Postpartum Progress

Washington Puts Out Great New PPD PSAs

The state of Washington has put together some public service announcements to support its "Speak Up When You're Down" campaign for public awareness of postpartum depression.  They did a great job, and I love the fact that they used real women, not actors, who have gone through these illnesses.  I'm proud to say that one of the stars of these ads is a reader of Postpartum Progress who saw the casting call on this site!  Watch one of the ads here (fingers cross that this works!): 

Download council_for_children__families__speak_up_b__streaming.mov

Weekly Roundup of Warrior Mom Stories

I want to keep you Warrior Moms up on what is happening out there on the world wide web.  So I'm going to start offering a weekly roundup of what women are writing about their experiences with perinatal mood and anxiety disorders.  I won't be able to link to everyone, but when women write very open and honest and beautiful things I will try and put links to them here.  I think it will help those who are suffering to see what their peers are saying, and it will also help the writers because we can reach out and give them a virtual hug.  Here's this week's Postpartum Progress roundup:

Here's Julie at Letter 9 again, in a post called "In Which I Complain About How Much Postpartum Depression Sucks."  I just love the way she describes her experience.

Jen at GNMParents has had PPD with her three children and is wondering if she'll get it with her fourth, who is three months old.  So far it hasn't happened, thankfully.

Here's a post from Jenna at adoptionblogs.com about postpartum depression among women who have relinquished their children.  It's important to remember that women who adopt children, and women who give their children up for adoption, are all susceptible to postpartum depression.

Janyce at What Shoes I Wear interviews Melissa, an artist, about her experience with PPD.  I like how she talks about the fact that she did all the right things -- exercise, seeing friends, etc. -- and she still felt awful.  Just because you do everything right doesn't mean you won't still feel bad. 

Come See Me in Chicago at the Jennifer Mudd Houghtaling Perinatal Depression Conference!

Mercy Hospital & Medical Center is presenting the Jennifer Mudd Houghtaling Perinatal Depression Conference at the University Club of Chicago on October 17, 2008.  Continuing education credits are being provided by the University of Illinois at Chicago and the St. Xavier School of Nursing.  Speakers include lots of fabulous people I am big fans of, including:

• Sonia Murdock, Executive Director of the Postpartum Resource Center of NY
• Dr. Manny Alvarez, Chairman of the Dept. of Obstetrics at Hackensack University Medical School and Chief Health Editor for FOX News
• Birdie Meyer, President of PSI and coordinator of the Clarian Health Perinatal Mood Disorders Program
• Dr. Lee Cohen, Director of the Reproductive Psychiatry Clinical Research Program at Massachusetts General Hospital
• Dr. Laura Miller, Director of Clinical Services at the Dept. of Psychiatry of the University of Illinois at Chicago
• George Parnham, whom you may recognize as Andrea Yates' lawyer

There will be other speakers as well, including me, which I'm very excited about.  It's an honor to be invited to speak among all these people who know a whole lot more than I do.  I hope to see some of you there!

You can register online for this event at www.mercy-chicago.org/ppd/.

ALSO:  On November 6, the Jennifer Mudd Houghtaling Postpartum Depression Foundation Benefit will be held at the Chicago History Museum.  (I got married at the Chicago Historical Society, FYI.  Great place.)  The event will be held from 5:30 to 9pm and will raise money to support the foundation's programs.  This year it will feature an interview with celebrated photographer Victor Skrebneski by Chicago Tribune columnist Rick Kogan.  Tickets are $150 per person.  To reserve tickets or get more info, please visit www.ppdchicago.org or call 773-477-2252.  Please reserve your tickets by October 31.  This is a wonderful organization that deserves your support. 

 

Solace for Mothers Offers Two Online Communities for Birth Trauma

Jodi from PTSD After Childbirth has informed me that a new online community group has been started for the people around women who have experienced birth trauma.  It is offered by Solace for Mothers and can be found at http://www.solaceformothers.org/advocates-forum.html.  They describe it as a safe landing space for family, friends and professionals to discuss their own experiences following unexpected birth outcomes.  This is a public forum.  Solace for Mothers also offers a private forum for mothers who have had challenging childbirths.

National Library of Medicine Creates One-Stop Shop for Women's Health Research

A new site was launched earlier this year by the National Library of Medicine to provide consumers with the latest information on significant topics in women's health research.  I didn't even know there was a National Library of Medicine.  These nice people have created a one-stop resource so that you won't have to visit a variety of websites, including PubMed, MedlinePlus and ClinicalTrials.gov, to get the research info you're looking for.  The Women's Health Resources site can be found at http://sis.nlm.nih.gov/outreach/womenshealthoverview.html.  Here's the specific women's mental health section: http://sis.nlm.nih.gov/outreach/womenshealthtopicsnlm.html#b011.

How to Use Postpartum Progress

You may be a new Warrior Mom who has just found Postpartum Progress, or someone who has been reading for a while but wants to learn about the various resources available in this blog.  You may have just been diagnosed, or be worried that you may have postpartum depression or a related illness.  Or, you may be a pediatrician, obstetrician, social worker or other clinician who works with moms and moms-to-be.  This blog is for all of you, and this page will help you find your way around.

Postpartum Progress is a blog about postpartum depression and related illnesses intended to provide hope and comfort to the women who suffer, as well as the people who care for them (family, friends, healthcare providers).  It features news, the latest research, a list of support groups around the country, stories from moms and fellow sufferers, and links to major support organizations and treatment programs. 

Below is an outline of some of Postpartum Progress' key features.

For Moms-to-Be & New Moms:

If you have been diagnosed, or think you may be suffering, from postpartum depression, postpartum anxiety, postpartum OCD, postpartum panic disorder, postpartum PTSD, postpartum psychosis or antepartum anxiety or depression, welcome.  I'm really glad to meet you.  I hope you will find a kindred spirit in this blog.

I cover every illness in the perinatal mood and anxiety disorder spectrum, so no matter what you're going through I hope you can find something here that gives you knowledge and comfort.

The "Help Is Here" section (on the right hand side of your screen, underneath the "Welcome" section) includes several important resources: 

• the "What's Wrong With Me?" description of all perinatal mood and anxiety disorders, including risk factors and symptoms
• a list of support groups around the U.S. and Canada
• a list of perinatal mood and anxiety disorder treatment programs in the U.S. and Canada, and
• a list of state and national organizations that offer a wide variety of local resources, services and information.  All of these may be helpful to you on your journey to recovery.  (Please note:  Many of these organizations and groups have "postpartum" or "postpartum depression" in the name, but that doesn't mean they don't serve women with other illnesses.  In fact, they are usually knowledgable of all illnesses across the spectrum and offer support services to everyone.  It's just that postpartum depression is the most widely known of all the illnesses, so that's the name they use.   The proper term for the entire spectrum is "perinatal mood and anxiety disorders" -- that pretty much covers us all.)

Surviving & Thriving Mothers Photo Album -- This fabulous photo album can be found on the right hand side of the home page screen, directly underneath "Help is Here" and above Readers' Favorites.  It features photos of women who have survived perinatal mood and anxiety disorders and their children.  I hope it serves as an inspiration to everyone going through one of these illness by showing that, with treatment, you can be a happy and healthy mom.  I look forward to adding your photo as well.  If you'd like to participate, email me a jpeg to stonecallis@msn.com, along with info on which illness you suffered, what year, and in which state you live.  I use only your first name and last initial.

If you're looking for specific information on a particular topic related to perinatal mood and anxiety disorders, check out the Categories section further down on the left of your screen.  We cover it all here, from Birth Trauma and Breastfeeding to Infertility and Intrusive Thoughts and everything in between.

The Readers' Favorites section (further down on the right hand side of your screen) includes links to the most popular posts I've ever written, based on reader feedback.  These were the ones that struck a nerve or have been most helpful or comforting.  I hope you'll feel the same way about them. 

Read Up (even further down on the right hand side) features a wide variety of books on our illnesses.  If you click on the book, it will take you directly to Amazon.com where you can learn about it, read reviews, and purchase it if you so choose.

As many moms do, you are also welcome to email me if you want to reach out, at stonecallis@msn.com.

For Healthcare Pros:

If you look in the Help Is Here section on the right hand side, you'll see a link to the Tools for Professionals page with a bit of helpful info specifically for you.  Check it out.  Plus, nearly every week I'm posting info on new research and on events that may be of interest to you.  To find them, scroll down the left hand side of Postpartum Progress until you see the Categories section. 
Some categories that may be of particular interest to clinicians:  Research, Obstetricians, Pediatricians, Effects on Children, Screening and Education & Training. 

If you are hospital that has created a special PPD program, someone with a support group or event related to perinatal mood and anxiety disorders, or a researcher looking for participants or announcing research results, please send your news to postpartumprogress@gmail.com so that we can cover it here.

For everyone:

I've created a series called Six Things.  You can find it on the left of your screen, directly underneath my picture.  These brief Microsoft Word documents are a "quick and dirty" way to let people know what I believe are some important things to understand about perinatal mood and anxiety disorders, which include depression and anxiety during pregnancy and in the 12 months postpartum.  If you or someone you know has time to read nothing else, hopefully these Six Things lists will help give you and those who care for you some clarity as you grapple with these illnesses.   

You can Search the entire blog with the search function (powered by Ligit).  It is on the left side of the blog, directly under the subscriber box.  Just type in the topic you're looking for (just like you would if you were searching on Google), and click search and it will take you to a list of posts from Postpartum Progress about that topic.

Home Delivery (on the left hand side, underneath Six Things) allows you to be a regular subscriber to Postpartum Progress.  Just enter your email address and click "Subscribe me!", and you're a subscriber via Feedblitz.  What does this mean?  In the morning, you will receive an email in your inbox with links to each post that I have written the previous day.  This way you always know what's going on without having to remember to visit the Postpartum Progress site every day.  FYI -- I have never, EVER shared the list of subscribers with anyone, so you won't be receiving unwanted email from anyone else.  Also, if you should ever decide you don't want to receive the emails any more, you can easily unsubscribe.

The Listed On section (further down on the left) is simply a list of some of the places on the web that feature Postpartum Progress or have highly ranked it among all internet health sites.  I'm very proud of those associations and happy to display my "blog bling".

I welcome comments on the posts I write.  Just click on the little "comments" link that can be found at the bottom of each post and let me know what you think, or if you disagree, or have a different idea.  And if you have a news tip or story idea, please email me at stonecallis@msn.com.  It is important to note that all commenters on this site are by default considered as non-medical professionals.  If you are a health professional and decide to offer medical information as a commenter, your status as a medical professional must be identified.  If you do make any medical claims, you must offer references or links to material(s) that would support those claims.  It is the policy of Postpartum Progress that all commenters behave at all times with respect and honesty. 

If for some reason you want to learn a little more about me, Katherine Stone, click on the About link and you'll probably get more info than you ever needed to know.  It's underneath my picture.  Just remember, I am not a healthcare professional.  I am simply a mom who has been through this.  Nothing on this site constitutes medical advice.  Postpartum Progress exists to provide peer support.

Again, I hope you find Postpartum Progress helpful and I'm really glad you are here.  God bless you.

P.S.  The Swiper, No Swiping! section (a reference to Dora the Explorer for those of you who don't know) on the left hand side of the blog is a reminder that Postpartum Progress has a creative commons copyright.  You may reprint the original content in this blog with permission, but it must not be altered in any way, and must be attributed to Postpartum Progress/Katherine Stone at http://postpartumprogress.typepad.com.

updated March 10, 2009

News & Observer Covers NC PPD Support

Here's a nice story in the Raleigh News & Observer (NC) about Ann Wimer and her MomsSupportingMoms group for women with perinatal mood and anxiety disorders.  "For more information, visitwww.momssupportingmoms.net or call (919) 454-6946. For information about other services, including how to receive brochures for medical practices and educational outreach opportunities, please contact Postpartum Education and Support at 919-889-3221 or visit www.postpartumeducationandsupport.com.

Videos for Women with PPD

Dr. Shoshanna Bennett, past president of Postpartum Support International and author of Postpartum Depression for Dummies, now has some free videos available online for those suffering with perinatal mood & anxiety disorders.  Here are links to a few of them, which reside at Empowher:

• Postpartum Depression & Lack of Sleep
• PPD Help for Women
• Can a Father Get Postpartum Depression?
• Does PPD Go Away By Itself?

There are several others, so go check them out.

Texas Hospital Launches Outpatient Treatment Program for PPD

Harris Methodist Springwood Hospital in Bedford, Texas, (Dallas/Ft. Worth area) has announced it has opened Texas' first hospital-based intensive outpatient program devoted to treating depression in women during childbearing and post-childbearing years.

The Springwood Program for Women is a comprehensive program tailored to meet the needs of women struggling with pregnancy complications, postpartum depression, loss of a child, infertility, premenstrual dysphoric disorder, perimenopause and menopause.  Services start this week at the Siratt Women's Center at Harris Methodist and Arlington Memorial Hospital.

The intensive program involves a time commitment of three hours per day and is designed to help women balance their treatment requirements with work, education and home-life schedules.  The Springwood Program for Women offers morning and evening programs:  Monday, Wednesday and Friday from 9am to noon, and Monday, Wednesday and Friday from 6 to 9pm.  Patients can be referred to the center by a physician, therapist, EAP counselor or through self-referral.  To reach the Arlington location, call 817-960-2499.  To reach the Bedford location, call 817-355-7700.  Or visit www.texashealth.org/springwood.

Online Study of New Mothers' Sleep & Fatigue Needs Participants

Cheryl Jazzar has shared with me that Kathleen Kendall-Tackett and Thomas Hale, in conjunction with the Texas Tech University Health Sciences Center, are conducting a new online survey about mothers' sleep and fatigue.  The study is open to all mothers with babies 0-12 months old.  They would like to include breastfeeding and non-breastfeeding women, as well as women of all ethnicities and income levels.  They hope to document:

• Where and how much babies sleep
• Whether mothers who breastfeed and co-sleep are more or less tired than mothers who don't
• Whether mothers tell their friends, relatives and healthcare providers where their babies sleep
• If there are ethnic group differences in where babies sleep
• The role of depression, psychological trauma and difficult birth in mother's ongoing daytime fatigue

The online questionnaire takes 20 to 30 minutes to complete and is confidential.  Click here to participate: http://neonatal.ttuhsc.edu/lact

UNC Hosting Women's Mood Disorders Symposium in November

The University of North Carolina Center for Women's Mood Disorders will be hosting an informational symposium called "Depression Across the Reproductive Life Cycle: Pregnancy, Postpartum, the Menstrual Cycle and Menopause" on November 1, 2008 from 1-3pm.  The event is open to the public and the registration fee is $25.  For more information, visit www.womensmooddisorders.org or call 919-966-9640.

Moms All Over the Blogosphere Write About Perinatal Mood & Anxiety Disorders

Here's a roundup of what's going on out there in the world of perinatal mood and anxiety disorders this week ...

Cate at 18 Years and Counting is suffering from postpartum depression and anxiety and needs a Warrior Moms Virtual Hug.  Here's a post she just wrote about her obsessions and fears.

Jodi Kluchar has just created the PTSD After Childbirth blog.  I'm am sure that those of you with postpartum post-traumatic stress disorder will want to follow along for information and comfort.  The blog offers info on conferences, birth stories, research and more.

Miranda has just created a blog called Postpartum Help to share her experiences with postpartum depression and try and help others.  Give her a shout out!

Laura at Depressed (but not unhappy) Mormon Mommy has written about the helpful things people said to her when going through postpartum depression, and what she would say to others.

Lisa at the Lis & D blog writes about the recent loss of a friend of hers to postpartum psychosis.  (This breaks my heart.) She also shares her own experience with postpartum depression.

Diane at The Mommy Diaries writes about postpartum depression vs. stress.

Breastfeeding & Postpartum Depression: A Mother Without A Breast

Breastfeeding. 

That word, and the process that accompanies it, can bring about immediate stress for women suffering perinatal mood disorders.  It's a highly charged issue.  For some of us, difficulties in being able to do it at all send us into a tailspin, and can either cause or exacerbate postpartum depression and anxiety.  I thought, if breastfeeding is one of the few things a female body was meant for, why the hell can't I do it?  What a defective mother I was!!  For others, breastfeeding is one of the only ways suffering moms feel connected to their babies, and the idea of taking medication is terribly distressing.   They'd rather continue to be ill than take meds and have to stop breastfeeding, and are nervous about the risks of continuing and passing trace amounts of meds in their milk to their babies.   No matter how we try to look at it, we are filled with dread, guilt and indecision.  I've been meaning to write about this topic for a long time, but then I received an essay in my email this week from Lisa Sniderman.  It is very poignant, and I've decided it will be more powerful to share her confrontation of this issue than mine, with her permission, of course:

"My name is Lisa, and I have a 2-year-old daughter. Unlike some mothers, PPD was far from my first experience with mental illness. I have been diagnosed with bipolar disorder since age 22, although that diagnosis took 4 years of frequent hospitalization and medical guesswork. I have "treatment-resistant" illness; most medications simply increase my symptoms. In 1993, I finally found my miracle in a combination of doxepin and lithium. I got on with my life goals, thanked my lucky stars, and never looked back... until 2005, when I was newly married and hoping to start a family. It turns out that while my medications could be titrated during pregnancy, because of my history I really, really needed them in full dose immediately after delivery.  [Reader's note: titration is the process of gradually adjusting the dose of a medication until the desired effect is achieved.]  Just when my daughter really, really needed to breastfeed. Thus commenced a frantic search for safety information about the drugs.

The outlook couldn't have been worse.  Doxepin has been shown to cause respiratory distress in nursing infants whose mothers take one-third to one-eighth the dose I needed.  Meanwhile, the lactation and neonatal experts are divided on lithium; some recommend 'extreme caution' and frequent neonatal bloodwork, while others say it is completely contraindicated.  Call me nuts, but I couldn't really see myself, in my vulnerable postpartum state, carefully monitoring my newborn for apnea and hepatoxicity 24/7.  I don't think I ever would have slept.

As it was, I panicked right after delivery and tried to go without my meds for my baby's sake.  I lasted three days before uncontrollable suicidal ideations and racing thoughts sent me to the hospital.  At that point, I realized just how real my illness was, though it had been dormant for over a decade.  I went back on doxepin and lithium, and added an antipsychotic for the short term.  At the time, I thought I was a terrible mother for needing these medications.  Worse -- I thought I was a terrible mother for having the illness that these medications treated (hello, stigma!).  Was bottle-feeding really a 'choice' for me?  Only if I could somehow have 'chosen' instead to spend my daughter's first year either in unbearable torment or dead.  The rhetoric of personal responsibility that surrounds breastfeeding, despite the very real barriers so many women still face, disturbs me in general.  When it is applied to severely mentally ill mothers who need uninterrupted sleep, mood stabilizers and antipsychotics, it absolutely stops me cold.

With the passage of time, I stopped cursing God for making me one of the few women who truly cannot breastfeed.  I tend to search for the larger meaning in things, and I don't think it's an accident that the two medications I need are among the only psychotropic medications unsafe for nursing.  I believe this happened so that I could critically re-evaluate my identity as a mother -- and begin educating myself on the cultural disease of maternal self-negation that enrobes new motherhood in impossible expectations.

I gave my daughter a mother without a breast, because I couldn't give her a breast without a mother.   I know that she and I missed out on a precious experience, but we humans are extremely adaptable and many other equally precious experiences came out of my recovery from PPD, and her subsequent development into a secure and happy little girl.  I learned that self-acceptance radiates out, from me to my daughter.  I learned that the real joy of mothering only comes from mothering oneself first.  My husband and I are trying for our second child, a decision I made only when I felt fully reconciled to the idea of not breastfeeding this one, either.  The stakes are just too great.  The risks of bottlefeeding are well-known; the risks of untreated maternal depression, though they can be equally or more grave, are far less imprinted on the public consciousness.  I accept this; the fact that I am knowledgable about my own situation is enough for me.

The ironic thing to me is that someone seeing me mixing formula at the mall might think to herself, 'What a bad mother.  She must not care about breastfeeding.' When, in fact, I am a breastfeeding advocate and would staunchly defend anyone who took flak for nursing a baby -- or a pre-schooler -- in public.  My story is not a threat to everything we know about the wonders of breastmilk, and I'm not presenting it as such.  It is because breastfeeding is so important that my decision was so difficult.  The interaction between PPD and breastfeeding can be a lot more complex than 'take Zoloft -- it's safe!!'  There are other women, caught in the distorted thinking so common in PPD, who refuse any medication out of fear of harming their nursing babies; weaning is sometimes necessary if it is the only way a desperately ill woman will accept treatment.  Many OB/GYNs, lactation consultants and psychiatrists have little appreciation for these complex issues.

I am sharing this in the hope that some other mom out there reads my story and knows that if it comes to the point of treatment vs. breastfeeding, which thankfully isn't often the case, she can find the courage to be a mother without a breast, rather than no mother at all." 

                     

Take Lisa's words to heart.  Your child needs a healthy mother.  Some of you will be able to alleviate perinatal mood disorder symptoms with psychotherapy alone.  Others will continue to breastfeed while on medication, because you and your doctor decide the risks are relatively low.   Still others will stop, because it is easier for them or because certain medications prohibit breastfeeding.  It doesn't matter.  Your child needs you more than anything.

PPD Study in Pittsburgh Offers Participants Care & Support Services

A reminder that any woman who gives birth at Magee-Womens Hospital in Pittsburgh can participate in a five-year, $2.5 million study funded by the National Institute of Mental Health, the only large-scale research screening program in the country.

Mothers who score more than 10 points on a postnatal depression screening scale are eligible for home visits and referrals to mental health and other support services, according to Dr. Katherine Wisner, director of the Women's Behavioral HealthCARE program at Western Psychiatric Institute and Clinic and a leader of the study, which has served nearly 5,000 women since its inception two years ago.

For more information, visit the Women's Behavioral HealthCARE website.

Postpartum PTSD Study Looking for Participants

Jodi Kluchar at PTSD After Childbirth sent me the following on a new postpartum PTSD study:

In order to help clinicians provide better care to mothers who are having a subsequent childbirth after suffering through a previous traumatic birth, Cheryl Beck (Professor at the University of Connecticut) and Sue Watson (chairperson of TABS) are now conducting a research study on this topic. Women who have had another child after having experienced birth trauma are invited to participate in this research study.

Just like Professor Beck's previous studies on birth trauma and PTSD after childbirth, this study will be conducted over the Internet. Mothers will be asked to describe their experiences during pregnancy, and labor and delivery after having suffered a previous traumatic childbirth.

If you are interested in participating in this research or wish to find out more about this study, please contact Professor Cheryl Beck directly at the University of Connecticut. Her email address is Cheryl.Beck@uconn.edu.

Hawaii Hosting Perinatal Health Summit in October

The 2008 Perinatal Health Summit will be held October 23-24 at the Hilton Waikoloa Village on the Big Island of Hawaii.  (I'm SO jealous of anyone who gets to go!!)   For more information, click here.

Mom Writes About Difficulty of Sharing PPD With Others

This is a fantastic essay on the postpartum depression experience by the blogger at Down-to-Earth Mama.  Here's a highlight, where she writes about how hard it is to talk about PPD with others:

In my personal experience, talking about it was extremely hard.  I talked to Ben about it, as with him, I can fully let down my guard.  But he was an overwhelmed first time dad too.   I really couldn’t get across much to my family as they were states away at the time.  Being so far away, it would have stressed them too much as well, yet they would have been able to do little about it (again, the genetic component).  I didn’t need extra guilt their stress would have caused me  (oh, and that guilt wouldn’t have come from them.  It is just par for the course growing up Catholic).

We were living with my in-laws at the time, so I felt like I was a bit under the microscope. While my mother-in-law and I have an excellent relationship (I consider her a second mother), I really didn’t feel like I could completely open up to her about all that I was feeling either.  I mean, risk looking completely insane?  To your mother-in-law?  To whom you have just given a grandchild?  Well, I really didn’t feel comfortable doing that.  On top of that, I have this need to maintain control (not of others, but myself and my personal situation).  If I don’t have control, I feel the need to maintain this facade, for better or worse.  I did not feel secure in letting anyone into the madness brewing in my brain.

You can read the whole post here.

Postpartum Participants Needed for Online Study of Effectiveness of Internet-Based Programs

An instructor at Walden University, an online degree university, is conducting a study called "Health & Wellness for New Moms" that is exploring whether internet-based stress management programs are effective in reducing stress, anxiety and depression during the first year after giving birth. 

She is looking for new moms to participate in the study.  To participate you must:

• Be able to sign into the program at least one a week
• Be 18 years of age or older
• Have given birth within the last 12 months
• Be willing to complete a 4-week Internet-based program teaching various techniques including meditation, the relaxation response, visual imagery and cognitive behavioral skills

For more information, visit www.thestressplace.com or email ewhitelo@walden.edu. 

MSNBC: Celebrity Mamas Fuel Post-Baby Body Blues

Here's a story on celebrities, postpartum body image and the potential connection to postpartum depression from MSNBC health ...

It is definitely depressing when your stomach still looks like you're 5 months pregnant and you see Nicole Richie walking around in her formerly skinny state seemingly just weeks after birth.  Give us a break. 

Thanks to Tara at Out of the Valley for pointing out this article!

Upcoming PPD Screening Event in Massachussetts

Shrewsbury Youth & Family Services in Shrewsbury, MA, will be holding a special event on Tuesday, September 2nd from 9am to 6pm offering free PPD screenings, the opportunity to speak to clinicians and information on perinatal mood disorders.  For more information, call 508-845-6932.

Reach out to another worried mom ...

Warrior Moms -- reach out if you can to this anxious pregnant mom who is worried about getting postpartum depression.  Her risk factors include infertility treatments and a concern that she has suffered depression in the past.   

Facilitators & Deterrents to Seeking Care for Women Receiving Referrals for Postpartum Depression

There is so much interesting stuff coming out right now about perinatal mood disorders I can hardly keep up!!  GABA receptors, serotonin transporters, the Childbirth Connection research on the large numbers of women experiencing postpartum depression symptoms, predictors of postpartum suicide ... wow.   

There is yet another study, published in Qualitative Health Research, about women's care-seeking experiences after referral for postpartum depression.  I am so annoyed that I don't have full access to this article because I'd love to read it.  The small study of 18 women, conducted by researchers at McMaster University, looked at the factors that prevented women from reaching out for professional help after receiving a referral, as well as the factors that facilitated care-seeking. 

Deterrents included:

• a limited understanding of PPD among women and their families
• women who wanted to wait for symptoms to improve
• discomfort discussing mental health issues
• normalizing of symptoms by the women, their families and health professionals (normalizing is the process of rendering extraordinary situations as seemingly ordinary)
• offering of interventions, or treatments, that are unacceptable to the patient

Things that were likely to lead women to seek care included:

• women not feeling like themselves and wanting to feel better
• established and supportive relationships
• outreach and follow-up
• legitimization of PPD
• timeliness of care

Cavett on Depression

I usually only write about women on this blog, which I think you'll agree makes perfect sense.  But, upon reading Beyond Blue over at Beliefnet, I came across links to two recent articles by Dick Cavett on depression.  Mr. Cavett, as some of you may recall, hosted "The Dick Cavett Show" on both ABC and public television, has appeared on Broadway, and has a blog called "Talk Show" at The New York Times. 

I'm going to give you a few highlights and then send you directly to the posts:

On the fact that you can't tell by looking:  "... I can assure you that whether it’s enduring an unwelcome house guest, your co-workers or your tax man, one of the wretched ailment’s mysteries is that you are in fact coming off 10 times better than you feel. Or think you look."

On how easy it is to believe the awful things we think:  "I’ve decided that the single worst thing about this illness is its terrible authority. I mean the way it thunders at you, 'This is the reality. This is how it is and how it’s going to be. Any memories of fun or wellness are flukes, delusions. And will never come again. Now you have 20/20 vision and see life for the dreadful mess it really is.'"

Smiling Through

Smiling Through, Part 2

As I mentioned in a comment I left on his post, I think we should make him an honorary Warrior Mom, despite his lack of ovaries.  Enjoy the laugh at the end of Smiling Through, Part 2.  I cackled OUT LOUD.  In the middle of Starbucks. 

New Research Relates Crosstalk to Postpartum Depression

A week or so ago we learned that researchers at UCLA uncovered that mice lacking a certain protein (remember GABA?) were depressed and neglected their babies.  When the protein was reintroduced it restored the mama mice to normal maternal behavior. 

This week, a different study out of the Medical College of Georgia finds that something called "crosstalk" may help identify the cause of baby blues and postpartum depression.  Crosstalk is the term used to define the exchange of nutrition and oxygen from mother to child during pregnancy in blood traveling through the placenta. 

Platelets that enable blood clotting secrete serotonin.  Apparently the serotonin prompts the clotting.  This leads the placenta to try and get rid of the serotonin so that blood vessels don't constrict and prevent the fetus from getting all that it needs.  A serotonin transporter gene prevents clotting until after birth. 

Once the fetus and placenta are delivered, platelets then move in to stop unterine bleeding.  Serotonin released by those platelets leads serotonin levels to rise, which stimulates production of interleukin-1 beta, another type of protein.  Interleukin-1 beta gets in the mother’s bloodstream, crosses the blood brain barrier, and creates more serotonin transporters on the neurons when they are not needed.  Why is that a problem?  Because serotonin transporters reuptake serotonin and terminate its function.  That's not what we need, because serotonin helps regulate mood, sleep and appetite.   

Until interleukin-1 beta levels normalize, there’s too little communication between serotonergic neurons and moms get the blues, says researcher Dr. Puttur Prasad.

In more serious postpartum depression, variations of the serotonin transporter gene – which already have been linked to non-pregnancy related depression – appear to make bad matters worse because they are even better at taking up serotonin, he says.  Which means we have even less.  Yikes. 

Dr. Prasad now plans to analyze DNA to see if women identified with postpartum depression have some of the same variations of the serotonin transporter gene already identified with non-pregnancy related depression.

Americanized Latinas Have Higher Rates of Perinatal Depression

Researchers at the University of Texas' School of Public Health and Health Science Center have published a study in the Maternal and Child Health Journal finding that "Americanized" U.S. and Mexican-born pregnant and postpartum Latinas have higher levels of depression.  They describe “Americanization” as the process by which immigrants adopt the lifestyle and customs of their host nation, lead author Marivel Davila said. 

"Elevated levels of depression were reported by the women born in the United States, as well as those who asked to conduct their interviews in English. Two non-acculturation variables were associated with elevated depression - being single and being pregnant.

'Screening for depression during pregnancy is important for this population group, given Latinas’ high rates of fertility and births to single women, particularly among more acculturated U.S.- born Latinas,' Davila and her colleagues wrote in the article ..."

To read more, click here.

Most Effective Treatment for Depression: Therapy & Meds

Psych Central has reported on a new study released in the Journal of Consulting & Clinical Psychology that finds that a combination of psychotherapy and medication is usually "the best possible treatment option for depression (acute or chronic) for nearly everyone.  If you're only doing one or the other, you're likely not going to get well as quickly, it's that simple."

Manber and colleagues (2008) re-examined previous data on 656 patients with chronic depression to see who would get to remission first. Remission in depression research is simply when a person’s depression score on a commonly used depression quiz (the Hamilton) falls below a certain number.

People who had scores of less than 26 on the Hamilton fared best with the combination treatment — 40% of them attained ‘full remission’ within the 12 week study period. So in just 3 months of combined treatment, your depressive feelings could be significantly decreased.

To read the entire article, click here.  I'm not at all surprised by the results of this study.  We don't know exactly what causes depression.  It may be a combination of both physical and social factors.  A "one-two punch" of medication to help improve the physical processes of the body in some way and therapy to help you work through personal issues makes perfect sense to me as the best way to recover. 

PSI Hosts 2-Day Training in Tampa in October

University Community Hospital in Tampa, Florida, will be hosting Postpartum Support International's 2-day training program entitled "Perinatal Mood Disorders: Components of Care" on October 24 and 25.  The conference will be held at Pepin, the hospital's heart institute.  Attendance is limited to the first 100 registrations.  For further information, please contact June Vinyard at 813-615-7907 or jvinyard@mail.uch.org.  This is a class very much worth taking, especially if you're considering in specializing in the treatment of perinatal mood disorders. 

The Yellow Wallpaper On Stage This Fall in Chicago

The Chicago Danztheatre Ensemble will close its 8th season with an updated thatrical production of their original adaptation of "The Yellow Wallpaper."  The play is based on Charlotte Perkins Gilman's short story of her battle with postpartum depression.   Performances will be held October 3-5 and October 10-12 at the Gorilla Tango Theatre in Chicago.  Tickets are $15.

Actress Amanda Peet Reveals Bout with PPD

According to Celebrity Baby Blog, actress Amanda Peet has revealed that she struggled with a fairly serious postpartum depression following the birth of her daughter Frances Penn in an interview with Gotham magazine.

The 36-year-old actress says that the feelings of euphoria she enjoyed while pregnant "all came crashing down the second [Frankie] was born; "expecting to feel fulfilled," Amanda says she instead felt "sleep-deprived beyond belief" and ambivalent about motherhood. She adds, "I want to be honest about it because I think there’s still so much shame when you have mixed feelings about being a mom instead of feeling this sort of 'bliss.' I think a lot of people still really struggle with that, but it’s hard to find other people who are willing to talk about it."

Thanks for being a Warrior Mom, Amanda.

Predictors of Postpartum Suicide Attempts

A study just published in the August 2008 issue of the American Journal of Obstetrics & Gynecology, found that a history of psychiatric disorders or substance abuse was a strong predictor of post-partum suicide attempts. 

After adjusting for fetal or infant death and other variables, women who had been previously hospitalized for psychiatric disorders were more than 27 times as likely to attempt suicide as women without this medical history. Women with a history of substance abuse were six times as likely to attempt suicide, while psychiatric hospitalization and substance abuse together increased the risk by 11 times.

A recent recommendation from The American College of Obstetricians and Gynecologists suggested screening for psychosocial risk factors, including depression during prenatal care. This article emphasizes the need for more careful follow-up of postpartum women with current or past psychiatric diagnoses or substance use. The authors state, "Future studies should evaluate the effectiveness of screening for psychiatric and substance use disorders on decreasing adverse outcomes such as suicide attempts during the postpartum period. If found to be effective, such interventions may prevent the devastating impact associated with postpartum suicide attempt."

The article is "Psychiatric risk factors associated with postpartum suicide attempt in Washington State, 1992-2001" by Katherine A. Comtois, PhD; Melissa A. Schiff, MD, MPH; and David C. Grossman, MD, MPH. This study was supported by a grant from the American Foundation for Suicide Prevention.

Study Finds Significant Numbers of Women Experiencing Depression Symptoms Postpartum

Childbirth Connection, a leading national not-for-profit organization that works to improve the quality of maternity care, today released "New Mothers Speak Out, National Survey Results Highlight Women's Postpartum Experiences."  The combined survey results from two "Listening to Mothers" surveys provide an in-depth look at women's postpartum experiences during the first eighteen months after giving birth.

The survey utilized validated tools to screen for postpartum depression and traumatic stress associated with childbirth, and found that notable portions of mothers experienced symptoms of depression and of traumatic stress many months after giving birth, according to Reuters.

"Postpartum mothers experience a troubling burden of physical and emotional health challenges after giving birth. Although many of these problems abate over time, far too many women were still experiencing them from 6 to 18 months after birth. With more than 4.3 million births each year in the United States, it is an urgent priority to better understand the reason for these challenges, their implications for women and their families, ways to prevent distress and morbidity, and ways to help women and families before they experience detrimental effects," stated Maureen Corry, MPH, Executive Director of Childbirth Connection.

The study also looked into breastfeeding experiences, co-sleeping, social support from others and maternity leave benefits and employment issues.

 

"The overall picture is of recent mothers engaged in a juggling act, carrying multiple and sometimes conflicting responsibilities while experiencing high levels of social, physical and emotional health challenges. There are concerns about whether large segments of this population have access to adequate health and social services and social support. We are letting our mothers and babies down at one of the most critical and vulnerable times in their lives. These survey results are a clarion call to action for programs, policies, clinical services, and research to better understand and improve the experiences of new mothers and their families," said Corry.

The "Listening to Mothers Postpartum" survey reached 903 U.S. women, ages 18-45, who gave birth in a hospital to a single infant in 2005, with the infant still living at the time of the survey. The survey was carried out by Childbirth Connection, a national non-profit focused on improving the quality of maternity care through research, education, advocacy and policy, in partnership with Lamaze International and conducted by Harris Interactive.  The "New Mothers Speak Out" report, along with survey questionnaires, details about the survey methodology and related documents, are available at www.childbirthconnection.org/newmothersspeakout/

Matria Healthcare Launches MaternaLink PPD Screening Program

Matria Healthcare, LLC, a subsidiary of Inverness Medical Innovations, Inc., announced today that it has launched its MaternaLink Postpartum Depression (PPD) Screening Program, a service to help identify new moms at risk for PPD. The program's focus is to provide earlier clinical evaluation and support, better mental health and improved clinical and financial outcomes.

Matria will partner with health plans, Medicaid and employers to confidentially screen new moms. Matria's trained staff will use a validated screening tool to assess a new mom's potential risk factors for postpartum depression. Depending on the results, new moms are then referred to behavioral health providers for additional evaluation and treatment.

The new MaternaLink PPD program is an expansion of Matria's Total Maternal-Newborn Solution (TMNS), which comprises services that cover the entire continuum of maternal-newborn care from risk screening, education and case management to home-based OB services and NeoLink, a comprehensive NICU case management program. All participants receive 24/7 access to highly-experienced OB and NICU trained nurses who work in tandem with patients' physicians' plans of care.

"As more health plans and employers begin offering Matria's new PPD screening services to their members and employees, we look forward to the opportunity to positively impact the lives of moms suffering from this treatable but often ignored, medical condition," said Gary Stanziano, M.D., executive vice president of Matria Women's and Children's Health.  Matria Healthcare is a leading provider of integrated comprehensive health enhancement programs to health plans, employers and government agencies.

Note:  From the news release below I am unable to tell what type of screening tool they plan to use or exactly how the process works.  It will be interesting to find out.

Mental Health America To Host Workshop in Atlanta on Addressing PPD in Communities

Mental Health America will be hosting a free maternal depression workshop on Monday, August 25 from 11 to 1:30pm in the Zaban Room of the Carter Center in Atlanta, GA.  This SAMSHA-sponsored maternal depression workshop is designed to initiate discussion and brainstorming around how communities can address maternal depression.

Space is very limited, so if you'd like to attend please call Sarah Schwartz, executive director of the Georgia chapter of MHA at 678-904-1970.

I'll be there!

Screening in Hawaii; Misguided Opposition to the MOTHERS Act

Here are some links to women writing about PPD in the blogosphere:

Diane in Hawaii writing about the organizations that conduct PPD screenings in the Aloha state

Tiffani writing about the MOTHERS Act and the misguided opposition to it