is possibly one of the most powerful things we can ever do for a new parent.

Will it keep more pregnant women from being held in seclusion, naked in a prison cell, after they’ve attempted to kill their older children and themselves? Not all of them, no. But it’s a start.

An even better start would be to continue educating people about Perinatal Mood & Anxiety Disorders, including those in the law enforcement and legal arena. I realize they are bound by the courts and must adhere to the law but if they had a better understanding of the facts behind Perinatal Mood & Anxiety Disorders, perhaps, at least, the treatment of mothers imprisoned for crimes committed whilst experience these disorders would stand a chance of improving.

In the meantime, I genuinely hope that Ebony Wilkerson receives the help she so desperately needs as she awaits trial for her actions on the fateful day she drove her minivan into the sea. We’re watching, Volusia County. Don’t fail us more than you already have failed Ebony.

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If Postpartum Mamas Banned Bossy


“Shhhhhhh. Don’t talk too loudly and don’t let anyone hear you.” the woman whispered as they chatted in the vestibule at church. Her companion had just expressed concern about a young new mother in the congregation who looked a bit exhausted that morning as she wrestled with her six week old and two year old toddler.

She patted her grey curls and adjusted her purse as she glanced around and leaned in to speak. “Don’t say anything but I heard from Ethel that she’s struggling with…” she lowered her voice to barely a whisper “that postpartum depression stuff.”

Her companion gasped and put her gloved hand over her mouth.

“No… not that. Why, in our day, we didn’t have that sort of thing. We just made do. These new age mamas and their excuses not to do the work mothering requires of them. Why it just makes me so angr…” Susan wagged her finger in front of her mouth as the bedraggled topic of their gossip approached.

“Well, hello there, Beth! Just how are things with you these days? And ohhhh… look at the new little one! Isn’t she just precious?” Beth sighed, glanced at the baby then back at Susan. She forced a smile and said “Just fine, come on, Ethan. Let’s go find Daddy.” As they started to walk off, Susan made a knowing eye contact with Joan, motioning after Beth, as if to say “I told you so.”

They stood there for a few more minutes, dissecting every aspect of Beth’s behaviour, dress, and choice of clothing for her children but not once did they discuss how they could help Beth as she learned how to navigate her way through this brand new motherhood of two children. Instead, they simply stood aghast and whispering at her apparent failure, ignoring all the signs that something was amiss.

Sadly, this still happens to many mothers. We are judged. Discussed. Analyzed. Dismissed. All because so many fail to discuss what is actually going on inside our heads. Because not enough of us get BOSSY about it.

What if, when Beth finally heals, she grabs the bull by the horns and starts a support group at her church? What if she dares to get up in front of the congregation and admits to her experience and educates those sitting there? What if she dares them to do more for new mothers and therefore changes the lives of new mothers touched by this church? But if we ban bossy, the Beths of the world won’t do this because well, they’ll be sitting down and not doing anything to blaze a path because SHHHHHHH. We dare not be bossy.

If I had not been bossy with my maternal medical care, things would have gone unnoticed. Hell, even though I was bossy the first time, I still went untreated because I was seen as “wrong” even though I knew myself better than anyone else. My “bossy” hormones should have slid magically back into place at four weeks postpartum so it wasn’t possible for me to have PPD. Shame on me for daring to say anything about not feeling well and daring to expect the doctor to actually, oh, I don’t know, DO SOMETHING. I slinked away, disappointed at not receiving help and resolving to stand up for myself down the road if necessary even if it hadn’t gotten me anywhere the first time around.

I got bossy the second time around too after my docs scheduled me for an induction WITHOUT MY CONSENT after noting that my first baby had been “big” at birth (she was 8lbs 3oz, thank you very much.)

What would happen to women, to all the progress we have made in the birthing world – hell, in the postpartum world, if we banned bossy?

There would be no Katherine Stone.

There would be no #PPDChat.

There would be no ample supply of kick ass doulas.

There wouldn’t be a chorus of PPD advocates or breastfeeding or formula feeding advocates. Or Attachment Parenting advocates. Or…. do I really need to go on?

What about NICU Parents? Where the hell would they AND THEIR CHILDREN be without the bossy trait?

Bossy is necessary.

Bossy saves lives.

Banning bossy is akin to telling someone to sit down, shut the eff up, and take whatever life shoves their way. Maybe that’s not what this campaign is about, maybe it’s about taking charge and finding a more positive way to spin it but dammit, no one gets to tell me what word to use to describe myself.

Words are powerful things. They incite strength, they spark revolutions, they can make us cower or they can give us power. But the beauty of words is that WE get to decide what they mean to us, not those who are spewing them at us. We define them. We can take them and twist them into the most beautiful and amazing things ever seen by mankind. It is up to us to choose how to process that which is spoken to us, about us, by us, and for us.

No one should ever put bossy in the corner.

No one.

Instead, we should grab it by the hand, drag it out to the dance floor, and flaunt that baby like there’s no tomorrow. Own it as if we are in the spotlight with Patrick Swayze himself, getting ready to dive off the stage into his arms.

The idea that we are to ban this word to encourage young girls not to be afraid of being “leaders” scares me.

Are we really empowering girls by doing so or are we further protecting them from the big bad world out there waiting to swallow them whole? Bossy gets you places. Bossy starts inside, it drives us forward, and it ENABLES us to be leaders. Not the other way around. If we ban bossy instead of embracing bossy, we are further shaming the word and the attitude. Hell, motherhood alone requires a certain level of bossy, does it not? As does fatherhood.

I am bossy.

I am not afraid to say no.

I am not afraid to stand up for my beliefs. I am not afraid to stand up for others and the rights they have. I am not afraid to tell someone “No, that’s not right. This is the truth, and you need to listen to it.” I am not afraid to protect and defend mothers who suffer from Perinatal Mood Disorders.

I will be bossy about Perinatal Mood & Anxiety Disorders until the day I die.

No social media campaign (or anything else for that matter) will ever change that.

Let’s not ban bossy.

Let’s make some noise…and make some history while we’re at it.

Because “well-behaved women seldom make history” yanno.

Here’s to all of us bossy women – rocking the world, taking names, and kicking ass.

Stay bossy forever.

#PPDChat Topic 02.10.14: Love In The Time of Perinatal Mood Disorders


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When you are struck with a Perinatal Mood & Anxiety Disorder, as with any illness, you focus on healing yourself. It’s perfectly okay to do this but it is also important to remember that this experience extends to those you love as well. If you are in a positive environment, the people around you should be diving in to provide the safe cocoon you need to heal. Even in the most supportive environments, however, chaos still may thrive and after the initial crisis mode fades away and the sun appears on the horizon, a storm may be brewing just behind you.

It is beyond imperative for all of us, not just the one struggling against the beast, to focus on the form the relationship between our most intimate partner takes during the Perinatal episode. If we let it slide too much, the relationship may be irreparable.

Tonight’s chat will focus on how to deal with several types of relationships, a brief discussion of signs of dangerous types of relationships (and how to get help) as well as little things you can do to keep the romance alive in your marriage/partnership as you also navigate the waters of your Perinatal Mood & Anxiety Disorder.

There won’t be a worksheet go go along with tonight’s chat but there will be a resource sheet as well as some coupons/certificates you can share with someone you love who may be depressed (or, if you’re the one who’s depressed, share with someone you love as something that they can do for you to help you out). I sincerely hope you won’t miss tonight’s chat. It’s gonna be invaluable.

See y’all on Twitter at 830pm ET!

#PPDChat Topic 02.03.14: The Five Senses Challenge


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Life is lived through the senses, isn’t it? Memories are not just thoughts put on shelves in our brains, they are remembered best through sights, sounds, tastes, touch, and scents, right?

I remember my grandmother’s perfume. I could not, for the life of you tell you the name of it (I want to say Charlie, but I think I am horribly wrong) but whenever I briefly smell something similar, I think of her. Well, that and bouillabaisse but perfume is far more common.

The scent of ink takes me back to my childhood spent in the family print shop. That’s a cascade of memories – the sound of the presses whirring, the cutter chopping stacks of paper, the cement in the alley outside, the giant cardboard boxes and pallets of paper we would hide behind. Or the darkroom filled with massive amounts of chemicals I’m sure weren’t safe for me to be around but bring a dizzying memory of darkness glowing in the bath of a red light to the forefront of my mind.

Ocean waves crashing make me smell the salt spray drifting through the air, I hear the seagulls overhead, and the warm sun slowly baking me into a loaf of human bread. If I focus just enough, I hear the chatter of other people playing at the beach over the humdrum of the ocean waves.

The wafting scent of a cigar reminds me of my grandfather. He always had one chomped in his mouth as he puttered around outside, it seemed. Mix that with the scent of wet leaves in the fall and the memory of my grandfather is complete. Weird, yes, but that’s him.

Don’t even get me started on the deliciousness that is Entenmann’s or an Eggplant Parmesan sub because YUM. Oh, and delicious saltwater Taffy. OH the memories as it would melt in my mouth and stick to my teeth. Gah, I miss being a kid.

Right now, there is snow falling outside, floating and dancing as it drifts to the ground where it has collected en masse to add up to a minimum of 7 inches for now. It is a good healthy wet snow which means we get to make a snowman at some point. But for now, it is quite peaceful to just sit here and watch it silently and gracefully cover the entire landscape as if it were a bride preparing for her groom. Everything is draped in white, laden with heavy snow.

This week’s #PPDChat will focus on the senses and how living life mindfully helps you navigate your view away from the negative toward the positive. There is beauty in everything, it just takes a few extra minutes to tune in to the heart of it all. Once you do, you will find, however, that you can’t possibly miss the beauty in even the smallest of things.

I hope you will join me at 830pm ET tonight for this fabulous chat. Stay tuned for the worksheet to go along with tonight’s chat – I think you’re gonna love it!

How the @BostonGlobe got Postpartum Depression Wrong


With more news stories mentioning Postpartum Depression these days, it is becoming painfully obvious that reporters are scrambling to get their facts straight. Bless them for trying but sometimes, even with the best of intentions, they fall short. Like Karen Weintraub’s article “When the ‘baby blues’ are something more” at the Boston Globe on October 21, 2013.

Karen defends herself in the comments (all two of them at time of writing) about the term “baby blues” by saying that in her researching for this piece, she discovered there is such a thing as baby blues:

Boston Globe Comments

Kudos to Ms. Weintraub for doing enough research to realize that baby blues ARE distinct from depression.

BUT.

There are a multitude of omissions and errors within the article as it stands right now. Let’s go through them:

Ms. Weintraub breaks the Perinatal Mood & Anxiety Disorder experience into only three groups:

  • Baby Blues
  • Postpartum Depression
  • Postpartum Psychosis

Immediately, sirens sound. Particularly because the case study, a Nicole Caligiuri, a first time mother, states she felt “angry and anxious” all the time. While anger/irritability is a sign of depression, anxiety combined with anger is typically (in my non-professional opinion) more closely related to an anxiety disorder. Ms. Caligiuri, however, was diagnosed with Postpartum Depression.

By ignoring the additional facets of the PMAD spectrum, Ms. Weintraub does a severe disservice to those mothers who may be suffering from Postpartum Anxiety, Postpartum Post-traumatic Stress Disorder, or Postpartum OCD.

Weintraub states that 50-85% of new mothers experience baby blues, 14% experience postpartum depression, and a “fraction of 1 percent of new moms” experience Postpartum Psychosis. If you go by those numbers (at the higher levels), nearly 100% of all new mothers experience one of these three phenomena and none experience Postpartum Anxiety, Postpartum Post-traumatic Stress Disorder, or Postpartum OCD.

According to Postpartum Support International’s Get the Facts page:

  • Approximately 6% of pregnant women and 10% of postpartum women develop anxiety. Sometimes they experience anxiety alone, and sometimes they experience it in addition to depression. 
  • Postpartum Obsessive-Compulsive Disorder (OCD) is the most misunderstood and misdiagnosed of the perinatal disorders. It is estimated that as many as 3-5% of new mothers will experience these symptoms.
  • Approximately 1-6% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth.

But in Weintraub’s scenario, there isn’t room for the nearly 20-27% of women who develop these particular Perinatal Mood & Anxiety Disorders. As a survivor of Postpartum OCD, I find this troubling. Particularly because OCD can scare a new mother into thinking she is experiencing a form of Psychosis due to the horrific intrusive thoughts.

As I have mentioned multiple times, it is beyond important to differentiate the varying aspects of a Perinatal Mood & Anxiety Disorder. Why? Because when you lump Postpartum Psychosis sensationalism in with Postpartum Depression, things get murky. You scare new mothers who may be a bit depressed into thinking if they go get help, they will be thought of as potential criminals and have their babes ripped from their arms the instant they admit to feeling anything less than happy.

An additional issue with this article is the strong focus on early motherhood. The logic of this focus is evidenced by the study on which it is centered but a quick mention that PMAD can persist beyond early motherhood would have been a quick fix for this bias.

Why is it important to emphasize that PMAD onset can extend beyond early motherhood?

Often, many mothers do not realize they have issues until they are well into the 6th month or more. I have had mothers contact me at almost a year postpartum to share that they think something has been deeply wrong since the birth of their child but they did not recognize it until now. Many Perinatal Mood & Anxiety Disorders crop up within the first 2-3 months, often immediately after the period of baby blues, but some mothers do not recognize them or even get hit with them until much later. PMAD’s can crop up  within the first 12 months after birth and even then, may not be recognized until much later. But this information is not mentioned anywhere in the article nor are we ever told at what point Ms. Caligiuri sought help.

I deeply appreciate Ms. Weintraub’s effort to reach out to Dr. Katherine Wisner and Dr. Michael O’Hara, respected experts in the research field of Perinatal Mood & Anxiety Disorders, however, I wish she (or her editor) had taken the time to allow this article to be a bit more clear regarding the wide scope of Perinatal Mood & Anxiety Disorders. I also wish a side bar had been included to resources for women and families who are struggling with these issues, particularly given that Ms. Weintraub included this quote from Dr. O’Hara:

Social support is probably the most important thing to provide a new mother, who is at a particularly fragile point in life, said Michael O’Hara, a professor of psychology at the University of Iowa, who has been researching and treating postpartum depression for three decades.

 

Postpartum Support International will connect new mothers with social support. Also, specifically in Hadley, Massachusetts, there is Mother Woman, a fabulous organization who is making fantastic strides toward improving access to support and care for struggling women & families. Advocates in the trenches, such as the volunteers with PSI and Mother Woman, recognize how important it is to have peers support each other so they do not feel all alone in the dark. It is an oversight that neither of these organizations are mentioned anywhere in Ms. Weintraub’s piece.

Overall, Ms. Weintraub, despite making a few blunders, seems to handle the issue at hand with a respectable grace. The study at the heart of the article focuses on the development of depression in children born to mothers who struggled with depression but Ms. Weintraub is fabulous in her handling of this issue, particularly with this paragraph:

But parents shouldn’t feel like they’ve ruined their child’s life if they go through a period of depression, Pearson said. The increased risk of depression in their children is small. Overall, 7 percent of teens are depressed, compared with 11 percent of teens whose mothers were depressed early in their children’s lives.

She side-steps the potential onslaught of guilt and gracefully allows parents to breathe a sigh of relief by including this information from the study’s co-author.

As I stated in the opening, coverage of Perinatal Mood & Anxiety Disorders is greatly improving. But we still have a long way to go to get to fully informed reporting. For the most part, Ms. Weintraub’s article is generally free of sensationalism, includes quotes from respected experts, and manages to allay any potential guilt a new mother with a PMAD may feel in reading it. However, it is still just a few small adjustments away from being truly spectacular and informative.