Katherine Stone

is the founder & editor of Postpartum Progress. She was named one of the ten most influential mom bloggers of 2011, a WebMD Health Hero and one of the top 25 parent bloggers using social media for social good. She also writes the Fierce Blog, and a parenting column for Disney's Babble.com.

Will you ever get better from postpartum depression?

Share Button

Climb Out of the DarknessWill I ever get better from postpartum depression? Will I ever get back to the old me, the one who wasn’t like this? Will I ever recover from postpartum anxiety? Or postpartum OCD? Will my pregnancy depression ever go away entirely? My psychosis? Am I permanently “crazy”? Is it even possible that I’ll fully recover and go back to “normal”?

I think almost every mom I’ve ever talked to over these last ten years, no matter which maternal mental illness she has, has been convinced she’d never recover. She’ll be the special case that doesn’t respond to any treatment for postpartum depression or related illnesses. She’ll be the one who improves but never, ever really gets back to her old self. You’re all convinced that there’s no way this will ever go away. That you are permanently scarred or ruined in some way and will forever suffer. And I always tell you, you’ll see. One day I’ll get to say, “I told you so.” You will get back to the you that you’ve always been. You will get back in the world again. 

Perinatal mood and anxiety disorders are real illnesses. They don’t just go away on their own, especially if you have moderate to severe symptoms. They require professional help. But there IS help. It’s not like we’re still searching for the cure. There are people who know exactly how to help you. And with that help you will get better. You will get back to you.

In honor of our worldwide event Climb Out of the Darkness this month, Postpartum Progress put together a special video just for you, featuring the music of British singer-songwriter and Grammy-nominated artist David Gray. I want you to look very carefully at the faces in this video, because every single one of these Warrior Moms was once in the same awful, dark place and each believed fully that she’d never get better.  But she did. They did. They’re back. And you will be too. Meantime, know you are not alone. The Warrior Moms of Postpartum Progress are with you.  

If you’d like to join Climb Out of the Darkness, please do. We’d love to have you. Find your local climb here. And no, you don’t have to be fully back or even partway recovered to Climb. We’d love to have you with us no matter where you are on this journey.

I have to extend a very special thanks to David Gray for allowing Postpartum Progress to use this amazing song as the official song of the 2nd annual Climb Out of the Darkness. His new album, Mutineers, is dropping June 17th, and “Back in the World” is the first single released from that album. This song helps symbolize that you can get back in the world and back to yourself again, even if you struggle from postpartum depression, postpartum anxiety, postpartum OCD, postpartum psychosis, pregnancy depression, and more.  Gray has also just announced a North American summer tour. Tickets went on sale Friday, June 6th, for the 23-city outing kicking off on August 1st and heading to places like Boston, New York City, Atlanta, Charlotte, Indianapolis, Cincinnati, Las Vegas and San Diego. Get tickets here! Here’s the official video of the song if you’d like to check it out as well: https://www.youtube.com/watch?v=mBS6UgiYTr4.

I’d also like to send all my gratitude to my amazing friend Barbara Jones of One 2 One Network who made this video happen, and Nick Romero of Moded Films for editing the video.

 

Share Button

Why Do Women Get Postpartum Depression & Postpartum Anxiety? Risk Factors

Share Button

postpartum depression risk factorsEveryone wants to know, “Why me?”  Why did I get this? What did I do wrong? You didn’t do anything wrong. Lots of women get postpartum depression, postpartum anxiety, depression or anxiety during pregnancy, postpartum OCD, postpartum PTSD, postpartum psychosis and related illnesses. And there’s very likely more than just one reason why they do. So what are the postpartum depression risk factors? What causes postpartum anxiety and the like?

Perinatal mood and anxiety disorders may be caused by a combination of nature and nurture. Yes, there is likely something going on inside your body — with your brain processing or your DNA — that makes you more  likely to get PPD, PPA, PPOCD, etc. than the girl standing next to you. For instance, you might have a family history of mental illness that makes you genetically susceptible. Or there’s something about how your body works that makes you more sensitive to hormonal changes. Makes you more vulnerable. This is the “physical” part of what may be making you sick that you hear people talking about – actual things and processes that you could see in a microscope or test for — brain chemistry and all that.

Why is it, though, that you can have two women who both have family histories of mental illness and only one of them gets PPD and the other one doesn’t? Why doesn’t every mom who has the “wrong” gene or set of genes, or who is more vulnerable, get sick? That’s where the nurture — what has happened or is happening to you in your life outside of the realm of your neurotransmitters and the confines of your skull – part comes in. What is or has happened in your life, believe it or not, can turn your possibility of getting PPD into actually getting PPD, turn your susceptibility into fact. These are the things that are going on outside your body that raise your risk as well.

First, a definition of the term risk factor: risk factor is any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or illness.

If you have experienced a period of or been diagnosed with depression, anxiety, OCD, bipolar disorder, eating disorders or other such illness in your life, then you clearly have a higher risk for getting a perinatal mood or anxiety disorder like PPD. But there are many risk factors for these illnesses besides having a family member that has a psychiatric disorder or episode or having a history of one yourself — things that most moms don’t know about.  These risk factors include:

  • An experience with emotionally painful or stressful experiences around pregnancy, childbirth and/or early parenting – Did you struggle with and/or were you treated for infertility? Have you suffered a previous miscarriage or other pregnancy loss? Did you just deliver multiples? Do you have a special needs baby? Does your baby have colic or a difficult temperament? Have you had difficulty with feeding your baby?
  • A history of domestic violence, sexual or other abuse – Were you abused as a child, or have you been as an adult?
  • A traumatic childhood – Did you have a traumatic childhood? Did you lose a parent? Did you have a troubling relationship with your own mother? Trauma as a child can have a VERY big impact on your emotional health as an adult, even if you think you’re “over it” and it’s “in the past.”
  • Stress – This is such a big one, and it surprises people, because everyone has stress right? But there are major stressors that can tip your brain over the proverbial edge. These include the loss of someone close to you, a job loss, financial hardship, divorce or strain in your relationship with your partner and even a house move. Big changes in your life can have a big impact on your emotional health.
  • Lack of social support – Do you feel alone and as though you have no one to help you? Do you live far from your family and close friends? Do you feel like when you need help there is absolutely no one to ask? Are you a military wife whose partner is deployed?
  • Personality – Are you a perfectionist? Do you have a controlling personality? Do you have low self-esteem? This is not so much a risk factor but studies are showing there is, as Karen Kleiman calls it, a “clinically relevant” relationship between this type of personality and having PPD or anxiety.

Here were my risk factors, none of which I had any awareness of when I had my first child and ended up with postpartum OCD:

  1. family history of mental illness
  2. baby with colic
  3. traumatic delivery
  4. traumatic childhood/traumatic relationship with mother
  5. perfectionist personality and likely had always had OCD but just didn’t know it

Any of these things can mean you are more likely to get PPD or a related illness than the mom next to you. They’re not a guarantee, but they raise your risk. And someone should tell you that. You should know about that. You should know about postpartum depression risk factors. You should know that bipolar episodes raise your risk of postpartum psychosis. You should know whether you might end up having postpartum OCD and intrusive thoughts. Because if you and every other mom knows, then she can be prepared. She can be read to learn what the symptoms are and identify them in herself. She can know that she needs to reach out for help and figure out who might be able to help her in her town. She can make sure her family or friends or someone in the community who cares are at the ready.

If you’re willing, we’d love for you to share your risk factors with us on our Facebook page, here: http://www.facebook.com/PostpartumProgress/posts/10152157454631229

Photo credit: © tang90246 – Fotolia.com

Share Button

Cutting Teeth: Two Authors Share Stories of Postpartum Anxiety

Share Button

Cutting TeethI am so excited to share the following interview with you, between authors and fellow Warrior Moms Elizabeth Isadora Gold and Julia Ferro on the occasion of the release of Julia’s new novel, Cutting Teeth. Both had risk factors for postpartum anxiety, but were never warned or screened, and both found it difficult, as so many of you do, to find the help they needed.

I met Julia Fierro in 2009, when I was her student at one of her fiction workshops. We were both struggling writers, but Julia was also the mother of a toddler, Luca. I would sit in her kitchen, allegedly discussing a short story, but really staring at photos of her beautiful boy, wondering if I’d ever have a child. One day, towards the end of the workshop, she casually mentioned she’d had postpartum depression and postpartum anxiety after Luca’s birth. Though I’d heard of PPD, I’d had never known anyone with such a (to my mind, then) “rare” condition, and didn’t know what to say. We weren’t in touch much after the workshop – she had a second child, Cece (now four), I had my daughter, Clara (three). When I suffered my own postpartum mental illness, isolated and fearful, I didn’t feel comfortable reaching out to Julia. Then, last spring I saw via facebook that Julia had sold a novel, Cutting Teeth, and she would be reading a preview at a local Brooklyn bookstore. The excerpt was hilarious: a lone stay-at-home-dad in a mommy group, admires his nursing friends’ lactating breasts. After the reading, Julia and I hugged like long-lost friends. We’d spent several years on parallel tracks, both suffering from postpartum anxiety, writing about parenthood, community, and anxiety. In a happy coincidence, we were also each writing books about mother’s groups, though hers is a novel and mine is nonfiction. As Cutting Teeth (St. Martin’s Press) approached its release date, we chatted for Postpartum Progress about writing, motherhood, and life.  ~ EIG

EIG: So we should catch each other up on what we never talked about:  I was your student when Luca was a toddler, and knew you’d been sick, but I didn’t really understand.

JF: I’ve been obsessive compulsive since I was a child. I went on medication at the end of my college senior year, because I was having debilitating panic attacks. The first twenty-five years of my life were very exhausting. Obsession, obsession, and depression. When my husband, Justin, and I started getting ready to have a baby, the psychiatrist I was seeing made me go off medication a year before we even started trying. But she was the only person I could find on my insurance within miles.

EIG: No psychiatrist takes insurance. Which is an issue, because if you can’t afford a psychiatrist who doesn’t take insurance, you get less good psychiatric care.

JF: Right. She said, “You don’t want any medication. You don’t want to hurt the baby.” I didn’t have anyone to talk to. It was hard to go off medication, but I was working from home, I didn’t have a kid yet, and the business wasn’t as big. The pregnancy was difficult – I threw up every single day.  It was a difficult birth. I was in labor for three days. On the third night, they gave me the epidural and pitocin, but it still felt like he was going to come out of my hip. The delivery room was where the insecurity and the self-doubt that would hang over me for years began. The midwife was yelling at me to push, and I was like, “I don’t know what you’re telling me!”

EIG: For so many women, the birth is the beginning of feeling like you’re doing everything wrong. I don’t know if that’s a chicken and an egg thing. Would someone who had a difficult birth but not go on to get postpartum depression or anxiety feel okay about the birth? Or should part of the diagnostic for postpartum depression or anxiety be, immediately after birth, “How do you feel about this experience?”

JF: There should be some kind of therapy. Even a social worker in the hospital to ask, “How do you feel?” Just talking for five minutes would be more than nothing. I couldn’t even get a lactation consultant to visit me.

EIG: Me neither! You know who came to my room? People wanting to take photographs that I could pay for. They came twice.

JF: Yes!

EIG: Did you have a c-section?

JF: Yes. After that, for two days, it was great, Luca was beautiful. On the third night, they took him to get his vitals checked, and they didn’t bring him back! An intern came, stopped in our doorway, and said, “Your baby has a fever, so we took him up to the NICU.” And she just walked out! We were so exhausted, we cracked. Now, I met Justin when I was 21, so he practically raised me, getting me through my obsession, and the medications. So seeing him crumble? I actually said, “If the baby dies we can have another baby.” He just had a fever! Our family wasn’t there because they don’t live nearby. It was the worst moment. (Sighs.) I can’t believe I’m getting upset about it. It was seven years ago. His birthday is next week.

EIG: I’ve been doing interviews with moms for my book, and everyone starts crying when they talk about the birth.

JF: Luca was in the little bubble incubator, and I turned to the pediatrician – I was so out of my mind –and said, “Is he going to die?” And he was like, “No.” When they moved him to the bigger room in the NICU, and then I saw how big he was compared to the tiny preemies, that made me realize he was okay. That shaky feeling stayed with me for the next two years.

EIG: I had a very similar experience after my c-section, and I think it’s very common for women who have had surgery. I was very jealous of how Danny (my husband) was with her, how easy it seemed for him, how proud he was of her. For example, I didn’t seen Clara’s fully naked body until I was home for like a week, which was so upsetting. In my mind, I was supposed to have this experience where I would see her body come out of me, we would be naked together, and she would be on my chest. Because of the surgery, I never had that moment. As a result, for me, it took me a longer time to attach. I was like, I don’t know who this person is, this could be anybody’s baby. There was a sheet over me when I gave birth. It’s a very primal, primate-like thing when someone else touches your baby first.

JF: For me the breastfeeding was such a disaster that first time. I couldn’t breastfeed, because I was too anxious. I wish I could go back in time and fix that.

EIG: Do you wish you could go back in time and make the breastfeeding better? Or that you could get on medication, and make the feeling better? 

JF: Yes. (Laughs.) I didn’t know things like, your baby is going to want you to hold him. My babies were not the kind you could put down. They would cry endlessly. My philosophy of early parenting: do what’s easiest. That’s always going to be the right thing for you and your baby. I realized later we should have put Luca on formula, because it was so agonizing to breastfeed. Trying to nurse that first day when we were back home, I’d left the breast pump on, and I thought it was saying to me, “You can’t do this, you can’t do this.” I decided to stay off medication because I didn’t know you could go on medication and nurse. I didn’t have anyone to turn to. Our parents did this thirty years ago. They didn’t remember.

EIG: Having kids later, you don’t receive the same benefit of parental wisdom, because they don’t remember. My mom always told me, “We carried you around in a basket!” Once I had Clara, I was like, “With a pillow? Was I smothered?”

JF: Justin was back to work, and here I was with the baby who cried all day long. One weekend I panicked because I was worried about him getting dehydrated (which is why he got the fever and ended up in the NICU). He wasn’t nursing. We went to our pediatrician, who said to me, “Look at your baby, he is so healthy and fat. Do you think maybe it is your own anxiety that is causing him not to nurse?”

EIG: In that moment, he could have caught the fact that you were sick, and reframed it. He could have said, “Look at your baby. He’s healthy and fat. I’m concerned about you.”

JF: Or how about, “You’re doing a good job!” Instead, he said, “If you’re anxious, the child is going to feel that.” When a woman is feeling an uncontrollable postpartum depression or anxiety, to have someone say, “If you don’t stop feeling what you’re feeling you’re going to harm your child.” It’s so irresponsible. [Read more...]

Share Button

Warrior Moms Book Club Review: Marie Osmond’s “Behind The Smile”

Share Button

Behind the SmileThe following is a conversation between several members of the Warrior Moms Book Club after reading “Behind the Smile,” the latest in our book club’s maternal mental health-related reads.  This book was authored by Marie Osmond. You may visit the author at http://marieosmond.com.

AKP: On pages 41 and 42 Marie discusses “not having been a stranger to depression in connection with her children” as she later realized by talking with a panel of experts on Oprah that what she had experienced was actually post-adoption depression.

Had you had any depression or anxiety with prior adoption or births that you didn’t realize was a form of PPD before you had the PPD experience that changed things or that was actually diagnosed or treated?

If so, did having that experience help you to more quickly realize it in the future or did it make it more difficult to detect?
If not, did having PPD after already having adopted or birthed at least one child and not having suffered PPD that time make it more difficult to detect? (We know that some moms do not suffer perinatal mood and anxiety disorders with first births but go on to suffer with later children.)

APR:  I experienced postpartum depression and anxiety with my first child, so I have not had this experience. I am hoping to birth a child and not suffer with this with my second (due any day now).

AKP: Speaking of giving birth, on p. 86 Osmond laments that “our current system of discharging a mother so soon after giving birth is a hazard. It may save money overall, but I have to question what the cost is to a woman’s well-being and the welfare of her infant. They are sending home an exhausted, hormonally confused, physically stressed woman with a tiny, fragile infant that needs 24 hour care. I think that alone is enough to cause depression in anyone.”
What are your thoughts about her statement and how do you think that we could best care for women in the immediate postpartum period in order to better prepare them for a healthy long-term postpartum experience mentally and physically?

SBC: I agree with Osmond’s statement. I think new mothers need community after having a child. We need friends, family members, co-workers, church members if we belong to a church, to help. So many people want to come and “hold the baby” right after birth, but it could be so helpful if these visitors also ran the dishwasher, made a meal or something. I needed this type of help and I asked for it. It was hard to ask for help, but I later realized my friends and family were so happy to help. Also, my health insurance company had something called Better Beginnings. Because I enrolled in this program, I had a free home visit with a lactation specialist, they sent me a good book and someone from the program called me just to see how I was (and they didn’t know I was having PPD). I felt pretty fortunate for this extra help.

SRK: I feel differently; I felt like the faster I could get out of the hospital the better. Maybe that was because I felt neither my husband nor I could rest comfortably in the hospital. My symptoms didn’t really start until our son was around 3 to 4 months old, so I don’t believe that being in the hospital any longer would have benefited me more. I definitely am a homebody through and through and enjoy having all the comforts of home available.

AJK: I agree.  The only benefit in my opinion to staying in the hospital longer would be IF it truly allowed the mother to rest. It wasn’t restful to me, or many others, to be there though. When/where the help and support is needed is afterwards, at home.

AKP: I wonder if there could be a middle ground on this. The hospital was awful for me, too, and my severe anxiety began there, both times — the lights, constant interruptions, lack of fresh air and access to the outside world. I watched a special on a particularly expensive Asian childbirth and postpartum care center for the wealthy about a year ago. Moms can stay up to two months postpartum and be cared for in the comfort of a medically equipped luxury hotel with round the clock care for themselves and their babies. But instead of the sterile hospital environment and being poked and prodded and fed awful food, they are pampered and nursed back to a place of recovery from birth while they are helped or taught how to care for their baby, which also boosts their confidence. If only this type of experience could be more standard, I do believe women would go into the postpartum period better equipped for a healthy experience. Nothing will fully prevent PPD, but having a full tool-box and being primed certainly would make it much less challenging to navigate and recover from.

LL: I also had a bad experience in the hospital. I was there for five days due to a failed induction and C-section and I never slept more than 45 minutes at a time. It was a teaching hospital so people were constantly in and out. Babies “roomed in” and when I asked them to take my baby for a few hours so I could sleep, they brought him back to me within thirty minutes. In addition, the nurses all gave conflicting advice to me about breastfeeding — every shift change someone would come in to “re-educate” me because apparently the nurse who had been there before had taught it to me incorrectly. While it was nerve-wracking to go home and not know how I was going to keep this child alive, I think the hospital (at least the one I was in) was not a helpful place to be. I am not going back to that hospital for my next birth, so maybe I will find a place that is more nurturing and would be beneficial like Marie states.

BR: I remember shortly after returning home from the hospital, wishing I was back there. I had a mixed experience during my hospital stay (which was just shy of 48 hours). It was scary, as my daughter had to go through some tests that we weren’t expecting. But I felt secure being surrounded by the medical staff, who coached us through learning those early tasks of caring for a newborn and I knew if anything went wrong they would be there to provide immediate care. I think being in the hospital also validated that something significant had just happened, and that it was okay for me to get extra care. When we got home I felt like it shifted to being all about caring for my daughter, which was exacerbated by my extreme anxiety about my ability to care for a newborn and intrusive thoughts about SIDS that kicked off my PPD. Every mother will have her own distinct needs following giving birth, but in my experience I think I could have benefited from a longer hospital stay to feel stronger and more competent about my new role as a mother.

APR: I gave birth to my first child in a free standing birth center, partially because I didn’t feel like I wanted to be in a hospital postpartum. I felt like I’d be comfortable at home. But, I should have arranged more help for myself postpartum and made it more clear to visitors and well-wishers how they could help. It was overwhelming to go home three hours after the birth and to have so many people coming over to the house the same day because everything seemed fine. With this next birth I am putting so much more emphasis on postpartum support, hiring a postpartum doula, using babysitters for my older daughter, taking a friend up on her offer to arrange a meal train, and putting limits on the amount of visitors. I think Marie is on to something that postpartum support for women is sorely lacking in our culture, since extended families are separated and work often doesn’t even allow spouses to help moms much. The hospital is better than nothing I suppose, for women who have no support at all and who will go right back to their family or work obligations directly after coming home from the hospital, but it’s definitely not ideal.

AKP: Related to support, Marie talks about one of her mother’s moments of wisdom when she said, “You have to be as gracious in the receiving as you are in the giving. If you’re not, you deny the other person the blessing of giving.” How were you at accepting help/giving before PPD? Did having a maternal mental illness change that?

SBC: That statement is so true. When I was really struggling, I called my midwives’ office and a nice nurse said that exact thing to me. She said “Give your family the gift of allowing them to help you.” It was hard because before the PPD I had thought of myself as completely self-reliant, a leader and the type of person who helped others. But I had to let go of this self perception. It helped me to think about it the other way around. If I had a friend or family member in need as I was, I would want to help them.

SRK: No one really ever mentioned to me that I needed to accept help from my family and friends. Before PPD I tried not to need much help and was a lot less willing to ask for help. After PPD I am much more aware of when I need help and willing to ask for help. I have accepted that it is okay to need help, whereas before I would try everything I could to do it all on my own. I feel that I am a better mother and wife for accepting help when necessary and using my support structure when available has kept me from digressing back into my depression.

AKP: My faith has helped me to accept this. I do believe that God’s grace is the perfect example. He doesn’t require our prayers, thanks, and worship, but he accepts it and offers his grace freely. I try to think of this example in that he was us to offer grace and generosity to others and to accept it ourselves, whether we “deserve” or need it ourselves. I realize not everyone sees through this particular lens, but regardless of religion, like SC and SK, I also took this important lesson away from my PPD experience…surprisingly one of the many positives.

LL: I personally have never been good at accepting help from others but always felt that I should be able to handle things on my own. Having PPD was the first time where I had to admit that I was helpless and needed support from others. People from church brought me meals for weeks, my friend came and cleaned my filthy kitchen, and while at first all of this embarrassed me I later realized that people weren’t helping because they felt obligated — after all, I could hardly bring myself to ask. They were helping because they wanted to. Since things have become easier for me with PPD (I wouldn’t say I’ve totally recovered, but I’ve gone into remission so to speak) I have tried to make it my mission to help other new moms, and it is such a help to me now that I know it must have blessed the lives of the women helping me when I was struggling myself. I think it is all a cycle.

BR: I think I have always felt confident about asking for help when I need it. However, one feature of my PPD/anxiety was thinking I should be capable of doing it all, and the fact that I needed help not only caring for my daughter but caring for myself as well as well influenced a strong sense of failure. It took support from my family to encourage me to really communicate what I needed so that I could get the treatment I needed and be the healthy Mom I so wanted to be.

AJK: It was very difficult for me to accept help. Or rather, I think it was for me, to GIVE UP even more CONTROL and have others do things I “should be” doing and do things FOR ME. It was ultimately a GOOD THING but very difficult really for me.

APR: I was not good at asking for help and my husband is practically allergic to it. After our experience with postpartum depression and anxiety and now a difficult pregnancy, we know we’ve got to ask for help when we need it or things get so much worse. We’ve also become much less reserved in paying for help, because it pays off big time in the long run. [Read more...]

Share Button