BabyCenter Finds PPD Moms Don’t Seek Help Due To Guilt & Shame

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BABYCENTERBabyCenter®, the number one pregnancy and parenting digital resource, recently asked 1,400 moms about their experience with postpartum depression and found that 40% said they didn’t seek medical help for their illness. Their reasons for avoiding reaching out for help included feeling like they should or did have the strength to get over the feelings without a doctor’s help (30 percent), believing their symptoms weren’t serious enough (25 percent), or feeling too much embarrassment (24 percent) and guilt (23 percent).

 “This study revealed serious findings that need to be addressed,” says Linda Murray, BabyCenter Global Editor in Chief. “Depression is dangerous for women and their babies, and untreated depression can become worse and lead to other complications. Depression affects people from all walks of life, but new moms are particularly susceptible given the stress of becoming a parent, lack of sleep, and hormonal changes. We want moms to understand that seeking help for PPD isn’t something to be embarrassed or ashamed about; in fact, it’s one of the most important things they can do for the well-being of their babies.”

Postpartum Progress is thrilled that BabyCenter put its resources behind taking a deeper look at postpartum depression and how it affects women. It’s so important to understand the barriers that prevent moms from seeking treatment to get the help they need. It stands out to me that the results of the survey found in particular that women felt they should be able to get over PPD themselves or that their symptoms weren’t serious enough to need professional help — those are beliefs we can effectively change by raising awareness about this illness and how it can affect both mom and baby when untreated.

In response to the findings of their study and to lend support to the cause of maternal mental health, BabyCenter is now graciously allowing me to blog regularly on their site to shed additional light on PPD and remind new and expecting moms that there is no shame in feelings of anxiety or depression. If you are experiencing PPD, please know that getting treated as soon as possible is important. Please go check out my very first post on BabyCenter: Asking for Help for PPD: Failure or Fierceness?

“I can’t stress enough that PPD is treatable, but only if moms ask for help,” says psychologist Susan Bartell. “It can be hard, but moms don’t need to be afraid to seek support during this difficult time. And it’s important for moms to remember that help comes in many forms ranging from friends who simply fold your laundry to therapy.”

About BabyCenter

BabyCenter® is the voice of the 21st Century Mom® and modern motherhood. It’s the number one pregnancy and parenting digital destination worldwide, reaching more than 40 million moms monthly in 11 languages across 14 owned and operated properties from Australia to India to China. In the United States, 7 in 10 babies born last year were BabyCenter babies. BabyCenter is the world’s partner in parenting, providing moms everywhere with trusted advice from hundreds of experts around the globe, friendship with other moms like them, and support that’s remarkably right at every stage of their child’s development. BabyCenter is a member of the Johnson & Johnson family of companies.

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Misdiagnosis and Missed Diagnosis: Part 2

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Trigger Warning: This is part 2 of a 2 part story (part 1 can be read here) of my misdiagnosis and missed diagnosis after giving birth in 2009. This post contains some references and details about Postpartum OCD, Intrusive Thoughts, miscarriage, and D&C. If you are feeling particularly vulnerable and prone to triggers, you may want to avoid this post until a later time. 

After I was discharged from my second hospitalization, I still hadn’t been able to get in to see the psychiatrist and ended up at the ER because I was out of Lexapro and had no more refills. Since TriCare doesn’t cover Lexapro on the formulary, I was switched to Celexa (the generic version) and told to keep trying to find a doctor who could see me. I called various doctors and they either weren’t accepting new patients, didn’t have any openings, or in one case, “Refused to take me on” and wouldn’t explain why. Let me tell you, this didn’t make me feel any better.

I went in to see my PCP (Primary Care Physician) to get my Celexa refilled and while I was there, he ordered a lab test to have my thyroid levels checked. I never heard anything back so when I returned to get another refill ordered, I asked the nurse about the results. She looked it up and said “Oh yes, it’s abnormal, he’ll need to talk to you about that”. When the doctor came in, I asked him about it and he said “We’ll take a look at that after we get your meds taken care of”. He never looked at my lab results and left without saying anything.

At the end of November, the day after Thanksgiving, my husband, daughter, and myself were in a car wreck. I was driving and we rearended another vehicle. I had a nasty case of whiplash and a concussion, my husband broke his ankle, and our daughter’s car seat did it’s job and she wasn’t even sore. I was given a small amount of painkillers to help with the whiplash, but the whiplash persisted past the medication. I went back to the medical clinic and saw a different doctor. While I was there, I mentioned the thyroid labs that had been done and that I was curious to know what the results were. She took a look and hit the roof, saying that my thyroid results were WAY outside normal limits. She wanted to do a re-test since it had been months since the last test, so she put in a lab to recheck my thyroid levels and put a rush on it, promising to call me back to let me know what the results were.

In less than 24 hours, I got a call back from her nurse telling me that I definitely had hypothyroidism and could I come in that day to see the doctor so she could talk to me about the condition and get me started on medication, and let me know how it would all be handled moving forwards. I was at the hospital with my husband in surgery having his ankle repaired, so I had to wait a couple of days but they got me in ASAP. The numbers on my lab results were extremely bad and I’m surprised my symptoms weren’t worse. I promptly switched doctors so that this “new” doctor was my primary and I refused to ever see the other doctor again. In hindsight, I should have filed ICE Complaints on both him and the Nurse Practitioner who ignored my Edinburgh Scale at my 6 week postpartum check up, but hindsight is 20-20 and all that.

The new doctor informed me that hypothyroidism can be caused by pregnancy. It often clears up, but in some cases it just sticks around. I was started on the lowest dose of Levothyroxine, 25 mcg, and had my thyroid levels checked again in a week or two. The repeat lab showed that my thyroid levels were improving but I needed a slightly higher dose so I was bumped up to taking 50 mcg of the Levothyroxine, and that turned out to be my magic dose. After 3 months of Levothyroxine, my PPMD symptoms were totally cleared up and I was able to wean off of the Celexa, Ativan, and Ambien. I had finally found a therapist to see, and she had me come in a little more often until we were sure that I wasn’t going to have a recurrence of symptoms but soon I was able to stop seeing her as well.

It’s been 4 ½ years since my hypothyroidism was diagnosed and 50 mcg of Levothyroxine has managed my condition ever since. Normal protocol is to have my thyroid levels checked once a year, but when I’m pregnant my levels are checked once each trimester. Even with the pregnancies, the same dose of Levothyroxine has done me right and I haven’t had the same issues, even through 3 pregnancies, one of which was as a Gestational Surrogate and ended at 12 weeks with a D&C for a missed miscarriage.

There are several morals to my story. One is that we desperately need better availability of mental health care, both inpatient and outpatient. I should not have had as much trouble finding a doctor and therapist to see me as I did, nor should I have needed to wait for a month or longer to have an intake appointment after inpatient treatment. The second moral of the story is that medical professionals need to have better training on the difference between suicidal/homicidal ideations and intrusive thoughts and between the various forms of PPMD. Screening on intake (including arrival at the ER) should include noting the differences. There also needs to be better availability of treatment options for postpartum mothers. Being put in a general hospital wing wasn’t that helpful. People who are recovering from substance abuse and addiction aren’t going through the same thing and we just weren’t able to really understand or offer much helpful advice to each other because the situations are so totally different.

The biggest lesson in this story is to be your own advocate. Don’t let medical professionals shirk on their jobs, don’t let them overlook symptoms and cries for help, definitely don’t let them leave an appointment without going over your lab results. Don’t let them rush off without giving you the attention and help that you need. This is not “causing trouble”, this is asking them to do their job. You are your own best advocate.

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Misdiagnosis and Missed Diagnosis: Part 1

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Trigger Warning: This is part 1 of a 2 part story of my misdiagnosis and missed diagnosis after giving birth in 2009. This post contains some references and details about Postpartum OCD and Intrusive Thoughts. If you are feeling particularly vulnerable and prone to triggers, you may want to avoid this post until a later time. 

In July of 2009, 3 months after having my first baby, I finally admitted that all was not well in my world. For 3 months, I had been falling deeper and deeper into a spiral of awful. Sometimes I felt indescribably angry. Sometimes I felt a deep sense of sadness and despair and would just cry and cry and cry, or maybe I’d be about to get out of the car in the parking lot at the store and suddenly burst into tears and not even know why. Sometimes I felt completely numb; I would just sit in my rocking chair holding my beautiful little girl, staring off into space, not really thinking or feeling anything at all other than blankness and emptiness. The worst of all was pictures and thoughts that flashed unbidden into my mind. Thoughts and pictures of dropping or throwing my daughter down the stairs. It terrified me and I would actually cancel appointments if I was upstairs because I didn’t want to carry my child on or near the stairs and those pictures and thoughts become reality. As soon as they entered my mind I would chase them away and hug my baby a little closer and pray “God, what’s happening? Please forgive me and make this go away”. I had no idea what was wrong with me.

At my 6 week Postpartum check up at the Wilford Hall Medical Center OB/GYN clinic, I filled out the  Edinburgh Postnatal Depression Scale questionnaire that I was handed. My answers clearly indicated that I needed further screening but the Nurse Practitioner who saw me just put it to the side without saying anything and never really asked how I was feeling, so I figured that what I was experiencing must be normal (news flash: it wasn’t). Things kept getting worse until eventually, one night in July, I found myself standing at the top of the stairs while everyone else was asleep thinking that everyone else would be so much better off without me if I threw myself down the stairs. I walked away and started to go to bed and then thought that it would be easy to take a massive amount of the painkillers my husband had left over from ankle surgery and just go to sleep and not wake up. I called the chaplain and he met me at the Emergency Room.

I was diagnosed with Postpartum Depression and transferred to a psychiatric facility in San Antonio, since WHMC (the military hospital on Lackland Air Force Base) only admitted service members for inpatient treatment of mental health issues, dependents automatically got referred out. I was breastfeeding my baby and didn’t want to have to stop, so we tried going the medication-free route first with talk therapy, both individual and group. We quickly realized that it wasn’t making enough of a difference, so on to medication it was.

During this time, one of the biggest questions asked of me was “Do you have thoughts of harming or killing yourself or others?”. I answered yes. Partly because I had found myself on the brink of attempting to commit suicide, but also partly because of the thoughts I had been experiencing. I later found out that the thoughts and images that shoved their way uninvited into my mind were Intrusive Thoughts, one of the classic and tell-tale symptoms of Postpartum Obsessive-Compulsive Disorder. I didn’t know, at the time, that there was a difference between suicidal/homicidal ideations and intrusive thoughts, or that there was a whole spectrum of Postpartum Mod and Anxiety Disorders, I thought it was just all part of Postpartum Depression. Unfortunately, it seems that none of the staff caring for me at either of the hospitals knew this either, and I was diagnosed as simply Postpartum Depression. This is one of the things that I eventually hope to see changed: to see better education for medical professionals making them aware of the differences between types of symptoms and the various PPMD.

It only took a few days after starting medication (Lexapro) before I started to feel better. Before starting medication, my mom and my husband had come to visit me at the hospital and when my daughter started to cry, it was a noticeable trigger. My mom and husband had to keep the baby up front and switch off who had her and who was visiting with me. After starting meds, I was able to cope better when she started to fuss, I started to open up a little in therapy instead of sitting huddled up in the corner unable to speak without crying. After a little over a week in the hospital, I was sent home with prescriptions for Lexapro to manage my symptoms on a daily basis, Ativan for sudden anxiety attacks, and Ambien to help me sleep at night. I was also given an appointment to see a psychiatrist outside of the hospital.

When I went to my first appointment it was a total disaster. I ended up having to reschedule after I had been there for a couple of hours and still not been seen, because I had to get home since my babysitter had to leave. They weren’t able to reschedule me for another month or so out. I ended up back in the hospital a month after being discharged due to a recurrence of my symptoms (again, the intrusive thoughts that I didn’t know much about and didn’t know how to manage), and had my medication dosage adjusted. Thankfully, I only had to stay for about a week again and was able to go back home.

To be continued tomorrow…

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When Everything Is Unexpected: From Natural Birth Plan to C-Section

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RaivonToday I’m happy to welcome Raivon Lee from Climb Out Team Atlanta to the Warrior Mom community and share her story with you. Raivon wanted a natural birth at home, but the stress of a breech baby and C-section were the start of her experience with postpartum depression and anxiety.

Hi, my name is Raivon and I’m a 28-year-old mom of a sweet 15-month-old boy.

Back in April of 2012 when I found out I was pregnant, I was literally shocked! I couldn’t even say the words to my husband so I typed out the words “I am pregnant” on the notepad on my phone during church and showed it to him. I eventually got used to the idea of being a mommy and I was very excited. I knew I wanted a natural water birth at home and submerged myself in everything about natural birth. Books, classes, forums, groups, etc. A few weeks into my pregnancy the morning sickness hit. It was rough but I was sure it would be over by the 2nd trimester. After all that’s what EVERYONE told me.

Unfortunately for me I had morning sickness and took medication for it until the day Ari was born. My idea of an awesome, healthy pregnancy, and long jogs through the park were replaced with the reality of me struggling to make it off the sofa just to brush my teeth.

During the last month of my pregnancy, I went in for an ultrasound to make sure that everything was a go and safe for my home birth. We found out then that Ari was breech. This devastated me. I did NOT want to give birth in the hospital. Being a nurse made me scared of  hospitals (crazy, I know), and it just wasn’t in my plan. My midwife and back-up OB thought I could possibly still give birth vaginally depending on the type of breech positioning of the baby at the time I went into labor, but a home birth was out of the question.

My husband and I did everything we could to get the baby to turn. Chiropractic adjustments, moxibustion, inversions on the ironing board, cold packs, flash lights and last but not least … external extroversion. This was the most painful experience I think I’ve ever had. Imagine two grown men trying to turn a baby by pushing and twisting your stomach.

We did all of this and by the time my water broke, Ari was still breech.

I was admitted to the hospital and a few hours later after crazy painful contractions, I had a C-section and my sweet baby boy was born. I was actually ok with the c-section and my birth experience, even though it was the complete opposite of what we wanted.

Fast forward a week. I was home crying in pain. No one told me that breastfeeding and engorgement would be so very painful. The scabs on my nipples made it impossible to nurse, and I was so engorged that even when I tried to nurse Ari could not latch on. The thought of possibly having to give Ari formula sent me over the edge. I felt that everything else I wanted for my pregnancy and birth had been taken away from me and breastfeeding was the only thing I was doing right. It was rough but we got through it and eventually breastfeeding got easier.

But still…

I was not sleeping, but I was exhausted. I wasn’t eating and I was crying daily, and I NEVER cry. I would just be sitting and tears would begin flowing from my eyes uncontrollably. I would look at picture of Ari and cry. I thought maybe it was just baby blues and that it was normal. It would go away. I was afraid for my husband to go to work. I didn’t want to be left alone, yet when he was home I didn’t want him to take care of or help with Ari. I HAD to be the one to care for him. My husband and I had many arguments about me letting him help. He wanted to help desperately but the thought of him helping caused me great anxiety. Yes, I was exhausted and I wanted to sleep but I couldn’t let even my husband help.

After four months of this I decided I needed help. My husband talked to my midwife (our home birth midwife) and she gave me a list of natural supplements to try. I did and I felt a little better, like the edge was taken off, but it didn’t last long. I eventually went into my OBs practice and the midwife there prescribed an antidepressant. I started it immediately and honesty I felt worse. I felt like I was outside of myself. I’m sure I was hearing things as well. After two days I stopped taking it. And I suffered three more long months.

During those months, I spent the day at home alone with Ari, not eating, not showering and crying. I was so tired (Ari wasn’t the best sleeper). I thought to myself, “If I die I could finally get some sleep.” The thought of death was so peaceful to me. I was on forums constantly trying to figure out what was wrong with my baby -why wasn’t he sleeping? What was wrong with me? What was I doing wrong? I would try to talk to others about how I was feeling but I feel like they down played the pain I was in.

My husband would come home and thanks to him I would eat. Then I would go into a dark room and try to sleep with Ari (because he couldn’t sleep or stay asleep on his own) I’d be in that room for 12 hours. This this was my life.

One night while crying, I just couldn’t take it anymore. I knew I had the prescription somewhere, and I was going to give them another try. I decided to start with half of the dose.

I am so happy and blessed to be able to say that taking those meds saved me! I was able to find a PPD support group that was an awesome help. Knowing that I wasn’t alone, that I wasn’t overreacting, and that postpartum depression and postpartum anxiety are very real and serious things, made me feel good, but honestly a little sad too. I needed to know that it was real and serious, and not just in my head. I think overall I was trying to downplay my issues.

Today I’m feeling great! I feel like Raivon again, maybe better. I often think of what it will be like to stop taking my meds. Sometimes I feel like a fraud, like the person I am now isn’t really me. But until then I’m going to try to enjoy each and every day I’ve been given.

Raivon

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