#PPDChat Topic 01.13.14: Leaving It All Behind – Embracing Emotional Minimalism


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Today’s chat will focus on a concept I introduced in a post last night, emotional minimalism. The idea behind emotional minimalism is not to be completely numb to feelings but rather to process them in a timely, mindful, and healthy manner thereby traveling light with your emotions instead of dragging a ton of unnecessary baggage along with you. 

Go read last night’s post here and get ready for a challenging chat tonight. See you at 830pm ET!

A Simple Dream


A mum in the UK recently took her own life. Fellow PPD blogger Ivy Shih Leung wrote a very long and insightful piece about it here.

While I have not read anything beyond Ivy’s piece, I want to address one of the issues Ivy touches on in her post. For me, it is one of the primary reasons women who struggle with a Perinatal Mood & Anxiety Disorder still fight so desperately with reaching out for help and then with actually receiving the proper help.

Our battle has multiple levels. Were PMAD’s a video game, we would have to survive level after harrowing level before finally reaching a properly educated doctor or therapist. Some of us may be lucky enough to skip all these harrowing levels but for most of us, we are destined to fight with all we have while we don’t have much just to get by in a world expecting us to be super mom while we are at it.

First, we have to fight with ourselves to acknowledge that there is a problem.

Then, we fight with loved ones for help with every day tasks and with reaching out for help.  We fight the argument that we are “faking” or “pretending” just to get out of housework or parenting. We are, some of us, told to suck it up and get over it. Move on. We’ll fall in love with our children eventually. Worse yet, some of us are told depression is some sort of luxury the former generations did not have time with which to deal.

Next, we fight with the front desk folks at the doctor’s office who may tell us such things as “If you’re not suicidal, don’t call us until you are.” (And yes, shamefully, that DOES happen in real life).

We then level up to arguing with a doctor who may brilliantly tell us that our hormones should be back in order by now so of course it can’t be Postpartum Depression despite the fact that we just admitted several high risk symptoms to them. So we are referred to the therapist who calls and reschedules until we are exhausted and cancel altogether.

So we suck it up and try to make do on our own until the next baby when we completely fall apart and start the entire routine all over again. Only this time around, there is a little less resistance from family members and friends because they have seen you go through this before and realize that maybe, just maybe, she isn’t making it up this time around.

But we have to stay off the Internet because it’s a dangerous place for a woman with a PMAD to be – we will be judged for breastfeeding while taking medication or for giving formula because we have to medicate. We didn’t try hard enough to protect ourselves, there is something wrong with us. Damn straight there is something wrong with us – it’s an illness, it’s real, and it is hell.

Psychiatric stigma is bullshit. The divisiveness motherhood brings to a woman’s life is bullshit. Hell, sometimes just being a woman altogether is bullshit. Why we judge each other so harshly for our choices is so beyond me I don’t even know how to begin to understand why we do this. I’m serious – I truly do not understand the in-fighting or bickering.

It comes down to understanding one simple truth:

Each mother needs to do what is best for HER and for HER family. As long as she is doing just that, we do not need to judge, we do not need to place blame, stigma, guilt, or any other negative blanket upon her or her family.

The Internet can be a fabulous place for support if you end up surrounded by the right people and ignore the wrong people. It’s finding the wonderful people that is the challenge.

I have a simple dream, in closing. It’s a dream that one day, mothers of all sort of different beliefs, will be able to have a discussion about parenting without inadvertently reducing each other to panic attacks and/or tears because they’ve judged someone for doing something outside the realm of *their* comfort zone.

One day, right?

#PPDChat Topic 11.4.13: Developing Self-Care Strategies


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With the holidays rapidly approaching, it is time to revisit the topic of self-care. As women, we so very often forget to mother the most important person in our lives – ourselves. If we do not take the time to refill our souls and our bodies, we are useless to those around us. Self-care is not selfish, it is selfless for it allows us to give others more when we are giving from full capacity. Just as it is impossible to pour a glass of water from an empty pitcher it is difficult to pour ourselves into others if we are empty.

Go check out this worksheet and rate your level of self-care. What areas are lacking? Where are you thriving? Then I want to challenge you to doing what the worksheet says at the top – commit to improving at least ONE thing from each section every week. Baby steps matter and with the busy holiday season right around the corner, it is important we all remember to give the gift of ourselves to ourselves. While the small things are not at all a FIX for your issues, they matter and they add up over time.

It is also important to remember to care for ourselves during the winter months, particularly if we struggle with Seasonal Affective Disorder. Having moved back north where there is less sunshine during the winter, I am finding this a challenge. Feel free to jump in and share any strategies you may have to combat this common issue as well as discuss the challenge struggling with SAD in addition to PPD may bring.

Looking forward to chatting about the importance of self-care during the fall & winter months at 1pm ET & 830pm ET. See you on Twitter!

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.

#PPDChat Topic 10.21.13: Turning Your Experience into Advocacy


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New this week and going forward: Clicking on the announcement will take you directly to the Tweetchat page for #ppdchat so you can join in the discussion.