A special series on African-American, Asian-American and Latin-American women with postpartum depression.

Warrior Mom Conference Re-cap

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This past weekend, over 100 Warrior Moms from around the world gathered in Boston for the first ever patient-centered conference on perinatal mood and anxiety disorders. To call it a success would be a massive understatement. We didn’t want it to end.

Postpartum Progress’ #WarriorMomCon was ground-breaking and centered on connection, education, support, and healing. Women who had once struggled with being able to simply get out of bed came together with fiery, sparkly, joyous passion. We were united in our intense desire to collectively raise our voices. Being there this weekend was our way of telling the world that perinatal mental health issues are REAL and we want to do our part to raise awareness in our communities.

Warrior Moms gather at the Lenox Hotel before the start of the conference

An informal gathering on Friday evening was the start of all the excitement, as Warrior Moms began arriving in Boston. We introduced ourselves, hugged, and the conversations started flowing. You could feel the buzz of fierce energy in the air.

Katherine Stone opens #WarriorMomCon

Katherine Stone opens #WarriorMomCon

On Saturday morning, the conference got underway. Founder and Warrior-Mom-In-Chief, Katherine Stone, kicked us off with an inspiring keynote emphasizing how Postpartum Progress exists because of the dedication and drive of her tribe, Warrior Moms all over the world. She stressed that she may have founded Postpartum Progress, but it wouldn’t be the powerhouse life-changing non-profit organization that it is today without our commitment to the mission of increasing maternal mental illness awareness and providing peer support.

The first panel entitled Educate & Empower: Panel and Moderated Discussion on Perinatal Mood & Anxiety Disorders was filled with eye-opening information on just how many women are affected each year by postpartum depression and anxiety disorders, and how the term “postpartum” isn’t even completely accurate given that 60% of these conditions occur during the “antepartum” period – or during pregnancy.

from left to right: Dr. Ruta Nonacs, Mara Acel-Green, Peggy Kaufman, and Dr. Lekeisha Sumner

Take-aways during the first session:

  • Dr. Ruta Nonacs, Psychiatrist, Massachusetts General Hospital, Harvard Medical School: “PPD is preventable if we can identify the women who are at the greatest risk.”
  • Mara Acel-Green, Founder, Strong Roots Counseling: “Postpartum Depression can happen even when a child is adopted. PPD occurs in approximately 20-25% of adoptive moms.”
  • Dr. Lekeisha Sumner, Clinical Psychologist quoted Maya Angelou: “As soon as the healing takes place, go out and heal.”
  • Peggy Kaufman, Director of The Center for Early Relationship Support at Jewish Family & Children’s Service: “Say the word JOY. It’s very powerful.”

We broke for lunch into small groups, and then met back up for an afternoon full of inspiring knowledge sharing.

Kate Kripke, LCSW presents

Kate Kripke, LCSW presents

 

During her “Thriving After PMAD” session, Kate Kripke, LCSW, Founder, Postpartum Wellness Center of Boulder shared tips and exercises for thriving after a postpartum mood disorder. My favorite quote from Kate’s beautiful session: “Give yourself permission to love yourself.”

 

 

 

Divya Kumar presents on privilege

Divya Kumar presents on privilege

Our final speaker of the day was Divya Kumar, Sc.M., CLC, PPD, Southern Jamaica Plain Health Center. Divya’s presentation focused on teaching us how to reach underserved moms and families in our local communities and how privilege can limit our perspectives and advocacy. My biggest lesson learned: “Don’t make assumptions. Be conscious of privilege.”

We finished up the day with Self-Care workshops where we learned the importance of self-care and how there are endless options for taking time to pamper yourself. Adult coloring books, knitting/crocheting, massage, yoga/pilates/meditation, walking, talking with friends – online via Twitter chats and other social media or in-person, and the list goes on.

Warrior Mom self-care: adult coloring!

Warrior Mom self-care: adult coloring!

The evening ended on a high note: the Warrior Mom Celebration Dinner. It was spectacular.

Instagram photo by @jzb2

Instagram photo by @jzb2

Day 2 started with a panel discussion around “Raising Awareness Online” moderated by Katherine Stone and featuring Jill Krause of Baby Rabies, Morgan Shanahan of the818.com, both leading professional bloggers who have written openly and honestly about their experiences with postpartum mood disorders. They were joined by Jennifer Labit, the founder of Cotton Babies, the official sponsor of the Warrior Mom Conference. It was an empowering and engaging session on how to amplify your impact online.

from left to right: Morgan Shanahan, Jill Krause, Jenn Labit, Katherine Stone

The conference wrapped up with a final session presented by MotherWoman’s passionate Founder Annette Cycon and Program Director, Liz Friedman. After sharing their own experiences with perinatal mood and anxiety disorders, Annette and Liz led the group in a guided meditation followed by their support group guidelines. We then broke into small sharing circles where were were able to share our own stories and experience peer-to-peer support and healing.

Instagram photo by @danielle.nelson

Instagram photo by @danielle.nelson

Seven years ago I experienced postpartum psychosis after my first child was born, and five years ago I suffered from antenatal psychosis during my second pregnancy. Those were some of the most isolating and terrifying times of my life. I found Postpartum Progress after I had begun my recovery journey, and I am eternally grateful the blog existed when I stumbled across it. If I wouldn’t have had maternal mental illness, I may never have found Katherine Stone & Postpartum Progress, and might not have met this incredible community. My Warrior Mom friendships are the gift of light born out of my darkest moments and I will treasure them always.

One in seven women will experience a postpartum mental illness {postpartum/antepartum depression, anxiety, ocd, psychosis}. Chances are, if you haven’t gone through it yourself, someone close to you has or will in the future. Postpartum Progress is here to help, every step of the way. Share this video and it’s message. We can conquer postpartum mental health disorders together. We are warrior moms.

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Mommy Shoes – Parenting While Recovering From PPD

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Please welcome Mirjam Rose to Postpartum Progress today, as she shares her experience of parenting while recovering from PPD.

Mirjam is an elementary school teacher and blogger who lives in the Netherlands with her husband and three children. She has battled and survived 3 postpartum depressions. You can find Mirjam at her blog Apples and Roses, where she blogs about her ongoing battle with depression and finding beauty in the simplest of things. Mirjam is a contributor for World Moms Blog and can also be found on Twitter.


Mommy Shoes

It has been nearly two years since I asked for help.

Motherhood and life felt like too much of a burden for me. After years of thinking that the problem was me, it finally dawned on me that there might be something wrong. I started therapy and found out that I had suffered from postpartum depression. Not once but three times. I also found out that the feelings I struggled with in my early teens, were not just regular teen struggles. I found out that it was also depression that I had struggled with.

These past two years have been the most intense years of my life. I have experienced tremendous growth. I have opened new doors and have closed old doors behind me.

People talk about therapy lightly. They think therapy is nothing more than paying someone to listen and to give you advice. Therapy is no such thing. Therapy is facing yourself. Therapy is opening doors and looking into the dark corners of your soul. It is work. Hard work that sometimes leaves you exhausted. Being as courageous as walking into a lion’s den unarmed. Vulnerable. It is raw naked honesty and perseverance. Going down a steep, rocky and sometimes dark road, without knowing when you will reach the end of it. It’s knowing that you can decide to leave that road at any moment, yet not giving in to that thought. Because you want to get well.

For the past two years I have been going down this road. To say it has been a roller coaster ride, is to take a devastating hurricane and to call it a warm summer’s breeze. The hardest part? Being a mother at the same time.

There is no time off. No time to lick my wounds or to take a break. When I come out of therapy, I need to step quickly into my mommy shoes. Some days I come out of therapy feeling empowered. I stand tall and firm and switch roles like a pro. Other days I feel delivered, freed from a burden that has been carried for way too long. Those are the days that my mommy shoes feel like dancing shoes. Then there are days that I am exhausted from the hard work and I feel empty with little left to give. On those days my Mommy shoes are put on reluctantly.

Some days the carefully constructed bandages around my heart are ripped from their place and old wounds are exposed. My heart breaks and scatters into a thousand pieces. An hour passes as I work through the pain.  When the clock strikes reality, I hastily gather the pieces and put them back into place as best I can. I wear my mommy shoes, and though it is I that longs to be nurtured, it is I that gives the loving smile; it is I that spreads my arms in welcome;  I that carries and I that offers warmth and shelter.

On such days my feet struggle to find solid ground underneath my shoes. When my child reaches for me, my grasp is firm. And as I hold her little warm hand softly in mine, the ground underneath my feet gradually feels stable again.

 

This post was first featured on World Moms Blog, March 2014.  Shared with permission.

Photo credit: Mirjam Rose

 

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How Women of Color Can Manage The Impact of Acculturative Stress and Discrimination During Pregnancy

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dr sumner acculturative stress and discrimination during pregnancyToday I’m thrilled to have Dr. Lekeisha Sumner with us to share insight on two very common types of stress women of color may experience during pregnancy and tips on how we can manage both. Dr. Lekeisha Sumner, PhD, ABPP is a board-certified clinical psychologist with specialization in both clinical psychology and medical psychology. She is currently an Associate Professor in the Department of Psychology at Alliant International University and Assistant Clinical Professor in the Department of Psychiatry & Biobehavioral Sciences at UCLA. A frequent commentator on psychological science, she has written extensively on trauma and the intersection of culture and gender in health and well-being. Dr. Sumner maintains an independent practice in West Los Angeles where she was recently commissioned by the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment to serve on the Strategies for Improving Outcomes for Peripartum Women committee.

With so many changes in one’s body, daily routine, and responsibilities, it’s typical for many women to feel overwhelmed at times both during pregnancy and after the birth of baby. And yet, for some women, these feelings can be compounded by stressful experiences related to their cultural backgrounds or ethnicities, which increases their vulnerability for emotional distress.

Take for example, Olivia, a bright and compassionate 28-year old woman who was in the second trimester of her first pregnancy when we met. She had moved to the United States several years ago from her native country and was elated to finally have the opportunity to be with the man of her dreams and start a family. Her husband, a US native, was supportive of her adjustment to life in a new country and particularly attentive to her needs during pregnancy. She was especially grateful for the comfort he provided now that she lived without her extended family.

Despite all the wonderful changes that were happening in her life, Olivia felt chronically overwhelmed and was stunned by the recent discovery that she had developed hypertension during her pregnancy. She had already unsuccessfully tried the home remedies her mother suggested which included taking a walk around the block and listening to relaxing music. But, at the urging of her husband who observed her increasingly distressed mood, she decided to enter psychotherapy.

Olivia began experiencing stress on her job long before she became pregnant but things only intensified once she disclosed her pregnancy to her boss. Since that time, she began to experience difficulty sleeping, little appetite, constant worrying, and difficulty concentrating and had even begun to grind her teeth during sleep. Given the severity of the symptoms, Olivia was concerned that they would negatively impact her pregnancy. As she began to delve into the underlying sources of her stressors and the contexts in which they occurred, it became clear that many of the experiences she described are common among women from some ethnic and cultural groups (especially women of color, refugees, immigrants, etc.) yet rarely discussed: acculturative stress and discrimination.

Acculturative stress typically refers to the emotional strain of having to alter one’s cultural attitudes, beliefs or behaviors to adapt to and navigate a distinctly different culture. For Olivia, acculturative stress presented as the strong social pressure she felt to quickly learn English and lose the accent of her native language. She also experienced discrimination on her job as her boss would often humiliate her by making snide comments about immigrants within earshot. He would keep constant tabs on her, would make embarrassing “jokes” about people of color and her accent, and routinely give her lower performance evaluations than her colleagues even though her productivity was equal too or greater than theirs. After disclosing her pregnancy, these incidents worsened. Although working in a hostile climate resulted in her having performance anxiety, ruminative thoughts and nightmares, she was too intimidated to report this behavior to human resources and believed she would have been labeled as being “too sensitive,” “playing the race card” and perhaps worse, risk further alienation and stigmatization.

Over a period of time, intense and chronic stressors like the ones Olivia experienced can wear on a person and leave them feeling emotionally drained and depleted. The stress brought on by discrimination and acculturative strain during pregnancy can quickly erode one of the most sacred and enjoyable periods of a woman’s life and render women at risk for symptoms of depression and anxiety, and poorer lifestyle choices (e.g. eating habits, nicotine use) as they attempt to cope. For some groups, these stressors may alter the release of bodily hormones that may affect the outcomes of pregnancy. For example, African American women across the economic and educational strata have the highest rates of preterm birth in the United States. Studies confirm that these findings are in part due to the high levels of chronic stress and ethnic discrimination they are exposed to throughout the lifespan. While research shows that these stressors do not affect everyone or every group of pregnant women exactly the same, they can certainly diminish mood mood, energy, and confidence in caring for baby.

There are some ways to help lessen the impact of acculturative stress and discrimination. For instance, women who use healthy coping strategies (e.g meditation, walking, journaling, asking for help), those with a strong belief in their ability to overcome obstacles and those who have pride in and a connection with their cultural heritage and cultural values all seem to have better emotional responses in the face of these types of stressors than those without. Also, women who feel a sense of belonging and receive support from their partners throughout pregnancy and post-partum also tend to respond better. For Olivia, getting involved in an on-line support group, a local church that appreciated congregants from diverse backgrounds and engaging in psychotherapy were all beneficial in helping to restore her well-being and equipping her to improve her ability to cope.

For all women, the pregnancy experience is shaped not only by biology but also by psychological and cultural influences. While you may be limited in eradicating all stressors during pregnancy, given the suffering that severe culture-specific stress during pregnancy can cause for you and baby, it’s a good idea to discuss with your doctor as soon as possible any concerns in your life.   You will also want to monitor your stress levels not only during pregnancy but also in the many months after your bundle of joy is delivered. Taking a few extra steps can help you better prepare to be the best warrior mom you can be.

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3 Ways We Can Improve Maternal Mental Health Care For Women of Color

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women of color Earlier this week, I shared my growing concern with women of color and their maternal mental health being underserved by professionals and those in the mental health advocacy space. (Note: “Women of color” refers to women who are not considered to be Caucasian: Hispanic/Latina, Black or African-American, Asian/Pacific Islander, Native American, Indian, of biracial heritage, etc) Today, I’d like to offer just a few ways in which I think we can improve our efforts, and make maternal mental health advocacy more inclusive of mothers of color, our experiences, and our needs.

Believe Us

I mentioned in my earlier post that many of the women I’ve spoken with expressed frustration and dismay that they were not taken seriously when they told their doctor, social worker, pastor, or a mental health professional that they were struggling. Their symptoms were minimized, their concerns and lack of awareness about what they were experiencing dismissed, and some even stated they were degraded by the professionals they reached out to. That’s unacceptable, and does more harm to women already suffering. One mother, who is African-American, described her experience to me as this:

“When I FINALLY went to a therapist, after my second child, I was dealing with PPD then. We began talking about my life (two kids under 3, stressful full time job, lack of support from significant other), and her response was to ask me if I was on birth control so I wouldn’t have any more kids.”

Her experience mirrors my own. After the birth of my second child, I knew something was wrong but couldn’t identify what. I was depressed and anxious and my moods were out of control. When I mentioned it to my OB at 8 weeks postpartum, he said I just needed more sleep. When I told him how out of control I felt, he wrote me a prescription for an anti-depressant, said I should discontinue it in a few weeks once I was feeling better, and told me to follow up with my primary care doctor. The medicine didn’t work. I was still a wreck. I went to my primary care doctor and she just told me that again, I was just tired. When I finally realized what I was experiencing was PPD and anxiety (thanks to Postpartum Progress’ Plain Mama English Guides), I called the NJ state PPD hotline. It took two days for a call back, and I was told that because I was on Medicaid, I’d have to see a social worker who was also a therapist from the state’s mental health program. At that appointment, I unloaded everything to him: my swinging moods, rage, intrusive thoughts, depression, fear. He asked me questions about my “living situation” and his next words I remember to this day:

“Well, you know, I mean what you’re experiencing isn’t postpartum depression or anxiety. You’re just experiencing the stress of being an unwed mother to two children who’s in a rocky relationship. Women like you…in your type of situation…in your culture, experience it, you know? Of course you’re stressed. You’re young, with an infant and toddler, going to school and working full-time…there are plenty of other Black women like you who face these kinds of daily challenges, you know what I mean? You just have to shoulder it and keep going the best you can. I think you’re going to be alright once you figure out how to manage it all.” 

Despite taking down my family and personal history where I detailed several things that placed me at risk for PPD (family history of mental illness, personal history of depression and anxiety, single, unexpected pregnancy, early childhood trauma, minimal support from family and friends), this therapist ignored all of it and said what I was experiencing was expected because of my cultural experience. This (White) man was not helpful nor was he culturally competent and a good match for my particular needs. I struggled to find adequate help for two more months.

Tell Us, Talk to Us, Become Culturally Competent

During my first and second pregnancies, I wasn’t screened for PPD or told anything about it, despite being at risk for developing it.  I didn’t even know PPD was A Thing. Other mothers of color have told me they’ve had similar experiences:

“I wish my doctor had told me anything. I had no information whatsoever.”

“When I had my daughter I was 20 and unwed (but my boyfriend was present). I got lectured from a social worker about my elevated risk for shaken baby syndrome. But no one asked about my mental health, either at discharge or at my follow up appointments.”

” I was upfront about my bipolar disorder with staff at the birth center. In the office, they even said, “You know you’re at increased risk for postpartum depression, right?” Then after the birth, the midwife attending just went about her business doing paperwork and asked me to sign to accept financial responsibility. Another midwife came in to check on me and asked me how I was feeling in front of family and friends. I was NOT about to say that I was having intrusive thoughts (I didn’t even know what to call it then). A lady who wasn’t a midwife (I think she was in billing) called to ask how I was doing. I broke down in tears on the phone. She called me weekly for several weeks. She gave me more care and concern postpartum than any of the midwives did.”

“She (my doctor) mentioned it, I just wish maybe she talked about it more in depth with me- signs/symptoms, etc.”

We need those in charge of our pregnancy and postpartum care to do a better job of informing us about what the signs and symptoms of postpartum mood disorders are. We need to be made aware of how they can manifest in our lives, and what places us at particular risk for occurrence. Providers need to become more culturally competent on how issues such as racial and gender discrimination, racial profiling and harassment, the high rate of domestic violence in our communities, our high rates for chronic illness, violence, poverty, and other sociopolitical aspects of our lives impact our mental health. Treatment plans then need to stem from an understanding that takes all of these factors into consideration.

Advocate for Better Access, Better Quality of Care, More Awareness

Reports have shown that there are disparities in mental health treatment, quality of care, and access to services when it comes to minority mental health, especially for women of color. Aside from cultural stigma, barriers to treatment include lack of insurance coverage post pregnancy, the costs of mental health services, and very little community resources in neighborhoods with significant minority populations. Educational literature and books on maternal mental health are hardly written with our experiences and needs in mind. Research on women of color and maternal mental health does exist but it is not extensive. Many awareness campaigns lack a multi-cultural focus, despite pregnant mothers of color facing significant and unique physical and mental health risks .

How can we do better? I’d like to see more literature featuring women of color distributed in doctors offices and where social services are located. It would alleviate a huge burden if mental health offices had childcare so we could safely leave our children in the care of others while we are seeing a therapist. We should create more spaces for mothers of color to gather and discuss their struggles and experiences with each other to gain support. More mental health professionals should offer reduced rates or at least accept Medicaid. There should be collaboration between cultural institutions our neighborhoods trust and national mental health organizations to raise awareness and eradicate cultural stigma on an ongoing basis. I’d like to see the expansion of Medicaid so more mothers can have comprehensive and longer coverage that enables them to access mental health services.

I think while some strides have been made, we still have much further to go to help women like myself. I’d like to see a more concentrated effort made in advocating for better care, easier access, and more awareness that empowers mothers of color. Doing so will help us give our families and ourselves the strong starts we deserve.

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