Myths About Postpartum Depression & Motherhood Show Up In Momblog Debate

I hear I missed a big debate last week. The “postpartum depression is real/I’m not sure about motherhood” versus “motherhood is hard so just man up ladies/motherhood is the best thing on the planet” camp. I’m kind of glad I missed it, in a way, because it might have led to some serious high blood pressure on my part. I might have been blogging from the hospital while having surgery for a myocardial infarction. At least they’d have internet there.

It all started with Heir to Blair writing about motherhood and how it just hasn’t been what she expected, after she read a piece at another blog on the topic.

“It’s not that I thought it would be 24/7 picnics & skipping & lollipops & unicorns that fart magic fairy dust that makes puppies fly. But I didn’t think I’d have a baby that screamed at me all day. I didn’t think I’d have moments where I wished I could just put him in a cage with toys & walk away for an hour. I didn’t think I would wind up in the hospital being sedated to sleep. I didn’t think that I’d have so many moments where I just felt like, ‘OH MY GOD, I can’t do this anymore. I don’t WANT to do this anymore.’”

She received 217 responses on that post, and most of the commenters agreed with her. But then there were some whose responses truly concerned me, and some that were outright hateful. This is highly pertinent to Postpartum Progress because Blair has postpartum depression, and PPD was drawn into the comments. I’ve decided to write about some of the comments individually, so that we can break down the myths that still exist.

Here goes …

“I feel really sad that there are so many people that agree with you on this. I think it is great support which you are obviously desperate for but I am shocked at how many people have this feeling. I never thought that becoming more fulfilled with my life after I had my daughter would make me an outcast.”

“Motherhood has been the best experience of my life. Yes there are definitely days where I’m ready to tear my hair out and hope that he takes a LONG nap, but honestly those days are not numerous, and I definitely don’t question my choice to become a mother. I’m so saddened by so many people saying that they do, I’m glad they feel comfortable admitting it, but it still saddens me. I don’t feel I was lied to at all, but then I don’t look to others to form my opinions or draw conclusions from, I look at every situation myself, of course NOTHING is unicorn farts and rainbows all the time, NOTHING in life is that, and for every mom, or soon to be mom out there, if that is what you seriously expected I feel very sorry for you.”

When a mother admits that motherhood is hard, or that some days she wishes she could be off on an island by herself, it doesn’t mean she doesn’t love her child or isn’t fulfilled. It means she’s normal. Plenty of women feel this way, and not just those with postpartum depression.

I am a mother with two children who believes that there is nothing else she could ever do that wouldtop being a mother to her children. I love them so much that it takes my breathaway. Truly. At the same time, I guess because of my anxiety, or my personality, or my difficult childhood or who the hell knows what, they overwhelm me and there are times when I feel I just don’t know what I’m doing and would like a break. To the commenters on Blair’s blog and those who just love judging other mothers: You NEVER know where a woman is coming from. You don’t know what stresses she has in her life, from financial to marriage to other issues. You don’t know what kind of childhood she had and what kind of mother she had,and how that colors her view of motherhood. You don’t know what kind of child she has: a healthy, easy, happy-go-lucky child or a screaming, colicky, difficult personality child. Unless she is a dear friend, you don’t know a whole lot about her personality. For example, if she is truly a perfectionist, then even though she logically understands that motherhood is not perfect, the experience of not being in control will be extremely difficult for her. All these things can affect how a woman views motherhood and just because you think it’s just fab doesn’t mean she should.

Oh, and there is no black and white on this subject. It’s not that you either think being a mother is the most wonderful thing in the world or you hate it. Believe it or not, you can love your children and be a good mom while at the same time questioning yourself and feeling frustrated and wondering whether you ever should have had kids in the first place.

“I’m sorry you feel lied to, but I think the most important thing we can do as mothers is to think about how YOU would like your life to be if you were your child. Would you want a mom that wishes she were somewhere else while she cares for you? Or is thrilled to put your to sleep for the night? We’re all able to mold our lives into something that makes us happy. Sometimes it’s just time to pull ourselves up by the bootstraps and put others first.”

Oh goody. The bootstraps argument. Reserved for those who are completely ignorant about mental illness. Blair is having a really hard time with motherhood right now, as many women do, but hers is made that much harder by having severe postpartum depression. Bootstraps do not apply.

“I mean if you really want to change, to be the mother you wanted to be, change your perspective. Read some stories about mothers who have sick babies and use that as your comparison for ‘bad days’. Sometimes when DD is being ‘the terrorist’ I think to myself ‘Well, at least she is healthy, because it could be a hell of a lot worse’.”

You can be sure that in any debate such as this the “there are starving people in China” argument will surely raise its head. Just remember how much worse off someone else is and then you’ll be okay. I wonder if they say that to people with cancer? Just remember about the person whose house burned down, and then they were fired, and then their pets ran away, and then their whole family died, and then you’ll feel SO MUCH BETTER about having cancer!! Yay!!!

Perhaps you weren’t aware that perspective pretty much goes out the window when you have postpartum depression.

“I’ve always thought your PPD was a total front. You just hate being a mother because it didn’t work out the way you wanted. People want to come see him now and NOT YOU. It’s all about him now and NOT YOU.”

Oh, and here’s the “she’s just selfish/lazy/weak” argument. You knew that one would come up. Because, of course, we women with perinatal mental illnesses have control over how we are feeling and how our brains are working. The real reason for all of this is that we just hate not being the center of attention anymore/hate having to do all this damn work/are just defective humans who can’t handle life.

You’re right, commenterperson! I’m sure Blair is enjoying being miserable, and in fact CHOSE to be hospitalized in a PSYCH WARD because she’s just not the center of attention anymore. I CHOSE to go crazy because I just didn’t want to wipe noses and butts and have everyone coo over the baby instead of me.

Bullshit.

“I just don’t see how you could be bored with Harrison when you only see him like 3 hours a day. I would think you would be DYING to see him. Trying to eat him up, almost. Not being bored because he’s splashing in the tub and happy…”

Many new mothers are thrilled to see their babies splashing in the tub. Not all mothers, though, are that fortunate. They may have illnesses that prevent them from enjoying these kinds of moments. Imagine for a second that, like me, every time your baby was in the tub all you could think about was him or her drowning. Not only did I not enjoy watching him splash in the tub, I couldn’t give him a bath for the entire first year of his life because I was SCARED TO DEATH.

Again, it’s easy to make assumptions that all mothers should have the same feelings you have. It’s not fair.

“There has never been one moment that I wanted to walk away. I can understand feeling stressed, tired, etc. But this whole wanting my life back/can’t believe how horrible life is with a baby thing is shocking to me! And it seems that most people who agree are not suffering with PPD. I truly hope that those of you who feel this way will think long and hard about having another baby. I just can’t imagine directing all of that negative energy towards a baby…that you chose to bring into this world. No wonder they are miserable little beings.”

“What exactly did you think motherhood was going to be? Your overall tone shows your strong dislike for motherhood and being with your child. And yet you have mentioned before wanting to have more children – it sickens me to think that more children would be subjected to your feelings.”

Someone hold me down.

How terribly insulting. She’s not abusing her child. She’s not neglecting her child. She hasn’t run away. She hasn’t quit. She takes care of him and loves him the best she can. She’s reached out for help with her postpartum depression. So she expresses her misgivings and her conflicting feelings and now she shouldn’t have children?! Wow.

When I was sick with postpartum OCD I had the “strong dislike for motherhood” you mention. Who the heck wouldn’t? Prior to becoming a mom, I was fine. After becoming a mom, I went straight down the tubes, descended into hell and had a plan for killing myself. But guess what? After a long recovery and much professional help I was and AM fine. And I had another baby. And I’m a rockin’ momma. Don’t you dare say that women with perinatal mental illness shouldn’t have children, or that women who experience motherhood differently than you shouldn’t have children. Don’t you dare.

“If you didn’t already have PPD, I would have suggested getting yourself checked because the harsh statements about motherhood that you made are really only relevant to those that are going through PPD. I hope the expecting first time mothers or those thinking about having children who read this post understand this is coming from a dark place.”

Not true. In general, the statements expressed by Blair are things many moms feel. They aren’t reserved for women with postpartum depression. I don’t think saying that sometimes you wish you were somewhere else means you have PPD, and I don’t think saying that you feel like no one told you the truth about motherhood means you are necessarily coming from a dark place.

While most women have some idea that motherhood will be a difficult challenge, NO ONE expects or has an understanding of how devastating perinatal mental illness is until she is hit with it. Period. As far as Blair is concerned, no one DID tell her the truth about how her motherhood experience would be, because no one can ever really tell a mother what it will be like if she gets PPD. You only understand it if you’ve been through it. That being the case, I believe that what she wrote was partly arrived at from her PPD experience and partly arrived at because she’s a normal mom with normal motherhood frustrations.

Others weighed in on this as well. Here are Lauren Hale’s and Amber Koter’s responses to this debate as well. Also, check out the post at Not Super … Just Mom and the response from the mom at Disasters in Domesticity. What do you think?

Marlene Freeman, MD: On Getting To A Happy Mother’s Day

Dear New Moms,

Mood and anxiety disorders take a tremendous toll on the individual woman. There are consequences for those who love and depend on her. Motherhood is a tough gig. When a mother is suffering, the basic tasks of caring for an infant or older child are daunting. Emotional wellness is essential for a mother to meet the emotional needs of her children.

Maternal depression at any time affects the woman and her entire family. Postpartum depression is especially complicated. Factors include a major life transition, recovery from childbirth, sleep deprivation, hormonal changes,and the incredible neediness of the human infant. At best, a new mother is profoundly exhausted. At worst, she is faced with a marathon of monumental tasks of extreme importance when she is ill. Meeting the physical needs of a newborn baby is only part of the job. Perhaps the most important part, the most difficult for moms who are suffering, is what is supposed to be the fun stuff. A baby needs mom to fall in love, bond and attach, snuggle, sing and play. She needs to engage the new baby in this new central relationship that will foster security and help him or her lay a foundation for a healthy sense of self and future relationships. This is a tall order for a woman who is not herself due to a mood or anxiety disorder.

The consequences of a mother's depression upon her children are well-studied and well-documented. The consequences of depression among mothers and fathers are important, but maternal depression has received a larger amount of study. Negative effects observed in children when mothers have untreated depression are virtually global across areas of child development. These include problems with bonding and attachment, relationship problems later in life, poorer neurocognitive development, behavioral problems and risk of depression and other psychiatric disorders. The long-term impact of anxiety disorders has received less attention, but it stands to reason that a mother's untreated anxiety will also effect her children.

The impact of the treatment of a mom's depression has been recently and dramatically demonstrated. In a pivotal study, investigators assessed children of mothers participating in a treatment study for major depressive disorder (MDD). In the large, national STAR*D study (Sequenced Treatment Alternatives to Relieve Depression), mother and child pairs were assessed as the mother entered and underwent treatment for MDD. Children participated in assessments when their mothers started treatment and had repeated assessments for up to one year. Children did not receive any mental health treatment during the course of the study.

Of the mothers who participated, almost half responded to treatment within three months. Children of women who responded to treatment experienced a significant reduction in psychiatric symptoms and diagnosable psychiatric disorders. On the other hand, children of mothers who did not respond to treatment experienced a slight increase in symptoms and diagnosable conditions. The results were similar at one-year follow-up. These data demonstrate that successful treatment of a mother's depression has important beneficial consequences for her child's emotional well-being.

In the above study, the first treatment offered was medication. The key, however, does not appear to be the choice of treatment but the response to it. Therefore, the take-home message to mothers is to pursue treatment until they feel better, back to themselves, free of symptoms. Treatment should be individualized for her specific needs and preferences, and my include psychotherapy, medication, other treatments and often combinations of treatments.

Sometimes women have difficulty seeking or accepting help. They may feel guilty about taking the time to see healthcare providers or other activities that support their own wellness. Many women feel shame around having depression or another psychiatric disorder. It is important to remind mothers that taking good care of themselves is good for their children. In the midst of a depressive episode, some women will not feel motivated to care for themselves but would do absolutely anything for the well-being of their children.

If you are a mother who is suffering from a mood or anxiety disorder and has put off seeking help, know that taking good care of yourself and recovering is of great importance for your children. It also role models self-esteem. Would you not hope that your child would seek help if he or she were suffering? Depression, anxiety, shame and self-doubt can get in the way of valuing your own health simply because you are worth it. If that is the case, take care of yourself now for your children. You can look forward to the day when you will appreciate your own recovery and value your own wellness. That will be a great Mother's Day.

Marlene P. Freeman, MD, is a psychiatristwith Massachusetts General Hospital's Center for Women's mental Health. Shealso serves as vice-editor-in-chief of the Journal of Clinical Psychiatry and chairs the American Psychiatric Association's Task Force on Complementary and Alternative Medicine.

APA Changes Language About When Postpartum Depression Can Occur

The initial revisions for the new DSM-V (the diagnostic manual that healthcare providers use to diagnose mental illnesses) have now been made available to the public. We've been watching to see what changes were made, since the information they've had in the past on postpartum depression has been dead wrong. In the DSM-IV it said that you could only consider someone as having postpartum depression if its onset (when it showed up) occurred in the first 4-6 weeks after having a baby. As you all know, that's just not the case.

Postpartum depression can show up any time in the first year after birth. It may be that it shows up earlier, but women may not recognize the symptoms or that something is wrong with them until later. I was diagnosed with postpartum OCD in the first 2.5 months postpartum because I recognized it and reached out for help early. It's prettyhard toignore those intrusive thoughts. But I hear from other women all the time who aren't diagnosed untilmuch later down the road. And even more women who go in later in the first year postpartum and are told they don't have postpartum depression because it's too late for them to have it.

The new DSM-V has changed the onset period from 4-6 weeks to the first 6 months postpartum. Much better. I still worry about women who don't notice any symptoms until after that period, but I'm glad they made a change at all.

I'm going to delve into this further this week, as I've read some of the language regarding perinatal mood and anxiety disorders that they've written and find it a little confusing. I've asked some of the best known experts to comment, and I will let you know what they say.

In the meantime, a couple of media stories on the subject (none of them cover perinatal mood and anxiety disorders, but they do cover some of the major changes in the DSM-V related to autism, eating disorders and bipolar disorder among other things.

New York Times

USA Today

Psych Central

Professional Training Events on Postpartum Depression

Postpartum Support International’s comprehensive 2-day training for healthcare professionals on perinatal mood and anxiety disorders like postpartum depression is coming up in several locations this Spring.

  • Tampa, Florida on February 19th and 20th at the Women’s Center at UCH
  • Louisville, Kentucky on March 4th and 5th at the Indiana Southeast University Conference Center
  • Missoula, Montana on April 15th and 16th at the Quality Inn Conference Center
  • Indianapolis,Indiana on April 22nd and 23rd at Methodist Hospital

If you are interested in attending any of these professional training events, click here for more details.

PSI Launches Compelling Short-Film on Postpartum Mood & Anxiety Disorders

Postpartum Support International has produced and launched a compelling new multi-cultural short film on what it's like for women who go through a postpartum mood or anxiety disorder such as postpartum depression. It's really the best I've ever seen, and will be a great tool for use in maternity wards, support groups, therapist's offices and more.

"Healthy Mom, Happy Family: Understanding Pregnancy & Postpartum Mood and Anxiety Disorders" features four women sharing their stories — Nicole, Kim, Nina and Denise. Through their honesty and openness, these women will help educate and reassure new mothers, their family members and friends, and healthcare professionals that postpartum depression is temporary and treatable. Their poignant stories are complemented by the most current, evidence-based knowledge on perinatal mood and anxiety disorders, offered by four experts in the field: PSI President Birdie Gunyon Meyer RN, MA, Pec Indman, EdD, MFT, Jane Honikman, founder of PSI, and Caroline Little Cribari, MD, PhD. These practitioners share what women and healthcare providers alike need to know for the effective identification and treatment of mental illnesses related to childbirth.

"Healthy Mom, Happy Family" has a run-time of 13 minutes. You can see a preview of the film on YouTube.

To order the DVD, click here.

Production of the "Healthy Mom, Happy Family" DVD was made possible by the generous support of alt-country performing artist Wade Bowen, whose wife suffered from postpartum depression. Its distribution is being supported by a generous grant from Jenny's Light.

Postpartum Progress' New Research Page Provides Better Access to Studies on Postpartum Depression

Since it is so hard to keep track of the research coming in almost daily on perinatal mood and anxiety disorders, I've decided to add a research page to Postpartum Progress. You can find it on the right-hand side of your screen underneath "Help Is Here", #5.

I won't be able to list every single piece of research that comes down the pike, but I will put links on that page to the most current, most interesting, most often cited research. I've created categories to try and organize it, such as Genetics & Postpartum Depression, Screening for Postpartum Depression, Risk Factors for Postpartum Depression, etc.

Hopethis page ishelpful to you should you need to find some specific data. If you know of a study that should be listed there and it isn't, please send me a link at postpartumprogress@gmail.com. And to my brainy, scientific-type, evidence-based medicinereaders, if you see a study on there that you don't think is valid, tell me that too and I'll remove it.

Do You Really Need a Specialist To Treat Your Postpartum Depression?

I was very happy to see that Parents magazine and CNN.com have covered the specialized inpatient unit for women with severe perinatal mood and anxiety disorders, including postpartum depression, at the University of North Carolina. Go Dr. Elizabeth Bullard, Dr. Samantha Meltzer-Brody and nurse Chris Raines!!!!

“Immediately, Meehan-Machos’s obstetrician referred her to the University of North Carolina at Chapel Hill (UNC). There, doctors had recently debuted a groundbreaking inpatient psychiatric unit, the first in the nation specifically tailored to women suffering perinatal (prenatal and postpartum) mood disorders. Unlike a general psychiatric unit, it offered:

  • A core group of doctors specializing in perinatal issues
  • Psychiatrists attuned to medications that wouldn’t harm a pregnancy or a nursing newborn
  • An unusual policy of allowing children, even babies, on the ward during extended visiting hours
  • Mom-only counseling focused on anxiety and bonding”

There aren’t near enough specialized programs for women with postpartum anxiety, postpartum depression and postpartum psychosis. These women have a distinct set of issues and deserve treatment from clinicians who have a lot of experience treating them. Whether its psychiatrists, psychologists, therapists and social workers who specialize in postpartum depression, special inpatient units like the one at UNC or special outpatient units like the one at Women and Infants Hospital in Rhode island, we need more hospital administrators and healthcare systems to recognize that perinatal mental illness is a public health problem and to create the kinds of services that help new moms and moms-to-be get better as quickly as possible.

I can tell you that when I had postpartum OCD I first went to a psychiatrist that I later came to realize had almost no experience with women with postpartum depression. After dealing with that for ONE YEAR (argh!) and making little headway, I switched to someone who had trained under specialists in perinatal mood and anxiety disorders. It was like night and day. Out came the sun!!

I realize that not everyone has access to specialists. It is my wish that one day every woman will, no matter in which corner of this country (or any other) she lives. It is my personal opinion, though, that seeing a specialist in the best case scenario for women trying to get well. If it’s a friend of mine, a relative, a neighbor or my own daughter, I’m going to fight like hell to find a specialist to help her.

I’m just saying.

Update:

I received the following comment to this post and I’d like to share it so that it isn’t missed.

“With reimbursement of mental healthcare as poor as it is, there are not (and may never be) even enough regular psychiatrists to go around, much less psychiatrists who treat only patients with perinatal issues. If we have special clout and extra connections we may be successful in getting our friend, relative or neighbor in to see a specialist (as long as she lives in a major metropolitan area and has good insurance, of course). But the vast majority of people aren’t so well connected. We need to make sure not to alienate non-specialists. OBs, family physicians, midwives etc. can and should be trained well enough to treat straightforward perinatal mood disorders. And if general psychiatrists are unable to successfully treat the more complicated cases, I don’t think the solution is just to hope and wait for more postpartum specialists. The solution is to insist that general Psychiatric training programs adequately address these common and important conditions.”

Thank you for your comment. I understand what you are saying. It is true that we are sorely lacking in this country when it comes to having enough psychiatrists to go around, especially in rural areas. I do not think, though, that you need any particular clout when it comes to seeing a specialist. Insurance, perhaps, but not clout. When I was sick I had zero clout. When I finally got tired of being treated by someone who didn’t know what they were doingthe only thing I did have was empowerment. The courage to demand more for myself and my health and to ask around and ask around and not give up until I found someone with more training than the average doc on these illnesses (which doesn’t take much actually, because as you rightly point out, the current med school training is inadequate). There are many healthcare providers from various disciplines who have taken the time to learn more, get CEUs, attend a conference or go to a PSI training.These are the people I think women should try and see.

Additionally, I know that many of the specialists in this field do consults and confer with women’s personal physicians to discuss care for perinatal mood and anxiety disorders like postpartum depression. They are aware that, because this specialty is so unique, their expertise is needed both inside and outside of their “neighborhoods”.

And finally, I would never suggest women who are suffering wait and hope until we have every specialist we need. I hope that’s not how it came across in my post. Thankfully, with organizations like Postpartum Support International, women don’t have to. They can connect with one of more than 100 trained volunteers spread out across our country in every state who can offer information on healthcare providers in the vicinity who can help.

Updated List of Specialized Treatment Programs for Postpartum Depression

This week I have updated the list of specialized treatment programs at hospitals and universities around the country for women with perinatal mood and anxiety disorders, which can be found here.

The University of Louisville Women's Mental Health Program, the University of Michigan Perinatal Mood Disorders Program, the Women's Health Consortium program in NYC, the Columbia University Women's Program, the Penn Center for Women's Behavioral Wellness and UT Southwestern's Women's Mental Health Center have all been added.

A big thank you to the hospitals and universities who have recognized women's reproductive psychiatry as a mental health issue important enough to deserve a specialized program with trained individuals who can provide some of the best support and treatment around to the women who need it.

If you know of another program that should be on the list, email me at postpartumprogress@gmail.com and I'll take a look.

Wishing for an Open Discussion Between Clinicians & Consumers on Perinatal Psychiatry? Now's Your Chance!

I'm really excited to share with you that the current issue of the Journal of Clinical Psychiatry features a set of commentaries all focused on Perinatal Psychiatry.Read on, because there is a way that you can be a part ofan interestingdiscussion on the treatment of women with perinatal mood and anxiety disorders, and I really want you to participate.

There are9 commentaries, plus an introduction by Marlene Freeman, MD.Each isa short read and not too full of medical jargon, so for those of you who aren't clinicians I'm pretty sure you will be able to understand what they're saying.(No multilayer perceptrons here.)If you're wondering what a commentary is: Rather than being a paper on the results of a specific piece of research that is published in a medical journal, commentaries are more like op-ed pieces. The writers provide their observations and opinions, citing the research that forms the basis of these ideas. Here's one of the titles to whet your appetite: "Influence of the Media on Women Taking Antidepressants During Pregnancy" by Adrienne Einarson.

Here's the even cooler, interactivepart: The Journal of Clinical Psychiatry has created an online, open forum for you to post comments and ask questions about each of them. Did you agree with what you read? Disagree? Do you have other ideas? Would you like clarification on something?

You can start posting your responses today in the forums, and later in the month the authors of the commenataries will offer responses to your comments and questions.

Anyone can participate; you don't have to be a doctor or in the psychiatric field. I would encourage allthe Warrior Moms out there to read these pieces and share your own opinionsor ask questions for clarification. (Just please be sure to be dignified and constructive if you disagree with something.) This is an important way to keep the lines of communication open between the medical field and the patient community. We don't always get to interact in this way so I really encourage you to take advantage of this. And of course the Journal would love to hear from my clinician readers as well!

It is free to participate but youwill need to register for a free account in order to do so. Just click on the link in the above paragraph. For each article you can click "full text with forum" and it will allow you to read the piece and comment. The first time you try to do it, you will be asked to join the Net Society Platinum. Fill out the form and you'll be on your way. (Note for the consumers who sign up: for medical school graduation year, I clicked N/A. For profession I clicked other mental health. Once you fill out the initial form and submit it,you will then be taken to a page asking you if you want to subscribe to theJournal. You don't have to. You can scroll down to the bottomto find your name and login. It may ask you one more time if you want to update your profile. Once you're done I'd suggest closing the window and using the link above again, logging in and commenting away.)

SAMHSA Offers Two New Publications on Women's Mental Health

It seems I may have missed National Women's Health Week back in May. I didn't notice any big celebrations or news or parades or million women marches — did you? And may I ask, IS THAT ALL WE GET?! A measly week?!!!

Nonetheless, in honor of our health, the US Department of Health & Human Services' Office on Women's Health released two women's mental health publications that are available to you free. You can either download them or order free copies through the Substance Abuse and Mental Health Services Administration's Health Information Network (SHIN) or call 1-877-SAMHSA-7.

The first is called "Action Steps for Improving Women's Mental Health" and was created for healthcare pros. This is a report that brings together the most recent research, resources, products and tools on mental health issues in women and explores the role gender plays in diagnosing, treating and coping with mental illness. It outlines specific action steps for policy-makers, health care providers, researchers and others to take. The item number for this report is OWH09-PROFESSIONAL. To view it, click here.

The second is called "Women's Mental Health: What it Means to You" and is for consumers. It is a 22-page booklet addressing the stigma associated with mental health, with information on the signs and symptoms of mental illness. It also provides suggestions for support and solutions for preventing and coping with mental illness. The item number for this report is OWH09-CONSUMER. To view it click here.