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!

Just joking!

Have you ever seen or heard someone say something along the lines of "I'm going to kill myself, this sucks so bad. Ha ha, just joking!"? I know I have, and it bothers me. Before anyone says "you're being too sensitive" or "lighten up, (s)he is just spouting off.", let me explain why this issue bugs me.

Suicide is no light matter. It's not something to laugh or joke about. It's not funny or humorous. People kill themselves every single day, for a variety of reasons. It's serious. Just how serious is it? Let's take a look at some numbers.

• According to a link from the NIMH (National Institute of Mental Health), "In 2007, it was the tenth leading cause of death in the U.S., accounting for 34,598 deaths. The overall rate was 11.3 suicides per 100,000 people. An estimated 11 attempted suicides occur per every suicide death.". So, in 2007, not only did 34,598 people successfully take their own lives, but doing the math, it's estimated that 380,578 people attempted suicide. *Maybe* some of those 380,578 people now consider it a joking matter, but I find it hard to believe that those 34,598 peoples loved ones consider it something to joke about.
• The previous NIMH link was statistics from 2007. According to this link from the CDC (Centers for Disease Control and Prevention), the number of suicide deaths in 2010 was 38,364, with suicide still sitting at the #10 spot for causes of death. 
• There aren't any good statistics for suicide related deaths among women with PPD because PPD isn't tracked nearly as closely as it should be in the US. The CDC estimates that am average of 8% of moms end up with PPD, and some of those women are killing themselves. Katherine Stone of Postpartum Progress estimates that the number may be more likely to be an average of 20% of women ending up with PPD each year
• According to this article from the NPR, the number of suicide deaths in the U.S. military in 2012 was 349 (a new record for the military), higher than the number of deaths among Americans who died in combat in Afghanistan in 2012.

The reasons why people kill themselves (or attempt to kill themselves) are varied. Mental illness, terminal illness, difficult situations that leave them feeling helpless and hopeless, and so many more. I've never killed myself (yes, you may call me Captain Obvious) but I was hospitalized twice with suicidal ideations and intrusive thoughts after my first baby was born. There was absolutely nothing funny about it then and I still (almost 4 years later) don't find any humor in people "just joking" about wanting to kill themselves. It's not a laughing matter that people are in that much pain (mental/emotional or physical). It's not a laughing matter that their family and friends have to deal with the pain and anguish of losing a loved one to suicide. There's nothing to laugh about. It's not a lighthearted subject.

Not only is it a serious and painful matter for those who (in whatever capacity) are dealing with suicidal ideations, attempts, or successes, making "jokes" about suicide contributes to the stigma around not only suicide but mental health and seeking help for mental illnesses. When people joke about suicide, it's hard for the people around them to ask for help (who wants to risk being laughed at, dismissed, and possibly be made the butt of a "joke"?). When people joke about suicide, it can be hard to recognize when they're no longer joking (ever heard the story of the boy who cried wolf?). When people joke about suicide, it contributes to the stigma surrounding not just suicide but mental illness in general.

The statistics I included in this post are specific to the United States of America, but the sentiment of "Suicide is not something to joke about" is most certainly not. I personally have friends around the world who have suffered/are currently fighting mental health issues. Except for the statistics, everything I've said here applies to you no matter where you live, no matter where you're from. The fact that suicide is not something to make light of  doesn't change based on location. Please, take it seriously. If you see or hear someone "just joking" about killing themselves, take it seriously. You could save lives.

This so-called disease

Recently(ish), someone told me that there was not really a need for further mental health awareness efforts, that all the information is out there, and it is the responsibility of everyone to do the research that leads them to this information and get the help they need. I disagreed quite vehemently, and still do, because awareness isn't just about putting information out there for those suffering from... say... Postpartum Depression, it's also about fighting the myths and stigmas that are out there, about trying to help people who perpetuate fallacies like "It's all in your head" or "you can pray it away" realize how wrong that line of thinking is and how much harm such attitudes can do.

The other day, while I was sitting on Facebook, I happened to look over at my ticker and see that a friend of mine had commented about Zoloft and breastfeeding. I went to look at the status and shared a little bit about my personal experiences. All was fine and dandy until someone posted this little gem.

Immediately, my mind flashed back to the conversation a few months ago in which I was told that there's enough awareness already, and thought "Yeah right!". I'm happy to report that this person was pretty swiftly told (very nicely) to stuff it. I, of course, promptly thought of my blog (as I always do when I see or hear someone say something incredibly ignorant, asinine, offensive, and generally just straight up wrong about mental health and especially Postpartum Mood and Anxiety Disorders) and decided that this would be good material for a post.

The more I looked at this comment, though, the more frustrated I got, and the more thoughts I had running through my head. I finally decided that I might be better off using it as the foundation for a series and focus each post on one particular element. My first series, yay!

What I want to address in this post is the use of the phrase "this so-call disease". (typo is left because that's how it was typed in the original comment). Anytime someone uses this phrase (or one like it) it gives a tone of "It's not a REAL disease, it's all just in your head." which, of course, is not true. Diagnoses don't get put in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) just because someone decided to throw a bad thought process in there.

Mental health illnesses such as Postpartum Depression, Postpartum Psychosis, Postpartum Obsessive-Compulsive Disorder, and so many others exist. They aren't made up. They are truly illnesses just as much as cancer and diabetes are. They aren't pretend illnesses that the pharmaceutical industry decided to invent so that they could sell even more drugs and make more money (yes, I have been told this before, and I rolled my eyes as hard as I hope you are now). Mental illnesses aren't something that can be prayed away. Changing how you think doesn't make it go away. Ignoring it doesn't make it disappear. Believe me, I tried. Many other people have tried. Usually, the only thing that ignoring it accomplishes (in my personal experience) is to exacerbate the symptoms.

Phrases such as "so-called disease" are born of ignorance and a lack of education. Unfortunately, not only does this type of nonsense spread the ignorance of the individual with verbal diarrhea, it adds to the harmful stigmas that make it harder for people to reach out for help. I can not tell you how much damage it does to hear things like "this so-called disease". Of course it's bad news if you're already struggling, but even if you're not it builds a flawed and cracked foundation that could crumble to pieces if the wrong burden is added.

If you think of a mental illness as a "so-called disease", do yourself and everyone out there (especially those struggling with a mental illness) a favor and drop it from your vocabulary. Don't even THINK the phrase again. Adjust your thinking and accept that just because you can't necessarily see outward physical symptoms doesn't mean someone isn't struggling from a legitimate illness. Would you call cancer, diabetes, influenza, polio, tetanus, HIV, etc. a "so-called disease"? Then don't insult and put down mental illnesses and those suffering from them (or those who have survived) by insinuating (or outright saying) that it's not a real illness. It's real. I've lived it. I came frighteningly close to not living through it. Don't sit there and try to tell me I imagined it.

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

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


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


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


It's scary.

Let's make Capitol Hill take notice that PPMD needs to be a priority.

Once again, I've been inspired by something I read on PostPartum Progress. Today, Katherine posted the following article:

Yesterday, the federal government heralded the Affordable Care Act and how it helps women.  They touted the fact that, “20.4 million women with private health insurance gained expanded preventive services with no cost-sharing in 2011, including mammograms, cervical cancer screenings, prenatal care, flu and pneumonia shots, and regular well-baby and well-child visits.” They trumpeted the fact that, “… 8.7 million American women currently purchasing individual insurance will gain coverage for maternity services.”

Better healthcare for women is a great thing, but here’s what I want to know: What about the mothers with postpartum depression? What about postpartum depression screening?

Section 2952 of the Patient Protection and Affordable Care Act,enacted two years ago, called for more research into PPD screening,  increased awareness for postpartum depression and better services for women who have it.  Where are those things? When might they be coming? Why has no money been appropriated?

I read the brief that was released this week, entitled The Affordable Care Act and Women. It lauds the legislation’s sections 1001, 1401, 1421, 2001, 2401, 2404, 3509, 4104, 4201. I didn’t see anything about section 2952. I care about those other sections, I truly do. But it’s my job to care most about section 2952. I really, really need to see action on 2952. I want to work with the federal government to get 2952 off the ground.

WE NEED 2952.

Are you with me? Do you care about 2952? Are you wondering why more isn’t done?

My initial reaction was "WTF?!?". Then I sighed. Then I thought "Wow, I wish there was something I could do. I'm no good at writing online petitions, just at signing them.". Then, I happened to see a tweet from one of my US Senators, John Cornyn. Senator Cornyn tweeted 

"Funny if it were'nt painfully true RT@Doctorfreefall:@JohnCornyn Obama has approved his "Pipeline to nowhere!". ". 

This was just the latest in a line of tweets taking aim at President Obama. I thought back on the Tweets I usually see from my elected officials. I follow (on Twitter) President Barack Obama, Senator Kay Bailey Hutchinson, Senator John Cornyn (Texas' Senators), and Congressman John Carter (Texas, District 31, U.S. House of Representatives). I tend to see a lot of tweets that are partisan politics, a politician taking aim at either another politician or the "other" party, etc. So I thought "If they have time to tweet about why we shouldn't like another politician/candidate or why one party is better than the other or what exactly the other party is doing wrong, they should CERTAINLY have time to read - and respond to - a tweet about an issue that affects constituents across party lines!"

I proceeded to tweet to all four something along the lines of  

 Pls make care/research for #PPMD a priority. Signed,1 of your voters http://p.ost.im/p/eXnhUU via@postpartumprogr 

It had to be tweaked and edited depending on who I was tweeting, to allow for the 140 character limit. However, that is the copy-and-pasted tweet I sent to Congressman Carter. 


After that, I thought "Why not tweet about this to Rick Santorum and Mitt Romney too? To them, I tweeted 

"What is your stance on bettering care&improving access to that care for women w/ #PPD? What about #PPMDresearch?"

I'm not holding my breath that any of them will respond to my one tweet. Really, my hope is that more people will see this and start tweeting the same types of questions and requests to THEIR elected officials and to the presidential candidates. My one little voice may not register on their radar but hopefully, if we can get a whole bunch of voices raised together, they'll start to listen (and maybe even respond?). 


Let's start a Twitter campaign to bring awareness of the need for PostPartum Mood Disorder research to be made a higher priority on a national level, to the need for our elected officials to work to improve the standards and quality of care for those who are suffering or will do so in the future, to improve the ease of access and affordability to this care so that no woman has to worry about whether her insurance will cover her care or whether she'll be able to find a medical professional who will help her how she needs it, when she needs it. Let's remind our elected officials that they are elected by us to work for us, to represent us and our interests. Will you join me in this endeavor?

If you don't know who your elected officials are, find out. Once you know, look up and see if they have Twitter accounts(I've been able to find this information on their .gov websites). I've provided the Twitter handles for the President, the two US Senators from Texas, and the Congressman who represents Texas District 31 in the U.S. House of Representatives, as well as Mitt Romney and Rick Santorum. Once you have the Twitter info you need, Tweet away. Feel free to use the tweets I sent out or compose your own. The main thing is to let them know that we will not be silent, that we are here, and that we are watching and listening, that we expect them to do their jobs in taking care of us, even if it means taking a break from party politics and (heaven forbid!) working together. And one of the beauties of this is that as we tweet about this, every time we @ one of those politicians, everyone who follows them can see that tweet. We have the potential to reach literally hundreds of thousands, if not millions, of people.


If you don't have Twitter or don't use it or, for whatever reason, don't want to get involved on Twitter. You can still join in the effort. Link this post and others related on your Facebook. Send it to your friends and family. There are so many ways that you can help spread the word that it's time to make Capitol Hill take notice. Many of us suffered through a PPMD in silence, our families may have suffered in silence with us. We don't have to be silent any longer. Will you join me?



P.S. 
If you have ideas or suggestions, please feel free to comment and share them here!

It's just a game, a joke, right?

If you're on Facebook, I feel pretty safe in saying it's a sure thing that you've seen the various FB status games where there's a circumstance and you tag people from your friends list as certain characters in the situation. I didn't paticipate in most of tem, although I did do the Zombie Apocalypse one b/c, well, it's Zombies. Most of them I just ignored, unless I was tagged in one and then I laughed at being the sniper or whatever. However, there is one that I've seen that bothers me a little


You're in a mental hospital use the first six people on your list on your profile.
1. Person who drove you crazy:
2. Person who signed you in:
3. Your doctor:
4. Person in the corner drooling on themselves:
5. Your roommate:
6. Person who helps you break out:


I think my first problem with this is that there's still such a big stigma associated with mental health problems and being admitted to a psychiatric facility that I don't think it's something that should be made light of and used as a joke. And I think it was Number 4 that bothered me the most: "Person in the corner drooling on themselves". In both my stays at Laurel Ridge, there wasn't anyone drooling on themselves. And if there were, it wouldn't be something to laugh at and make fun of.


I'm sure I'm taking this one personally because I've BTDT. I've been admitted to a hospital twice. I've struggled with the shame, guilt, and fear of telling anyone that I had PosPartum Depression. I've struggled with the shame, guilt, and fear of even asking for help. When I did ask for help, I was terrified that they were going to take my daughter away or get CPS involved and say that until I was "over" the PPD I had to move out of the house and not be around her. I dealt with being upset that I had to stop breastfeeding my daughter at 3 months old because the meds they put me on weren't something I could take and safely nurse her. I've dealt with the people who say "Just make up your mind to get over it". With this last pregnancy, I struggled with deciding whether or not to take Zoloft at 38 weeks as a preventative measure. I'm sure that most people who are posting this aren't trying to mock those who have dealt with mental health problems, but the fact is that things like this do make light of it, and they can be very hurtful to those who have struggled with PPD, BiPolar, PTSD, MPD, etc. I doubt that people even realize that this type of thing can help perpetuate the stereotypes that need to be dealt a death blow: It's something to be laughed at, it's not serious, it's a joke.


Please know that I'm not trying to make anyone feel bad, I just want to try to shed some light on it from another perspective.

What do I have to live for?

When I was hitting my lowest point in my struggle with PPD, the night I decided to go to the ER, I had suicidal ideations. Making the choice to reach out for help, to say "Hey, this is how I feel" was incredibly difficult. It's not an easy thing to admit that you struggle with something that is as stigmatized as PPD is and that you need help, that you really can't do it on your own.

What helped me make the choice to make that call? What was it, when I was standing at the top of the stairs looking down and thinking how easy it would be to jump forwards, that moved me to step back and go get the phone and call the Chaplain, to get the car keys and drive to the ER? 

It was the knowledge that my daughter needed her mommy, that I didn't want to hurt her in any way, that my husband loved me and would be so hurt and lonely without me, that did it. I don't even remember that going through my mind as a rational, logical thought process, I just remember that it was there in my thoughts, that I didn't want to end up another Andrea Yates. 

I did it for my daughter, and I would do it again for my daughters. I realize now, on the other side, that I have so much to live for. I have two beautiful, wonderful, healthy daughters. I have a husband who loves me, treats me better than a queen, and who would do anything for me. I have a home, pets I love, family and friends who would (and have) drop anything to help me. To anyone who's reading this who struggles with feeling like their life is worthless, like you don't matter and you and/or anyone else would be better off if you were dead, like you're alone, you're not alone, you are not worthless, you do matter, and someone out there cares. When you ask yourself "What do I have to live for?", stop and think, you might have more to live for than you first realize.

PostPartum OCD

I recently read about a condition I had never heard of before called Post-Partum Obsessive-Compulsive Disorder.

"Postpartum Obsessive-Compulsive Disorder (OCD) is the most misunderstood and misdiagnosed of the perinatal disorders. It is estimated that as many as 3-5% of new mothers will experience these symptoms. Symptoms of perinatal OCD can include:

• Obsessions, also called intrusive thoughts, which are persistent, repetitive thoughts or mental images related to the baby. These thoughts are very upsetting and not something the woman has ever experienced before.

• Compulsions, where the mom may do certain things over and over again to reduce her fears and obsessions. This may include things like needing to clean constantly, check things many times, count or reorder things.

• A sense of horror about the obsessions

• Fear of being left alone with the infant

• Hypervigilance in protecting the infant  

Moms with postpartum OCD know that their thoughts are bizarre and are very unlikely to ever act on them.
Risk factors for postpartum OCD include a personal or family history of anxiety or OCD.
Postpartum OCD is temporary and treatable with professional help. If you feel you may be suffering from one of this illness, know that it is not your fault and you are not to blame. You can use our resource page to reach out now. We understand what you are going through and will connect you to people who understand and can help. http://www.postpartum.net/Get-the-Facts/Postpartum-OCD.aspx"

From http://ppdcenter.com/What_Is_PPD_.html:

"Postpartum Obsessive Compulsive Disorder (OCD)
The PPD symptoms may also be mixed with anxiety symptoms that take on an obsessive (thoughts) and/or compulsive (behaviors) feature OR these may be experienced without depressive symptoms.
According to Postpartum Support International, "This disorder is one of the most under-recognized and under-treated types of perinatal mood disorders. It occurs in approximately 3 to 5 % of new mothers, yet it can be most alarming for a new mother. The symptoms include intrusive and persistent thoughts or mental images and a sense of horror about the thoughts/images. The thoughts are typically accompanied by behaviors to reduce the overwhelming anxiety that accompanies the thoughts."
These compulsive, ritualistic behaviors often include checking baby frequently, obsessively searching for information on the internet/books, etc. For example, a mother may have an irrational fear that she is going to drop the baby down the stairs. Consequently, she may avoid using the stairs or even going near a staircase. These mothers are NOT in danger of harming their infants and are disturbed by these troubling thoughts."
Again, if you or a loved one are experiencing the afore-mentioned symptoms, call your physician because help is easily available. "

The bolded is actually one of the biggest things I worried about when I was experiencing PPD before I got treatment. I wish that this was something that was more widely known about. Do your part to help spread the word and educate people about the various PostPartum disorders and to combat the stigmas that so often come along with them.

I'm me!

3 months of medication for my thyroid has done what the Celexa and Lexapro and Ativan never could quite do... I feel like myself again! I think it's a misnomer to say that I feel like my old self again, I will never feel like my old self again because I will never BE my old self again. I've had a daughter, adjusted to motherhood, struggled with PPD and suicidal ideations and all the feelings of guilt and inadequacy that come with PPD, and some much more. I'd like to think that I am a stronger woman and to some degree, wiser and more mature although I don't know how far that goes. :P However, I am happy with who I am and where I am and I feel like a PERSON again. I feel like I've stepped out of a land of shadows into the daylight.

I've come off of the antidepressants totally, the last time Celexa touched my lips was March 30 and I haven't had Ativan since December. I'm doing great, I haven't had any relapses into wanting to hurt or kill myself or anyone else, I haven't been sick or anything, I've barely even had any issues with RLS. I'm so incredibly happy to finally be off the meds. It was with the blessing of my psychologist and the GP I saw at the Family Medicine Clinic. It feels like a huge weight has been lifted from my shoulders. All the glory for this belongs to God. As incredibly off as my thyroid was (the numbers were HIDEOUS), there's no way that I *should* have gotten to Within Normal Limits in 3 months and on only the second dose they put me on (started on .25 and am now holding steady at .50) but I am not only okay on my thyroid, I'm off the antidepressants faster and easier than I *should* have been.