Meditating on Some Actual Facts

As the discussion continues to swirl around recent remarks by popular author and "spiritual guru" Marianne Williamson decrying depression screening and medication during and after pregnancy and claiming that PPMD is normal (news flash: it's not normal), I've realized that there appear to be some misconceptions contributing to Ms. Williamson and her supporters' commentary. I thought I'd take a moment to address some of the comments I keep hearing that are inaccurate.

1. Across-the-board screening doesn't mean across-the-board medication. Screening is intended to help identify women who are struggling and/or at risk for prenatal or postpartum mood and anxiety disorders, such as Postpartum Depression. That's it. If you go to an appointment, are screened, and your doctor says "I'm worried, let's talk", that isn't synonymous with "Here's a prescription for medication."

2. No, the screening is not a blood test. That's because there is no blood test for prenatal and postpartum mood and anxiety disorders. Blood tests can't read your mind and tell that you're having Intrusive Thoughts. Blood tests can't detect suicidal ideations. Blood tests can't tell that you're hearing voices in your head. Blood tests can't pick up on the fact that you're spending half the day crying for no reason, not sleeping, sleeping too much, have no interest in sex, or most of the other symptoms. Is screening perfect? No. But neither are blood tests. Is increased screening a vast improvement? YES!

3. Prenatal and Postpartum Mood and Anxiety Disorders are not the same thing as the normal hormonal changes that occur during and after pregnancy. PPMD go far beyond that. The normal hormonal changes that occur should clear up within the first few weeks postpartum, and should not leave you unable to function. These normal changes should not include Intrusive Thoughts, thoughts of hurting yourself or someone else, hearing voices, etc. For more on the symptoms of PPMD, check out Postpartum Progress' lists of Symptoms of Postpartum Depression and Anxiety (in Plain Mama English) and Postpartum Psychosis Symptoms (in Plain Mama English) .

4. There is no one guaranteed or right way to prevent or treat PPMD. Not all women will respond the same way to the same treatment, not all women need the same treatment, and even the same woman may need or respond differently to different treatments at different times. I myself have experience in the fact that different pregnancies meant different situations needing different responses. After one pregnancy, I needed medication. After a different pregnancy, I needed to switch the birth control I was using. A different pregnancy lead to me needing therapy but no medication starting or stopping. The point is not to try to get all women to use medication. The point is to make all methods of treatment available for everyone, with no shame or stigma.

5. There is no conflict of interest for the task force that has recommended increased screening for pregnant and postpartum women. The U.S. Preventative Services Task Force has a page specifically for the disclosure of Conflicts of Interest and it can be viewed here. Here's the screenshot.

The idea that the recommendations for increased depression screenings of pregnant and postpartum women is designed to pad the pockets of "Big Pharma" is a manufactured conspiracy theory that is inaccurate and dangerous.

Increased screening is a good thing. Increased screening means more women getting the help they need at a very vulnerable time. Increased screening means fewer lives lost. Increased screening means healthier and happier moms, babies, and families. If increased screening means more women taking medication, cool. Medication SAVES LIVES. Too many women currently suffer in silence. PPMD go underreported, too often going undiagnosed and misdiagnosed. The way to fix this is through more conversations (ones that are NOT ignorant and based in fallacies), through more education and awareness, through a decrease in stigma and shame. That is what I and my fellow Warrior Moms have been working towards, and we will not sit quietly and see it undone by people who are uneducated and ignorant about the truth, as we have already shown through our success with #MeditateOnThis.

When it comes to PPMD, facts trump conspiracy theories. Meditate on that, Marianne & Co.

Postpartum Depression Is Not Normal

Content/Trigger Warning: This post contains discussion of suicide and symptoms of Postpartum Mood and Anxiety Disorders, including intrusive thoughts. If you are feeling vulnerable, you may want to exit this post and read it some other time. You are loved.

"CODE ALERT: U.S. Preventative Services Task Force says women should be 'screened for depression' during and after pregnancy. Their answer, of course, is to 'find the right medication.' And how many on the task force are on big pharma's payroll? Follow the money on this one. Hormonal changes during and after pregnancy are NORMAL. Mood changes are NORMAL. Meditation helps. Prayer helps. Nutritional support helps. Love helps." 

-Marianne Williamson

Dear Marianne,
Last night (Wednesday 1/27/2016), I read your post opposing screening for Postpartum Depression. And you know what? It hurt my heart. As I read your words, I thought back to my own experiences after giving birth, and thought of the many stories I've heard from other women who struggled, and there are many of us out there. We have struggled with Postpartum Depression, Postpartum Anxiety, Postpartum OCD, Postpartum Psychosis, Postpartum PTSD, Antepartum Depression, and the list goes on. Our stories are many and varied, but one thing remains consistent: what we have been through and continue to go through is not normal. It may be common, but it is not normal.

There is nothing normal about Intrusive Thoughts that make you change your routine out of fear of the terrible thoughts and pictures that spring unbidden into your brain.

There is nothing normal about depression that leaves you unable to function, that leaves you sitting listless in a rocking chair, staring off into space with tears rolling down your cheeks as you rock your baby, wishing the pain inside you would ease for just a few moments.

There is nothing normal about anxiety attacks that cause you to have to pull over on the side of the road while you struggle to breathe, or have you sitting on the stairs at home hugging yourself and rocking back and forth while you hyperventilate.

There is nothing normal about hearing voices tell you that your baby is being possessed by the devil.

There is nothing normal about being traumatized by a birth experience that feels like something out of a nightmare and has you terrified at the idea of giving birth again.

There is nothing normal about finding yourself at the top of the stairs in the middle of the night, considering throwing yourselves down them to try to make the pain stop. There is nothing normal about walking away from those stairs and then thinking "I could just take a bunch of painkillers left over from a loved one's surgery, so I could go to sleep. Everyone would be better off without me and I'd find some relief from this crap."

There is nothing normal about having to go to the Emergency Department in the middle of the night and ending up admitted to the hospital for a week for in-patient psychiatric care while you stabilize from crisis mode. There's nothing normal about not being able to stop crying long enough to answer the nurse's questions.

There's nothing normal about feeling like you're a total and complete failure as a mother, a monster, because of the lies your brain is telling you.

There is nothing normal about Postpartum Mood and Anxiety Disorders. There is nothing normal about the number of women we lose to Postpartum Mood and Anxiety Disorders each year. There's nothing normal about the fact that suicide is one of the highest causes of maternal mortality in developed countries. There's nothing normal about the fact that new cases of Postpartum Depression occur in at least 600,000 women in the United States each year, and that's just the ones we know about. Once you start factoring in unreported/undiagnosed cases, the numbers jump significantly. It is common, but it is not normal.

There is nothing normal about Postpartum Mood and Anxiety Disorders. Postpartum Depression is not the same thing as the "baby blues", it's not the result of the "normal hormonal changes" that occur after pregnancy. It's not those normal hormonal fluctuations that are seeing calls for increased depression screenings during and after pregnancy. It's not those normal fluctuations that require medication and hospitalization and therapy.

I've experienced the normal baby blues, and I've experienced Postpartum Depression, Postpartum OCD, and Postpartum Anxiety that left me with two hospitalizations. There's a world of difference. Prayer, meditation, reading books, and good nutrition helped with the typical postpartum hormonal adjustments. They did NOT help with my PPMD. You know what did help when I ended up in the hospital after wanting to kill myself?

Medication.

And for that life-saving medication that helped return my life to some semblance of normal, that helped me be able to function, I thank heaven and "Big Pharma".

Please, Marianne, educate yourself before you cause any more harm, before you do any more damage to fragile women who are hurting. And you have already done harm and damage. I know this because I have been told this by women who were hurt and ashamed and scared after reading your words on Facebook and twitter.

And a quick note to all the mamas out there who are experiencing PPMD, you are not alone. What you are going through is not normal, but it is common. You have people who love you. We see you, we know your pain and desperation, and we love you. We are here for you. You have only to reach out to us and we will stand by your side and help you find your way through this. Don't let the stigma and ignorance that exists in the world get you down or keep you from reaching out for help.



For anyone who wants to educate themselves about the realities and truths of Postpartum Mood and Anxiety Disorders, these links are a good start.

Postpartum Progress
Postpartum Support International
My Postpartum Voice
#PPDChat on twitter