Postpartum Progress

Califnornia Mom's Thought on "Whining" Mary Jo Codey, "Questionable" Antidepressants & "Trumped Up Illnesses Like Postpartum Depression"

This article by a mom who clearly has absolutely no idea what she's talking about really annoys me.  Thank goodness I have her to tell me about an illness that she doesn't think exists since she's never experienced it.  Genius.  (I wonder if she believes in cancer or diabetes?)  Let me give you a few highlights:

" ... With the newfangled Brooke Shields-mental-health-prostitution, many new moms read her book and say, "That’s me!" And then the moms jump on the post-partum depression bandwagon themselves, along with the little pills that supposedly cure the depression ..."

" ... As trumped up illnesses such as post-partum depression continue to make women feel as though we’re victims, we will spend our time talking in support groups instead of fighting for our dwindling freedoms ..."

I share this, of course, because it's an example of the stigma and ignorance that exists about mental illnesses, and in this case perinatal mood disorders.  It makes me sad.  I have a hard time accepting the smugness of people who are convinced they have complete control over their mental state, or that a good walk will shake off a deep depression.   Perhaps Ms. Shore has a medical degree that we're not aware of??

I agree with the premise that every illness doesn't require medication.  But the truth is, no doctor or mental health industry or advertisement or any other such thing made me think or do anything.  I made the choices about being treated, working with my doctor, and I recovered.  I am neither weak nor uneducated. Ms. Shore, I'd be more than happy to compare my intelligence level and accomplishments in life with yours.  I think, despite my experience with postpartum depression, you'd be quite surprised.

Being concerned about the government's involvement with medical screenings is one thing, but making light of postpartum mood disorders?  Not very cool. 

More Sad News & Something You Can Do About It

More sad news to share.  But first, let me explain something.  I don't share this news with you to make you feel bad or scare you when it comes to your own situation.  If you're reading this blog, it means you're doing something to get yourself better.  You're reaching out to learn more, and hopefully you're getting treated.  At minimum, I'll be here for you if you need me.  I share sad news because it's extremely important that everyone be informed about the most dire consequences of our illness.  This is real life, and people need to be confronted with it so that they might be urged on to act, and act quickly. 

PLEASE write your senators and congressmen and women and tell them to pass the MOTHERS Act.  I know it seems futile - I myself had never done it until now.  But we've got to do something.  Click here and look on the left side of the screen where you can enter your zip code.  Feel free to print out my story from the other day and this one so that you have proof to share that more people could get harmed if something isn't done.

Here's the news, from yesterday's Fayetteville Observer (NC): 

"By the time detectives got to the two-story brick home in northern Cumberland County on Tuesday, Faye Johnson Vick and her two children had likely been dead for several days.

Detectives found their bodies inside Faye Vick’s vehicle, which was parked in the two-car garage and had run out of gas.

On Wednesday, investigators said Faye Vick killed herself and her children, 2-year-old Jason Vick and 3-month-old Madison Vick. A state Medical Examiner’s Office report said the three died of carbon monoxide poisoning.

No one can be sure what went through Vick’s mind before she climbed inside the vehicle with her two children and turned on the engine.

Debbie Tanna, a spokeswoman for the Cumberland County Sheriff’s Office, said Faye Vick, who was 39, had a history of postpartum depression ..."

Father in Kansas City Shares Poignant Perspective on Wife With PPMD

The following is a very poignant letter from Jim, a new father in Kansas City whose wife is experiencing a postpartum mood disorder:

At first hearing about postpartum depression, I will be the first to admit I thought that it was a fictional event created by women to explain or excuse their behaviors after the birth of a child. I was irritated that Andrea Yates was allowed to walk after drowning her five beautiful children. Then it hit home by attacking one of the strongest people I have ever met: my wife, a woman with a master's degree plus forty hours and an accomplished teacher.  This illness transformed her into a withdrawn, hollow person who had so much self-doubt that she could not even muster up the words to describe what she was feeling. It was then that I came face to face with this horrible illness and realized it is very real. There is not any information that comes to you in pregnancy classes or even a pre-evaluation to see if you're susceptible, and the OB/GYN doesn't even see their patients for six weeks after delivery. This seems convenient since most women have symptoms in their first month of being a mom and that way it is some other doctor's problem. The fact that this was told to me by an OB/GYN should show society that this is a VERY common illness that they have no clue how to treat. How can a doctor deliver a baby and not be there with the necessary tools to help cure the mother to protect her, the child and the family as whole and guarantee that this remains the happiest times of their lives?

It all started out innocently enough.  We were leaving the hospital when a nurse told us that this illness was out there and if we see it to get help right away. This is the same nurse my wife blamed for her breastfeeding problems. According to my wife she said the baby lost 9% of his weight and she was not breastfeeding right. I was not there at the time, and thinking back on this illness I wonder if that is really what transpired. Maybe this experienced nurse saw something in K. that made her think K. had had the onset of this illness. When we got home K. was quiet. I thought it was due to her recovery from her c-section and nothing more. In my mind this woman was too strong to have postpartum depression. Then she thought the baby was not getting enough breast milk when, in fact, he had the required diapers to prove that he was sufficiently fed. She went to pumping and bottles to assure her that he was getting the required ounces. This was not enough to quell her irrational thoughts. From there the next item of irrationality was how much sleep the baby was getting. According to her, he was getting too much but according to her pediatrician and books he was sleeping the normal amount. Part of the problem was that K. never met a goal that she did not surpass and then some, but this baby did not come with a to-do list and it was eating her up inside.

K. is brilliant and loves kids. She is the chosen person that my brother and her sister had decided to take care of their children in case something happened to them. She also runs an infant room at our church and has taken care of her nieces and nephews from a very early age. In short, she has a lot of experience with babies and infants. That made it even more shocking when she first uttered the phrase that our son would be better off with a different mommy. My heart sank and I knew we were in for the fight of our lives. She later confessed to me that she thought of harming herself.

Then all of a sudden one Saturday night she was her old self for about four hours and then the roof caved in. In the early stages of this illness she would get up and pace all over the house and get the baby out of the bassinet no less than ten times. I thought that she was just a very nervous first mom, dealing with a lot of anxiety. Well, this Saturday night was no different; she got up and I mean got up a lot. Her mom and sister called her because they were supposed to go to the pumpkin patch with her nephews and our son that morning. I was asleep when my mother-in-law came into my room and said "Get up, we need to do something about K". When I found her she was almost catatonic with our son on her lap. What followed was a ten-day hospital stay where most of what she would say was, "yes, no or okay." I talked to her doctor twice to figure out what was going on with her and what is sad is the conversation was initiated at my request and my phone calls. Is there not a need to ensure that there is a solid support team set up for these women when they come home and face their fears all over again?

Prior to this illness it was a joke of mine that if K. wanted to talk and no one else was around, she would talk to a mannequin. It was hard for me because I knew less about babies than anyone ever placed on this green Earth. I was about to get a crash course as the only care giver and full time worker. I have a new-found admiration for single moms. Luckily for me, my parents and mother-in-law helped me with day-to-day events and even watched our baby some nights. This was a big help.

We are still dealing with this illness and K. has shown some improvements but not a lot. I came to the realization that doctors either don't know much about this illness or they don't care enough to learn more about it. That is when I found my own help (the Kansas PPD group, Helena Bradford [who is a Godsend], Postpartum Dads, Dr. Ronald Rosenberg, Carol Blocker, Katherine Stone and others too many to mention). It is strange to me that regular people are leading the way to learn more about this illness and that there is not a bigger push from the medical community. We, as a society, are all about protecting children, so it is hard to understand the lackadaisical approach we have about this illness that effects so many and has a potential for such dire consequences. [AMEN, Jim!]

Where we are today: K. still thinks she is a bad mom and thinks she will never feel better -- no matter what I tell her. We are lucky to talk to her doctor once a week. Her mom took off work to help us out, and I could not imagine what we would do without her help. If this can happen to K. it could happen to anyone. Think about that the next time you are with a group of people.  Look at them and think, "They could suffer from this illness sometime in their life". It could be a CEO of a company, a teacher, a doctor, a secretary or a senator. Postpartum Depression is not prejudiced and attacks the strong and weak with the same vigor. One quote I read about this illness is the most accurate: "A mother lion will fight to the death to save her cubs, and this illness is what happens if that lioness turns that same ferocity on herself." Lastly and most importantly this could have been your mother, sister, daughter or scariest of all, your wife. If it is then know you will be in my prayers because as Helena told me,"I would not wish this on my worst enemy". These are my notes from the battle -- from the front lines, and not after the war is over.   Believe me when I say "War is hell!!"

Murders & Attempted Murders in California, South Carolina and Connecticut Should Move Congress to Pass the MOTHERS Act

There are WAY too many cases in the past couple of months where children are getting injured or killed.  WAY too many.  Hello, Senators and Congressman???!!!!!!  Are you seeing this?  Are you beginning to understand the necessity for better treatment for and research into perinatal mood disorders?  Why are you still shuffling around?  What is the problem?

I am absolutely incensed.  Make a stand, Congress.  Pass the MOTHERS Act so we don't lose any more women or children!!!!!!!!!!! 

It's happening in Connecticut --

According to the Hartford Courant, "The young mother accused of stabbing her children early Saturday may have been suffering from postpartum psychosis, a respected Hartford psychiatrist speculated Sunday ... Dr. Harold I. Schwartz, psychiatrist-in-chief at Hartford Hospital's Institute of Living, said ... it is reasonable to assume that Carmela Ortiz, 22, was suffering from the rarest and most severe form of postpartum depression when, police say, she critically wounded her 2-year-old twins and 7-month-old baby ... Ortiz used a knife to stab her three sons in their apartment ... Police said the children were critically injured but are expected to survive ... Postpartum psychosis does not happen suddenly, so there is time to intervene before a new mother hurts herself or her children, Schwartz said. One impediment to care has been that after a baby is born, doctors rarely ask new mothers about their frame of mind ..."   

It's happening in South Carolina --

From the Associated Press:  "A mother accused of killing her twin sons has postpartum depression and should be released from jail to receive treatment, her attorney told a judge.  Lakeia White, 20, was being held Friday on two counts of homicide by child abuse ... Berkeley County sheriff's detectives said White admitted smothering her 9-month-old sons Devion and Trevon Wilson last month because they were crying and she didn't feel well."  From the Charleston Post & Courier:  "White already has been evaluated by a psychiatrist in Columbia and was subsequently admitted to the private facility Palmetto Lowcountry Behavioral Health in North Charleston for treatment. That was at Davis' behest, and he said doctors concluded that White had postpartum psychosis."

It's happening in California --

From the San Diego Union-Tribune: "Kristen Lawson, now 30, gave birth to her third child, a girl, five months ago. When news spread among Lawson's friends that she'd been arrested for trying to kill both daughters, everyone assumed, without being told, that she had been struck low by another postpartum episode. [She experienced postpartum depression with the birth of her first two children.] There was simply no other explanation for why Lawson – whom one friend calls 'the epitome of what a mom should be' – reportedly tried to drown the girls in a bathtub ... Even the police say postpartum depression – or some sort of mental collapse – appears to be the culprit for Lawson's behavior."  Thank God she didn't succeed, but now Ms. Lawson is forbidden from ever going near her children again.

Do something, Congress!

Genetic Test Can Predict Impact of Antidepressant Side Effects

Wendy Davis sent me a VERY interesting article called "The Right Drug?" from the Mayo Clinic website, which first appeared in the Minneapolis Star-Tribune in November 2004. Psychiatrists at the Mayo Clinic have found that they can use genetic tests to predict which people will have side effects from certain antidepressants.  This could be huge!  Here is much of the article verbatim:

"Psychiatrists at the Mayo Clinic have come up with a new way to help people avoid some of the nasty side effects of antidepressants and other drugs.

They're using genetic tests to predict which patients are likely to get headaches, nausea or other problems from medications such as Prozac and Paxil. And they're changing their treatment accordingly.

The tests are among the first in a new wave of genetic tools that, experts say, will transform the way doctors make decisions about treating their patients.

'At this point in time, the test really can't tell you what drug will work,' said Dr. David Mrazek, Mayo's chief of psychiatry, who has led the charge for genetic testing. But 'it will identify drugs that don't work.' And that, he says, can help reduce side effects and failure rates.

In effect, the DNA tests look for faulty genes that can interfere with someone's ability to process drugs normally. Doctors can use the information to adjust dosing levels or steer people away from drugs that may harm them or can't help them ...

At Mayo, Mrazek and his colleagues have focused on genes for a family of enzymes known as cytochrome P450. Those enzymes control how the body processes dozens of medications, including some antidepressants, heart drugs and cancer drugs. If those genes don't work right, the body's ability to metabolize drugs -- to use them and dispose of them -- goes haywire.

For some patients, this translates into years of frustration, searching for a drug that works and won't make them sick.

By the time one woman came to see him, Mrazek recalled, she had spent about 10 years seeking help for her depression. She claimed that every antidepressant she tried caused excruciating headaches or other problems. Her doctors would roll their eyes and scold her for not taking her medication.

When she had the DNA test, Mrazek said, he discovered that she was a classic 'poor metabolizer.' Because of faulty genes, she couldn't produce a key enzyme, known as 2D6, which helps break down certain drugs in the body. Without the enzyme, the antidepressants built up in her bloodstream like a toxic overdose, triggering the side effects.

He switched her to a different drug that didn't need that enzyme to function. And her relief was palpable. 'This is the reaction I have over and over again -- We're not crazy. We're not hypochondriacs,' Mrazek said. 'They feel like they've been sort of mishandled by doctors who haven't listened to them.'

Many depressed people simply stop taking their drugs because of side effects, experts say.

So for patients, this kind of test could be a dream come true, according to Sue Abderholden, executive director of the National Alliance for the Mentally Ill, Minnesota chapter. 'If we could reduce the side effects -- boy, that would be huge.'

At the other extreme, some patients don't benefit at all from certain antidepressants, at least at standard doses. In those cases, Mrazek says, they may have too many copies of a certain gene, which results in a surplus of enzymes working overtime to clear the medicine out of their bodies. They may need a bigger dose than normal, or a different drug.

This kind of test won't prevent all side effects, he notes. For example, antidepressants have been linked to an increase in suicidal thoughts, and he said genes may have little or nothing to do with that. But genetic differences are clearly to blame for other types of side effects, such as impotence or loss of sex drive.

Generally, most people tolerate these drugs well, he adds. Only about one in 10 people may have a genetic variation that causes a problem, though the rates vary by race, geographic origin and the type of drug involved.

The DNA test Mrazek uses is a simple blood test and needs to be done only once in a lifetime. But some worry about the costs. At the Mayo Clinic, it's about $650 to test just two key genes.

That's one problem psychiatrists at the Veterans Medical Center in Minneapolis are wrestling with as they prepare to start offering the tests. 'Depression is such a common thing. If you start doing this indiscriminately, it's a lot of cost,' said Dr. Adityanjee, a VA psychiatrist who is part of a committee studying the DNA testing. For now, he said, they'll probably limit it to certain patients, such as those who have had problems with medications in the past. 'It's too early at this point in time for this to be part of, let's say, gold-standard treatment,' said Adityanjee, who uses only one name.

But as costs drop and more tests become available, he predicts, 'It will become part of our day-to-day treatment" ...

Mayo is also offering the test commercially, to doctors and clinics around the world.

Eventually, Mrazek hopes to fine-tune the tests to be able to predict which drugs will work best for each patient. 'We're not there now,' he said. But he's optimistic: 'I think it will happen in the next five, 10 years.'"

Carolyn Brink, who experienced postpartum depression and eventually became a patient of Mrazek, found the right medication thanks to Mrazek's cytochrome p450 test.  Her new book "Mommies Cry, Too" chronicles her experience.  You can learn more about it here.  I have a copy (thanks Carolyn!) but haven't had the chance to sit down and read it yet. 

Washington Post article on PPD

Click here to read an article from a few days ago in The Washington Post about another woman just like us and her experience with postpartum depression.