Postpartum OCD Powerpoint

This past semester (Fall 2014), one of the (college) classes I took was Women's Health Issues. One of the assignments was to do a research presentation on a women's health issue. This included putting together a slideshow addressing the basics (symptoms, definition, treatment, etc.) which we then had to present to the class. I chose Postpartum OCD. We had a 4-minute time limit, which was REALLY difficult for me to meet, so it ended up being a VERY basic overview. I could have easily talked for the whole class period and just scratched the surface of PPOCD. It's such a complex and under-discussed issue...

Anyways, I thought I'd share my Powerpoint presentation in case it can be of help to anyone. I've got it uploaded to Google Drive so that anyone with the link can view it. Enjoy. :)

Happy 10th Anniversary to Postpartum Progress and Katherine Stone!!!

"If you have knowledge, let others light their candle in it." -Margaret Fuller

5 years ago, I was a brand new mother. I had a whopping almost 3 months of experience as a parent under my belt. I had given birth to a beautiful daughter on April 23, 2009. Life as a new mom was pretty terrible for a little while, courtesy Postpartum Depression, Postpartum OCD, Postpartum Anxiety, and what I suspect was some Postpartum PTSD after a very difficult birth. I ended up being hospitalized twice, taking medication, and seeing a therapist. It was one of the darkest periods of my life.

One day (I can't remember when, exactly), as I dragged myself through the dark tunnel of PPMD, I came across a candle. It burned brightly. It called out to my soul and to my heart. At the time, my own candle was pretty much out, but that candle gave me hope. It helped me find my way out of darkness and isolation, to safety, support, and love. From that flame, I was able to re-light my own candle. That flame was Postpartum Progress.

10 years ago, Katherine Stone started Postpartum Progress. Countless women and families have been helped in many ways. I and my family stand among them. Postpartum Progress made a huge difference to me. It was helpful beyond words to find a site with so much good information written in a way that I could understand, a community of women to help support me, a safe haven to let me know that I wasn't alone and I really was a good mom, a warrior. Postpartum Progress has been a God-send to so many.

Today, I dedicate my blog to celebrating Katherine and Postpartum Progress. 10 years of dedication to awareness, education, and outreach is kind of a Big Freaking Deal. Postpartum Progress has been a game-changer for women with PPMD and today, I'm throwing virtual confetti in honor of an amazing person who had an idea and then put that idea into action.

Katherine, my dear friend, you beautiful wonderful soul, you rock my socks off! And I put socks on specifically to type that, which should tell you exactly how much you mean to me, since I pretty much never wear socks. Thank you for everything you have done and continue to do. I am forever grateful to God for leading me to you and to Postpartum Progress. Because of Postpartum Progress, I got the courage to share my story and to reach out to a fantastic community of some of the strongest women I know, who have become friends and sisters of my heart and my spirit. I hope you never go a day without the knowledge that you are loved. As we celebrate the birthday of Postpartum Progress, know that your candle has been a much-needed beacon to help light the way for many who couldn't see on our own. Some day, I will get to meet you in person (and I will squeal and make a fool of myself and probably end up a blubbering mess as I tell you what an honor it is to meet one of my honest-to-goodness heroes who helped save my life, my sanity, my marriage, and my family, who has become a friend). For now, I'll have to stick with sniffling my way through the beautiful stories I've been reading about the other women you've helped. We are many.

Happy Anniversary!!!!!

*eats more ice cream*

To everyone reading this, I'd like to share the words I borrowed from Good Girl Gone Redneck:

If you'd like to help support Katherine's efforts with a donation to Postpartum Progress you can do so very easily online. Postpartum Progress is a non-profit organization and your donation will be tax deductible. Your donation will go towards supporting an organization that supports ALL mamas EVERYWHERE.

If you or anyone you know is experiencing symptoms of postpartum mood disorders, please consider reaching out for help. Postpartum Support International has a toll-free support line you can call 1.800.944.4PPD and a map of local support resources for you.

Looking to talk to mamas like you? #PPDChat is a weekly Twitter chat where you can find discussions related to living your life postpartum.

Looking for hope? A reminder that you WILL get through this? Check out the Warrior Mom Photo Album and see these smiling faces. That will be you - soon.

Breastfeeding and medication

Recently, I was talking to someone on Twitter about breastfeeding on (and after) antidepressants, and it hit me once again how big a role breastfeeding can play in a woman's decision whether or not to seek treatment for PPMD. For me, among other fears (such as my child being taken away from me), I was so far into the whole "Breast is best" mindset that, when the filter of PPMD was added to the mix, the idea of having to stop breastfeeding my baby was horrifying and extremely upsetting. Concern over having to stop nursing is one that I frequently hear/see brought up and it is totally understandable.

I have written a couple of blog posts in the past about why Breast is not always best (part 1 and part 2). That is not going to be my focus for this blog post. In this post, I'm just going to share what my personal experiences have been with breastfeeding and medication.

When I was admitted to the hospital with a diagnosis of Postpartum Depression, my baby was 3 months old and exclusively breastfed. I had held off on getting help but finally realized I was at a crisis point and went to the ER, where I was transferred and admitted to a psychiatric facility. Because I specifically didn't want to have to stop nursing my baby, we tried talk therapy for the first day or two, but I could hardly even open up about how I was feeling and we quickly realized that medication was necessary. They started me on Lexapro (I was soon switched to Celexa, a generic version, for Insurance reasons), Ativan, and Ambien, which are not considered "safe for breastfeeding", so I had to stop nursing. I was extremely upset, but accepted that if I wanted to get better, this was what needed to happen. My baby did fine switching over to formula and the only discomfort was on my end because I stopped nursing/pumping cold turkey (ow, ow, ow). 5 years down the road, my daughter is extremely smart and well-adjusted, and we continued to bond very nicely. Actually, I think we bonded better because I was on medication and was able to connect better (I definitely remember the connection better after starting medication).

That first admission, diagnosis, and start of medication were in July 2009. At the beginning of December 2009, I was diagnosed with hypothyroidism (my doctors had previously missed it, but that is a whole different story for another time). Pregnancy can cause hypothyroidism, and hypothyroidism can cause mental and emotional health problems. I was promptly started on a low dose of Levothyroxine, a thyroid hormone replacement medication, and started to see my symptoms lessening pretty immediately. My dosage only had to be adjusted once to get my TSH and T4 levels back to within normal limits, and that also kicked the rest of the PPMD symptoms. After 3 months of Levothyroxine, I was able to stop taking the Celexa, Ativan, and Ambien that I had been on since July, and all was well.

I have been on this same dosage of Levothyroxine for 5 1/2 years now and it has never needed adjusting. During my pregnancies, the OB monitors my thyroid levels with bloodwork once a trimester (more often if I start experiencing anything unexplained  that could be symptoms of my thyroid medication needing an adjustment), but so far everything has been fine.

In April 2011, I gave birth to our second baby. Even though we were sure the PPMD had been related to the hypothyroidism, at my midwife's recommendation, I started taking Zoloft at 38 weeks pregnant (read what the Mayo Clinic has to say about antidepressants during pregnancy) as a prophylactic measure, and weaned off of it at about 6 or 7 months postpartum. This was shortly before finding out that, much to my shock and attempts to prevent pregnancy, I had another bun in the oven.

That second baby nursed through Zoloft, Levothyroxine, and the first two trimesters of my third pregnancy. She finally weaned herself at about 13 months. I was about to force her to wean since she had started biting (yay for teething). Let me tell you, I thought getting a tooth to the boob was painful enough under normal circumstances but with pregnancy making the girls extra tender? Yeeeeeeeeah.... "ow" doesn't quite do it justice. But, at that point she was down to usually only nursing in the middle of the night and she weaned herself, so it all worked out happily for both of us.

I started on Zoloft again at about 35 weeks with my third pregnancy. The original plan was to wait until 38 weeks again but I had some symptoms of depression and anxiety that were due to situations that were going on totally unrelated to pregnancy and we thought it best to start the Zoloft a little early. Baby #3 was born in September 2012. I was able to come off the Zoloft at about 3 or 4 months postpartum that time, again with no issues. The only issues I had were when I started using the Nuva Ring and got super tired (plus some intrusive thoughts) but that all went away when I discontinued the Ring. Baby #3 was EBF until I started school fulltime when he was ~4.5 months old. At that point, I got a good double electric breast pump and started pumping so that he got exclusively breastmilk at daycare and EBF when he was with me. With my school schedule and everything else going on in life, the pumping got to be a bit too much and eventually I stopped pumping; he got formula at daycare and breastfed when I was around. He self-weaned at 9 months.

I've done a wide range of options for feeding my children. Exclusively breastfed, Formula fed, breastfed through pregnancy and a little past the first year mark, breastfed plus breastmilk in a bottle, and breastfed plus formula. I've nursed on different medications and off of them. There is no shame or failure in any of these methods that I chose to feed my children. At the end of the day, what matters the most isn't *how* I fed my babies but *that* I fed them.

My experiences and feelings may not be yours. I can not say what is right or wrong for you and your family, aside from telling you that taking care of yourself is absolutely right, and that anyone who looks down on or tries to shame you for how you feed your children is 100% wrong. What I can tell you is that you are a good mother no matter what method (or combination of methods) you choose to feed your baby[ies]. In order to take care of others, we have to take care of ourselves first and practice radical self respect. Self-care is vital to not only our own well-being but the well-being of our babies and our families.

Whatever your choice, make it and don't let anyone get you down. If they want to say that they don't approve or agree or whatever, you feel free to send them on over to me and I'll gladly have a friendly chat with them.

Mental health hero moment: Elder Jeffrey R. Holland

In the past, I've written about my frustrations with people who attribute struggles with PPD or any other mental health issue to a lack of faith or any other spiritual failing. Today, I want to talk about someone who is getting it right: Elder Jeffrey R. Holland of The Church of Jesus Christ of Latter-day Saints.

During the 183rd Semiannual General Conference spanning from October 5-6, 2013, Elder Holland gave a talk titled "Like a Broken Vessel". Elder Holland, THANK YOU!

Elder Holland's talk should be required viewing/listening/reading for all Christians, no matter what church you do or don't go to. If you're not Mormon, ignore the Mormon-specific language. You can still get a lot out of it.

Here's one of of my favorite quotes from his talk:

"However bewildering this all may be, these afflictions are some of the realities of mortal life and there should be no more shame in acknowledging them than acknowledging a battle with high blood pressure or the sudden appearance of a malignant tumor."

Here, Elder Holland hits on a point of vital importance: mental illness is an illness. I have no problem posting on Facebook things like "My sinuses are terrible" and "The doctor says I have Pneumonia, time to break out the antibiotics", and should similarly not be afraid to say something like "I'm having a lot of trouble with horrible thoughts popping into my mind unbidden" and "I've just been diagnosed with Postpartum OCD. I'll be starting medication and finding a therapist". I absolutely love that Elder Holland has specifically acknowledge and pointed out that health is health and illness is illness and there should be no shame in acknowledging or seeking help.

I've talked before about how frustrating and non-helpful it is to say things like "Just pray more", "Just have more faith", "Are you sure you've confessed all your sins?", or anything else that insinuates that the person with PPMD (or any other mental health issues) is at fault or is somehow choosing to have PPD etc. The fact of the matter is that PPD etc. is not a spiritual issue, it's a health issue. It's not something that you can automatically just pray away. There are people who say that they prayed and received miraculous healing, and I'm truly happy for them, but that doesn't always work. Sometimes, prayer really isn't enough. You can have all the faith in the world and still have PPD, etc.

Elder Holland is one of my heroes in the Church, for being so willing to be open about his own struggles and for standing up in General Conference and saying "This is real. There shouldn't be any shame". For getting up there and saying that it's ok and good to seek help from professionals. For showing so much love and compassion and understanding. I hope to someday get to meet Elder Holland and tell him exactly how much his words meant to me and to so many others

For anybody out there who's reading this and trying to find their way through their own dark tunnel, especially for my LDS sisters, I leave you with these words from Elder Holland's talk. They are words that give me hope and I pray that they also bring you some measure of comfort.

"I testify of the holy Resurrection, that unspeakable cornerstone gift in the Atonement of the Lord Jesus Christ! With the Apostle Paul, I testify that that which was sown in corruption will one day be raised in incorruption and that which was sown in weakness will ultimately be raised in power. I bear witness of that day when loved ones whom we knew to have disabilities in mortality will stand before us glorified and grand, breathtakingly perfect in body and mind. What a thrilling moment that will be! I do not know whether we will be happier for ourselves that we have witnessed such a miracle or happier for them that they are fully perfect and finally “free at last.” Until that hour when Christ’s consummate gift is evident to us all, may we live by faith, hold fast to hope, and show “compassion one of another,” I pray, in the name of Jesus Christ, amen".

Momentarily breaking the radio silence

TW: pregnancy, death of a pet, miscarriage, D&C

Hello! My apologies for the lack of posts lately. This year has been NUTS. January involved an IVF cycle as a Gestational Surrogate, culminating in a Frozen Embryo Transfer at the end of the month. February brought the news that my Intended Parents were going to get twin boys, due in October. March started off with having to put our family dog to sleep when her bone cancer got to the point that pain control wasn't possible, included my husband and kids alternating between a vacation and getting sick, and ended on March 31 with Spring Break starting with an OB appointment where I found out that I had a missed miscarriage of both twins. April started off with Spring Break involving lots of appointments and ending up at the hospital at the end of the week for a D&C and continued with me missing the first week back to school as I recovered, the kids missing 1 1/2 weeks of daycare sick, and both the girls having their birthdays. May involved Yumyum having to come back out of daycare for a couple of weeks with a food poisoning thing (not dangerous, just can't be at daycare b/c large groups of little kids too often have absolutely awful hygiene). All in all, I'd say I missed easily 1 1/2 months of class between various health issues. Oh yeah, did I mention that in all this craziness I'm still a full time college student? This semester I've been taking Intermediate B&W Photography, Intro to Linguistics, Public Speaking, and Intermediate Algebra & Coord. Geometry (that's all one math class) for a total of 13 units. PHEW!

Anyways, it's been nuts. It's like life in general decided to just kind of throw lots of crap at us all at one time, including deaths in the (extended) family. I have lots of ideas floating around in my head for blog entries but just haven't gotten around to finding the motivation (or time) to write them. I'm hoping that will change soon since it looks like things are moving in a much more positive (and calmer!) direction. But I figured I out to post an update to let anyone who happens across the blog know that yes, I am still out there and Through the Tunnel has not been totally abandoned.

I think that's about it for now. If you want to read more about my surrogacy journey, head on over to The Womb Fairy. I can, as always, be found on Twitter as @cornmuffinsmama. Much love and light to all of you!

Living through tornadoes

The morning of Good Friday in 1991, I was sitting at the kitchen table with my mom and my brother, eating breakfast. Breakfast that morning was blueberry poptarts. Dad was in the bathroom at the other end of the house taking a shower. The weather was awful at our house in Marietta, GA. There was a thunderstorm unlike anything I can remember ever seeing before that. Despite being approximately 8:30am, it was as dark as midnight outside, except for the flashes of lightning which were so bright, they lit everything up like it was high noon. It was raining. Specifically, it was raining really hard, and the wind was blowing the rain completely sideways. The thunder seemed nearly constant and shook the house on the foundation. I remember my mom going to the front door to look outside and my brother and I followed her. I remember looking over and seeing our American flag blowing wildly and asking if we should bring it in. The radio was playing in the background but I don't remember what it was saying, it seems like it was the "wah wah wah" that you hear when adults speak in a Charlie Brown cartoon.

Suddenly, Mom said we had to get down to the basement. We lived in Georgia so people actually had basements underneath the house, down in the ground and everything. I remember following her and, despite me going as fast as I could, she was dragging me and I was stumbling. The steps were so steep as they went down into darkness, down into the ground where everything was cool and still.

We sat there in the basement, listening, straining our ears, trying to hear what was going on upstairs as a tornado disrupted our lives and tore up our house. On his website, my dad describes the tornado activity across the county and in our neighborhood/over and around our house:

"We would later find out that six maximum force tornadoes (winds measured well over 250MPH) all touched down in close proximity in the county essentially simultaneously. A friend on the south side of Atlanta (we were north) called because he had seen on eyewitness news there had been a tornado near us, and wondered if we had seen it. Andre', my best friend, called. "Pray for Darlene & the boys - they were hit in the car by a tornado! They're all shaken up; I'm going to try to get to them now." We had to laugh. We'd been through so much with them - here we went again! (They turned out to be fine, other than being shaken up.)

One tornado had come through the neighborhood, straight across the street, tearing up homes left and right. Another had gone right through the woods behind us; they had crossed by our back property line (after, we found, following roughly parallel courses for over a mile). There was a 50 yard swath cut through the woods at about 5 feet off the ground. All the tree tops were laid out nicely in the same direction - like Paul Bunyan and Babe had just gone through or something."

All of this was going on while we sat in the basement, scared of not only the tornado but scared for Dad, who was still in the shower when the tornado hit (an experience described here). We were a little off to the side of the stairs. There was a wooden desk sitting there. It was older, made out of solid wood, and had a little opening for your legs with wood sides all around, totally enclosed but for the front. I remember hunching down and pressing back as hard as I could, trying to get underneath the desk, instinctively feeling that the safest place was to be surrounded by something solid, not liking all the empty cavernous space of the basement and afraid that the ceiling (aka, the rest of the house) would fall down around us. I couldn't get underneath the desk because the leg space was filled with books (that's totally normal, right?) but still pushing back with all my might. I remember what those books felt like against my back. I was terrified.

After what seemed like an eternity, my Dad opened the door to the basement and came down to tell us it was safe to come upstairs. Mom and Josiah went upstairs with Dad. They all stood at the top of the stairs, calling down to try to reassure me it was okay to come back upstairs. Eventually, I had to be carried up the stairs. I still wasn't totally convinced that the tornado wouldn't come back. As far as I was concerned, life had just gone from normal to terrifying in a split second and now, a few minutes later, everyone was trying to convince me that it wouldn't happen again? Ha!

I emerged from the basement to find a world that seemed to me, a 6 year old girl, to be turned totally upside down. Windows were out of their frames and there were broken glass, dirt, and mud everywhere.  Outside, there were trees uprooted, but the glass cake dish on the kitchen counter was untouched. My brother's bedroom was undamaged except for a little spot in the ceiling where some water was leaking (a result of the roof being in less than fantastic shape). Across the hall, my bedroom was a total mess, having been hit the hardest of all the rooms in the house. As with many tornadoes, there were examples of this kind of surreal contrast all throughout the house and the neighborhood, the entire county.

An hour after the tornado ended, I realized I was still holding onto my blueberry poptart. Holding onto it might be a rather mild way of putting it, since my grip was so tight my fingers had made holes clean through and was basically wearing the poptart like some kind of odd ring.

This year, 2014, will be 23 years since the tornado hit our house with us inside. 23 years later, I can still remember clearly what it looked and sounded and felt like when the thunder rolled, the lightning struck, and the wind rattled everything, blowing trees over in half. I didn't get much sleep that weekend, terrified that a tornado would hit again. It was a long time before rain stopped freaking me out. 5 years later, I was still conducting tornado drills and fixing up the closets and bathrooms to be as safe and comfortable as possible if we had to take shelter every time there was a tornado watch or warning (we had moved to Central Texas where the limestone makes basements all but impossible). I think it's safe to say I may have been suffering some PTSD.

Maybe you're thinking "This is a PPD blog. Why am I reading about a tornado from Esther's childhood?". People often ask "What is PPD like?" and it hit me the other day that PPD, at least for me, was exactly like living through that tornado.

One minute, I was celebrating what should have been one of the happiest times of my life, but with a nagging sensation that something was wrong. All of a sudden, there was a storm. A massive and nasty storm, that turns my mental and emotional landscape, my entire life, everything around me, into an unrecognizable and scary scene. Everything becomes total chaos. Terrifying chaos, and I have no clue whether I'll live through it, whether or not my family will come out of it complete. There's noise. Things are light then dark then light, and my whole world is shaking and shaken. I'm utterly terrified, senseless with fear and uncertainty.

But eventually, into the darkness and chaos, light begins to extend. I start to notice that things are quieter, calmer. I'm being told that everything is over, that it's ok to come out of the dark, that life is safe again. It takes some doing but slowly, I emerge from my hiding place. I come out to find that everything in a shambles, that things are broken, but people pick me up and carry me to safety, and then people, loved ones, step in to help clean up the mess that this unasked for storm has made of my life.

When it's all said and done, nothing looked the same again. Nothing has ever been the same, either since the tornado or since PPD. But it is life, and it is put back together, it is mended, and I move on. Sometimes, I still get scared. 23 years after I lived through The Good Friday That Wasn't, I still have trouble sleeping through thunderstorms. I still go into pregnancy a little apprehensive, ever watchful for the symptoms, always on guard for signs that the storm that tore my life apart for those months might be reappearing, but I lived. I SURVIVED. And now, when I look back on both experiences, I see that I have come out of both times stronger and wiser, with more compassion and understanding for others whose lives are rocked by storms, whether physical or otherwise.

For 4 years, I've been trying to figure out why PPD felt so familiar, how to describe PPD, what PPD is like. I finally know.

If you're living through PPD, hang in there. It doesn't last forever (it only feels like it does). Eventually, the storm will let up and you'll be able to come back into the light. I can't guarantee that you'll come out unscathed, you may have some scars after all is said and done, but you will still be alive, you will still be you. The storm will end and you will be ok. There are people here for you to help you, to stand by you, to support you, to offer you a place to rest your head while you fix your roof. You are not alone in this storm or in the aftermath.

*Note* Pictures of the physical aftermath of the tornado that hit our house in 1991 can be seen here.