Postpartum Progress

Straight Talk About Hospitalization & Postpartum Depression

One area I don't like to talk about is hospitalization.  I don't know why.  It's like the ultimate embarrassment for me or something that at one point I had to be hospitalized in a mental hospital (UGH!) for depression.  It was only for a few days, but it's one thing of which I have to say I still feel slightly ashamed.  If our society considered mental illness a physical illness, then of course I wouldn't be ashamed, because there is nothing at all wrong with being sick and having to go to the hospital.  But you and I both know that's not the way people think when it comes to "mental institutions."  Nonetheless, I can't let that stop me from talking openly to you about a type of treatment that some women with postpartum mood disorders must experience, so here goes ...

The truth is, if we are a danger to ourselves or others we need to be hospitalized.  Period.  I wish there were another way, a better solution, but as far as I know there isn't.   I got to a point where I thought I might kill myself.  And so, that's where I was sent.  The minute I got there and saw what was coming I completely changed my mind about killing myself, of course.  I told them very articulately that I was all better and there was no need to move forward.  (Stop the train, I want to get off!)  But once the proverbial cat is out of the bag you can't put it back in. 

Here's what you should know:  Mental hospitals aren't a treat.  It can feel like being in jail.  Once you are in you can't just get out any old time you want.  At least not for 48 hours or so.  You don't have access to all of your things because they take them away from you to make sure there's nothing dangerous or illegal in them. You don't have free access to the people you love, except during limited visiting hours.  The decor is sorely lacking.  The food stinks.  The beds are lumpy.  You don't even have the right to go to the bathroom at any time without permission.  I remember at one point being in the cafeteria trying to eat the awful food and I needed to pay a visit to the facilities.  They wouldn't let me, because they couldn't leave my group and couldn't let me leave the cafeteria alone.  I was humiliated and infuriated.  "I'm a competent grownup!  How dare you tell me I can't go to the bathroom!  What happened to basic human dignity??!!"  They were unimpressed by my reaction, and I had to wait.  Also, I was in the general adult ward, with men and women in all sorts of mental states -- addicts, schizophrenics, people suffering from depression or bipolar disorder -- and I was scared.  The truth is no one would choose to hang out with a group of people she doesn't trust to make safe choices.  But be all of that as it may, it was the exact right place for me. 

I truly benefited from being in that hospital at that moment.  Once we get over the thinking that we are somehow better, special and different from the rest of the people in the "asylum", it can be a profound experience.  First, they took care of me and helped me become stable.  I was in a crisis and they helped me out of it.  Second, I was humbled and made to understand via circumstance that we are all one step away from losing our minds no matter where we come from or how much money we make or what we look like or what job we have or how competent we've been up 'til now.  Third, I learned that severely mentally ill people are still people, and I became very empathetic to their plight.  I remember watching a man who stood in the corner all day brushing himself off and found out it was because he thought there were snakes on him.  Another young man curiously kept cutting the eyes out of pictures of people in magazines.  Only later did I notice he had been taping them up surreptitiously in strategic places throughout the ward -- in the leaves of the ficus tree, on the wall clock, in the plastic floral wreath covered in a layer of dust.  The eyes watched me wherever I went.  I imagined what those two men, and some of the others, might have been like as innocent, happy children with no inkling of what was to come in their lives.   Could they help the situation they were in now?  Maybe, maybe not.  I went from a state of fear to one of wonder and to one of caring about these people and hoping for their well-being.   

I have family members of women with postpartum depression or psychosis reach out to me to tell me their sister or daughter has been hospitalized and that it's absolutely the WRONG place for her.  "She doesn't belong with those other people.  She's not crazy.  She's just not doing well."  I completely understand what they mean.  It's the wrong place for everyone.  Wouldn't we all like to go recuperate from wanting to kill ourselves in Tahiti?  Don't they have a "Mental Health Weekend" 3-day package at the Ritz?  That would be lovely but that's not how it works.  So I tell them I know it seems like a mistake, but it's actually the exact right place for her at that moment.  I tell you that if it's what you have to do to restore your sanity and return home a more healthy mother to your baby, just do it.  Suck it up and do it.  No matter how yucky it is, you will live.  And you might be a better person for it.

   

Postpartum Depression By The Numbers

Quick, guess which number is higher:  the number of people who sprain their ankle each year or the number of women who experience a postpartum mood disorder?  Actually, it's about equal.  Surprised?

In so many books, articles and news programs, you hear the statistic -- approximately 10 to 15% of women suffer from postpartum mood disorders (PPMDs), including postpartum depression (PPD), postpartum anxiety/OCD and postpartum psychosis.  What bothers me about that statistic is that it holds no meaning for most people, and because of that I think these illnesses get much less funding and attention than so many of the other prevalent illnesses that strike Americans.  As a result, I decided to do a bit of quick, non-scientific research to help people understand the real impact that postpartum depression is having on the women of our country.

According to the National Center of Health Statistics, there were approximately 4.1 million live births in the United States in 2004.  This statistic does not include fetal losses, including miscarriages and stillbirths.  The National Vital Statistics report indicates that the total number of clinically recognized pregnancies is around 6.4 million.  This is important to know, because all postpartum women are susceptible to PPMDs, regardless of the pregnancy's outcome.

So let's split the difference between the high and low estimates of PPMDs and say that 12.5% of all postpartum women in the US suffer.  This would mean that each year approximately 800,000 women are suffering a serious postpartum mood disorder.  How does that compare with the incidence among women of other major diseases in America?

• Each year approximately the same number of women -- 800,000 -- will get diabetes. (Nat'l Diabetes Information Clearinghouse)
• Each year about 300,000 women suffer a stroke.  (Centers for Disease Control)
• Each year approximately 205,000 women are diagnosed with breast cancer.  (National Cancer Institute)

In fact, more women will suffer from postpartum depression and related illnesses this year than the combined number of new cases for men and women of tuberculosis, leukemia, multiple sclerosis, Parkinson's disease, Alzheimer's disease and epilepsy.  This is not to minimize these other terrible diseases, of course.  I simply want to illustrate just how prevalent postpartum mood disorders are.

Dr. Ruta Nonacs of Massachusetts General Hospital and Harvard Medical School adds, "Postpartum depression is far more common than gestational diabetes.  All women receiving prenatal care are screened for diabetes, but how many pregnant and postpartum women are screened for depression?  PPD is also more common than preterm labor, low birth weight, pre-eclampsia and high blood pressure; in other words, PPD is the most common complication associated with pregnancy and childbirth."

Let me leave you with one last thought:  More women will suffer from a postpartum mood disorder than men will be diagnosed with new cases of impotence (617,715) this year.  Yet you wouldn't know it, considering the overabundance of erectile dysfunction (ED) ads and people falling all over themselves to discuss ED openly.  Why don't PPMDs get the same attention from pharmaceutical companies?  Why doesn't society work as hard to eliminate the stigma of postpartum mental illness?

This really is a big problem, and deserves much more attention that it's getting.

Note:  This article has been revised and updated from a piece I wrote for Postpartum Progress in 2004.  It is crossposted today on BlogHer.

 

People Magazine Reports Britney Did Suffer PPD

People.com is now reporting that Britney Spears did in fact suffer from postpartum depression.  Not surprising.  I've been saying all along that it seemed like her life was bumping right along until she had her children, and then there seemed to be a huge change in her demeanor. 

Britney Spears has "suffered from a psychological disease for years," says a source close to the singer.

Two separate sources who are acquaintances of the family believe the singer has never been formally diagnosed with bipolar disorder, but "there is no question she is bipolar ... she's had manic episodes for years" ...

PEOPLE has learned from multiple sources that the singer also suffered from depression after both her pregnancies. "She had postpartum depression after Preston was born," says a source who was close to the family during her marriage to Kevin Federline. "She didn't want anyone's help ... It got worse after Jayden was born" ...

A close family friend says "the tragic thing is that Britney loves her children and would never knowingly put them in harms way. Her mental instability is getting in the way of her making proper judgment and it's extremely unfortunate."

If it is true, the important thing to point out here is how important it is to seek treatment.  A lot of us don't want any help, as the article states about Britney, because we don't want people to know and we don't want to admit that we may need therapy or medication.   And in her case, I can completely understand her reluctance since she knew any problems she had would be shared with the entire world.  But the alternative is SO much worse.  I'd rather admit maybe I'm not the invincible person I thought I was than to descend into a vortex of misery.  Untreated mental illness can become much worse, and have a greater negative impact on the sufferer and everyone around them.  Get past the stigma, get past the fear, get past the disappointment and reach out.  Ask for help.  You and everyone around you will benefit from your courage.

Ways to Insult Someone With Depression, From "Finding Optimism"

I found the following link while reading Therese Borchard's Beyond Blue blog over at Beliefnet.  It's a list of ways to insult someone with depression from the Finding Optimism blog.  I just know those of you who have gone through or are going through PPD will enjoy this.  Much of it may sound VERY familiar.  Click here.

Understanding Impact of Race on Resistance to Seek Counseling

Here's a link to a very interesting column from the New Jersey Record by columnist Lawrence Aaron about what he sees as the reluctance of African-Americans to seek mental health counseling.  It helps to remind me that there are many reasons -- including resistance from family members, worries about effects on insurance and social pressures, among others -- that prevent people from reaching out for help.  This is something we need to respect and to keep in mind as we try to get help for women who need it, regardless of their race, origin or creed.

Postpartum Progress Beacon of Hope: Mary Jo Codey

Announcing the Postpartum Progress Beacon of Hope for March 2007 (drumroll please) ... Mary Jo Codey!!!!  If you haven't heard about the impact the former first lady of New Jersey has had on the issue of postpartum mood disorders, then you've missed a LOT!! 

Mary Jo Codey was first introduced to postpartum mood disorders 22 years ago after she experienced PPD with the birth of her son Kevin.  Prior to that, she had no idea that PPD even existed or that she might be at risk.  She also went through PPD again four years later with her second son, Christopher.  Even though she had all the signs of PPD, no one seemed to know what was wrong with her.  She checked herself into a mental institution for a month but found no help there.  Eventually she began to see a psychiatrist who did know about PPD and was able to help Mary Jo.  She began to experience scary, intrusive thoughts about hurting her son.  For months she worked with the psychiatrist tying different antidepressants, but the intrusive thoughts increased until she finally decided to "just end it all".  Fortunately, the psychiatrist had decided to try an MAO inhibitor as a last-ditch effort, and within a few weeks the intrusive thoughts began to decrease and finally disappear.  All in all, it took a year for Mary Jo to get better. 

She became angry, as so many of us do, that it took so long for her to get the help she needed, and that until then no one recognized the signs.  She realized that people needed to know and care about this disorder, and she didn't want anyone else to have to go through the self-blame and shame she experienced.  To that end, she became an advocate extraordinaire.  She has publicly shared her story with a wide variety of audiences, from health care and mental health professionals, to women's groups, PPD support groups, the general public and the media.  During her husband's tenure as governor, New Jersey created a comprehensive awareness campaign called "Recognizing Postpartum Depression: Speak Up When You're Down".  The campaign -- which made New Jersey the first state to commit resources to uninsured new mothers for PPD screenings and treatment -- features a 24/7 helpline and a bilingual website with valuable information and contacts for women and their families, as well as for medical professionals.  The campaign includes literature and radio and TV PSAs.  Mary Jo is very proud to be the spokesperson for that campaign, and was instrumental in its development.   

Of all the work she has done, she is most proud of New Jersey's Postpartum Depression Screening and Education law, which took effect in October 2006 and is an outgrowth of the efforts that began during her husband's administration.  Now every pregnant woman in New Jersey is educated about maternal mood disorders before giving birth; the mother of every baby born in the state will be screened for postpartum depression; and all licensed health care professionals who provide pre- and post-natal care will be educated about maternal depression.  There is a budget of $4.5 million for education and screening.

As for the future, most of all Mary Jo wishes for New Jersey's law to become national law.  The MOTHERs Act is actually based on the New Jersey law and is soon to be reintroduced in the Senate.  She says it's time for it to come out of committee and get passed!!

Her biggest concern is that too many women are slipping through the cracks and going untreated.  PPD is one of the most common complications of pregnancy, and progress is being made on raising awareness and increasing screening, she says.  But the latest study published by JAMA shows we need to do more.  There are lives at risk, she explains, and we owe it to women and their families to provide more education, screening, treatment and support.

Thank you, thank you Mary Jo Codey for your willingness to speak out, your courage, your honesty and most of all for your commitment to women like us!  You are definitely a Beacon of Hope!

Reluctance to take Meds: What If It Was Diabetes or High Blood Pressure Instead?

I get so many comments and questions from women who want to know how to get over postpartum depression without taking medication.  I'm NOT judging them or questioning their reluctance one bit, because truthfully I didn't want to take medication either.  But all these concerns have led me to wonder what our reluctance really is.  As I said in an email to one of these women earlier today, if I was diagnosed with diabetes I wouldn't think twice about taking medication prescribed to me.  If I was told by my doctor that I had high cholesterol or high blood pressure, I'd take the medication prescribed to me.  Sure, I'd need to change my lifestyle as well to address the underlying problems causing the high blood pressure or cholesterol -- I'd exercise more, I'd eat better, I'd develop better coping mechanisms for stress -- but I'd also take the medication to address the current crisis until my other activities kicked in and my blood levels were safe enough that I could discontinue the meds.   

Isn't it the SAME THING with postpartum mood disorders?  Aren't meds ok to help resolve the immediate crisis, while at the same time we can use exercise and/or talk therapy and support gropups and whatever else works to resolve any contributing underlying factors and to recover and get back to our old selves?  And when we do recover, we can reduce them until it's okay to stop taking them altogether. 

It seems to me that psychiatric medication, where appropriate and prescribed by an experienced professional, is simply addressing a physical medical crisis.  Our bodies don't differentiate between psychiatric illnesses and other physical illnesses.  Only society does.  It's society, and the damn insurance companies, that make us feel like psychiatric illnesses are some how different and highly questionable.   Who the hell is some insurance person to tell me how many damn doctor visits I'm allowed to have to get better from postpartum depression?  Are you kidding?  ... sorry ... it just incenses me that we're given hard limits on what treatment we can have to get better as if (wink, wink) we're probably not really sick in the first place, now are we??

Anyway, I'm sure there are people who have recovered from postpartum mood disorders without taking medication.  And I say more power to them, seriously.  Potentially, through continued research into various hormones and brain chemicals and genes and levels of various things in our blood we may get to a point where there is a more direct treatment for these illnesses which may or may not involve medication.  Until then, I can only tell you that I, myself, would not have recovered without the medication I took.  As Oprah says, that's one thing I know for sure.

P.S.  On the same topic, click here to go over to The Perinatal Project blog to read about some recommended changes in the way mental illnesses are covered by insurance.

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. 

Mental Health Ministries Needs Your Donation to Complete PPD Video

Mental Health Ministries is putting together a video resource for postpartum depression.  They have already taped interviews and their production partner, Pacific Media Ministry, is currently editing the tape to be shown on the Hallmark Channel and other cable channels.  They need an additional $1500 to "re-purpose" the material from Pacific Media Minstry so that they can use it as a Mental Health Ministries Resource.  This money would cover editing, graphic design, printing of a discussion guide, replication and other expenses.  You can help by making a donation.  All tax deductible donations are welcome, but donations of $500 or more will be included in the credits so that they can educate churches on how to recognize the signs of PPD and provide appropriate support.

To donate, click here.  Be sure to tell them you heard about it from Postpartum Progress!

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. 

Nationally-Recognized Author/Social Worker Karen Kleiman Sounds Off

Karen Kleiman has written an excellent response to the ignorant Ms. Shore on her Postpartum Stress Center blog:

Katherine Stone (and her wonderful Postpartum Progress Blog) has called our attention to the words of Tricia Shore , a writer who, when she isn't stirring up trouble, is a comedian (someone should tell her this isn't funny) who has declared her comments on PPD for all to see. On behalf of women with postpartum depression, I feel compelled to clarify a few things:

It's a shame that so many ill-equipped and opinionated writers have such an expansive audience to whom they can further spread their misconceptions. In the past, when someone found a forum to preach misinformation, it could be dismissed as an isolated aberration or an individual’s distorted interpretation or simply unbridled discourse at a cocktail party.

But today, as we continue to seek or be bombarded by Internet-available information we may or may not want or ask for, sometimes something seeps through cracks. We are then forced to spend what little available time we have wondering why someone actually spent the energy and bandwidth to put forth a particular message. The reason we have to respond is because there is now, more than ever, greater access to these unsupervised communications and more lives potentially impacted.

So I reluctantly confess that I spent superfluous time reflecting on the piece written by Tricia Shore that Katherine so responsibly brought to our attention.

In what might, at first glance, be a not-so-popular posture, I must admit that I agree with her opening opinion which raises a concern of my own: Has our media-soaked attention to a devastating illness, somehow diminished its worthiness in the medical and mental health community? Is there so much hype surrounding postpartum depression that in addition to promoting much needed awareness to this underdiagnosed illness, it might actually dilute the impact and sabotage our own efforts?

I hope not.

Those of us who treat this illness know only too well how excruciatingly painful and potentially deadly it is. Quite frankly, we should not be the least bit influenced by the misguided insights of a bystander who claims to have a worthwhile opinion. But for the sake of those who have been disturbed by this very well-written commentary, and on behalf of women who struggle with postpartum depression, let me do my best to respond to some of her specific points with a few of my own opinions:

--Postpartum depression does not make strong women appear weak. It makes strong women sick.

--Claiming that Brooke is "prostituting", Oprah is "enabling" and Mary Jo is "victimized" is inflammatory and simply unmerited.

--"Little pills that supposedly cure depression" can save lives and improve the quality of life. This is not a belief, it is evidence-based information that may or may not be significant to Ms. Shore or anyone she loves.

--Breastfeeding may indeed facilitate a pre-pregnant hormonal state. Breastfeeding may also be contraindicated if a woman is sick and unable to adequately care for herself and/or her baby. Breastfeeding can be associated with increased fatigue, depletion of personal resources and guilt that renders a mother virtually frozen with ambivalence. Pressuring a woman to breastfeed when she is in the throes of a major depressive episode and feeling suicidal can have catastrophic consequences.

--If a woman is fortunate enough to be surrounded by family and friends to "help hormones return to normal", she is likely to feel less isolated, less agitated and far more comforted. The presence of her loving family and friends cannot, however, prevent nor treat a major depressive episode.

--She makes a good point regarding the thyroid and it's worth repeating by one of the "supposed experts" who understands and treats women with postpartum depression: Before a definitive diagnosis of postpartum depression is made, depression caused by medical conditions such as thyroid dysfunction or anemia must always be ruled out.

--It’s okay for her to be skeptical about our mental health industry. She should be. We all should be. Women who are sick should be especially skeptical about misdiagnoses, mistreatment and misinformation. No one should be prescribed medication if they do not need it. And no one should question the use of medication by someone who does.

--"I even wanted to be a social worker… my plans have changed about becoming a social worker…"

This point, Ms. Shore, is very good news for all of us.

Sheer perfection!

Another Great Piece from MomSquawk about PPD

The following is a great post called "The Shame of Postpartum Depression" written by Momma Steph over at MomSquawk:

According to an article in Psychiatric Times, postpartum depression and psychosis are often missed by practitioners.  Around 10-15% of new mothers will be diagnosed with postpartum depression (not to be confused with “baby blues”, which affects around 80%), and less than 1% of new mothers reportedly experience postpartum psychosis.

But postpartum depression may be more prevalent than thought, because women are reluctant to reveal the symptoms, Dr. [Phillip J.] Resnick said. Fearing of falling short of society’s ideal of motherhood, women may hold back from telling their husbands. And many fear that if they tell a doctor or social worker about their depression, their baby might be taken away, he said.

Gee… women who are blindsided by postpartum mental disorders aren’t likely to fill anyone in voluntarily?  YA THINK?!  “You know, honey, I can’t seem to stop obsessing about putting the baby in the dishwasher.  Isn’t that odd?  I guess we should get takeout.  Why are you looking at me like that?”

I wonder if other undiagnosed women got hit with PPD as I did - in such a bizarre and scary fashion that it didn’t even occur to me that I’d been hit.  I thought women with PPD hated their babies, or cried all the time, or didn’t feel like leaving the house.  I loved my baby fiercely, didn’t cry much at all, and didn’t at all shy away from leaving the house - many evenings I headed down the road, clutching the baby, making a beeline for my husband’s office, if only to intercept him partway through his walk home and hand off our spawn so that I’d know he was safe.  Safe from the dishwasher.

Had I known that intrusive thoughts are a fairly common symptom of PPD, I probably would have told someone.  And I’m certain that the obsessions would have been much less severe, more easily laughed off and dismissed.  As it was, I just thought I was going crazy, and that admitting it would make it worse, and might cost me my child.  So I decided to just use all my mental strength to keep it together.  And I made a pact with myself that if I ever found myself in real danger of harming the baby, I’d kill myself first, as a pre-emptive move.

Yes, the unclouded bliss of new motherhood, indeed!

Some facts on infanticide, from the article:

About 40% of mothers with postpartum depression have thoughts about killing their child, Dr. Resnick said. And for depressed mothers of “colicky” babies-babies not soothed even when fed, changed, and held-that figure climbs to 70%, he said.

Of the mothers whose depression develops into psychosis, as it did with Yates, about 4% will harm their children if the psychosis is not treated, Dr. Resnick said.

This is why education and screening are so important.  I’m a well-read person, I pored over all the pregnancy books I could get my hands on, but nothing prepared me to recognize PPD.  For me, bad thoughts = Andrea Yates.  My only available coping mechanism (so I believed) was denial.

I’m praying that the MOTHERS Act gets out of committee and onto the floor of Congress.  Its stated purpose:

To ensure that new mothers and their families are educated about postpartum depression, screened for symptoms, and provided with essential services, and to increase research at the National Institutes of Health on postpartum depression.

I had great healthcare, by all obvious standards, and I was in the dark about the signs of postpartum depression.  How many other women are uninformed?  How many mothers and babies are at risk?

If and when the legislation makes its way onto the floor, we should be ready for idiotic hissy fits like this: “PPD is made up by whiney mothers and screening is a grand conspiracy by the patriarchy” essay (link courtesy of Katherine at Postpartum Progress).   Debate over the proposed law is one thing.  But denying the existence of PPD, and further shaming women who may be suffering from it by calling them weak, is unconscionable.

Postpartum Women Respond to Ignorant Writer

Regarding my post yesterday about that insulting woman who wrote a very uninformed piece about postpartum depression, Postpartum Progress reader Sandra Wolf, M.A. LMFT, wrote a great response:

Here is the e-mail I sent this self-righteous you-know-what:

I just read your article and I have to say that I am appalled by your level of ignorance and non-compassion for your fellow women. I am so happy you never experienced postpartum depression. No woman should ever have to experience that and that is precisely why it is extremely important that women be screened for this disease. Yes, Virginia, it is indeed a disease. I was absolutely overjoyed and over the moon when I discovered I was pregnant with my son. But, not once did my OB/GYN during my pregnancy ask me how my mood was (which, looking back was mildly depressed throughout the pregnancy despite my initial elation at discovering I was pregnant), or ask me if I had a history of previous depression, or ask me if I have a familial history of depression. If she had, then I could have been notified I was in a high-risk group for developing postpartum depression. After the birth, I knew something did not feel right. And despite my trying to tell people something was wro ng, I was dismissed and told it was just the "baby blues", even after the initial 2 week period when "baby blues" should have subsided. I didn't tell ANYONE about the thoughts I had of harming my baby, even though I knew in my heart I would never do it...that is the defining difference by the way between a mother experiencing psychosis who will likely kill her infant when having such thoughts and a mother who simply has OCD and depression and is appalled and terrified of having such thoughts. I didn't tell anyone precisely because I was frightened someone would take my child away from me and my husband. Had I could have been assured that I would have been helped rather than judged negatively or harshly or labeled as "evil", I would have spoken up and therefore not have had to suffer for as long as I did (6 months before I finally sought help). That is why I think it is extremely important for women to be screened and specifically asked about possible symptoms of this disorder. If you don't have it, which fortunately, the majority of women do not, great for you! However, if you fall within the 10-20% of women who do experience such symptoms, then you should not have to worry about others trying to silence you due to their fear and ignorance. This disorder is VERY TREATABLE. There is MORE THAN ONE successful means of treatment and each woman should decide with a professional upon the level of treatment that will work best for her. Not everyone needs medication, but for those who do, then so be it if it means a WELL mother! If you are such a proponent of motherhood and children, then you should realize a WELL mother is what is best for a child, not a mother suffering in silence, afraid to speak up about her experience for fear of being chastised by women like you! As for your tirade about breastfeeding being the best "medicine", that is not always the case. I breastfed my son for 13 months, and y et, I STILL suffered from postpartum depression! And no, the mental health profession is not seeking to "brainwash" people as you suggest...I am a Licensed Marriage & Family Therapist, and not ONCE did it occur to me that I was suffering from postpartum depression, though I did know something felt terribly wrong and not right. I didn't realize this is what I was suffering from because no Dr. bothered to screen me for it and it wasn't taught when I was in graduate school. I would come home and cry after spending an afternoon with my best friend who would state to me that her son was "the joy of her life". I cried from the depths of my soul because I so DESPERATELY wanted to feel that for my son, but I didn't and I couldn't understand why or what was wrong with me. Lucky for me, once I sought therapy and became well again, I have subsequently discovered what that feeling is like as I can now say assuredly that my son IS the joy and love of my life! Unfortunately, this disorder ROBBED me from feeling that for most of the first year of his life and I ache thinking I can never go back and change that for him. But now, after having received treatment, I can feel assured that he knows what it feels like to have a WELL mohter now who takes pride in being his Mama! But, when I was experiencing this disorder, I never dared say a word for fear of coming across people with small, judgemental minds like yourself. Shame on you!...You seem to tout yourself as a Christian....aren't Christians supposed to feel compassion for others, even when their experiences are not the same as yours or fall along your way of thinking??!!! At least that was what I was taught growing up in a religious school for 12 years!

Sandra