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.

Just keep swimming, just keep swimming

Ever feel like you're drowning (metaphorically speaking) and you're not sure where the life preserver is that you know is out there somewhere, nor are you sure you want to take it? Yeah, that's me lately. School has been an absolute BEAST to adjust to (which is probably related to that whole "taking 17 credits in school thanks to the academic adviser from hell who set me up for failure" thing). And of course, having 3 small children and a husband at home, all of whom are also having to adjust to the total change in lifestyle and schedule for all of us, well, that adds a little extra dimension or ten to matters.

Lately, I think to myself "Just keep swimming, just keep swimming" (you know, from Finding Nemo), and then I think "I don't want to keep swimming. I'm tired of swimming.", and then of course I beat myself up for my defeatist attitude, and then I beat myself up for beating myself up, and then I scold myself for being so dramatic, and eventually I finish my homework, go to bed, and then go through the whole routine again the next day.

I decided to drop my Anatomy classes (I was taking Anatomy Lecture and Lab) which takes me down to 13 units. It's still pretty intense but it's more manageable. I didn't want to drop a class but it was way too much and I wasn't doing well at all in Anatomy (and by not doing well, I mean I'd be lucky to have passed the course at the end of the semester).

Hopefully, dropping Anatomy will be the life preserver I needed and I can get back on top of things.

And yes, I am being totally metaphorical and am in no way a danger to myself or anyone else.

Dear Senator Feinstein,

I just sent this off to Sen. Feinstein. Feel free to copy and/or circulate it as you see fit. PLEASE, please please please contact Sen. Feinstein about her ignorant, incorrect, and insulting remarks about PTSD and veterans. I"m not even asking her to stop supporting gun control, I just want her to correct her remarks about PTSD and apologize.
(Not sure what I'm so upset about? Check out my blog post from earlier today)

Dear Senator Feinstein,
I'd like to begin by explaining the background I come from. I am a U.S. Army veteran. I am also a survivor of Postpartum Depression, Postpartum Anxiety, and Postpartum Obsessive-Compulsive Disorder, and I am an advocate and blogger for women struggling with Postpartum Mood and Anxiety Disorders. My husband is currently on Active Duty in the U.S. Army and is a combat veteran of multiple deployments in the Middle East. One of my grandfathers served in the U.S. Navy and one of my grandmothers and my other grandfather served in the U.S. Air Force. My brother is a veteran and combat veteran of the U.S. Army. My mother-in-law and father-in-law were both in the U.S. Navy. I have a sister-in-law and brother-in-law who serve in the U.S. Coast Guard. I have multiple other extended family members and close friends who have served or are serving in various branches of the U.S. Military.
I am writing to you today regarding your comments during the March 7, 2013 Judiciary Committee Hearing on S.150 The Assault Weapons Ban. Yesterday, you stated on record that "with the advent of PTSD, which I think is a new phenomenon as a product of the Iraq War, it's not clear how the seller transfer of a firearm covered by this bill would verify that the individual was a member or veteran and that there was no impairment of that individual with respect to having a weapon like this... I think if you're going to do this you have to find a way that veterans who are incapacitated for one reason or another mentally don't have access to this kind of weapon".
There are several problems with your comments. I'd like to address several of these problems in no particular order of importance.
1. PTSD is not a new phenomenon, nor is it a product of the Iraq War. Even if the only PTSD cases you want to consider are those of military personnel, service-members in conflicts preceding the war in Iraq were already suffering. World War 1, World War 2, Vietnam, the Korean War, and the first Persian Gulf War, just to name a few. My own grandfather was a POW in North  Korea during the Korean War and he came back with PTSD as a result of the atrocities he endured while he was a prisoner. Your statement that PTSD is a new phenomenon following the Iraq war is insulting to all these other veterans and passes them off as unimportant, saying that they don't count and don't matter, it wasn't really a problem before Iraq. It was.
2. PTSD is not specific to the military or to combat veterans. PTSD affects people who have never served a day in the military. PTSD stands for Post-Traumatic Stress Disorder and I think everyone can agree that Traumatic situations can and do affect anyone, no matter what their situation is. Postpartum PTSD affects as many as 7-16% of new moms and that has nothing to do with the military, combat, or Iraq. Rape victims, victims of tragedies such as Hurricane Katrina, survivors of 9/11, and so so many other people facing a myriad of countless types of situations face PTSD, and your comments insult them and say that if you're not a veteran during/since Iraq, you don't matter.
3. There is already too much stigma surrounding mental health. It's incredibly difficult to reach out and say "I need help" when people think and say things that either insinuate or flat out say that people with mental health issues are all violent monsters waiting for the right time to flip out and go on a murderous rampage. Comments such as yours only add to that stigma and further perpetuate the myths that I and my fellow mental health advocates are working so hard to disperse.
This is especially ironic considering that you claim to be highly involved with and supportive of veterans, working for better help and research for veterans with PTSD and TBI.
I urge you to publicly retract and apologize for your statement that I quoted at the beginning of my email. You have done great harm to veterans and to the entire mental health community; please take this opportunity to do the right thing by publicly admitting that you misspoke and apologizing for your insulting and factually incorrect remarks. As an elected official. you represent the people of the United States and you work for us; it is your duty and responsibility to correct these statements you have made that have the potential to so greatly misinform people as to the nature of mental health in general and PTSD specifically. Please do the right thing.
Sincerely,
Esther Dale

Sen. Feinstein's insulting lies about veterans and PTSD

Senator Dianne Feinstein (D-CA) has managed to stick her foot in her mouth in a very big and particularly insulting way. During yesterday's Senate Judiciary Committee hearing on Senate Bill S.150 (The Assault Weapons Ban of 2013 [1], Sen. Feinstein made the following comments:

"with the advent of PTSD, which I think is a new phenomenon as a product of the Iraq War, it's not clear how the seller transfer of a firearm covered by this bill would verify that the individual was a member or veteran and that there was no impairment of that individual with respect to having a weapon like this... I think if you're going to do this you have to find a way that veterans who are incapacitated for one reason or another mentally don't have access to this kind of weapon." -Sen. Dianne Feinstein"

You can hear her words at this link: http://www.youtube.com/watch?v=DjR-UaLl5PM

Since this is not a political blog, I won't get into my feelings about gun control, and I ask my commenters not to. What I want to talk about here is Sen. Feinstein's inaccurate and insulting comments about PTSD and mental illness.

Every time a tragedy happens and someone says "Oh, she must have Postpartum Depression" or "Oh, he must have PTSD", I object, and I say that I think that mindset further stigmatizes mental illness, as well as causing people to buy in to the idea that if you have PPD or PTSD or any other mental health issue, you're a ticking time bomb just waiting to go off in a blaze of tragedy and homicide. I get so many arguments about it that I've written blog posts to further explain my point of view (these posts can be found here and here). Today, I believe that Sen. Feinstein has just proven my point for me.

I have several very big problems with Sen. Feinstein's remarks. One problem is that what she said is so incredibly insulting to veterans, whether they have PTSD or not. To assume that all veterans are just waiting for the right nudge to go murder someone is the exact opposite of the supportive attitude we should have towards those who volunteer to serve our country and, for many of them, end up in combat as a result.

On top of that, there's the fact that she has just assumed that PTSD means that you're a violent person. Sen. Feinstein's remarks are indicative of the problematic attitudes and stigmas towards mental health that make it so hard for people to speak up and say "Hey, I need help.". I mean really, who wants to seek help if it's just going to make people treat them like monsters, or mean that they get things taken away from them?

That doesn't even touch on the fact that her comments are factually inaccurate. PTSD is not a new phenomenon. Veterans of the Iraq War were not the first servicemembers to come home with PTSD. ALL wars have left servicemembers struggling to make sense of their experiences and left them with PTSD. I'd love to see Sen. Feinstein go tell the veterans of World War 2, Vietnam, Korea, the first Persian Gulf War, and every other conflict our country has been involved in that PTSD wasn't a problem for them. Please Sen. Feinstein, go ahead. Say that to their faces. I'll go along and hold the camera to record the reactions you get.

The other issue is that PTSD is not specific to the military or to combat. PTSD stands for Post-Traumatic Stress Disorder. I will agree that a large amount of the awareness that the American public has towards PTSD now is due to the servicemembers who have come home with PTSD, but people who have never served a day in the military end up with it too. Rape victims, people whose houses burned down, people who survived 9-11, first responders who help at scenes of accidents, crimes, etc., survivors of Hurricane Katrina, people who lose a loved one unexpectedly, women who have a traumatic childbirth (Postpartum PTSD is a real thing), and so many other scenarios. Any traumatic situation can cause PTSD.

I worry that Sen. Feinstein's remarks may have done irreparable damage not only to the men and women who struggle with PTSD (or any other mental health issue) but to the very cause of fighting for awareness, education, and the destigmatization of mental illness.

I will be calling, tweeting, and emailing Sen. Feinstein to ask her to please apologize for her troubling and factually incorrect comments about PTSD and mental illness. Will you join me in contacting her? Here's her contact information.

Senator Dianne FeinsteinUnited States Senate331 Hart Senate Office BuildingWashington, D.C. 20510

Phone: (202) 224-3841
Fax: (202) 228-3954
TTY/TDD: (202) 224-2501

Sen. Feinstein's website: http://www.feinstein.senate.gov/public/index.cfm/contact
To email Sen. Feinstein: https://www.feinstein.senate.gov/public/index.cfm/e-mail-meTwitter: https://twitter.com/senfeinstein

Let's speak up and let Capitol Hill know that we won't stand for this type of blatant lying and misrepresentation. Let's speak up for the veterans who volunteer to serve our country, as well as for people suffering from all manner of mental health issues.

[1] Title of S.150 crafted by the bill's author, Senator Feinstein.