Toward A Better Understanding of Postpartum Depression

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emergency-stop-buttonThe following post is about a potentially triggering topic.

Please be aware of this as you continue and if you are in a particularly fragile or sensitive state, you may want to skip this post altogether.

This post will continue below the graphic to the left.

If you’re choosing to skip this post, here’s a really adorable video of a tiny hamster eating a burrito to watch instead.

Because well, a tiny hamster. Eating a burrito. What’s not to love???

(I’m kind of in awe of how fast the little guy chows down!)

 

 

 

Last night, on Facebook, I noticed a post by The Postpartum Stress Center:

 

Postpartum Stress Center FB Snapshot

 

 

 

 

 

As an advocate, one of the biggest things I fight is stigma and misinformation. Sure, I reach out and help women seek help as they battle against whatever form of Perinatal Mood & Anxiety Disorder they may have looming large over their lives, but the majority of time, I am correcting issues like the one Karen Kleiman (founder of Postpartum Stress Center) refers to above. The post refers to an article appearing at the Miami Herald’s website about a mother who attempted to drown her child. She also tried to poison and smother him when he was just two months old.

Nothing is more infuriating than reading an article about a mother who has harmed her child only to discover the only term used within said article is postpartum depression.

I cannot emphasize the following enough: Women with postpartum depression are highly unlikely to harm (and therefore kill) their infants. Women who struggle with postpartum psychosis, however, are far more likely. That said, at this point, the only person stating she suffered from postpartum depression is the mother. Her family admits she sought treatment shortly after her child was born but we do not have details. Yet one mention of postpartum depression and boom. We’re off to the races without putting the right saddle on the horse.

I reached out to Karen Kleiman for her thoughts about this situation. This is what she had to offer about Armour “blaming” PPD:

“Of course Armour blamed it on PPD. That’s all we talk about. PPD is so frequently used when referring to any postpartum mood or anxiety disorder. in fact, it is used when there is NO mood or anxiety disorder, such as the Baby Blues. So, yes, until we have a clear diagnosis (and even then, the diagnosis can be wrong) we need to be careful. That’s the media as well as the public at large. She is being judged by all of us.”

She is most definitely being judged by all of us, whether we want to admit it or not. All we can offer at the moment is conjecture, which is a dangerous thing if accompanied by misinformation as well.

Here’s a quick lesson:

Postpartum Depression, a commonly used umbrella term for the mood disorders on the Postpartum Mood Disorder spectrum, is also the term for one of the disorders on the spectrum. Postpartum Depression may consist of but is not limited to: sadness, crying for no reason, lethargy, lack of interest in previous activities/hobbies, distance from baby and family or social activities, anger, irritability.

Postpartum Psychosis, the most serious of the Postpartum Mood Disorders, often involves (but again, is not limited to): auditory or visual hallucinations, the inability to care for oneself and make decisions. Considered a medical emergency requiring immediate hospitalization, this particular disorder also carries the deadliest rate of both infanticide and suicide.

As you see, the two are quite different beasts. They are on the same “spectrum” as they are both mental disorders which occur after the birth of a child, but the signs and symptoms for both are of completely different degrees.

Karen continues, with this:

Let’s face it, even the experts disagree. The lines are blurry and they are getting blurrier instead of clearer. More and more cases are unfolding that are confounding experts and have us wondering what variables are related to what, if you know what I mean. So education is indeed the key. But education isn’t enough. Because mental illness isn’t crystal clear and many definitions merge into each other. So we also need compassion and patience. We need to stop jumping to conclusions, stop judging, stop presuming we understand what happened, and we need good assessments, good treatment, good journalism and continued advocacy. But in reality, we live in a culture that wants information NOW and they want it whether it is accurate or not. Sensationalism sells and we scaring the hell out of women who are just trying to understand and trying to heal.

How can we fight back? By continuing to do what we do. Get the right information out there. Spread it around as best we can. Journalists are fighting against deadlines and unfortunately, this doesn’t always leave them time to check their facts.”

What can families and friends do to better educate themselves in order to help loved ones who may end up fighting the nastier beasts on the Perinatal spectrum? They can do the following, according to Karen:

Again, women and their families need to be alert to changes in personality or behavior after a baby is born. If something doesn’t seem right, it probably isn’t. It is far better to overprotect her and be mistaken, than to miss the opportunity to get her the help she needs. Here is a link to our Emergency Room Guidelines, which will give you info about screening for psychosis.”

The number one thing to keep in mind, particularly if you think it can’t happen to you or someone you know, is that it can.

Postpartum depression and psychosis can happen to any one. It happens to loving mothers who have anticipated the birth of their baby with joy and excitement in their hearts. It is cruel, brutal illness that does not discriminate. It is no reflection on the mother, who is suffering. Surely, we can have compassion for mothers who are suffering.” -Karen Kleiman

The article at the Miami Herald pointed out that Armour had created a video, portraying her love story with her partner, and her joy about her upcoming birth. What went wrong? How could a happy mother possibly go from overjoyed to attempting to kill her own child? Therein lies the more important question and story, in my opinion. It’s a difficult story to write, to comprehend. But the more we write about it, with the proper terms and information included, the more we encourage mothers to step forward, courage in their hearts, to seek help before it is far too late.

I reached out to Dr. Kenneth Johnson, the chair and professor of obstetrics and gynecology in the Nova Southeastern University College of Osteopathic Medicine, who was quoted in the Miami Herald article, offering him a chance to clarify the statement used in the piece. This is his response:

“I of course agree with you that even with severe postpartum depression it is very rare for mothers to harm their baby.  Postpartum psychosis is more severe and more likely to be associated with risk to the mothers baby.  Separating the two conditions is very difficult clinically as there is almost always overlap with severe depression when psychosis is evident.”

He is right, and Karen Kleiman makes the same point in her article at Psychology Today. The difficult issue with Psychosis is that until there is a break, it’s very difficult to discern if the person is struggling with severe depression or with psychosis. Psychosis is always a medical emergency and requires immediate attention.

Another thing to keep in mind, particularly given that July is Minority Mental Health month, is the lack of education regarding mental health issues among minority populations. A’Drianne Nieves, who blogs at Butterfly Confessions, is passionate about speaking up about mental health issues and the lack of resources, voices, and education which exists today. She had this to offer about Armour’s situation:

Education, man. Distinction between illnesses & awareness about the range of their symptoms. Doctors need to really start educating women on this. She didn’t have PPD. Whatever treatment she received I’m sure it wasn’t adequate or last long enough or maybe they just misdiagnosed her. Her family-did they know the symptoms of psychosis? What to do? Who to call? Education. Education, especially in minority communities is lacking and is a critical need.

A’Drianne also offered this on her FB page when sharing the Miami Herald article:

This is why we need more awareness on postpartum mood disorders and their symptoms among women of color. FACTS. We need FACTS on the wide range of symptoms and distinction between each illness. Facts and support/access to resources…..This is why #MinorityMentalHealth Month matters. This is why we need to keep advocating and have more people of color SEEN in the mental health advocacy space, especially online and in mental health magazines and other publications/literature.”

The media is not only getting their facts wrong, they are increasing stigma. As Karen so brilliantly states in her piece at Psychology Today, ” Journalists, Doctors, Everyone: Let’s Get it Right”:

“Let’s get it right. Lives depend on it.”

They do depend on it. The wrong description or sensationalized information causes women and their families to fear help instead of embracing it with open arms. I have lost count of how many times a mom told me she can’t take medicine because her partner is afraid it will turn her into Andrea Yates. Or how many of us must avoid the Internet when sensationalized stories are bandied about with horrible comments attached – comments which range from the pitied to the enraged to the downright vicious. Comments which categorize all of us with a Perinatal Mood Disorder as monsters. We are not monsters, you know. We are you. We are your mothers, we are your sisters, we are your daughters, your cousins, your wives, your aunts…we are the cashier at the store, the accountant down the hall, the lawyer defending you in court, the doctor you take your children to when they’re sick, the employee at your favourite restaurant, the postal employee who delivers your mail, we are every woman and we are just like you with hopes, dreams, and lots of love to give. But we live in fear as we struggle because the media paints what we fight with such dark intense strokes.

Journalists are inching closer to getting it right but there’s still a long way to go. A long, long way.

If you see a story which includes misinformation, reach out. Contact the journalist. The paper. Write a letter to the editor. Speak up.

We owe the women on this road behind us a smoother ride than we have had on our own and in order to do that, we cannot afford to remain silent.

If you are a journalist writing about Perinatal Mood & Anxiety Disorders, reach out to Postpartum Support International for the facts. Or if you’re pressed for time, you can find them online at their Get The Facts Page. If you’re a mom or have a loved one struggling with a Perinatal Mood & Anxiety Disorder, there’s plenty of help out there. You can reach out to Postpartum Progress, to Postpartum Support International, or use the hashtag #PPDChat on Twitter. You are not alone and there is help. Don’t let stigma fool you into believing you’re a monster. You’re not. You are loved, you are not to blame, and there is absolutely a light at the end of your tunnel.

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Educating mamas-to-be one story at a time

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I think of mental illness the same way I view cancer. It can strike anyone at anytime. For me, the time came at the age of twenty-six. I was blindsided. Two manic episodes two weeks apart; two stays in two different psych wards at the end of 2005.

If the first time was a complete and utter shock, the second reinforced what I guessed was happening to me. My family and I were in denial after the first incident, totally unprepared for the road ahead. The second bout of mania solidified the fact that this was real.

Even after living with bipolar illness for two years, I had yet to fully understand the disease. When my husband and I reached a point where we agreed I was stable enough to try for a baby at the end of 2007, I read everything I could get my hands on about postpartum depression, the only postpartum mood disorder I knew about. I had lived through a year of debilitating depression following my diagnosis of bipolar type one, and was terrified of falling into the darkness again. Especially with a new baby who would be depending on me for survival.

Impressed with what I thought was a great job preparing for my postpartum experience,  you can imagine my confusion when instead of the intense case of the baby blues I had expected, mania began taking over my mind in the weeks following my son’s birth.

The pressure I had placed on myself to succeed at breastfeeding made everything worse. Instead of turning over my sweet, swaddled little boy to my husband so he could give a bottle of formula and I could get some decent rest, I pushed my body further than I ever have, on top of having just given birth via emergency C-section after a sixteen-hour labor. I was not allowing others to help me care for my baby, which in turn contributed to the swift deterioration of my mental health.

It was only the third time in my life that I had felt full-blown mania, and now having been there four times I can easily say that it’s like an out-of-body experience. You have the strangest thoughts, such as the time I believed every song that came on the radio was a sign specifically meant for me and my life. Sleep and food became things I needed very little of to function, my energy level soaring through the roof. I felt invincible.

Until everything fell apart and I spent the fourth week of my son’s life in a psychiatric ward of our local hospital suffering from postpartum psychosis.

I’m very lucky in that I respond well (and fast) to medication, and so I was back at home before I knew it, returned to my precious baby who had no idea I had gone away. My recovery was slow and steady, and within a few months I felt like myself again, and was settling into my new role as a first-time mom.

These days I am so glad that Postpartum Progress is a community of women who share their experiences. I know there are people out there who have read these stories and who have become more educated about postpartum mood disorders (PPD, postpartum anxiety, postpartum psychosis, postpartum OCD, postpartum PTSD) from visiting the site. By sharing to educate and to inspire, we can prevent or minimize the occurrence of postpartum mood disorder hospitalizations by catching the symptoms early. Keeping more mamas and babies together by sharing one story at a time.

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Postpartum Psychosis Doesn’t Equal Failing as a Mom

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A few days ago, I walked into the grocery store holding hands with my three and five-year-olds. The delicate scent of baby powder overwhelmed my nostrils the second we stepped into the diaper-filled walkway of the baby aisle for pull-ups. Immediately and without warning, my memories drifted back to my first postpartum experience. A fresh pack of Pampers always does it.

In September of 2008, I was eagerly awaiting the impending arrival of our first child. I thought we had prepared for everything – nursery, diapers, clothes, breastfeeding supplies – we were ready. I had even read up on postpartum depression. I thought I might be more susceptible to the illness since my mom had a touch of the baby blues after my brother was born and I had been diagnosed with bipolar disorder two years before becoming pregnant. Little did I know it would be the complete opposite end of the spectrum that would grab ahold of my mind the day after our son was born.

I ended up having a C-section because my progress stalled after the epidural and the baby’s heartrate was becoming deeply affected by the contractions. My OB made the quick decision to do the surgery and get him out, to be safe.

It was scary, but over quickly and seeing my son for the first time was a dream come true. I was shivering uncontrollably from the epidural meds, but gave him a kiss and stared at him for a good ten minutes while a nurse took pictures for us and then whisked him off to the nursery. I was wheeled into Recovery for a few hours where I called our friends and family with the good news. The mania hadn’t set in yet, but by this time it was 1am and I had been in labor since 5:30am the day before. By the time I got settled into my room and my son was brought to me so we could try nursing, I had been up for a full twenty-four hours and I was yearning for rest.

But at the same time, I couldn’t take my eyes of my baby boy. This little life grew inside of me for nine months and I finally had the chance to hold him and feel his teeny fingers in mine. I was awestruck by what had just happened, and sleep was the last thing I wanted to do in that moment. I wanted to get to know my baby. I tried nursing him, and we did some skin-to-skin, but by that point I was dizzy with exhaustion. My best friend who is a labor and delivery nurse and who had been with us the entire time, urged us to send him to the nursery so I could try to sleep. I took her advice the entire time we were in the hospital, but with the hourly checks on my vitals, there was no way to get any real rest.

I had been medication-free during my entire pregnancy and planned to stay med-free so that I could breastfeed him. We were sent home after three days in the hospital, and even though I had felt the onset of mania while we were there, I didn’t dare tell anyone because I didn’t want to fail at my first attempt at being a mom to my son.

We arrived home and after the initial wave of exhaustion had passed the morning after he was born, it became fuel for the fire of the vicious escalation of my symptoms. I remember being so anxious about my milk coming in that I would wake up from short stints of sleep covered in burning hot, puffy red hives all over my legs and mid-section. The baby’s schedule made sleeping long stretches impossible, so my sleep deficit grew with no end in sight.

I wasn’t willing to let anyone take over night feedings and my symptoms kept getting worse. From the intensity of my anxiety over not being able to provide my baby’s nourishment, to my sudden sense that I could be supermom and extremely productive on barely any sleep, to auditory hallucinations which eventually were what tipped off my husband and parents that I needed to go to the hospital. I was admitted on October 22nd for Postpartum Psychosis.

Being taken from my four-week old son two days after he was baptized was one of the most grueling events of my life. Nothing can bring back that week we lost. I saw him grow and change so much in one short week via photos my family brought me in the hospital. It broke my heart to be away from my newborn.

But believe it or not, looking back now I can appreciate what we went through. I have embraced my past because it has brought me here. My hope is that sharing my story will help educate people so they can understand that postpartum mood disorders are brain illnesses are like any other illness that can affect the body. We can treat them and we can recover from them. And we will emerge stronger because of them.

No one should ever be afraid of admitting and asking for help. Help starts here. You are not alone.

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Why She Kept Quiet About Her Postpartum Psychosis Symptoms

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JessicaI’m so happy to welcome Warrior Mom Jessica Torres today, sharing her story of postpartum psychosis.

I gave birth to a beautiful boy that ended up in the NICU. Devastated, I knew immediately it was my fault. I could barely touch him – he was so scary and tiny to me. Fast forward two weeks later and he was finally home.

Everyone was happy, and I do mean everyone. The house was full of well-wishers the day after he came home. I couldn’t help but think: How dare they come to my house during flu season? Didn’t they know they had the potential to kill my son? HE was gonna die right here because of their selfish stupidity! My husband was just as anxious so I shrugged off these scary thoughts. I was a new mom, right? It’s normal to think people are gonna kill your son, right?

A couple of months later, we moved into a new apartment. Scarier thoughts started to come. I won’t share them – but trust me I knew I needed help. I talked with a doctor. She told me not to worry. She explained, “Postpartum depression is when you can’t stand to be around your family.”  She said I was just tired. I didn’t believe her, so I kept asking until I heard: “You can’t get postpartum depression after your child is six weeks old.”

So, my family and I needlessly suffered as I went through hell undiagnosed, despite me crying out for help. Then – we found out I was pregnant with my daughter. I went through such severe antenatal depression and anxiety that I can tell you I don’t remember much of the pregnancy. Just feeling that I had the worst life in the world – and at times wanting to end it. But like a good Christian girl, I just prayed it away. It was just the enemy attacking me – how little did I realize it was so much more than that.

Then my daughter was born. The paranoid thoughts came as soon as she did: My husband loves this little girl more than me and this perv is gonna use her to replace me. That’s why he got me pregnant again so soon. He KNEW I was gonna have a girl and he wanted to replace me. But I shrugged them off like I always do; I mean, I did just give birth after all. I figured I was tired and loopy with hormones so I pushed on with praying.

One day at home, I went to change the baby and my son. I clearly heard my front door open and close twice. I grumbled that my husband just left me alone with the kids, but at that moment he walked out of the bathroom. I freaked out and told him what had happened – clearly the family of drug lords that lived downstairs came to case us out. “We need to protect ourselves,” I told him. He tried to convince me that I just was dreaming what I’d heard because of how sleep deprived I was. I didn’t believe him; I knew the neighbors were out to get us. TiIl the day we moved out, every time I passed by the family that I had been convinced entered our house illegally I held my babies tighter.

There was also another issue. Ever since my daughter entered the house, I felt nothing towards her, towards my son or my husband. Nothing. Often times I equated myself to a robot or a slave in my mind and I wanted to escape. I even had a plan.

I hated that empty feeling, I mean I loved them – would die for them. In fact I was planning on it if the drug lords came into the house while we were there; but really in essence I felt numb. I resented the fact that I had to take care of my daughter. She was just such a hard baby to take care of. She wouldn’t cry, she would scream. She would scream any time and all the time unless she was held – shoot, even then.

Then there was that night. I just could not get to sleep. For the first five months of her life I think I slept all of four hours a week. I tried to but I could not sleep. Anyways, that night came. I manhandled her and had a crazy thought … I can’t go on from there and tell you what I was thinking. I just remember sitting down on my bed and crying.

That next day I went to the OB. She told me that I had PPD with major anxiety disorder. Little did she know of the other thoughts that I had – the suspicious thoughts, not trusting the neighbors, the fact that I felt like I was going crazy and hearing things constantly. So I stayed quiet. I didn’t want her to think I was crazy and take my kids away.  I found Katherine Stone and Postpartum Progress; Lauren Hale and #PPDchat and began to get the information I needed. It took me months, but finally after some weird symptoms and convincing myself I needed help I finally saw a doctor who diagnosed me as bipolar and I began healing.

Please open up – get the help you need. Talk to someone, if you know something is not right with you – keep searching for a doctor who will listen. Postpartum depression and postpartum psychosis are very treatable diseases. You do not need to suffer needlessly like I did.

Ask for help.

~ Jessica Torres

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