Postpartum Progress

The Endless What-Ifs of Postpartum Anxiety

Dr. John Grohol at Psych Central offers up an explanation of anxiety in his discussion of a recent article in the New York Times Magazine.  What is it, he asks, then quoting from the Times piece:

"Anxiety is not fear, exactly, because fear is focused on something right in front of you, a real and objective danger.  It is instead a kind of fear gone wild, a generalized sense of dread about something out there that seems menacing -- but that in truth is not menacing, and may not even be out there.  If you're anxious, you will find it difficult to talk yourself out of this foreboding; you become trapped in an endless loop of what-ifs."

Oh, have I been there.

What if my son never loves me?  What if I don't know how to be a mom?  What if I never stop crying?  What if I harm him by ---------? (fill in the blank with the many terrifying ways I wondered about hurting my son which I won't list here so that I don't make you start thinking the same damn things) What if he doesn't wake up?  What if my husband doesn't come home from his trip?  What if I can't get my baby to eat?  What if I'm not who I thought I was?  What if I stay this way forever?

I wonder if I was more exhausted from the lack of sleep or the constant mental gymnastics going on between my ears.  My mind never stopped with the worrying and the thinking and the being scared of the thoughts I was thinking.  It wouldn't stop.  Why won't it stop?  MAKE IT STOP. 

That's when you want to quit.  To run away or give up or maybe something worse.  Because the noise in your head is loud and unbearable and hateful and exhausting. 

For some reason I didn't quit.  I think it was that roly-poly-baby-faced boy looking up at me.  I decided I'd try and reach out for help. 

There must be somebody somewhere who can help me fix this.  This can't be all there is. 

There was.  And it isn't.   

Small Heart Attack Imminent: The Impact of Postpartum OCD on Children

Dontcha know that seeing the title of this little piece of research would set my heart to racing!

"A preliminary investigation of the impact of maternal obsessive-compulsive disorder and panic disorder on parenting and children"

The research isn't on postpartum OCD or postpartum panic.  And what it found is that they need to do more research.

This means I can stop hand-wringing, pacing and self-flagellating for now.  ;-)

Tragedy & Misery Intertwined: 9/11 & the Birth of My Postpartum OCD

Today, September 11th, is a very moving day for me.  Among the remembrances of what happened in New York City, at the Pentagon and in a field in Shanksville, Pennsylvania, I also remember the beginning of what became both a devastating experience and a true blessing in my life -- my postpartum OCD.

Eight years ago today I was in the maternity ward at Piedmont Hospital in Atlanta, having just had my first baby, my beautiful Jackson, just a few days before.  I was in the hospital nursery, visiting Jackson and checking on whether his bilirubin levels were low enough (he had jaundice) to allow him to be released that morning from the hospital.  My husband walked in to the nursery to tell me that someone had attacked the Twin Towers in New York.  I thought he was joking.  As all of the hospital patients and staff and doctors came to realize what was happening, a strange buzz took over the hospital.  New York, DC ... no one knew if Atlanta, not much further down the Eastern seaboard, would be next. 

I remember begging the nurses in the nursery to get hold of the pediatrician who would decide if my son could be released and get whatever approval we needed so we could get out of there.  Threatening them that I was leaving and taking my baby with me, with or without their permission.  I remember going back to my room to throw my things in a bag and seeing the second tower collapse on TV, while my husband was relaying that the first tower had already gone down.  I remember bundling Jack up in his Piedmont onesie and a random blanket, with no time to dress him in the adorable "going home" outfit I'd so carefully picked out for him from Baby Gap as I had planned.  The shirt from that outfit, never worn, featured, ironically, a little blue shirt with two airplanes doing loop-de-loops. 

I remember my husband driving down Interstate 85 at 100 miles an hour to get us home, the center of Atlanta so surprisingly empty, as most everyone had already abandoned the city.  I remember in those first several weeks of his life, the songs I sang to Jack were "God Bless America" and "America the Beautiful" rather than "Twinkle, Twinkle Little Star" or "Itsy, Bisty Spider".  I remember wondering what kind of world I had just brought my son into.

That experience, among other things, sowed the early seeds of my postpartum OCD, which unbeknownst to me would burst into my life with such cruelty just a few weeks later. 

For so many reasons, I will never forget 9/11.  God bless America.

How To Talk To New Moms About Intrusive or Scary Thoughts

Karen Kleiman at the Postpartum Stress Center has created a guide for healthcare practitioners on integrating a one-question screen on intrusive thoughts into their practice for postpartum women.  This one-page guide on "scary" thoughts may help you more comfortably discuss this with your patients.

For more from Postpartum Progress on intrusive thoughts, click here.

The Link Between Parasailing & Postpartum Depression

Have you ever been parasailing?  I have. 

As described by Wikipedia, Parasailing, also known as parascending, is a recreational activity where a person is towed behind a vehicle (usually a boat) while attached to a specially designed parachute. known as a parasail. The boat then drives off, carrying the parascender into the air.

I went once when I was on vacation in Lake Tahoe.  This was when I was in college and was willing to risk life and limb just because a cute guy ran the parasailing boat. 

After the fright and thrill of going up into the air harnessed to a parachute, something immediately grabs your attention.  Silence.  You can't hear ANYTHING, except perhaps the air blowing past your ears.  You can see all the people down below, driving around in boats, waterskiing, wave running, frolicking.  At ground level, the beach is a noisy place.  Then up you go and the sound disappears completely.   You suddenly feel strangely separated from the world.  You know what's going on down there, you can see them and you understand what they're doing, but you get the clear sense that you could yell and scream and no one would hear you.  You're there, but then again, you're not.

I was thinking about that experience the other day and it reminded me so much of how I felt when I suffered postpartum OCD.   It was like an out-of-body experience; I was floating above my life watching all the people go about their day and I couldn't successfully communicate with them.  I couldn't connect to them.   I was still there, but in a different place, and I didn't know how to come down out of that place by myself.  Like the boat that eventually pulls the parasailer back down to earth, it took professional help to bring me back to myself, my friends and my family.  I got it, of course, and mercifully returned to the shore of my life.

For more on this, read "Profoundly Alone: The Disconnection of Postpartum Depression".

Don't Let the Terms "Baby Blues" or "Mild" Postpartum Depression Fool You

I want you to read this brief but great piece by John McManamy at McMan's Depression & Bipolar Web called "Mental Water Torture".  It's about the importance of not blowing off mild to moderate depression until it turns into major depression.  His words apply to women with antepartum and postpartum depression as well.  If we ignore what we're going through, just hoping it will wear off eventually, we may be sentencing ourselves to something much worse.  An excerpt:

"As I sit here writing this, the term mild to moderate depression mocks me. I won't even begin to estimate how many years I've lost to a disorder predicated by the modifiers mild to moderate. The least they could have done was assign the name of a Shakespeare character - Hamlet's disease, Lear's disease, anything, really. Just so long as it doesn't imply I was cut down in the prime of my youth by some invisible stupid nerf bat pounding against the inside of my brain.

For the rest of you: You can end it right now. You don't have to endure the mental water torture any longer."

Why do we wait to reach out for treatment when we know something is wrong?  Many reasons. There's stigma and the fear of facing the unknown (including medication and therapy for those who've never had it). There are those of us who just don't pay attention to how we're feeling and those of us who always put others ahead of ourselves.  There are those of us who decide this is just the "baby blues", even though the baby blues is a normal adjustment period that resolves itself approximately 3 weeks after delivery, and we are still feeling bad, perhaps getting worse, and have already moved past the first few weeks postpartum.

Susan Stone at Perinatal Pro adds to that list the misrepresentation in the media of postpartum mental illness.   Compared to the consistently bedraggled, crazy-looking, blank-eyed moms portrayed on TV, many of us can function and present ourselves in a way that hides our underlying misery.  Because of this, we think we don't have an illness requiring professional help.

"There are mothers who may have a pregnancy-related mood disorder but think that because their symptoms do not equal the extreme drama portrayed in such [entertainment] stories, they do not have postpartum depression or another affective pregnancy-related disorder.  They may conclude that their suffering is insufficient to warrant intervention and compassion.  These are the mothers who know that something is wrong, but compare themselves to these extremely rare depictions and think they are just "blue" and attempt to tough it out -- week after hellish week.  So months of silent anguish continue and the potential joy of motherhood is lost to the woman, her infant and her family."

None of these reasons for waiting to reach out for help is acceptable.  It's not worth the future pain we may cause ourselves.

Karen Kleiman, author of "This Isn't What I Expected" and many other great books on our illnesses, wrote about this issue recently in a comment on my post on deciding whether to take meds during pregnancy:

"Sometimes people feel that a risk is greater if they 'do' something or take action, as opposed to just letting things be. Like, 'If I get on that airplane during the storm, the risk will be greater than if I don't go.' That seems pretty clear.

Conversely, there are times when the risk is in fact higher when no action is taken, such as the decision not to do anything in response to having chest pains.

This is the case with women who are pregnant or postpartum. Women who are deciding whether or not to take medication are understandably unsettled by having to made this decision. Often they feel if they "take" the medication, they are taking an action, or engaging in behavior, or making a choice that increases the risk, or so they believe. Thus, they feel it would be better to do nothing.

But we know that in many of these cases, it is NOT better to do nothing and NOT TAKING ACTION can be detrimental; it can significantly increase the risk potential, particularly for women who are severely ill.

So it's a perception thing. We perceive the risk to be greater if we take action. 'If I put this pill in my mouth I will be hurting myself or my baby.' But it's a faulty perception. Sometimes, the risk is much greater when we do not act."

Exactly.  There are a variety of effective treatments.  Go talk to a professional to see if you need one.  Act.

For another piece on this topic, visit "The Myth of Wishing PPD Away".

Interview Today on Postpartum Depression & Related Illnesses

Getting ready to go do interview with CNN/Turner Private Networks for the CNN Accent Health Network that appears in doctors' offices and reaches more than 140 million viewers each year.  Thank you so much to CNN for being willing to cover the topic of postpartum depression and related illnesses for its audience.  They will also be interviewing Dr. Zachary Stowe from the Emory Women's Mental Health program.  Hopefully I can get a copy of the final story and post it here at Postpartum Progress. 

Wish I could lose 10 pounds before this afternoon.  :-)

UNC & Florida State Conducting Perinatal Anxiety Study

Perinatal anxiety — unhealthy distress experienced during or soon after pregnancy — is the subject of a major new study being conducted by psychologists at the University of North Carolina at Chapel Hill and Florida State University.

“We call perinatal anxiety the hidden disorder,” said Jonathan Abramowitz, Ph.D., co-principal investigator for the study, associate professor of psychology and director of the Anxiety Disorders Clinic in UNC’s College of Arts and Sciences. 

“About 60 to 70 percent of new mothers and fathers have these kinds of thoughts,” he said. “It’s normal to think these things, dismiss them and move on. But when you can’t control your thoughts, or they interfere with your sleep, your health or your ability to care for your baby, then you may need help.”

In some cases, such anxiety results in panic attacks (perinatal panic disorder). In the most serious cases, parents may become obsessed with senseless, intrusive negative thoughts which they can’t seem to control no matter how hard they try, Abramowitz said (pregnancy and postpartum OCD). “They may begin to worry about all kinds of things: What if the baby dies during sleep? What if I lose control and harm the baby? What if I do something terrible to the baby? Worse, they may feel scared and confused about what these thoughts mean — fearful that they will act on these obsessional thoughts.”

The researchers in this study will be looking at how effective cognitive behavioral therapy (CBT) is in treating perinatal anxiety.  All participants in the six-week study will receive helpful childbirth counseling as part of free weekly prenatal classes. Half of the participants will receive elements of CBT as well. Those who complete the study will also receive a modest fee at the end.  First-time pregnant women over the age of 18, and their partners, can learn more and complete a screening questionnaire online at www.babyprepstudy.com.

BeliefNet: 15 Ways to Stop Obsessing

For those of you who are going through postpartum OCD or knows someone who is, here's a good piece from Therese Borchard over at BeliefNet on 15 ways to stop obsessing.  These are tips on how to help rid yourself of the ruminations.  I think you will find some of these helpful.  It's worth a try, right?

Postpartum Depression & Anxiety: The Waiting Is the Hardest Part

I can't tell you how many women I've spoken to lately who are worried and upset by the setbacks they experience while recovering from perinatal mood and anxiety disorders.  They have a string of good days and think they're finally getting better, and then they have a terrible day and feel that all is lost.  It's heartbreaking.

I know exactly how they feel.  I can remember starting to feel better after beginning my treatment.  I'd have a few good days and begin to glimpse peace.  I'd feel like I was turning the corner.  I'd have a sliver of hope, for goodness sake.  And then -- SLAM! -- the sadness, anxiety, misery and guilt would flood back over me.  I'd think to myself, "Of course.  How could I have been so foolish?  I knew I'd never get better.  I'll never be me again."  I'd be crushed with disappointment, and angry for even thinking I could ever get back to my old self.

I did get better, though.  In fact, I'd venture to say that the me who came out of my experience with postpartum OCD is even better than the me who went in.   It took a while, but that's the deal unfortunately.  Recovery from these illnesses is a process.  I wish it was like bronchitis or strep throat:  Call doctor.  Go to appointment.  Get prescription.  Take 1 pill twice a day with food.  10 days later, all better.  It isn't.  It can be scary to hear that, but it's better to know what to expect so that you can be patient with yourself.   

We all start out with more bad days than good, or perhaps even all bad days.  Then you have a few good ones here and there.  Then you start having more good days than bad.  Then one day you realize you've had only good days, for a long time, and you have this slow and cautious realization that maybe the sun has come out for good.

In the meantime, don't let bad days define you or defeat you.  It's okay to have them, and to feel the bad feelings.  Just don't let them convince you that the progress you've made up 'til now is gone.  You're still moving forward, even on bad days.  Just continue to do the things you need to do to take care of yourself.   

There is one thing you can do to help your recovery process along:  Don't take it over as though you are a healthcare provider.  The first time you feel better, don't decide to quit your meds (if you're taking them) cold turkey, or quit seeing your therapist (if you're seeing one) cold turkey, or quit asking for help or taking care of yourself or following whatever method of treatment you and your doctor have decided to follow.  This could impede your progress.  I know lots of people who decide they know better than their healthcare providers, and so they start making decisions as to what they should and shouldn't be doing without the counsel of trained professionals.  I don't think that's a good idea. 

If you feel like the professional you're working with isn't helping you or hearing you, that's different.  It's okay to go out and find another one.  But if you like the one you're with, don't ignore your physician's advice just because you've started feeling better, or because you've bought into the false belief that you should be over this by now, or because you've bought into the false belief that you should be able to get over this all on your own.  There is no set timetable for recovering from perinatal mood and anxiety disorders. And there is no law of nature that states that you're a better person if you can get over it all by yourself.  No one can get through life on their own without help, regardless of whether they're ill or not.  We all need support at some point.  It just happens to be your turn.

In the meantime, try and accept that you're moving in the right direction, even if you have a bad day.  Try and find inspiration and patience in your faith, or in music and literature, or in nature, or in speaking with women who have long since recovered, who know how you're feeling and who know you can get better. 

We know how hard it is to wait for the clouds to lift.  We know that there are ups and downs, and that it can take a while.  We'll wait with you.  You're worth it. 

Women & Infants Day Hospital: One Mom's Story

Here's a story from Warrior Mom Amy Q. (whose pic appears in the Surviving & Thriving Mothers Photo Album) that appears on the Women and Infants Hospital of Rhode Island website.  This story helps explain how the day hospital works, which I think is the standard of excellence all hospitals should strive to achieve when treating women with perinatal mood and anxiety disorders.

Portland Family Magazine on Postpartum Anxiety

I'm trying to educate myself about perinatal psychiatric illness.  I've recently learned that I wasn't technically correct when I use the term perinatal mood disorders.  Mood disorders include postpartum depression and postpartum psychosis.  Anxiety disorders, like postpartum anxiety or postpartum OCD, are not mood disorders.  They're different.  Most people probably wouldn't care about such splitting of hairs, but I'm a word person and I always want to be so careful about being correct when I can.  (OCD, anyone?)

Since I went through postpartum OCD myself, I always want to make sure to "represent" for those of us with anxiety.  Stacy Larsen recently wrote a great story in the Portland Family Magazine about postpartum anxiety disorders.  It was well done, and reminded me so much of what I went through when my son was born.  It was like reading about myself.  If you have been through or are going through some form of postpartum anxiety, I think you'll really find this interesting.

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

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.

All That Naz: A Comprehensive Approach To Recovering from PPD

This is a nice post from the blog All That Naz in which she shares the well-rounded plan of attack she used to recover from her postpartum mood disorder.  This included medication, counseling, prayer, diet and lifestyle changes, support groups and more!  She serves as a great example that there is no one magic pill for getting better, and that it is often most effective if you address the mind, spirit AND the body in your journey to recovery.

Also, here is a link to a book review from Stop, Drop and Blog, where she talks about how different authors' styles and recommendations can truly heighten the anxiety of someone who has had a postpartum mood disorder and still suffers from anxiety.   It's so true that a lot of these books and child development/parenting experts just serve to make me feel worse about myself as a mom, which is something I DO NOT NEED.  That's why you should check out Ann Dunnewold's book "Even June Cleaver Would Forget the Juice Box."  She presented at the PSI conference last week and did such a great job in reminding us how we are bombarded with messages from the media about being the perfect mom.

Postpartum OCD Story from Grace Unbound

This is a very moving post from the blog Grace Unbound by a mother who wasn't able to confront her experience with postpartum OCD until her child was 6 years old.  Wow.  I can completely connect with her story, although I was able to get help much sooner thankfully.  I'm so glad she knows she's not "evil" now.  A highlight:

I don’t know the answer to ‘why me?’ Why did I get this disorder that changed the course of my early parenting years? Maybe I’ll never know. I know that it has taught me that secrets held too long leave their mark. I know that in some ways it did make me a better mother because fear gave me the desire to seek out parenting solutions that were gentle. I know it reaffirms the depths of love that my husband has for me, that when I finally told him he didn’t turn away, he didn’t reject me. I don’t know all the answers, but I know the peace that comes from being finally set free.

"From The Hips" Pregnancy Guide Offers Deeper Look at PPD

There is a great new pregnancy guidebook out called "From the Hips: A Comprehensive, Open-Minded, Uncensored, Totally Honest Guide to Pregnancy, Birth & Becoming A Parent," written by Rebecca Odes and Ceridwen Morris.  I think this book rocks and will eventually outsell many of the other books that just cause fear and confusion and frustration for women who are about to become mothers.  (Was anybody else freaked out after reading "What to Expect When You're Expecting," or was it just me?)

My favorite feature? The chapter called "The Postbaby Brain" on pages 188-205.  The authors take an unvarnished look at the feelings moms have about parenthood, both good and bad.  And they actually talk about postpartum mood disorders for 5 pages (!), rather than the usual paragraph or two, even offering a list of symptoms for postpartum depression, postpartum OCD, postpartum panic disorder and postpartum psychosis.  It's nice to see a general interest pregnancy book go into more detail about the variety of symptoms one can experience and recognize that PPD is not a one-size-fits-all illness.  I would have liked them to offer a little more information on how to seek help, but they do provide a list of resources on page 194 that includes Postpartum Support International and Postpartum Progress (wahoo!), among other good sites and books.

Odes and Morris offer ten "anti-rules" for parents-in-progress, which you can learn more about by picking up their book:

1. Everyone's an expert, but you're the authority on yourself and your baby.
2. Confidence is more important than instinct.
3. Strive for imperfection.
4. Parenting is out of control.
5. There's no such thing as a "natural" mother.
6. Shift happens.
7. Babies are people, not problems.
8. Frustration, resentment, anger, exhaustion, exasperation, aggravation, jealousy, nostalgia, regret, etc., don't make you a bad parent.
9. Look forward, not backward. 
10. There is no right way.

AMA Newspaper Focuses on Barriers to Caring for PPD Moms

American Medical News, the newspaper of the American Medical Association has just published a great story on postpartum mood disorders called "Beyond the Baby Blues: A Spectrum of Postdelivery Conditions."  It features myself and a host of fabulous doctors, including Dr. Marlene Freeman, Dr. Shoshanna Bennett and Dr. Katherine Wisner among others.  It covers barriers to care by physicians, which is extremely important given that we're trying to get a bill passed in the Senate asking for more education and training of doctors, among other things.  Here is my favorite quote from the article:

"This is a disease that lives between specialties [obstetrics/gynecology, psychiatry, pediatrics]," Dr. Wisner added. "Patients are running around in circles."

Exactly.

PSI Annual Conference To Be Held in Houston June 4-7

Save the Date!  This year's Postpartum Support International conference will be held in Houston, June 4-7 at the Hilton Americas-Houston.  The event is co-sponsored by the Women's Mental Health Initiative of the Mental Health Association of Greater Houston.  Some of the main speakers include Dr. Margaret Spinelli, Dr. Lucy Puryear, Valerie Plame Wilson and George Parnham.  Registation will begin in March.  I'll be there, and I hope to see you there as well!  For more information, visit www.postpartum.net.

Postpartum Progress Opens Up To Guest Authors

Would you like to be a guest author on Postpartum Progress in 2008?  I have decided to open the blog up to some additional voices this year, as Postpartum Progress continues to grow. 

I've thought about doing this in the past, but haven't done it because I've been nervous about offending people if I edit them or choose not to use their articles.  But I've decided to ty and get over that for the sake of diversity.

You can submit your stories/articles to me at stonecallis@msn.com anytime throughout the year.  Here is how I will make choices about what will and won't appear on the blog:

1) Stories should run no more than 700 words.  I try to keep all my blog posts fairly short and easy to digest.

2) The article must be 100% relevant to Postpartum Progress and its readers, meaning it should be focused on postpartum mood disorders (postpartum depression, postpartum psychosis, postpartum OCD/anxiety, postpartum PTSD) or antepartum mood disorders.  As a reminder, Postpartum Progress is written to SUPPORT the women who have suffered or will suffer, and for their families and friends and those who treat them.

3) I will not run any article in which the writer is attempting to sell their product or service.  No shilling.  I will make an exception, however, for published authors of books focused on PPD and related-disorders if they would like to share an excerpt of their book of which they are particularly proud.

4) I will not run any article where I feel the story has already been done many times on Postpartum Progress, so it would help you to be very familiar with the site.  The subject should be a new and fresh take on the issues surrounding PPD and related disorders.

5) I welcome personal stories of people's experiences with PPD as long as they are fairly concise and well-written.  I also welcome brief summations from people who have been able to attend conferences or roundtables or other events that I have not been able to attend, as long as there is some interesting, newsy nugget of info that came out of the event.  And I welcome stories about newly published research as long as it comes from a highly-regarded source.

I hope this makes sense to everyone.  You will, of course, be credited as a guest author for your story, and should you have a blog or website I will be happy to link to it in your article.  I will try and respond back to each person who submits an article to either let you know that it will appear and when, or to let you know why I don't plan to use it.  If I don't reply back it may be because I get too overwhelmed.

Informative First Thursday Teleconferences Offered By MedEdPPD

I think I've written about this before -- at least I hope I have -- but Dr. Ruta Nonacs was kind enough to remind me of the First Thursday teleconferences held by MedEdPPD.  Here's a link to her post on A Deeper Shade of Blue about these informative sessions.  The next one is Thursday, February 7, and will feature Dr. Margaret Spinelli of Columbia University discussing postpartum psychosis and infanticide.

The Future Is Bright

I had the opportunity this weekend to retell the story of my experience with postpartum depression/OCD.  Even though it has been six years, it astounded me how the feelings rise up and bubble over -- it surprised me that I cried.  I guess it just goes to show what an intense and indelible experience PPD is for everyone who goes through it.  It also served to remind me how different I am today than I was during those dark hours. 

I am so unbelievably happy to be a mom.  It is truly the best job I've ever had or will have.  My children are my oxygen.  Is it easy every day?  Of course not.  When my 20-month old decides to remove her diaper and spread its contents around her crib, I pray for mercy.  When they throw tantrums in public, I want to tell onlookers that they don't belong to me.  But then my funny little six-year-old tells me "Mom, just five more gallons and I'll be as tall as you", and I feel like the luckiest, happiest person in the world.

For those of you reading this who are going through postpartum depression right now I hope you can find some hope in that.  I went from being someone who thought I never should have been a mother, to being someone who delights in motherhood.  You will too. 

5 Things Every New Mother Should Know About PPD

I was recently asked to put together a list of things women should know about postpartum depression.  I thought a lot about what I went through in 2001 with postpartum OCD, and the things I wish I had known that I believe would have lessened the severity of my experience.  While the list below certainly doesn't cover everything, I think it's a good start and I hope it will help many women in their journey as new mothers.

PPD can and often does happen.

Many pregnancy books and childbirth educators gloss over postpartum mood disorders.  They minimally describe the symptoms and emphasize how rare it is.  Actually, 10-15% of new moms experience these illnesses, and some studies report it may be as high as 25%.  My childbirth educator told our class that we really needn't spend too much time worrying about it, so I didn't, and thus I was completely unprepared for what hit me.

Postpartum depression is only one in a spectrum of postpartum illnesses.

Postpartum mood disorders include postpartum depression (PPD), postpartum obsessive compulsive disorder (PPOCD), postpartum psychosis (PPP) and postpartum post-traumatic stress disorder.  PPOCD is often characterized by intrusive thoughts, which are disturbing unwanted thoughts.  When I experienced my first intrusive thoughts -- about smothering my infant son with the burpcloth -- I had never heard of such things.  No one ever told me they were possible.  I was convinced I had just gone permanently crazy, and it never occurred to me that I had PPOCD.  If I had been better informed, I would have felt comfort in knowing what was wrong and that immediate treatment was available.  Instead I kept quiet for weeks because I was afraid I'd be locked up forever and lose my family.  (For more information on each illness and its symptoms, visit the Postpartum Support International website at http://www.postpartum.net/brief.html )

Symptoms can appear anytime during the first year after birth.

Many women think that if they start feeling bad when their child is 3 or 4 months old, or even older, that it can't be related to postpartum depression.  Apparently, even the DSM-IV, the manual that psychiatric professionals use to diagnose psychiatric illnesses, states that your illness can only be diagnosed as postpartum if the symptoms show up within the first four weeks after birth.  This isn't necessarily true.  Postpartum mood disorders can occur any time within the first year after the birth of your baby, though it is true that most are diagnosed within 2 to 4 months postpartum.

Ask your friends and family to be prepared.

It's important to talk about the possibility that you might experience some form of postpartum mood disorder with the people closest to you.  Ask them to educate themselves.  Sometimes we can't see that we're acting differently, or we try to convince ourselves we're fine and purposefully ignore our symptoms.  In that case, it often takes someone close to us to point out that we might need help.  Neither my husband nor my mother knew about what to look for or what to do about it, which made it harder on all of us.

The sooner you get treatment the better.

Many recent studies show that children of mothers with postpartum mood disorders who go untreated for long periods can be negatively impacted over the long term with behavioral problems.  A study published in 2006 in the Journal of the American Medical Association (http://jama.ama-assn.org/cgi/content/short/295/12/1389), for instance, found that children of mothers who have received treatment via medication for major depression or anxiety are less likely to be diagnosed with anxiety, disruptive and depressive disorders themselves, compared to children of women who remain untreated.  You MUST push past the fear and speak up to lessen the impact of these illnesses on yourself and your children.  You must be willing to say how you are feeling and seek treatment so that not only you, but your whole family can heal.

Guest Author: MommaSteph of MomSquawk

Following is a very honest piece about intrusive thoughts and postpartum obsessive-compulsive disorder, written by MommaSteph, a blogger at Mom Squawk.

I would never put my baby in the dishwasher.

But I've thought about it.

I've thought about putting the baby in all sorts of major household appliances: the washer, dryer, fridge, microwave, oven. I don't have a trash compacter, but if I did, well, that probably would have occurred to me, too.

And I'm not particularly unusual in this regard.

I remember the first time I had a violent intrusive thought about my first baby. It happened shortly after I had brought him home. My brother and his children were just leaving from a visit. I stood at the window holding Henry up and waving goodbye. My brother turned to wave and smile back. And suddenly I thought, "What if I dashed Henry's head against the radiator? How quickly would what happened register on David's face? How quickly could he get in here to get the baby away from me? When would his kids realize what had happened?"

It all occurred to me in a flash. I started to sweat, my heart started to beat quickly, and I moved away from the radiator. I was horrified, ashamed, disgusted, and scared. Was I one of those crazy women? How could I have such an awful thought? And how could I protect my baby?

From there, it just got worse. And I told no one -- how could I? What if they took my baby away?

For the rest of this EXCELLENT article, click here to go to Momsquawk!

FSU Conducting Study on PPOCD

Here is a link to a story from the Tallahassee Democrat on a study being conducted by Florida State University on the occurrence of obsessive compulsive symptoms after women give birth.

Searching for Inspirational Items For Suffering Moms

Aside from the Postpartum Depression Links page I've newly started, which you can find on the left of your screen under "Pages", I'm also creating an Inspiration for Moms page that will feature quotes, songs, poems and anything else that might give moms comfort during their suffering.  LADIES, f you have a song, quote, poem, bible passage or any other little item that helped you get through this terrible experience, and would like to share it with other moms across the country and the world, let me know and I'll add it to the page.  Email me at stonecallis@msn.com.  Thanks!

Top Hospitals in U.S. for Psychiatry

U.S. News & World Report has its Best Hospitals feature in this week's issue.  They also rank hospitals based on specialties, including Psychiatry.  I think it is important for women to know which hospitals in the U.S. excel in Psychiatry, given that we need to know where we can go for the best treatment.  I know some of them excel in the treatment of postpartum mood disorders, like Massachusetts General Hospital, New York-Presbyterian University Hospital of Columbia and Cornell, Emory University Hospital, NYU and the University of Pittsburgh Medical Center.  I'm going to look into the others to find out what reproductive psychiatry programs they may have and report back to you.  In the meantime, here is the list of the top 22 hospitals in the United States in the area of psychiatry, as reported in U.S. News & World Report.  Rankings were determined solely by reputation.

1.  Massachusetts General Hospital, Boston, MA

2.  Johns Hopkins Hospital, Baltimore, MD

3.  McLean Hospital, Belmont, MA

4.  New York-Presbyterian Univ. Hosp. of Columbia and Cornell, New York, NY

5.  UCLA's Neuropsychiatric Hospital, Los Angeles, CA

6.  Sheppard and Enoch Pratt Hospital, Baltimore, MD

7.  Menninger Clinic, Houston, TX

8.  Mayo Clinic, Rochester, MN

9.  Yale-New Haven Hospital, New Haven, CT

10.  Stanford Hospital and Clinics, Stanford, CA

11.  University of Pittsburgh Medical Center, Pittsburgh, PA

12.  Emory University Hospital, Atlanta, GA

13.  Duke University Medical Center, Durham, NC

14.  Austen Riggs Center, Stockbridge, MA

15.  Barnes-Jewish Hospital/Washington University, St. Louis, MO

16.  NYU Medical Center, NY

17.  University of California, San Francisco Medical Center, San Francisco, CA

18.  Hospital of the University of Pennsylvania, Philadelphia, PA

19.  Cleveland Clinic, Cleveland, OH

20.  Methodist Hospital, Houston, TX

21.  Hartford Hospital, Hartford, CT

22.  Long Island Jewish Medical Center, New Hyde Park, NY

Ladies, Send Me Your Blog & Website Addresses So I Can Link To You

I am going to create a new page in Postpartum Progress that links to women who have blogs or websites that are either specifically about postpartum depression, or have included stories about experiencing postpartum depression.  If you have one of those blogs or sites, please email me at stonecallis@msn.com.  Tell me about your blog or website, and give me your URL web address.  Thanks!  I look forward to linking with you!

Back From BlogHer '07 With Great News

I just got back from BlogHer, the largest blogging conference in the world, attended by approximately 800 women bloggers (and a few men).  Anyway, it was FANTASTIC and it gave me so many ideas about how to improve Postpartum Progress and make it even easier to use and more helpful.  I also hope to work with some of the people I met to help get more information out to women around the world on postpartum mood disorders.  Just a few of the many interesting people I got to talk with about PPMDs include the manager of online strategy and programs for Planned Parenthood, the women who are launching themotherhood.com, the depression writer for Beliefnet.com, the people at Revolution Health, a blogger for Yahoo!, the editor for Urban Baby, and the president of the National Organization for Women.  There is so much great work to be done, so keep tuning in so that I can let you know what progress is made.

University of Michigan Needs Qualified Participants for Two Perinatal Mood Disorder Studies

For those of you living in Michigan, the University of Michigan is conducting two studies related to perinatal depression.  This would be a great opportunity to participate in important research and also to benefit from the care offered by a wonderful medical school.  If you know anyone who might be appropriate, please let them know.

The first is a study looking at the affect of interpersonal therapy on depression and/or anxiety in pregnant women.  It is open to women who are currently pregnant, and have a history of depression or anxiety disorders or are currently experiencing symptoms of depression or anxiety.  You will receive up to 16 sessions of interpersonal therapy free of charge as part of this study.  The locations for the study are Ann Arbor and Ypsilanti.  Click here for detailed info.

The second study is designed to learn more about communication between moms and babies and children's social development during early childhood. They are studying mother’s health issues during pregnancy, baby’s development, and how mother and baby interact with one another during baby’s first year. They will also be looking at hormones in blood and saliva to see how stress impacts mothers and babies both positively and negatively...and how healthy moms cope with stress.  This study is open to women who are less than 26 weeks pregnant and live within 60 miles of the University of Michigan Medical Center in Ann Arbor.  Click here for detailed info.

To Georgia PPMD Survivors & Practitioners

Calling ALL women in Georgia who have survived a postpartum mood disorder, including postpartum psychosis, postpartum depression, postpartum anxiety, postpartum OCD!!!!  (Or if you're a Georgia practitioner who treats a lot of these women.)  Please email me at stonecallis@msn.com.  It's very important.  Will explain later!  Thanks.

-- Katherine

Postpartum OCD & Anxiety Get The Focus

Here's a link to a good story from the Ann Arbor News about postpartum OCD and postpartum anxiety.  Following are highlights from the article by Jo Mathis:

"Postpartum depression has gotten all the press, grant money, and research, and relatively little is known about other mental health conditions in the perinatal period (the weeks before and after pregnancy), according to Michelle Van Etten Lee, training director for cognitive behavioral therapy at the University of Michigan's Psychological Clinic.

Onset of conditions such as OCD is most common during stressful times, said Van Etten Lee. About 30 percent to 40 percent of treatment-seeking women with OCD in their childbearing years date the onset of their disorders to pregnancy or the postpartum, she said.

There is also evidence that hormones play a role in anxiety conditions showing up during pregnancy or postpartum, Van Etten Lee said ...

Van Etten Lee said that just as there's not a lot of research on perinatal disorders, there's not much that looks specifically at treatments for anxiety disorders in perinatal women. ...

Women whose symptoms are significantly distressing or impairing to them, or for whom anxiety is taking significant amounts of time in their lives, should seek treatment, Van Etten Lee said."

A Roundup of Major Stories & PPMD News

You should see my inbox these days!  I can't keep up!  There is a LOT going on.  First things first, below is a current list of support groups.  Please check it out if you're looking for one in your area.

Download ppd_support_groups_52207.doc

This is a link to a good article that just came out of the annual meeting of the American Psychiatric Association this week.  No real new news, but it's nice to see the recognition of perinatal mood disorders as a spectrum disorder, and the fact that onset can occur anytime throughout the first year postpartum. 

This is a link to a new book called "Crazy In America: The Hidden Tragedy of Our Criminalized Mentally Ill".  It sounds like it could be good, and similar to Pete Earley's book called "Crazy", which I absolutely loved. 

I've added another beautiful survivor mom to our Surviving & Thriving Mothers' Photo Album.  Thanks Shannon for sending me the picture. 

Here's a link to a great editorial from Newsday by Sandra Wolkoff.   One highlight that reminds us we just don't get over this in a day:

"Frequently, women convince themselves that any slight improvement is a sign that recovery is around the corner. When the black clouds of despair return hours or days later, or another medication seems to prove ineffective, they feel like failures."

Here's a link to a recent story that appeared on the NBC affiliate in San Diego about the Michael Spangler, husband of Annie who committed suicide three years ago after suffering from postpartum depression.  I'm so sorry for his and his little boy's loss, especially when we all know these tragedies are completely unnecessary.

Here's a link to a story from last week in Chicago about Tonya Vasilev, who was found mentally insane for the killing of her two children.  She had suffered depression since childhood, and had been diagnosed with postpartum depression.  The judge said he felt comfortable finding her insane because of the expert medical testimony, thus Tonya will now receive lifelong commitment to a mental health facility rather than prison or the death penalty.  (Trust me, this doesn't mean I'm comfortable with those sweet children being killed.  I can think of nothing more awful and tragic.  But we need to work harder to treat and protect the mentally ill so that things like this don't happen.)

Margaret Trudeau, the ex-wife of the late prime minister of Canada Pierre Trudeau, spoke up about mental health recently and the importance of mental health check-ups to all Canadians.  Trudeau herself suffered from postpartum depression.  Here is a link to the story.

3 New Books About Postpartum Depression

There are lots of new books coming out that are about postpartum mood disorders.  Here are three to look for:

1)  Wiped! by Rebecca Eckler.  Eckler is a parenting columnist for the Globe & Mail daily newspaper in Canada, and shares her experience with postpartum depression, as well as funny accounts of the highs and lows of being a new mom.

2) The Journey to Parenthood:  Myths, Reality and What Really Matters by Diana Lynn Barnes and Leigh Balber.  Barnes, a past president of Postpartum Support International, and Balber help couples run through a "psychological dress rehearsal" of what life will be like once the baby is born and address issues in advance of the baby's arrival.

3)  The Lifter of My Head by Susan McRoberts.  McRoberts writes about how God sustained her during her bout with postpartum depression, and she shares scriptures and prayers that were helpful during that time.

PSI Offers Free Info Sessions on Wednesdays Via Conference Call!!!!

There is SO MUCH GOING ON!!!!!!!  This is very exciting for those of us who have survived these horrible illnesses.   Postpartum Support International has started to offer free Perinatal Mood Disorder Informational sessions via 800 teleconference line.  This new program began Wednesday, May 2, 2007 at 3pm EST and will continue weekly on Wednesdays, alternating between 3pm in the afternoon and 9pm in the evening EST.  The sessions are limited to the first 15 callers.  They are informational only and will offer participants an opportunity to ask questions and obtain information from PSI healthcare professionals.  They are open to women who feel they may be suffering from a pregnancy related mood disorders, as well as to concerned family members and friends. 

This is a HUGE, free resource for people all over the country.  You will be getting information from people who REALLY know what they are talking about.  I would recommend this to anyone who isn't sure if they have a postpartum mood disorder, who isn't sure if they are getting the right kind of help,  or who isn't sure how to provide the best support for someone they love who is going through this!

Participants must call 1-800-944-8766 five minutes before the call begins.  After the 15th caller joins the call, no other callers may join.  (I think this is a good idea because it lets those who are on the phone get more in-depth information.)  Check the PSI website for dates, times and facilitators. 

New Blog Tracks Pregnancy for PPOCD Survivor

Lauren Hale, the PSI co-coordinator for the state of Georgia, has started a blog in which she will write about her current pregnancy.  This is her third, it was unexpected, and she has already experienced PPOCD twice with her first two children.  If you'd like to follow along, go to www.unexpectedblessing.wordpress.com.

Need Help Creating List of Centers Specializing in Treatment and Research of Perinatal Mood Disorders

I've decided to create a new resource for Postpartum Progress.  I want to create a list of centers across the U.S. that specifically specialize in researching and treating women's perinatal mood disorders.   I want a list of places where women can go and be assured that these centers are on the forefront of treating perinatal depression and discovering its sources -- they're the best of the best.   Often, when people find out they have cancer, they conduct research to find out the absolute best places to go for treatment.  This list will provide that type of information for women suffering from perinatal mood disorders, including postpartum depression, postpartum psychosis and postpartum obsessive-compulsive disorder.

To be included, centers must clearly specialize in treating perinatal mood disorders, conduct research on perinatal mood disorders, offer clear and accessible web-based information on the types of treatment offered and how women can become patients, and also be accepting new patients for treatment.  Examples of such places would include:

*  The Emory Women's Mental Health Program at Emory University in Atlanta

*  The Massachusetts General Hospital's Center for Women's Mental Health in Boston

*  The University of North Carolina's Center for Women's Mood Disorders in Chapel Hill, NC

I personally was treated at Emory during my second pregnancy and I loved it for two reasons:

1)  They knew EXACTLY what they were doing, as this is what Doctors Stowe and Newport treat every day of the week.  It's not just a side job for them -- it's their life.  I believe you get better treatment from physicians who focus intensely on postpartum mood disorders.  And, they're more likely to be able to refer you to the best therapists in your area for these disorders as well.

2)  I was able to participate in a research program that will contribute to increased knowledge about the treatment of these disorders in the future.  I think that is extremely important.  The more information we have, the better the treatment will be and the less potential harmful side effects (hopefully) to ourselves and our children.  We need to be willing to contribute to the amount of data that is available on these illnesses.

Please email me at stonecallis@msn.com with your recommendations and their related website addresses, and, if appropriate, I'll add those centers to my list and keep it available on Postpartum Progress for all readers.

New PPD Awareness Campaign in Ontario, Canada

The province of Ontario in Canada has launched a new public awareness campaign on postpartum depression.  Here's some info from the Toronto Star:

"A new public awareness campaign launched this month is aimed at bringing the topic of postpartum mood disorders out of the closet to help struggling mothers ... find the support and treatment they need. And to let them know they aren't alone.

One of its slogans: 'Life with a new baby is not always what you expect.'

The campaign, launched by Best Start, an Ontario-government funded resource centre for mothers and young children, includes subway posters, shopping mall ads, television and radio clips, a 12-page brochure with information, strategies and resources for getting help, and a website (lifewithnewbaby.ca). Telehealth Ontario is also a partner, providing phone consultation and links to services and treatment for mothers needing help.

Hiltrud Dawson, health promotion consultant with Best Start, said several tragic deaths of women with postpartum mood disorders and their children over the past few years highlighted the need for more public information.

A survey by Leger Marketing last year showed that 80 percent of Canadians had heard of postpartum mood disorders, which affect one in five women and are treatable and in many cases preventable. But Dawson said there are still many misconceptions about the illness and many spouses and family members don't know what to do or how to seek help.

Campaign resources will help them distinguish the difference between 'baby blues' which affect most mothers but fade in a couple of weeks, and postpartum depression, which doesn't pass and can become debilitating. And it explains postpartum psychosis, a serious disorder that has generated headlines but is very rare, causing mothers to lose touch with reality and think about harming themselves and their babies."

Profoundly Alone: Take 2

I posted this the other day, but because of a glitch none of my subscribers got it.  So I'm posting it again because I think it's important.

Profoundly Alone: The Disconnection of Postpartum Depression

When you suffer from a postpartum mood disorder, you walk around in a haze while trying to seem as normal as possible.  You try to make yourself feel as connected as you can to your child and those around you.  Perhaps your dearest friends and family can tell that you don't seem like yourself, but then they just brush it off as normal baby blues.  And you soldier on, trying to pretend -- sometimes successfully, sometimes not so successfully -- that everything is cool.

When my son was a little over two months old and I was in the throes of postpartum obsessive-compulsive disorder I tried to host a ladies' luncheon at my house.  It was mid-December, and I guess I thought it would make me feel better to have a half-dozen women over and make them a nice little Christmas lunch.  I decorated the house.  I made goat cheese salad and butternut squash soup and little lemon tarts with sugared blueberries for dessert.

When the women came over, I'll never forget having one of the oddest feelings I've ever had.  I felt like I was inside of a bubble.  Or like I was hovering over the party watching it but that my guests couldn't see or hear me.  I was shocked out how disconnected I felt from the world, and it seemed like it didn't really matter whether I was there or not.  I tried to make small talk, but it seemed like the sentences just didn't come out right and that I wasn't making any sense -- it was almost like the air had been replaced by water that blurred my vision and muffled my sound.  Everyone seemed to have a great time, and they were chatting and eating away.  I kept trying to connect with them, to feel present, but no matter what I did it didn't work. 

To this day, I don't think they had any idea what I was thinking or feeling.  They seemed to have a lovely time.  After everyone had left and my son went down for a nap, I remember laying down on the couch in my family room and sobbing.  I had tried to do something to make myself feel better, to be a part of the world, and it only broke my heart.  I tried to be close to others and it only made me feel further apart.

One of the truly awful feelings you experience during postpartum mood disorders is that sense of disconnection from the world, from your friends and family, from your baby, and most of all, from yourself.  I felt so deeply, deeply alone. 

Profoundly alone.

This is why it's so hard for us to say anything.  We're ashamed, of course.  But we're also disconnected.  I didn't think anyone would hear me, or believe me, or perhaps even care.  I didn't even have myself to talk to anymore.  Myself had up and left and this new person I had become was clearly NOT my friend.  I had lost my ability to speak clearly and calmly and with reason.  I felt like I couldn't even communicate love to my own child.  How could I have been expected to understandably explain THIS?

I hope the people we love can try to understand why it is so easy for us to turn away.  It's much easier to run and hide, or give up, than to try and speak through the cement wall that life just erected between us and the world.  We try our best, but you may have to fill in the blanks for us until we find our words, and ourselves, again. 

When you suffer from a postpartum mood disorder, you walk around in a haze while trying to seem as normal as possible.  You try to make yourself feel as connected as you can to your child and those around you.  Perhaps your dearest friends and family can tell that you don't seem like yourself, but then they just brush it off as normal baby blues.  And you soldier on, trying to pretend -- sometimes successfully, sometimes not so successfully -- that everything is cool.

When my son was a little over two months old and I was in the throes of postpartum obsessive-compulsive disorder I tried to host a ladies' luncheon at my house.  It was mid-December, and I guess I thought it would make me feel better to have a half-dozen women over and make them a nice little Christmas lunch.  I decorated the house.  I made goat cheese salad and butternut squash soup and little lemon tarts with sugared blueberries for dessert.

When the women came over, I'll never forget having one of the oddest feelings I've ever had.  I felt like I was inside of a bubble.  Or like I was hovering over the party watching it but that my guests couldn't see or hear me.  I was shocked out how disconnected I felt from the world, and it seemed like it didn't really matter whether I was there or not.  I tried to make small talk, but it seemed like the sentences just didn't come out right and that I wasn't making any sense -- it was almost like the air had been replaced by water that blurred my vision and muffled my sound.  Everyone seemed to have a great time, and they were chatting and eating away.  I kept trying to connect with them, to feel present, but no matter what I did it didn't work. 

To this day, I don't think they had any idea what I was thinking or feeling.  They seemed to have a lovely time.  After everyone had left and my son went down for a nap, I remember laying down on the couch in my family room and sobbing.  I had tried to do something to make myself feel better, to be a part of the world, and it only broke my heart.  I tried to be close to others and it only made me feel further apart.

One of the truly awful feelings you experience during postpartum mood disorders is that sense of disconnection from the world, from your friends and family, from your baby, and most of all, from yourself.  I felt so deeply, deeply alone. 

Profoundly alone.

This is why it's so hard for us to say anything.  We're ashamed, of course.  But we're also disconnected.  I didn't think anyone would hear me, or believe me, or perhaps even care.  I didn't even have myself to talk to anymore.  Myself had up and left and this new person I had become was clearly NOT my friend.  I had lost my ability to speak clearly and calmly and with reason.  I felt like I couldn't even communicate love to my own child.  How could I have been expected to understandably explain THIS?

I hope the people we love can try to understand why it is so easy for us to turn away.  It's much easier to run and hide, or give up, than to try and speak through the cement wall that life just erected between us and the world.  We try our best, but you may have to fill in the blanks for us until we find our words, and ourselves, again. 

Profoundly Alone: The Disconnection of Postpartum Depression

When you suffer from a postpartum mood disorder, you walk around in a haze while trying to seem as normal as possible.  You try to make yourself feel as connected as you can to your child and those around you.  Perhaps your dearest friends and family can tell that you don't seem like yourself, but then they just brush it off as normal baby blues.  And you soldier on, trying to pretend -- sometimes successfully, sometimes not so successfully -- that everything is cool.

When my son was a little over two months old and I was in the throes of postpartum obsessive-compulsive disorder I tried to host a ladies' luncheon at my house.  It was mid-December, and I guess I thought it would make me feel better to have a half-dozen women over and make them a nice little Christmas lunch.  I decorated the house.  I made goat cheese salad and butternut squash soup and little lemon tarts with sugared blueberries for dessert.

When the women came over, I'll never forget having one of the oddest feelings I've ever had.  I felt like I was inside of a bubble.  Or like I was hovering over the party watching it but that my guests couldn't see or hear me.  I was shocked out how disconnected I felt from the world, and it seemed like it didn't really matter whether I was there or not.  I tried to make small talk, but it seemed like the sentences just didn't come out right and that I wasn't making any sense -- it was almost like the air had been replaced by water that blurred my vision and muffled my sound.  Everyone seemed to have a great time, and they were chatting and eating away.  I kept trying to connect with them, to feel present, but no matter what I did it didn't work. 

To this day, I don't think they had any idea what I was thinking or feeling.  They seemed to have a lovely time.  After everyone had left and my son went down for a nap, I remember laying down on the couch in my family room and sobbing.  I had tried to do something to make myself feel better, to be a part of the world, and it only broke my heart.  I tried to be close to others and it only made me feel further apart.

One of the truly awful feelings you experience during postpartum mood disorders is that sense of disconnection from the world, from your friends and family, from your baby, and most of all, from yourself.  I felt so deeply, deeply alone. 

Profoundly alone.

This is why it's so hard for us to say anything.  We're ashamed, of course.  But we're also disconnected.  I didn't think anyone would hear me, or believe me, or perhaps even care.  I didn't even have myself to talk to anymore.  Myself had up and left and this new person I had become was clearly NOT my friend.  I had lost my ability to speak clearly and calmly and with reason.  I felt like I couldn't even communicate love to my own child.  How could I have been expected to understandably explain THIS?

I hope the people we love can try to understand why it is so easy for us to turn away.  It's much easier to run and hide, or give up, than to try and speak through the cement wall that life just erected between us and the world.  We try our best, but you may have to fill in the blanks for us until we find our words, and ourselves, again. 

Help Important Research by Taking Online Survey

Karen Kleiman is working with the Department of Psychiatry at the University of Pennsylvania School of Medicine on a new screening tool for women with postpartum depression/anxiety.  You can help them with their research into the use of this tool by clicking the link below and taking a survey.  You must be over the age of 18 and have a baby under the age of 1.  Your answers will be COMPLETELY anonymous.  I hope you'll help out.  I just took the survey a few minutes ago.

Click here to take survey

Indiana Launches PPD Awareness Campaign

From the Ft. Wayne (IN) News-Sentinel:

“Something’s Not right” is ... the theme of a statewide postpartum depression awareness campaign that starts Thursday [in Indiana] ... The phrase “Something’s Not Right” will be seen in Fort Wayne bus huts, on signs inside city buses, and on billboards, public service announcements, posters and printed literature, in English and Spanish.

A local coalition that includes Neighborhood Health, St. Joe Behavioral Health, the Postpartum Depression Support Group of Lutheran Hospital and Healthier Moms & Babies received a $7,000 grant to develop an awareness and education campaign from the Indiana Perinatal Network, a consortium working to improve the health of pregnant women. A 24/7 hotline will be available for moms and mothers-to-be – and concerned fathers – who want more information on postpartum depression or who recognize help is needed (425-3113).

Happy New Year!

Happy New Year to all of you fabulous moms and PPD advocates out there!  I hope you had a good holiday.

This year it is my goal to widen my work as an advocate for postpartum depression.  I hope to generate even more readership for Postpartum Progress, the most widely read blog in the U.S. on postpartum mood disorders.  I hope you'll let other women know about it so they have access to all the information I've been compiling over the last 2+ years.  And I hope you find it helpful.  If not, or if you have suggestions, email me ASAP! at stonecallis@msn.com.

I also hope to start a support group for the Southside of Atlanta.  I wanted to start it in the fall, but I procrastinated.  Now that Madden is 10 months old, I think I can handle it.  I just need to get started and put the word out. 

I'd also like to ask that you be patient with me as I get quite a large number of emails from individuals.  It may take me a few days to get back to you but it is NOT because you are not important.  Each of you is VERY important and I love to hear from you and hear your stories and try to be supportive in whatever way I can.  Hearing from you is my favorite part of what I do.  It's just that, with the baby, I'm not able to check email every single day.  I try to do it two or three days a week and spend a couple of hours on it -- I've spent two hours this evening, for instance.  So please, please continue to email me.  Lay it on me!  Whatever you've thought or experienced, don't worry -- I've heard it all and I'm not shocked.  However bad you feel, it's okay with me.  Whatever help you need, I'll try and see if I can find someone somewhere who knows where you can get it. 

I feel like 2007 is going to be a great year for us.  Let's hear it for passage of the MOTHER'S ACT very soon, for more support groups to be started, and for an enormous reduction in the number of deaths from 2006.  Love you all!!

-- Katherine

15% of New Moms Experience Mental Problems

I'm sure you've all heard by now and all I can say is "Hooray, Hooray, Hooray!!!!!!!!"  The new study published in the Journal of the American Medical Association about postpartum mood disorders confirms what so many of us have believed for so long.  And just so you know, if 15% of new moms have PPD, that means that 600,000 women in the U.S. alone are experiencing these illnesses every single year.  This means there are millions and millions of women like us out there.

From the Associated Press:  New moms face increased risks for a variety of mental problems, not just postpartum depression, according to one of the largest studies of psychiatric illness after childbirth.

New dads aren't as vulnerable, probably because they don't experience the same physical and social changes associated with having a baby, the researchers and other experts said.

The study, based on medical records of 2.3 million people over a 30-year period in Denmark, found that the first three months after women have their first baby is riskiest, especially the first few weeks. That's when the tremendous responsibility of caring for a newborn hits home.

During the first 10 to 19 days, new mothers were seven times more likely to be hospitalized with some form of mental illness than women with older infants. Compared with women with no children, new mothers were four times more likely to be hospitalized with mental problems.

New mothers also were more likely than other women to get outpatient psychiatric treatment.

However, new fathers did not have a higher risk of mental problems when compared with fathers of older infants and men without children.

The prevalence of mental disorders was about 1 per 1,000 births for women and just .37 per 1,000 births for men.

The problems included postpartum depression, but also bipolar disorder, with altering periods of depression and mania; schizophrenia and similar disorders; and adjustment disorders, which can include debilitating anxiety.

The study underscores a need for psychiatric screening of all new mothers and treatment for those affected, according to an editorial accompanying the study in Wednesday's Journal of the American Medical Association. [my emphasis]

"Mental health is crucial to a mother's capacity to function optimally, enjoy relationships, prepare for the infant's birth, and cope with the stresses and appreciate the joys of parenthood," the editorial says.

Two of the editorial's three authors reported financial ties to the psychiatric drug industry. The study researchers said they had no financial ties to the industry.

They examined national data on Danish residents from around 1973 to July 2005. About 1.1 million participants became parents during the study.

A total of 1,171 mothers and 658 fathers -- none in whom any previous mental health issues had been diagnosed -- were hospitalized with a mental disorder after childbirth.

Lead author Trine Munk-Olsen, a researcher at Denmark's University of Aarhus, said similar risks for psychiatric problems likely would affect new parents in other developed nations including the United States. However, differences in screening practices and access to health care might influence whether parents elsewhere are hospitalized, she said.

Physical changes after childbirth might partly explain why women are vulnerable, including fluctuating hormone levels, Munk-Olsen said. These, alone or combined with sleep deprivation and the demands of breast-feeding could trigger mental problems, she said.

Hard data on the number of women worldwide affected by postpartum mental illness are scant, but postpartum depression alone affects about 15 percent of U.S. women.

The condition made headlines last year when actress Brooke Shields acknowledged taking antidepressants after her first child was born -- and Tom Cruise publicly criticized her for it.

It also has been cited as a factor in shocking cases of mothers killing their children, including Andrea Yates' drowning of her five children in Texas in 2001.

Dr. Nada Stotland, a psychiatry professor at Rush Medical College in Chicago, said gender differences in postpartum mental illness are not surprising.

Mothers generally bear the brunt of sleep deprivation, and many new mothers are socially isolated or live far from relatives who could provide support, Stotland said.

She said the study likely will provoke mixed reactions.

"There may be people who say, 'My mother raised eight children and she never needed to have mental health care,' and others will say, 'Finally somebody has noticed just how stressful this is and what people go through,"' Stotland said.

Tom Cruise Has Another Apology to Make

So Tom Cruise has now apologized to Brooke Shields, and she accepted his apology (see story here).  Good for them both. 

I, on the other hand, have not forgiven Tom Cruise.  It hurt all of us when he dragged our illness into the spotlight and essentially made us feel awful for having taken medications that were prescribed to us by legitimate physicians in order to recover.  It wasn't only his comments that hurt, but also the echoing, more destructive comments from so many ignorant people around the country when this story arose because of Cruise.  It was very hard to read the words of many citizens online and in print about how we're crazy and stupid and drugged up, etc.

When he apologizes to all women who have suffered or are suffering from postpartum mood disorders, I'll accept.  Until then, I don't plan to spend my box office dollars on his movies.

It's okay with me that he doesn't believe in antidepressants.  No problem.  But don't judge me because I do believe in them.  Don't make me look bad in the public eye because I had to take them.  They saved my life. 

Self Magazine Covers PPOCD

Sonia Murdock says there there is an article on PPOCD in the April issue of Self magazine.  I haven't had a chance to see it yet, because I'm a little busy with burping and changing if you know what I mean.  But I'll try to pick up a copy today.  It's always so nice to hear when the major media covers these issues ... I hope it wasn't sensationalized ...

Tags: postpartum OCD intrusive thoughts

Great article on PPOCD and Intrusive Thoughts

Bill Meyer, facilitator for the pregnancy/postpartum support group at the Duke University Medical Center, sent me this article today from the Washington Post that appeared on March 7 about postpartum obsessive compulsive disorder (PPOCD).  The article is called "Scary Thoughts" by Stacey Colino.  (You may have to register to see the article - registration is free.)  I suffered PPOCD during the birth of my first child and the article is definitely on target. Here are quite a few highlights that I think are important (the underlining is my emphasis):

"Indeed, some women ... develop clinically significant symptoms of OCD during pregnancy or the postpartum period -- a phenomenon that is vastly under-recognized, experts say.

While reliable statistics on postpartum OCD are lacking, the lifetime incidence of OCD in the general population is believed to be 2 to 3 percent. What distinguishes OCD symptoms from normal intrusive thoughts is partly the extent to which these ideas are anxiety provoking, irrepressible and persistent.

'To have a real obsession, it's an intrusive, unbidden thought, idea, or image that comes to your mind that you do not want and actively try to resist,' explains Gerald Nestadt, a professor of psychiatry at the Johns Hopkins Medical Institutions in Baltimore. 'You can't get rid of the thought' ...

Some experts believe postpartum OCD occurs primarily in women who already have the condition, sometimes in a mild and undiagnosed form.

Complicating matters, postpartum depression and OCD often go together, but many women and their clinicians focus exclusively on the depressive symptoms. Yet a study at Case Western Reserve University in Cleveland found that postpartum depression is accompanied by obsessive thoughts in 57 percent of new mothers.

The extensive media coverage of mothers who kill their kids (as in the widely reported 2001 incident where Andrea Yates drowned her five children) makes some new parents with intrusive thoughts worry whether they're headed down a similar path. In most cases they are not. But just being exposed to such stories can fuel the thoughts, Abramowitz says. 'You read things in the news, and it's normal to incorporate that into your experience' ...

There are key differences between obsessive thoughts and postpartum psychosis, explains Shaila Misri, a reproductive psychiatrist and director of the reproductive mental health program at BC Women's Hospital and Health Center in Vancouver, B.C.

Obsessive symptoms tend to be 'repetitive, unwanted thoughts that the person is aware are not normal even though she is unable to stop them,' she explains. With psychotic symptoms, 'the repetitive, unwanted thoughts are actually delusional, and the person who is having them believes they are real.' While women with OCD rarely harm their children, Misri adds, 'those with postpartum psychosis are in very real danger of doing so' ...

Yet there's often a 'don't ask, don't tell' dynamic surrounding this subject in the physician's office, experts say. While many doctors screen for postpartum depression these days, few ask about intrusive thoughts, Misri says. Meanwhile, new mothers often feel guilt and shame and stay silent.

'A lot of times people are afraid to mention these symptoms because they think if other people knew, they'd lock them up or take the baby away,' Dell says. 'When I ask [new mothers] if they're having unwanted, intrusive thoughts, they are often quite relieved to hear that this happens to other people and that there are probably some biological reasons for this' ...

Says Nestadt, 'The very sad thing is that many people who have experienced an onset or exacerbation of OCD during pregnancy or the postpartum period and didn't receive or respond to treatment may be unwilling to have other kids after the experience. . . . To have OCD and worry constantly day after day is dreadful.'"

That about covers it!!  I had horrible thoughts; I knew they weren't real but they scared me to death; I thought I would never be the same; I was afraid to tell anyone because I thought they'd lock me up and throw away the key; When I finally got help I was relieved to find out what was really happening and that I would be ok; It turns out I probably had mild OCD my whole life, and it was simply exacerbated by pregnancy; I was very afraid to have another child, etc., etc.  I hope you find this article helpful.

Tags: intrusive thoughts postpartum OCD postpartum psychosis PPOCD

A Primer on Intrusive Thoughts

I happened to come across this story and found it to be a very clear description of intrusive thoughts. If you've experienced them in the past or are worried about them now, you will want to read this: Dads Have Postpartum Obsessive Thoughts About Babies Just as Moms Do. Here's an excerpt:

A new Mayo Clinic study appearing in the Sept. 3 [2003] issue of the Journal of Clinical Psychology in Medical Settings shows 69% of mothers and 58% of fathers report having postpartum obsessive thoughts or worries about their new babies. The study surveyed 300 childbearing women and their partners, asking them questions about seven subjects including:

Suffocation or SIDS
Accidents
Intentional harm
Losing the infant
Illness
Unacceptable sexual thoughts
Contamination

While surveys showed that fathers do obsess about these subjects, it found mothers did so more.

It also states that researchers found there was " ... a big difference between having postpartum obsessive thoughts that will not lead to violence, and psychotic thoughts that may lead to the rare case of a parent harming the child. That difference is having fear of harming the child and being repulsed or afraid at the thought versus parents viewing their thoughts as realistic and rational."

I had no idea that new fathers had those thoughts as well. Obviously, they rarely mention it.

The only thing I really don't agree with is the last sentence: that it's best to simply dismiss such thoughts. There was no way in hell I could have just ignored them. They were unbelievably disturbing. Since thoughts such as those may indicate a postpartum mood disorder, it seems to me it would be better to seek a professional to find out whether you might need treatment in the form of therapy or medication.

Tags: postpartum depression intrusive thoughts postpartum OCD post partum depression