Why I'm seeing red

I’ve tried and tried so many times to start this blog off in a profound way that sounds educated and well thought out. Try as I may, I just can’t manage to do it. Why? Because every time, I end up seeing red and all my sage wisdom goes right out the window. I like to think that while I’m passionate about what I have to say with regards to PPMD, I’m usually pretty level-headed. But let me tell you, something happened this past week that made me so angry that I’m having a hard time staying cool, calm, and collected, much less putting my thoughts together in a manner that is readable without going “Huh?” or “Whoa, that’s a new cuss word” or maybe some combination of both.

I’m all for counseling. I’m all for finding and promoting alternative methods of dealing with PostPartum Depression. I love to read about the things other people do to help themselves or others. I love it when I see someone who has come up with a new and innovative way to provide education and support to people who are battling or have battled PPMD. People like Lauren Hale and #PPDChat, Katherine Stone at PostPartum Progress, and Yael Saar and her PPD SpeakEasy Phone Chats. Because, well, medication and therapy are all well and good, and are highly beneficial to many many people struggling with PPMD, but sometimes you need the support of a community that has been there, is there right now. I think it’s well beyond awesome that people come up with such fantastic ways to pull together and find a sense of community to be able to better support each other, educate others, and combat the stigma that comes with mental health in general and PPMD specifically

What I do not love is people who talk out of their ass. People who tout themselves as having a way to help when they don’t. People who throw something together without doing the research to know what it is they’re dealing with. And when you charge money for it? Ten times worse. How can you help someone when you don’t even know what it is they’re dealing with? Last week, I ran across one such person and I have been angry ever since. The offending person: Sheryl Paul of Conscious-Transitions.com. From the about me portion of her website:

Sheryl Paul, M.A., pioneered the field of bridal counseling in 1998. She has since counseled thousands of people worldwide through her private practice, her bestselling books, “The Conscious Bride” and “The Conscious Bride’s Wedding Planner,” and her websites. She’s regarded as the international expert on the wedding transition and has appeared several times on “The Oprah Winfrey Show”, as well as on “Good Morning America” and other top television, radio, and newspapers around the globe. Phone and Skype sessions available internationally.

Awesome! I’m sure she’s helped a lot of people. Getting married is a HUGE transition and if talking to a Bridal Counselor helps, go for it! It sounds like she’s done a lot of research and really knows her stuff… when it comes to “Bridal Counseling”. The problem is, she’s set up a new program called “Birthing a new mother” and from reading what she has to say, it’s evident that she is NOT well educated in PPD and really doesn’t know how it works. Why, you may wonder? On her websites, she says (among other things):

"This completely unique program is the only one available that will help you manage your fertility anxiety, calm your pregnancy fears, and prevent postpartum depression. With the bonuses and the support, it’s worth over $1000, but I don’t want price to stand in the way of you having this information, so I’m offering it to you today for only $197."

How generous... She also says:

"Would you enter any new job without preparing? You studied before taking your driver’s license test. You may have taken a premarital class. But we offer nothing for impending mothers and fathers on how to prepare for the biggest transition and most important job of their life!
Until now… In this program I will tell you exactly how to prepare. I will gather a group of experts around you and together we will guide you through the inner work that needs to be done and the questions that need to be asked so that you are ready to absorb the shock of your new life and experience the joy and ease of motherhood that is your birthright. And if you follow this roadmap – which isn’t hard to do and takes just 10-15 minutes a day – you will prevent postpartum depression! You will feel empowered as a new mother! And you will be giving your baby the best possible beginning for emotional health.”

This hot mess first came to my attention when PostPartum Progress (on their Facebook page) posted a link to a blog Sheryl Paul had written on mariashriver.com. The blog was pulled after 48 hours due to a great deal of outcry (rightly so) but not before I had a chance to save it to my website. Allow me to post the full text of this lovely little gem so you can see what it is that originally sparked my indignation.

Three Tips for Navigating New MotherhoodBy Sheryl PaulThe dominant message in our culture during the preconception through early motherhood stages is that any signs of anxiety or depression indicate that something is “wrong” and needs to be fixed. This message sets women up for unrealistic expectations, which lay the foundation that entrench normal anxiety and depression into clinical levels. 

What does it mean to have “normal” anxiety or depression during pregnancy or the postpartum stage? It means that every life change, no matter how positive and life-affirming, is accompanied by loss, fear, and doubt. 

Let’s break this down: You’re pregnant. You’ve wanted to be pregnant since you were four years old. But as soon as the pregnancy test revealed a positive result, you heard a door slam shut and felt a pang of loss. You pushed it aside because you thought that’s not what you’re supposed to be feeling at that moment. 

You feel fear arise during your first trimester. You’re scared you’re going to lose your baby. You feel scared again during your third trimester and wonder, “What if I won’t be a good mother?” Because you don’t understand how vitally important it is to acknowledge and express these losses and fears, you push them aside and instead focus on buying the right car seat. But the feelings don’t go away. Instead they mutate into anxiety, and your doctor suggests an anti-anxiety medication. 

Or you’ve just had your baby and everyone is healthy and thriving. While you’re deeply in love with your magical child, you also feel a profound sense of loss and longing for the familiarity of your old lifestyle and identity. You prepared for childbirth and you took classes on breastfeeding and baby care, but no one prepared you for the normal and necessary sense of loss that most women feel on the other side of the birth threshold. 

You wonder what’s wrong with you. You wonder if this means that you’re not cut out to be a mother. Nothing could be further from the truth, but because you’re not educated about what’s normal, you form false assumptions, which then prevent you from grieving the losses and allowing them to move through you to completion. Thus begins the slippery slope to postpartum depression. 

Here’s the good news: Pregnancy anxiety and postpartum depression are avoidable and preventable! They both result from normal thoughts and feelings that are pushed underground because we don’t realize that they’re normal, where they then grow into an unmanageable state. 

Here are three tips that I've learned for having an emotionally healthy pregnancy and avoiding postpartum depression:1. Educate yourself with the truth about what’s normal to feel during pregnancy and early motherhood. Most pregnancy guides pay scant attention to what’s happening emotionally for women and instead focus on the growth of the baby and your body. While this is important information, it won’t facilitate the birth of an emotionally healthy new mother. Here’s what you need to know in a nutshell: it’s normal to feel fear, grief, loss, confusion, ambivalence, uncertainty, terror, and doubt during every stage of this transition (as well as joy and excitement, of course!).2. Find a safe and compassionate place to express the difficult feelings. This may be with your partner, a friend, a therapist, or in the privacy of your journal. Your feelings are real and need to move out of your body. Most people hold the erroneous belief that so-called “negative” feelings will hurt your growing or newborn baby. The truth is that when you try to stifle these feelings, they’re amplified and that’s when they can harm your little one. So let them out!3. Find the courage to explore the hidden thoughts that are lurking in your pregnant or new mom mind. Just as the feelings need a place to land, the thoughts also need to be explored and fleshed out. This may be the first time in your life that you learn to work with your anxious or fear-based thoughts effectively, and there is no practice more worthy of your time! Whatever you learn now will serve you for the rest of your life as a mom, and as a human being. 

Taking these three simple steps can be the deciding factor that determines whether your normal fear and loss descend into anxiety and depression or transform into serenity and an empowered transition into motherhood.  

 

Sheryl Paul, M.A., is regarded as an international expert in transitions. Since 1998, she has counseled thousands of people worldwide through life transitions via her private practice, her bestselling books, her website, http://conscious-transitions.com, and her home study program, Birthing a New Mother: A Roadmap from Preconception through the First Year to Calm Your Anxiety, Fortify Your Marriage, and Prevent Postpartum Depression, which can be found at http://birthinganewmother.com. She lives in Boulder, Colorado with her husband and two sons."

I read that and I got so incredibly angry. I get angry again every time I read it, every time I go to her website to pull the quotes I wanted to include in this blog. I just... no. Argh! It's bad enough to feel invalidated, but when the thoughts, feelings, and experiences being invalidated are those of a traumatic time/event? Fifty times worse. I can't even put into words exactly how this all makes me feel. It's pretty rare that that happens, too, I don't usually have difficulty expressing my feelings and emotions. But this? This reduces me to primal instincts of anger, frustration, and generally wanting to throw things at the wall. I think this picture best expresses how this whole thing makes me feel.

This picture was taken when we were getting Elizabeth ready to go home from the hospital after she was born. She was madder than a wet hen that we had the audacity to change her diaper and *gasp* make her wear CLOTHES! She screamed, hollered, scrunched up, kicked, waved her adorable little fists, cried real tears, and generally made a ruckus. She was very angry. That's about how I feel.

Moving on to discussion of what Ms. Paul posted, there are multiple problems with her logic. Let's just look at the ones that jumped out most immediately to me.

1. Not everyone who experiences PPD feels that sense of “loss” and “grief”. Not everyone deals with all that stuff she outlined during pregnancy. One of the things about PPD is that there are no boxes that it fits into. Everyone struggling with PPD has their own story and to try to force us all into the same mold is insulting. Dealing with PPD doesn’t take away individuality, the experiences are as vast and myriad as the stars in the night sky. Some women will experience every single symptom listed in any book, some may only experience one symptom. Some may not sleep at all, some may sleep all the time. Some may not feel any emotions, may feel totally numb, and some may feel so many emotions they go into overload. I personally had a combination of the two. I had no idea it was possible to feel so many emotions and yet, at the same time, feel so emotionless. I don’t recall, though, that I felt a sense of loss or grief. Sad? Yes. Grief? Not so much.

2. Doctors don’t usually prescribe anxiety medication at the drop of a hat like she describes and if one does, they need to be reported for their irresponsibility. My experience has been that it’s actually difficult to get the help, diagnosis, and medication that you need.

3. “Exploring your hidden thoughts” can be DANGEROUS. If I had “explored my hidden thoughts” instead of seeking help, I would be dead right now. Not joking. I’d have a headstone at a cemetery instead of Facebook, Twitter, and a blog. When you’re depressed and having thoughts of harming yourself and/or others, those thoughts should ONLY be explored under he guidance and supervision of a licensed medical/mental health professional.

4. PostPartum Depression is not the result of faulty thought processes, lack of studying, or not taking a 200.00 course from a Bridal Counselor. PostPartum Depression is a very real mental health illness that is caused by physical factors. Hormone imbalances, thyroid problems, etc. A medical professional can explain it better than I. But I do know that it’s not something you can avoid just by changing how you think or reading a book or watching a video.

Sheryl Paul is essentially saying that those of us who have or are dealing with this are doing so out of some failure of our own. The message she is sending out is that it’s our fault. Oh, but good news, you can fix it by paying money to take her course! She is invalidating the feelings and experiences of all of us who have, are, or will deal with PPD. She is saying that she knows better than a doctor. She is setting us back when we have worked so hard to educate ourselves and others. She is furthering the stigma that we work so hard every day to combat. Her claims are audacious, faulty, irresponsible, and infuriating. She has the potential to cause a lot of harm if women see this and decide not to seek medical treatment that they need, or decide to explore their thoughts and end up killing themselves.

I don’t really know what else to say. I guess what it really boils down to is this: If you want to help people who are struggling with PPMD, do some research first. Make sure you know what you’re talking about before you start talking about it. If you are looking into a program like this that claims to help but is not affiliated with medical professionals, talk to a doctor first. The best way that I can think of to help is to educate yourself and to support someone you know who is dealing with PPMD. Make sure that anyone you know who is pregnant (and their family) is aware of the signs, symptoms, and risk factors for PostPartum Mood Disorders. Keep an eye on them and if you start to be concerned, talk to them. If they’re unwilling to listen, MAKE them get help. Believe me, it’s on harder the longer you wait. Be willing to speak up and speak out when you hear people say ignorant things like “PPD can be prevented by changing how you think” or “Just pray more” or “Are you sure you’re right with God?”. Know what some good resources are about PPMD so that when you hear about things like Sheryl Paul's program, you can say “You know, why don’t you check into this instead?”. Educate yourself, educate others. Love yourself. Love others enough to tell them when you see them struggling and they don’t realize it or don’t want to admit it.

I'm not sure how to close out this particular post other than to say "Thank you" for reading through my rantings. If you're looking for resources that are more helpful and educational than Sheryl Paul, the blogs I have listed here are a GREAT place to start. They have a ton of good information and links. Maybe some good can come from this whole fiasco. I only pray that disastrous bad does NOT come about.

Foto Friday: Daddy and his girls

I took this picture a while back at a park. Elizabeth is such a little Daddy's Girl and he is totally and completely wrapped around every single one of her fingers and toes. He actually found her in her room one day telling her stuffed animals "Daddy Izza-bear's finger" and making the "wrapped around your finger" hand motion. Oh how that made me laugh, especially at the look of chagrin on his face that she so totally and completely has his number.

I love that I have a husband who is so actively involved with parenting our children. He has no problem with changing a diaper, doing a bath, or coloring on the sidewalk. He wears Miriam in the Moby Wrap if she's cranky and that's the only way to console her. He loves to go to the playground and play with Elizabeth (Miriam is still a little small to play on the equipment). There are so many parents who are not so involved with their kids, and men who think that all that stuff is "the woman's job", and he is not one of them.

L - R: Eric with Elizabeth, April 2009; Eric with Miriam, April 2011

The night I wanted to kill myself.

It was the middle of the night when I drove up and parked at the Emergency Room at Wilford Hall Medical Center on Lackland AFB. It was dark outside, and humid. I parked the car, turned it off, and just sat there for a moment, staring at the doors. "I don't have to do this. I could just turn around and go back home.". But no, I knew that I had to do it. I got out of the car and slowly walked inside. I know it only took a minute but each step seemed to take an eternity. I went inside and stepped up to the desk, sat down and produced my military dependent id card, and started filling out the paperwork that everyone has to sign when they go to the ER at Wilford Hall. The person on the other side of the desk asked something along the lines of "What are you here for today?". I took a deep breath, hesitated, and said "I'm 3 months postpartum and I want to hurt myself.". The hardest sentence I'd ever spoken. 1 year earlier, I'd been sure that nothing would ever be harder to say than to tell my parents that my then boyfriend (now husband) and I were pregnant, but I had found a phrase that was more difficult to utter.

I don't really remember too much after that. I remember that the chaplain was there with me, having woken up in the middle of the night to meet me at the ER so that I wouldn't have to do it alone. I remember that they took me straight to the back instead of leaving me in the waiting room. I had my vitals taken and gave my medical history and then I was told that I was going to be given to the Charge Nurse. I don't remember her name, just that she was an officer in the US Air Force and had blonde hair and a very kind face and compassionate tone. She embodied what a nurse should be. She walked me back to a room right outside of one of the desks so that they could have eyes on me at all times. I was given a gown to put on. The Nurse asked me more questions about what was going on. I was crying. I told her my story. I told her that I felt like such a horrible mom and wife for abandoning my husband and baby daughter, that I felt so ashamed, that I was worried that someone would come to take my daughter away, that I was concerned that my husband would lose his security clearance because of me, that I was scared. The truth was, I wasn't scared. I was beyond terrified. I was terrified of how I felt, of what I might do to myself or my baby, and terrified that this would never end.

She was so kind to me. She told me that she had dealt with PPD and that there was nothing wrong with me that couldn't get better and that I hadn't done anything wrong but that I had done something very right by coming to the ER. She told me "I had PPD really bad and now look at me, I'm an officer in the Air Force and a nurse.". That was slightly reassuring. She told me "You will get through this, it won't last forever." and then wasn't offended that that was hard for me to believe.

I was given a gown to change into and my clothes and shoes were taken away, they made sure that there was nothing in the room that I could hurt myself with. They drew blood and ran an EKG on me, explaining that it was to make sure that there wasn't an underlying medical problem causing this. Everything came back normal and a doctor came in and talked to me. I said that yes, I would consent to being hospitalized and off he went to find out which facility out in town had room for me since neither of the military hospitals in town accepted dependents on a Psych hold, only Active Duty. Eventually, I was told that I was going to go to Laurel Ridge. The Chaplain prayed with me and eventually went home while I tried to get some sleep. Really I just laid there in the dark feeling so upset and ashamed, so weak, broken, feeling like a failure, waiting for the ambulance to come pick me up to transfer me to Laurel Ridge. That wouldn't happen until about 8:00am.

It was the longest night of my life. I laid there thinking that it was one of the worst nights of my life and that nothing would ever be the same again, that nothing would ever be better. I felt like I had let my family down. I can't really put into words properly all the emotions that were running through me, I can't depict how it felt. I was lying in a room by myself in the dark where I had to have the door open at all times, I had no privacy. I had to let them know if I needed to use the restroom. I felt dirty, ashamed, broken. It was one of the most humbling experiences I have ever been through. I can't even remember every detail, there's so much about the months leading up to that night, and that night itself, that are a hazy blur. I was there and I hated myself for it. I cried the entire night and a very good portion of the next day. If I finally settled down, someone could just glance in my direction and I would start back up again. I felt every emotion I possibly could and yet I felt nothing. I second guessed whether I should have gone. I was sure that I would regret it in the morning. I kept waiting for someone to ask me where my daughter was so they could take her away. I hated myself, what I had become, what I had almost done, and what I had done. Anyone who thinks that it's easy to admit to having suicidal ideations, PostPartum Depression, needing help, is mistaken. I literally felt like I was in a deep, black hole without any windows and without any sunlight even coming in from above. I wasn't sure I would survive.

I did.

I don't tell you this story to scare you if you need to seek help. I tell this story because I want people to know that I have been there. If you're there now, you will make it through. There is hope, there is help. If you know someone who is in this place right now, don't judge them. They're already doing a good enough job of that on their own. They need your help to be strong.

I tell this story to tell the world that not only did I survive, I came out a stronger and better person. I am a fighter. I am a warrior. I am a survivor. I am proud of it.

Become part of the solution.

"PostPartum Depression is all in your head."
"PostPartum Depression isn't actually a health matter."
"PostPartum Depression is a thought process"
"You don't actually need medication to deal with PPD."
"It's just a mood."

These are all things that people say. Some of them have been said to and/or about me, some of them to/about my friends, some of them to/about other people. These statements represent actual thought processes of real people who are alive today. Such mindsets are the result of a lack of education and understanding. I do not say this to insult anyone, but this is the result of ignorance on the part of those who say such things.

To those who hold such scorn, indifference, and disbelief, I offer this: do you believe yourself to be smarter and better educated in such matters than medical professionals? Did you know that there is research that proves that it is more than just a "way of thinking" or a "bad mood"? Allow me to present some information that states otherwise.

"What causes depression? What about postpartum depression?There is no single cause. Rather, depression likely results from a combination of factors:

• Depression is a mental illness
that tends to run in families. Women with a family history of depression are more likely to have depression.

• Changes in brain chemistry or structure are believed to play a big role in depression.

• Stressful life events, such as death of a loved one, caring for an aging family member, abuse, and poverty, can trigger depression.

• Hormonal factors unique to women may contribute to depression in some women. We know that hormones directly affect the brain chemistry that controls emotions and mood.
We also know that women are at greater risk of depression at certain times in their lives, such as puberty, during and after pregnancy, and during perimenopause. Some women also have depressive symptoms right before their period.

Depression after childbirth is called postpartum depression. Hormonal changes may trigger symptoms of postpartum depression. When you are pregnant, levels of the female hormones estrogen (ESS-truh-jen) and progesterone (proh-JESS-tur-ohn) increase greatly. In the first 24 hours after childbirth, hormone levels quickly return to normal. Researchers think the big change in hormone levels may lead to depression. This is much like the way smaller hormone changes can affect a woman's moods before she gets her period.
Levels of thyroid hormones may also drop after giving birth. The thyroid is a small gland in the neck that helps regulate how your body uses and stores energy from food. Low levels of thyroid hormones can cause symptoms of depression. A simple blood test can tell if this condition is causing your symptoms. If so, your doctor can prescribe thyroid medicine."
womenshealth.gov

womenshealth.gov is a project of the U.S. Department of Health and Human Services Office on Women's Health.

Another study at http://www.studentpulse.com/articles/558/case-study-examining-postpartum-depression-symptoms-and-treatment has this to say:

“Multiple investigations into the etiology of postpartum depression have not reached a consensus” (Leopold & Zoschnick, 1995), hence the inclusion of it in the DSM-IV as separate category diagnostically different from Major Depression. Biological theories suggest that deregulation of the neurotransmitters serotonin and norepinephrine, epinephrine, and dopamine serve as the origin of PPD. Other biological factors included prolactin levels are rise throughout pregnancy and fall during delivery, and have been considered to be a factor in the onset of PPD. O’Hara, Schlechte, Lewis, & Varner (1991) presented conflicted results showing higher levels of prolactin on postpartum days 2, 4, and 6, while lower levels in by week 6 postpartum. Other hormonal factors such as estrogen levels which decrease significantly in the postpartum period and regulate mood, memory, and cognition and brain function has been thought to play a major role in the onset of PPD. “The specific effects are best characterized in the dopamine system where estrogen increases dopamine turnover through the regulation of tyrosine hydroxylase, degradative enzymes, and turnover dopaminergic receptors” (Leopold & Zoschnick, 1995, n.p.).

Does all of this sound like a "bad mood"? If it were just a mood, would medical treatment help? If you are someone who has believed and said things such as "It's just a bad mood", I give you this challenge: Do your own research. Hit up Google, Bing, or any other search engine with phrases such as "Postpartum depression cause" and "postpartum depression study". What I've copied and pasted here is just a scratch on the surface. There is a wealth of information out there. Educate yourself and then educate others. It is through education and public awareness that PostPartum Depression and other PostPartum Mood Disorders will become better understood. Educate yourself and become part of the solution.

Foto Friday: My love story.

Welcome to my newest brainstorm: Foto Friday. Each Friday, I'll focus on a photo of something that represents my life, something I'm thankful for, something that makes me think, or even just something that I'm thankful for. It might necessarily have to do with PPD or mental/emotional health but I think that in general it's important to focus on the positives in life. And so, without further ado (did I spell that right?), I present my first Foto Friday.

October 2008

This week, Eric and I celebrated our third wedding anniversary. It's been a crazy three years. He's had three ankle surgeries and spent more time in a cast than out of one (or so it feels like to me). I gave birth twice in a little under two years, had two hospitalizations for PostPartum Depression, we had a wreck that gave me whiplash and a concussion and was the cause of two of his ankle surgeries, we bought a house, moved into it, moved out and moved across the country into a new house, obtained new pets, dealt with a crazy ex-wife (thank goodness they don't have kids, she was frustrating enough over furniture) and a million other things that I won't get into. It hasn't been easy but if I had to go through what I have, I can't think of anyone I would rather have gone through it with. Eric was by my side through the whole PPD ordeal and through both pregnancies and childbirths, and has been so supportive and caring.

With the love of my life

We originally met online. A mutual friend of ours knew we had both gone through nasty breakups and decided that we would be perfect for each other. She told us both about each other but neither of us were really interested in a relationship at the time. Eventually though, we talked online and got to be friends. I couldn't tell you when it turned into something more; all I know is that after he got back from his deployment, I went up to spend a weekend in Kansas City to meet him in person; it was a wonderful weekend. I cried when I got on the plane to go back home.

Our first "real" date

I couldn't tell you when I fell in love with him, all I know is that it happened fast and I fell hard. After that weekend, I made quite a few trips up to Kansas to visit him, and he drove down to Texas to visit me when he could. With him being in the Army, it was a lot easier for me to go up there though. And I didn't mind at all, I had friends up there and I liked getting to see them. 

Kansas, 2008

I spent a lot of time on I-35 that summer. I loved visiting him and we had a lot of fun. One weekend we had a little too much fun, which I realized one shocking morning in August. Yes, we had a little bun in the oven. Once we got past the shock, told our parents, and decided to get married, things moved pretty fast. We ended up choosing a date in October because that was when his mom could come out to visit us. He had just gotten orders to transfer to San Antonio so we had about 6 weeks to juggle my horrible morning sickness, both of our jobs (I ended up quitting because of my morning sickness), his move, planning a wedding, and OB appointments.

Yes, that is my child waving and looking like a Martian.

Finally, October arrived and it was the Big Day. Thankfully, my nausea had finally let up for the most part (as long as I ate every hour or so) and since I was just hitting 13 weeks, my dress still fit. We had beautiful weather (important since it was an outdoors wedding) and walked down the aisle to say "I do" surrounded by family and friends. It was one of the best days of my life.

With this ring, I thee wed.

In a fairy tale, this is where there would be a "And they lived happily ever after". I wish I could write that, but this is not a fairy tale and life is not always happy, but it is life and I am more thankful than I can put into words to share it with the love of my life. He is my soul mate, my best friend, my confidante, my lover, my other half, my better half. He completes me, I complete him, and we both complete each other's sentences. I look forwards to living the rest of my life with him, for however long God gives us together on this earth.

Here's to many more