Point of Contact

I entered the world of mental health advocacy kicking and screaming.  Some days, quite literally.

Studying English?  Easy, I loved literature and writing.  Teaching?  A way to purvey that love to another generation while parlaying it into a paycheck.  Motherhood?  An extension of the love my husband and I shared.

Postpartum depression and anxiety?  A most unwelcome and unpleasant recalculation in my life’s journey.

For years, I looked for reasons.  I hadn’t recalibrated my compass, had I?  What had happened to lead to this catastrophic turn of events?

I am not the grand cosmic poomba of all things so I cannot answer those questions with any sort of certainty, but I do know that my struggles awakened a raw, yet steely inner strength I’d never had before.  They fostered an empathy of a whole new level for others’ suffering; for the mantle of motherhood and all its ‘come-withs’.

I had to polish some ragged rock I’d gotten caught up on and dragged along on my journey into at least a burnished gem.  Something positive had to come out of all that suffering.  And perhaps even prevent another woman from travelling the same path.

I started this blog as a way to tell my story, which very few knew.  I thought, with complete disclosure, I might open the dialogue for others.  At least become an ally in an all too commonly silent struggle.  Perhaps I didn’t tackle postpartum directly enough – for many of my discussions and observations were integrated with my life.  However, I still haven’t decided if that was/is a failure, for mental health struggles quickly become an intimate part of one’s life, touching all parts of it.  It also hinted at some version of depression/anxiety becoming part of my ‘new normal’.

And with my ‘new normal’ so different from my old one, I began to develop further plans for burnishing rocks into gems.

I knew what I wanted to do, but with no clinical experience, I had limitations.  I could not mention the word ‘therapeutic’ in any official capacity.  I was petrified that if the programs I had in mind reached the end of my personal experience and empathy, that I wouldn’t be able to help someone in crisis.  

I embarked on a series of webinars offered by Postpartum Support International.  The Social Support Training series, one session every other week, stretched from January to June of last year.  While many of the participants were clinicians in the field of maternal mental health, the course was user-friendly and aimed at individuals interested in starting and supporting groups of mothers in various presentations of mental health.

The Social Support Training was the perfect first step toward a solution.  It offered a wealth of information – statistical and anecdotal, researched and proven – paired with the assurance that social support people are not meant to be clinicians.  They are meant to offer a safe place for mothers to gather and vent, ask questions and talk, discover resources and camaraderie, and just be.

I finished the series a few weeks before I headed to Boston for Postpartum Progress‘ first annual Warrior Mom Conference, the first ever maternal mental health conference for survivors of PMADs.  With my new-found knowledge and training, I looked forward to building on that momentum and connecting with other moms doing the same.  While I did that, I also found parts of me that hadn’t fully healed.  I realized I still had my own work to do and how very complex maternal mental illnesses are.

That fall, my PMAD baby started full-day kindergarten and, though scared as hell, I began formulating plans to kick my ideas into high gear.  I applied for a scholarship offered by Postpartum Progress and the National Council for Behavioral Health to be trained in Mental Health First Aid, which I was awarded a few weeks after discovering I was pregnant with my fourth child.  I faltered, wondering how I would enact my plans with a newborn baby.  But then, they were never my plans anyway.  And now I would have the full-circle experience informing my advocacy.  Up until now, I’d only ever experienced the postpartum piece of mental health; now I could speak to both pre- and postnatal.

I spent two days in New London, Connecticut with two fabulous humans from Child & Family Agency of Southeastern CT learning how to assess and support a person’s mental health status.  Again, the trainers stressed that we were not expected to diagnosis the individuals we come into contact with, but to assess their situation and determine whether they need additional help.  We then must help them feel comfortable and safe until such professional help is acquired.  The trainers helped me gain even more practical ways to help those in need as a civilian, a concerned individual, an advocate.

As I sat in that auditorium, surrounded by empathetic professionals and persons, I flashed back to an article I’d read a week and a half earlier.  “The Community Maternal Mental Health Professional” on The Burnout Cafe (click image for link) discusses the gap between women who need help and the services available to them.  While the central point of contact in this graphic from the article lists a woman’s professional caregivers, and a woman certainly does see these people quite frequently both before and after the baby is born, I would argue another layer of contact needs to be added.  If practitioners aren’t well-informed or comfortable dealing with maternal mental health issues, the assessments, diagnoses, and referrals needed will not occur.  Having been down that dark hole myself, I am well-versed in those discussions.  I can help normalize the feelings a woman may be experiencing, yet not want to admit for fear of retribution to her or her child.  I can point her in the direction of practitioners specializing in the exact type of care she so desperately needs.

ppd1

“The Community Maternal Mental Health Professional” as point of contact (via The Burnout Cafe)

With my personal experiences and new-found knowledge via recent trainings, I am a point of contact for mothers.  

My plans may morph and grow as my own life and family does, but the end goal is the same:

Helping Mothers Get the Help They Need.

An Argument for Self-Care

Isn’t it amazing that we only engage in self-care when we have to, when it’s absolutely necessary.  When we’ve reached such critical mass we’re about to blow apart.

That’s usually when I get a humdinger of a sinus infection.  Agony.  Aches and pains.  Congestion.  Fever,  Chills.  As horrible as it is, it forces me down for the count.  To the couch.  To bed early.  To forcing fluids and taking it easy.  Would I think to dial things down when the first symptoms show up?  Heck, no.  Push on through.

This morning I happily scrolled through the WordPress Reader, checking in on some of my favorite blogs.  Catching up.  Touching base.  Doing what bloggers do.  When the hormones of early pregnancy unleashed a horrible churning in my stomach.  I tried to ignore it, but finally had to shove a snack down my gullet before breakfast came up.  Self-care had become an interruption, an annoyance.

Arriving home from my brisk walk to the bus stop, I grabbed a glass of water.  One would think the neutral taste would be good for someone trying to avoid the aforementioned ‘upping-of-the-gullet’.  Un-unh.  It just reminded me that hardly anything tastes good anymore – and that my long-overdue to-do of buying lemons or limes to slice up and put in my water may actually help.  Why should it take utter disgust to push me to finally make this small treat a reality?

What is it about humans – and women in particular – that makes self-care always an afterthought?  Guilt?  A Puritan ethic?  Not wanting to be self-centered, self-absorbed, selfish?  Lack of time?  Money?

I’m sure it’s all of the above.  But I’d venture a guess that it’s most likely a feeling that we’re not worth it.  We don’t deserve a reward – no matter how small.  Especially when there are others in the world who have so little; who suffer so much.

That last point makes an especially compelling argument.  However, there’s a reason flight attendants tell us to put our oxygen masks on first before assisting those next to us.  Mothers, care givers, partners, aid workers, samaritans, humans – none of us are good to those who need us if we’re laid out, dog tired, dead sick.  We can enact great waves of tenderness and care in the world if we start in our own little atmosphere.

More to the Story

I spent an hour and a half sitting on the basement floor of my local library the other morning.  I’d found the general Dewey decimal neighborhood I’d wanted and set about meeting the locals.

One good thing about living in a small town on a frigid morning and rushing the library doors as soon as they open is that you have nearly the whole place to yourself.  I was the one who flipped on the banks of fluorescent lights as I descended the stairs.  I sipped from my travel mug of tea as I decided which books would aid me in my research journey.  I read nearly an entire chapter of one that I eventually set back on the shelf – one I’ll certainly return to, but didn’t match the goals of today’s project.

Today’s project is preventing postpartum depression.

Though I checked out nine books, welcoming jokes from the clerks at the front desk as to what kind of wagon I’d need to transport them to the car, none is about postpartum depression.  One is about ‘regular old’ depression.  Others have a few pages, maybe a section specifically about postpartum.  But not one of the towering stack I selected gave an in-depth discussion of postpartum depression.

In the online catalog of our state’s inter-library system, there were some, but still not that many.  And none that looked, on first glance, like they offered the kind of practical information and solace that a woman in the throes of postpartum would want or need.  I know.  It doesn’t take much to put myself back to that hopeless place I experienced myself.

I ended up checking out mostly childbirth preparation books or ‘how-to’ guides to pregnancy, which made my children, upon seeing Mommy read a book with a woman’s round belly on the front, very suspicious.  Two of my girls put in orders for a baby brother.  I asked my eldest if she’d want me to be pregnant, to which she said, no, but if you were I’d want a brother.  Only now do I see the irony in their thinking I needed to read another book about pregnancy after three times around the mountain.

Been there, done that.

But this time, I was trying to read these pregnancy preparation books with new eyes.  Having been through it and having had the experiences I did, what would help me do it differently?  Or more importantly, what support systems would have kept me from plunging into the depths of despair?  And how can I apply those to helping other women?

I was surprised to enjoy Ina May’s Guide to Childbirth (Ina May Gaskin) as much as I did.  I figured that title would be one I skimmed to find anecdotes or info pertaining to postpartum, but I am thoroughly enjoying delving into the personal accounts of unhurried, gradual childbirths.  I am rediscovering the empowering parts of my own labors and deliveries – the first two for their strengths and victories, the last for my eventual triumph over seemingly insurmountable odds.  With that last one as my capstone, I’d forgotten the positive parts of pregnancy and childbirth.  Remembering that gives me something to help women to which to aspire.

The disparity between parts of my own experience and beautiful birth stories brings into sharp focus those areas that can serve as triggers, flashpoints for distress and disorder.  And by beautiful, I do not mean perfect or idyllic.  As Anne Cushman says in The Mindful Way Through Pregnancy, “labor and delivery are wild and messy and animal and angry and bloody and painful.  The transcendent act of giving birth is made up of the earthiest of elements: bodily fluids, a hospital gown stained with blood and excrement, the bruises left on your partner’s arm by the agonized grip of your fingers.” (Piver 16)  All this is normal, to be expected.  That’s not what we need to worry about.  We (women, mothers, humans, physicians, therapists, ob/gyns, midwives) need to help women recognize when there is cause to worry.

So maybe sitting on the floor of my local library and freaking my kids out with pictures of the ocarina found in one of my books will help me figure out how exactly to do that.  As with anything, it’s all about dialogue.  Whether that dialogue comes through books at the library, blog posts, or conversations with doctors, expectant and newborn mothers need to know there’s more to the story.

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