Sharing the Journey with Teresa Twomey

Teresa Twomey is a fellow Coordinator with Postpartum Support International. Over the past couple of years we’ve emailed back and forth about a few various issues and I’ve really enjoyed my exchanges with her. More often than not, we’ve shared our mutual frustration regarding the mis-conceptions about Postpartum Psychosis vs. Postpartum Depression.

This past Tuesday, her book, Understanding Postpartum Psychosis: A Temporary Madness, released. I immediately scooped her up for an interview this week. Teresa is a survivor of Postpartum Psychosis and other PMD’s as well. In her book she hopes to present a realistic portrait of PPP and aid in removing the stigma so often associated with this misunderstood condition. With no further ado, here is Teresa’s interview. I am honored to share the journey with her!

Click here to purchase Teresa's book

Click here to purchase Teresa's book

Tell us about yourself – who is Teresa when she’s not a mom or a Postpartum Advocate?

Before I had children I was a litigation attorney and a professional mediator. I am now beginning to re-enter the workforce as a professional mediator. I also do some business consulting. I am currently working on a turnaround project for a packaging company.

I also enjoy writing – I have several writing projects going at any given time. Right now I have three children’s stories finished and another two I’m working on. I also am doing some more non-fiction writing that I plan to develop into a book. (In addition to my postpartum book, I co-wrote a chapter on mediation in a newly-released textbook on Employment Law and have had several academic articles accepted as proceedings or for publication in journals.)

I am active in our PTA, our Newcomers Group, our church and I co-lead two Girl Scout troops.

I enjoy doing new things and my latest “hobby” is working with stained glass (the soldered with lead type). I enjoy designing and creating a variety of pieces.

Sometimes I teach as an adjunct at a local university. I’ve taught Business Law, Business Communication, and Introduction to Women and Gender Studies.

As many of the moms who visit this blog, you’ve traveled down the dark road of Postpartum Mood Disorders. Share your experience with us.

After the birth of my first daughter I began to experience many strange things – I had nightmares, hallucinations, I could not read, I was paranoid. I did not know something like that could happen to someone like me – I was totally blindsided. I did not get treatment at the time, although I told everyone who would listen that I could not cope. I had physical complications and I think those around me thought that was the basis for my frustration and complaints. And I think that even the medical professionals did not understand that something like postpartum psychosis could happen to someone like me (educated, smart, capable, personable, and dynamic). After the psychosis I went into a depression. But still I did not identify it and did not receive help. I did not learn the name for my experience until I was on bed rest during my second pregnancy (with twins!) I was frustrated about the lack of information and misinformation. But I was fortunate – I did not have postpartum psychosis following the birth of my twins. Then when Andrea Yates killed her children and I heard many hurtful and ignorant comments, I decided to do this book. (The more detailed version of my story is in the book.)

At what point in your journey did you realize you needed professional help?

I knew I needed some kind of help almost immediately – but I did not know there was help for what I was experiencing. I did not know there was a name for it. I thought maybe I was going crazy. I did keep telling people I could not cope – that I was a terrible mom – that I wanted someone there to help me all the time – but I was afraid (and paranoid) so I didn’t actually describe in detail what I was experiencing. I just remember telling myself “just hold on – just hold on.”

What roles did your husband and family members play in your recovery? How did they handle your diagnosis?

I was better by the time my family learned of it. They expressed shock, dismay, some denial, and concern — all in a loving way.

My husband, mom, dad and brothers have all been very supportive of my work with Postpartum Support International.

You’re now a Coordinator with Postpartum Support International. What made you decide to become an advocate?

I recognized a need. Plus I was profoundly grateful that we had not suffered any loss of life. It felt right to express my gratitude for that by turning around and helping others. Plus, Jane Honikman asked me to be a coordinator. (I sometimes joke that she roped me in – and am usually met with a response like “you and everyone else at PSI,” or “join the club!”) I am honored to be a part of such an amazing organization.

Earlier this week your book, Understanding Postpartum Psychosis: A Temporary Madness, released. Tell us about this book and the concept behind it. What is your hope for this book?

I was dismayed about how little information there is about the actual experience of women with postpartum psychosis and the amount of misinformation most of us have. I believe those contribute to the ongoing mental anguish many women have as a result of this disorder as well as the occasional loss of life. I passionately believe that professionals and the general public need to know more about this disorder. It strikes so seemingly randomly that if people do not become informed until faced with this disorder it may be too late.

Public ignorance and mis-perceptions lead to:

  • Failure to identify and warn women (and their families) who are at high risk of having this disorder
  • Failure to take measures to prevent the illness
  • Failure to properly identify the illness
  • Failure to provide adequate care
  • Failure to take the steps necessary to prevent tragic outcomes
  • Mistreatment at the hands of police and other law enforcement professionals
  • Inequitable treatment by the legal system based on discredited science and societal myths
  • Misinformation and inaccurate portrayals in the media
  • Oppressive social stigma even for those who do not do any harm

In the short term my hope is twofold: First, I hope that this book will educate medical and legal professionals and the public to effect change regarding how we approach this illness. That this change will lead to aggressive steps to identify those at risk, to prevent the illness and when prevention fails, to adequately treat it and protect the woman and those around her. In the long term I hope this book helps to eradicate postpartum psychosis. I believe that could happen in my lifetime.

Secondly, I hope this book helps women (and their families and friends) who have had PPP to heal. I always say there are two levels of healing from this illness: There is the recovery from the psychosis and then there is the recovery from having had this illness — the learning to trust yourself again, dealing with the fear of a recurrence, being tormented by questions of “why me?” and so on. The illness is temporary – women recover from it relatively quickly. However, the emotional pain from having had this illness can last a lifetime. Just as these stories helped me to heal, to know I was not alone, to believe I could be completely well, I want them to be available to help others heal as well.

Name three things that made you smile today.

My girls singing.

Joking with the ladies in my aqua-aerobics class.

Seeing the sunshine.

I know my advocacy has affected those around me and increased their knowledge and understanding of Postpartum Mood Disorders. Have you found the same to be true about your loved ones?

Oh my, yes!

What do you find the most challenging about parenting? The least?

Most challenging: consistency and discipline.

Least challenging: loving, enjoying and genuinely liking my children.

If you had one chance to speak with an expectant mother (new or experienced) about Postpartum Mood Disorders, what would you tell her?

I would tell her that, unless she has a medical history that would indicate otherwise, it is unlikely that she will have a PPMD. But if she does, there is NOTHING she could experience that other women have not thought or felt and that ALL postpartum mood disorders are treatable. So if she does not feel right in any way, she should tell her doctor and contact me OR someone else through for peer support and information.

Thank you for this opportunity Lauren.


Sharing the Journey with Michael Puline

A couple of weeks ago, we shared the journey with Amber Koter-Puline. Today we’ll get her husband’s point of view. It’s important to include dad in the postpartum experience because his support is invaluable to recovery. I want to thank Michael from the depths of my heart for sharing his story so openly and for supporting Amber so wonderfully during such a difficult experience. I hope this provides invaluable insight for new or expecting fathers who may either find themselves in a similar situation or know someone who is already there.

What makes you tick? Tell us a little bit about who you are!

I enjoy business – specifically the retail real estate business.  I enjoy all aspects of my business.  I spend a good portion of my time dedicated to being successful in my work so that I can provide for my family.  I also enjoy spending time training Gracie jiu jitsu; its something that I have always wanted to get into before but didn’t have the opportunity.  When we moved to Atlanta and I found a place to train and I immediately began.  I am a morning person!  I like to get up very early before others to accomplish things.  I am generally waiting for the gym to open at 4:45am when I arrive.   Sometimes they let us in early.  On nights that I am not at jiu jitsu, I play the guitar and enjoy spending time with my family.

You’ve walked the dark path of Postpartum Depression with your wife. Share with us what it was like to watch the woman you loved seemingly slip away into a dark shell.

It was awful.  I saw a highly motivated and capable person become so helpless and undergo such a radical change.  It is almost as if you no longer know the person.  They are someone else.  It was very difficult for me because I didn’t really believe it was happening.  I thought that it would go away on its own.  But, when Amber came to me and recognized that she was in need of professional help I knew that it was serious.  It was  very difficult to deal with.  I had to change my work schedule and Amber had to even come with me to work some days.  It was almost as if she had regressed mentally to a 4 year old.  She had to be at my side almost 24-7.  You can’t believe it until you experience it.

How did your faith support you through Amber’s recovery?

It helped in many ways.  One of the biggest was seeing the outpouring of help from our church community.  Even people who we did not expect to come through for us came and truly tried to make a difference in our lives and help us with this difficult situation.  As a result of having gone through this, my faith has grown stronger and I can now see why God chose this to happen to my wife.

What has it been like to see your wife take something so painful and turn it into such a point of strength and grace?

It has been really nice. I know she enjoys it. Anytime you go through a challenge and are able to transform it into a positive aspect of others lives I believe it is the ultimate blessing you can receive.  Amber has done this.  She has put her heart and soul into a blog, website, communicating with others, and constantly trying to reach out and help others. It is very commendable. I love her for it. It feels really good to know that she wants to help others. She took the situation, transformed it, and is giving it back to God by helping others. It’s the only way to live.

Did PPD affect your marriage? If so, how?

Yes, in many ways. It has changed our plans for future children (we had previously wanted a larger family.) We had to change our schedules and had to change the dynamics of our child-rearing than we had previously planned. You see, Amber and I had initially thought about having several children, however when she went through such a severe PPMD it really changed her desire and made her feel as if she could never handle more than one child, as she could barely physically and emotionally handle this one. As she had continued to get better, I believe her opinion continues to change slightly. For the first 3 or 4 months I had to do the lion’s share of the night-time wakings, because she needed to rest. At first I think I resented her for it, but now I think it helped me to build an irreplaceable bond with my son. While it was difficult at the time, I am very much thankful for the opportunity to do that because the benefits clearly outweigh the sacrifice I made. Hey, whats a few hours sleep for a guy who gets up at 4:30am anyways? I think as a result we take specific time in our day to better ourselves- praying together, reading and discussing books together, etc. We truly want each other to grow and develop everyday as individuals and parents. We are much more committed to each other. Not just to having our marriage be ok or something we endure, but to flourish. It also changed how we now interact. We have a different relationship. It’s much stronger.
Fathers need to remember not to lose themselves in the process of parenting. What is it that you do to just hang out and be a “guy”?

Jiu Jitsu.  I train.  For me, jiu jitsu offers me the opportunity to escape.  Going to the gym is similar, but jiu jitsu provides me the one on one competition that drives me to do better every day.  I think one of the reasons I like it so much is that I wrestled as a child.  I always enjoyed wrestling and jiu jitsu is similar, but you wear a gi instead and the object is to submit an opponent vs. pin them.  Outside of that, I really like to watch football.  College, NFL, it doesn’t matter!  My wife will watch “our teams,” but can’t understand at all why I would watch other games.  For me, this is how I relax…sitting on the couch or in my chair, with a cold beer Sweetwater 420 (shameless local beer plug!) in my hand.  That’s my release.

3 things that made me laugh…

Telling others a story about how a rock hit my windshield.
My son saying “mango” as one of his first words.
Remembering when my wife saw a coyote walking down the middle of our street when she had PPD.  I asked her if it was real.  She replied, “I am crazy, but not THAT crazy!”  The next day we got a notice about a neighborhood coyote spotting.  :)

What do you find the most and least challenging about fatherhood?

Having patience with my son has been challenging.  I sell things…I am a salesman.  I have absolutely NO patience for anything and I don’t care to.  For me, patience was not important at all.  But now, with my son, I start to realize that there are times where it is needed.  I think that because my love for him is so strong I am able to be more patient and give him the attention that he needs.

I think just having fun with my son comes easily and naturally to me.  Ball, guitar, piano, wrestling, etc.  If there is one thing that I know how to do, it’s how to have fun!  I have spent my whole life enjoying every moment.  Get the fullest out of life.  I want to look back and say I wouldn’t have done anything differently.  It’s the only way to live.

Amber’s PPD Support means…

Alot to me because it means a lot to her.  I think it is important to her.  It helps her grow as a person and move past this terrible part of her life that occurred.


This is REAL.  It can happen to anyone.  Don’t feel badly.  Don’t try to hide it.  Don’t ignore it.  Seek professional help right away.  Be more proactive in finding out how your spouse is feeling postpartum.  Ask her- Are you feeling overwhelmed?  Are you feeling depressed?  Can we go for a walk and talk?  Observe her.  Is she getting enough rest?  She is human, too.  She needs more than 2 hours of sleep a day.  Is she getting it?  You are much better off taking the necessary time off in the beginning to try to avoid a PPMD getting worse than to let it evolve untreated.  It will get worse before better.  In closing you’ll note that in the beginning it may be harder to detect, but easier to cure.  While left untreated, it will become VERY apparent and much more difficult to cure.  My suggestion is to be proactive.  It really can happen to your family.

Sharing the Journey with you

I thought it would be a nice change to ask some fun questions that have nothing at all to do with Postpartum Depression.

Have fun!

1) What’s your favorite kid-friendly “expletive”? (A few of mine are sugar snappies, fudgesticks, and Oh PEACHES!)

2) Tell us the silliest thing you’ve ever done.

3) Name your favorite pizza toppings.

4) What’s your favorite animal?

5) Coke or Pepsi?

Sharing the Journey with Tonya Rosenberg

I’ve been waiting on pins and needles to share this interview! Tonya is the founder of the Online PPD Support Page and has built quite the support system over there. The typical population these days is in the low single digit thousands but that’s vastly more than the 50 women Tonya initially imagined gaining support from the dying site she took over quite some time ago. Now, there’s an amazing team of moderators (hey ladies!) who work very smoothly together to help keep the flow going without deterring the recovery of the women who visit the board. While I haven’t been active there for some time now, I am on the moderator team and am honored to be part of the group.

I am also honored to share Tonya’s interview with you – it’s worth it’s weight in gold, every single word is so intense, transparent, and informative. I read her interview on a rough morning with the kids and boy did it put things into perspective for me. I am always amazed at how that happens!

Enjoy the read and if you or someone you love are in need of some support and there’s nothing nearby or you just need to type some thoughts to get them off your chest, pop on over to the forums at the Online PPD Support Page. It’s like having your own best friend on-line! (Plus, don’t forget that recent study about peer support cutting the PPD risk in HALF – that’s right, HALF!)

Thanks, Tonya, for saving this invaluable resource from an early Internet grave. It’s meant so much to so many families and I know it will continue to do so for years to come. You my friend, ROCK.

Tell us a little about yourself – just who is Tonya as a woman?

Sometimes that’s a very difficult question to answer! I’m a woman who enjoys being 38 years old, as I’ve found some things have gotten better with age. I’m a wife, a mother, a friend, a sister, a daughter, and an individual. I have days in which I feel proud of things I’ve done, and other days when I feel I’ve not done enough – just like everyone probably feels from time to time.

Just like me, you are a two time survivor of Postpartum Mood Disorders. Share with us what your first path down this road looked (and felt) like.

It’s hard to believe that my first child is now 14 years old, and the journey I started on began so long ago!

I was, in hindsight, ripe for developing a postpartum mood disorder. I was a young woman who’d rushed into a marriage with an older man, who himself had a diagnosis of bipolar disorder at the time. My pregnancy was incredibly difficult – I dealt with hyperemesis (and the accompanying weight loss of 40 pounds in the first trimester alone, the multiple ER visits and hospital stays, the visits from home health care providers). I developed gestational diabetes.

During my pregnancy my husband at the time injured himself and was out of work, bringing our usual paycheck-to-paycheck life down to approximately half that income for a couple of months. We racked up a good deal of credit card debt during that time, compounded by the extra medical expenses incurred by my pregnancy and his injury. Near the end of my pregnancy, my paternal grandfather died from prostate cancer.

I was induced, because on top of everything else I started having some blood pressure problems. The birth itself probably wasn’t much different from many birth experiences – I had an epidural and an uneventful vaginal birth.

I remember being alone in the hospital room the first time, exhausted, and thinking that everyone was focused on the new baby – but I felt like the discarded packaging the baby came in. I felt oddly incomplete without the baby still in my now squishy belly, yet also strangely free at the same time.

Breastfeeding didn’t come naturally for me, and neither did motherhood in general. I felt overwhelmed, wrung out, guilty for not feeling the constant glowing love I “should” feel, and irritable. I was grateful when my (wonderful, amazing, fantastic) mother came over to take the baby for a bit so I could rest, yet it also compounded my feeling of being a horrible mother because I seemed to make the baby cry while my mom could calm and sooth and quiet her.

At just a few days old, I was hyper-vigilant about my baby. If she cried, I held her. If she was quiet, I was convinced she’d stopped breathing and would panic. One night in that first week I was sure she was breathing funny, and we wound up at the ER. I still remember the ER doctor laughing at me and chastising me by saying “ALL babies breathe funny.” But then he gave her a closer look and said he’d be back. I found out they were going to take her blood, and I was in charge of holding her steady while they poked her little foot and made her scream. I vividly remember crying along with her, apologizing for letting anyone hurt her. Results came back declaring she’d developed jaundice, and they wanted to keep her in the hospital. (I should mention the hospital I gave birth in was fantastic, but this hospital was the one closest to my house at the time and one I’d never go to again if I had any choice whatsoever!) They wanted to put her in the nursery and send me home, and I remember going into a total angry panic. I insisted they find a room with a bed, because I would not leave her alone in the hospital.

Being in the hospital with her was painful for me on so many levels. I was made to feel that my breast-milk actually caused the jaundice, and was instructed I would have to “pump and dump”, and that she’d be on a bottle of formula until she was well. I couldn’t hold her because she had to spend so much time in the clear plastic bassinet under the Bili-light. When it came time to feed her those bottles, I’d wind up in tears and hand her to a nurse to feed. Holding her with a bottle just made me feel like even MORE of a failure as a mother.

I struggled through, getting her back on breast-milk exclusively a few weeks after her hospitalization. I’m glad of that, because I truly believe (for me) breastfeeding saved my life. I had become more and more miserable to the point of being suicidal. The only things that stayed my hand in those low moments was the realization that she could only be fed by me (she never took a bottle or pacifier), and I couldn’t leave her behind to starve.

One day I got scared enough to call my doctor. She’d been crying and crying for hours, and I was about to lose my mind. I took her into her room and put her (probably not as gently as I could have) into the crib. I walked out, closed the door, and leaned against the wall just outside her door as she screamed. I closed my eyes, and the best way I can describe it is that I saw a movie play out in my mind. In my mind I could vividly see me walking back into her room, grabbing her tiny ankles, and slamming her head against the pristine white walls of her room. The graphic images of her in my hands, of red coating the walls, terrified me. I knew in that moment I couldn’t go another second alone – I was terrified of hurting her and would have very possibly hurt myself if I hadn’t picked up the phone instead.

I called my doctor, who got on the line immediately. I asked her if she could help me, and told her I was terrified of my thoughts. She soothed me and told me she had faith that I wouldn’t hurt my baby, that by knowing those thoughts were WRONG and was reaching out for help, that I wasn’t going to do anything bad. She told me to call my mom over, put the baby in the car-seat, and have my mom drive me to the office. The doctor said she’d make time for me whenever I got there.

Just saying out loud all the things I’d been feeling and thinking and fearing to my supportive and wonderful doctor helped to ease the weight I’d been feeling crushed under. With her help I began a treatment that involved an antidepressant and talk therapy.

It was a turning point in my life as a mother, and as a person.

Did you feel any more prepared the second time around? My second pregnancy was planned but my third was not. I was also still depressed during the second pregnancy which is what I ultimately felt led to my break a month after my daughter came home from the NICU. Was there a difference for you between your two experiences?

There were a lot of differences between my first and second postpartum experience. With my second child I still had challenges, of course. I had a new husband, a five year old daughter to care for, and I had moved across the country (and away from the loving support of my family and my doctor). On the other hand, finances weren’t a constant worry, my second husband is mentally much more healthy, and I only lost 14 pounds in the first trimester.

I knew that breast-milk does not cause jaundice, so I was ready to fight for the right to keep nursing if he developed it. I had educated myself quite a bit about postpartum mood disorders and knew I was at a higher risk, so I talked about that a lot with my new OBGYN. I also knew I was at risk for gestational diabetes again, so I worked harder to care for my health in that regard. (I still developed it, but I think it wasn’t as severe and that I managed it better.)

My second child was a very different baby than my first, too. He was quick to catch on with breastfeeding, he slept easily, and was just a more relaxed and happy baby. (I’ve since learned that my firstborn inherited bipolar disorder and a few other issues from my ex-husband, which actually goes a long way in explaining some of her behaviors even in infancy.) And my new husband was excited to be a new father, and did what he could to ease my burdens which made a huge difference as well.

I still wound up having postpartum depression, some anxiety, and intrusive thoughts, but I’d also opted to start back on antidepressants during the last bit of my pregnancy. I think, for me, it helped act as a bit of a cushion to soften the transitions my hormones went through.

As with any stresses that come towards us in life, one can choose to run or stand and fight. We’re both fighters dedicated to reaching behind us to help other struggling moms finding themselves where we used to be. At what point did you decide to become an advocate and get involved in supporting other moms?

It was rather by accident, truth be told! With my second pregnancy, I was away from all things familiar. So I turned to the Internet to search for resources for postpartum mood disorders. While there were a handful of sites that offered a bit of general information, there wasn’t much “out there” in terms of person-to-person support. I stumbled onto a website that had a very small email group, in which the babies were older and the mothers had left the PPMD world behind. The person who ran the place informed me within a few weeks of finding her that she was going to close the doors, so to speak.

I begged her to let it stay up, and asked if I could take up the reins. That was the beginning of my role as an advocate and supporter. None of the old site I took over remains today, but it was an important starting point and one I’m very grateful to have found when I found it.

I’d already been active on other on-line communities – even met my current husband on-line in a community for a couple of our favorite television shows at the time – and had seen how valuable and wonderful it could be to have this worldwide community of people from all sorts of backgrounds and experiences. It seemed a natural thing to take that concept and apply it to the postpartum site.

I started updating information, rebuilding the site bit by bit, adding things here and there, deleting outdated or irrelevant things, and playing with my image program to figure out how I wanted the site to look. I went through a few different designs before I struck on the current theme, but pink always seemed to factor into the mix. What can I say, it’s one of my favorite colors!

In essence, I went looking for people to support me. Somehow it became helpful for me to extend MY help to OTHERS – my support of fellow struggling moms seemed to put my own struggles in perspective, gave me a chance to focus outside of myself, enabled me to gain more education on the subject, and let me redefine who I was and who I wanted to become.

What are some of the things you do to take care of YOU?

I go to therapy at least once a week – except my therapy is called live comedy! Laughter is really good medicine, and I find that I get rather antsy if I miss a week or two of going out to see comedy. It’s also important for me, as a stay-at-home-mom, to get out around other adults. Going to comedy helps in that regard, too.
Reading is something I enjoy, so I often keep my eyes open for books to devour.

It’s been a struggle, but I try to make myself a priority. If I need sleep, I go to bed. If I feel restless, I take the dog for a walk or to the dog park. If I am hurting, I’ll allow myself to spend some time and money for a massage.

The hardest thing – the thing I still struggle with the most – is being gentle with myself. I have had to work on retraining my brain to stop the negative self-talk, to forgive myself if I mess up, and so on. I’m a work in progress. :)

Name three things that made you smile or laugh today.

Watching Nickelodeon with my kids made me laugh.

My dog Blackberry made me smile when she gave me lots of doggie kisses.

The crew of one of my favorite local radio shows were hilarious today.

As you navigate motherhood, what do you find the most challenging? The least?

The things I view as challenging can change from day to day! Some days I feel challenged by things like my kids purposely annoying each other, but then I’ll catch them being sweet and thoughtful. Sometimes my teenager presses my buttons by saying everything AS IF SHE IS YELLING AND ANGRY, but then she’ll say something really funny or profound. Sometimes my son will drive me up the wall because he seems incapable of being quiet for five minutes straight, but when he’s not feeling well he becomes quiet and just wants to curl up at my side.

I guess the biggest challenge I face as a mother is myself, to be honest. I challenge myself when I play the “shoulda, coulda, woulda” game, when I second guess myself, when I take ultimately unimportant things far too seriously. Alternately, I feel least challenged when I am able to adopt an attitude of letting go and having faith that things will be okay even if I’m not micromanaging every second of every day.

How did your husband handle your experiences with Postpartum? What effect did your struggle have on your marriage (if any?)

My first husband had his own issues with mental health, and did not handle things well. He did the best he could, I believe, but his own illness really limited how much he could handle. There were things that happened during and after the pregnancy that I think were harmful to the marriage, things for which I don’t think I ever really forgave. I needed support, and ultimately felt that I had an infant and an adult child to care for instead.

My second husband was a champ overall, but I definitely think it was difficult for him. I think even almost a decade later, there’s a part of him that probably hangs on to some of the things I did and said during the darker moments. I know from my viewpoint it gave me some perspective on the differences of a supportive, helpful partner versus a partner who doesn’t know how to be supportive or helpful – it’s made me appreciate him more, perhaps, that I would have without the postpartum issues.

Tell us a bit about the Online Postpartum Support Page. Has it exceeded even your wildest dreams in terms of sheer number of women who have found support there?

When I started out, I figured I’d consider myself lucky if over an extended period of time there were 50 or so moms who’d used the site and the on-line communication tools. I just wanted to talk to a few other moms who understood what I was going through, and to let them know they weren’t alone in their struggles. I never foresaw the website growing to the extent that it has over the years, and still often feel a little in awe of it. I often feel guilty about the site because I’m not very involved in it and haven’t been for a while, yet I’m also incredibly proud of the fact that I got this ball rolling and incredibly grateful for the women over the years who’ve recovered and decided to “pay it forward” by helping moms.

And last but not least, what advice would you give to an expectant mother (new or experienced) about Postpartum Mood Disorders?

I’d like all new and expectant mothers to be educated on all the facets of postpartum mood disorders (and all doctors, for that matter!) – awareness of potential vulnerabilities, the various ways a PPMD can express itself, knowledge that having a PPMD does NOT mean you are a bad mother, and so on.
I’d like these women to know that media lies to us! Babies don’t come out with perfectly shaped heads and evenly toned skin. Mothers don’t always instantly have a magical moment as soon as the baby is born where they are madly, deeply in love. Birth plans don’t always go as planned, and that’s okay.
I’d like moms to know, ultimately, that no matter what thought they have or what feeling they experience (positive and negative), they are not alone. There’s been another mother, many other mothers, who’ve thought or felt the same thing. There’s a certain power in the knowledge that you are not alone, I think.

Sharing the Journey with Ruta Nonacs, M.D.

Dr. Ruta Nonacs M.D., author of A Deeper Shade of Blue, also serves as Associate Director of the Center for Women’s Health at Massachusetts General Hospital and an Instructor in Psychiatry at Harvard Medical School. She received her MD from Cornell University Medical School and her Ph.D from Rockefeller University in New York.

She is very dedicated to ensuring women, families, and professionals have accurate information regarding depression during a woman’s childbearing years. In fact, her inspiration for her book, A Deeper Shade of Blue, lies within a strong desire to provide a carefully researched resource for women and their families that lays bare the myths and facts of symptoms, treatment, and recovery. Thank you Dr. Nonacs for your pioneering efforts in this area and I look forward to your continued work!

I sincerely appreciate her willingness to share her journey here and hope you enjoy her words!

Who IS Ruta Nonacs? What do you do when you’re not teaching or doing research?

I am trained as a psychiatrist and have spent my professional life doing a combination of research and clinical practice, working mostly with women during their reproductive years. I have recently been devoting more time to Postpartum Support International; it is one of my most important professional goals to increase awareness of postpartum depression. To this end, I spend a fair amount of time writing for both medical and lay audiences. Since having kids, I started working part-time and that has worked well for me. I have two daughters, ages 3 and 8, and I feel fortunate to be able to spend a lot of time with them.

How did you come to be interested in Postpartum Mood Disorders? Was there a particular experience or situation that drew you into the topic?

During my residency, the first patient I took care of was a young woman who was in the first trimester of her pregnancy, and I had the privilege of following her for the next three years. As a single mother, it was a difficult time in her life, and I felt that I was really able to help her a great deal. I can’t help feeling that this experience had something to do with my choices later on. I also had the good fortune of doing my residency at Massachusetts General Hospital, where they have a phenomenal perinatal psychiatry program.

As we both know, motherhood is a life-changing experience. How has motherhood changed you?

It has changed me in so many ways. For one, it has permitted me to slow down and enjoy all the little small pleasures in life.

Postpartum Mood Disorder recognition and treatment options have come quite a long way, even since my first episode a little over four years ago. How much further do we have to go and in your opinion, what can we do to facilitate the furthering of positive change regarding these conditions?

Depression in all shapes and forms carries a real stigma, and I think we still have a long way to go here. I think one of the things that has helped women with postpartum depression to get treatment is hearing about other women’s experiences with the disorder.

Moms need to take time for themselves in order to recharge their batteries. What is it that you do to relax and recharge?

I wish I could say that I am good at following the advice I give to my patients. I probably don’t relax as much as I should, but I do love bicycling, being outdoors, and photography.

Of all the research you have done in the Postpartum Depression area, were there any results you were particularly surprised to obtain? If so, what were they and why were you surprised? If not, would you mind sharing a brief overview of one of your favorite research projects with us?

I think one of the things I have enjoyed about my research (and my clinical work) has been the chance to make things better. Let me clarify this a bit. We have done a great deal of research on identifying risk factors for postpartum depression. Probably the strongest risk factor is having a history of depression or anxiety before pregnancy. By identifying women at highest risk for postpartum depression, we have been able to implement certain interventions that decrease the risk of postpartum illness. That means we can actually prevent postpartum depression, and that is a truly wonderful thing.

Tell us a bit about your book, A Deeper Shade of Blue and the related blog. What inspired these projects?

A Deeper Shade of Blue is a book for the lay public that provides reliable information on the spectrum of mood and anxiety disorders that affect women during their childbearing years. In this book there is information about postpartum depression and also about mood disorders that occur during pregnancy, as well as the psychological issues surrounding infertility and pregnancy loss.

I wrote the book because there is so little accurate information out there on these topics. While there has been increasing awareness of postpartum mood disorders, most women knew very little about mood and anxiety disorders that occur during pregnancy. There is also so much misinformation in this area; for example, many women assume that they can’t take medications during pregnancy or while they are breastfeeding, and that simply isn’t true. I wanted to give women a carefully researched resource, a guide that would help them to be better informed and to get the help they need.

What is your philosophy regarding your approach to Postpartum Depression? How did you develop this philosophy?

My general philosophy is that we can never afford to ignore postpartum depression. Even when it is relatively mild, depression takes a toll on a mother and on her family. This philosophy derives from my clinical experience — seeing way to many women who have not been able to enjoy or participate in important aspects of their lives because they were depressed and did not receive any treatment.

What advice would you give to medical professionals who may come in contact with a mother who is depressed? What are some of the best things they could do for this mom? What should they not do?

I think the first thing to do is to educate the mother. Many women don’t know a lot about depression; they do not know that this is a biological illness. They don’t know what treatments are effective. Depression still carries a significant stigma, and so many women are horribly ashamed about being depressed. Medical professionals need to help to enlighten women and help them to see depression as any other type of illness that requires attention. Medical professionals need to help women access the help they need, whether it is support from the family, talk therapy, or treatment with medications. These resources are sometimes difficult to find, and we need to make sure that women get the help they need.

And last but not least, if you had a chance to give an expectant mother (new or experienced) one piece of advice, what would you tell her?

As hard as it may be, you need to take care of yourself first. If you aren’t taking care of yourself, you can’t be the mother you want to be.