Who knows?

Yesterday, a dear friend of mine turned me on to a news story that was featured by Fox 5 out of Atlanta. Unfortunately, I haven't been able to get the video to play (my browser is being a little cantankerous) but the story I was able to read grabbed my attention.

The story Fox did covering Sarah Schwartz's fight with PPD is a familiar one. Breastfeeding. Anxiety. Not recognizing what was going on.

There was one thing that stood out in particular, though:

"Sarah says the irony in her story -- and the reason she wants to share it -- is that she works in mental health. She's been a social worker for 20 years and is the director of a nonprofit called Mental Health America of Georgia.

"And yet I was so sick that despite my knowledge, I still didn't recognize myself as being sick," Schwartz said.  "I thought, 'Could this be postpartum depression, could this be postpartum anxiety?'  And I thought, ‘No, I'm just a monster.  I am just a horrible person.' I understood for the first time in my life, why people commit suicide.""

People often say things like "How can you not know you have PPD?", "You must know what's going on with yourself", and all sorts of other phrases along the same line of thinking. The answer? I don't know.

What I do know is that for many of us, we don't recognize what's going on with us. You have to understand, PPD is literally messing with your brain. Me? My thought processes were different. My whole outlook on life was abnormal. I didn't recognize what was going on. It took me finding myself standing at the top of the stairs in the middle of the night thinking "I could just throw myself down the stairs", and then walking away only to think "I could take some pills and just go to sleep and not be hurting anymore and everyone would be rid of me, everyone would be better off without me anyways" before I realized "WHOA! Something is WAY off here, I need to talk to someone...".

I was good at hiding it; partly so others wouldn't think I was a horrible mother and partly, I suspect, so I wouldn't have to face the pain quite as much. Head buried in the sand, you know? I don't think most of my friends or family knew what I was going through. And most of them weren't that well informed and educated about PPMD anyways. Heaven knows I wasn't.

This difficulty that many women face in recognizing our own illness, recognizing that we need help, is why it's so important for everyone to be educated and informed about the realities of Postpartum Mood and Anxiety Disorders. It doesn't matter how well educated a woman is about the symptoms and risks of PPMD, if she's "In the fog", she may not be able to recognize her own symptoms. There are quite a few things from my PPMD months that I don't really remember. Small wonder I couldn't recognize the symptoms. If the woman in your life is suffering, she may need your help to even be able to ask for help from trained medical professionals.

Thankfully, Sarah and I (along with many other women) found help through Postpartum Progress. Postpartum Progress is a WONDERFUL resource on PPMD, for everyone, regardless of whether you are a parent, parent-to-be, or someone who is a friend or family member of a new or soon-to-be-new parent. Please, educate yourself about the realities of PPMD. Know the symptoms. Know the difference between the Baby Blues, Postpartum Depression, and Postpartum Psychosis. Know about Postpartum OCD and Postpartum Anxiety. Know about Prenatal Depression. Know it all. Knowledge saves lives. Postpartum Progress has some very handy lists of symptoms in "Plain Mama English". Read the blogs of women who have survived PPMD (a list of blogs I follow is conveniently located in a tab at the top of this page). Check out resources like Postparum Support International, who has a list of support groups by geographical location and specialized support coordinators for dads, military families, Spanish speaking families, and Arabic speaking families. Online support can be found through PSI, #PPDChat on Twitter, and many other venues (including blogs and Facebook groups and pages).

Learn. Know. Educate yourself. Educate others. One of the biggest obstacles to me getting help once I realized what was going on was shame and stigma, fear of what others would think of me because of so many false ideas. In my opinion, the best ways to fight those nasty monsters are through education and public discussion.

One last note: I'd like to give a HUGE thank you to Fox 5 for doing such a wonderful story. Far too often when I hear about PPMD in the news it's in a negative manner that may have bad/false information and just spreads the stigma. This story gets it right. I'm dancing on my chair in gratefulness. Thank you, Fox. And thank you Sarah, for being willing to speak up and speak out. Warrior Moms unite!

Liebster Award? Yes please!

A few weeks ago, I was nominated for a Liebster Award by Jen at Morning Coffee Confessions. I'm tickled pink and very happy that she thought of me. Thanks Jen!!!

It took me a couple of weeks to get to putting up my post (thank you midterms), but I figure better late than never. :)

In case you're wondering what the Liebster Award is, here's some information that I copied from Jen's blog:


What is the Liebster Award?
The Liebster Award is an award for pint size bloggers (bloggers who have under 200 followers) and is a great way to find new blogs to follow and hopefully make new bloggy friends.

The Rules:
1. Link back to the person who nominated you.
2. Answer the 11 questions asked by your nominator.
3. Choose 11 bloggers. each with fewer than 200 followers, and nominate them for the award.
4. Come up with 11 questions for your nominees to answer.
5. Contact your nominees and notify them of your nomination.

The questions Jen asked me:
1. When you looked at yourself in the mirror this morning, what was the first thing you thought?
"Wow, I can't believe it's our anniversary!"
(It's our fifth)

2. What did the last text message you received on your phone say?
"Sure. :)"

3. What's your life motto?
Just keep swimming, just keep swimming.

4. If you could pick anywhere to live the rest of your life, where would it be?
One of the Garden suites on a Norwegian Cruise Lines cruise ship.

5. What's the best route to your heart?
Be kind to my family, especially my children, and talk in an educated manner about how awful Postpartum Mood and Anxiety Disorders are and how much need there is to fight the stigma and misinformation floating around about PPMD.

6. What do your friends and/or family think about your blog?
They think it's great. My family and friends have been very supportive of my blog.

7. When you were a child, what did you want to be when you grew up?
What didn't I want to be? It changed hourly. I definitely wanted to be a mom though.

8. Did you have any resolutions this year? What were they?
No. I don't make resolutions anymore. I set goals and give myself permission to not beat myself up if they don't get achieved.

9. Do you have a day job? If so, what do you do?
I'm a full-time college student and a wife and mom.

10. Something that you learned recently?
When you're developing black and white photos in a darkroom, you can't pour Fixer down the drain. It's toxic after it's been used because it contains silver particles.

11. Coffee or tea?
Tricky question. As a Mormon who's observing Word of Wisdom, I should say herbal tea since WoW's guidance is to not drink tea or coffee unless the tea is herbal tea. However, I love me some Pumpkin Spice Latte or Frappucino. Or rather, I did. No, I still love it, I just don't indulge. There we go.

You're welcome.

My nominees:

1. Ashley at Hull: Family of Three.

2. AddyB at Butterfly Confessions.

3. Lindsay at With a Little Love and Luck.

4. Anna at Anna and Aaron.

5. StoryGirl at Sometimes It's Hard.

6. Cori at In Pink Ink.

7. Lauren at My Postpartum Voice.

8. Stephanie at The Mormon Child Bride.

9. Alice at Reclaiming My Inner Pioneer.

10. Julia at The Sugary Shrink.

11. Janae at Claire and Janae.

The Questions:
1. What is your best quality?
2. What is your blog about?
3. What is one cause, issue, charity, etc. that you wish more people knew about?
4. What kind of chocolate do you prefer?
5. What is one piece of advice you wish you could go back in time and give your teenage self?
6. Who is your hero?
7. What is your favorite tv show?
8. How many pillows do you sleep with?
9. If you could be any superhero or villain, who would it be?
10. What's your favorite holiday?
11. What's one thing you wish you could tell everyone in the world?

Have fun, bloggers! Please don't feel any pressure to answer this, or to answer it within any particular time frame. But, if/when you do answer, if you let me know, I'll add the link to your response post to this post so other people can read what you have to say. :)

Shout out to a hero, Cristi Comes

I know today is 9/11 and it's expected to talk about the events of that awful day and the people who were lost in those tragic events. But you know what? I want to take today to focus on something positive, talk about someone who is doing great things to help other people.

Picture from Motherhood Unadorned.

One of the lovely things about the internet is that it helps you meet people you might not meet otherwise. Take, for example, Cristi Comes of Motherhood Unadorned. I know Cristi (online) because of both of our involvement in the online PPD community. She's one of my Warrior Mom idols, I really look up to her. She's talented and her passion for advocacy, awareness, education, and support in the PPD community are beyond description. Straight up, she rocks.

This week is National Suicide Prevention Week and Cristi has been hard at work. She's done some fantastic blog posts including a guest post from Leila (who blogs at Life As Leels) and her own blog post about ways we can fight suicide. She's been posting up a storm of links and images, such as the one to the left. She's organized an online Stella and Dot Trunk Show to benefit the American Foundation for Suicide Prevention. She's been tweeting links and... well... tweets... that are relevant, helpful, etc.

Did I mention that Cristi is fantastic and I absolutely adore her?

Cristi is one of those people who truly embodies what it means to care about other people and work to make the world a better place, to fight against the stigma and myths that surround mental illness, suicide, Postpartum Depression, and related topics. She is a shining beacon of light and hope to people who feel worn out by life, who feel like they're alone, who feel like there is no hope.

There are a lot of people out there who don't get it. WAY too many who don't get it, people who actively fight against the idea that mental illness and suicide are serious, people who think that stigma is a joke and that it's okay to mock and deride those who speak up, people who think that suicide is a joking matter (it's not a joke and it's not a game). In fact, I've got another post cooking about an instance of that exact thing happening, an instance in which Cristi speaks up and people are just inane jerks to her, but I wanted to talk about the good first, because good people like Cristi deserve the spotlight more than the jerks of the world.

Thank you, Cristi, for everything that you do. You may never know how much good you accomplish and how much you and your efforts mean to other people, but your contributions can't be measured by any human markers. Keep up the good work, you inspiring person you.

Be sure to check out Cristi's blog, twitter, and the Stella and Dot show through the links posted throughout the blog.

Unexpected emotions

Recently, I posted about my new journey to be a Gestational Surrogate. I will not be using TriCare; instead, I'll be using private insurance, which I applied for after I matched with my Intended Parents. Recently, I got an email from the insurance agent stating that my application had been passed on to the underwriters for further consideration and that they would be in touch with me. Today, I finally got a call from them and, just as I had suspected, they needed to ask me some more questions about my medical history.

I had expected that they would want to ask me about my thyroid and the PPD I had after Lizzie was born. What I didn't expect was to feel ashamed talking to them about the PPD. I pretty quickly realized that I was giving way more information than they needed and that I felt like I was some sort of freak of nature for what I went through.

It was a little upsetting to realize that I still harbor feelings of shame about my PPD. I talk about my experiences all the time. I'm very open about what I went through. I blog. I tweet. I talk about it on Facebook. I talk about it in person. I try to be an open book about my experiences, partly so that people know they have someone to talk to instead of feeling all alone like I did. A big part of it, though, is that I talk about it so others know that it isn't anything to be ashamed of. And yet, I still sometimes get knocked for a loop by that lingering monster of false guilt. Ugh.


P.S.
If you're interested in following my journey through surrogacy, head on over to The Womb Fairy, my new blog devoted to the path towards being a very personal and very extended babysitter.

My mom's thoughts on PPD

In honor of the fact that my mom is celebrating her birthday this week, I thought I'd share a guest post she sent me a little while back. My mom is a wonderful and amazing person; I can't imagine having anyone but her as my mom and I'm so blessed to have such a supportive woman in my life. Please welcome my mother, Sharon O'Neal.

I would like to share some of my thoughts about PPD, in hopes that it'll be helpful.

I experienced some mild baby blues after my second baby's birth. They would happen unexpectedly at the strangest moments, but then pass in a short while. I'm sure my two-year-old daughter wondered why Mommy would tear up while reading about cars, planes, and trains! But, within a few weeks or so, they were gone, and life was wonderful and busy. 

Life happened and time passed, and I didn't think about it very often. Then, when our granddaughter Elizabeth was three months old, we received a call from our son-in-love letting us know that Esther had gone to the hospital to seek help for Postpartum Depression and he was at home with the (breastfeeding) baby. I promised to pack some things and go the next day. I stayed with them, helping with Elizabeth. 

When we got clearance to go visit Esther at the facility, we would go and take turns visiting Esther while the other one waited with Elizabeth in the waiting area. I remember the first time I saw Esther after her admittance. She had the bleakest, most lifeless look in her eyes. The despair in her was almost physically palpable. It broke my heart to think of how much she was and had been suffering. As I think back now, I have tears in my eyes, and I remember thinking, “We will do whatever we need to do to help this daughter and her precious family.” 

The following season was one of the hardest in my life. But, when I see how hard Esther and Eric have fought this disease, and how passionate she has become on behalf of others, I am so thankful that she had the courage to say, “I need help and I deserve help.” And that's the message I now try to pass on to others: no matter what you're dealing with, you are loved, you do deserve help, and there's no reason to feel any shame or guilt for this problem. If there's a family member of a woman with PPMD who needs someone to listen, I'm here for you.

I can't put into words how grateful I am for Mom's love, support, and acceptance during that difficult time, and ever since, extending now to how grateful I am for this post. I love you, Mom!

My new journey: gestational surrogacy

Recently, I told my family and friends about a new journey I've undertaken: Gestational Surrogacy. In a nutshell, I'm going to carry a baby (or babies?) for someone else. I won't get into a long spiel about why I'm doing it; if you want, you can follow my journey at my surrogacy blog, The Womb Fairy.

Today, I want to address a question that I've been getting a lot. In various forms and wordings, people ask me "But what about PPD? Why put yourself through that again?".

In large part, I think this is due to a misunderstanding of what, exactly, my experience with PPD has been. After my first daughter was born, I was hospitalized twice and had to take medication after being diagnosed with Postpartum Depression. I believe there was also undiagnosed Postpartum OCD since I had the classic symptom of intrusive thoughts, but for this post, that is neither here nor there. Regardless of what the diagnosis was, it was an absolutely horrible experience that nobody should ever have to live through; I wouldn't even wish it on my worst enemy.

However, when I was 8 months postpartum (December 2009), I was (belatedly) diagnosed with hypothyroidism (I say "belatedly" because I came to find out that the numbers had been there earlier, my previous doctor just didn't say or do anything about it). The hypothyroidism was caused by the pregnancy and was what was causing my PPD. As soon as my new doctor diagnosed this, she started me on 25 mcg of levothyroxine. Drugs.com explains levothyroxine as "a replacement for a hormone normally produced by your thyroid gland to regulate the body's energy and metabolism. Levothyroxine is gven when the thyroid does not produce enough of this hormone on it's own". Levothyroxine is classified as an FDA pregnancy category A drug, meaning that it is not expected to harm an unborn baby. 25mcg was the lowest dose that I could be started at. Upon checking my levels at a follow-up apointment, my thyroid levels were improved but still not within normal limits so the doctor up'ed my prescription to 50mcg. Follow-up labs showed that 50mcg was my magic dose. To date, including during my 2 subsequent pregnancies, my thyroid levels have been monitored (at least once per trimester during pregnancy and once a year outside of that) and have never gone outside of normal limits, my medication dosage has never had to be adjusted, and I've never again had trouble with PPMD.

I did take Zoloft at the end of pregnancy and throughout the first few months postpartum with the last two babies, as a prophylactic measure, but have been able to come off of that easily and quickly, and - again - have not had a repeat of 2009.

So, why would I put myself through this when I know there's a risk of a repeat of PPMD? There are several reasons.
1. Anyone who is pregnant, for themselves or for someone else, risks PPMD.
2. From a risk-benefit assessment standpoint, I don't see the risk as being high. It is very clear that 2009 was a direct result of my thyroid being off, and history has shown that subsequent pregnancies have not been an issue. The doctors are fine with it and so am I. And *if* I were to end up with PPMD again, I would feel in the long run that it was worth it, to give someone the precious gift of a baby. But again, I simply don't think there's that much of a risk
3. If I live my life according to "But what if...", I've let PPMD win. I refuse, absolutely REFUSE, to let fear rule my life. I certainly refuse to let PPMD have such a say in what choices I make. PPMD doesn't get to decide what I do, where I go, who I associate with, or how I live my life. PPMD doesn't get to hold me back. I let PPMD do that in 2009 and I won't allow it to do so now when I haven't even had PPMD in years. I don't care to allow PPMD that much of a foothold in my life.

A big part of the reason why I have this blog, why I'm involved in the PPMD awareness/education community, is because I hate PPMD and I don't want PPMD to win. If I let fear of PPMD dictate my choices and hold me back, I've handed it a trophy. I won't do that. PPMD is a bastard that I want to see defeated and eradicated and a big step in that direction, for me, is in making my own choices instead of letting PPMD make those choices for me. I will not let fear run my life. I've taken my life back and I plan on keeping it that way.

*DISCLAIMER* I am in no way judging those who feel that a different choice is better for them. Everyone has to do what they feel is right for them, that is not for me to decide for anyone but myself. There are other people who feel different for themselves and I totally support that. This blog post and the opinions contained in it are strictly my own thoughts and feelings, my own choices, for myself, and should not be assumed to be what I think anyone else should do. This blog should also not be taken as critical of anyone who has asked me why I would be a surrogate, it is only an explanation of how I'm thinking on this issue.

PPD isn't impressed by titles or wealth

I'm one of those people who is fascinated by royalty, especially the British Royal Family. I remember watching the funeral of Diana, Princess of Wales when I was a teenager. I watched Prince William's wedding to the former Kate Middleton live (streamed it on the internet) very early in the morning while I nursed a newborn baby. I've been enthralled waiting for the arrival of the newest member of their family (who came into the world on July 22, 2013), formerly known as "the royal baby" and now (since his name as been announced) known as HRH Prince George Alexander Louis of Cambridge.

This evening, something struck me that has stuck with me in the back of the mind for the last couple of days. I got to watch via live stream (yay for smart phones) as the Duke and Duchess of Cambridge brought Prince George out front of the hospital to meet the press, the public, and - in a way, the world - before leaving for Kensington Palace. Kate said something then that has been niggling at my brain; she said that it's "very emotional".

Pregnancy is emotional. Childbirth is emotional. Becoming parents is emotional, whether it's your first child or your third. She nailed it.

But I hope - and I don't know how well I can translate my thoughts and feelings on this in to words - that she knows to watch out for the negative emotions. I hope that she is surrounded by people who know about Postpartum Depression, Postpartum Anxiety, Postpartum OCD, Postpartum Psychosis, etc., who can help her keep an eye out for it and - should she start to suffer - help her get help.

But I don't just wish this for her. I wish this for EVERY new mom out there. My hope for all of you is that you have educated yourself about the realities and symptoms of PPMD, that you are surrounded by people who know about it and who will speak up and help you get help if they notice something is wrong.

PPMD is no respecter of persons. It doesn't care who you are. It's a bastard like that. We ALL deserve to be able to get help, though. Don't think that because you don't have a title you don't deserve help or are supposed to suffer. And don't think that because you're a celebrity you have to suffer in silence and just try to push through it.  If you need help, ask for it.

We all matter.

My Mother's Day wish for you

I'd like to start by apologizing for my silence. It's been kind of a crazy month-plus since my last post and some personal circumstances have made it hard for me to post anything (emotionally, writer's block, that kind of hard). However, I'm dusting off my pen (so to speak) for Mother's Day.

For all the mothers out there, of any variety, Happy Mother's Day. If you are a mother, you are fierce and you are awesome. Whether you are a birth mom, adoptive mom, stay-at-home-mom, work-at-home-mom, employed outside the home mom, mom who goes to college, mom who's lost a baby or a child, or any other kind of mom (and this is by no means an exclusive list), you rock. You are a wonderful mom, no matter how much you feel otherwise (goodness knows I feel less than awesome quite often). It doesn't matter what you look like, what you wear, whether you breast feed or formula feed or some combination, whether you use cloth diapers or disposable, whether you wear your baby or not, whether or not you vaccinate or if you do so on schedule, delayed, or alternative/selective schedule, whether you gave birth with medication, without medication, vaginally, or by c-section, how many children you have, whether they live with you, with someone else, or in heaven, whether you are tall or short, skinny or fluffy, all that doesn't matter. You. Are. Awesome. You are fierce. You are amazing. You are fantastic, fabulous, wonderful, beautiful inside and out, lovely, and great.

Motherhood is not all about being the "perfect" mom. It's not about meeting some nonsensical ideal that the world has set up for us. It's not about being some specific religion or member of any one church. Motherhood is not about baking cookies every day, sewing your own clothes and having them look like they came off the rack at Nordstrom. It's not about having the best Pinterest boards (and making everything off of them and having the projects turn out perfectly). It's not about always being happy, having beautifully done makeup and manicured/painted nails. Motherhood is not even the one thing that defines you. You are a complex woman with many roles and many defining factors and aspects.

Don't let the hype of being the perfect mother get you down or make you feel less than worthy. I assure you, there is no such thing as the perfect mother who has everything together (maybe my own mom, but I'm pretty sure she'd disagree with me since she's the one who told me there's no perfect mom).

And to all my PPMD mama's, I'd like to send extra special gentle and loving hugs to you. Having PPMD doesn't say anything about your capabilities as a mom. It doesn't make you any less of a mom or a worse mom. Love yourself, accept yourself, give yourself permission to feel whatever you want or need to feel, even if that means not liking Mother's Day because it reminds you of all your struggles. I'd also recommend you head over to Postpartum Progress and check out the 5th Annual Mother's Day Rally for Mental Health.

If you are a mom, today is for you. I know sometimes Mother's Day can be so incredibly difficult. This year, it has difficult aspects for me. If Mother's Day is bittersweet for you, that's okay. If it's sad, that's okay. If it makes you angry, that's okay. Today, if Mother's Day is happy, I wish you a Happy Mother's Day. If it isn't, I wish you Whatever Kind Of Mother's Day You Need Mother's Day To Be.

You have my love.

HAWMC Day 4: Sharing Resources

Sharing Resources:

Create a “care page” – a list of your best resources that someone who is newly diagnosed could

go to when starting to advocate for themselves or a loved one. Remember to include sites that

lead to successful self advocacy!

PPMD related blogs I recommend:

• PostPartum Progress
• Band Back Together
• Beyond PostPartum
• Kate Kripke, LCSW: Prenatal and PostPartum Wellness Strategies
• Butterfly Confessions
• Farewell Stranger
• James and Jax
• Learned Happiness
• Motherhood Unadorned
• Multitasking Mumma
• My PostPartum Voice
• Our Giggles & Grimaces
• Our Journey Through Life
• PostPartum Desert
• PPD Survivor
• PPD to Joy
• Really? I'm A Mom?
• Self-Care Tips For Women
• Sometimes It's Hard
• Supermom
• The Rebuild Blog
• To Breathe Again
• With a Little Love and Luck

Other recommended links:

• Jenny's Light
• March of Dimes: PPD
• The PostPartum Resource Center of New York
• PostPartum Support International
• PSI Support for Military Families
• PostPartum Progress: PPD Support Groups in the US and Canada
• The Online PPMD Support Group
• The Baby Blues Connection

Twitter:

#PPDChat is a weekly Twitter chat  led by Lauren Hale on Mondays at 1pm and 8:30pm Eastern Time. The #PPDChat hashtag is used during non-moderated chat times as a community of support, friendship, and advocacy whenever wanted/needed.

HAWMC Day 3: Wordless Wednesday

Wordless Wednesday - Post a picture that symbolizes your condition and your experiences.

Photo (C) Esther Dale, 2013

HAWMC Day 2: Introducing PPMD

Introduce your condition(s) to other Health Activists. What are 5 things you want them to  know about your condition/your activism? Share links to 3-5 of your old posts (or posts from other Health Activists!) that you think will help the newly diagnosed.

I’m a Health Activist for Postpartum Mood and Anxiety Disorders. I personally have suffered from Postpartum Depression, Postpartum OCD, Postpartum Anxiety, and Antenatal Depression (not a PPMD because it occurs during pregnancy prior to giving birth) but I also feel that it’s important to talk about Postpartum Psychosis and Postpartum PTSD. As much work as remains to be done to better educate the public about Postpartum Depression, I think there’s even more to be done to raise awareness about other lesser-known PPMD. I say this based on the fact that not only do most every-day non-medical people I talk to not know about anything other than PPD, even medical personnel misdiagnose other PPMD as being PPD and are uneducated about anything other than PPD.

I think this ties in nicely with the part of today’s prompt that says to share 5 things I’d like others to know about PPMD. Please note that these are not necessarily listed in order of importance, as I think they’re all equally important.

1. Different PPMD are not all the same thing and the terms can not and should not be used interchangeably. The biggest example I see of this is people saying someone has/had Postpartum Depression when they actually had Postpartum Psychosis. What far too many people don’t realize is that, although they both fall under the heading of PPMD, PPD and PPP are not the same thing.
2. When someone says they are having thoughts of hurting themselves or the baby, it’s important to make sure that they’re truly experiencing suicidal/homicidal ideations typical of PPD or PPP; too often, what a new mom thinks is thoughts of hurting herself/her baby is actually intrusive thoughts, which are a distinctive symptom of Postpartum OCD. It’s important to distinguish between the types of thoughts and symptoms and make sure that the correct diagnosis is made because different PPMD may respond better to different methods of treatment.
3. Postpartum Mood and Anxiety Disorders are not a cop-out. They’re not some pretend thing that people use to get out of trouble or to make excuses for not doing housework. PPMD are legitimate illnesses that suck  to an extent that is impossible to comprehend until you’ve experienced it. And even after experiencing PPMD, you still can’t expect to understand what everyone else with PPMD experiences, because everyone’s experiences are different.
4. PPMD are not automatically something you can just pray away. It’s not as simple as singing more hymns, having more faith, saying the right prayers, repenting of sins, binding Satan and his demons, attending church faithfully, being exorcised, getting blessings that are worded the right way, or anything else faith related. Sometimes those things may help comfort an individual and help them feel relief from symptoms, but to assume that PPMD are tied to one’s faith (or lack thereof) is wrong, and hinting (or outright saying) that they must not be taking the right steps with regards to their faith can be more harmful than one might imagine.
5. There is no one way that women with PPMD can be assumed to look. You can not assume that a woman with PPMD will be disheveled, be perpetually in tears, or appear to be in distress. Many women can and do hide the fact that they are suffering, and/or the extent of their suffering, not only from the world but from the loved ones they are the closest too. I speak from personal experience about that.

Five bullets is barely even a scratch on the surface. For more information about PPMD, go do some more reading. Read more of my blog entries, follow the links in this post, and check out the resources and blogs in the tabs at the top of this page. Happy HAWMC and enjoy your reading. :)

HAWMC Day 1: Getting Started!

Hello, and a very Happy HAWMC to you! If you just said “Gesundheit”, thinking maybe I sneezed, thank you, but there was no sneezing. :D “What?!”, you say, “You didn’t sneeze? Then what on earth is that... uh... word. HAWMC? Haymitch? OMG! Are you going to blog about the Hunger Games movies and books?!? You’re the coolest blogger e-var!!!1!”. Nah, hold your horses. Much as I love Hunger Games, and as much as the Hunger Games books are fantastic about expressing mental health issues like PTSD without making it look like it drives you nuts and turns you into some raving lunatic, and as much as I get all melty inside when... never mind, don’t want to get in trouble for spoilers... no. I did not say Haymitch. I said Happy HAWMC. HAWMC is an acronym standing for Health Activist Writer’s Month Challenge. April is Health Activist Writer’s Month, and every year, WeGo Health does the HWMC, where they send out a list of prompts and Health Activists take up the gauntlet to try to write one blog post a day for 30 days. I tried it last year but due to travel and pregnancy, it just didn’t really go very well. This year, I’ve decided to try it again. Considering that I’m in school full time and my husband is currently away with the Army (meaning I’m also juggling the kids by myself), I’m not sure whether I’ll actually make it all the way through all 3 days, but it should be fun and I’m going to give it a go. This year, I’m just not going to put much pressure on myself and see it as a challenge rather than a commitment. Pregnancy hormones last year had me feeling (unreasonably) like I was letting someone (not really sure who) down by not completing the challenge. *rolls eyes* Yay, pregnancy hormones.

Anyways, getting on to the first prompt...

HAWMC Day 1: Getting Started! Why you write – tell us a little bit about why you write about your health online and what got you started.

My name is Esther, for those of you who don’t already know me, and I am a survivor of Postpartum Mood and Anxiety Disorders. I’ve fought my way through Postpartum Depression, Postpartum Anxiety, Postpartum OCD, Antenatal Depression, and what I think was probably some Postpartum PTSD. The majority of this happened after my first baby was born in 2009. When she was just a few months old, I was hospitalized twice with what was then being called PPD and PPA; I now (a grand total of 4 years later) recognize that I also had a nasty case of Postpartum OCD. At the end of the year, the doctors figured out that the pregnancy had caused me to develop hypothyroidism, which can cause mental health issues including, after pregnancy, being the real culprit behind PPMD for some women. At any rate, once my thyroid levels were under control, my PPMD cleared right up.

When I was suffering in silence, even after my hospitalization when I was still hurting and confused but keeping quiet because I thought nobody would understand, I came across Postpartum Progress. Postpartum Progress helped me more than I can say. Once my thyroid issues were diagnosed, I realized that there needed to be a louder conversation about thyroid and PPMD, about pregnancy and thyroid issues, and about PPMD in general. I realized how much of a help Postpartum Progress and the other PPD blogs I was starting to find were helping me, and I started wanting to speak up more to let other women know they weren’t alone.

Eventually, I discovered #PPDChat, the brain child of Lauren Hale from My Postpartum Voice. I started to realize that there really were a lot of women out there like me and that there were women who were still suffering in silence like I had, because they didn’t realize that it was normal and that there were people to talk to who had BTDT. I started blogging more and more and now, if you get me started talking about PPMD, it can be hard to get me to shut up.

So why do I blog? I write about PPMD because I know how much it hurts. I know how dark the tunnel is. I know how oppressive the cloud is. I know how hard it can be to even get out of bed and go change a diaper and make a bottle. I know the doubts and fears that pop up when you start to think “Maybe I should ask for help”. I know how absolutely terrifying it can be to go in to the ER and say “I’ having these thoughts I know something is very wrong”, to do the admission paperwork and all the while, wonder if CPS is going to swoop in and snatch your baby away from you because you have PPMD. I know how dull and lifeless the world can seem, how hopeless it can all appear. I know what it’s like to be standing at the top of the stairs, looking down in the middle of the night, and thinking “Maybe everyone would be better off without me”. I know what it’s like to be a military spouse and worry about whether your husband will get chaptered out, lose his clearance, or get reclassed because of your inner demons, inner demons you certainly never wanted and that you only want to be rid of.

I write because I know how much it hurts to hear people say things like “What sin have you left unconfessed?” or “It’s all just in your head”, I know how painful it is to hear people talking about Andrea Yates and say “Women with Postpartum Depression shouldn't be allowed to have kids.”. I know how maddening it is to hear people say “Oh, well, you’re just thinking the wrong way” or “Why don’t you just pray more?”. I write because I’ve been there and, thank God, I survived. I made it through to the other side of the nightmare thanks to the support of my family and close friends, but some people don’t have that, and I want to be that for them. I don’t want anyone I know to ever think that PPMD is something they have to walk through by themselves.

I write because I want to fight the myths and the stigmas, because I want to bring greater awareness to the public, to better educate the people around me (both in real life every day and on the internet) about the realities of PPMD and that it’s not just a cop-out.

I write because that was me, and someday, when my daughters have children, I want them to feel comfortable seeking help if they need it.

I write because others wrote, and what they wrote helped me more than I can ever say, and it taught me that words can make a difference. I want to make a difference. I want to be part of the difference. That is why I write.

A big old can of Troll-B-Gone

Recently, I read a blog post that Susan from Learned Happiness wrote, titled "So you think I shouldn't have had children". Susan's blog post talked about the recent discussions about PPMD that have occurred across the internet as the result of various talk-shows deciding to focus on moms who take anti-depressants. I tried to pick a quote from the blog post that stood out the most, but it all stood out; it was wonderfully written. Susan expresses beautifully the problems with the mentality that women who need medication shouldn't have children. Since I don't want to post the entire blog post here (I'd rather direct the traffic directly to her blog), I'll just leave the link up and tell you to go over there RIGHT NOW and read Susan's post.

Anyways, I had read Susan's blog post and it really resonated with me, so I posted the link on my Facebook profile. Several people shared the link on their own pages, which made me squeal with delight (I always love it when PPMD blogs get more visibility). I hoped that some good discussions would perhaps get started. That is, after all, part of the point in posting about PPMD, to get people talking and combat the stigma. I got my wish, in part. I say "in part" because on one of these links, a discussion definitely got started, but I don't think I would exactly label it "good".

The ignorant comments made by someone who read the Facebook post got me irritated (I think if you look closely, you can still see a little hint of smoke coming out of my ears), and not for the first time in the last few weeks, I find myself thinking about trolls and how to avoid them.

It seems like the best and only way to really avoid getting trolled is to avoid reading the comments of... well, pretty much anything. For example: Huffington Post featured Katherine Stone of Postpartum Progress, Fierce and Powerful, and Something Fierce in a post titled "It's time for everyone to get the facts about Postpartum Depression". I read the post and cheered. Then I made the mistake of reading the comments and went from "Woohoo!!!" to "Yahoos!!!".

This is a common occurrence. There's a media storm about PPMD (usually surrounding a tragedy, such as Cynthia Wachenheim's suicide, or a mother killing her children, such as with Andrea Yates and Otty Sanchez. Or maybe the discussion is the result of a celebrity speaking up about having/survived a Postpartum Mood and Anxiety Disorder, such as Lashinda Demus). For whatever reason, when the media starts talking about PPMD, it brings out the trolls and the uneducated, ignorant masses who believe things like "PPD can be prayed away" or "You shouldn't take such medication". These people spout their rhetoric and spew their word-vomit and the result is the furthering of some nasty stigmas that are about as much fun as constipation and hemorrhoids.

So what is it about PPMD that brings out the trolls? Why do people feel free to say horrid things about mental illness? Why do they feel that it is acceptable to judge the fact that some of us really do need to take medication to control a condition that is trying to control us?

Maybe you're reading this and scoffing, thinking "Pssh. She's just being overly sensitive." or "That poor woman, doesn't she know that mental illnesses aren't REAL illnesses? Doesn't she know that antidepressants are over-prescribed and our society is over-medicated?". Let me tell you, that is simply NOT true. Yes, I am sensitive about mental health, mental illness, and especially maternal mental health. But you know what? I HAVE GOOD REASON TO BE! (yes, that is me yelling). I have lived through the pain of PPD, PPA, PPOCD, and Antenatal Depression. I've struggled through trying to ignore it, refusing to ask for help, and trying to "pray it away" or "think enough happy thoughts". I've struggled through the decision to start taking medication. I've struggled through the hospitalizations. I've fought my way through the emotional minefield of feeling like a failure because I needed that help. I've seen other women try to make their way through that same minefield. I know first-hand exactly how much harm it does to hear someone say "You should just be more thankful to God for your blessings". I know from personal experience how hurtful it is to read and hear people saying all the nasty things they say in these blog posts and news stories in the comments sections. So yeah, I'm a little sensitive, but I'm not overly so because I don't think there's any such thing as being overly sensitive when it comes to this topic that is still far too under-diagnosed and the center of too much unnecessary controversy as the result of stigmas, myths, ignorance, and a lack of awareness and education.

So what do we do when we see these trolls? I haven't figured that out yet. I think I stand with a lot of other PPMD survivors and bloggers in being conflicted on the matter. On one hand, reading the comments can be triggering and infuriating. Engaging the trolls can be the same and gives them exactly what they're looking for: a reaction. On the other hand, not speaking up allows others to get only one view and perhaps to have incorrect opinions strengthened. Speaking up is how we combat the stigmas and myths, it's how we correct the misinformation being spread. And sometimes, it's hard to tell whether someone is being a troll or if they are legitimate in their beliefs and are uneducated and in need of hearing the other side of the story.

All that to say that I'm not sure what the "right answer" is, or if there is one. I'm not even sure why people think that such a major life-or-death issue like PPMD is acceptable to troll. I would, however, like to say this to the trolls:

STOP IT!!!!!!

Please. For the love of Peter, Paul, and Mary, just stop. Stop trolling. Hopefully you don't realize how much damage you have the potential to do, but it's a lot. PPMD isn't some subject that gets talked about and after the heated discussion, nobody is worse off for it. PPMD is a topic that is real, and the hurtful things that trolls say can cause real and lasting damage for the vulnerable women who read the comments.

I asked on twitter what people thought about PPMD trolls and I wanted to share these responses:

@donotfaint: "I had a troll stuck to me once who "double-checked" my research & drs & told me I was exposing my son to a higher risk of SIDS if I didn't breastfeed him. She changed her email address to keep writing to me after I blocked her! ... That is how I learned that trolls are always actually talking about themselves." 

@learndhappiness: "trolls are dangerous bc they say what we think on our worst days & struggling moms won't know they're full of shit".

Trolls, you may not realize it, but this topic is not fun and games. Postpartum Mood and Anxiety Disorders are literally a life and death matter. When suicide is cited as the second leading cause of death in the postpartum period, trolling PPMD is not a joke. When you make the decision to troll an article, blog post, or other conversation about PPMD, you are playing with peoples lives. Women who are suffering from PPMD are already fighting those nasty thoughts and feelings that they're a failure and shouldn't have children. Hearing it from someone else serves only to reinforce those problematic notions, sometimes with disastrous consequences.

If you're not a troll (that is to say, you aren't causing a ruckus just to get a rise out of people), please consider the same thing and think about what you're going to say. If what you say could even remotely be taken as unsympathetic, blaming the mom, judgmental, attacking, stigma-inducing, etc., please, just don't say it. At the very least, talk to someone who has BTDT and is not currently struggling, and ask them to help you figure out how to best phrase your thoughts in a manner that will not be likely to cause emotional and mental distress to a vulnerable new mom.

Trolling can be harmless, in the right environment. A discussion involving PPMD is not the right environment. Don't be That Guy. Don't troll PPMD.

Yesterday, I cried.

Warning: if you are currently having a rough time with PPMD, you may want to avoid this post. It contains potential triggers.

Yesterday, I cried. It wasn't a messy cry. It was a quiet, gentle, soft cry, with small tears and no snotty nose. But it was still a cry.

Why did I cry?

I cried because Cynthia Wachenheim killed herself.

The story I linked above, from the New York Times, reads:

Sometime before 3:25 p.m. Wednesday, Cynthia Wachenheim, a lawyer who was on child-care leave from her job, wrote out a note. On lined notebook paper, it ran for 13 pages.

According to a law enforcement official who has seen the note, she wrote that her infant son, Keston Bacharach, had previously taken a few tumbles, including “two shameful incidents,” a fall from a Gymini play set onto the wood floor when she walked out of the room for five minutes, and off a bed. She blamed herself, and was convinced that those falls had led to a series of concussions and seizures that aggravated or contributed to maladies that would harm him for the rest of his life.

Her friends, family members and pediatrician did not believe her, she wrote. But she noticed changes in the baby — changes that only a mother who spends all day with her child would notice. For instance, she wrote, her son had grown sleepier and cried more frequently.

She wrote that she could not bear the thought that he might suffer because she had failed to protect him. She wrote that what she was about to do was “evil.” 

She then jumped out of her eighth-floor window. She left behind the note. She did not leave behind her son, strapping him to her body in a Ergobaby carrier, bringing him down with her as she crashed to the ground, the crack sounding like a gunshot to people passing by.

Ms. Wachenheim, 44, died. But her 10-month-old son, apparently cushioned by her body, survived. He bounced out of the carrier and suffered only a bruised cheek.

“I’m sure you understand, I’m absolutely overwhelmed with grief,” her husband, Hal Bacharach, said in a brief telephone conversation Thursday from his apartment at the Sutton, a new sleek building at 147th Street and Bradhurst Avenue in Harlem, where he had lived with his wife.

“I have my son, who was lucky enough to survive, in my lap,” Mr. Bacharach said, sounding in shock as he repeated similar words several times. “It’s unbelievable. Right now my crying son is in my arms.” A child could be heard whimpering as he spoke.

Ms. Wachenheim’s leap was a jarring twist in the life of a highly educated, socially conscious woman who had been active in a women’s group in her synagogue, B’nai Jeshurun on the Upper West Side, and, according to her college class notes, had been a coordinator for a Harlem tutoring program.

She was on leave from her $122,800-a-year job as an associate court attorney in the Manhattan State Supreme Court system, court officials said. She had worked for the courts since 1997, doing legal research and helping judges write opinions.

Christian Johnson, a lawyer who lives a few doors down, said he had seen Ms. Wachenheim twice last week. There was no indication “that anything was askew in their household,” he said. “I was shocked.”

The baby seemed normal, he said. Mr. Johnson would sometimes ride the train with Mr. Bacharach, who never said anything about developmental issues. “Hal never mentioned that to me,” Mr. Johnson said.

But Mr. Bacharach’s mother, Barbara Bacharach, said that her daughter-in-law had not been her usual self lately.

Mr. Johnson said he had overheard the couple arguing — which he said was very unlike them — about two hours before Ms. Wachenheim jumped. He paused in the hallway to make sure it was nothing serious, then moved on when it seemed like a normal marital spat. “He was just asking her why she didn’t answer the phone and why wouldn’t she pick up the phone,” he said. “He just kept asking her and she wouldn’t respond.”

Several times in her note, according to the law enforcement official, Ms. Wachenheim expressed deep love for her son, referring to him as “beautiful.”

She said that she would give her life to bring his health back and that she hated herself for the first time in her life. She believed that her son’s falls might have brought about a serious medical condition, perhaps cerebral palsy or autism, which would have “lifelong consequences.”

Her belief that she failed to prevent it caused her to “crumble.” She wrote that she was depressed and could no longer socialize. She was sure that people would see her behavior as postpartum depression or psychosis.

Dr. Catherine Birndorf, a reproductive psychiatrist at Weill Cornell Medical College, said the word “evil” in the note stood out for her. “Usually these intensely lethal acts happen in the context of losing some kind of touch with reality,” she said. “What mother in their right mind would kill their kid?”

Postpartum depression does not usually lead to suicide and homicide, she said, unless it is left untreated or progresses to more serious mental illness, like psychosis. She compared it to the case of Andrea Yates, the Texas woman who was found not guilty by reason of insanity of drowning her five children in the bathtub. Ms. Yates, who had been struggling with postpartum psychosis, thought that she was a bad mother and that she was protecting her children by killing them, Dr. Birndorf said.

About 10 to 20 percent of new mothers have postpartum depression, according to the state health department, and only 1 or 2 out of 1,000 new mothers have postpartum psychosis. Postpartum psychosis is characterized by delusions, often about the baby, agitation, anger, paranoia, and sometimes commands to harm the infant. It has a 5 percent suicide rate and a 4 percent infanticide rate, according to the health department.

Ms. Wachenheim was valedictorian at Colonie Central High School, near Albany, and graduated from what is now known as the University at Buffalo, and from Columbia University Law School. In 1993, she traveled to Pakistan to work in a law office specializing in women’s rights and worked on subjects like “honor killings” of women suspected of adultery, according to an article at the time in The Times Union of Albany.

Mr. Bacharach said he met his wife on a bus to Boston and was smitten by her “innate kindness.” They were married in 2009, two years after she bought her apartment at the Sutton for $190,750, according to city records.

It is across the street from Jackie Robinson Park, where neighbors said Ms. Wachenheim took her newborn to the outdoor pool in the summer.

Randy Leonard and Sheelagh McNeill contributed reporting.

A version of this article appeared in print on March 15, 2013, on page A19 of the New York edition with the headline: Mother Knew Her Final Act Was Evil One.

I When I read this, I cried for Cynthia. In fact, I'm crying right now while I write this. I don't know that I know the exact pain she was struggling with, but I know the type of pain that leads you to think that maybe the best solution is to kill yourself. I know the kind of pain that makes you feel hopeless and like you're just hurting everyone around you. I know the pain that says "Everyone would be better off if I was gone". I know the pain of "What if I hurt my baby?".

I think it's important to note that this article does not say definitively whether or not Cynthia had a diagnosis of any type of Postpartum Mood and Anxiety Disorders, but the article does list several things that can be symptomatic of PPMD, and there's the fact that the article lists her son as being 10 months old (PPMD can rear their ugly heads at any time in the first 12 months after giving birth, and does not necessarily go away just because a mother and baby hit the baby's first birthday). I feel that it's important to note that I am not diagnosing Cynthia with anything. I'm not an M.D., R.N., C.N.M., or any other type of medical/mental health professional, and I don't know nearly enough about Cynthia and her history/situation to make that call.

Regardless of whether or not Cynthia was suffering from a PPMD, she was obviously hurting and struggling with a great burden. I've never met Cynthia but I know that she was so upset and hurting so much in some way that she decided the best thing for her and her baby was for both of them to die, that that was the best way to protect them. I can't say that I can't imagine what she was going through, but I think I can, just a little bit.

Cynthia is the reason why I blog. Her baby, who could have died with her but didn't, is why I blog. Her husband and the rest of her family and friends are why I blog. They are why I cry now. The world is such a cold hard place and for some people that is more true than it is for others. And when I hear about stories like this, it makes my heart hurt. I wish I could go to New York a few days ago and hug Cynthia. I wish I could tell her "It's okay, Cynthia. You're not a bad mom. You need help, let's go talk to a professional. I'll go with you and hold your hand so you're not alone. But you don't have to do this.". I wish I could save her, save all the people she leaves behind. But I can't. All the wishes in the world won't change that. All I can do is hope that she is at peace now and pray for those she leaves behind.

I can't save Cynthia, and as much as I want to, I don't have the technology to be able to go back in time to tell her those things. But I can tell you. And so, I am.

If you are out there reading this and you are hurting, let me help you. If you feel hopeless, please know that there is hope. There is always hope, even when you can't see it. If you feel like you can't go on, you can, and I will go with you. I HAVE BEEN THERE. I was hospitalized twice after my first daughter was born for that very reason. I have survived Postpartum Depression, Postpartum Anxiety, and Postpartum Obsessive-Compulsive Disorder. Cynthia's story is how mine could all too easily have ended if I hadn't gotten help.

You do not have to go through PPMD alone. Let me walk with you. You are not alone and you are not a bad anything. You are the most beautiful and fantastic you that could ever exist.

If you need help, let me help you.

Please.