Los Angeles County Wins Award for Innovative Maternal Depression Project

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The National Association of Counties has awarded Los Angeles County a 2011 Achievement Award, given for innovative county government programs that modernize and streamline county governments and increase services to their citizens.

The county received the award for its Maternal Depression Improvement Project, a joint project of the Los Angeles County Public Health's Maternal, Child and Adolescent Program and the Public Defender's Office. Their collaboration has been a great example of public-private partnership, via the Los Angeles County Perinatal Mental Health Task Force, to help support women with perinatal mood and anxiety disorders. They've trained hundreds of local healthcare providers and built awareness via events, bilingual patient education materials, awareness campaigns and more.

I'm so happy that all of their hard work is being recognized in this way!

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Finding Balance Between Body, Mind & Social Network During Postpartum Depression

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Are you still there? Holding your own hand and looking your suffering in the eye, as we talked about in yesterday’s post on wishing away postpartum depression?

If so, then you are probably ready to add some of the “doing” parts into your recovery process. Yes, the “being” and “doing” is a tricky balance that needs to be considered all along the way. Sometimes you may need to allow yourself to slow down the pace and to acknowledge, once again, where you are and how you are feeling.

We know that perinatal mood and anxiety disorders like postpartum depression are a biopsychosocial challenge for women, meaning that they are most likely caused by disruptions or challenges in a woman’s biology (physiological system), psychology (emotional and psychological system), and social network (including friends, family, and community). Usually, finding wellness requires a look into all of these areas to see where there are strengths and where there are challenges. And these systems are usually somewhat overlapping, like the Olympic Games logo’s circles. There are places where strength in one area might allow for strength in the other, and vice versa. But wellness almost always involves feelings of wholeness in each of these three areas.

So, in my practice I often walk women through each one of these areas in an effort to take inventory, so to speak. We look at where she is grounded and full and also where she is feeling untethered and lacking.

This process looks something like this:

PHYSICAL SELF: What are you doing right now to help your physical body to feel strong? What does your nutrition intake look like? How is your sleep? Are you currently taking medicine for your postpartum depression or anxiety symptoms and, if not, is it important to have a medication evaluation? Are you pushing yourself too hard? Are you engaging in some exercise each day whether it be stretching or walking or other more moderate forms? Are you breathing deeply? Are you drinking plenty of water? Are you getting outside to breathe fresh air and feel the sun on your face?

PSYCHOLOGICAL SELF: Are you meeting yourself where you are or do you need to set more realistic expectations? Are your priorities clear? Are you consumed by the “shoulds” placed on us by society, books, family, and friends or are you allowing yourself to follow a path that feels right to you? Are you using words of kindness and compassion with yourself or are you using a tone with yourself that is harsh and unsupportive? Are you engaging in thought patterns that are useful and realistic or are you engaging in perfectionist thinking? Do you find yourself thinking in black and white extremes or are you allowing yourself to be open to all that is in between? Are there old family patterns or unresolved family conflict that is interfering with your ability to be present with your baby right now? Do you have a trauma history that is resurfacing and deserves attention? Do you have a number of stress reduction and grounding strategies that are useful in times of chaos or are you feeling ill equipped in this area? Are you currently working with a trained therapist who can help support you and work with you to find new ways of thinking and managing your stress or is it time for you to find one?

SOCIAL SELF: How supported are you? Are you able to ask for help when you need it? Do you have a community of friends, family, neighbors and/or health providers to support you along this journey through postpartum depression? Are you and your partner able to work together during this time of high vulnerability or can you use some support around relationships?

Sometimes it is helpful to see all of this on paper, to create a sort of a table along the way. If this resonates and if you choose to go this route, you might consider a table in which the vertical columns contain the 3 areas of wellness (Physical, psychological, and social) and the horizontal columns contain space for strengths and challenges:

WELLNESS ELEMENT CURRENT ACTIVITIES SUPPORTING WELLNESS IS ANYTHING MISSING?
PHYSICAL
EMOTIONAL/PSYCHOLOGICAL
SOCIAL

I want to reiterate that this is a process that is correlated and, often, requires the help of a trained professional who can work with you to sort through the many layers of your being. Sometimes, sometimes, simply going through this process with intention can help you to feel more empowered and in control of your wellness. Often, this is not the case and unbalanced biochemistry or sleep deprivation is just making it too darn difficult to do what you know that you need to feel better. It is likely that once you find some sense of wholeness and wellness in your physical body (including adequate sleep, nutrition, and balanced biochemistry), the other three areas will be easier to work with. And, usually, when you feel a bit more full in all three areas of holistic health, you will feel happy to great yourself right where you are. And you will find joy in simply “being.”

Kate Kripke, LCSW

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Need Help Finding A Postpartum Depression Specialist?

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postpartum depression

Fotolia - © Vladimir Vydrin

On the Postpartum Progress Facebook Fan Page, a reader asked about how to find the best help for postpartum depression or related illnesses. My advice? Ask a mom who knows. I think the best people to talk to are women who have already been through PPD who have been to someone who was really supportive and helped them recover.

There are a lot of survivors hanging out here with us at PP, so I feel fortunate to have gotten to know a lot of the specialists around the country thanks to them and my advocacy work. I am always happy to connect you with them. You can find some listed on the Postpartum Progresspostpartum depression specialists page, or you can ask me a question on Facebook, or you can email me.

Another great thing to do is speak to local advocacy organizations. They often have the best knowledge around about who has a lot of experience in your state treating women with perinatal mood and anxiety disorders. We have a list of postpartum depression support organizations – just find your state alphabetically in the list and contact the organization directly.

Please note, when I say “postpartum depression specialist” that is shorthand for a specialist in perinatal mood and anxiety disorders, also called reproductive psychiatry or perinatal psychiatry. This means this person should be able to help you regardless of whether you have postpartum depression, postpartum anxiety, postpartum OCD, postpartum psychosis, antenatal depression (depression during pregnancy) or whatever. So don’t feel that if you don’t have PPD there is no one who can help you.

I try wherever possible to include special treatment centers from other English speaking countries as well, including the UK, Australia and Canada, so if you are from one of those countries, you may be able to find good contacts from our support organization and specialists lists as well.

Oh!, and DO NOT feel uncomfortable asking me for help, silly. That’s what I’m here for. YOU. So ask away if you just don’t have the energy to search yourself.

Just wanted to do a quick refresher for those of you who aren’t sure how to find someone to help you.

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Uncontrollable Anger Can Be Part of Postpartum Depression

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postpartum depression

Fotolia - © Jason Stitt

I waited very impatiently staring out the picture window. The diaper bag packed hours ago rested on the floor by my feet. I held on tightly to the bundle of screaming baby in my arms and I thought angrily,

“Where is he?”

Minutes passed.

My teeth clenched.

Half an hour passed.

My heart pounded.

An hour passed.

Foot tapping anxiously.

When my husband finally came in the door to greet us my eyes scrunched with so much anger I was sure that he had felt it pierce his soul.

“What is the matter?” he said.

“What’s the matter? What’s the matter? We were supposed to meet my parents an hour ago for fish and chips,” I said, my tone of voice getting louder and more forceful.

“Oh I forgot. Well we can go now,” he said reaching for our baby out of my arms.

“We can’t go now. It’s done. We do this every year on Good Friday and you ruined it,” I hollered.

“Babe, I didn’t ruin it. We can still go and get fish and chips!”

“You don’t get it. We missed my family because you’re a jerk who can’t remember our stupid dinner plans. Plans that we do every year!”

He started to walk away with our screaming infant. I hated that he just walked away and never fought back and without thinking I kicked my foot through a wicker chair.

You see, postpartum depression gave me something fiercer than tears and anxiety.

That betch gave me anger so uncontrollable that not only did it scare me, but scared the people around me.

Yes I, Kimberly, the once meek and shy girl, turned into a raging hostile shat storm of hormonal and chemically imbalanced monster.

And it didn’t take much to ignite that fiery monster within me. It billowed in my stomach every day just waiting for the right moment to combust outwards and it didn’t matter who or what it was directed towards. Dishes, walls, wicker chairs, family and friends, and worse directed towards myself in the form of self-mutilation.

No one or nothing was safe from it.

It was terribly irrational and I couldn’t control it.

Family and friends were afraid of me.

I was afraid of me.

So what things rocked my tension scale?

  • The way my husband slurps his soup.
  • The way my brother just trampled in the house with his shoes still on.
  • The way my dog barked to go outside the second I sat down.
  • Changing a diaper again after changing it 0.2 nanoseconds ago.
  • The lady who rammed her cart into the back of my heels.
  • Anybody who wanted to give me advice on how to parent.
  • Dog hair on the floor
  • The house wasn’t clean enough.
  • So on and so on

Everything.

I felt so ugly inside.

My psychiatrist said that anger and irritability were symptoms of postpartum depression and we worked really hard together at finding the right medication combinations and talking to get me through it.

I also have a little black book that my husband has dubbed the “black bonkers book” where I immediately write down what made me mad. It puts my anger on the paper and I can walk away from it.

Oh, and then there is mommy time out.

Yes, I’m 30 years old and I take a time out either in my room or in the bathroom. It helps to just remove yourself from a situation and just breathe deeply and slowly.

Since blogging, I haven’t read much about the anger and rage portion of this illness which is why I’m writing this today.

So how about you? Do you suffer from rage and irritability among your postpartum depression symptoms? What types of techniques do you use to calm yourself down? How does your family react to your behaviour?

Kimberly

Note: For more stories on anger and postpartum depression/anxiety, read these:

Stark-Raving Mad: Anger & Postpartum Depression

The Rage of Postpartum Depression

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