31 October 2011

Why I'm seeing red

I’ve tried and tried so many times to start this blog off in a profound way that sounds educated and well thought out. Try as I may, I just can’t manage to do it. Why? Because every time, I end up seeing red and all my sage wisdom goes right out the window. I like to think that while I’m passionate about what I have to say with regards to PPMD, I’m usually pretty level-headed. But let me tell you, something happened this past week that made me so angry that I’m having a hard time staying cool, calm, and collected, much less putting my thoughts together in a manner that is readable without going “Huh?” or “Whoa, that’s a new cuss word” or maybe some combination of both.

I’m all for counseling. I’m all for finding and promoting alternative methods of dealing with PostPartum Depression. I love to read about the things other people do to help themselves or others. I love it when I see someone who has come up with a new and innovative way to provide education and support to people who are battling or have battled PPMD. People like Lauren Hale and #PPDChat, Katherine Stone at PostPartum Progress, and Yael Saar and her PPD SpeakEasy Phone Chats. Because, well, medication and therapy are all well and good, and are highly beneficial to many many people struggling with PPMD, but sometimes you need the support of a community that has been there, is there right now. I think it’s well beyond awesome that people come up with such fantastic ways to pull together and find a sense of community to be able to better support each other, educate others, and combat the stigma that comes with mental health in general and PPMD specifically

What I do not love is people who talk out of their ass. People who tout themselves as having a way to help when they don’t. People who throw something together without doing the research to know what it is they’re dealing with. And when you charge money for it? Ten times worse. How can you help someone when you don’t even know what it is they’re dealing with? Last week, I ran across one such person and I have been angry ever since. The offending person: Sheryl Paul of Conscious-Transitions.com. From the about me portion of her website:
Sheryl Paul, M.A., pioneered the field of bridal counseling in 1998. She has since counseled thousands of people worldwide through her private practice, her bestselling books, “The Conscious Bride” and “The Conscious Bride’s Wedding Planner,” and her websites. She’s regarded as the international expert on the wedding transition and has appeared several times on “The Oprah Winfrey Show”, as well as on “Good Morning America” and other top television, radio, and newspapers around the globe. Phone and Skype sessions available internationally.
Awesome! I’m sure she’s helped a lot of people. Getting married is a HUGE transition and if talking to a Bridal Counselor helps, go for it! It sounds like she’s done a lot of research and really knows her stuff… when it comes to “Bridal Counseling”. The problem is, she’s set up a new program called “Birthing a new mother” and from reading what she has to say, it’s evident that she is NOT well educated in PPD and really doesn’t know how it works. Why, you may wonder? On her websites, she says (among other things):
"This completely unique program is the only one available that will help you manage your fertility anxiety, calm your pregnancy fears, and prevent postpartum depression. With the bonuses and the support, it’s worth over $1000, but I don’t want price to stand in the way of you having this information, so I’m offering it to you today for only $197."
How generous... She also says:
"Would you enter any new job without preparing? You studied before taking your driver’s license test. You may have taken a premarital class. But we offer nothing for impending mothers and fathers on how to prepare for the biggest transition and most important job of their life!
Until now… In this program I will tell you exactly how to prepare. I will gather a group of experts around you and together we will guide you through the inner work that needs to be done and the questions that need to be asked so that you are ready to absorb the shock of your new life and experience the joy and ease of motherhood that is your birthright. And if you follow this roadmap – which isn’t hard to do and takes just 10-15 minutes a day – you will prevent postpartum depression! You will feel empowered as a new mother! And you will be giving your baby the best possible beginning for emotional health.”
This hot mess first came to my attention when PostPartum Progress (on their Facebook page) posted a link to a blog Sheryl Paul had written on mariashriver.com. The blog was pulled after 48 hours due to a great deal of outcry (rightly so) but not before I had a chance to save it to my website. Allow me to post the full text of this lovely little gem so you can see what it is that originally sparked my indignation.
Three Tips for Navigating New MotherhoodBy Sheryl PaulThe dominant message in our culture during the preconception through early motherhood stages is that any signs of anxiety or depression indicate that something is “wrong” and needs to be fixed. This message sets women up for unrealistic expectations, which lay the foundation that entrench normal anxiety and depression into clinical levels. 
What does it mean to have “normal” anxiety or depression during pregnancy or the postpartum stage? It means that every life change, no matter how positive and life-affirming, is accompanied by loss, fear, and doubt. 
Let’s break this down: You’re pregnant. You’ve wanted to be pregnant since you were four years old. But as soon as the pregnancy test revealed a positive result, you heard a door slam shut and felt a pang of loss. You pushed it aside because you thought that’s not what you’re supposed to be feeling at that moment. 
You feel fear arise during your first trimester. You’re scared you’re going to lose your baby. You feel scared again during your third trimester and wonder, “What if I won’t be a good mother?” Because you don’t understand how vitally important it is to acknowledge and express these losses and fears, you push them aside and instead focus on buying the right car seat. But the feelings don’t go away. Instead they mutate into anxiety, and your doctor suggests an anti-anxiety medication. 
Or you’ve just had your baby and everyone is healthy and thriving. While you’re deeply in love with your magical child, you also feel a profound sense of loss and longing for the familiarity of your old lifestyle and identity. You prepared for childbirth and you took classes on breastfeeding and baby care, but no one prepared you for the normal and necessary sense of loss that most women feel on the other side of the birth threshold. 
You wonder what’s wrong with you. You wonder if this means that you’re not cut out to be a mother. Nothing could be further from the truth, but because you’re not educated about what’s normal, you form false assumptions, which then prevent you from grieving the losses and allowing them to move through you to completion. Thus begins the slippery slope to postpartum depression. 
Here’s the good news: Pregnancy anxiety and postpartum depression are avoidable and preventable! They both result from normal thoughts and feelings that are pushed underground because we don’t realize that they’re normal, where they then grow into an unmanageable state. 
Here are three tips that I've learned for having an emotionally healthy pregnancy and avoiding postpartum depression:1. Educate yourself with the truth about what’s normal to feel during pregnancy and early motherhood. Most pregnancy guides pay scant attention to what’s happening emotionally for women and instead focus on the growth of the baby and your body. While this is important information, it won’t facilitate the birth of an emotionally healthy new mother. Here’s what you need to know in a nutshell: it’s normal to feel fear, grief, loss, confusion, ambivalence, uncertainty, terror, and doubt during every stage of this transition (as well as joy and excitement, of course!).2. Find a safe and compassionate place to express the difficult feelings. This may be with your partner, a friend, a therapist, or in the privacy of your journal. Your feelings are real and need to move out of your body. Most people hold the erroneous belief that so-called “negative” feelings will hurt your growing or newborn baby. The truth is that when you try to stifle these feelings, they’re amplified and that’s when they can harm your little one. So let them out!3. Find the courage to explore the hidden thoughts that are lurking in your pregnant or new mom mind. Just as the feelings need a place to land, the thoughts also need to be explored and fleshed out. This may be the first time in your life that you learn to work with your anxious or fear-based thoughts effectively, and there is no practice more worthy of your time! Whatever you learn now will serve you for the rest of your life as a mom, and as a human being. 
Taking these three simple steps can be the deciding factor that determines whether your normal fear and loss descend into anxiety and depression or transform into serenity and an empowered transition into motherhood.  
 
Sheryl Paul, M.A., is regarded as an international expert in transitions. Since 1998, she has counseled thousands of people worldwide through life transitions via her private practice, her bestselling books, her website, http://conscious-transitions.com, and her home study program, Birthing a New Mother: A Roadmap from Preconception through the First Year to Calm Your Anxiety, Fortify Your Marriage, and Prevent Postpartum Depression, which can be found at http://birthinganewmother.com. She lives in Boulder, Colorado with her husband and two sons."
I read that and I got so incredibly angry. I get angry again every time I read it, every time I go to her website to pull the quotes I wanted to include in this blog. I just... no. Argh! It's bad enough to feel invalidated, but when the thoughts, feelings, and experiences being invalidated are those of a traumatic time/event? Fifty times worse. I can't even put into words exactly how this all makes me feel. It's pretty rare that that happens, too, I don't usually have difficulty expressing my feelings and emotions. But this? This reduces me to primal instincts of anger, frustration, and generally wanting to throw things at the wall. I think this picture best expresses how this whole thing makes me feel.


This picture was taken when we were getting Elizabeth ready to go home from the hospital after she was born. She was madder than a wet hen that we had the audacity to change her diaper and *gasp* make her wear CLOTHES! She screamed, hollered, scrunched up, kicked, waved her adorable little fists, cried real tears, and generally made a ruckus. She was very angry. That's about how I feel.

Moving on to discussion of what Ms. Paul posted, there are multiple problems with her logic. Let's just look at the ones that jumped out most immediately to me.

1. Not everyone who experiences PPD feels that sense of “loss” and “grief”. Not everyone deals with all that stuff she outlined during pregnancy. One of the things about PPD is that there are no boxes that it fits into. Everyone struggling with PPD has their own story and to try to force us all into the same mold is insulting. Dealing with PPD doesn’t take away individuality, the experiences are as vast and myriad as the stars in the night sky. Some women will experience every single symptom listed in any book, some may only experience one symptom. Some may not sleep at all, some may sleep all the time. Some may not feel any emotions, may feel totally numb, and some may feel so many emotions they go into overload. I personally had a combination of the two. I had no idea it was possible to feel so many emotions and yet, at the same time, feel so emotionless. I don’t recall, though, that I felt a sense of loss or grief. Sad? Yes. Grief? Not so much.

2. Doctors don’t usually prescribe anxiety medication at the drop of a hat like she describes and if one does, they need to be reported for their irresponsibility. My experience has been that it’s actually difficult to get the help, diagnosis, and medication that you need.

3. “Exploring your hidden thoughts” can be DANGEROUS. If I had “explored my hidden thoughts” instead of seeking help, I would be dead right now. Not joking. I’d have a headstone at a cemetery instead of Facebook, Twitter, and a blog. When you’re depressed and having thoughts of harming yourself and/or others, those thoughts should ONLY be explored under he guidance and supervision of a licensed medical/mental health professional.

4. PostPartum Depression is not the result of faulty thought processes, lack of studying, or not taking a 200.00 course from a Bridal Counselor. PostPartum Depression is a very real mental health illness that is caused by physical factors. Hormone imbalances, thyroid problems, etc. A medical professional can explain it better than I. But I do know that it’s not something you can avoid just by changing how you think or reading a book or watching a video.

Sheryl Paul is essentially saying that those of us who have or are dealing with this are doing so out of some failure of our own. The message she is sending out is that it’s our fault. Oh, but good news, you can fix it by paying money to take her course! She is invalidating the feelings and experiences of all of us who have, are, or will deal with PPD. She is saying that she knows better than a doctor. She is setting us back when we have worked so hard to educate ourselves and others. She is furthering the stigma that we work so hard every day to combat. Her claims are audacious, faulty, irresponsible, and infuriating. She has the potential to cause a lot of harm if women see this and decide not to seek medical treatment that they need, or decide to explore their thoughts and end up killing themselves.

I don’t really know what else to say. I guess what it really boils down to is this: If you want to help people who are struggling with PPMD, do some research first. Make sure you know what you’re talking about before you start talking about it. If you are looking into a program like this that claims to help but is not affiliated with medical professionals, talk to a doctor first. The best way that I can think of to help is to educate yourself and to support someone you know who is dealing with PPMD. Make sure that anyone you know who is pregnant (and their family) is aware of the signs, symptoms, and risk factors for PostPartum Mood Disorders. Keep an eye on them and if you start to be concerned, talk to them. If they’re unwilling to listen, MAKE them get help. Believe me, it’s on harder the longer you wait. Be willing to speak up and speak out when you hear people say ignorant things like “PPD can be prevented by changing how you think” or “Just pray more” or “Are you sure you’re right with God?”. Know what some good resources are about PPMD so that when you hear about things like Sheryl Paul's program, you can say “You know, why don’t you check into this instead?”. Educate yourself, educate others. Love yourself. Love others enough to tell them when you see them struggling and they don’t realize it or don’t want to admit it.

I'm not sure how to close out this particular post other than to say "Thank you" for reading through my rantings. If you're looking for resources that are more helpful and educational than Sheryl Paul, the blogs I have listed here are a GREAT place to start. They have a ton of good information and links. Maybe some good can come from this whole fiasco. I only pray that disastrous bad does NOT come about.

28 October 2011

Foto Friday: Daddy and his girls


I took this picture a while back at a park. Elizabeth is such a little Daddy's Girl and he is totally and completely wrapped around every single one of her fingers and toes. He actually found her in her room one day telling her stuffed animals "Daddy Izza-bear's finger" and making the "wrapped around your finger" hand motion. Oh how that made me laugh, especially at the look of chagrin on his face that she so totally and completely has his number.



I love that I have a husband who is so actively involved with parenting our children. He has no problem with changing a diaper, doing a bath, or coloring on the sidewalk. He wears Miriam in the Moby Wrap if she's cranky and that's the only way to console her. He loves to go to the playground and play with Elizabeth (Miriam is still a little small to play on the equipment). There are so many parents who are not so involved with their kids, and men who think that all that stuff is "the woman's job", and he is not one of them.


L - R: Eric with Elizabeth, April 2009; Eric with Miriam, April 2011
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26 October 2011

The night I wanted to kill myself.

It was the middle of the night when I drove up and parked at the Emergency Room at Wilford Hall Medical Center on Lackland AFB. It was dark outside, and humid. I parked the car, turned it off, and just sat there for a moment, staring at the doors. "I don't have to do this. I could just turn around and go back home.". But no, I knew that I had to do it. I got out of the car and slowly walked inside. I know it only took a minute but each step seemed to take an eternity. I went inside and stepped up to the desk, sat down and produced my military dependent id card, and started filling out the paperwork that everyone has to sign when they go to the ER at Wilford Hall. The person on the other side of the desk asked something along the lines of "What are you here for today?". I took a deep breath, hesitated, and said "I'm 3 months postpartum and I want to hurt myself.". The hardest sentence I'd ever spoken. 1 year earlier, I'd been sure that nothing would ever be harder to say than to tell my parents that my then boyfriend (now husband) and I were pregnant, but I had found a phrase that was more difficult to utter.

I don't really remember too much after that. I remember that the chaplain was there with me, having woken up in the middle of the night to meet me at the ER so that I wouldn't have to do it alone. I remember that they took me straight to the back instead of leaving me in the waiting room. I had my vitals taken and gave my medical history and then I was told that I was going to be given to the Charge Nurse. I don't remember her name, just that she was an officer in the US Air Force and had blonde hair and a very kind face and compassionate tone. She embodied what a nurse should be. She walked me back to a room right outside of one of the desks so that they could have eyes on me at all times. I was given a gown to put on. The Nurse asked me more questions about what was going on. I was crying. I told her my story. I told her that I felt like such a horrible mom and wife for abandoning my husband and baby daughter, that I felt so ashamed, that I was worried that someone would come to take my daughter away, that I was concerned that my husband would lose his security clearance because of me, that I was scared. The truth was, I wasn't scared. I was beyond terrified. I was terrified of how I felt, of what I might do to myself or my baby, and terrified that this would never end.

She was so kind to me. She told me that she had dealt with PPD and that there was nothing wrong with me that couldn't get better and that I hadn't done anything wrong but that I had done something very right by coming to the ER. She told me "I had PPD really bad and now look at me, I'm an officer in the Air Force and a nurse.". That was slightly reassuring. She told me "You will get through this, it won't last forever." and then wasn't offended that that was hard for me to believe.

I was given a gown to change into and my clothes and shoes were taken away, they made sure that there was nothing in the room that I could hurt myself with. They drew blood and ran an EKG on me, explaining that it was to make sure that there wasn't an underlying medical problem causing this. Everything came back normal and a doctor came in and talked to me. I said that yes, I would consent to being hospitalized and off he went to find out which facility out in town had room for me since neither of the military hospitals in town accepted dependents on a Psych hold, only Active Duty. Eventually, I was told that I was going to go to Laurel Ridge. The Chaplain prayed with me and eventually went home while I tried to get some sleep. Really I just laid there in the dark feeling so upset and ashamed, so weak, broken, feeling like a failure, waiting for the ambulance to come pick me up to transfer me to Laurel Ridge. That wouldn't happen until about 8:00am.

It was the longest night of my life. I laid there thinking that it was one of the worst nights of my life and that nothing would ever be the same again, that nothing would ever be better. I felt like I had let my family down. I can't really put into words properly all the emotions that were running through me, I can't depict how it felt. I was lying in a room by myself in the dark where I had to have the door open at all times, I had no privacy. I had to let them know if I needed to use the restroom. I felt dirty, ashamed, broken. It was one of the most humbling experiences I have ever been through. I can't even remember every detail, there's so much about the months leading up to that night, and that night itself, that are a hazy blur. I was there and I hated myself for it. I cried the entire night and a very good portion of the next day. If I finally settled down, someone could just glance in my direction and I would start back up again. I felt every emotion I possibly could and yet I felt nothing. I second guessed whether I should have gone. I was sure that I would regret it in the morning. I kept waiting for someone to ask me where my daughter was so they could take her away. I hated myself, what I had become, what I had almost done, and what I had done. Anyone who thinks that it's easy to admit to having suicidal ideations, PostPartum Depression, needing help, is mistaken. I literally felt like I was in a deep, black hole without any windows and without any sunlight even coming in from above. I wasn't sure I would survive.

I did.

I don't tell you this story to scare you if you need to seek help. I tell this story because I want people to know that I have been there. If you're there now, you will make it through. There is hope, there is help. If you know someone who is in this place right now, don't judge them. They're already doing a good enough job of that on their own. They need your help to be strong.

I tell this story to tell the world that not only did I survive, I came out a stronger and better person. I am a fighter. I am a warrior. I am a survivor. I am proud of it.

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25 October 2011

Become part of the solution.

"PostPartum Depression is all in your head."
"PostPartum Depression isn't actually a health matter."
"PostPartum Depression is a thought process"
"You don't actually need medication to deal with PPD."
"It's just a mood."

These are all things that people say. Some of them have been said to and/or about me, some of them to/about my friends, some of them to/about other people. These statements represent actual thought processes of real people who are alive today. Such mindsets are the result of a lack of education and understanding. I do not say this to insult anyone, but this is the result of ignorance on the part of those who say such things.

To those who hold such scorn, indifference, and disbelief, I offer this: do you believe yourself to be smarter and better educated in such matters than medical professionals? Did you know that there is research that proves that it is more than just a "way of thinking" or a "bad mood"? Allow me to present some information that states otherwise.

"What causes depression? What about postpartum depression?There is no single cause. Rather, depression likely results from a combination of factors:
  • Depression is a mental illness
  • that tends to run in families. Women with a family history of depression are more likely to have depression.
  • Changes in brain chemistry or structure are believed to play a big role in depression.
  • Stressful life events, such as death of a loved one, caring for an aging family member, abuse, and poverty, can trigger depression.
  • Hormonal factors unique to women may contribute to depression in some women. We know that hormones directly affect the brain chemistry that controls emotions and mood.
  • We also know that women are at greater risk of depression at certain times in their lives, such as puberty, during and after pregnancy, and during perimenopause. Some women also have depressive symptoms right before their period.
Depression after childbirth is called postpartum depression. Hormonal changes may trigger symptoms of postpartum depression. When you are pregnant, levels of the female hormones estrogen (ESS-truh-jen) and progesterone (proh-JESS-tur-ohn) increase greatly. In the first 24 hours after childbirth, hormone levels quickly return to normal. Researchers think the big change in hormone levels may lead to depression. This is much like the way smaller hormone changes can affect a woman's moods before she gets her period.
Levels of thyroid hormones may also drop after giving birth. The thyroid is a small gland in the neck that helps regulate how your body uses and stores energy from food. Low levels of thyroid hormones can cause symptoms of depression. A simple blood test can tell if this condition is causing your symptoms. If so, your doctor can prescribe thyroid medicine."
womenshealth.gov


womenshealth.gov is a project of the U.S. Department of Health and Human Services Office on Women's Health.

Another study at http://www.studentpulse.com/articles/558/case-study-examining-postpartum-depression-symptoms-and-treatment has this to say:
“Multiple investigations into the etiology of postpartum depression have not reached a consensus” (Leopold & Zoschnick, 1995), hence the inclusion of it in the DSM-IV as separate category diagnostically different from Major Depression. Biological theories suggest that deregulation of the neurotransmitters serotonin and norepinephrine, epinephrine, and dopamine serve as the origin of PPD. Other biological factors included prolactin levels are rise throughout pregnancy and fall during delivery, and have been considered to be a factor in the onset of PPD. O’Hara, Schlechte, Lewis, & Varner (1991) presented conflicted results showing higher levels of prolactin on postpartum days 2, 4, and 6, while lower levels in by week 6 postpartum. Other hormonal factors such as estrogen levels which decrease significantly in the postpartum period and regulate mood, memory, and cognition and brain function has been thought to play a major role in the onset of PPD. “The specific effects are best characterized in the dopamine system where estrogen increases dopamine turnover through the regulation of tyrosine hydroxylase, degradative enzymes, and turnover dopaminergic receptors” (Leopold & Zoschnick, 1995, n.p.).
Does all of this sound like a "bad mood"? If it were just a mood, would medical treatment help? If you are someone who has believed and said things such as "It's just a bad mood", I give you this challenge: Do your own research. Hit up Google, Bing, or any other search engine with phrases such as "Postpartum depression cause" and "postpartum depression study". What I've copied and pasted here is just a scratch on the surface. There is a wealth of information out there. Educate yourself and then educate others. It is through education and public awareness that PostPartum Depression and other PostPartum Mood Disorders will become better understood. Educate yourself and become part of the solution.

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21 October 2011

Foto Friday: My love story.

Welcome to my newest brainstorm: Foto Friday. Each Friday, I'll focus on a photo of something that represents my life, something I'm thankful for, something that makes me think, or even just something that I'm thankful for. It might necessarily have to do with PPD or mental/emotional health but I think that in general it's important to focus on the positives in life. And so, without further ado (did I spell that right?), I present my first Foto Friday.

October 2008

This week, Eric and I celebrated our third wedding anniversary. It's been a crazy three years. He's had three ankle surgeries and spent more time in a cast than out of one (or so it feels like to me). I gave birth twice in a little under two years, had two hospitalizations for PostPartum Depression, we had a wreck that gave me whiplash and a concussion and was the cause of two of his ankle surgeries, we bought a house, moved into it, moved out and moved across the country into a new house, obtained new pets, dealt with a crazy ex-wife (thank goodness they don't have kids, she was frustrating enough over furniture) and a million other things that I won't get into. It hasn't been easy but if I had to go through what I have, I can't think of anyone I would rather have gone through it with. Eric was by my side through the whole PPD ordeal and through both pregnancies and childbirths, and has been so supportive and caring.

With the love of my life


We originally met online. A mutual friend of ours knew we had both gone through nasty breakups and decided that we would be perfect for each other. She told us both about each other but neither of us were really interested in a relationship at the time. Eventually though, we talked online and got to be friends. I couldn't tell you when it turned into something more; all I know is that after he got back from his deployment, I went up to spend a weekend in Kansas City to meet him in person; it was a wonderful weekend. I cried when I got on the plane to go back home.

Our first "real" date

I couldn't tell you when I fell in love with him, all I know is that it happened fast and I fell hard. After that weekend, I made quite a few trips up to Kansas to visit him, and he drove down to Texas to visit me when he could. With him being in the Army, it was a lot easier for me to go up there though. And I didn't mind at all, I had friends up there and I liked getting to see them. 

Kansas, 2008

I spent a lot of time on I-35 that summer. I loved visiting him and we had a lot of fun. One weekend we had a little too much fun, which I realized one shocking morning in August. Yes, we had a little bun in the oven. Once we got past the shock, told our parents, and decided to get married, things moved pretty fast. We ended up choosing a date in October because that was when his mom could come out to visit us. He had just gotten orders to transfer to San Antonio so we had about 6 weeks to juggle my horrible morning sickness, both of our jobs (I ended up quitting because of my morning sickness), his move, planning a wedding, and OB appointments.

Yes, that is my child waving and looking like a Martian.

Finally, October arrived and it was the Big Day. Thankfully, my nausea had finally let up for the most part (as long as I ate every hour or so) and since I was just hitting 13 weeks, my dress still fit. We had beautiful weather (important since it was an outdoors wedding) and walked down the aisle to say "I do" surrounded by family and friends. It was one of the best days of my life.

With this ring, I thee wed.

In a fairy tale, this is where there would be a "And they lived happily ever after". I wish I could write that, but this is not a fairy tale and life is not always happy, but it is life and I am more thankful than I can put into words to share it with the love of my life. He is my soul mate, my best friend, my confidante, my lover, my other half, my better half. He completes me, I complete him, and we both complete each other's sentences. I look forwards to living the rest of my life with him, for however long God gives us together on this earth.

Here's to many more
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20 October 2011

What's your "stuffed bunny"?

Growing up, I had a favorite stuffed animal: a bunny named Bugsy. I stole acquired Bugsy from my Auntie when I was a baby. We were visiting her house and I fell in love with Bugsy. When I ended up with an ear infection by the time we were getting ready to drive back to Georgia from North Carolina, she didn't have the heart to take Bugsy away from me and my Mom dreaded the thought of even trying. For years, Bugsy was my constant companion. In fact, I was still sleeping with Bugsy in my early twenties. I loved that once stuffed rabbit. It was a velveteen rabbit story in real life.

Now, Elizabeth, my two year old, has her own best friend and constant companion. Care to guess what type of stuffed animal it is? You guessed it. Blue Bunny goes everywhere with her, and I do mean everywhere. He's even gone into the bathtub with her on occasion when she moved a little too fast for me. She followed in my footsteps in her acquisition of Blue Bunny. Eric and I had her out with us at the BX (Base Exchange, sort of a military version of Super Target or Wal-Mart Supercenter) before Easter in 2010. Eric saw a display of stuffed bunnies and showed her one to see if she would like it if it appeared in her Easter basket. Blue Bunny did not appear in her Easter basket, due to the fact that she wouldn't even let go long enough for the cashier to scan it on the belt, the cashier had to come around to scan it. I think I can literally count on one hand the number of times she's gone somewhere with Blue Bunny since.

Blue Bunny even goes in our family pictures.

The other night at Target, Blue Bunny gave us a scare. As we neared the end of our shopping list, she asked "Blue Bunny?". I said "Yes, you have Blue B.... WHERE'S BLUE BUNNY?!?". Blue Bunny was no longer in the cart. There ensued a frantic dash around the store, out to the car, and back inside, looking for Blue Bunny. All the while I was praying "Dear God, please please please let us find Blue Bunny". I could feel my pulse hammering, my heart was both in my stomach and my throat simultaneously, and I'm sure my blood pressure was somewhere around 400/250. The thought of life without Blue Bunny was... well... let's just say that if I had had access to Ativan I would most certainly have taken it. I foresaw a very very long night stretching ahead of me. Fortunately, we found Blue Bunny in a display of plastic pumpkin trick or treat baskets. The crisis was averted and I think my Blood Pressure is finally starting to return to the neighborhood of normal. Blue Bunny will most certainly be wearing a "Contact if found" tag on his harness as soon as I can get a tag with the pertinent info made.


 

Blue Bunny, then and now.

The whole experience got me thinking, though. Elizabeth has a favorite stuffed animal, as did I, as do many children. If not a stuffed animal then a blanket or  favorite pillow or something of the sort. a "lovey". We look at it and go "Oh how cute". I wonder though, how many of us adults have something of the sort and just don't realize it? Something or someone that is our rock in all circumstances. I suspect that we all do, regardless of whether we realize it or not. I think that for those of us dealing with PPD or something of the sort, it may be more important than we know. To have that thing or person we can count on no matter what. When I was dealing with my PPD after I had Elizabeth, mine was my cell phone. If I realized that I had forgotten my cell phone at home, I freaked out in a major way. And the time I realized I had forgotten, in my haze of, well, everything, to pay the Time Warner and AT&T bills, and didn't realize it until the cable/landline/internet (yay for bundles) and my cell phone were cut off simultaneously? I was in tears, hyperventilating, dizzy, ready to black out. The thought of being without access to the outside world terrified me. That was actually one of the worst panic attacks I had. Of course, after I took an Ativan and calmed down enough to realize that I had a whole street full of neighbors whom I could walk to if need be I felt slightly silly for my freak out, but still.

I don't think though, that it's bad to have a "Bugsy". In fact, I think perhaps it could be beneficial. If clinging desperately as though for dear life to a stuffed bunny makes me feel better and brings me out of a panic attack, hey. Whatever works.

What's your "stuffed bunny"?
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17 October 2011

I am not my diagnosis

When I was at Laurel Ridge the first time, one of the therapists who led group sessions had a rule. You didn't say "I am *insert diagnosis here*", you said "I have a diagnosis of *insert diagnosis here*". So, taking myself for example. I couldn't say "I am depressed", I had to say "I have a diagnosis of PostPartum Depression" or "My diagnosis is PPD". We asked him why he had that rule and he explained to us that "You own your diagnosis, your diagnosis does not own you".

That didn't make a whole lot of sense to me at the time. I went by the rule but was like "Whatever". After the fact, however, it started making a lot of sense. I started to realize something very important: that I am not my diagnosis. I am not PostPartum Depression. I had PPD, yes, but it was a small part of who I was, a small facet of my personality and individuality. I realize now that to automatically assume that someone's behavior, feelings, attitude, etc. must be because they have PPD, OCD, BiPolar, etc. is to say "You don't matter. You are nothing more than your diagnosis. When I look at you, I don't see a person, I see *insert diagnosis here*". For someone to say "Oh well, you just feel that way or say that because you have PPD" if I tried to say "No, I'm really not okay with that" was for them to take away my individuality, to minimize my feelings. Essentially, they were saying "You no longer have a right to feel, act, speak, or think simply as a human. You are nothing more than your condition.". For them to do that was for them to minimize my feelings, to invalidate me.

Just because someone has what you consider a problem, whether it be a mental/emotional health condition, a physical impairment, an addiction, etc., does not reduce them to nothing more than that diagnosis or issue. Don't make the mistake of objectifying them. They are still an individual with human feelings, thoughts, and emotions. They still retain the right to disagree, to think someone is a jerk, to get mad, sad, glad, or any other emotion, and express it without it being because of their diagnosis. Don't objectify and belittle them like that.

If you're reading this and you are the one doing this to yourself, don't limit yourself like that. Recognize that you are not your diagnosis. You are so much more. You deserve so much more than reducing yourself or allowing yourself to be reduced to a short description like that. Regardless of how you prefer to word your statements, change your thinking. Be yourself first and foremost, not your condition. Rise above the labels. You are more than your diagnosis. You are you.


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13 October 2011

What's the big deal about PostPartum Depression?

I've heard people ask "What's the big deal about PostPartum Depression?" and while part of me thinks "How can anyone say that?", part of me knows that that question comes from a place of ignorance. I speak from experience when I say that it can be hard to understand and hard to be sympathetic when you've never dealt with PPD or a loved one with PPD. Prior to my own experience with it I would hear the stories about the extreme cases (think Andrea Yates) and think "That's just an excuse". Maybe it is an excuse for some people but for far too many, it's not. PostPartum Mood Disorders don't have to cause someone to kill or try to kill, but they most certainly are something to be taken seriously.

PostPartum Depression is not a "bad mood". It's not a matter of "choosing to wallow". It's not indicative of someone who "Needs to pray harder" or "Should go to church more often". PostPartum Depression is a legitimate medical condition that must be treated by a qualified medical professional. In a blog entry titled How Many Women Get Postpartum Depression? The Statistics of PPD , Katherine Stone of Postpartum Progress addresses the sobering statistics.

Quick, guess which number is higher: the number of people who sprain an ankle each year, the number of people who have a stroke, or the number of women who experience postpartum depression?
PPD. 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 look at the real numbers and to help people understand the real impact that postpartum depression is having on the women of our country.
There were approximately 4.3 million live births in the United States in 2007. 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 postpartum depression, regardless of the pregnancy’s outcome.
So let’s split the difference between the high (20%) and low estimates of PPD (11%) and say that an average of 15% of all postpartum women in the US suffer, as the CDC reported in its 2008 PRAMS research. And let’s use the number of clinically recognized pregnancies and not live births. This would mean that each year approximately 950,000 women are suffering postpartum depression.
BUT, did you know the CDC’s research only reflected self-reported cases of postpartum depression? How many women do you think did not mention they had PPD out of fear or shame? Should we increase the estimate of sufferers to 17% or 20%?
ALSO, these numbers don’t take into account women who may have suffered other perinatal mood and anxiety disorders like PPOCD or postpartum psychosis. Should that make the numbers go even higher?
I’d argue that the average number of new mothers who experience perinatal mood and anxiety disorders is more likely in the 20% range, which would mean around 1.3 million annually.
How does that compare with the incidence among women of other major diseases in America?
In fact, more mothers will suffer from postpartum depression and related illnesses this year than the combined number of new cases for both sexes 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 & anxiety 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 moms will suffer from PPD than men will be diagnosed with new cases of impotence (approx. 600,000) 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 doesn’t PPD get the same attention from pharmaceutical companies?
Why doesn’t society work as hard to eliminate the stigma of PPD? Why aren’t more corporations and foundations concerned about PPD and supporting awareness campaigns?
This really is a big problem, and deserves much more attention than it’s getting.

If ever there were chilling statistics, I think this makes the cut with no problem. Making it worse, an additional statistic is that only an estimated 15% of those women will receive professional treatment. That means that (going by the numbers laid out above) a estimated 1,133,334 women will suffer n silence, will go without help. Still wondering why all the fuss? 

My experience with PPD was that it made me a totally different person and not in a good way. I spent my days sitting in a rocking chair holding my baby and staring off into the distance. I cried for no reason all the time. I had horrible mood swings. I felt like nobody cared. I couldn't sleep. I felt like I was falling into a dark pit that was totally devoid of light. I felt like life wasn't worth living. I didn't want to go anywhere or do anything or see anyone. I got incredibly angry and frustrated and felt so overwhelmed. This was supposed to be the happiest time in my life and I was wishing I had never been born and that I could just go to sleep and never wake up. The feelings were both intense and lifeless. I don't know how better to describe the fact that I felt such intense emotion and yet felt at the same time that I wasn't feeling anything. 

1.3 million women are feeling like this and their family and friends are dealing with the stress and frustration of it.1,133,334 women and their families are suffering in silence at what should be the happiest  time of their lives and not getting the help they deserve, the help that is out there for them. More than a million women going without help and afraid to say anything. More than a million families struggling to make sense of it. More than a million women wondering "Why bother living? What's the point? Nobody gets it." and some of those women actually will act on it and kill themselves, all for a lack of public awareness and education. More than a million women at risk of committing suicide because they think there's no help for them. Are you still asking what the big deal is?

05 October 2011

Happy Strong Start Day!

Having a baby was supposed to be one of the happiest times of my life, and for many people it is. For me, though, it turned into one of the darkest times I've ever known. After Elizabeth was born, I joined a most undesirable club of women suffering from PostPartum Depression. For 3 months, I buried my head in the sand and refused to acknowledge I had a problem or ask for help. I felt so alone, helpless, and hopeless. One night when I was trying to decide whether to throw myself down the stairs or to overdose on pills, I realized that I needed help and went to the E.R. I was hospitalized for a little over a week and put on medication. It was a long hard road back but eventually I found my way to the end of the tunnel and back into the light.

A big part of the problem was that I, and my family and friends, weren't educated about PostPartum Depression. I thought I was just a bad mom. My husband thought I was just in a bad mood and refusing to stop wallowing. At my 6 week postpartum checkup, the Nurse Practitioner didn't ask me anything about how I was feeling or look at my questionnaire. When I was admitted to the psychiatric hospital (twice), I was put in general wards with people who were dealing with alcohol and drug addiction combined with multiple other mental health problems. There was nobody else dealing with PPD and the staff had only a basic knowledge. After I was released from the hospital, one psychiatrist refused to see me and the rest of the psychaitrists had very long waits to be seen. I actually had to go to the ER to get my medication refilled. There were no psychiatrists, psychologists, therapists, or anyone else who specialized/had much experience with PostPartum Mood Disorders.

All of this is indicative of the sad fact that in the united States of America, general education about PPMD and healthcare for women suffering from them are sadly lacking. Watch tv and you'll see plenty of advertisements for treatment options for Erectile Dysfunction, high cholesterol, blood pressure, heart problems, incontinence, insomnia, diabetes, and plain old depression. What you don't see are spots talking about PostPartum Depression and it's symptoms, causes, treatment options, etc. There are hospitals and doctors aplenty specializing in all sorts of problems, where are those that specialize in PPMD? And why is it that people hear that someone has a PPMD and say things like "You need to pray more" or "Make up your mind to just get over it"? People hear "I have PostPartum Depression" and think "Oh, you're going to go kill your children". The public needs to be educated about the realities of PPMD and the healthcare system needs to have more resources available to treat and support women with PPMD, and their family members.

PostPartum Progress is a wonderful resource that's dedicated to changing that. Thanks to Katherine Stone and PostPartum Progress, women are learning that we aren't alone in this journey. We're learning that there is a way out of the pit and that suffering alone is not the only option. We discover resources and advice. For someone wondering "Could this be PPD? What does PPD feel like?" there are blog posts about PPD Symptoms in "Plain Mama English". For those who are wondering "What if I can't get an appointment?", there are blogs about that too.

As you can see on the blog header, today is October 5. October 5 is, for some reason, the day that more babies are born than on any other single day. October 5,2011 is also Strong Start Day 2011 at PostPartum Progress. To explain Strong Start Day, here's the letter Katherine wrote and posted at PostPartum Progress:


Postpartum Progress needs your help.
I write today because I’m personally asking you to support the work of Postpartum Progress.  I know you have trudged the dark and lonely road of postpartum depression, either as a sufferer, a family member or someone who cares for new mothers.
I must tell you that nothing makes me more anxious or, quite frankly, sick to my stomach, as asking for donations.  Well,one thing makes me sicker: the fact that today only 15% of all women with perinatal mood and anxiety disorders ever receive professional treatment.  This means that each year hundreds of thousands more women and their children may suffer from the negative effects of untreated PPD and related illnesses for the rest of their lives.
Postpartum Progress will change that with your help.  We are developing a compelling national awareness campaign for postpartum depression, as well as new and improved patient education materials (the kind new moms won’t throw away!), and new uses of technology to reach suffering moms no matter where they are.
On October 5th, the day when more children are born each year than any other day, I am asking you to do one of three things:
1)   Make a donation to Postpartum Progress.  Any amount is welcome.
2)   Ask at least 2 other people who love you and know what you went through – people who’ve come to know that postpartum depression is real and that all women deserve to have access to the best information and help – to make a donation today in your name.
3)   Refer us to contacts at organizations that can help us with our work.
If you are financially unable to donate, send us your prayers or moral support so that we may find the right people to help us make major change.
Every single person who donates this week will be honored on our website (unless you prefer to remain anonymous).  We are a 501c3, so your donation is tax-deductible.
Today’s the day.  Please help us build stronger families, one mom at a time.


I hope that you'll consider supporting PostPartum Progress. The work Katherine is doing is so far beyond valuable. I can speak from my own experience that both in the midst of PPD and in the time following when I have wrestled to come to terms with what I went through, as well as in teh months following Miriam's birth when I've been worried about whether I would develop it again, it has been a beacon of light. Check out the website and help make care and resources more readily available for new moms and their loved ones.
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03 October 2011

It's not always easy being a blabbermouth

Despite the impression you might get from interacting with me on the internet or reading my blog, I can be shy when I first meet people. It can take a little while for me to come out of my shell as my first response to being in a new setting or around new people can be to sit quietly and observe. However, once you get to know me, I can be quite the talker and on occasion, it can be hard to get me to shut up. I'm a talker, what can I say? You never would have guessed, right? Yeah yeah, insert smart aleck jokes and responses here... One of my favorite topics to talk about is Post Partum Depression and my experiences with it. You never would have guessed that either, right?

It's (usually) easy now for me to talk about, because I've discovered that talking about it gives me power over it, and I love that I've been able to help others by talking about it. I never ever want anyone who knows me to feel like they or their loved one have to suffer alone and/or in silence due to a lack of anyone who understands. I want everyone to know that there is at least one person who gets it and who won't judge. It wasn't always easy to talk about though. In fact, for a long time, I tried to make sure nobody knew that I had any problems, or had been in a mental hospital, or anything of the sort. I felt like I would be judged and found lacking, seen as a bad mom, looked down on, made fun of. I was still worried that someone would try to take my baby away.

Why did I decide to start talking about it? I think it was because I wanted others to know that they could come to me if they were experiencing anything like it, or knew someone who was. Then it turned into a desire to educate people so that they could know the warning signs to look for in their loved ones. Then it evolved into wanting to help combat the stigma asociated with PPD and mental/emotional health problems in general. However, I know from experience that it's not always easy to talk about. So, I wanted to pass along a video that @yaelsaar on twitter shared with me during the #ppdchat today.


http://www.ppdtojoy.com/tough-convo/

Yael made this video so that it would be a resource for people who need a way to help talk about PPD. It's VERY good and has a lot of good facts and statistics. Now. I'm not saying that you need to start a blog or write articles or anything like that. However, if you are suffering from PostPartum Depression, Anxiety, OCD, PTSD, Psychosis, or any other postpartum mood disorder, you do need to talk to family members about it. They need to know what you're going through. Why? So they can understand you, support you, look out for you. They need to know that it's not just as easy as getting more sleep, deciding to get over it, or praying more often.

They also need to know that it's okay for them to experience their own confusion and to need support of their own. As was covered in the #ppdchat today on twitter, PostPartum Depression and other PPMD don't only affect the mom. They affect those living and interacting with the mom and it's okay for them to need to seek counseling of their own. There should never be any shame in saying "I don't know how to deal with this, I don't know how I feel".

It's not always easy to talk about PostPartum Depression but I believe that it is important. Some ideas for opening up the conversation:
Show them the video linked above.
Show them this blog.
Show them another blog such as PostPartum Progress or My Postpartum Voice.
Show them links such as PostPartum Support Int'l and the information on PPD that's available at March of Dimes or any other resource link on my blog.
Take them to a doctor's appointment with you and let the healthcare professional do the heavy lifting.

What ways have you found to open the lines of communication? If you are a family member, what did your loved one do to start the conversation?
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01 October 2011

When is it time to talk to your doctor about PPD?

First off, I apologize for being MIA. My internet has been pretty sucky.

Quite a few women recently have asked me the same question: "How do you know when you need to talk to your doctor about PPD?" and my answer is always "If you're asking that, you should be talking to them". My rationale being that if you're noticing something about yourself that makes you even question the possibility of whether you MIGHT be struggling with PPD, it's better to be safe than sorry and PPD is definitely one of those things that the longer you wait to begin treatment, the sorrier you will be.

With that in mind, I've come to the conclusion that it's time to take my own advice and talk to my doctor. I don't know whether I have some PPD going on in the background, whether my thyroid levels might be a little off, or whether I'm just reacting to all the stress, turmoil, sleep deprivation, and exhaustion I've been dealing with over the last little while. It could be some of all of the above. Regardless, I've just been feeling... off. I can't sleep at night, I'm tired even when I do sleep, I'm irritable. Half the time I feel blah and unimportant, sort of gray and two-dimensional if that makes any sense. Being homesick for my family and friends (but not the heat) isn't helping anything. All of it is classic PPD symptoms... it's also classic stress responses. Regardless, I'd rather make sure. I need to see a doctor anyways since I'm still on the Zoloft I started at 38 weeks pregnant. I had to wait, though, for the insurance to all get sorted out and become effective. Now that that has happened, I can get it taken care of.

I won't lie, I'm scared. Last time, being scared was what kept my mouth shut until I reached a crisis point. I was scared of what people would say/think, scared that "They" might take my daughter away, scared of the stigma. This time, that doesn't scare me. What scares me this time is the thought of going back to that dark place I was in before, of getting so far down into the pit that I can't see the light any more. This time, being scared of that is stronger than the urge to say "Well, if I don't admit it it won't be real". It probably helps to that I know that there's a very good possibility that it's just a matter of needing my Synthroid dosage adjusted, or being told I need more sleep (I tried taking Tylenol PM and the baby slept the entire day after it came through my milk to her) or that I may just need to try therapy, yoga, or getting out of the house more. Heck, maybe I can talk them into giving me a prescription for more regular massage therapy visits and get TriCare to cover it... Haha What helps, though, is that this time I know that even IF it turns out that it is PPD, I am educated. I know that it's just a hormonal imbalance and that it really WILL go away, because I've lived through it before. It helps that I know that I have people who will support me and not judge me.

So, wish me luck. And if, like me, you're asking yourself (or someone else) "Do I need to talk to the doctor?", just do it. There's nothing wrong with making an appointment and saying "Look, this is what's going on". If it's not PPD, well, you haven't lost anything. But if it is PPD, and you wait and ignore it, you stand to lose so very much.

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