Irrational Reptile

With tough, leathery skin,
it’s a wonder she moves without notice.

Yet she skulks and slithers
throughout the mind,

the soul,

the psyche

leaving a trail of bad decisions in the name of self-preservation

Seeking only comfort and survival
not peace or progress

After years of hiding in the shadows,
she is an expert at skirting around the edges,
dropping pebbles here,
rolling beads of water down there,
until they gather in a puddle,
pushing behind the eyes
pulsating in the inner ear
an ache in the chest
an unease in the soul

Don’t trust this,
she says.
Run the other way,
she says.
And if you won’t listen,
she whispers ways to sabotage

All so softly that you don’t even question that her voice isn’t your own.

Find Your Umbrella

Jennifer Butler Basile

This collection of items has sat on my dresser for the last year.  Plus a few weeks.  There was a rectangle of dark wood in the dust when I lifted it from its spot today.

It is a self-care kit I purchased at a holiday fair last year.

Our community has a fabulous youth task force that started in our schools and now focuses on the mental and emotional health of our youth at large.  Each year, they have a display at our district’s arts showcase, which is how I first learned of their work.

via Chariho Youth Task Force

In 2017, when they were launching their ‘Let’s Talk About Mental Health’ campaign, my heart sang when I saw these young people standing in front of their green screen of watercolor rain under a blue umbrella.  I, of course, jumped right in, my older two daughters sidling away as Mom started talking shop.

Finding my umbrella with two of my cooperative children / photo by Jennifer Butler Basile

Young people fired up and active about the cause I held dear to my own heart and psyche – I applauded their efforts, took their literature, and started following them.  The next year, I picked up their ‘Mental Health and Stress First Aid Kit’.

Last fall, I saw that they’d be selling ‘Self-Care Kits’ to support their efforts.  I went to this full-scale fair and bee-lined straight to these adorable bags emblazoned with affirmations.  Once home, I made my children well aware this bag full of goodies to destress and reward oneself was all for Mom.  I was even inspired to recreate the kits as Christmas gifts for two of my relatives depleted by selfless caretaking of parents.

I could see the value of these kits for these two women who sorely needed to take some care and time for themselves, I preached the virtues of self-care, I knew the therapeutic effects – and yet, my own gift bag sat unopened upon my dresser.

The idea of self-care for my-self has been in a box as well-defined as that dust-free square on my dresser.

I spilled the contents onto my bed today to take this picture.  Ironically, the impetus for their spillage was not to partake in their benefits, but to write this post.  It’s a long way round – and I don’t think I’m rationalizing too much – but writing this post, which could be considered ‘work’, was a radical act of self-care.  See, I was neck-deep in Christmas preparations today.  I baked three recipes worth of goodies, prepped two batches of dough for our weekly pizza evolution, and never got to the wrapping and other recipes still on my list.  I almost enlisted my eldest to watch her siblings while I continued on with my tasks instead of heading out to write.  I was so close.  I’m so tired with so much to do; so full of guilt for the things I should be doing.  After all, adults should pick the requisites and let the extracurricular fall to the side when time and circumstances dictate, right?  It’s only the responsible thing to do.

But there’s always something to be done and never enough time.  In my (our) frenetic world and with my unrealistic expectations and standards, I could never possibly get it all done.  Sure, there are certain things I must do before the holiday – but there is always tonight (or the wee hours of some night, as I usually roll) or tomorrow.  If I don’t put myself first at least some of the time, my needs and I will always come last.

And the spilling of that bag for this piece has led me to know its contents, to meditate again on the importance of self-care, given me a cup of tea and some quiet time.  And maybe just maybe reminded me that I’m worth it and need to make these times a priority.

Jennifer Butler Basile


Chariho Youth Task Force is a wonderful resource for exploring mental health – what it is, how to obtain it, and how to maintain it.  Explore these resources:

 

Incremental Illness

It’s easy to ignore when it creeps up on you,
increasing slowly, by small degrees

Or not even ignore –
just not even notice

the paranoia that maybe you’re not cool enough to hang
the resentment for the life you do not have
the loneliness
the inability to relax
the overwhelm over everyday things:
shopping, showering, getting out the door

Just not feeling
talking, going, doing –
                              it

Until one day it’s suddenly all you can see,
all you can feel

And you have to deal with it all at once

Holiday Hangover

Is it Tuesday already?

It came as quite the shock this morning when I had to wake up and rouse myself and kids to face another school day.  The holiday weekend seemed much longer than three days, as if we’d all already slipped into summer mode.

The long weekend was some weird sort of stasis.  It was neither too long nor too short; not stupendous nor horrible.  It was good.  In the midst of PMS and prepping for my two-year-old’s birthday party, I managed to not lose my mind and then relax a bit and enjoy the rest of my weekend.

Yet, even though I cleared out a wood pile that had been lingering in the yard and set up my compost area; even though I cleared a garden bed and planted two long-waiting potted plants; even though I enjoyed laughing with my husband and girls as we ate our first outdoor ice cream of the season – my thoughts turned last eve to how it all may not have been real.

The fact that I survived and thrived may have been a fluke.  The fact that I managed to not only be productive, but enjoy it; that I could not only enjoy my children, but feel joy with them; the fact that I wasn’t overly irritable, low, or unmotivated – I couldn’t just be in these wonderful feelings.

As I looked to a return to routine, I wondered whether I’d fail on my own.  Without the buffer of helpers in the house, would I be overwhelmed with the task of caring for my little one?  Would I feel trapped without the option of another set of hands if I had to tend to a household task or take a moment for myself?  Would my mood plummet without the excitement of a holiday weekend and the drudgery of the everyday?

It is said that comparison is the thief of joy.  Depression is as well.  It’s also said depression is a liar.  It is.  It is telling me lies about how I may fail.  And anxiety is helping spool out its prophecies far into the future.

I may have reached a point where therapies and supplements are finally coming together for my success.  But I cannot trust that.  If I do, the bottom of what I wish for so vehemently may fall out from underneath me.  I may have just had a pretty great weekend.  But even that, I can’t enjoy.  Because I figure my balance is due and I must pay up at some point.

directv-soggy-groceries-large-4

iSpot.tv

I look forward to celebrating the holiday where the right treatment and my own ability to sit in and take a moment for what it is converge; where no thing is the thief of my joy.  That will be a true celebration.

What Tully is Really About

When I saw the first trailer for Tully a few months ago, I was excited.  A full-length feature film that portrayed the real story of new motherhood?  The heartache, the frustration, the despair?  I was ready to book my mom’s night out right then.

 

What Tully is not about – or only part of the picture

 

But something stayed my hand from hitting the share button.  Even in a thirty second promo, her night nurse seemed too good to be true.  How could she possibly say the right thing at the exact right time every single time?  And do it all with the Zen voice of a life coach?  Or not even.  Like a lover trying to woo Charlize Theron’s character, Marlo.  I wasn’t sure what, but something was off.

A few days later, a fellow maternal mental health advocate sounded the alarm.  Read Graeme Seabrook’s take here.  More problems arose as the days went on, though.  Apparently, Tully is not just a flawed character; she does not exist at all.  She is entirely a creation of Marlo’s mind.  No wonder she was too good to be true.

In the film, Marlo apparently does receive a diagnosis of postpartum depression.  The plot does admit that her behavior and experience are not ‘normal’.  She does suffer from a condition of mental illness – except postpartum depression is not what it is.  Marlo suffers from postpartum psychosis.

As explained in a recent HuffPost article on the subject:

Postpartum depression is characterized by feelings of anger, irritability, guilt, shame, hopelessness, and sadness, but delusions, strange beliefs and hallucinations are symptoms more in line with a diagnosis of postpartum psychosis, as are cases of infanticide, according to Postpartum Support International (PSI).

The fact that the extreme separate reality Marlo has created is attributed to postpartum depression is dangerous.  If we take this film at face value, which many viewers will if they have no experience with maternal mental health, two things may happen.  One, women who do not have hallucinations will not seek help because they don’t feel they’re that bad.  Two, women who do not have hallucinations but suffer from debilitating depression (or anxiety or OCD) will be seen as mothers who will harm their children.  Women are already afraid to seek out the help they so desperately need when suffering from maternal mental health issues.  If they also have to fear being deemed unfit to care for their children, they will even less likely to obtain and benefit from treatment.

Society already sees every mother with postpartum depression as one with those who desperately drown their children.  As recently as this January, police were called to a California emergency room when a mother requested help for postpartum mental health concerns.  There is enough stigma to fight without movies like Tully perpetuating myths and muddying the water advocates fight daily to clear.

A star-powered film in mainstream cinema has tremendous potential to slay such myths and spread awareness.  What a squandered opportunity.  Many mental health advocates are asking, why didn’t they ask us?  If only Jason Reitman or Diablo Cody had consulted professionals and organizations for the full picture.  But honestly, I don’t think the Hollywood players working on this film are concerned with the women who will come to this movie looking for a funny cathartic look at their real life, but instead get sneak-attack triggered by the surprise turn of events.  They are more concerned with plot; with a compelling, unexpected story.  They are dealing with fictional characters, after all.  Except that they have failed to take into account the devastating effect their largest imaginary character will have on their very real viewers.

Even writers of fiction must research their topic, their time period.  Even in fiction, world-building must be believable.  Egregious errors ruin the integrity of the world, the characters, the entire experience.  Not only did those responsible for Tully fail sufferers and survivors of maternal mental illness, but the standards of good writing as well.

From the moment this film was named, it took power away from mothers – the very first being Marlo.  It’s not her story.  It becomes the story of her illness.  Maternal mental illness does overshadow the mother in its darkest depths.  But it does not define the woman.  The most compelling part of the story should be the journey out of those depths.  A mother’s eventual triumph, not her despair.  Tully totally misses that.

 


Another great discussion of the film from Motherly here

So Much Blah

For such a bland, nonspecific word, blah actually does a lot.

At the end of last month, I started a mood tracker to get a closer look at and more specific language for my moods.  I’d been using blah too much and too widely.

Now that I’ve been pinning my days and moods to – what I thought were – more specific descriptors, I realize just how evocative blah is for me.

Blah is not wanting to get off the couch – either from physical exhaustion or lack of motivation – or both.  Blah is not knowing where to start when faced with a day’s plan or duties.  Blah is not knowing how to structure a day with no plan or duties.  Blah is feeling off.  Blah is not wanting to get dressed because you haven’t had the time to shower or because nothing would feel as comfortable against your skin as pjs.  Blah is worrying about an unnamed idea.  Blah is not wanting to interface with people.  Blah is not eating because nothing seems appealing.  Blah is eating candy or snacks that will bring on more blah for sure – but perhaps will be a happy treat.  Blah answers the question, ‘How are you?’ with a shrug because blah really isn’t sure – even if things aren’t that bad.

Blah is a lot of ‘not wanting to’.  Blah must be a toddler.  Or a moody teenager.

Blah comes to visit me a lot – and not because I have all of those in my house.

I wanted to get away from using blah to describe my state of mind because I wanted something more specific.  I don’t know that I realized how many versions of blah there were.

In my mood tracker, I opted for descriptors like ‘not focused’, ‘not productive’, ‘unsettled’.  According to those little squares of color on my chart, there’s been a lot of unsettled lately.  I think I just switched blah for unsettled.  I need to unpack the feelings in that paragraph above and figure out the different shades of blah or unsettled or whatever I want to call it.

blahblah

from sillyoldsod.com

 

How Much I Learned from One Day of Mood Tracking

This past Sunday afternoon, I finally sat down with my thirteen year-old to create a mood tracker bullet-journal style.

It was an activity months in the making.  Once I expressed an interest, she would bring it up from time to time, asking me when we’d actually sit down and bu-jo together, as she says.  Eventually the questioning took on an annoyed tone as she began to wonder when and if it would actually happen.

Initially, it really was just a matter of scheduling.  When did we actually have an afternoon off to spend together with markers and blank books?  Looking back, I now realize there were other factors at play – none of which had to do with this lovely little being who wanted to spend time with me on the cusp of not wanting to spend time with me.  So I shoved those aside, or at least down enough for the day, so she wouldn’t begin to take things personally.  Those factors, however, say a lot about where I’m at right now.

First, I was unsure where to start.  I’ve never bullet journaled before and haven’t sketched or doodled just for the joy of it in decades.  Ain’t no mom got time for that.  And I certainly couldn’t let go enough to enjoy it.  If I was going to do this, it had to be done right and in an aesthetically pleasing manner.  And if I was going to invest time and blank page space, the information I collected had to be useful.  I wanted facts and indicators I could bring back to my practitioners to prove my case and plan of treatment.  When I finally sank into the couch with her, I realized I hadn’t started because I didn’t know which layout to use to best serve my needs.  Bless her thirteen year-old technologically saavy heart, she launched you-tube and pinterest searches in conjunction, showing me what she found.

Of course, I had to create my own hybrid version of a few I’d found.  I also think I let go of the idea of perfection for this month, figuring I won’t know what exactly works for me until I actually interface with it and can adjust as needed going forward.

After I created a grid with just over two weeks’ worth of dates running down its side, I set about choosing mood indicators to list across the top.  Five manner of emojis was not going to do it for me.  I was seeking language to differentiate blah from ennh to my physician.  I needed specific descriptors.  But choosing those descriptors was another story.  I broke out a pencil and began a list on a separate page.

20180327_125151.jpg

Jennifer Butler Basile

In a very short time, I realized how many more negative descriptors I had than positive ones.  Why did I have so many words appropriate for shitty ways of being than good ones?  The easy answer is that I’ve had lots of practice, apparently, with low moods.  The more difficult answer I’m still unpacking is how my mind tends to the negative.  Is my brain wired to a pessimistic program?  Or is it stuck in a rutted road of negativity since it’s been travelling in that direction for so long?  Does it need a reprogram?  Is that possible?

My final list, which I’m still not completely sold should be absolutely final, has one more negative descriptor than positive, but I forced myself to beef up the positive side so it wasn’t totally lopsided.  I also find my negative words so much more specific, evocative.  I find the positive descriptors more vague and general.  Again, I’ve been living in the land of low moods so apparently I know them better.

Writing such a raw, vulnerable list with my daughter at my elbow was unsettling to say the least.  The fact that she aided my progress both makes me proud that she’s so creative; that she’s so willing to accept me as I am.  It also makes me hopeful that perhaps an idea like tracking moods will become so commonplace to her generation that dialogue surrounding mental health will be like breathing air.  But I’m also terrified.  I’m afraid she’ll see what a broken person I am.   And not due to some ‘I’m so strong and perfect’ façade I’m trying to portray.  Just, I don’t know, that I struggle.  As in, how can I take care of her if I haven’t perfected how to care for myself?  But even as I write that, I know that’s all a part of being human and she’ll figure it out sooner or later no matter what.

20180327_125209.jpg

Jennifer Butler Basile

The reason I wanted a mood tracker was to turn a highly subjective entity – moods and feelings – into a quantifiable collection of data.  For some reason, I think I actually expected that by putting it into a grid would miraculously turn it from one thing to the other.  Perhaps I knew that was wishful thinking and why I postponed it for so long.  I also realized how much my procrastination is fueled by my perfectionism.  I also learned that, whatever its origin, I need to check my negativity so that it doesn’t rule my life.

So before I’ve even collected more than a day’s worth of data, my mood tracker has already proved to be an illustrative tool – in ways I may have never even imagined.

 

Post Script

The following is not advisable, nor is it recommended or endorsed by any of the information herein; the anecdotes serve as a reflection of my personal experiences. Do not take the same road I have.

 About three and a half weeks ago, I weaned myself off my antidepressant of seven years. For all the advice I’ve heard saying not to do so without medical supervision and all the times I’d poo-poo’d those who abruptly stopped medications – I weaned off my meds without medical supervision having made the decision totally independently.

I’ve written before about the panic that ratchets up watching the tablets dwindle in my amber colored bottle of sanity; about the same reasons I take them leaving me overwhelmed enough not to call the doctor for a new string of refills. It happened the same this time.

Except this time, I’d been growing ever more resentful of that daily bitter pill, something to remember, something to lean on heavily, something to possibly poison me.

In an as-yet-to-be-seen brilliant realization, I decided to space out my tablets to make them last longer – ‘until I got a refill’. I think that was my rationalization. I went down to one for several days, half for several more, and then a quarter.

Also around this time, however, I began reading A Mind of Your Own: The Truth About Depression and How Women Can Heal Their Bodies to Reclaim Their Lives by Kelly Brogan. Now, if the rest of my follies here are not endorsements, this most certainly is not an endorsement of this book. It took me an awful long time to swallow – pun possibly intended – what Brogan had to say. After years of coming to terms – mostly – with taking antidepressants, here was an in-your-face account of how they were absolutely unhealthy and unnecessary. The whole first half of the book told me in no uncertain and sometimes holier-than-thou terms that I had been duped and made a terrible decision for and possibly irreparable damages to my body.

As I said, I started reading this book around the same time I was weaning. I did not read one ‘expert’s’ book and change my entire life regimen around it. As I was already tapering these ‘evil’ meds from my system, however, I was curious to see what other options could help me complete this process.

The second half of Brogan’s book is the best; the part where she gets to the heart of her mission: helping women live healthy and whole lives. I don’t know that her tone was less sanctimonious or I was better able to temper it with my own decisions of what would/would not work for me. Her plan focuses on a four-week implementation of diet, detoxing the home, meditation, exercise and sleep – a four-pronged approach to keeping the body and mind on track.

There is a lot in this book that resonates with me – some of which I already do, in fact. However, the four-pronged approach makes that panic rise in my chest almost as much as the rattle of fewer and fewer pills in the bottle.

When I started meds, feeling so like a failure for needing them (no projection, just my own neuroses), my therapist said, “this is the tenor of your life right now. Whether or not you were previously suffering with a mental illness, you were able to cope. Now, mothering several children, there are significant unalterable circumstances that make you unable to cope. Your medication can help you do so.”

Tenor still untenable.   Nothing new there. Well, actually there is a new kid.

So perfecting diet, sleep, mindfulness, exercise, clean living – all factors dependent on me, everyday, in my imperfect life is a little terrifying. Especially considering that failure, which is inevitable really, means a depressive state. No big.

Back to weaning: Brogan advises her 30 day detox before weaning to reset your system first. Ha. That may have helped. It also may have helped if I didn’t wean in the last week before my period as I prepped and embarked on a week-long trip with all four kids solo only to return, take two weeks to prep for school, and pack for one final vacation that ends on the eve of the new school year. Timing is everything.

There were times I wanted to scalp myself or my children that first week; times I wanted to scream louder than the baby refusing to just.go.to.sleep; scared that the crying jags meant my depression was coming back; irritable and snippy with my husband; and in a much lesser, yet slightly amusing development, America’s Got Talent’s package materials and any high note hit by a contestant made me well up.

Brogan warned me the withdrawal symptoms might present as a relapse of the original condition. Who’s to say I was struggling because I desperately needed the pill to supplement my body or give it a crutch?

I didn’t complete a long yoga session last week seeking clarity of mind in regards to all this. I was finally sick and scared enough at the skin and muscle getting looser around my frame and the big kids were shoe shopping with their grandparents. The amount of tension in my muscles shocked me. I sobbed at even the slightest release of it. Not the wet, slimy tears of a betrayal or breakdown, but the semi-silent, breath-catching heaves of chest with a few slick tears sliding down from the corner of eyes when I unsquinched them long enough to let them fall. I didn’t realize how much I’d been carrying until I tried to let it go.

And that was just the physical.

As trite as it may be, I had an epiphany on the yoga mat that morning. Even if I was taking medication to take care of my mental health, I wasn’t taking care of my self. I’d forgotten to force time for the things that keep my soul alive. Stretching, meditative thought and moments, reading, writing.

Did I need to stop meds to hit rock bottom hard enough to make the burning fire of my calves burn a hole in my consciousness? Perhaps not. Would I recommend cessation of meds as a path to clarity? No. But stopping meds to see where my mind and body were at this point in my life, nearly eight years out from the offending episode of postpartum, and then having such a visceral reaction to the stress in my life and body – that sent me an important message.

Regardless of what my decisions are in regard to lifestyle and care, self-care must be part of it. Placebo or perfect chemistry, a pill isn’t a miracle. All cylinders of my life, my soul must be firing.

Life will never be perfect. Even if I decide to follow Brogan’s regimen or another with or without meds, there will be times I fail. I can’t control circumstances outside my body, my sphere – hell, even in my sphere. (Did I mention I have four children?) But perhaps with the balance of self-care, I can temper the abberations. It’s a tall order, but right now, it’s keeping my mind centered on care – not maintenance or even just keeping the lid on.

That’s a pretty compelling read for me.

No More Smoke Screens

Last Wednesday, I had my six week follow-up appointment after the birth of my newest baby girl. The six weeks that had elapsed seemed like an eternity and yet instantaneous – like any spool of time surrounding a major life event does.

In the thick of summer vacation, I marched my older three girls into the office with me. Not ideal, but with the aid of electronic devices and some seats just outside the examination room door, I was able to avoid the embarrassment of an internal exam with the oldest two looking on and retching. I stationed my six year old’s chair full of crayons and coloring books at my head, the infant nestled in my chest.

Upon my arrival, the receptionist handed me the ubiquitous clipboard with the Edinburgh Postnatal Depression Scale. I knew it was coming. I was actually looking forward to it. I took it in hand almost giddily. There were a few reasons for this.

1. I didn’t need it.

Just a few days after the birth of my baby, a visiting nurse came to our house. Since it was a holiday weekend, we weren’t able to get an appointment with our pediatrician to check our breastfed baby’s weight and absence of jaundice so the hospital arranged for the home visit. While I expected the nurse to check the baby, she also looked after me, administering an EPDS. My score fell far below the range of danger for postpartum mood and anxiety disorders. Ever the overachiever, I joked with my husband that was a test I’d happily fail.

2.  But if I did, my answers to these questions would signal to my practitioners what sort of help I needed.

3.  If they gave the questionnaire to me, they gave it to all postpartum patients, which meant that all women had access to help if they were struggling.

epds

Jennifer Butler Basile

Still, when I handed the clipboard to the nurse in the examination room, and she followed up with questions like, ‘Have you ever thought of harming yourself or the baby?’, she asked them in a hushed voice. She apologized, saying she had to ask everyone.  Her tone insinuated it wasn’t me that was crazy, but it was her job to ask every mother in case one of them was. I knew part of her low volume was to spare my very aware six-year-old the world of suicide and psychosis, but I knew that wasn’t all of it. The apologies were born of shame, stigma; to separate me from those ‘tainted’ women, those we can’t speak of, for fear of ‘catching’ what they have.

But I was like them. I had what they had. I was just six years out.

Six years earlier, I would’ve been scared off by whispers like that. I wouldn’t have answered truthfully, if I’d thought it would smear me with that shame. Not because I didn’t need help. Not because I wasn’t having irrational thoughts. Not because I knew how to fix it myself. Because I felt that saying yes would be submitting to defeat.

I’m not trying to pin the shortcomings of postpartum care on this one nurse. If anything, this one nurse’s demeanor only shows just how difficult it is to discuss these matters. But the only reason I didn’t face these struggles this time is because someone asked the tough questions. Because a friend, a mother who had gone through the same struggles insisted I get help. And because once I healed, I knew how to prepare and preempt the struggles this time.

So wave the clipboard proudly. Answer the questions honestly. Ask for help loudly.

Mental health screenings should elucidate symptoms, not throw up smoke screens.

When does a perinatal mood disorder start?

Please read on to pinpoint when you or a woman close to you will begin to see signs of a perinatal mood and/or anxiety disorder.

  • When two lines appear on the pregnancy test
  • When pregnancy is unexpected
  • When pregnancy is finally achieved
  • When pregnancy is not achieved
  • When the mother loses the baby
  • When the mother chooses not to have the baby
  • When the adoption falls through
  • When the drastic changes in lifestyle that having a baby will induce begin to occur:
    • nausea
    • extreme exhaustion
    • no more wine with dinner or beer after a rough day
    • limited mobility
  • When the hormones at flux in the pregnant body affect thought processes
    • heightened anxiety at the amazing responsibility of growing and then caring for a baby
    • fear of the unknown or varied outcomes of gestation, labor, delivery, and aftercare
    • ambivalence over the new self the mother must create or become
    • mourning the loss of the former self
  • When medication regimens must be altered due to unknown effects of routine prescriptions on the fetus
  • When mother worries and feels guilty about continuing medication and its effects on fetus
  • When mother suffers a loss during pregnancy
    postpartum_pathways_logo

    postpartumpathways.com

    • death of a loved one
    • separation from partner
  • When the mother has no partner or support person
  • When a drastic transition occurs during pregnancy
    • moving homes and/or locations
    • away from support network
    • loss of own or partner’s employment
  • When labor and/or delivery does not go as planned or expected
  • Traumatic labor and/or delivery
    • physical trauma
    • emotional or psychological trauma
  • Complicated recovery from labor and/or delivery
    • infection
    • injury
  • When adoption is complete
  • Unexpected medical condition in infant
  • Loss of infant
  • Difficulty feeding infant
    • breastfeeding
    • colic
    • reflux
    • allergies
    • tongue tied
  • Extreme fatigue recovering from labor and caring for newborn around the clock
  • No routine
  • No schedule
  • No down time – constantly being needed, touched, suckled
  • Disappointment at real life not matching imagined version of motherhood
  • Hormones further thrown into flux after baby-growing part of process complete
  • Stress
  • Too much interference and advice from others
  • Not enough support and help from others
  • Isolation
  • Weaning child from breast (days, weeks, years after birth)
  • Being sole caregiver for a fragile, totally dependent being

After reading this list, it should be an incredibly simple and precise process to pinpoint exactly when you or a woman close to you will exhibit signs of a perinatal mood disorder. Diagnosing and treating it should be even simpler. And recovery? Piece of cake.


Hopefully it is quite obvious that the way I’ve chosen to frame this list is tongue in cheek. The individual items on the list are anything but. They are varied; some mutually exclusive and many overlapping – to show that there is no one road map for predicting, preventing, diagnosing, or treating perinatal mood disorders. Perinatal mood disorders come in many different forms with many different time lines. The one surefire tool to helping yourself or a woman close to you who is suffering is awareness. Awareness of the myriad possible causes and many symptoms that can present. And then reaching out.

To her. To your physician. Midwife. OB. GYN. Pediatrician. Counselor. Therapist. Psychologist. Psychiatrist. Friend. Mother. Partner. Neighbor.

With an illness this insidious, multi-faceted, and far-reaching, silence is not an option. The lives of our mothers, babies, and families depend upon it.

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