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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Cristi Comes: On a Life Preserver for New Moms

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postpartum depression, mental health, maternal mental healthDear New Mom,

Does it sometimes feel as though you’re swimming at night in a sea of choppy water? Waves crash all around you as seaweed and other debris crowd your path and grab hold. Some moments may feel like a strong anchor is weighing you down. Like you’re slowly (or sometimes very quickly) drowning. You bob up and down looking for land, struggling to reach the shore where safety and help exist.

Where is the life preserver? Where is the raft? Where are the strong arms reaching out to save you?

The power of the sea of motherhood often throws us into waves of exhaustion, hormonal imbalance, physical and emotional strain, and feelings of being alone in the darkness. It can be very scary and often feels shameful. We feel like we are the ultimate failures. Like we cannot be what we as women were born to be. We think…

“I’m not cut out to be a mother.”

“Why can’t I just suck it up?”

“My faith should see me through.”

“Others have done this for centuries. Why can’t I?”

“I should feel joy, and all I want to do is run away.”

“Someone will take my child away if I admit what I am feeling.”

So many women have these thoughts, myself included. Running away and letting a “good mom” take over can seem like the best option for your child. But in reality it’s your depression or anxiety or mania or OCD or psychosis that is lying to you.

There is NO perfect mother. I repeat there is no perfect mother. Those happy photos you see on Facebook of sweet smiling children in their moms’ loving arms are an illusion. A snapshot in time. Because even those women have bad days, and many of them have, without a doubt, had feelings of hopelessness or fear or exhaustion, and have questioned if they are good enough.

If your own struggle goes one step farther (like mine did) into a postpartum mood disorder–a real medical condition that effects oh-so-many moms–the waves you swim in right now are even more powerful. The churning sea is potentially more devastating, unless you find and grasp that life preserver.

So I’m throwing you one…with love from me to you.

life saver art by Cristi Comes

On this day designated to celebrating motherhood, you may not want the recognition. If you’re reading this, you may feel unworthy of a day that honors you and your job as mom. But read the words that make up this life saver, and try with all of your might to change your inner dialogue.

“I am a warrior.”

“I am brave.”

“I can stay strong, hold on and find help .”

“I can get treatment and find recovery.”

“I am not alone.”

I’m glad you found us here for the Mother’s Day Rally for Mom’s Mental Health on Postpartum Progress. It’s such a special day where we honor all mothers, not just the happy ones, because we deserve it too. You are more than enough. In fact, you are exactly the mom your child wants and needs. Trust me.

~ Cristi

Cristi Comes is a warrior mom, wife, writer and mental illness fighter. A mental health and suicide prevention advocate, she serves on the Board of Directors the American Foundation for Suicide Prevention in Washington State. Follow her blog at www.motherhoodunadorned.com, on Twitter @motherunadorned and Facebook at Motherhood Unadorned. Also please follow her Mental Health Hope Group Pinterest Board.

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Postpartum Progress, the world’s most widely-read blog on all things related to emotional health around pregnancy & childbirth, is a service of Postpartum Progress Inc., a 501c3 nonprofit devoted to raising awareness of postpartum depression and similar illnesses. Please consider making a donation today, Mother’s Day, so we can continue and expand our work supporting maternal mental health. Thank you!
DonateNow

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Jenni Chiu: On “Will it ever end?”

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postpartum depression, mental health, maternal mental healthDear new mom,

It’s possible that there will be a time… several times… maybe even an incomprehensible amount of times when you will find yourself sleepless, swaying in the dark, crying, cradling your baby, and thinking, “Will it ever end?’

The sleep deprivation…

the feeling overwhelmed…

the sharpness of infant cries.

Not having claim to your own body

or space

or thoughts.

It can all seem endless at times.

Take it moment by moment, minute by minute, or second by second if you have to. Just make it to 2:30… then to 3:00… then to 3:30.

It won’t all be bad. It shouldn’t all be bad.

I want you to be fearless about asking for help. Find someone to help you get a nap, have some soup, or take a bath alone. The early months will be stressful, and consuming… but if they ever start to feel dark – if your gut tells you that you’re not acting like yourself – talk to your doctor. Be brave. You have absolutely nothing to lose by doing it.

We don’t live in villages like we used to. Most of us don’t have a team of other women who cook, clean, and shower us with support while we spend weeks and weeks in bed with our babe. Postpartum mood disorders are more common than people think.

I’ve been the woman pacing, rocking, and crying in the dark. I’ve squirmed with the certainty that I made a terrible mistake and was completely incapable of the life I was suddenly thrust into. I’ve looked up to the heavens with tears streaming down my face and scream whispered, “Will it ever end?”

It will.

Take it all as slow and as easy as you can…

Because the sounds of little baby slurps while feeding,

the moments of baby fingers squeezing yours,

and the gentle feel of your infant trying to eat your cheek…

Those moments will end too.

Take care of yourself so you don’t miss them…

And take heart…

Because though I’m only six years into motherhood, I can tell you the memories of the light will outlive the memories of the dark.

You’re going to be happy you did this.

~ Jenni

Jenni Chiu is a proud member of the editorial team at Postpartum Progress, and you can find all of her other internet places at http://JenniChiu.com. She lives in the Bay Area with her husband, two boys, and two lesbian dogs.

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Postpartum Progress, the world’s most widely-read blog on all things related to emotional health around pregnancy & childbirth, is a service of Postpartum Progress Inc., a 501c3 nonprofit devoted to raising awareness of postpartum depression and similar illnesses. Please consider making a donation today, Mother’s Day, so we can continue and expand our work supporting maternal mental health. Thank you!

DonateNow

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Lesley Neadel: On the Journey through PPD 

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postpartum depression, mental health, maternal mental healthDear New Mom,

I am you.

I am either you three years from now, or five months ago.

I am hoping it is only the former, as the mother of the most incredible three-year-old girl, Bex, and a survivor of postpartum depression and anxiety, who is now halfway through her pregnancy with her second child.

Right now I feel great, and I assure you, you will too. There is a light at the end of the tunnel, and time, talking to the right support network / therapist and perhaps medication will help you reach that light, I promise. Ugh, I know, I know… people said things like this to me – “Just get to the three-month-old mark. It all changes starting at three months!” – and it is of little solace when the days feel like weeks and the weeks like months and the months like endless years. Unfortunately, there is no shortcut, no way to get over or around how you feel, just the journey through it.  So just get through one day at a time, then one night at a time, doing what you have to do for yourself and your baby and I promise, the light will find you.

Notice I only said yourself and your baby – forget the rest of the world for right now. You don’t need any more pressure than I know you already are putting on yourself. I encourage you to be open about your struggles to anyone you feel comfortable telling, and to have faith that they will give you the leeway you need. Your relationship with your husband / partner / fiancé / boyfriend  / sperm donor can, will and must take a back seat during this time. (Show them this letter and have them reach out to me if they have a problem with that.) Your family and friends will want to help, and you should let them, in ways that truly ease your burden. And your home can survive a few weeks (or months!) of not being spotless (or even close), I assure you. Even Facebook updates can wait. Just.Take.Care.Of.You.

My journey into PPD was rapid, steep and impossible to ignore or deny. I sought the help of a therapist who started me on medication when Bex was only three weeks old. For me, recovery came slowly and steadily. One day, after weeks of not being able to, I realized I could hold my daughter and sway or bounce to comfort her just like the other moms I knew! Then, another day, I realized I was singing a lullaby when weeks before I actually Googled lullabies because my brain failed to produce the title of even one song to sing. Yet another time I realized I was alone with my daughter and laughing – a sound I had not made in months. And finally, when she was about ten weeks old, standing in my kitchen on an unremarkable Tuesday, I kissed the top of her head and whispered “I love you” to Rebecca for the first time. And I promptly burst into tears – of happiness – because I truly meant it.

That year for Mother’s Day my husband (and rock, best friend and lifesaver) gave me a slim Tiffany bangle engraved with the word Love in red enamel. I have worn it every day since, to remind me of that completely remarkable Tuesday in my kitchen.

This Mother’s Day, I am almost 20 weeks pregnant. I am hoping that this is my “do-over” and my coming months are as bright as I feel right now. But I am all too familiar with the darkness and fog that you are currently experiencing. I know what slogging through each day feels like, and how “going through the motions” of caring for your baby without actually caring brings on endless bouts of crying. I hope your journey through your darkness is as steady as mine turned out to be – that you suddenly find yourself continually achieving tasks that seemed impossible before. And that you have your very own version of my remarkable Tuesday.

And I know that if I find myself in that dark again, I will slowly and steadily find my way through and back out.

With love, compassion and complete understanding,

Lesley

 

Lesley Neadel lives in Hoboken, NJ, with her husband and daughter. She works in PR in NYC and writes letters to her daughter at http://www.dearbex.blogspot.com. An open book about everything in her life, she is proud to be a Warrior Mom, and will do anything she can to help anyone she can to not feel alone, embarrassed or paralyzed by their PPD. 

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Postpartum Progress, the world’s most widely-read blog on all things related to emotional health around pregnancy & childbirth, is a service of Postpartum Progress Inc., a 501c3 nonprofit devoted to raising awareness of postpartum depression and similar illnesses. Please consider making a donation today, Mother’s Day, so we can continue and expand our work supporting maternal mental health. Thank you!

DonateNow

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