Warrior Mom Book Club: Inconsolable by Marrit Ingman

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Inconsolable book coverThe following is a conversation between members of the Warrior Mom Book Club after reading Inconsolable by Marrit Ingman, the latest in our maternal-mental-health-related reads. You can visit the author’s website at http://www.marrit.info/.

Welcome to the Warrior Mom Book Club interview based upon the book Inconsolable by Marrit Ingman. We appreciate those who read along, and especially those who took the time to discuss this book.

AKP: On pages 9 and 10 (and throughout the book) Ingman writes about cultural impacts on the understanding of PPD. Did you recognize any specific cultural impacts in your experience? Are there specific cultural changes that you would most like to see that may have a more positive impact on understanding PPD and providing care for new mothers and families?

SRK:  I haven’t seen/experienced too many of the cultural impacts due to my background. But getting involved with the Warrior Mom group and speaking with other mothers who have experienced a PMAD, I have realized that in a lot of other cultures it could be even harder to speak up. I feel that to make a positive impact there needs to be more accurate information readily available to mothers, and treatment needs to be covered (more completely) by insurance. It shouldn’t be that the only way you get help is if your symptoms are severe enough to be admitted to a hospital due to your PPD.

AKP: Absolutely. I see this with so many women who reach out to me in person or via social media/email re: treatment resources. I hate that those who do not have extensive financial resources generally receive a lack of effective treatment or opt to wait it out, almost always resulting in a prolonged illness and many more complicated issues.

CX: I personally did experience some differences depending on culture. Some of my family is first generation to this country and felt that this is “just something you get over” and didn’t understand the real-life implications of how serious PPD really is. I also mentored a girl who is first generation from the Dominican and her family had those same feelings. They did not support her at all and often said “toughen up.” They were very against medication as well. She did a lot of her treatment in secrecy from her family. I fortunately had very supportive parents, so that was not the case for me. I believe there is definitely a cultural stigma.

BR: As a full-time employed professional, I live in a culture where 6 weeks is reinforced as the appropriate time for a new mother to take off from work to heal from labor and birth and transition to life with a newborn, through the offered FMLA benefit following a birth. And I feel fortunate that I have that “benefit” from my employer. But 6 weeks is hardly enough to heal and transition into the new life of parenthood. And for many Warrior Moms, they might not even begin to experience symptoms of a PPMD until well beyond that 6 weeks. And many parents don’t even get that time (my husband had to use his sick and vacation time). I think we as a culture and society need to work harder to meet the needs of new families while also protecting the rights of parents to be active in the work place. I think our understanding of the postpartum period of 6 weeks as a period of “short term disability” is not accurate and does not provide families with the opportunity to build a grounded base to support the growth of a healthy family. I think we need to provide more paid leave to the parent who gives birth, as well as the partner or other support person who may be offering care. (I’m less familiar to benefits provided to adoptive parents, but would support the same amount of time.) I think that should be a given, and not just a “benefit” to people employed in jobs that provide such benefits. Allowing a longer period of supported and nurturing time to adjust and heal would acknowledge the major shift of being coming a parent and support the health and wellness of all family members.

AKP: Speaking of support, in the Chapter titled “Are You Okay” Ingman focuses on the power of connecting with others in genuine and caring ways. Recognizing how hard this can be, has it been part of your recovery experience (initiating or receiving the outreach)? What are your thoughts on this general idea?

SRK: Since experiencing PPD I have made it a point to be open and honest about it. I wasn’t able to talk about it at first, but after receiving treatment and beginning to get better I decided to start speaking at a luncheon for new moms at our local hospital. A few other mothers and I speak about our experiences so we can put a face to PPD and show other moms that it can happen to anyone. Speaking out has helped me regain my confidence and has shown me that so many people do suffer but never admit it. I would like to try to help change that, so that more mothers/families will be willing to get the help they deserve.

CX: I found this chapter difficult to read as I looked back on my own experiences with asking people how they are doing, if they are OK. It is extremely difficult to approach someone, never mind a complete stranger. Even when people asked me that loaded question, I would just fake a smile and answer with a yes. However, I really do wish someone had gotten into the true detailed questions that I was waiting for someone to ask. The first time I became public with this was not until Climb out of the Darkness. One of the hardest decisions to make, but I found after I came out about my experiences, it’s easier to ask others about theirs. I still find it difficult to initiate but I have been able to direct some people in the right direction to get the help they needed.

BR: I craved this when I was at my darkest times. I wanted someone to be able to ask me that question in a genuine way and really be able to get in my experience with me and unburden me of some of my pain. I got closest to that through a connection to another PPD mom that I made through our shared pediatrician who recognized my need for such a connection. I know my family and friends were trying to offer genuine caring, but I found it hard to interpret their gestures in the same way as from someone who I felt could relate more fully to my experience. I think my pain and sense of isolation didn’t always allow me to fully embrace the care they offered.

AKP: On page 52, Ingman writes of an encounter when she identifies herself as still postpartum many months after she gave birth. She then poses the question, “Does a woman ever stop being postpartum?” What does this statement mean to you, and how do you think it connects to PPD/ maternal mental health?

SRK: I think it is a great question. I don’t really know when you stop being postpartum, but I know that PPD doesn’t always happen immediately. I also know that some doctors will disregard your anxiety/depression if they think it has been too long.

CX: Before getting PPD, I had no idea it could last “officially” a year. After getting treatment, I thought PPD ended at that magical one-year mark. However, I did not feel myself until almost 2 years later. I do wonder if you always feel “postpartum” or different from your old self, but hopefully it is not in a bad way. We all change throughout our lives and I look at this as a very dark time in my life that I fought through! I also think this shows that many of us (myself included, not having gotten treatment until my daughter was 6 months old) do not get help soon enough. We wait, we put it off, we put everything else first. Maternal mental health is not as strong as it should be or needs to be. Just ask someone what that terms means and many have no idea.

BR: For me, becoming a mom and journeying through PPD/PPA had major impact on my identity and understanding of myself and my life. I interpret her question as reflecting on a similar process – that the time after the birth of a child/the postpartum period doesn’t just stop after a number of weeks or months or a year. It ushers in an entirely new phase of life that impacts every element of living. Recognizing that honors that immense responsibility and power of becoming a mother.

AKP: I agree that she is implying that being a PPD survivor means both you may forever feel “postpartum” in the way that once you have such a life-changing experience your lens shifts to one that is through that set of circumstances. I also think there is a point at which we stop being in the midst of PPD, and then move on to recover, and then to a next phase that really can empower us as mothers, having not only adjusted to motherhood and taken care of our families, but having done so under extreme duress.

On page 157 and in the chapter titled “When You Are Strong Enough,” Ingman writes of times when she experienced a shift in perspective and understanding of her experience, including significant shifts in her mood and her views of motherhood. Have you experienced moments like this? What has the impact been on your experience and healing?

CX: This too shall pass was such a trigger for me because with PPD, NOTHING was passing. Every hour, minute and second felt like decades. Those statements made me feel worse instead of relieved. I do, however, feel that way now, but I watch what I say to new moms because of my own experiences with those words. Things started to change for me gradually so I cannot remember exactly when I had those moments, however I can say Mother’s Day when she was 18 months old was the first one I could remember (2 had passed) and I planted a new garden to commemorate it. I know that I resented everything I experienced in that first year; now I yearn for it.

BR: I have definitely experienced moments such as those Ingman writes of that have influenced significant shifts in my perspective and moved me along in my healing process. They have come from conversations and connections with other Warrior Moms, or friends or family members who have survived their own personal struggles. They’ve come from sessions with my therapist, or listening to myself describe my experience to others. These moments feel to me like the healing moments. When I make meaning of my pain and integrate it into my understanding of myself and my now identity as mother/ Warrior Mom.

AKP: On page 172 Ingman describes the perfect social space that she would find supportive and healing for herself as a PPD mother. What would your perfect space look like?

CX: In reality I spent a lot of time at malls, just as she described. I just walked and it felt good to be around others. I also spent a lot of time at a local store that was child-friendly. The adult interactions and the non-judgmental staff made my day. Sometimes I counted down the days between my visits when I had money to spend so that I could get that interaction in. My perfect place was and would be my local moms’ group. Without them I do not know where I would be. They are the ones who helped me get into treatment and 3 years later we are still friends and meet regularly. I think about how fortunate I am for them on a daily basis.

BR: My perfect space would be somewhere nurturing and comforting, with other moms and babies who were sharing my experience. Maybe a comfortable, warm and safe lounge with older Warrior Moms to care, comfort and provide hope to those moms in the thick of things. Unfortunately my community had no support groups, but I craved the connection with others who could truly understand what I was going through. I got the nurturing piece from my mother and other family members, but there always felt like a piece of true understanding missing.

AKP: On page 195, and throughout the book, Ingman writes of what she retained of “herself” throughout her experience of becoming a mother/ surviving PPD. Has this been important to you? How have you worked to manage this in your own life?

CX: I think this is something I am always reassessing. I do feel like I lost a lot of myself in the PPD. I am remembering how things have changed and, as I have progressed along, how things have slowly come back that I do enjoy. Ingman describes her music as really important to her; for me it was my friends and being outside. In my PPD, neither of those things happened. Slowly though I began going on walks and being around friends. We also share interests in reading and going out to eat! So much has changed and I am hoping to continue to return to my old self.

AKP: It’s amazing how the PPD stranger that we see in the mirror eventually blossoms into something even more beautiful for so many Warrior Moms with support and treatment. I do like the analogy of the caterpillar and butterfly. I think of PPD as the painful change that happens in between, for me. That chrysalis was cramped, isolating, painful, and sometimes even hard to breathe inside, but once I began to break out of that shell I spread my wings and each month was able to fly farther and farther and eventually begin to help other caterpillars become butterflies themselves. For me, that has been the greatest gift.

Thank you to those who shared so openly for being a part of this discussion, and to the Postpartum Progress followers for reading this post. We hope that you found it helpful, both in considering this book as well as realizing that you weren’t and aren’t alone in your experience of motherhood.

If you are interested in joining the Warrior Mom Book Club, please email Amber at atlantamom930 @ gmail (dot) com. Next up is Brooke Shield’s popular book Down Came the Rain. We encourage you to borrow or purchase it ASAP as our goal it to have it read and to complete the interview prior to the holidays.

~ Amber Koter-Puline, Warrior Moms Book Club

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Warrior Moms Are Key to Fighting Stigma

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Susan and Tiny BeanI had the thrill and honor recently to attend the recent Special Legislative Commission on PPD meeting with Representative Ellen Story this month.  My new friend (and fierce advocate and mental health professional) Mara Acel-Green extended an invitation to the open meeting – and upon walking in, I was floored by the feeling that Postpartum Progress belonged in the room.

The Commission invited Deborah Wachenheim to speak about her sister Cindy, whose story was featured in The New York Times earlier this year. Listening to Deb speak about the events leading up to her sister’s postpartum psychosis and death, I was struck by the genuine interest and concern of the room.  This was a meeting full of top tier mental health and birth professionals, legislators, and non-profit leaders.  Their heartfelt appreciation for Deb’s willingness to share something so personal (and freshly raw) and thoughtful questions gave me hope that the meeting was not just government lip service.

As the meeting progressed, organizations checked in with progress reports, included MCPAP for Moms, the Department of Public Health and the Community Health Center pilot programs.  Throughout each of their discussions, time and time again, the question that kept resurfacing was “How do we make sure screened mothers are being supported after their diagnosis?”

What these doctors are really concerned about is How do we get moms to follow through with their diagnosis and treatment?  The Commission has been focused up until this point primarily on training primary care physicians, pediatricians, and birth care workers on screening for postpartum mood and anxiety disorders.  But as any survivor can tell you, screening and diagnosis (though absolutely essential) are only the first of many hurdles on the path to wellness.  As suggestions were shared, I noticed that their solutions all focused on actionable items for healthcare workers.  And it seemed to me they were missing a piece of the puzzle.

Postpartum Progress doesn’t just “drop kick despair.”  It kicks stigma in the teeth.

After my own diagnosis, 5 months postpartum, I continued to struggle for almost 6 months with treatment compliance.  It wasn’t that I refused treatment, but instead that I was still struggling with so much shame that I just couldn’t comply.  Depression and anxiety rob a person of their sense of truth and rationality.  Psychosis steals reality itself.  How anyone could expect me to take responsibility for my own mental health treatment in 2009 still leaves me in disbelief.

I attended therapy regularly but fought against taking medications.  And though I knew the right answers to my therapist’s questions and believed them on some level, deep down I still carried such stigma about mental illness that I couldn’t separate myself from my disorders.  Not until I found Postpartum Progress.

Reading stories of other mothers just like me, I found my own courage reflected back to me.  Here were women who had battled the same terrible thoughts, who had raged at their babies, and who had felt worthless in their roles as mothers – and I looked up to every. single. one.  Postpartum Progress doesn’t just “drop kick despair.”  It kicks stigma in the teeth.

This is why I credit Postpartum Progress and #PPDCHAT with saving my life.  Not because Katherine Stone or Lauren Hale treated my anxiety and depression, but because they showed me I was worth saving – that I could and would get better.

This is what legislators, healthcare professionals, and non-profit organizations need to know: the key to getting mothers to follow through with treatment?  Is to disintegrate the stigma.  No one does that better than the Warrior Moms.

I’ll be meeting with the Commission staff and other Massachusetts organizations in the coming months to make sure Postpartum Progress is a part of the important conversations they are having about treating and supporting mothers during and after pregnancy – because the patient community?  Is that final piece of the puzzle.

 

Author’s Note: Postpartum Progress recently collected survey data from its Warrior Mom community and FaceBook fan page.  75% of respondents indicated that Postpartum Progress increased their likelihood to seek professional help for their condition.  You can read the entire report HERE.

photo credit: Susan Petcher

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Off to Preschool: Postpartum Depression Milestones

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I tearfully sent off my nearly DSC01078four-year old PPD baby to preschool yesterday.  She beamed with excitement and pride as she marched off to “big girl” school with her older sister, a first grader.  I spent my day alternating between sorrow and happiness.  My sweet baby girl is no longer a baby.  My postpartum depression and postpartum anxiety manifested itself in a hyper connection with her.  I worry that I have damaged her by being so sick the entire first half of her first year of  life.

I felt so helpless as I saw her uncertain face and her tiny hand waving at her dad and I as we dropped her off. I wanted so badly to take her in my arms and just keep her small.  This childhood transition rocked me to my core.  It exposed all of those old feelings of inadequacy, guilt and shame that ruled my psyche with an iron fist during my darkest days.  I decided instead to write a long letter to my daughter’s teacher.  I wanted this new teacher to understand how sometimes my early experiences of being my baby girl’s mom cloud my perception.  My sweet girl loved her first day, and she told me all about it for a half hour.  Her joy and excitement were contagious.  Her favorite part of her day was music class.  She skipped into school this morning with the confidence of someone twice her age.  I know that she knows how much I love her.  I hope that she always remembers that.  I will keep reminding myself to give myself grace during these milestones and transitions.  I am a good enough mom, and I am exactly the mom my sweet girl needs.

I offer this to my fellow Warrior Moms.  Give yourself grace during these childhood transitions.  Know that you are exactly the mom that your baby needs.  No one else can take your place.  Do not forget to bring Kleenex and sunglasses so that your baby will see your lovely smile behind the tears.

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Navigating Your Perinatal Mood or Anxiety Disorder

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8363033986_503c7a47f3As a mom with bipolar disorder who blogs openly about my experiences surviving a postpartum mood disorder, people often ask my opinion on ways to deal with and manage their diagnosis. I am not a medical professional, so I hesitate to even answer these emails. But my heart tells me I need to address their questions.

Having been in the same shoes not long ago, I remember the desperate desire to connect with others who had gone through something similar. Back then, people weren’t talking as openly about mental illness, the stigma was thick and heavy, and I felt as though I was harboring a shameful secret. It wasn’t until I found Postpartum Progress that I truly felt I had found a group of women who understood.

So I get it when other moms, and sometimes dads, write to me about their story, asking for advice on what to do after receiving a diagnosis. They’re looking for the same connection I found. The same searching that led me to join this community.

Here are my suggestions: [Read more…]

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