31 August 2012

Sometimes people just do bad things.

Over the last few days, two news stories in particular have been coming across my news feed a lot. One is about Terrence Tyler, a 23 year old Marine (no longer in the Corps) who shot and killed two fellow store employees before killing himself at a New Jersey supermarket. According to the news story, 
"Tyler, formerly of Brooklyn but living in Old Ridge, served in the U.S. Marine Corps from 2008 to 2010, a Marines spokesman said. Tyler was a lance corporal and rifleman, who received two medals and never served overseas, the spokesman said.". 
I have not been able to find any information as to what kind of discharge he received (Honorable or otherwise). The news story also states that, according to a law enforcement source, 
"Tyler may have had a history of depression or mental illness".
Naturally, plenty of reactions seem to be "He must have had PTSD". Another opinion I've seen floating around is that "He couldn't have had PTSD, he never deployed". These are both inaccurate. As to the first, no, he does NOT have to have had PTSD. For one thing, if it's true that he had a past history of depression//mental illness, why could it have been that instead? Are we assuming that since he served in the military any mental issues that caused something like this have to automatically be PTSD?

As to the second, PTSD is not something that is reserved specifically for troops who deploy to combat, it's not something exclusive to overseas military service. PTSD stands for Post-Traumatic Stress Disorder. We usually hear about it in the news most often in relation to servicemembers and veterans but it is hardly exclusive to the military community. PTSD can come about as a result of any traumatic event. Rape and abuse survivors, vehicle accident survivors, someone who was caught in a fire, people who are onlookers witnessing an event that is traumatic to them, people who have lost a loved one, anyone who experiences anything that is traumatic to them can suffer from PTSD. PTSD can occur after a woman has a childbirth that was traumatic to her. Someone living with a spouse or loved one with PTSD can develop their own PTSD. According to PostPartum Support International,
"Approximately 1-6% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth. Most often, this illness is caused by a real or perceived trauma during delivery or postpartum. "
Women who have survived a PostPartum Mood Disorder can struggle with PTSD as a part of the aftermath. 911 personnel can develop PTSD due to the situations they may be put in as part of their work. PTSD is not exclusive to any one community, nor is it limited to a specific type of situation. If Terrence Tyler experienced something that was traumatic to him during boot camp or any part of his time in the U. S. Marine Corps, he could most certainly have developed PTSD and it is certainly possible that that could have been linked to his actions in shooting and killing two others in addition to himself. The thing is, we just don't know.

The other story I've been hearing a lot about it that of Tiffany Klapheke, a woman arrested after her 22 month old daughter died, apparently from extreme neglect. Her other two children, a 3 year old and a 6 month old, are currently in the hospital, apparently also suffering from the same. And of course, as is the norm when a mother is responsible for the death of her child, many people are jumping straight to "Oh, well, since it's a mom who killed her child, it must be PostPartum Depression".

NO. It does NOT have to be PostPartum Depression. Again, it could be another mental illness. It could be totally unrelated to mental health altogether and be the result of bad parenting or other factors. Just because a mother is responsible for the death and/or injury of her children does not mean it's automatically a PPMD. This isn't even getting deep into the fact that most of the time, when people refer to "PPD" as the reason a mother kills her child (usually citing the cases of Andrea Yates and/or Otty Sanchez), they are actually referring to PostPartum Psychosis, another PPMD but a separate and different illness than PostPartum Depression. PPD and PPP are not the same and can not/should not be used interchangeably. If you're going to toss around "So-and-so must have *insert mental health problem*, please, at least know what it is you're actually talking about.

But beyond that, it is injurious and unfair to automatically assume that someone who does something bad must be suffering from a mental illness. It makes it harder for people who are suffering to ask for help. To focus specifically on servicemembers who are dealing with PTSD, it's already incredibly difficult for them to go talk to someone about it. Among other things, they fear being seen as weak, as not being able to do their job, as not being good Soldiers/Airmen/Marines/Sailors/Coasties. They worry that if they speak up about their problems, they will automatically lose their security clearance, be reclassed to a different job, be discharged from the military altogether. They worry about being mocked and made fun of by their coworkers, about being looked down on and told to "Suck it up and stop being a pansy" and of being seen as malingerers by their Chain of Command. They already fight these stigmas, concerns, and myths. People automatically jumping to the conclusion that servicemembers who do bad things must be the result of PTSD add another layer of fear to it: the fear that they may be immediately seen as a threat and a potential monster. This is all aside from whatever internal pain and traumatic events are causing them to suffer in the first place.

Assault/abuse survivors may already be wrestling with unnecessary guilt over "Was this my fault? Could I have done something different to prevent this?", or with people being suspicious that they somehow brought it on themselves or are lying about what happened to them. People who are dealing with PTSD as a result of anything other than military service may not even be aware that PTSD could be something they face, or they may worry that people will laugh and bring the exact attitude of "You're not military, you weren't deployed, you don't have PTSD". Women who are struggling with PTSD after childbirth face those who have the attitude that "Childbirth couldn't possibly be traumatic" (and yes, I have personally heard/seen that said and that attitude thrown around).

With regards to a PPMD, I can't stress enough how terrifying it was to be suffering from PPD. To feel like I wasn't in control of my emotions and, to some extent, my actions and reactions, to have thoughts that popped unbidden into my head of hurting/killing myself, to constantly feel numb and dulled and in a fog and not even know why, to feel those waves of anger and sadness, to know deep down inside that something was wrong but not know what or why, and to feel like it must have been something I was doing wrong. It was beyond scary. Once I realized that I had all the symptoms of PostPartum Depression and NEEDED to get help, that was a whole new dimension of fear. Fear that it meant I was a horrible mom and a failure as a wife and mother, fear that it meant I was a monster, worry that when I went in and said "I need help, here's what I'm dealing with" CPS would be called in to take my baby girl away so that I couldn't try to kill her. After I was released from the hospital I dealt with the concern that if I told anyone what was going on, they would look down on me, mock me, laugh at me, judge me, criticize me, not trust me, and assume that I must be like Andrea Yates, that I must be on the verge of killing my child in some horrific manner.

These stigmas and fears are perfectly normal for anyone who is dealing with PTSD, PPD, or any other mental illness. These stigmas are exactly what I and so many others are trying to fight, why we work so hard to educate people, why public discussion, education, and advocacy are so vital. Steps in the right direction are being taken and forward progress is being made. However, sadly, when people hear about stories like this and start talking about what mental illness must have caused the person in question to have done whatever they did, it is a step in the wrong direction, movement backwards, and adds to those stigmas and myths we all work to combat and dispell. It's not harmless to toss around these attitudes and assumptions, it hurts people who are dealing with these issues and makes people who need treatment more afraid to ask for help. It hurts the loved ones who are tying to support them and see the pain they're going through. It hurts everyone who has suffered, is suffering, and will suffer.

It also does a disservice to those who are doing the spreading. You don't deserve to believe false things, you deserve to be educated and knowledgeable about these issues that society is dealing with. You deserve to know what the symptoms of PostPartum Depression is and exactly how many women suffer. You deserve to have the confidence to be able to ask for help if you need it someday instead of ignoring your own problems because you believe the stigmas you've helped to perpetuate and spread.

Today, you're the one saying that Terrence Tyler must have had PTSD or Tiffany Klapheke must have had PostPartum Depression. But remember, one day you could be the one dealing with your own inner demons and not wanting to reach out for help because you don't want to be seen as the monster you have labeled Andrea Yates and Otty Sanchez as. It could be your son who comes back from combat with more wounds on the inside than the outside or your daughter who can't find her way out of the darkness after she has a baby. It could be you who suddenly has to fight the very attitudes you've helped foster. Why not do yourself and your loved ones a favor and take some time to educate yourself about the causes, symptoms, victims, and survivors of the various mental illnesses you think you know so much about? Educate yourself, educate your loved ones, educate the world, and maybe as that happens you'll help someone who is suffering to get help before they become a news story.

24 August 2012

Project Runway made me want to run away

*Warning* Project Runway spoilers.

You'll have to bear with me as today's post doesn't really have much to do directly with PostPartum Depression, although the themes could tie in somewhat.

I'm a huge fan of Lifetime's television show Project Runway. I love to watch it every week and have it set up to record on DVR since it's pretty rare that I get to watch it when it's actually airing. I love seeing the challenges, the outfits the designers come up with, critiquing the designs, and trying to predict who will win and who will be "Auf'ed". Project Runway is one of the shows that I look forwards to watching each week, it's one of the totally unnecessary fluffy things that provides an entertaining and fascinating distraction each week from the stresses and exhaustion that come with pregnancy and taking care of two small children.

As much as I love my shows, it's extremely rare that one makes me truly and deeply angry but that is exactly what happened when I watched Project Runway last night. Last night's challenge was for the designers to give a regular (aka non-celebrity) client a makeover, complete with a trip to the hair and makeup teams and designing a new outfit for them. The clients were brought by a friend or family member. Great premise, right? Sounds like a fun and special experience, right?

For most of the clients and designers, it seemed to be. The designers had fun getting to design for an everyday woman and the women enjoyed getting a totally new look and getting to have a say in their own ensemble being designed, to say nothing of getting to model on the runway. Unfortunately, one designer blew his opportunity. Ven Budhu spent the entire episode "dogging" on his client (Terri), both to her face and behind her back, in fittings/consultations and in the workroom footage and the interview segments. He constantly made comments about what a "nightmare" her before picture was, how it wasn't fair that he had to design for a "plus sized woman" while other designers had clients who were closer to the models he's used to designing for, comments to her and her friend about how "Well this will be nice and slimming" and "All these belts are too small, I'll have to get a bigger one and hope it's big enough". CONSTANT remarks the ENTIRE show. Oh, and his idea of "Plus sized"? He estimated that she was a "size 14". Yeah, Size 14 is absolutely "Plus sized"...

He spent the entire episode being a 100% jerk and making his client feel like crap. She was literally in tears. Her friend was in tears when she described to the judges that Terri is a hardworking mother who drives 2 hours each way to her job, then putting in a full day's hard work, and taking care of her family at the end of the day. They wanted Terri to have a special experience and instead they got a designer who didn't ask questions, totally ignored what both of them were saying, designed an outfit that wasn't exactly the most flattering (and wasn't close to his normal standard of excellence, he didn't appear to want to put in the work to make his usual caliber of item), and spent the whole show demeaning and insulting her with snide comments. Even when he was talking to the judges, defending his design (when he was kept out in the bottom 3), he was still being a jerk. I wish I could say he was sent home but he got to stay.

His twitter feed has been full of tweets that show that he is thoroughly unrepentant and sees no issue with his attitude and remarks. The biggest irony of all: his client isn't as big as he makes her out to be AND he is definitely bigger than she is. What's that saying about pots and kettles? Ven made a beautiful woman feel like crap. He was insensitive and rude, to say the least.

I went to bed last night fuming but hoping that the posts I had put on Lifetime, Project Runway, and L'Oreal's Facebook walls would help me wake up a little calmer in the morning. They didn't. I woke up today and I'm still beyond furious.

At first I was asking myself "Why are you so upset about this?". I know some people think it's ridiculous to be this upset over a tv show, and I've asked myself if that's the case. What I'm realizing, though, is that this is about more than just a tv show. This is about a real woman who was, unfairly, demeaned and insulted on national tv. This is about anger over an injustice that actually occurred. Even more than that, it's about how this affects women around the world, including me.

I've come to realize that part of why this resonates so deeply with me is because I'm one of those "Plus sized" women Ven seems to have such disdain for. When Ven made his comments on the show, they didn't just hurt Terri, they hurt the rest of us around the world who are watching and going "But she's me.". Yes, I'm pregnant, and naturally I'm going to be larger than when I'm not pregnant, but through my 3 pregnancies I've gained weight that I've had trouble shaking.

Before my first pregnancy, I wore a size 4-6, sometimes an 8, depending on what the clothing item was and the brand (thanks to the fact that clothing manufacturers all seem to have their own method of determining sizes). I was pretty stinking slender. During my first pregnancy, I gained 75 lbs. and couldn't explain why. I ate pretty well, exercised as much as I could, etc. But still, I gained a lot of weight. I had no idea why. Later on, when we realized that the pregnancy had caused me to develop hypothyroidism, I learned that the PostPartum Depression wasn't the only side effect of the thyroid problems, the weight was part of it too. Since then, I've worked between pregnancies on losing weight and getting back in shape and then, naturally, I gain the weight back again while pregnant.

Before I ever even got pregnant, there was someone close to me who made a lot of nasty remarks to me about my weight and looks, calling me fat and ugly. This person occasionally makes snide remarks about my pregnancy weight too. Other people feel that it is their right to tell a pregnant woman when she's "gaining too much weight" or say things like "Should you be eating that?" and "Don't you think you should have a salad instead"? There was a McDonald's employee at the drive thru who was an insulting jerk when I bought a couple of S'Mores pies.

The old saying "Sticks and stones may break my bones but words will never hurt me" is way off the mark. Words have the power to affect us in lasting ways. The incidents with the person who was so nasty to me growing up were YEARS ago but the words still sometimes hurt and cause me to doubt my looks and my self-worth (I'm working on not finding so much importance and self-worth in my physical appearance but it's still hard and still stings). When people say things like Ven said, IT HURTS.

The truth of the matter is, Ven didn't just hurt Terri with his actions, words, and attitude. Ven hurt so many of us who already struggle with our weight. Ven sent a message to the world that it's okay to treat people like crap because of their physical appearance. It's already hard enough to go shopping for clothes and depressing to have trouble finding things that fit well and look good. To now have this floating in the back of the brain? Ouch.

When you look at someone and think "They don't fit my definition of what a person should look like" or "Wow, why aren't they smaller", first stop and think about your own flaws and how you would feel if someone made a big deal about them. Then stop and think that what's on the outside isn't as important as what's on the inside. Then realize that you don't know why that person looks the way they do. Maybe they have a health condition. Maybe it just doesn't matter.

Project Runway, Lifetime, and L'Oreal need to do something to make this right. Partly for Terri, a beautiful, inspiring, and strong woman who was treated in a manner no person should ever be treated, and partly for all the women out there who are hurting right now, saying "Am I fat? Do I not deserve to look good? Why am I somehow less important because of my size?".

We are all beautiful. Whether you're a size 0 or a size 26, you have your own unique beauty. You matter. Your story matters. You are important. There is no other you, you are the only one. You are a gorgeous creation who deserves to know that you are beautiful and unique. Don't doubt your worth. Don't doubt your beauty. Regardless of what the Ven's of the world say and think, you matter. YOU MATTER. We matter.


23 August 2012

PostPartum Depression, PostPartum Psychosis, it's all the same thing, right?

There's a saying that goes "You say po-tay-to, I say po-tah-to...". I've never heard it actually used specifically in reference to the pronunciation of the word "potato"; instead, it is usually used as an illustration or argument that although two things may sound different, they're really the same thing. Sometimes this is a legitimate point. Sometimes, however, it is quite the opposite.

You might be asking "What do sayings about potatoes have to do with PostPartum Depression?". Something that I hear a lot is people talking about "She killed her child because she has PostPartum Depression". This often comes up in discussions that reference Andrea Yates and/or Otty Sanchez. Currently, I'm hearing it tossed around in reference to Chevonne Thomas, a mother with a history of mental illness and drug use who decapitated her 2 year old son and then killed herself. I would like to note, I have not read anything indicating that the cause of her actions has been determined through investigation/diagnosis by medical professionals to be a PPMD. The only diagnoses I'm seeing are coming from people around the web who are immediately jumping to the conclusion that since she was a mother and killed her child, it must be a PPMD.

Without even getting into the issues that come with immediately assuming that someone who does something bad MUST have a mental illness, and specifically that a mother would only kill her child if she had a PPMD, the issue I'd like to focus on is the misuse of the term "PostPartum Depression". Otty Sanchez and Andrea Yates did not have PPD. They were both suffering from PostPartum Psychosis.

What far too many people don't realize is that PostPartum Depression and PostPartum Psychosis are not at all the same thing. They are both PostPartum Mood Disorders but they are two separate PPMD. The terms get used interchangeably (usually, in my experience, with people substituting PostPartum Depression for PostPartum Psychosis) but that is not as it should be. It's no more accurate to think/claim that they are the same thing than it would be to say someone has Breast Cancer when what they actually have is Lung Cancer.

The Mayo Clinic lists the following as symptoms of the two:

Postpartum depression symptomsPostpartum depression may appear to be the baby blues at first — but the signs and symptoms are more intense and longer lasting, eventually interfering with your ability to care for your baby and handle other daily tasks. Postpartum depression symptoms may include:
  • Loss of appetite
  • Insomnia
  • Intense irritability and anger
  • Overwhelming fatigue
  • Loss of interest in sex
  • Lack of joy in life
  • Feelings of shame, guilt or inadequacy
  • Severe mood swing
  • Difficulty bonding with the baby
  • Withdrawal from family and friends
  • Thoughts of harming yourself or the baby
Untreated, postpartum depression may last for a year or more.

Postpartum psychosisWith postpartum psychosis — a rare condition that typically develops within the first two weeks after delivery — the signs and symptoms are even more severe. Signs and symptoms of postpartum psychosis may include:
  • Confusion and disorientation
  • Hallucinations and delusions
  • Paranoia
  • Attempts to harm yourself or the baby

When I was being admitted for my hospitalizations for PPD a few years ago, they specifically asked if I was hearing voices or seeing things/people. I've known some people who said that when they were suffering PPP, they had an overwhelming feeling that there was a demonic force waiting to snatch their baby. Some think that they are hearing from God to kill their baby to save it from some disastrous fate. With both PPD and PPP, although there are guidelines, markers, and symptoms that health professionals look for to diagnose a PPMD, there is no guarantee that all mothers will feel an entire checklist or experience the symptoms in the same way or at the same time. In my opinion, the unpredictability is one of the things that makes PPMD so difficult. You can't just assume that someone with a PPMD will look, act, or talk a certain way. There is no one face of PPMD. There is no "This is what a PPMD always looks like or acts like".

Katherine Stone of PostPartum Progress (yes, linking to my favorite PPD blog again) has a couple of excellent posts about the Symptoms of PostPartum Anxiety and Depression and the Symptoms of PostPartum Depression. These lists are written in "Plain-Mama English". They make the symptoms a lot easier to understand and relate to, as well as getting a lot more in-depth than most symptom lists on the internet. If you're wondering about the differences between PPD and PPP, I highly recommend going to those two posts and reading what she has to say.

PostPartum Depression and PostPartum Psychosis are both horrible illnesses. They can both be completely debilitating and, if left untreated, have long-lasting and tragic consequences and implications for the new mother, her baby, her family, her friends, and any number of people. They are both illnesses that I hope someday soon will be the topic of more research and public education campaigns. Neither of them are anything I would ever wish on my worst enemy and they are both something that, in my wildest dreams, I would love to somehow see totally eradicated from the face of the earth. Yes, they have some similarities and some shared symptoms, but that doesn't mean they are the same thing or that they should be referred to as the same thing or the terms used interchangeably. Please, educate yourself on the differences between the two and then spread your knowledge on to other people. Educating ourselves and others, and being willing to speak up and say "Hey, you realize that's not accurate, right?" when we see/hear someone using the terms incorrectly is a good place to start on fighting the stigmas and combating the ignorance that surrounds PPMD.

20 August 2012

The power of a good man's support

In the discussions about PostPartum Depression, the focus is often on women and the struggles we face (go figure). Today, though, I’d like to focus on some people who are too often overlooked: men.

Recently, a friend of mine read one of my blog posts and related an experience he had with a friend who was dealing with PPD. The discussion was on Facebook and my mom commented with something I completely agree with: never underestimate the power of the love and support of a good man.

I was fortunate to have the support of several good men when I was fighting my own battle with PPD. First and foremost, my husband. He had to learn as much as I did, he had to pick up the slack when I couldn’t cope, he had to deal with my mood swings, he had to learn to deal and cope just as I did. He did so with an incredible amount of grace and strength. He was always there for me, always loved me, always supported me. He never blew me off or told me to just suck it up. He listened to me and heard me on a deeper level than just the words I was speaking, he heard what I meant.

I didn’t tell very many friends or family what I was going through because I was afraid that none of them would understand or that they would turn their backs on me or (in one specific case) use it against me in a fight or something. Of the few friends I did tell, one of my dearest friends is like a sister to me and she helped us watch Elizabeth the second time I was in the hospital. Naturally, her husband knew what was going on and he was nothing but supportive of me. He prayed for me and made sure we knew that he supported us through it all.

My dad was one of the only family members who knew at the time and he was also supportive; our family didn’t really know a lot about PPD at that point but he never let that stop him from just loving on me and making sure I knew he was there for me. He happily let us borrow my mom when we needed help with Elizabeth during hospitalizations.

The Elders/missionaries from church (we’re LDS) were incredibly supportive as well. They offered to come visit, give me a blessing, pray for me, help with the house, or do whatever we needed. Most of all though, they never once made me feel like my PPD was a sign of a lack of faith or need to pray more or a consequence of sin or any of the other lovely things that Christians too often insinuate and/or outright say when a woman is dealing with PPD. They were just there.

These men are far from the only examples I have of people who loved an supported me through my journey, but they are the men who first come to mind with regards to the particular topic of this post. See, you don’t have to be a woman to support someone through PPD, and you don’t have to be her husband or even family to love her and support her.

So to all the men out there who feel helpless and powerless, who feel like “There’s nothing I can offer/do to support the woman in my life who’s dealing with PPD”, please just toss that concept right out the window. You can be just as much of a help and support, your love and kindness can make just as much of a difference to her as that of the other women she knows.


10 August 2012

From PostPartum Depression to the Olympics

Right now, the world is all buzz over the London 2012 Olympics, or the "Games of the XXX Olympiad". I myself have been happily absorbed in watching some of the sports and following various teams/athletes/stories that interest me, and not so happily absorbed in trying to avoid spoilers of results and medals since NBC insists on holding their footage until Primetime. I've watched with delight as athletes have soared to new heights and won hard fought medals, broken records, made history, and achieved their goals. I've watched with sadness as athletes have made unfortunate mistakes and bobbles that cost them the gold or knocked them off the podium. I've gasped when athletes have injured themselves. I've gotten teary eyed over inspiring stories of personal courage and fortitude and of overcoming what seemed like insurmountable obstacles to even be present at the Olympics. I've beamed with delight and gotten the warm fuzzies over incredible displays of sportsmanship and brotherhood reaching across the lines of nationality.

One of the athletes that I've been the happiest to follow and cheered the most enthusiastically for is Lashinda Demus. Lashinda Demus is part of Team USA and competed in the Womens 400m Hurdles, making it all the way to the Finals and receiving a silver medal. What is it that sets Lashinda Demus apart for me? She's a PostPartum Depression survivor.

I picked up on this fact when Katherine Stone of the widely read PPD blog Postpartum Progress posted about Lashinda in "A Warrior Mom In the Olympics and More PPD News You Can Use". I was immediately captivated and went off to read about Lashinda. It turns out that she gave birth to twin boys in 2007 and struggled afterwards with PPD, fighting a tough battle and making it out of the darkness with the help and support of her family.

I can't tell you how happy it made me to find articles on the web about her and her struggles, or the fact that a PPD Survivor is IN the Olympics. To me, it is first and foremost an encouragement to see the media mentioning her struggles and not making it out to be some nasty thing that happened because she did something wrong or any of the other stigmas that are so often attached to women with PostPartum Mood Disorders. On top of that, what a great example of strength and courage!

As I deal with the fact that I've had to start Zoloft at 35 weeks pregnant and will be on it for a while, and fight the fear that the Zoloft might not be enough, Lashinda Demus is like a beacon of hope. Her story serves as a reminder to me, and hopefully to many others, that no matter how dark the days get, no matter how badly we want to give up, all is not lost. Yes, things might not be the greatest right now but they can and will get better, if we just hang in there. Lashinda went from PPD to the Olympics and won a medal!

For those of us struggling with pregnancy related depression (whether it's before or after giving birth), we can do it too. We might not get a physical medal and recognition on the world stage but our victories, our winning our own individual races, are just as important and matter just as much as any athlete who's receiving a medal in London this summer.

Lashinda, thank you for the example you've set for us all, and thank you for your courage in being open about your PPD. You, your family, and your story are an inspiration. I don't know if you'll ever know how much it means that a PPD Survivor is participating in the Olympics (and medaled!) but it means a lot. Thank you thank you thank you!

07 August 2012

Pre-Natal Depression? What's this you speak of? Guest post by Sarah Payne

Recently a fellow military spouse who is a friend of mine, saw a link I had posted to an article about Pre-ntatal Depression and mentioned that it's a battle she's fighting right now. I asked if she'd like to do a guest post and this is what she sent me. Thank you Sarah Payne for your post and your courage in speaking up about your struggles.

Being pregnant is supposed to be a joyful time in your adult life, or so it's been said. I personally have heard it over and over from about a million different people. “Pregnancy is so awesome.” “You'll love being pregnant.” “I could be pregnant forever.” are just some of the statements I got when I revealed that my husband and I were thinking about having a baby.
A little about myself before I begin: I am a licensed counselor. I have dealt with all kinds of psychological issues with my family and with strangers in my career. I knew how to recognize the signs of depression, anxiety, and a myriad of other issues. Also, before we decided to conceive, I had only been on an anti-depressant medication very briefly (less than 6 months) quite a few years ago when my husband first deployed to the Middle East. I never sought therapy with someone during this time, only the medication. I also started my Master's degree at this time so it gave me something to focus on while waiting for him to get home. I have had no other psychological issues in my past other than normal, everyday ups and downs.

In late 2011 I stopped taking my birth control pills that I had been on since I was seventeen. Needless to say, I had been on the pill for 10 years, give or take, and never ever had a problem with them other than remembering to take them, but we all do that, right? We tried and tried and tried to get pregnant. Trying was the fun part. Seeing my period show up month after month was not. I had been warned in the past that since I had some scarring in my uterus due to a birth defect that conception might be difficult and I might experience some miscarriages or I might even need a fertility specialist. This idea frightened me but we went ahead anyway. After about 6 months of practice I finally had a positive pregnancy test. The moment was bittersweet though as the day after we found out I was pregnant my wonderful husband deployed, yet again, to the Middle East. His deployment was scheduled for 100 days. As anyone who has ever been in the military or a military spouse can tell you, that was never going to happen. At this point, he's been gone for almost 5 months and still has not been given a proper return date.

I started to notice at about 7 weeks that I was feeling funky. I had started my internship to finish my degree requirements but found myself struggling to get up in the morning for work. I didn't care one bit how I looked when I arrived or what kind of attitude I gave to my co-workers. I flip-flopped between periods of not being able to sleep for days to sleeping for 18 or 19 hours at a time. I also wasn't eating, keeping up on my homework, taking care of my home, or providing basic care for my dogs aside from feeding them and opening the door so they could do their business. This was definitely not me. Around 11 weeks all of the symptoms listed above got worse and I even contemplated having an abortion at times. I thought, if I can't handle being pregnant how in the world am I going to handle a newborn? What was I thinking? I felt so incredibly guilty and I couldn't tell anyone.

One night, when I was about 13 weeks or so, I was on the phone with my husband trying my best to pretend that everything was just fine and that things were going along as planned. I gave him nothing but good news about the dogs, prenatal appointments, and my progress at work. He knew though that something was wrong with me. I don't know how he knew but he did. I am so glad that he did and that he confronted me on it. He was so supportive and understanding when I finally told him what was going on in my head. He also said, you're a therapist, you know better than that. Go get help right now. I sat down that night and started looking up information on prenatal depression. While there is some information out there, I don't feel like it's enough, nor is it ever talked about. I've purchased several of the popular books about “expecting” and whatnot. None of them, none, ever mentioned anything about being depressed or anything but “glowing” while pregnant. Some of them spoke about the depression after a birth but that was about it.

 Since I was actively in an internship situation I went and spoke to my internship supervisor about it who said that he had noticed a rapid change in me just in the short time he had been working with me and suggested that maybe a trip to my doctor was a good idea. I made an appointment with my OB and talked to him about it. He gave me a little battery of tests that I knew all too well but took anyway. We both came to the conclusion that I was experiencing some depression and he suggested medication that had a low chance of birth defects. I was very reluctant to take medication. I felt guilty that I couldn't handle my symptoms on my own. I was a therapist for goodness sakes. I should be able to self-help. I waited a few more weeks and hunkered down with my library of books on depression before I came to the conclusion that I needed more help that my own brain and books could provide. I went back to the doctor and he wrote me out the prescription for an anti-depressant. I noticed a difference in about 4 days. I was sleeping better and was able to stay awake during the day. I wasn't as irritable and short with people I worked with. I cared more about my appearance and the appearance of my home.

I still have doubts sometimes but I'm sure every new expectant mother does. Only difference is, this time, I am able to function despite my fear. 


06 August 2012

How can I help?

One of the things that people ask me the most when someone they know is struggling with PostPartum Depression is “What can I do to help them?”. It’s a pretty normal question to ask when a loved one Is dealing with something difficult and it touches me and makes me happy to see people who have a desire to be supportive to their friend or family member.

The problem with that question is that there isn’t really any one answer. Every person and situation is different, every woman presents a little differently as far as their symptoms and how their PPD manifests itself. For some women, they can’t do anything but sleep while others can’t sleep at all. Some have no energy and some have more energy than they know what to do with. Some don’t want to be around people or leave their house at all, some can’t stand to be alone and either have to have people over constantly or be away from their house. Some will feel totally detached from their baby, some will feel obsessed and won’t be able to let the baby out of their sight or stop checking on the baby for fear of something bad happening. Some will be sad and cry, some will be angry and have fits of rage, some will just feel numb. Some women may feel all of these, none of these, or some combination. And bear in mind, this is far from an exhaustive list. There are as many possibilities and combinations as there are stars in the sky, if not more (I won’t pretend to know the limits – or lack thereof – of PPD and it’s symptoms/manifestations).
The type of support that any given woman will need/want isn’t really something that can be predicted, and it may change from day to day or even moment to moment. The best thing to do is to ask HER what SHE needs/wants.

While I can’t tell you exactly everything she’ll need, I can tell you something that will be helpful to her: just be there for her. You don’t have to have all the answers or solutions, you don’t have to be able to “fix” everything, just knowing that there is someone there for her who loves her unconditionally and will support her no matter what, who’s willing to listen to her without judging her for the thoughts and feelings she can’t help having, can be a huge help. One of the worst things I can say that I and every woman I’ve known with PPD has struggled with is the feeling of “I’m totally alone, nobody knows what I’m going through, nobody understands, if they knew how I really felt and the things that I really think they would think I’m a monster and turn their backs on me. There is nobody out there whom I can talk to about this.”. If you’ve never had PPD, you probably won’t understand, but you can give her that ear to talk to, that hand to hold. You can be that person who says “No matter what, I support you and nothing you are fighting can make me turn my back on you or betray you or walk away from you”. I can not tell you how much of a help it is to know that somebody is listening.

So, if you know someone who is hurting, who feels lost in their emotions and thoughts, who is fighting their way through the dark tunnel of PPD, ask them what they need, and make sure they know that you care and you will be there for them the whole way through, that they’re not taking this dark journey alone.


03 August 2012

I started on Zoloft a little earlier than I had planned.

The plan for me, with my history of PostPartum Depression, was to start taking Zoloft at 38 weeks like I did with Miriam. A couple of months ago at a checkup, I talked to the midwife about whether I should start it sooner because I was having some mood wonk. She said that as long as it was up and down mood stuff it sounded like normal reactions to stress/hormones/exhaustion/kid shenanigans etc. The agreed upon plan was that if, at any point, Eric and/or I noticed it was devolving into a down-down spiral, I felt like it was getting to be too much to handle, etc., to let them know and they'd start me then, she made a note in my file and talked to the OB about it so that even if I called between appointments they could go ahead and call in the RX then and there.

I'd started to wonder if I was going downhill. My emotions are out of control, I've started having abnormal anxiety, etc. Well, then the other night Eric told me he was seeing that I had in fact gone into a down-down-down and he thought I should talk to the doc about it. So, I did, at my OB appointment (which happened to be the next day). She sent in the RX then and there, talked to me about the medication itself and how long I should plan to be on it at a minimum, potential side effects of irritability for the baby in the first few days of life and how to cope, etc. I picked up the meds and started taking them last night. I just got my third trimester labs done (they check my Thyroid levels once a trimester) and that all came back WNL so it's not a thyroid thing at this point.

I've got so many conflicting emotions about this, and most of them I know are false thought patterns that I "know better" than to buy in to, like feeling guilty for not being able to handle everything without needing medication, or thinking "What is wrong with me?". And then part of me is going "You're so dumb, you blog about PPD and mental health, you're an advocate for women with PPD, why is it so hard for you to accept the things you believe and tell other women?". It's not really surprising though, partly because the stigma surrounding mental health and Antenatal Depression/PostPartum Depression and lack of understanding/education about them are still SO strong, and partly because in general I suck at taking my own advice.

It's scary.


02 August 2012

Breast is not always best, part 2.

Note: I'd like to refer everyone to a post I wrote a couple of months ago about the fact that there are antidepressants you can take while breastfeeding.

In a previous post, I wrote about why Breast is not alwaysbest. Today, I’d like to discuss a specific facet of that.

Usually, people who espouse the idea that Breast Is Always Best will acknowledge that “Of course this doesn’t extend to women with legitimate medical issues”. Here’s the problem that I often see: these people will either not truly acknowledge PostPartum Depression as a legitimate medical problem, or the women with PPD will not realize that they fall inside this criteria and will still succumb to the guilt of “If I get help and have to stop nursing my baby because of medications, I am not doing what is best for my baby”, thus either prolonging the time they go without treatment or, if they do seek treatment, adding unnecessary guilt which may make it even harder to deal with the PPD. Also, when women give a reason other than a “legitimate medical problem”, they are dismissed and scorned as “selfish”. What those doing the dismissing too often fail to take into consideration is that the new mother may in fact have something like PPD going on below the surface that they either don’t realize or don’t want to talk about it.

Even if there is no medical problem, again, if they just do not want to nurse, they should not be made to feel guilty for that. As I stated in my previous post, a woman who breastfeeds due to pressure and guilt, despite not wanting to for her own reasons, may end up suffering negative repercussions such as difficulty bonding, depression, and a host of other problems.

We need to get away from this idea that the only acceptable reason to not breastfeed is to have a “legitimate medical problem”. We need to realize that using this terminology and pushing this mindset may cause those very problems. Who are we to decide what constitutes a “legitimate” reason to make a particular non-life threatening choice?

Of all the issues that we could be devoting our time and energy to, we choose to spend it on judging women for why they choose to feed their child a certain way? As I’ve said before, by all means, let’s educate people about the benefits that breastfeeding can give to both mother and and baby; benefits such as passing along to the baby the mother’s immunities, reducing the mother’s risk of cancer, assisting the mother with weight-loss, the fact that breastmilk contains/helps the baby develop pro-biotics and pre-biotics, and many other positive benefits and side-effects . But please, let’s do so in a manner that makes the mother feel empowered to make an educated choice as to what she feels is best for her and her baby and family, rather than feeling judged for making her choice, a manner that does not add to the stigma, myths, and problems that women with PPD (and their families) already face.