Postpartum Progress

Postpartum Depression Resource for Spanish-Speaking Women on Postpartum Progress!!

I am SO excited about this!! -- postpartum depression information en espanol for readers of Postpartum Progress.  The following was created by Ana Romero, Margarita Franco and Julie Smithwick-Leone.  Julie is the program director of PASOs, an excellent postpartum depression support program for Latina women in South Carolina supported by the South Carolina Public Health Institute.  PASOs stands for Perinatal Awareness for Successful Outcomes.  So here it is ....

La depresión posparto y otros trastornos relacionados: ¿Qué son? ¿Me pueden afectar a mí?

tristeza posparto

Nos da gusto saber que desea aprender más sobre la depresión postparto. Es una enfermedad común que afecta a las madres y también a sus familias.

Los científicos creen que los cambios en los niveles hormonales durante y después del embarazo pueden causar la depresión postparto. Así que NO ES SU CULPA NI TAMPOCO SIGNIFICA QUE USTED NO QUIERA A SU BEBE.

Muchas nuevas mamás se sienten felices un minuto y tristes un minuto después. Si se siente mejor después de aproximadamente dos semanas, probablemente era solamente una etapa de

, el cual es muy común y normalmente pasajero. Si le toma más tiempo sentirse mejor , es posible que tenga una depresión posparto o alguna otra enfermedad relacionada con el cambio hormonal que se da después de dar a luz.

¿Que son la Depresión Posparto y los Trastornos Relacionados?

La depresión posparto puede provocar sentimientos de angustia, ansiedad, fatiga o desvalorización. A algunas nuevas mamás les preocupa lastimarse o hacerle daño a su bebé. A diferencia del período de melancolía o tristeza después del parto, conocida en inglés como

"baby blues," que generalmente ocurre las primeras semanas del embarazo y desaparece pronto sin necesidad de tratamiento. La depresión posparto no desaparece rápidamente. Muy raramente, las nuevas madres desarrollan un cuadro aún más serio. Pueden dejar de comer, tener dificultades para dormir y estar nerviosas o paranoicas. Las mujeres con este cuadro suelen necesitar hospitalización.

Usted tiene mayores probabilidades de experimentar depresión posparto o trastornos relacionados si:

• Tiene menos de 20 años.

• Actualmente consume alcohol, drogas alucinógenas o fuma (éstos también son riesgos médicos serios para la salud del bebé).

• No planeó o no desea el embarazo

• Tuvo un trastorno de ansiedad o del estado anímico antes del embarazo, incluyendo depresión con un embarazo anterior.

• Le ocurrió algo estresante durante el embarazo, incluyendo una enfermedad, la muerte o enfermedad de un ser querido, un parto difícil o de emergencia, un parto prematuro o una enfermedad o anomalía del bebé.

• Tiene un familiar cercano que haya experimentado depresión o ansiedad.

• Tiene una mala relación con el esposo, el novio u otro ser querido en su vida, o no está casada.

• Tiene poco apoyo de la familia, los amigos o de otros seres queridos.

• Tiene problemas financieros (bajos ingresos, vivienda inestable).

• Anteriormente intentó suicidarse.

• Recibió poco apoyo de los padres en la infancia.

Síntomas de la depresión posparto o trastornos relacionados:

Además del estado de ánimo deprimido, usted puede presentar los siguientes síntomas:

• Agitación e irritabilidad

• Pérdida del apetito

• Dificultad para concentrarse o pensar

• Siente que las labores que usualmente hace no tienen ningún valor,

• Tiene sentimientos de culpa

• Siente pocas ganas de comunicarse y estar en compañía de otras personas. Siente que quiere estar sola la mayor parte del tiempo.

• Falta de placer en todas o en la mayoría de las actividades

• Pérdida de energía

• Sentimientos negativos hacia el bebé

• Pensamientos de muerte o suicidio

• Dificultad para dormir

Testimonios de algunas madres que han sufrido de depresión posparto:

Gloria:

"Estaba feliz porque iba a ser mamá por primera vez" manifestó Gloria. Ella dio a luz a un bebe prematuro quien tuvo que quedarse en la unidad de cuidados intensivos neonatales (NICU por sus siglas en inglés). Una semana después del nacimiento de su bebe, Gloria tuvo que ser hospitalizada de emergencia debido a complicaciones de salud. Solo después de tres semanas, madre e hija pudieron estar juntas de nuevo. "Cuando llegué a casa, estaba muy contenta de ver a mi bebé" recordó Gloria. Pero después de unas horas de su llegada, ella comenzó a experimentar síntomas de un trastorno posparto.

"Físicamente, me sentía cansada y emocionalmente estaba muy tensa e irritable, no quería hablar con nadie, solo quería estar sola en mi cuarto y lo único que hacia todo el día era llorar si razón,"

manifestó Gloria.

"Me sentí muy desconectada de mi bebé, no quería verla, abrazarla o estar cerca de ella. El llanto de mi bebé me irritaba demasiado, hasta el punto que quise sofocarla colocando una almohada sobre su cara. Cada día los pensamientos de hacerle dañó a mi bebe eran más fuertes hasta que un día me deje llevar por los malos pensamientos y trate de hacerle daño. Afortunadamente, pude recapacitar y le quite la almohada de su carita antes de que fuera demasiado tarde. Yo estaba aterrada porque no entendía lo que me estaba pasando…."

Gloria decidió acudir a su doctor y consultarle lo que le estaba pasando, y el médico le recetó un tratamiento con medicamentos para su trastorno. "

A cabo de una cuantas semanas, comencé a sentirme mejor. El medicamento y el apoyo que recibí de mi familia me ayudaron a superar la enfermedad y la situación por la que yo estaba atravesando".

Rosa

: Rosa tuvo un embarazo normal y no tuvo ninguna complicación al dar a luz. Ella comenzó a experimentar síntomas de depresión posparto dos semanas después de que su bebe nació.

"De repente me puse de muy mal humor y muy deprimida, todo me molestaba y tenía mucho coraje con mi esposo y familiares. A pesar de la compañía de mi familia y amigos, me sentía sola y triste. Solo lloraba y permanecía en mi cuarto, el cual siempre estaba oscuro porque no toleraba la luz. Cada día me sentía peor, no tenia ánimo ni energía para participar en las actividades y labores domesticas. Perdí el apetito y el sueño. Nada en la vida tenía sentido y solo quería que mi hijo y yo dejáramos de existir. Por varios días tuve pensamientos de tomarme unas pastillas para terminar con mi vida y quise poner cloro en el biberón de mi bebe para que así él también muriera"

Afortunadamente Rosa recibió ayuda médica profesional y después de dos meses recuperó su estado de ánimo.

Signos y exámenes

No existe un examen único para diagnosticar la depresión posparto y otros trastornos relacionados. El médico puede solicitarle que llene un cuestionario en su visita al consultorio para buscar signos de depresión o riesgos para estas enfermedades.

Algunas veces, la depresión después del embarazo puede estar relacionada con otras condiciones médicos. El hipotiroidismo, por ejemplo, ocasiona síntomas como fatiga, irritabilidad y depresión. Las mujeres con depresión posparto deben hacerse un examen de sangre con el fin de verificar si hay bajos niveles de las hormonas tiroideas.

Tratamiento

El tratamiento para la depresión posparto a menudo incluye medicamentos, terapia o la combinación de ambos. Existen varios tipos de medicamentos antidepresivos que se les pueden administrar a las madres lactantes, incluyendo nortriptilina, paroxetina y sertralina. También existen muchos medicamentos para otros trastornos pospartos.

Si usted está pensando en hacerse daño a sí misma o al bebé, busque ayuda médica de inmediato. Si se le diagnostica depresión, usted puede necesitar seguimiento durante al menos seis meses.

Expectativas (pronóstico)

Los medicamentos y la asesoría profesional con frecuencia son efectivos para reducir o eliminar los síntomas.

Complicaciones

Sin tratamiento, la depresión posparto puede durar meses o años y usted puede estar en riesgo de hacerse daño a sí misma o al bebé.

Las complicaciones potenciales a largo plazo son las mismas que en la depresión grave.

Situaciones que requieren asistencia médica

Coméntele al médico o al pediatra si experimenta depresión después del embarazo. No le dé miedo buscar ayuda inmediatamente si se siente abrumada y con temor de que pueda hacerle daño al bebé.

Prevención

El hecho de tener un buen apoyo social por parte de la familia, los amigos y los compañeros de trabajo puede ayudar a reducir la gravedad de la depresión posparto, pero puede no prevenirla.

Los cuestionarios de evaluación pueden ayudar a la detección temprana de la depresión o los riesgos de tenerla.

Si usted sospecha que sufre de depresión posparto o algún otro trastorno relacionado no dude en buscar ayuda. Recuerde,

usted no está sola y no es su culpa. Con la ayuda apropiada se sentirá mejor.

Algunos grupos de apoyo:

La participación en grupos de apoyo puede ser valiosa, pero debe ser combinada con medicamentos y psicoterapia formal. Aquí encontrará una lista de diferentes grupos de apoyo en varias partes de los Estados Unidos, que proveen servicios en español. Si usted habla inglés puede acceder a la lista de recursos en la página de Postpartum Progress.

• Apoyo de PSI (Postpartum Support International) para las familias hispano- hablantes: 1-800-944-4773, seleccione el número 1 .

Chicago (Southside): Este grupo es gratuito y se reúne cada tercer jueves del mes de 6:30 a 7:30 PM. Para mayor información y para registrase por favor llame al 312-567-5420.

Arizona, Tucson (Carondelet St. Joseph’s Hospital): Para mayor información acerca del grupo de apoyo de depresión posparto para madres que hablan español, llamar al 520-873-6857

North Carolina (Greensboro Mental Health Association): Para mayor información y para registrarse por favor llamar al 336-373-1402.

North Carolina (Mecklenburg County Area Mental Health): Para mayor información y para registrase por favor llamar al 704-336-6446.

South Carolina: Si usted vive en Carolina del Sur, mire a la pagina del internet: www.scpasos.org o llame a 803-312-1723 para conseguir mas información a cerca del programa PASOs (PASOs para una familia saludable).

Wisconsin: Baby Daze Postpartum Doula Service (Servicio de doula para el postparto): 1001 Greenwich DriveMadison, WI 53711. Teléfono: Ruth Hoffman Hein, (608) 273-4724 Experiencia en la comprensión y el cuidado de mujeres que están experimentando depresión postparto. Hay una línea telefónica de apoyo para hablar sobre sus sentimientos/síntomas y explorar los recursos médicos y de la comunidad disponibles para ayudar a las nuevas madres.

Washington: Centros comunitarios de salud Sea Mar. Sea Mar cuenta con diversas clínicas en la región que trata problemas de adicción y psicológicos. Los programas son bilingües y se provee a individuos, grupos y familias. No requieren prueba de residencia. Aceptan Medicaid y seguros médicos. Los costos varían dependiendo de los ingresos y el tamaño de la familia.

Poem from a Mom with Postpartum Depression & Anxiety

Arriving on Christmas day with those beautiful pink chubby cheeks and eyes of curiosity….

So tiny, so beautiful, this life filled baby squirming, watching, anticipating.

A new life… what mother could ask for more.

Ten little fingers, ten little toes, a beautiful healthy baby girl.

Home from the hospital it all feels surreal, this baby to treasure. We celebrate she’s here!

What happened next, I wish I understood.

Oh if I could.

Darkness and fear have settled in.

It’s all too much where do I begin?

Postpartum they call it and promise it won’t last.

It’s been twelve weeks. I just want my mind back.

Overwhelmed, my mind's always racing,

It never ends the organizing, cleaning, pacing.

Bursts of energy, thoughts that race,

If I could slow down just long enough to concentrate.

Tears fall sporadically night and day…

Can someone please take this pain away?

Doctors prescribe meds and friends are there to listen

But at the end of the day fear closes in.

The sessions, the medications, the attempts to heal me

When will I be free of this anxiety?

Loss of interest, loss of appetite

Please dear God no more nightmares tonight.

I’m sick of living in this gray, in this anxious sorrow.

I choose to have hope for today, for tomorrow.

I know the sun is shining, I can feel its rays.

My baby is beautiful, I am thankful in so many ways.

Jesus, I know you're there, I know you're watching over me.

Squeeze my hand tightly so I can feel you through this insanity.

Remind me Lord that trials make us stronger

Then give me the patience to hold on one day longer.

 

This beautiful poem was written by Barb Lynch, who has gone through postpartum depression twice.

Pundits Ponder Whether Palin Had Postpartum Depression

I just LOVE it when pundits and politicians talk about postpartum depression.  In the latest issue of the magazine Vanity Fair, Todd Purdum writes this in his article on former Vice Presidential candidate Governor Sarah Palin and the 2008 Presidential campaign:

"Some top aides worried about her mental state:  was it possible that she was experiencing postpartum depression? (Palin's youngest son was less than six months old.)"

Purdum doesn't go into why Palin's aides would have thought that.  In the paragraph in which he refers to postpartum depression, his only explanation is that Palin was doing what she wanted to, rather than following the campaign's direction, and was "maintaining only the barest level of civil discourse" with certain handlers.  Wow.  I've never seen either one of these behaviors mentioned as symptoms of postpartum depression.  Perhaps we should add a question about that to the Edinburgh Postnatal Depression Screening Scale to make it more effective:

In the past 7 days, I have been able to have civil discourse with my colleagues:

- Most of the time

- Sometimes

- Not very often

- No, not at all

Purdum, as per usual when it comes to the media, shows very little understanding of postpartum depression.  PPD is not a joke.  It is NOT about being able to get along with others, even though of course anger and irritability can come into play.  It's NOT about being an independent woman, or being disagreeable, or being emotional. 

Women with postpartum depression are so affected by their illness that it impacts their ability to function on a daily basis.  If Gov. Palin had been having difficulty sleeping and eating, wondering why she had ever become a mother, withdrawing from family and friends, crying nonstop, feeling absolutely miserable and disconnected from herself, wondering how on earth she could get through the next five minutes and even possibly considering suicide, then perhaps she did indeed have postpartum depression.  I have seen NO evidence of that.  Indeed, it would surprise me that any new mother in the serious throes of postpartum depression would be able to fly all over the country gladhanding and making public speeches and smiling so damn much all day long.

Even more interesting to me is that Purdum shows no concern for Palin, should she in fact have been suffering from postpartum depression, and it doesn't seem anyone else quoted in the article was concerned for her health and safety either.  Does he understand how serious postpartum depression is?

I might actually have been able to shrug this article off to media ignorance about perinatal mood and anxiety disorders, were it not for continued references throughout the article to mental illness.  Purdum uses words, either his own or those of whom he chose to quote for this article, to describe Gov. Palin like "erratic" and "whack job." 

One of the subheadings of his article: "Polar Disorder."

He also writes, "Several [people] told me, independently of one another, that they had consulted the definition of 'narcissistic personality disorder' in the Diagnostic and Statistical Manual of Mental Disorders—'a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy'—and thought it fit her perfectly." 

Another quote: "It’s frustrating dealing with Sarah, because it seems we’re always dealing with emotional crap."

Emotional. Erratic.  Mentally ill.  Purdum wants us to believe Palin has bipolar disorder, postpartum depression and narcississtic personality disorder, all wrapped up into one.  I wonder why he didn't also figure out a way to get schizophrenia in there, and perhaps throw in kleptomania and anorexia for kicks. 

Does Purdum think his constant references to mental illnesses will help to convince us all of what an awful person Sarah Palin is?  That she is not to be trusted?  Is Vanity Fair trying to tell us what a terrible political candidate Palin would be because she has a mental illness, which as far as anyone knows, she doesn't?  Does the simple fact of having mental illness disqualify someone outright, whether Democrat or Republican, for public office?

Now other journalists are weighing in as well.  From Andrew Sullivan at The Atlantic, who is at least kind enough to tell us he doesn't think Palin had PPD:

"I recall speaking to a very eminent physician in the campaign - among several leading obstetricians who found her pregnancy story highly implausible - who immediately noted that in his view, Palin was clinically delusional, narcissistic and unstable."

I'm so pleased that all of these journalists have received clinical psychiatric training and are qualified to diagnose whether people have a mental illness and if so which one.  Wait.  They aren't?  Are you SURE?! 

I just do not like it when people bandy about mental illness to make a political point, regardless of their political persuasion.  I have to wonder whether these writers have received any sensitivity training whatsoever when it comes to understanding and writing about mental illness.  It seems it's more important to make your point by labeling and inference, rather than simply by talking about facts.

Despite my complete lack of psychiatric training, I feel very confident in giving Purdum and his editors at Vanity Fair this diagnosis: They are a bunch of idiots.

Editor Seeking First-Person Account of PPD for Book

Professor Craig LeCroy at the Arizona State University School of Social Work is editing a book on first-person accounts of mental illness.  He is looking for a first-person account of postpartum depression.  It should be about 6-15 pages in length.  If you'd like to submit one, you can reach him at craig.lecroy@asu.edu.

How Spirituality Can Impact Recovery from Postpartum Depression

I noticed a flurry of blog posts on religion and depression in the last couple of weeks, and decided I'd share them all with you in a single post, as I know for many of you spirituality is an important part of your recovery.

Last week, Lauren Hale at Sharing the Journey hosted a discussion about religion and spirituality and perinatal mood and anxiety disorders.  If you scroll down and read the comments, you'll see a brief but very nice discussion of this topic from some of Lauren's readers, including one woman who is an atheist and who blogs about her PPD experience.  I LOVE to see these diverse viewpoints discussed so openly and positively.

In this post, Therese Borchard at Beyond Blue features an interview from NAMI FaithNet with Jay Mahler, founder of the California Mental Health and Spirituality Initiative, and Reverend Laura Mancuso, director of the aforementioned Initiative.  In the interview they discuss why spirituality can be important for mental health.

Amber, over at Beyond Postpartum, writes about a new book called The Postpartum Survival Guide that she says addresses PPD from the Christian perspective.   (Note: I haven't read it yet, so this reference doesn't constitute an endorsement.)

Dads Needed for Online Research on Experience of New Fatherhood

Dr. Will Courtenay is seeking participants for research to better understand the experiences of dads with their babies.  He is conducting the study in collaboration with the Center for Men and Young Men at McLean Hospital, Harvard Medical School.  Participants will complete an online survey about their experiences as a father and their attitudes on a variety of topics.  The survey is completely anonymous and takes 20-25 minutes to complete. 

It is open to men over 18 years of age who have had a baby or babies within the last 12 months.  All fathers of babies are invited to participate, including fathers who have adopted, fathers who are gay, and fathers whose spouses or partners gave birth to their babies.  If you would like additional information about the study, contact Dr. Courtenay at DadsStudy@MensDoc.com.

Men who would like to participate and meet the eligibility requirements can click this link to begin the survey.

Ladies out there with newborns, I hope you will encourage your husbands to participate!!

Fall Conference on Postpartum Depression in Canada

The authors of the book "The Smiling Mask" have worked to put together a conference in Canada this fall called "Unmasking Postpartum Depression".  It will be held September 29th through October 1st in Regina at the Delta Hotel.  The keynote speaker for the event is Margaret Trudeau, wife of the former prime minister of Canada.  There will also be presentations by several physicians, including noted perinatal mood and anxiety specialist Dr. Shaila Misri, and one by Carol Blocker, mother of Melanie Blocker Stokes.  The conference fee is $300 (or $250 for early bird registrants).  You can download a PDF of the conference schedule and register online at www.cntgrp.ca/unmaskingppd. 

New PPD Support Group in NY + Fundraiser Soon for Postpartum Resource Center of NY

The Postpartum Resource Center of NY has announced its first hospital-based pregnancy and postpartum support group in Suffolk County, NY.  It is based on their Circle of Caring program and is offered by St. Catherine of Siena Medical Center in Smithtown, NY and there is no fee to participate.  If you'd like more information, call 631-862-3330 or email postpartum@chsli.org.

Also, the non-profit organization Sounds of Silence, which supports the Postpartum Resource Center of NY, will be hosting a Summer Networking Dinner on Monday, July 13, at the Sea Levels restaurant in Brightwaters, NY.   The event starts with networking at 5:30pm and dinner at 6:30pm honoring Gail Burrus, Executive Director of the Suffolk Perinatal Coalition, and Geraldine O'Keefe, author.  Cheryl Zauderer will also speak on postpartum depression and altered newborn attachment.  Tickets are $40 per person.  To reserve your ticket, email postpartum@aol.com or call 631-422-2255.

Mom Shares Her Methods For Surviving Postpartum PTSD

"Imagine the terror of it - all of a sudden realizing that you’re a shattered mirror. I couldn’t watch television. Every pregnant woman screaming for an epidural on a sitcom made me want to smash the TV. A commercial for the local hospital’s “birth center” made me want to chew my own limb off to escape. I couldn’t stay in the same room with women who began discussing their births ..."

From the website Heal My PTSD comes the story of a mom who experienced postpartum post-traumatic stress disorder and her description of how she got through it.

Two Short & Sweet Videos About Postpartum Depression

I wanted to share with you some nice videos on the web today about postpartum depression.

The first comes from the BBC in the United Kingdom, and features a doctor discussing the basics of postnatal depression, as the Brits call it, quite nicely.  Check it out here. 

This next one is from a mom named Heidi Howes.  This is part one of three videos she's created to share her experience with postpartum depression.  In this one, I really like how she describes what it feels like as I think many of you will relate.  Check it out here.

And get ready for video from Postpartum Progress as well -- my Mother's Day present was a Flip Mino Ultra videocamera.  I'm getting the hang of it right now but excited to be able to share some video with you very soon!

Can Yoga Relieve Anxiety Symptoms?

From the journal Complementary Therapies in Clinical Practice comes a study on yoga and postpartum women with anxiety.  Researchers from Iran found that participation in a two-month yoga class can lead to significant reduction in perceived levels of anxiety in women who suffer from anxiety disorders. 

Esperanza Seeking Feedback on Postpartum Depression Feature

The magazine esperanza, which recently featured a story on postpartum depression, as well as pieces on Mary Jo Codey, Amy Sky and yours truly, is seeking feedback on those articles.  If you would like to send a letter for the Summer 2009 Letters to the Editor, click here.

Chinese Custom of "Doing the Month" Not Always Protective for Postpartum Depression

A study published in the August 2009 issue of the Journal of Affective Disorders has examined 16 different studies and concludes that there is little consistent evidence that the Chinese postpartum custom of confinement or "doing the month" reduces postpartum depression among Chinese mothers. 

The practice of confinement involves comprehensive social support and has been though to protect new moms from PPD.  The new mother is confined to her home for the first month after chidlbirth and someone cares for both her and the baby's needs during that period, sometimes the mother-in-law and sometimes a paid pui-yuet or "confinement lady". 

The study authors, from the University of Melbourne in Australia, state that "confinement cannot be presumed to be available to, welcomed by or effective for all Chinese women or to be a substitute for health service provision."

PSI Invites You To Casino Gaming Night in LA Area

Postpartum Support International and the Los Angeles County Perinatal Mental health Task Force will be hosting a Casino Night on Saturday, July 18th at 7:30pm at the Braemar Country Club in Tarzana, CA.  They'd like you to join them for casino gaming, prizes, live entertainment, dinner and dancing to support their work helping women who are suffering from mood and anxiety disorders related to childbirth. They ask for a charitable donation of $100 at the door from those who attend.  This event is sponsored by Score Gaming and Binions Hotel & Gambling Hall Las Vegas.  If you have questions or would like to donate an item to the evening's silent auction, please call Dr. Diana Barnes at 818-887-1312.  Please RSVP by July 10th if you plan to attend.

Emory Announces New Ethics Policy

In a follow up to my story last week on Emory psychiatrist Zachary Stowe's conflict of interest situation, wanted to let you know that, according to the Carlat Psychiatry blog, Emory University now has a new ethics policy that bans its faculty from accepting gifts or money for speaking engagments for drug companies.