Category Archives: Maternal Health Month

Maternal Health Month, perinatal mood and anxiety disorders, postpartum depression

Blackish Cloud of Depression

In October 2017, the maternal mental health world was atwitter with news that the TV sitcom, Blackish, was going to tackle postpartum depression in its storyline.  I, just like everyone else, was curious to see how it would be treated; however, I had not been watching the series.  Like the anal-retentive reader that I am, I knew I wouldn’t be able to watch except from the beginning, to get a full sense of the story, the setting, the characters.

I started binge-watching this winter during one of the multi-week stretches of snowstorms and flu-like symptoms.  I loved getting to know the Johnsons, seeing their story unfold.  As soon as Rainbow told Dre she was pregnant, though, I waited anxiously for the signs.  They didn’t come until the last episode of season three: Sprinkles.  A headache brought Bow into the doctor’s office and the train of preeclampsia rushed from the station.

As she lay on the operating table waiting for the anesthesia to kick in, Rainbow delivered the opening address of postpartum depression.  She may not have known it at the time, but she outlined many of the contributing factors of postpartum depression.

“This wasn’t supposed to happen like this.”

Unrealistic or unmet expectations

 

“I’m really good at this stuff. I’m a baby maker.”

High standards.  Betrayal or failure of body.

“This is not normal.

Doesn’t meet the ideal.

“I’m really scared.

Fear.  Anxiety.

What if something goes wrong?”

Ruminating.  Irrational fears or worries.

While her blood pressure began to decrease immediately following the baby’s delivery, Rainbow couldn’t hold her baby.  He’s whisked away to NICU while she’s anchored to the operating table.  Go with him, she pleaded with Dre; someone needs to be with our baby.

Dre had his own emotional trauma surrounding the birth.  The doctor intimated that their first priority in cases such as Bow’s is to save the mother, introducing the concept of maternal or fetal mortality.  Trying to anchor his wife in this unexpected development was complicated tenfold by the possibility of losing one or both of his loved ones.  Even when the baby was successfully delivered, he confessed to his father that he’s afraid to love him in the event that something horrible happens to him.

Sprinkles isn’t even the postpartum episode.  But even if I didn’t have the spoilers I did, the writers did a phenomenal job foreshadowing the struggles to come.  As was my own experience with postpartum depression, a perfect storm of conditions converged and they’re laid out in a nuanced and real, respectful manner.

I’d had a long day yesterday and needed to decompress at the end of it.  I knew I was staying up far too late for my level of exhaustion, but needed to unwind.  As I sat there, solitary, sobbing, as the rest of my family slept, I thought, well that didn’t work.  But then, I remembered the date:  May 2, World Maternal Mental Health Day.  How very fitting that I finally happened upon the postpartum part of the Blackish story on this of all days.  This story stirred the very raw emotions of my own experience because it was so eloquently treated – and the story is just beginning.

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Maternal Health Month, may is maternal mental health month

Maternal Mental Health Week 2018

Starting yesterday, April 30, and running through Friday, May 4, the maternal mental health community celebrates and spreads awareness of the illnesses affecting women and mothers.

Did you know?

Created by Jennifer Butler Basile with info from thebluedotproject.org

1 in 5. That means we all know someone whose mental health has or is suffering – and yet we may not know it.

#AskHer

Ask a mom you know – each and every mom you know – how she is doing: the pregnant mom, the grieving mom, the new mom, the fourth trimester and beyond mom.

Your question may be the first in a line of interventions needed to get her back to herself. Other points on the line may be her child’s pediatrician, her primary care physician or ob/gyn, a therapist, and/or organizations like Postpartum Support International and The Blue Dot Project.

You can help her start her journey. You can help her see she’s not alone.

The push is on this week. The hashtags are on fire these five days. But the struggle is real everyday.

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anxiety, childbirth, Maternal Health Month, May is Mental Health Month, motherhood, postpartum depression, pregnancy

Locked On

They put the baby lo-jack on the umbilical stump.

If I had to choose one phrase illustrating how relaxed my most recent and hopefully last tour of a maternity ward was, that would be it.

It may not seem like much, but to me, it’s a huge deal.

Over six years ago, it was an errant lo-jack slipping off my baby’s slender little ankle that precipitated my fall into postpartum mood and anxiety disorders (PPMAD). Her squirming and that slipping gave my irrational mind the fuel it needed to doubt whether I was taking home the right baby.

I haven’t had that fear this time or denial or doubt, and the nurse only mentioned that additional bit of information as we headed for the elevator, but it capped our visit in the best way possible. As the elevator doors slid shut, I looked at my husband with relief and said if she’d told us nothing else, our tour was worth that one statement.

It’s an odd sensation that washes over one as she walks the floors she knows she’ll next be pacing in pain. To see the calm, the fresh beds, the quiet daylight streaming in the windows. I know the harsh fluorescent lights will glare, the linens no longer be fresh, the quiet replaced with beeps and moans and directions. It’s enough to put anyone on edge – either a woman trying to anticipate something she’s never experienced before or one who knows all too well what to expect.

This fourth tour I’ve taken was the least anxious I’ve ever been, however. It was due in large part to the relaxed community atmosphere of this particular ward. I think I also have finally realized that how ever much I dread labor, there is no way around it, only through it.

The nurse was very low-key, gentle and calming, as she shared information and answered our questions. When I asked about labor positions and modifications due to a weak pubic bone, she explained how the end of the bed came off, a yoga ball could be used, a kneel or squat bar . . . she even said she’d make a note in my chart to request an automatic PT consult after the birth. I wanted to hug and kiss her.

And then she made my day even better when she shared the positioning of the lo-jack. I hadn’t mentioned anything about my postpartum experience last time. I hadn’t mentioned that a tiny locator device could be such a trigger. I hadn’t expressed any concerns about security. Maybe it was just that we were approaching the locked door of the ward as the tour ended, but she told us hospitals have changed procedure to attach the device on the umbilical stump because it can’t fall off.

With that one bit of information, that I hadn’t known I needed to hear or was even a possibility, my mind opened up. The iron grip of anxiety I’d unwittingly been living with lifted – if only enough to let me breathe. To see that this labor and delivery and recovery will be different. There will be no fear concerning the baby.

I am hers, she is mine. Everything will happen as it should.

baby feet

flickrhivemind

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Living, Maternal Health Month

Unintentional Hiatus

 

My month-long series on maternal mental health ran up to the end on a high-note. It organically happened that I took Sundays off (which happened last year, too, I believe) and I missed one Monday. But the second to the last day of the month led into a multi-day outdoor assault – my own family’s feet on the rocky outcroppings of a letter-boxing trail and my husband and I splitting wood like the lesser versions of Paul Bunyan that we are – keeping me away from blogging for much longer than I anticipated.

Shouldn’t have been a big deal, missing that last day of the month, right? Wouldn’t have been – save my anal-retentive perfectionist tendencies and overbearing need to summarize. I couldn’t post any inane essay on my pre-series schedule before concluding the series. And life was ratcheting up, not allowing me to sit and form any cohesive set of thoughts.

My youngest’s preschool program finished for the year, also ending those blessed two and three-quarter hours of writing time twice a week. Some of it had also become crush tortilla chips while surfing the web after writing time, but it was alone time nonetheless.

image from Peggy Lampman

image from Peggy Lampman

Perhaps the biggest challenge to my settled psyche, however, is the change in schedule itself. I can hear the words of my wise LICSW repeating in my head, telling me the beginnings and endings of school years are transitional times for everyone in the household. I still try to tell myself it’s no big deal, but apparently it is. Yes, we’ll all be liberated from hectic mornings and rigid schedules, but we’ll all have to get used to spending all day everyday with each other. None of us will have freedom from each other. No alone time. No individual activities. No uninterrupted playtime with friends – be it other children or corn chips.

Then it started raining. I half-heartedly set myself to chipping away at the piles of laundry and dishes that had accumulated whilst we frolicked with sharpened woodland tools outside. And I went and read this amazing – in its content, expression, and ability to scare the bejeezus out of me – article about motherhood that messed with my already fragile state of juju (which may, in fact, become the starting point for the summary posthumous post of my series).

So I’m here. In some state of transition. But aren’t we all. God damn walking the tightrope/balancing life again. Isn’t there just some set state of equilibrium I can have installed in my inner ear?

 

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Maternal Health Month, Maternal Health Month 2014, may is maternal mental health month, postpartum depression

Work in(g on) Progress

When I started this blog chronicling my survival as a mother postpartum, I sought out other blogs with a similar focus.  My research took me all the way to South Africa.  I found Lebogang and her blog, For His Love.  A woman living a totally different life in a totally different part of the world felt the exact same way as me.  I was so glad to read my story on her pages with a different set of characters and timeline, especially since she was further along in her story, which meant I, too, would make it.  After all, that’s what the badge in the bottom right hand corner of her page said:

I survived postpartum depression.  You can too.

This image was like a magic talisman to me.  I clicked on it, half-expecting, I think, the spontaneous appearance of the how-to handbook for solving all my problems.  This mythical handbook did not appear – but Postpartum Progress did, which is, really, the next best thing.

Postpartum Progress is the brainchild of Katherine Stone.  She has built and branded a maternal mental health empire.  It started, as she says, with the blog, then a conference, and is now building its nonprofit status.  But while it started with Stone and her own struggle with postpartum OCD, its success is in the amazing community she’s created for women who all-too-often feel completely alone.

Simply their social media feed is enough to inspire hope, with affirmations, informational tidbits, and links to in-depth articles.  The blog and website offer a wealth of information and resources, that would help any woman while away the wee hours of the panicked postpartum morning before the doctor’s office opens.  And that may be precisely the point that Postpartum Progress exists.  To offer a voice and ear 24/7 to a struggling population whose problems do not adhere to office hours and are not as cut and dry as a short symptom list.

A disclaimer on all their pages states that the information and advice is not a substitute for professional care and consultation.  However, it is a place to start the journey and a companion throughout it.  It offers a place for women who have no vocal allies in their everyday lives, due to stigma, to find friends and examples of success despite struggle.

It is organizations like Postpartum Progress that give me hope for the empowerment, validation, and vindication of all women suffering from perinatal mood disorders.  Even ones like me, who are post postpartum.

IsurvivedPPD1

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A Common Language

 

I’ve been thinking a lot about how to ensure that available mental health resources get into the hands of the women who need them. When and where resources are available, there seems to be a gap between the offering and the accessing. As always, I think back to when I first slid on the shoes of the women now making the postpartum trek.

Women of all socioeconomic, racial, and educational backgrounds share one extremely daunting obstacle when in need of such help: they must articulate their exact problem in order to get the help they need.

In a complex web of medical jargon, insurance restrictions and loopholes, and a frustratingly-absent physical presentation of symptoms (for the most part), it falls upon the sufferer to demand treatment for the condition that, no doubt, impairs the very confidence, decision-making skill set, and strength it takes to do so.

It’s an ironic catch-22. The doctor has the tools to ‘fix’ you, but you must lead her to the workshop. The doctor is the artist, but cannot pick up the paintbrush unless you led her to the canvas. The horse must determine the source of water before the doctor can lead it there.

There is no solution unless the patient gives the doctor information to determine the problem.

When I hinted that I felt like running away a few months postpartum, my midwife recommended I talk to a LISCW. This therapist helped me chip away at the enigma that dragged me down, but it was I who eventually had to request medication from my physician. When that dull cloud still hovered, I made the final call to increase dosage. More recently when I intimated to her that I still felt low sometimes, I apparently wasn’t descriptive enough because I was told the meds shouldn’t make me feel flat; there should be ups and downs.

How well my mental health situation is addressed directly correlates to how accurate I am in describing it. How empowering and crippling at the same time. If I do not share every pertinent detail in clearly descriptive language, I will not feel better. I will not get the meds, therapy, tests, information, etc. that I need to make anything resembling a full recovery.

Regardless of my level of medical literacy, the debilitating effects of depression and anxiety can keep me from adequately representing my plight. Regardless of the quality of care available to me, its benefits will not be afforded to me if I do not say just how much I need it. Nothing will be given to me unless I ask.

How do we on the receiving end of such conversations draw the stories out of the women who need help? How do we teach/speak the language to give them a voice? How do we release the language bubbling beneath their skin? In that wordless abyss is the bridge between therapeutic, wholistic maternal care and the women who need it.

word bubbles

 

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Maternal Health Month, Maternal Health Month 2014, may is maternal mental health month

What Postpartum Depression Recovery DOES NOT Look Like

Read this article, peeps.  Truth.  Simple, yet sage advice.  Your rational side may know it all already, but that stubborn irrational side of you needs to hear it again.  Believe me, I’ve been there and felt all these – and so has Katherine Stone, the author.

 

What Postpartum Depression Recovery DOES NOT Look Like.

Get well card with fresh chamomile flowers on blue background

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Maternal Health Month, Maternal Health Month 2014, may is maternal mental health month

It Just Makes Me Sad

News broke late last week that a California mother had taken the lives of her three children.  Conduct a man-on-the-street interview and you’d likely hear outrage, vile epithets directed at the monster who would kill her own offspring.  My own husband brought it up to me in a pained tone of voice.  He was disgusted.  It IS disgusting when such a thing happens.

But I’m not angry at her.

Horrible events like this make me sad.

Sad that three lives on the cusp were snuffed out.  Sad that poor defenseless, innocent babes were terminated.  Sad that the father had to watch his bloodied babies be carried from his home; that his partner in life, in giving life, was the one responsible.

Sad that no one connected to this woman perceived any threat of dangerous behavior. Sad that perhaps she felt she couldn’t express such feelings before it was too late for fear of judgment, backlash.  Sad that she didn’t know how to get help.  Or perhaps didn’t have such resources available.

Sad that things like this continue to happen needlessly.

We live in a society with a different-hued ribbon for everything – and things like this still happen.

And woman like this are still labelled as crazy.  I found ONE account that handled this story sensitively.  (Read here)

In the anger and outrage that follow such an event, it’s easy to point fingers.  Why was she left alone with the children?  Why didn’t anyone ensure she got treatment? Thankfully, I never experienced postpartum psychosis (nor has it been substantiated that this woman did); even still, I hid my negative feelings for fear of judgement as a bad mother.  I never asked for help because my struggles were so far out of the realm of a competent mother.  Would I have been more likely, then, to admit to homicidal thoughts toward my children?  Not something someone who loves and cares for their children – which all postpartum mothers do on some level – would readily admit.  Therefore, there may not have been warning signs of this impending tragedy.  Many postpartum mothers are uncannily adept at masking the turmoil inside.

So here’s the lowdown:

  • For all its awareness, we still live in a society where women are compelled to hide their unhealthy mental symptoms.
  • For all the coverage of tragedies such as these, a lot of people still cannot recognize or suss out the warning signs and symptoms of the mentally ill to prevent future scenarios.
  • For all the resources available, the paths to these therapeutic and rehabilitative programs are still unclear and/or blocked.
  • For a species that values nurturing, we are quick to throw a troubled and needy person under the bus.

There is work to be done, people.  It is sad that we cannot look each other in the eye and see the need in that person.  It is sad that we look away for fear that the beast inside us will be awakened by the raw reminder in front of us.  It is sad that, instead, we cannot look and see a solution, a way to lift up the depressed and rise together.

kids

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Maternal Health Month, Maternal Health Month 2014, may is maternal mental health month

Playing the Odds

 

We always hope that our child will get the best characteristics from that special person we partnered with and ourselves. A winning combination. We hope that the less desirable pieces of ourselves will be filtered out in the next generation. Unfortunately, that doesn’t always happen.

Our second daughter was an easy baby. She ate well. She slept well once she discovered her thumb. She rolled with the punches of a dual-sibling household. Her laugh came easily as did her socialization. We labeled her gregarious and thought for sure she’d be comfortable in any social situation as she grew.

Partway through her year of preschool, she began complaining about going. No one likes me. No one plays with me. Kindergarten followed with more of the same, with daily fights of shoe, sock, and shirt selection – one of which ruffled me so much I slid into a tree one snowy morning. This year, it intensified, with afternoons added to the agenda. Denial of a specific snack or a disagreement with one of her sisters would send her reeling. Over-the-top anger. Violent outbursts. Negative self-narrative.

My husband and I tried extra cuddles and attention, positive reinforcement, avoided giving such outbursts attention . . . it only seemed to escalate. It was not a fun time, to say the least. What finally pierced my heart was when she began with self-harming statements.

I’m just going to throw myself out the window and break my head.

It would be better if I just died.

How would you feel then?

I doubted whether my first grader had horribly morbid intentions. I sensed it was a more dramatic way to express inexpressible incredibly pissed-off feelings (which was later confirmed by the school psychologist) and that she didn’t fully understand the gravity of her declarations. BUT – and a big one – I’ve read and heard enough about mental illness to know you never take such statements lightly. And I’m a former English/Language Arts teacher, used to evaluating journals and writing pieces where many such revelations come out in school. Teachers and school personnel have strict protocols to follow surrounding such language – even if it’s erring on the side of caution.

What scared me most about these statements was that they reminded me so very much of my own running narrative born of postpartum depression: I hate my life. Just kill me now.

Had my child inherited the very worst part of me, the part from which I truly hoped she and her sisters would be free? In tense conversations after the children went to bed and my husband and I tried to find a solution to this seemingly impossible one, I said, You know why I’m paranoid, right? He did. Though he’s never seen me as such, he knows I think of myself as broken, flawed, and that my worst fear is that it affects the children. What if she’s got what I have? This fear hadn’t fully formed itself in my soul until those words issued from her mouth, but then it blossomed exponentially. We agreed to make an appointment with the school psychologist.

Fortuitously, the school psychologist’s curriculum already brought her into the first grade classroom discussing identification and expression of feelings. Ironic. Perhaps my anxious little bean hadn’t progressed far enough into the curriculum, but my concerns meshed nicely with the goals of the program. The school psychologist helped us extend and reinforce what they’d been discussing in the classroom in our home.

It wasn’t an instant fix. Though it started with a great amount of enthusiasm, a week into our initiatives had my daughter ripping up the yellow diamond of construction paper listing her triggers (you know, the warning zone meant to make her more aware of them in order to cut them off at the pass). In her calm moments, she could tell you exactly what bothered her. When she was seeing red, there was no talking her down until she’d run herself out. Closer to the end of the year now, I hear her using more of the language from the school program on her own. It makes me happy to see her acknowledging ‘rock brain’ moments and telling said rock to get lost.

And that, I think, is the memory and lesson I choose to take away from this year. For all the machinations I took this year, in the end, it was she who enacted the change. She has the power to determine her own destiny. She is not a mini-me, though she looks an awful lot like I did as a child. She isn’t my clone, complete with my anxious tendencies. After all, she inherited her father’s temper, too. 😉 She is a unique individual who will create her own unique solutions for any problem she encounters.

Being aware of how my genetic make-up may influence the presentation of her behaviors is good to keep in the back of my mind, but it shouldn’t be in the forefront.  Using what I learned in my struggles to create a support system for her only makes sense and compassionate parenting, but it’s not a self-fulfilling prophecy.  She is a certain percentage of me, a certain percentage of her father, but she’s 100% herself.

 

a onesie gifted to us by a dear friend

a onesie gifted to us by a dear friend

 

Related Posts:

Vantage Point

You Got Some ‘Splainin to Do

 

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Maternal Health Month, Maternal Health Month 2014, may is maternal mental health month, Weekend Write-Off

Sometimes My Mommy Gets Angry

 

The book begins like any other for children. A breakfast scene, a mother making pancakes for her daughter in a sun-filled kitchen. She helps her dress and tells her how “beautastic” she looks before sending her off to school with “a kiss and big smile.” But here, the mood shifts. Annie, the daughter, hopes that Mommy “is still smiling when [she] comes home” because “sometimes my mommy doesn’t smile at all.”

angryAnd it is no mistake that the tone and plot of the book changes with a shift in mood. Sometimes My Mommy Gets Angry by Bebe Moore Campbell is the story of a child living with a mother suffering from bipolar disorder.

Indeed, when Annie returns home from school that afternoon, it is not smiling Mommy that greets her. Her mother yells at her to stop making noise, to get in the house, to ignore the neighbor’s inquires about her school day. Then she turns on the neighbor, accusing him of always spying on her.

And apparently this isn’t the first time, for once Annie gets inside, she follows a well-scripted plan. She calls her grandmother. “Mommy is yelling again,” she says. After her grandmother assures her she’s done nothing wrong, she tells her to go to the neighbor’s house until she comes to get her if she feels scared. When Annie tells her she’s not scared talking to her, she is to get her “secret snack without bothering Mommy.” But most importantly, to “think happy thoughts.”

The next day dawns much differently than the first. The rain pours down rather than sun through the windows. Annie is left to fend for herself, eating cold cereal rather than hot pancakes. But her friends help her brush out the knots she missed in her hair. They joke and laugh on their walk to school despite the raindrops.

True to her grandmother’s directive, Annie does manage to think happy thoughts. She says, “Sometimes my mommy has dark clouds inside her. I can’t stop the rain from falling, but I can find sunshine in my mind.”

How do we, as parents, ensure our child finds the sunshine in her mind – even when we simply cannot? Whether it’s from bipolar or another mental illness, how do we shield our children from the worst of the disease without also blocking out our love for them? Annie’s grandmother emphasizes that her “mother loves you even when she’s yelling.” She even goes so far as to say, “It’s okay for you to be angry. I know you love her too.” How do we teach this give and take and encourage our child’s healthy feelings in response to our unhealthy ones?

An author’s note before the story, which also provides important information on bipolar disorder and other mental illnesses, states that “the ‘village’ that supports the children of the mentally ill – the grandparents, aunts, uncles, teachers and neighbors – can help foster within these fragile children a sense of security and hope that life can get better, and encourage self-esteem in the face of extremely trying situations.”

Is that how we parents support our children? By farming it out to the surrounding village when we can’t do it?

This book is directed toward the children of parents with mental illness. I’m looking at it through the lens of guilt and worry that comes from being a parent with mental illness. Perhaps I should take Grandma’s advice: have a healthy snack, look to the support of neighbors, and think happy thoughts. I feel terrible that my conditions keep me from being ‘the end all and be all’ for my children. But maybe I never was supposed to be anyway. Maybe it really does take a village.

At the very least, Sometimes My Mommy Gets Angry takes on the task of telling the story of one special little girl’s resilience in the face of great difficulty. And that’s a story a lot of kids out there really need to hear.

 

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