Kristen Dunbar of the Indianapolis Working Moms Examiner talks about her PPD

Kristen's story:
Six months after having my son, I found that I was constantly finding myself in a bad mood. I suddenly hated my job. I picked fights with my husband. I cried at random times including at work and for no reason at all. I weeped when I took my son to day care. In the back of my mind, I though I was just going through a normal hormone change. Then, in the middle of yet another argument with my husband, he states that if I do not call the doctor then he will. I looked at him like he was crazy because I did not understand what he meant, but then it clicked: I had post partum depression.

Many think that post partum will occur sooner than later after having a baby. In many cases, it can take weeks to months to develop. It generally happens in the first year after giving birth. For me personally, it happened I was diagnosed about 6 months after I had my son, but I think it truly started 3 months after he was born. (Just about when I went back to work) I just remember my doctor telling me that it seems to happen to women that have a career outside of home as well as women that had rollercoaster pregnancies.

From one of my favorite baby websites, Babycenter, I found several wonderful coping articles as well as a list of different symptoms for postpartum depression. Several common symptoms include moodiness, sleeplessness, and crying. Others include withdrawal, a change in eating patterns, or anxiety. One symptom that my doctor asked me a lot was if I felt overwelmed at all. She did not mean how busy I was, but just how I was coping with my lifestyle change by adding a baby into the mix of a career and a marriage. She sat down with me and explained that adding a new addition is one of the most stressful events to take place in a marriage and that emotionally it can be a lot to take in.

Some treatments suggested were therapy and medicine. Another one, that I love, is simple exercise, such as a walk or run. Other coping mechanisms that I also use are just simply taking a half hour to myself each day to scrapbook, read, or write. If you should ever feel the urge to harm yourself or your baby, please get help immediately.

A couple of great articles to reference include:

• Postpartum Depression on Babycenter
• Women's Health on postpartum depression

I was embarrassed to admit that I had postpartum. I felt like something was wrong with me. However, I had to come to terms with what was happening, and thankfully found a happy medium in which to deal with my condition. I have my great days and my not so great days as well as good and bad moments, but in the end, I know that I will be able to live life to the fullest again without anxiety or overwelming feelings.

Transcranial Magnetic Stimulation: new treatment for depression

US News and World Report:
Patients who struggle to beat back the demons of depression have another option that is creating serious interest among clinicians and researchers. Transcranial magnetic stimulation (TMS) is a form of brain stimulation, which reorganizes a brain's dysfunctional neural circuitry to the benefit of the patient. It's currently being used for people suffering from depression that is treatment-resistant—meaning it doesn't respond to the first-line approaches including lifestyle changes, psychotherapy, and antidepressant medications, but it is being studied for other uses, too. One big appeal: Unlike medications, it specifically hits the brain instead of the whole body So it is also offers an intriguing possible treatment for postpartum depression in women, say, who are breastfeeding and don't want their babies to be exposed to drugs.

To deliver TMS, a clinician presses a device to the patient's head to deliver magnetic pulses that reach about an inch deep inside the skull, causing electrical changes in targeted neurons. Typically, a TMS patient goes through a series of about half-hour treatments, usually several times per week over the course of a few weeks or maybe a month. But the results are temporary and may only last weeks or months; patients may need to return for an additional series of treatments if symptoms return. Side effects include headache, scalp discomfort, twitchy facial muscles, feeling light-headed, and being bothered by the loud noise of the machine. Less commonly, people can suffer seizures, mania, or hearing problems. Any long-term side effects are not yet known.

TMS therapy provides a more gentle option than electroconvulsive therapy (ECT), which has long been a next step for some patients when all else fails. While ECT has had a checkered past, techniques and research have refined the treatment, which induces a seizure to rejigger the brain's circuitry. So electroconvulsive therapy remains a valuable option for some patients, particularly for depression. But TMS does not require inducing a seizure, which means it doesn't entail anesthesia or a hospital stay. Nor does it appear to produce ECT's cognitive side effects, such as memory loss. It is also far less invasive than deep brain stimulation, which requires surgery to implant a pacemaker-like device. (DBS is mainly used to treat movement disorders and Parkinson's disease but is being tested against depression and other conditions).

The Otty Sanchez case: From a different perspective- women in today's society

From Feministing: Otty Sanchez and Watching Women Fall

Warning- if you are emotionally fragile right now (no reason to be embarrassed) take care of yourself and don't read this or any other media on the most recent story of infanticide to take the nation by storm. If however, you have already read all the gruesome details of this case presented by the news and want an interesting POV to consider more related to how women are perceived, portrayed and respected (or not) in our society, then read on.

This Monday, Otty Sanchez murdered her child and then attempted suicide, claiming the devil had commanded her to do it. It was a gruesome act of cannibalism. Police reported that every officer was silenced by the scene. And while this was a tragedy beyond comprehension for most people, the act’s similarity to Andrea Yates’ 2001 murders and the media’s response imply a larger problem. Why does the media fetishize women cracking under pressure?

Andrea Yates

There is an undeniable similarity to Andrea Yates’ infanticide in 2001. Like Sanchez, Yates claimed the devil compelled her to drown her five children. Both lived in Texas, Yates around Houston and Sanchez in San Antonio. And like Sanchez, Yates had a nervous breakdown and was hospitalized for psychiatric reasons twice, then diagnosed with postpartum psychosis within a year of the killings.

Yates stands out for feminists because when she married, her newly adopted religious beliefs included the Quiverfull movement:

“As arrows are in the hand of a mighty man;
so are children of the youth.
Happy is the man that hath his quiver full of them”

Psalm 127:3-5

Members of the Quiverfull movement abandon contraception, natural or otherwise, and procreate as much as nature will allow. Prior to the deaths, Yates experienced criticism from her church and family that she was not an adequate mother in the eyes of God. She claimed it was this that drove her to kill her children, the belief that her spiritual failure had spread to her children, who would by extension never be saved.

Otty Sanchez’ story is reminiscent of this; the week of the killing, she had a nervous breakdown for which she was hospitalized and released. Then, her boyfriend’s family also called the police about alleged child negligence on her part for failing to use a car seat. Forbidden from driving upon threat of calling the police again, the boyfriend’s family allowed her to return to their house. Sanchez was heavily reliant on her sister for help with the child at this time.

It’s possible that the pressures on these women, religious, familial, and otherwise, expedited their breakdowns. Though Sanchez was additionally diagnosed with schizophrenia and quit taking medication, the parallels between the situations suggest an underlying problem of women being pressured to choose motherhood regardless of their well-being.

Also, postpartum psychosis affects 1/1000 mothers, while less-severe postpartum depression affects 1/10. Sanchez had ceased taking medication for her schizophrenia, while her boyfriend still took medication for his. This increased her risk for postpartum psychosis by 50%.

Here, the “devil made me do it” connection is strengthened. Richard Pesikoff, a psychiatry professor at the Baylor College of Medicine, gave the following testimony in Yates’ trial:

“Postpartum psychosis is far rarer, affecting only about one woman in 1,000. Women with postpartum psychosis have delusions, frequently involving religious symbols and a desire to harm their newborn.”

Watching Eve Fall

The American media already has an unhealthy obsession with unhinged women. Reality shows glorify women “cracking” or “breaking,” getting in fights and losing control of their emotions. This is inherent to everything from Jerry Springer to Fox’s upcoming reality TV adaptation of the 1988 film, “Women on the Verge of a Nervous Breakdown. ”

Furthermore, even lightweight shows like Nanny 911 or Wife Swap put women under extraordinary scrutiny and encourage them to be suddenly self-critical of their parenting. This perpetuates the idea that there is just one effective parenting style. The larger theme of all these shows, of course, is that women are unpredictable and crazy. And while an underlying cause of this was the lack of adequate schizophrenia medication, Sanchez’ diagnosis of postpartum psychosis is instead chalked up to the mythical power of “hormones” to turn the kindest woman into a raging monster.

One question is, “Were Otty Sanchez a man, would his media coverage be the same?” I can speak for my local paper of 17 years, the Sacramento Bee, that Otty Sanchez made the front page on Monday with a headline with the phrase “Eats Brains,” which they later changed to “Child dismemberment.” And how common is front-page coverage of a man killing his child ? It would possibly make it into the B section, titled “Metro”- just for local news.

The mainstream media mirrors the grisliness in shows like “Law and Order: SVU,” furthering a desire of viewers to watch women as criminals. There is an American fetish for building unattainable standards for women, and watching as women fall short and blame themselves . This includes beauty, career, sexual, spousal, and parenting standards. Just as tabloids satisfy the desire to see other women’s flaws, (“Celebrities without makeup! You’ll never believe her cellulite!”) there’s a desire to tear down mothers as crazy. Furthermore, I would argue that this dates back past reality TV, past women being thrown in asylums, to the story of Adam and Eve that underlies the understanding of interactions between men and women today —audiences and the general public want to see women experience guilt and punishment for not measuring up.

Who’s to blame for Sanchez ceasing to take medication? Did she feel it was stigmatized? Did she lack the money or insurance to pay for it? Was she under religious as well as familial pressure? Did she feel her diagnosis was dismissed as trivial? Was there any way to prevent this?

So...what do YOU think?

I don't think she is an anomaly, and I think the media's glorification of the failure of women is a symptom.

Post Adoption Depression and Resources

From Strollerderby: As postpartum depression begins to slowly come out into the light and be spoken about openly by brave mothers on blogs, in magazines and books, its lesser-known cousin, post-adoption depression remains mostly hidden.

Adoptive parents can feel especially ashamed and guilty for experiencing doubts, anxiety or even just a post-big-event let-down once a longed-for child arrives at last.

Perhaps the pressure of infertility has already left an adoptive parent feeling inadequate or judged. Perhaps a few false starts in the adoption process have left her with a tough skin a new baby or child has trouble breaking through. Perhaps the same sleeplessness and new parent anxiety and–yes–even new parent hormonal changes (they aren’t all based on pregnancy and birth) that plague biological mothers hit an adoptive parent and send her into a downward spiral.

Adoptive parents are at risk for much of the same difficult adjustment issues that biological parents are threatened by. In addition, however, adoptive parents are often at the end of a long, difficult and possibly expensive journey to a new child. After wishing and hoping and trying and working and waiting, if the arrival of that child brings despair instead of joy, the guilt and shame only add to the misery.

Here's a list of possible go-to resources/suggestions on Post-adoption depression:

The Post-Adoption Blues: Overcoming the Unforseen Challenges of Adoption (Paperback)

From Adopting.org-

Clearly, PADS is a real feeling for many adoptive couples. What are some suggestions that can help you as a new adoptive parent deal with these feelings?

1. Recognize that Post Adoption Depression Syndrome is common and there are several valid reasons for feeling down after your child is placed with you. This does not mean that you have made a bad decision or are different from many other new parents.

2. In focusing and sharing birth mother grief . . realize that the birth mother made a positive plan for her and her child. You are an integral part of this special plan. If you share in her feelings of loss and grief, then take positive actions to help you both feel good about the plan that has come together for the adoptive triad. Write her a letter, make her an album, make certain that she knows what a great job she has done in giving this precious gift of life to you. Recognize that her grief is a natural part ofthe healing process.

3. Being anxiety ridden about certain legal risks and unresolved/unexpected issues is often a major source of stress. As adoptive parents, we must all accept the fact that with adoption comes certain risks. But, before accepting an adoptive situation make sure that the risks are ones that you can comfortably handle. It is a good plan to keep your head in control when evaluating each potential adoption situation. Once the baby is placed in your arms, the head control is usual replaced by heart control. Ask questions and know in your head the limit that your heart can endure.

4. Go to an infant parenting seminar. These seminars are often a part of child birthing classes at most hospitals. Call your local hospital to see when a class is being offered. Some hospitals will even allow a neonatal nurse to work one on one with you to show you how to care for your new born. Added confidence can relieve some of your feelings of anxiety and inadequacy about properly caring for this little, but very demanding little bundle.

5. Arrange for time to adjust to your new status. Unfortunately, many companies do not allow adoptive parents to take paid time off. With the rising cost of adoption, many families simply cannot afford to take time away from work without pay. Consequently one alternative is to rearrange your work schedule, if possible, to be more flexible for the first six - eight weeks. Another suggestion is to make plans for food and other necessities for the initial weeks in advance. One client I knew has a casserole shower from her local dinner club. Fifteen frozen casseroles came in very handy when the new baby arrived. "I wanted to spend every available minute with the baby. Clearly cooking was a low priority for me. " stated one adoptive mother. Paperplates, utensils, and cups can also cut down on work time and give you more time to relax and adjust.

6. Many adoptive couples feel that they must be super parents. They can pick up a baby on Friday, go back to work on Monday, have a meeting on Wednesday night, keep the church nursery on Wednesday night, have gourmet club at your house for the regularly scheduled monthly meeting on Saturday night, never missing a meeting or activity- all on four hours of sleep a night. Realize that birth parents usually take six weeks off of regularly scheduled activities. This time is not just for the healing of the body, but also for adjustment and bonding to the baby. Allow yourself the same time frame to adjust. Take a sabbatical from other responsibilities for six weeks and learn to love your baby.

7. Join an adoption support group, if you have not done so already. Share your feelings with others. A former client confided that she did not feel comfortable complaining about the baby's colic and her lack of sleep. "I felt like people would say that I asked for him. . . shut up. " Adoptive parents are not superhumans. We are real parents, who get tired, irritable, and have REAL feelings. Share your feelings with another adoptive parent in the support group.

Bringing your baby home is one of the highlights in your life. It is the beginning of a long and wonderful journey called parenthood. As with most journeys, there can be detours and bumpy spots in the road. Learning where the pot holes are makes the journey a little bit smoother.

Happiness: 5 Ways to Practice Gratitude

From this article at Psych Central, we find great suggestions on being happy. While we don't have a choice about how PPD may effect us, we do have a choice about how we make efforts to increase our "happiness factor." More and more research is showing that we have some control over how happy we are and that happiness is more important than hard work in terms of success.

1. Write gratitude letters.

One strategy that has been test proven to promote happiness is writing gratitude letters. After you spend some time thinking about the people who you most appreciate you sit down to draft a letter to them. The mere act of expression is what is most important, so you don’t even need to give them the letters.

2. Express gratitude in person.

Extroverts might benefit from expressing their gratitude in person to a special mentor, sibling, co-worker, or friend. It doesn’t need to be formal. Just a simple gesture of thanks is only needed to feel the benefits of this kind of gratitude.

3. Express gratitude in art.

For more artistic folks, you could make a gratitude collage, where you cut out images of things or places or people that you most appreciate. For example, you might find a photo from a special vacation and paste it on your collage with other favorite things, like dark chocolate.

4. Make a gratitude date.

I like to make a gratitude date. By that I mean that I run with a partner and we will discuss all the things we are thankful for, so that the run is a time set aside to count blessings.

5. Devote one time a day to gratitude.

And there are certain times you can devote to gratitude. For example, at the beginning of your meals, or at bedtime, or when your husband gets home from work. Committing to a specific time establishes a practice of gratitude.

Antidepressants and Breastfeeding: Are They Compatible?

Here is a research based article on the safety of prescription medication while breastfeeding. The recent debates about the Mother's Act have certainly stirred up strong opinions on both sides about the risks associated with taking meds while pregnant or nursing, as well as the impact of untreated depression and anxiety on the fetus or infant and it's mother. In an effort to provide information that you can read and consider I will post this as one point of view. Clearly, you and your doctor need to weigh the pros and cons of medicating and make a very personal and individual decision that best meets your family's needs.

Any woman who has recently given birth is susceptible to post-partum depression. There are also some mothers who suffer from depression during pregnancy and some mothers that have been on long-term treatment for depression. When it comes to nursing their newborns, they often are given the choice to try prescription antidepressants. A great deal of misinformation and simple lack of knowledge on the mothers' and the doctors' part has led to confusion and reluctance to use medications. However, experts consider a number of antidepressants to be relatively safe for mother and baby.

Dr. Thomas Hale, Ph.D. is the leading expert on medications and nursing. He is the author of Medications and Mother's Milk: A Manual of Lactational Pharmacology, the go-to source for pediatricians, obstetricians and lactation consultants. His website has a forum for medical professionals to ask him questions, but anyone can search it and read the posts. He writes about all categories of medications, not just antidepressants. The American Academy of Pediatrics also maintains lists of medications and their effects on nursing infants. They have a separate list for psychotropic drugs, which can be found here. The United States National Library of Medicine has a searchable database of medications, LactMed. The scope of this article does not include an in-depth discussion of the different categories of antidepressants...

Postpartum Doulas help families deal with early days at home and prevention of PPD

I have written about the benefits of Postpartum Doula in other posts and have even suggested that instead of a baby shower or gift people donate towards the cost, which can be pricey- from $15-$20/hour. Here is an article about a Canadian family who decided to hire a PP Doula with #2.

Colette and Paul Pritchard knew they'd have their hands full when they returned home from the hospital with their second baby.

So they hired an extra pair -- the experienced hands of Maria Keirstead, a postpartum doula.

While a birth doula helps parents through pregnancy and birth, a post-partum doula helps new parents and their babies in the first weeks and months after the child is born.

"It's been wonderful," says a smiling, laughing Colette, sitting in the sunny family room of their Beaumont home with Maria and two-week-old Adrian.

"I wish I had known about her before."

"The benefit is getting some sleep and not worrying that the baby is going to wake up and I won't hear him. And she's been there a lot for emotional support."

When Colette's first son, Grant, was born 41/2 years ago, the new mom was overwhelmed.

She had trouble breastfeeding and was getting little sleep. She began to get dragged down by the "baby blues," she says.

Her own parents are older and were unable to help much with the newborn. Paul's parents live far away.

"That put a lot of burden on Colette," recalls Paul. "And that post-partum depression is a sneaky thing. It just creeps up on you."

This time, Paul was determined to be more prepared. "I wasn't aware of the depression that women can suffer because it isn't talked about that much," he adds...

...Postpartum doulas are like the modern-day version of the baby nurses of old, hired by mothers to help in those first, sleep-deprived, trying weeks and months of new parenthood.

Pregnant mom's stress affects baby's IQ

From Toronto Globe and Mail

Severe stress during pregnancy can damage a baby's brain and put the child at greater risk of anxiety, depression and attention deficit hyperactivity disorder later on in adolescence, according to British research.

Studies have shown that severe stress during pregnancy can damage a baby's brain and put the child at a greater risk of anxiety, depression and attention deficit hyperactivity disorder.

Metro Creative Images

The higher the levels of cortisol - a stress hormone - in the womb, the lower the toddler's "baby IQ" at 18 months, the researchers found.

"We found that if the mother was more stressed while she was pregnant the baby scored significantly lower on the mental developmental index," said Vivette Glover, lead researcher and professor of prenatal psychobiology at Imperial College London.

...The British researchers are also pushing for more professional support.

"In the developed world, the physical care of pregnant women is pretty good, but the emotional care is very, very lacking," Glover said.

"We need to be finding out about the emotional state of women in pregnancy, whether they're anxious, depressed or having problems with relationships with a partner, and then providing appropriate help."

The researchers also called out fathers: Glover said that 25 per cent of 125 respondents complained about emotional abuse from their partners.

Contraception during the Postpartum period

I know that when I was initially postpartum, especially when I was feeling my worst and then in the few months following that, I was unable to "go there" emotionally or physically. However, that is not the case for all women, in fact some may re-institute a physical intimacy with their partner in order to have a sense of normalcy or connection to their former life if they are having trouble adjusting to motherhood. There are many myths and misconceptions regarding birth control/pregnancy after childbirth. Women who are experiencing postpartum mood disorders are at special risk of becoming pregnant again because of the extra stress they are experiencing and the fact that their decision making capabilities may be compromised by this. It is recommended that women wait an entire year before becoming pregnant again so that the body can return to its pre-pregnancy state, which often takes up to a year. This article provides some facts and suggestions for women regarding pregnancy prevention postpartum. It is really important that ALL women, even those breastfeeding, take appropriate measures to prevent unwanted pregnancy during this time. PPD that leads directly into Antepartum Depression during an unintended pregnancy can further complicate a woman's mental health.

New moms have specific contraceptive needs. They want birth control that is effective, simple to use, can be used over a long period of time, and allows for sexual spontaneity. An important question often asked by new moms is, “How soon after giving birth do I need to start using birth control?” Usually, doctors recommend that birth control be started six weeks after giving birth (if medically it’s okay to have sex) or when menstruation resumes. Breastfeeding does not prevent pregnancy, as many couples accidentally realize, so often couples use condoms until they decide on another form of birth control.

Read more on this topic HERE.

Susan Dowd Stone's response to the Time article

Here's a bit of the article Susan wrote for Empowher in order to address the good and bad of the Time article and clarify regarding the Mother's Act. You can read the entire piece HERE.

...The recent article which appeared, “The Melancholy of Motherhood,” presents a thinly-veiled bias against life-saving legislation, The Melanie Blocker Stokes MOTHERS Act, which continues its steady march toward adoption.

The article was researched, outreach made to many who attested to the critical need for this bill. Several of our nation’s most prominent PPD researchers such as Dr. Katherine Wisner and Dr. Michael O’Hara were interviewed; however, some comments were taken out of context to apparently support an editorial view.

Completely ignored were any reference to the interview with Katherine Stone, author of Postpartum Progress, the most widely-read blog in the U.S. on postpartum depression, or any attempt to interview Former NJ First Lady Mary Jo Codey who, along with her husband, spearheaded our nation’s first PPD legislation, which has led to the saving of so many lives in New Jersey. Both of these brave ladies are PMAD survivors who continue to challenge the stimga of maternal mental illness.

Also glaringly absent were the many family-founded national non-profit foundations, formed after the tragic losses of beloved wives, daughters and friends. One example is the Jennifer Mudd Houghtaling Foundation out of Chicago, which sponsors an annual educational event attracting researchers and advocates from around the world. Another is Jenny’s Light, which hosts fundraisers each year to help end the devastation of perinatal mood disorders.

Postpartum Support International, the world’s leading non-profit volunteer organization on postpartum issues, with coordinators in every state and 42 countries around the world, was not even referenced, despite its wealth of information, statistics and world-wide prominence on this issue. Nor did the article mention the long and impressive list of medical and professional organizations who have long endorsed this life-saving legislation...

Dr. Judith Reichman's opinion featured

One physician weighs in on her blog about depression and pregnancy...
From her site: Dr. Judith Reichman is considered to be one of the leading voices in America on women’s health issues. She has been a medical contributor on women’s health for the NBC Today Show, appearing bi-weekly for over a decade. Currently, Dr. Reichman has a thriving practice in Los Angeles. She is an attending physician in gynecology at Cedars-Sinai Medical Center. She is a fellow at the American College of Obstetricians and Gynecologists.

Clinical depression peaks in our reproductive years. Nine percent of women will have an episode during or within 3 months of pregnancy. The consequences can be harmful to both mother and child. There are entire medical journals dealing with “the safest way” to deliver a baby, the pros and cons of Cesarean vs. natural delivery, the concerns about vacuums, forceps, routine episiotomy, not to mention tables to ascertain desired weight gain, concerns about preterm deliveries and of course tests to ensure the genetic integrity of our offspring. But few Ob Gyns are trained to either recognize or treat clinical depression in pregnancy. When asked by a patient whether it is safe to start or continue antidepressant medication during pregnancy….we hem and haw...

Her advice:
If you are on a medication for depression that works, especially an SSRI and you conceive….keep taking it. If you stop, chances are you will have a relapse and this can harm you and your pregnancy. Know that you may need higher doses as the pregnancy develops. (There are a lot of changes in the metabolism and dilution of any medication as you and your pregnancy grow.) After 4 to 6 weeks you and your doctor may decide you need to increase the dose every 2 to 3 weeks until your symptoms are in remission.

Every time the media reports on a new adverse effect from an antidepressant….remember that bad news makes news. If you suffer from clinical depression before or during pregnancy, treatment can make a very positive difference in your pregnancy outcome and the future health of your child.

New Moms Urged to Take Care of Postpartum Health

Remember, it is of utmost importance to care for your own physical and emotional needs postpartum while caring for your child...

“Easily over half of women who have vaginal birth, at least their first birth, will have some problem in terms of bowel, bladder or sexual dysfunction that can occur,” said Dee Fenner, M.D., director of the University of Michigan Health System’s Healthy Healing After Delivery Program. Fenner is also a professor in the Department of Obstetrics and Gynecology, director of both Gynecology and Surgical Services, and the Harold Furlong Professor...

Many women wrongly believe that postpartum ailments are simply a part of giving birth, and that they need not be addressed.

Fenner urges women to take care of their own health after delivery, not solely their infant’s.

“Unfortunately, I think many women suffer in silence in that they don’t really complain or know that something can be done,” Fenner said.

Read more HERE...

One woman's Postpartum Anxiety turned drug addiction

WOW: This brave mama talks about her horribly destructive and addictive habit that she developed when self-medicating her PP Anxiety...

After I had my son, I had severe postpartum anxiety, which resulted in insomnia and lack of appetite. I felt so much shame because I loved my son more than anything, but I was such an emotional wreck. I tried different homeopathic and traditional therapies, none of which were effective. I had a therapist who only knew me as a sober and highly functioning woman. She told me her daughter had a prescription for medical marijuana. "It's a nothing drug," my therapist said, "Everyone does it."

This underground trend of the therapeutic and medical community promoting medicinal marijuana is eerily similar to the time when doctors pushed Valium on "stressed" women. The point is not whether it's better or worse than alcohol, because doctors don't prescribe a fifth of Jack for insomnia. And while yes, marijuana should be legal just as cigarettes and alcohol are, because people should be free to choose, it's well established that some people can't handle those things. The legal arguments are getting tangled up with people's flat-out desire to smoke weed, which is understandable, because the fact is, getting high is awesome and people like to believe that things are healthy for them. Some people CAN handle it -- good for them! It just seems like a sign of danger when someone says they're doing it because they need stress relief. My experience is that it did indeed do that, but that there was a cost to pay for suppression over a long period of time.

Within a couple of days of obtaining my prescription, I was back to smoking pot all throughout the day. Only now, I wasn't a single 18-year-old girl running around Manhattan without any real responsibilities. I was a wife, a mom, and I had a place in my community. I completely hid my pot smoking and began to live a double life.

When pot worked for me, it worked beautifully. When I was high, I could cope with the stress of new motherhood. There was something sweet about being stoned and totally in the moment with my baby. I felt like I could handle and even enjoy the relentless and demanding tasks of new motherhood. I rationalized my smoking by telling myself that I had a prescription, I wasn't harming anyone, and pot made me a better and happier mom. Just like in college, my life began to revolve around weed -- scoring it, smoking it, and maintaining my high. Smoking wasn't nearly as easy as it was back then, when I could lock myself in my dorm room. I had to make sure my son was sleeping, sneak outside, hide in a corner, and quickly smoke as much as possible, hoping my neighbors wouldn't see or smell me.

I was totally addicted. Physically or psychologically is just a matter of semantics, but I believe I was both. This seemingly benign herb had once again taken over my life. My tolerance increased and I needed more and more pot to produce the desired effect, so I began to supplement my pot smoking with pills and alcohol. Suddenly I was back full-force in my addiction. For me, pot is a gateway drug. It alters my mood, stops working, and ultimately leads me to seek out more powerful and effective substances.

I bottomed out again and came within millimeters of losing everything, all because I bought the "harmless and medicinal" propaganda. The stakes were much higher this time than when I first got sober at 20. The fact that I evaded child protective services or any real consequences is a product of sheer luck -- there are many women who have used drugs just the way I did and have completely lost their families because of their addiction.

I am not going to lie -- being a clean and sober mama isn't always easy. There are days when I am excruciatingly uncomfortable and would give anything to check out, just for an hour or two. My children challenge me on so many levels, and without any buffers, motherhood can feel overwhelming. But I remind myself that my kids deserve a clean and sober mom who is truly present. I believe that my sobriety offers them a realistic world view, as they have the opportunity to experience my humanness without the edges being hazed by the influence of marijuana...

Today I embrace the opportunity to teach my children healthier forms of self-soothing through example.

The full article can be found HERE...

Thankfully, her addiction was resolved and her children remained safe. If you are suffering from a perinatal mood disorder and have not yet sought legal and helpful treatment from a professional, please find a physician or therapist educated in PMDs who you trust. Self-medicating almost always has disastrous results.

Postpartum Psychaitric Emergency definition and resources from MedEdPPD

More from the great website, MedEdPPD...

What is a postpartum psychiatric emergency? There are three types of emergent situations:

• Risk of harm to self (suicidality)
• Risk of harm to others (homicidality)
• Inability to provide basic care for self (usually due to psychosis). Psychosis is associated with both suicidality and homicidal ideation toward the infant or others.

For a complete list of information and resources related to psychiatric emergencies in the postpartum period, visit the MedEdPPD website.

Great FREE audio resources from MedEdPPD!

MedEdPPD has great resources all over its site. The latest and greatest that I have stumbled upon is a list of audio or video files that can be listened to in mp3 format or that you can even subscribe to free via itunes. To check out the current list, click HERE.

Here's a description of the resource:
During our First Thursday teleconference series our expert faculty presented on PPD topics ranging from the latest in screening and treatment methods to the epidemiology of postpartum psychosis. You can view these archived presentations online or download them as podcasts or vodcasts and listen at your convenience.

09-10 Events that feature Education and Advocacy for Perinatal Mood Disorders

7/13/09 Monday	Summer Networking Event Sponsored by the Sounds of Silence, Friends of the Postpartum Resource Center of New York at Sea Levels Restaurant 391 North Windsor Avenue Brightwaters, New York 5:30-6:30 Networking and Book Signing with Geraldine O'Keeffe, Author of The Stork's Revenge 6:30 Dinner Honorees: Gail Burrus, Executive Director, Suffolk Perinatal Coalition Geraldine O'Keeffe, Author and Volunteer of the Postpartum Resource Center of New York Guest Speaker: Cheryl Zauderer, MS, RN, CNM Postpartum Depression and Altered Newborn Attachment Raffle Drawing To Reserve Your Ticket: $40 per person (of the $40 ticket price, $10 is tax deductible) E-mail: postpartum@aol.com or call 631-422-2255
8/4/09 - 8/7/09	Postpartum Support International's 23rd Annual Conference to be held in Los Angeles, California, USA Dates: August 4 - August 7, 2009 August 4 & 5: PSI Pre-conference trainings August 6 & 7: Conference Location: The California Endowment Conference Center 1000 North Alameda Street The PSI 2009 Conference is Co-Sponsored by the LA County Perinatal Mental Health Task Force For more information go to www.postpartum.net
10/27/10 - 10/30/10	Marce International Meeting at the Sheraton Station Square in Pittsburgh, Pennsylvania, USA. To pay dues online as well as for information and updates go to www.marcesociety.com Katherine Wisner, MD - President, Marce International

John Grohol at Psych Central sounds off about the Mother's Act

I have reprinted this article in it's entirety below so that you can read this great piece addressing the FACTS about the Mother's Act and responding to the opponents' claims. I applaud the thorough manner in which he answered so many questions using valid research. Applause to Psych Central for making this a priority.

By John M Grohol PsyD
July 14, 2009

Psychiatrist J. Douglas Bremner has weighed in on the Melanie Blocker Stokes MOTHERS Act, an effort to provide voluntary screenings to pregnant women to help identify postpartum depression before it becomes overwhelming. I’ll let Bremner speak for himself:

The problem with this is the attitude that being a mother is a risk factor for a psychiatric disorder. First of all, there is no evidence that women without a prior history of anxiety and depression have any increased risk of getting post partum depression. So to screen all moms as if giving birth is a risk factor for depression is ridiculous.

My BS alert goes off whenever someone tries to change the argument from a reasonable effort to help increase education and information about a stigmatized mental health issue, to hyperbole, suggesting that a piece of legislation is trying to turn motherhood into a psychiatric disorder. It goes off again when a professional makes an extraordinary claim like, “there is no evidence that women without a prior history of anxiety and depression have any increased risk of getting post partum [sic] depression.” Really? Absolutely no evidence? That’s quite a strong statement, and easily proven false with a literature review.

Where shall we begin? (I have limited space and you have a limited attention span, so I’ll just highlight a few studies…)

Ross & Dennis (2009), for instance, in a literature review found that both substance use and current or past experiences of abuse are associated with increased risk for postpartum depression (PPD).

In urban South African women, Ramchandani and colleagues (2009) found the strongest predictors of postnatal depression were exposure to extreme societal stressors (e.g., witnessing a violent crime/danger of being killed) and reporting difficulties with their partner.

Robertson et al. (2004), in a large meta-analysis of research to-date, found that a previous history of depression and anxiety (not just during pregnancy) was predictive of postpartum depression. But they also found that simply experiencing a stressful life event during pregnancy or low levels of social support (e.g., not having any emotional support from your friends or family) could also lead to postpartum depression.

Beck’s (2001) meta-analysis of 84 studies found:

13 significant predictors of postpartum depression: prenatal depression, self-esteem, childcare stress, prenatal anxiety, life stress, social support, marital relationships, depression history, infant temperament, maternity blues, marital status, SES, and unplanned/unwanted pregnancy. 10 of the 13 risk factors had moderate effect sizes while 3 predictors had small effect sizes.

Look at all of those factors which are not depression or anxiety — I count 9. Even if 3 of those are small-effect size factors, that still leaves 6 factors which are not depression or anxiety.

What about the argument that if depressed women are the most at-risk, we should simply focus on them?

Ingram & Taylor (2007) found it wasn’t just a woman’s pre-birth depression severity that was important — poor emotional support and women who had more negative descriptions of their own childhood were additional risk factors that played a role in increased risk for postpartum depression. Who’s going to screen for these things, the obstetrician?

Well, no, because the obstetrician is already not doing a good job at screening for postpartum depression, even in high-risk women. Hatton et al. (2007) found that, among high-risk women, obstetric care providers may be overlooking up to one fifth of women with current major depression. Not exactly great numbers there. If obstetric care providers can’t deal with the obvious cases, I can only imagine how well they do with the more complex or less obvious ones.

Monk et al. (2008) sums the state of our knowledge on PPD:

Depression is relatively common during the perinatal period (Gavin et al. 2005; Ross and McLean 2006). Approximately 8.5–11% of women experience either a major or minor depression during pregnancy (Gaynes et al. 2005). Nearly 20% of women have a minor or major depression in the first 3 months following delivery (Gavin et al. 2005).

So up to 1 in 5 women have depression after giving birth, and this isn’t something worth noting or screening for? (For comparison’s sake, 1 in 10 men and women in the general population might have depression at any given time.) Giving birth doubles your risk of depression, and this isn’t an issue? Amazing.

But don’t just take my word for it. Zajicek-Farber’s (2009) study conducted on high-risk women for postpartum depression concluded that:

These findings provide additional supportive evidence that more efforts are needed to identify and assess women’s depressive symptoms to promote health and safety of young children.

These are objective researchers calling for more screenings. Not politicians. And not people (or professionals) with a political agenda.

Now, I understand Bremner’s point — let’s not medicalize and catastrophize ordinary motherhood. I agree. And of course a woman’s pre-birth depression or anxiety is strongly correlated to postpartum depression. But not exclusively, as Bremner claims.

Bremner claims, with no evidence, that all mental health screenings are simply pharmaceutical sales tactics to help increase prescriptions. That’s ridiculous. When I worked in community mental health, we ran annual mental health screenings in the clinic — with no funding from any pharmaceutical company — because it reduces stigma, decreases misinformation and increases education about mental health issues in the general population.

Sorry, but most people don’t have time to keep up with a dozen blogs or read monthly journals on the latest research in mental health. Most people know what they know about mental health largely through mainstream media, or their own first-hand experiences with an issue. How is the promotion of more information and education about mental health issues a bad thing?

Bremner uses teens as an example of screening gone wrong, but conveniently fails to mention the facts about teenagers and mental health. Teens are an “at-risk” population, hence the reason they are sometimes targeted for screenings. Teens are notorious for being limited in their treatment options (especially in the U.S., where their treatment may be covered by their family’s health insurance, meaning a talk with their parents about their mental health issues), and for peer pressure limiting their ability to accept or seek help. (Yes, sorry, if you’re seeing a therapist for depression as a teen, you’re typically not seen as a “cool” kid.)

Sadly, whether people want to admit it or not, mothers are another “at risk” population. Why? Because society has told mothers time and time again that giving birth is supposed to be a joyous, happy occasion. If you’re depressed after giving birth to a child, there must be something wrong with you. Don’t draw attention to yourself or your problems. Just try and deal with it, try and take care of the baby, and make it through each day. Mothers don’t know they might have something recognized as postpartum depression, much less that they can talk to someone about these feelings or that there’s treatment — psychotherapy or medication — readily available for it.

So respectfully, I disagree with Bremner’s assessment of the MOTHERS act and its need in today’s society. And if you’re not going to bother to do the legwork and just make general (false) pronouncements about what the research actually shows (or worse, suggest the all research that disagrees with you must be in pharma’s pocket), then that’s a lazy person’s argument. There are too many logical fallacies at work here to list, so I’ll just suggest that I expect more reasoned and professional arguments –based upon the actual research — about such important legislation.

Psych Central continues to support the Melanie Blocker Stokes MOTHERS Act because the research shows it would help in the efforts to increase education and correct mis-information about postpartum depression.

Read Bremner’s entry here: Motherhood is Not a Medical Disorder

Little Attention Paid to Effect of Parents' Depression on Their Children

The Institute of Medicine notes there are large gaps in knowledge about the effects of parental depression on children and a need for multigenerational approaches to care.

Depression is too often a family affair and ought to be viewed that way, but the unsystematic nature of the U.S. health care system serves as a major block to identifying and treating millions of parents whose depression may affect their children's future, according to a report from the National Research Council and the Institute of Medicine.

"[P]arental depression is prevalent, but a comprehensive strategy to treat the depressed adults and prevent problems in the children in their care is absent," said the report from a task force chaired by Mary Jane England, M.D., president of Regis College in Weston, Mass., and a former president of APA. She spoke at a press conference in Washington, D.C., last month announcing the study's results.

The report estimates that there are 7.5 million parents with depression in the United States caring for 16 million children under age 18...

"We need to think about depressed parents as parents first and then as depressed people," added panel member William Beardslee, M.D., academic chair in the Department of Psychiatry at Children's Hospital Boston and the Gardner/Monks Professor of Child Psychiatry at Harvard Medical School. Current approaches to depression focus too narrowly on symptoms and diagnoses in individuals while ignoring broader effects on families. Existing screening, treatment, and research protocols, for instance, do not take into account the possibility that the patient is a parent.

The problem has received less attention than it should because it falls along the boundaries of professional and policy domains, from research to payment for services.

Read more HERE...

Response to conversations around the Time magazine article and the Mother's Act

As much as I would like to be, I am just not that angry about the recent Time article. The conversation that it has sparked, the re-ignition of passion and commitment to seeing the support of the Mother's Act through is what I am trying to focus on. I have to believe that good is at work through all the discussion spawned by this one little article, however biased, inaccurate and seemingly caustic.

In response, I am choosing to share with you the eloquent, heartfelt and informative posts that my colleagues in the world of postpartum support have spent their time and energy this weekend writing. Please, take the time to read and digest what is said and then share your personal opinion with those who can make a difference. You can contact your local, regional or national government servants or your local or national media sources and share your experiences, your opinions, your support, opposition, etc.

If you'd like to share your story here on Beyond Postpartum, please email me. I will be beginning a series of interviews in the next couple of weeks/months that will hope to shed some light on the extremely unique and individual postpartum experiences women across our country have. Perhaps these stories will help to offer insight and inspiration to others...it certainly can't hurt.

Read Ivy's take on the Time article HERE.

Read Katherine's take on the Time article HERE at Postpartum Progress.

Read Lauren's post from her website, Sharing the Journey.

And if you are not yet compelled to help endorse increasing the number of postpartum women being screened for PPD, you probably just need to read:

How Postpartum Depression Screening saved Marcie's life.

SLEEP...need I say more?

Hate to say "duh," but, um, this is not shocking...I feel like sending all of these articles to the people who seem to believe that women should suck up sleep deprivation and not spend so much time talking about how little sleep they are getting during the first 6-12 months after childbirth...reality check...even if some of you have been parents in the past, clearly you don't remember how sleep deprived you probably were (God's glorious design, like the way He mysteriously wipes all vivid memories of labor from the mind in like 30 seconds after delivery). OR, maybe your baby was being fed formula and eating rice cereal from birth like I have heard stories of... OR, maybe you got luckier than a "2-petered goat" (thanks to my husband's friend for this splendid image of RARE luck) and your child slept through the night from birth. Either way, PLEASE do not antagonize, patronize or minimize a mom's feelings when she talks about how desperate she is for real sleep or how poorly she feels mentally and/or physically as a result of her sleep deprivation.

And, if you are feeling alone in your desperation for sleep, just log on to Facebook. It seems at least 5-10 of my female friends are posting status updates about how much (or usually little) their babies slept the night before. I bet you'll be in good company with your friends, too.

The truth is, sleep is necessary for survival. And we're not talking about 6 or 8 30 minutes chunks of sleep, but a REAL 5.5 hour COMPLETE sleep cycle!

Here's part of an article from Elements Behavioral Health that discusses the topic:
Postpartum depression is a part of new baby reality for many parents as they try to adjust to the major changes in life due to creating a new one. While many a new mommy has taken specific drugs designed to address postpartum depression, a new study finds that the she might just be tired.

The Gant Daily News examined a study by Canadian doctors that pointed to the simple remedy of more sleep to help cut postpartum depression...

Steiner, who is the founder of the Women’s Health Concerns Clinic, then began advising women giving birth at the clinic to stay in the medical facility up to five days after their childbirth in order to rest. Women stayed in a private room, with the newborns in the nursery overnight...

At the same time, the clinic is studying a new treatment for postpartum depression by giving estrogen and antidepressant medication to women who just gave birth. The results of this study will be compared against those of the sleep study to determine the best therapy for postpartum depression.

While sleep could be the obvious answer for those new moms, trying to find enough of it once they return home could be another challenge. Coaching new mothers on setting schedules for baby and how to sneak naps when possible could be moving in the right direction for keeping postpartum depression at bay.

Hormones May Affect Neurological Disease Risk

Forbes reports:
Fluctuating hormone levels may explain trends in the timing of women's susceptibility to neurological diseases such as Parkinson's, schizophrenia, Alzheimer's, Tourette's and attention-deficit/hyperactivity disorder, new research suggests.

Significant estrogen level changes occur at various stages of women's lives, including adolescence and menopause, and as a result of menstrual cycles. The onset or exacerbation of neurological diseases are most likely to occur at these times, said researchers at the University of Texas Medical Branch.

They found that a number of estrogens acting through their receptors affect the dopamine transporter (DAT). Dopamine is a neurotransmitter in the brain that plays an important role in normal functioning of the central nervous system.

"The significance of estrogen-coupled regulation of the DAT by both direct and indirect (kinase-mediated) interactions between estrogen receptors and the DAT should provide insights into how neurological diseases which involve the DAT are related to developmental, gender and life-stage issues," study author Cheryl Watson said in a news release from BioMed Central.

"Such regulation may suggest new ideas about treatment and prevention of diseases associated with extreme hormonal fluctuations, such as in postpartum depression," she added.

The study was published online in the journal BMC Neuroscience.

Study on seratonin may shed light on appropriate medications for PPD

From Momlogic:
In the German study, two groups of mice were put in a cage -- normal mice and those with a serotonin deficiency. The serotonin-deficient mice were markedly negligent toward their babies and were five times more likely to eat them!

Sure, people aren't exactly mice, but researchers do think the results might be transferrable to us. This group of scientists can use this information to create a new drug for humans that activates an enzyme in the brain to make more serotonin, as opposed to selective serotonin reuptake inhibitors (SSRIs) currently used to treat depression, which merely block the reabsorption of serotonin, and can be tough on other parts of the body.

Does this mean a prescribable end to postpartum depression? That remains to be seen, as scientists are still evaluating the connection between serotonin and the volatile hormone balance of postnatal women.

But you might be able to get a heads up if you're likely to experience postpartum depression. Earlier this year, scientists discovered a period of time in pregnancy where hormone levels could be tested to predict PPD.

Read the full article HERE...

Depression and Christianity

Biological depression is as prevalent among Christians as it is among the general population, however it often goes undiagnosed due to erroneous views held by many in the church regarding the cause of depression. In her book on Spurgeon’s struggle with depression, Elizabeth Skoglund notes:

With the advent of Freud in the early twentieth century, and his emphasis on sexual dysfunction as an underlying factor in emotional problems, psychotherapy changed, and anyone with emotional problems became stigmatized. The understanding of the connection between body and mind—and eventually spirit—was lost for the most part. With that loss the mind was seen as solely responsible for emotional problems and thus the implication was drawn by some that such problems could be controlled by the will alone. In this way the overspiritualization of emotional problems became reinforced.

She goes on to give an example:

A woman going through menopause may experience periods of depression that should not be labeled as primarily psychological or spiritual. She may derive help from spiritual or psychological sources, but the primary cause is physical.

It is important for Christians, especially those in counseling positions, to realize that many times, the depressed person is suffering from a medical disease and it needs to be treated as such. As Miller and Jackson note: “…it is abundantly clear from current research that certain kinds of depression have important biological roots and can be substantially relieved through the appropriate use of medication. The counselor who is unaware of this biological side of depression is overlooking significant information.”

Hmmm....

To read up on the entire article, click HERE...

We interupt the regularly scheduled blog posts...

Okay, so if you know me at all, you know I am a huge Dooce fan. The honesty, the grit that borders on offensive, but doesn't quite make it there, the REAL accounts of motherhood, the discussions of family dynamics that sound at least a little familiar to my dysfunctional relatives...all of it! Anyway, the quick catch up is that Heather, aka Dooce, recently had her 2nd baby, another girl, 5 years after having her first baby girl. The first time around she (like so many of us) nearly lost her mind, wrote about it on a blog (like so many of us), and eventually found that she and her husband could retire early and work from home on how much she made from her blog alone through marketing and sponsorships (completely UNLIKE so many of us). Anyway, I think its just great that she is raking in the dough since she has literally brought a real perspective on perinatal mood disorders to seriously like hundreds of thousands of readers. Oh, and of course she wrote a book. One my dear friend Jen, author of The Wide Smiles of Girls, got autographed for me! Yay! Seriously, I was almost as excited as if Ronald Reagan had autographed one in my treasured Ronnie and Nancy collection. She's like the superstar of the PPD blogging world (aside from Katherine, no offense to you my dear, but we know each other so that doesn't count).

Anyway, I read Heather's post from a few days ago just now and HAD to share it with you, like yesterday...so many issues addressed here and so much hope, too! Read it, enjoy it, comment on it, LOVE IT!!!!

However, on day three something happened. At first I thought it was the sleep deprivation catching up with me, so I ignored it. But by day five and six I couldn't pretend I was okay anymore. I started having panic attacks and such severe anxiety that my hands started to contort and clutch into twisted positions that I could not relieve. I couldn't fall asleep or stay asleep, and my mind started spiraling into dangerous places. I was so angry, so frustrated because there was no reason to feel this way. Intellectually I knew everything was okay, and my god! I knew what I was doing! I loved the baby and knew how to meet her needs! WHY WAS I PANICKING?! There just wasn't a good explanation for my crippling anxiety, but there it was. And it was robbing me of the experience I was determined to have.

So early last week we called the doctor who treated me in the hospital back in 2004. He does not normally see patients who are not in the hospital, but by some lucky twist of the universe he thought I was someone else, someone whom he owed a favor, and agreed to see me as an outpatient. And two days later I'm sitting there on a couch in his office facing him as he contorts his face in an effort to figure out just who the hell I am. And I'm sweating, and the anxiety is crawling up my body and paralyzing my neck, and he's all, hmm... you're not who I thought you were. But here you are, and dear God, woman. You look just awful.

So he pulled up my record from five years ago, glanced back at me, looked back at his computer, and that's when I involuntarily blurted out, "I wrote a book about my experience in the hospital." Maybe to let him know that I was serious? That here I was dumb enough to try and do this whole thing again? And he immediately whipped his head around and said, "You're THAT woman?"

Yes. Indeed. THAT woman. The woman who writes about poop and hemorrhoids and stitches in her vagina YES DEAR GOD THAT'S ME. Listen, my Republican, Mormon, gun-owning father read my book and he still loves me! That counts for something, right? I guess his wife had heard about my book, and when she was describing it to him he knew immediately that I had to have been someone he treated because of the speed with which I healed. He treats postpartum depression very differently than most doctors, and his patients usually see results instantly. And that is exactly what happened with me in the hospital five years ago, I took a cocktail of meds and within two hours I felt like a different person.

So we did a lot of talking, and since he's been treating women for this very condition for over 30 years I did a lot of listening and learning. The odds were completely stacked against me, and he said that if I had been gearing up and treating the possibility of this in my third trimester I might have been able to avoid it. But since I didn't it was time to attack it now. So he made a minor tweak to my meds and asked me to come back and see him in two weeks, and I am not even kidding, I felt better that night. In fact, better does not do what I was feeling justice. I felt free.

So what about breastfeeding? That's what you're all wondering, I know, and this is what I'm going to say: he thinks that what I'm taking is perfectly safe to take while breastfeeding. He's prescribed it before to women who are breastfeeding and everything has been perfectly fine. No, I'm not going to talk about what I'm taking because one, it's no one's business, and two, I don't care that you think I'm poisoning my baby. I also think that anyone going through this needs to consult their own doctor and make an informed, personal decision about their individual situation. And then go on and live a better, happier life.

I've been on the new meds for over five days, and I haven't had a panic attack once. I feel like a regular person who has an infant and can handle it, and during my pregnancy that was exactly what I was aiming for. Turns out I needed a little help, a tiny adjustment, but here I am and I am loving it. I love what it has done to my relationship with Leta, what it has helped me see and appreciate in Jon, and I love that I can barely stand to be away from that baby for a minute. Jon has been watching Marlo so that I could write this, and a little bit ago he came rushing downstairs with this kicking, yelling, hungry bundle in his arms, and it was like I hadn't seen her in years. And that yelling... that raucous, staccato, one-too-many-beers yelling... it didn't make me cringe, it made me laugh.

What would you do?

The renowned MGH Center for Women's Health posed this question on their website...

Ms. A is a 27-year-old woman who is seven weeks pregnant and is currently taking duloxetine (Cymbalta). She has a history of recurrent major depressive disorder (MDD) and has had a good response to duloxetine at 60 mg per day. She has had four previous episodes of major depressive disorder (most untreated) and has been in remission for one year. Past episodes have lasted up to six months and caused difficulty with functioning at work and in relationships, although she was not diagnosed and treated until one year ago.

Ms. A is concerned about her baby’s exposure to medication, but she also is afraid that she will experience a recurrence if she stops her medication.

With the Mother's Act legislation needing all the support it can get and some people out there trying to derail it by spewing untruths about it and who it would benefit (first and foremost MOTHERS!), it's good for us to think about how we would consider a decision like taking meds while pregnant or nursing. Let me know what you think!

Dads of colicky babies at risk for depression

From USA Today, this article deals with the increased incidence of depression in fathers of babies with colic. For those of you who have dealt with the constant crying and fussiness of colic, it's no wonder that parents would experience more stress and depression than with a baby not suffering from this disturbing problem, BUT, this study seems to propose that the colic was caused by the parents' depression...sound off and let me know what you think!

Studies have suggested that the babies may be more likely to have colic — often defined as crying three hours a day, at least three days a week — if their mothers are depressed.Now, researchers are asking whether colic also may be more common in children of depressed men.It's a sensitive subject. "The last thing parents need is more guilt," Asta says. "These people are pretty strung out as it is."Still, van den Berg says, it's important to identify fathers who need help, both for themselves and for their children.So van den Berg and her colleagues looked at 7,600 babies and their parents, screening both mothers and fathers during pregnancy and following up two months after birth, according to the study in today's Pediatrics.

PPD pamphlet from ACOG

Here's a link to a pamphlet that American College of Obstetricians and Gynecologists produced in January of this year. This printer-friendly version should be a helpful tool that you can give to your OB-GYN, nurse or midwife if they are not well-educated about PMDs. Keep in mind, perinatal mood disorders barely get a couple of hours of focus during an OB's entire medical school career and residency, so you should not assume that your doctor is fully aware of how to screen for or diagnose a PMD. You may also want to provide this resource to your peditrician. Even if you are not suffering from a PMD, you can be sure that many other women in the Practice ARE and you may just help someone to get treatment faster by giving your Doc this tool!

Oh, and let's remember that ACOG's president made PMDs his top priority...you can read more about that HERE!

Dealing with a miscarriage

Since perinatal mood disorders can strike during pregnancy and after a loss of pregnancy or abortion (in addition to childbirth), it is important to remember the emotional health of the parents after a miscarriage. In this Savannah, GA newspaper, one couple asks how to help themselves heal together from their loss and is answered by by a local psychotherapist. Read the story HERE...

Out of the UK...an exhibit explores effects of stress on fetus

Stress in the womb can last a lifetime, say researchers behind new exhibit

Visitors can see how their stress levels could affect the heart rate of their unborn baby and find out why pregnant women should reduce their anxiety, at a new exhibit at the Royal Society Summer Science Exhibition, which opens today (30 June 2009).

The researchers behind the exhibit, from Imperial College London, hope that it will raise families' awareness of the importance of reducing levels of stress and anxiety in expectant mothers. They say that reducing stress during pregnancy could help prevent thousands of children from developing emotional and behavioural problems.

Visitors to the Exhibition will have the chance to play a game that shows how a mother's stress can increase the heart rate of her unborn baby. They will also be able to touch a real placenta, encased safely in plastic. The placenta is crucial for fetal development and it usually protects the unborn baby from the stress hormone cortisol. However, when the mother is stressed, the placenta becomes less protective and the mother's cortisol may have an effect on the fetus.

The Imperial researchers' work has shown that maternal stress and anxiety can alter the development of the baby's brain. This in turn can result in a greater risk of emotional problems such as anxiety or depression, behavioural problems such as Attention Deficit Hyperactivity Disorder, and being considerably slower at learning. Some studies have even suggested that it may increase the likelihood of later violent or criminal behaviour. Their findings have suggested that the effects of stress during pregnancy can last many years, including into adolescence.

Professor Vivette Glover, the lead researcher behind the exhibit from the Institute of Reproductive and Developmental Biology at Imperial College London, said: "We all know that if a mother smokes or drinks a lot of alcohol while pregnant it can affect her fetus. Our work has shown that other more subtle factors, such as her emotional state, can also have long-term effects on her child. We hope our exhibit will demonstrate in a fun way why we all need to look after expectant mothers' emotional wellbeing.

"Our research shows that stress due to the mother's relationship with her partner can be particularly damaging. We want fathers visiting our exhibit to see how they can help with the development of their child even before the birth, by helping their partner to stay happy," added Professor Glover.

The researchers say that the stress hormone cortisol may be one way in which the fetus is affected by the mother's anxiety during pregnancy. Usually the placenta protects the unborn baby from the mother's cortisol, by producing an enzyme that breaks the hormone down. When the mother is very stressed, this enzyme works less well and lets her cortisol through the placenta. By studying the amount of cortisol in the amniotic fluid, the Imperial researchers' latest study suggests that the higher the level of cortisol in the womb, the lower the toddler's cognitive development or "baby IQ" at 18 months.

Kieran O'Donnell from the Institute of Reproductive and Developmental Biology at Imperial College London said: "We are very excited to have this opportunity to talk with the public about our work. We think that by promoting awareness of this subject we may be able to benefit many families in the future."

Great Article about Postpartum Psychosis

Here's a fantastic and enlightening article from a Canadian newspaper that describes the horror of postpartum psychosis and also touches upon the much more common disorder, postpartum depression...

"It is devastating for a family," Staseson says. "The dad who has responsibility for the new baby, and possibly other little ones, doesn't know what has happened to the woman he has married. It's absolutely frightening because psychosis is characterized by very bizarre and often violent behaviours."

Medical professionals — nurses, midwives, family physicians, obstetricians — must closely monitor patients for clues of depression. They must ask pregnant women directly about family support, how they get along with the significant people in their lives. They must determine if there's a family history of mental illness. Postpartum depression is more likely if the pregnant woman's mother suffered from depression.

... We need to be more vigilant in our assessment and screening and we have to ask the hard questions. New moms don't want to say they aren't enjoying this baby or that they're feeling really crappy or they don't want anything to do with their husband right now."

Those feelings don't fit with society's presumption that women are nurturing and every new mom is blissfully ecstatic about her new role.

"If you aren't those things, you feel like a complete failure, and you won't admit that to your closest friend or your own mother," Staseson says. "It's really important that not only professionals know about this, but our own families need to know when our mood is changing, when our normal behaviours throughout the day are changing and when a mom is losing interest in things that she'd normally be interested and engaged in."

Video by PPD Sufferer sheds light on the very personal side of PPD

Over at The Mommy Manual, Heidi was invited to describe her PPD on video. Here, you can watch part one, part two, and part three.

Heidi, a singer/songwriter and PPD Survivor hopes to help others by sharing her story. She says, My name is Heidi Howes and I have postpartum depression. I usually say “severe” postpartum depression because that’s how it feels to me, very severe.

There must be more to motherhood

This article, found at The Times Online out of the UK, addresses BOLDLY the myth of parenthood for most adults and endeavors to bring to light the feelings that most often moms are experiencing, but won't say out loud, for fear, embarrassment or believing that they are the only ones feeling that way.

Confessions you’re unlikely to overhear at the school gates: “I want to put my kids up for adoption and get my old life back.” Or how about this: “I fantasised about killing my babies.” Or: “Suicide is always on my mind. If I kill myself now, my child won’t remember me.”

The author and new dad Michael Lewis admitted in his latest book, Home Game: An Accidental Guide to Fatherhood, how boring and disappointing he found fatherhood. His experience had him “drowning in self-pity” and wondering what he’d do “if it wasn’t against the law to hurl [my baby daughter] off [the balcony]”. Mothers, he argued, just don’t have the same problem, because they are blessed with a maternal instinct. However, behind the veil of online anonymity, protected from judgment and finger-pointing, more and more mothers are also admitting as much — the confessions above were found on parenting support forums such as Mumsnet, Netmums and Parentline Plus. In fact, 75% of callers to Parentline Plus’s free support line — for “the call you make at 2am instead of reaching for the bottle or the axe” — are mothers, and only 11% are dads (the rest comprises steps, grands and so on).

As one miserable mother confides on Mumsnet: “There is so much pain, so much frustration and so little joy [in motherhood]. From the outside I have a great life, yet I feel trapped in a gilded cage. I have never even come close to telling anyone how I really feel, which is, I feel, the crux of the problem.” Another says: “The conspiracy should be blown apart because the result is a lot of women feeling inadequate and a lot of [children] confused as to why their mummies are so unhappy.”...

And here's a paragraph that addresses what I have always thought played a big role in depression after becoming a parent...
The rise of the mature mother is also a factor. “Younger mothers are generally more laid-back,” says the fertility expert Zita West, who has opened a postnatal visiting service at her London clinic, to help new mothers struggling to adjust. “Older mothers build up their expectations. Plus, because they know a lot more, they’re more anxious.” And, of course, that mummy tummy can be harder to shift. For those who have “left it late” and have two children in short succession without recovering from the first, it can be a much bigger deal, says West.

Here's an article about the challenges of being an older Mom.

Here's a link to an article from the same publication that describes one woman's experience with postpartum depression with her second child, even though she had not suffered from it with her first child.