Here’s the letter I will be sending out to multitudes of people tomorrow, including most likely you, for Strong Start Day. I hope that you, too, will consider sending this letter to as many people as possible to urge them to donate to Postpartum Progress Inc. to support women’s health and mental health. You can make it personal. Make the letter your own. Talk about your own experience and how Postpartum Progress has helped you. (Oh, and please let us know if you’re going to reach out!) PLEASE join us and spread this far and wide this week:
Strong Start Day: How You Can Ask For Support (A Letter)
By October 4, 2011
Register for PSI’s Annual Conference in Seattle This September
By August 31, 2011
Postpartum Support International will host its 25th annual conference in Seattle on September 16 and 17, in conjunction with PSI of Washington. The theme of the event is “Whole Care for the Whole Family” and it will be held at the Red Lion Hotel & Conference Center in downtown Seattle. Registration is $395 for PSI members, and $445 for non-members.
The evening of Friday, September 16, will feature the PSI Annual Banquet, with Valerie Plame Wilson as this year’s featured guest speaker. The banquet includes a cocktail reception, silent auction and dinner.
On September 14 and 15, they will hold their 2-day certification training, Perinatal Mood Disorders: Components of Care, at the same location. Registration for the training is between $200 and $30o depending on whether you are a member and whether you are also attending the main conference.
Warrior Moms of the Week – 8/26/11 Edition
By August 26, 2011
I’ve decided to start asking you, dear readers, to give me suggestions for Warrior Moms of the Week. I am now finding it impossible to keep up with all the reading I’d like to be able to do, and it pains me when I don’t have enough time to do a Warrior Moms of the Week post and point you to all the great writing moms are doing about postpartum depression and related illnesses. I love spending Fridays sending you out into the world of courageous mamas who are fighting back against perinatal mood and anxiety disorders.
UNC Opens First Freestanding Inpatient Perinatal Psychiatry Clinic in US
By August 15, 2011
They already know this, because I talk to them quite a bit, but I couldn’t be more proud of or excited for the wonderful people at the University of North Carolina (UNC) for opening the country’s first freestanding perinatal inpatient psychiatry unit. Hooray! Bravo! Yippee!!!!! What a gift for moms with postpartum depression.
There are other specialized clinics and treatment programs, of course, but this is the first separate unit solely for mothers who need to be hospitalized for perinatal mood and anxiety disorders like severe postpartum depression or postpartum psychosis. In most other places, a woman requiring inpatient treatment will be hospitalized with all other psychiatric patients, without any special services or tools that support her needs as a new mother.
Postpartum Depression on iVillage: How They Got Help & Why You Should Too
By August 3, 2011
This has been a very exciting few days for spreading the word about postpartum depression. We saw Heidi Koss on NPR, my online interview with More magazine came out last Friday, and … today iVillage is featuring an iVoice video that includes me and two other Warrior Moms: the lovely Joey Fortman and Stephanie Stearns Dulli, who are both regular iVoices and have been participants in Postpartum Progress’ Mother’s Day Rally on Moms’ Mental Health. I’m so happy to join them to reach the massive iVillage audience and share our stories of postpartum depression and hopefully make other new moms feel less alone. Thanks to Kelly Wallace for supporting this!
Go watch the iVoices iVillage video on postpartum depression – or watch it here below — and let me know what you think, ladies!! (give it a second to load, and then there’ll be a short add before it starts, FYI) Please give your support to Stephanie and Joey, both of whom are still SO CLOSE to this illness and did such an amazing job — we all know how long it gets to get over this and how hard it can be to talk about it.
The Difference Between Hypomania & Mania
By August 2, 2011
Last week Kimberly wrote about her experience with hypomania. I heard from many of you who wanted more information about this, so I wanted to offer my understanding of the difference between hypomania and mania. (Physician readers, I expect you to speak up if you have something to add or clarify!!) If you experience these symptoms in the postpartum period, it may be that you have bipolar disorder that has presented in the postpartum period, and not postpartum depression.
You may have hypomania if you experience any combination of the following:
- less need for sleep
- feel more productive
- feel a higher sense of well-being
- feel euphoric, like you can do anything
- feel very talkative (like you just can’t stop talking)
- feel more irritable than usual
- feel smarter, more sensual, more powerful and/or more creative
- feel the need to participate in activities that may have negative consequences for you (sex, spending)
If you are suffering from mania, you may experience any combination of the following:
- experience any of the above, but it begins to feel uncontrollable or becomes more severe
- feel angry, confused and/or frightened
- indulge in very reckless behaviors, for example serious overspending or reckless sexual activity
- delusions or hallucinations
It is possible to start out experiencing hypomania and then cross into mania.
It’s pretty confusing to understand the difference between hypomania and mania because they are so very similar. From what I understand, the major difference is in the severity of what you experience and how much it impacts your ability to function on a daily basis. This is not something you should diagnose yourself. Talk to a trained professional who can provide a proper diagnosis and discuss what path you should take forward. Bipolar disorder is treatable, and just like any of the other illnesses we talk about at Postpartum Progress, it’s not your fault and you are not alone. With help, you will be well.
Photo credit: © Argus – Fotolia.com
The Enticing Euphoria of Hypomania
By July 25, 2011
The first time I ever experienced hypomania came shortly after a medication dose increase. I woke up one morning and felt like a great weight had been lifted from my shoulders. The world around me was vibrant, alive and inviting, like it had been waiting for me for so long. It gave me a sense of excitement and positivity that emanated deep into my soul.
I was miraculously recharged and for the first time in months, I was ready to start living again.
I felt amazing.
Thoughts began to fire through my mind at lightning speed and there were many things that I wanted to do right away. Projects I would start but never get finished because my mind would be easily distracted to start something new, but I still felt a sense of accomplishment in my productivity.
The energy I experienced was very intense. The best way that I can describe this energy is if you drank a pot of coffee every hour. If I stopped to sit, I felt like I could jump out of my skin. Within a few days I had stopped sleeping entirely. I remember trying to rid some of the energy by enduring long grueling workout sessions on the elliptical machine.
It didn’t matter.
Friends and family noticed my change in moods almost instantly. I remember them telling me how happy I was and talkative. It convinced me that everyone liked me more, even my few months old son who I had such a horrible time bonding with.
He finally loved me.
All this made me feel extremely giddy and I would burst out in hysterical laughter when I would think about how wonderful I felt and how beautiful the world was. I didn’t think that there was anything wrong with what I was feeling at all but there was a downside to this euphoria.
Extreme agitation and paranoia.
I would fly off the handle on complete strangers for no good reason. Once a woman had rammed a cart into my heels at a grocery store and I had humiliated not only her by my extreme outburst of yelling and name calling, but myself and my husband.
Then there was the constant fear that someone was coming to take my son away because they thought that I was a bad mother.
The day my husband put his foot down and dragged me to my psychiatrist’s office, I was convinced that someone had been in the house while I was taking a shower and I could “smell” them. When my husband said that no one was in the house I became combative and started swinging at him.
That day I was diagnosed as being hypomanic. I can’t remember exactly what the treatment plan was. I believe I was weaned off of the anti-depressant which sparked the episode and it took me a few weeks to recover.
While these symptoms of elation and energy seem very enticing especially when you have been feeling so ill I assure you that being hypomanic can be extremely dangerous. Please I urge you if you do have any of these symptoms let your doctor know immediately. Hypomania can lead to severe crashes and even mania itself.
Kimberly
How Mania Feels
By July 19, 2011
Mania.
Have you had it? I never did. I do understand from others, though, that it can sometimes seem like a pretty cool thing. Like you’re on top of the world. Except being manic, in the end, is not a good thing.
Here’s how author and bipolar disorder sufferer Kay Redfield Jamison explains it [note: in this reference when she refers to "high" she means the high of mania, not drugs]:
“When you’re high it’s tremendous. The ideas and feelings are fast and frequent like shooting stars, and you follow them until you find better and brighter ones. Shyness goes, the right words and gestures are suddenly there, the power to captivate others a felt certainty. There are interests found in uninteresting people. Sensuality is pervasive and the desire to seduce and be seduced irresistible. Feelings of ease, intensity, power, well-being, financial omnipotence, and euphoria pervade one’s marrow. But, somewhere, this changes. The fast ideas are far too fast, and there are far too many; overwhelming confusion replaces clarity.”
Have you been through mania? Did you avoid being treated because you liked the energy or feelings it gave you? How did mania impact your experience of pregnancy or the postpartum period? Let us know.
Postpartum Depression: The Fight Isn’t Always Pretty
By July 8, 2011
I saw a mom with postpartum depress tweet: “Today I am not winning.”
I know at Postpartum Progress we use a lot of battle imagery. We have the Warrior Mom. We talk about fighting back, not giving up and “kicking PPD’s ass”. This imagery has a purpose: I believe it helps us reframe ourselves and feel more empowered, recognizing that we have a say in what happens to us and we can get the help we need and triumph over our illnesses.
At the same time, I want to make sure you know that you don’t have to be a hero during postpartum depression. You don’t have to “win” every day by doing all the right things to help yourself, or taking each hit with a smile. You don’t have to be Wonder Woman, with bulletproof bracelets and an invisible plane.
It’s easy to forget that. I forget that all the time.
It’s okay to cry.
It’s okay to be mad or disappointed that you’re going through this.
It’s okay to have five great days in a row and then two horrible ones. (Or seven bad days in a row and one good one.)
I fought postpartum OCD and in the end I won, but the battle wasn’t pretty. I didn’t always handle it well. I wasn’t always good at telling people what I needed, or explaining what I was going through, or being patient with those who were trying to help me. I didn’t face every single day with courage. Initially I didn’t always follow my treatment plan as I should have. I certainly wouldn’t want to watch a videotape of me during that time, as I imagine it’s very wince-worthy.
I wouldn’t have won any Medal of Valor, because I wasn’t always valiant. Some days I won. Some days I succumbed. That’s okay.
It’s not about how you look or behave every day of the fight during postpartum depression, it’s that you make it through to the end the best you can that matters.
Pregnancy, Antidepressants & Autism: Is There A Link?
By July 6, 2011
© Fotolia - photo-Dave
Yesterday it was widely-reported that a new research study found a link between autism and SSRIs taken by mothers during pregnancy.
SSRIs, if you don’t know, are certain types of antidepressants, and include such name brands as Zoloft, Prozac, Paxil and Luvox. I’ve already heard from some of you with understandable concerns about this news. I know it only adds to the stress all of us experience when making the decision whether and how to be treated with antidepressants if needed during pregnancy.
I reached out to Postpartum Progress Inc. board member Marlene F. Freeman, MD, director of Clinical Services at the MGH Center for Women’s Mental Healthand associate professor of Psychiatry at Harvard University, to help clarify what the study means for us. Here is her response:
“Autism is a very serious condition, and it would be extremely important to know what risk factors are definitely associated with the condition.
A recent article published first online in the Archives of General Psychiatryreported an association between autism and maternal SSRI use during pregnancy. The authors conducted a case controlled study of a Kaiser Permanente database.They found a greater risk of autism spectrum disordersamong children of SSRI users compared to non-usersduring pregnancy.Authors included diagnoses of autism spectrum disorders, maternal lifetime psychiatric diagnoses of mood and anxiety disorders and schizophrenia, and SSRI and other antidepressant prescriptions dispensed during pregnancy in the analyses. Maternal symptoms and burden of illness during pregnancy were not assessed.
The study generates questions for further study, but does not find a cause-and-effect relationship between SSRIs and autism.While previous history of mood and anxiety disorders is factored into the analyses, acute illness during pregnancy is not at all factored in. I believe that this greatly diminishes the value of the article to assess the impact of SSRIsin pregnancy on the risk of autismin children. Current use of SSRIs may be a better indication of acute illness during pregnancy than history of previous diagnoses (as many women will be undertreated during pregnancy due to concerns about fetal exposure, hence leading to a dual exposure of both medication and untreated maternal illness). The possibility that SSRI use may represent acute symptoms or illness is not among the limitationsof the study discussed by its authors. Since the authors state”the combined effect of maternal serotonin transporter geonotype and prenatal stress may contribute to autistic-like behaviors in offspring,” it is disappointing that their study did not control for prenatal maternal stress or burden of illness. Therefore, it is not possible to separate out genetic predisposition and symptoms experienced by mothers during pregnancy — suspected to contribute to risk of autism — from medication exposure in this study.
At this time, we need further research to determine whether maternal anxiety or depression or medication use may increase the risk of autism spectrum disorders, and whether unknown factors associated with maternal mental health conditions or medicine use increase risk. Until risk factors are clearer, women with serious mood and anxiety disorders that do not find relief from non-medication treatments such as psychotherapy should talk about risks/benefits of medicationwith their doctors, and antidepressants are still considered first-line treatment for moderate to severe illness. Women with more mild illness, as before this report, should be encouraged to try psychotherapy first, and perhaps othernon-medication strategies.”
Translated into plain mama English: They don’t know whether it was the treatment (SSRIs), or the illness for which the mom is being treated (antenatal depression/anxiety, or depression/anxiety she has always had), or some genetic factor in the mom that may be related to both autism and the fact that she is vulnerable to depression/anxiety that led to the incidences of autism in the study. Not to mention the women whose children have an autism spectrum disorder who have none of the above.
The authors of the study themselves suggested caution in how their findings are interpreted (from the Archives of General Psychiatry):
“Our results suggest that prenatal exposure to SSRIs, especially during the first trimester, may modestly increase the risk of ASDs [autism spectrum disorders]. The fraction of cases of ASD that may be attributed to use of antidepressants by the mother during pregnancy is less than 3% in our population, and it is reasonable to conclude that prenatal SSRI exposure is very unlikely to be a major risk factor for ASD. Although these findings indicate that maternal treatment with SSRIs during pregnancy may confer some risk to the fetus with regard to neurodevelopment, this potential risk must be balanced with the risk to the mother or fetus of untreated mental health disorders. We recommend that our findings be considered as preliminary and treated with caution …”
So there you have it. I know many of you had seen this news and I wanted you to get the most balanced information possible.
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