Episode 250

Many families I work with have no idea that Depression can begin anytime during pregnancy or postpartum. You may begin to feel anxious during your pregnancy. Perhaps you felt find during pregnancy and the early months of postpartum. Things may be fine with you and then you begin feeling symptoms of depression when you baby is 8 months old. For some moms, depression coincides when your baby weans.

Sometimes it can be hard to tell the difference between clinical depression and the normal stress and exhaustion of new motherhood. In fact, this is what most moms tell me. They did not say anything because they thought what they were feeling is normal. And sometimes it is. However, if your feelings of sadness or despair are so powerful that you realize they are preventing you from enjoying your baby, from doing daily tasks, greatly affecting your sleeping and eating habits and you realize you are pulling away from friends or family or are so distracted with your thoughts when you are with them, you could be suffering from postpartum depression

Postpartum depression is NOT the baby blues which is considered a normal part of postpartum adjustment and one that requires no requiring no medical or psychological intervention. Postpartum depression (PPD) is an umbrella term that refers to various mood or anxiety disorders which can follow childbirth. PPD can present in a number of ways depending on the predominating set of symptoms. PPD is typically an agitated depression, with symptoms of both depression and anxiety. When depressive symptoms dominate, we refer to it as postpartum depression. When anxiety is the compelling symptom, we refer to it as a postpartum anxiety disorder.

Postpartum anxiety disorders include postpartum panic, postpartum obsessive-compulsive disorder and postpartum posttraumatic stress disorder.

Some experts are now comfortable using the term postpartum distress to encompass both symptoms of depression and anxiety and perinatal depression and anxiety to include pregnancy and the postpartum period.

Postpartum depression is the most common complication following childbirth,characterized by frequent crying, mood swings, irritability, extreme fatigue, difficulty concentrating, sleep problems, loss of sexual interest, anxiety, appetite changes, negative scary thoughts, feelings of inadequacy, hopelessness and despair. In addition, thoughts of suicide and feelings of anger, rage, shame and guilt are often present.

Postpartum psychosis is a severe medical condition that is often misdiagnosed as postpartum depression. Psychosis occurs in 1 or 2 out of 1,000 postpartum women and if often associated with bipolar illness. The most common symptoms are severe agitation, delusional or bizarre thinking, hallucinations, insomnia, confusion, and a feeling of being out of touch with reality. Although this is a fairly rare condition, it is always an emergency and requires immediate medical attention.

Long time listeners have learned that for some moms, breastfeeding is just not possible for them. There are health issues on their or their babies part that have prevented them from breastfeeding.

Postpartum depression can affect the early days of breastfeeding and it can also be the cause of breastfeeding challenges.

When your early days of motherhood are fraught with painful breastfeeding sessions, unusually long breastfeeding sessions, high anxiety about a baby who has lost too much weight, and with a baby who sleeps for very short periods of time, perhaps only up to one hour at a time – all these challenges can cause sleep deprivation, which is an additional risk for postpartum depression.

I am a strong birth advocate as well as a strong breastfeeding advocate. Both are important to the physical and emotional health for the new mother. Birth and breastfeeding trauma are both risk factors for postpartum depression. When a mom experiences both, this puts her at an even greater risk for some degree of postpartum depression, anxiety and possible pp psychosis.

The lack of education as well as the known stigma about this major mental health issue are the reasons why I am producing several shows on this subject.

I did not start off my career as an IBCLC. I started by becoming certified as a childbirth educator and taught classes to several hundred couples before I took training to become a birth doula. Over the course of 10 years, I attended over 100 births as I continued my role as a childbirth educator. Research and information on postpartum depression was not easy to come by as there was not much written about it, particularly for the lay person.

There are times when I think about some of the moms that I worked with who suffered from ppd, I have some regrets at not being able to help them, to be there for them in ways in which they needed me. I am not battering myself, because I realize that I did not have training in this area as there was not much knowledge. I understand that I didn’t know what I didn’t know and feel badly for that.

You may have heard me say this, but it bares repeating. In all the guest that I have interviewed, at least 80% of the moms suffered with some degree of postpartum depression. I have facilitated hundreds of groups with new mothers and a majority of the members say they have suffered from some degree of postpartum depression. 1 in 1 in 1000 women will develop postpartum psychosis. Pyschosis can lead to suicide or infanticide. Loving, caring mothers who take their own lives and some take the lives of their babies that they dearly love. They feel deep physical pain and they take their babies lives because they want to save their child from this pain. Of course, none of this makes sense to most of us, who are thinking clearly.

This is horrifying to me and I am sure horrifying to you. Mothers with mental health issues such as posptartum depression and psychosis have a sickness of the brain. They frequently have not been educated about this, frequently have risk factors that go unnoticed and frequently have a lot of fears in talking about this, telling others in their life that they are having awful thoughts keeping them awake at night, distracting them through the day.

Visions of throwing their baby over the balcony. Putting a pillow over their babies face and suffocating them. Killing them with knives. Drowning them in bathtubs. They have the mindset that their babies will be better off without them. Can you imagine having these thoughts? No wonder moms keep quiet and suffer in silence.

Mothers describe feeling disconnected to their newborns and babies. They are sleep deprived and perhaps go through the motions of caretaking for their babies, but they are not really connecting to them. Many mothers with depression are less likely to engage positively with their children. Less likely to sing and play and cuddle with their babies. Depressed mothers are inconsistent parents to their children. As symptoms come and go and each day can be different, this leaves children in an unstable environment, never knowing what the day is going to bring and who the mother who is going to care of them that day.

It is not enough to talk about this mental health issue without giving you resources. Places for you to call and seek help. Online resources who can point you in the direction of local resources. This show is as much for pregnant and new mothers as it is for the providers who care for you. This show is also for lactation consultants and midwives and obstetricians and pediatricians. It is for childbirth educators and birth doulas and even pregnant and new baby photographers. You all come in contact with moms and babies. You may notice that something is not quite right and you are now manned with resources to share.

RESOURCES: Websites

Postpartum Support International http://www.postpartum.net/
Here you can get information on connecting with local resources. You can chat with an expert, join an online support group, call their telephone support line

On there website, they list a crisis text line: Text the word HOME to 741741 from anywhere in the USA, anytime

They also list the National Suicide Prevention Hotline and Website:
1-800-273-8255 www.suicidepreventionlifeline.org This is free and confidential.

First Mondays of every month Resources for dads and partners — PSI hosts a free call-in forum for dads facilitated by a perinatal mood disorders expert. Call for information, support, and connection with other dads. Click HERE for more information and call-in number

https://www.maternalmentalhealthnow.org/index.php

Maternal Mental Health NOW is dedicated to providing increased awareness of maternal depression and its impact on the mother, child, family and community at large amongst health care and community providers. This audience includes therapists, clinical psychologists, social workers, community health workers, counselors, nurses (neonatal, labor and delivery,maternity, NICU), midwives, nurse practicioners, physicians (psychiatrists, OB/GYNs, pediatricians, neonatalogists, family practitioners, general practitioners, primary care physicians), lactation consultants, health educators, doulas & home visitors – essentially anyone who comes in contact with new moms and moms-to-be!

Institute offers basic and advanced trainings on perinatal mood and anxiety disorders, including depression and anxiety during pregnancy, postpartum depression and anxiety, OCD, and postpartum psychosis.

Bringing Light to Motherhood: Perinatal Mental Health Community Provider Toolkit

This toolkit is an easy-to-use resource geared toward any health care provider or caregiver that interacts with new moms and moms-to-be. With over 100 pages are full of tips and advice on the risk factors, symptoms, prevention, screening, intervention and treatment of perinatal depression and related mood disorders, the toolkit also provides handouts that providers can distribute to patients, and an exhaustive list of resources and information in Spanish.
Please complete the form below to receive a link to download the digital file for FREE

postpartumstress.com

website where you can find information that can be utilized by families and by professionals

<p>Books:

Jennifer Moyer, A Mother’s Climb out of Darkness, A story about overcoming postpartum psychosis
Walker Karraa, Transformed by PPD
Brooke Shields, Down Came the Rain, my journey through ppd
Karen Kleinman, This isn’t what I expected

Film:

When the Bough Breaks – Can find on netflix and itunes
Dark Side of the Full Moon – Amazon and itunes