Posts Tagged 'postpartum depression'

Feelings go Up and Down

This seems obvious, that feelings go Up and Down, but you would be surprised at how often people forget this.

The nature of feelings is that they’re sometimes intense. Sometimes you can anticipate them, sometimes not. Occasionally something catches you by surprise. When you can anticipate them, they’re easier to deal with, if you’ve anticipated them accurately, that is. But we as humans are really bad at that! We don’t anticipate how we’re going to feel very accurately at all.

We’re not very accurate predictors of feelings

I’m not going to hunt down a study and prove it to you at this moment. Instead think about the last time you thought you would feel a certain way when you knew some big event was coming up. Let’s take Graduation. We’re coming up on Graduation season. Most people anticipate feeling really, really happy, ecstatic even, giddy, joyful.

But most people will also say afterwards that it was a bit of a let down, or they expected to feel better than they did. That’s because they anticipated feeling a certain way and didn’t anticipate the mix of feelings that they may experience. So chances are they felt really, really happy but also nervous and perhaps a bit sad. Those last two brought down the happiness a bit.

Generally, Feelings go Up and Down.

Yep, so you’ll feel some happiness and then it will go down a bit and you feel more normal/neutral. And then you’ll feel happy again, etc, etc.

But this also applies to negative feelings. So when we’re sad, we’re bad at predicting that we’re going to feel better. We think we’re going to stay sad forever. But generally speaking, that’s rarely the case. We feel sad, then we feel closer to “normal.” Then sad again, then neutral, then maybe even a moment of happiness happens, then more neutral.

We go up and down and a bit around with our feelings. They key here is to talk to yourself about them. So when you’re in that sad state, tell yourself that you will feel happier again sometime soon. Sadness is not going to last forever. Just knowing that and reassuring yourself will help you feel better, less sad. Knowing that it will pass truly helps.

Talking to a counselor or psychologist or psychotherapist also helps. They help you figure things out. They help teach you strategies to deal with and handle sadness and other feelings. They help you notice what helps and what doesn’t.  And they help you talk about the feelings. If you’re in South Florida or Broward County and need a counselor, then feel free to contact me at 954-309-9071 or visit my Florida Psychotherapy website.


Should I have had this child?

I was recently at a going away party for a mom who has grown children. Most of the moms in the room had children ranging from Littles to teenagers. Several had grown children.

We all talked about those mothering moments when we ask whether we should have had the child. It goes like, “maybe I shouldn’t have had this child. . . . maybe I shouldn’t have had the first one, only the second . . .  maybe I shouldn’t have had the second and was only meant to be mom to one . . . maybe I shouldn’t have had the third . . .” Etc., etc., etc.

They all admitted to having doubts at one time or another, usually during a really hard mama day, about whether they should have had that child.

One, I felt huge relief to hear these mamas talking about this.

Two, I gathered that everyone has these thoughts which means . . .

(three) . . . forget the guilt that goes with them. Just throw it out! Everyone has the thoughts. Everyone has bad mama days. Everyone struggles, whether you’ve had one kid or six.

What the thought is a sign of is not your commitment to your child or your love for them rather that you’re having a bad day; that you’re struggling and probably need a break (at least a 5 minute one!).

It’s only information about your own process so next time the thought comes up, realize that and take the break!

Make it to bedtime

Sometimes you’re having a really bad day and the kids are driving you cra-zee. Here’s a mantra for you  – “I only have to make it until bedtime.”

Now it’s bad if you’re thinking that at 9 a.m. in which case you may want to pick a closer goal – “I only have to make it until naptime.” If naptime has been given up long ago, well then  . . .

You have full permission to decompensate, collapse, freak out at that point. In fact, you have full permission to do that before that point if you need to. I know plenty of moms who go into their bedrooms for a little private time. Make sure the baby/kiddos are safe and go for it.

Some days are just going to be like that. You’ll get through them. Call a friend, get out of the house, go to the grocery store, put the t.v. on for the kids, anything to help you cope. If you have willing relatives/friends, ask if you can drop the baby off for a bit. Nothing horrible is going to happen if you take a couple of hours to yourself. And you need it!

If it doesn’t help, well then contact a professional. Seriously. If the depression doesn’t let up and just keeps coming at you, never giving you a break, and you feel like this day after day after day you need to see someone. It will help like it helps thousands of women every day.


There has been a lot of media attention about the Melanie Blocker Stokes MOTHERS Act. John Grohol at PsychCentral does a great job refuting that there are false claims of PPD, complete with a mini-research review to back up what he’s saying. That’s in contrast to most of the mainstream media articles published about this topic. It’s as if the reporters somehow forgot that there’s an incredible amount of research on this topic.

It’s a no-brainer that we need more screening, more education, more awareness about this issue, not less. Imagine more mothers getting the help that they need and being happier during early motherhood (at least).

Harvesting the Heart

I’m reading Jodi Picoult’s novel “Harvesting the Heart.” I’ve been a fan of hers for a while and it was a last minute addition to my stack at the library. It was published in 1993 and I had no idea it was about postpartum depression. I don’t know if Ms. Picoult did either but reading it in 2009, it’s crystal clear.

Beware – spoiler coming up!

There are two main characters, an artist and her heart surgeon husband. The woman is sitting in her OB’s office at her 6 week appointment and says,

——— (sorry, I can’t figure out how to get WordPress to indent!)

“How long does it take?” I asked, a thousand questions at once. How long
before I know what I’m doing? How long before I feel like myself again? How
long before I can look at him with love instead of fear?

Dr. Thayer helped me over to the examination table. “It will take,” she said,
“the rest of your life.”
So wise! There are about a million passages I could quote from this book that elucidate PPD. The mom ends up leaving her 3 month old one night to do some errands and just keeps driving. The rest of the book is an exploration of her “escape.” I just posted about this in my last post! It also goes into her husband’s perspective.

If you’ve had PPD, you practically can’t put the book down. If you haven’t, you’ll understand it better in a way that’s not preachy, not text-booky, not humorous, just, well . . . Jodi Picoult at her best.

PTSD after childbirth

Women can experience Post-traumatic Stress Disorder after childbirth. Most women go into their births with plans of a beautiful, wonderful birth where she sees the baby afterwards and they immediately bond. But it doesn’t always go that way. A lot of births end up less than ideal but some births end up actually traumatic. I’m going to review the DSM-IV-TR criteria for PTSD and comment on how they can apply to birth.
According to the DSM-IV-TR, the following criteria must be met to be diagnosed with Post Traumatic Stress Disorder (PTSD):

A. The person has experienced, witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others AND the person’s response involved fear, helplessness or horror.

Has the mother felt like she or her baby was in danger of death or injury? And how did she react to that during the event? Panicking? Dissociating? Cooperating, resisting, crying, doesn’t remember? All of these can be stress reactions to an event.

B. The traumatic event is persistently re-experienced in at least one of the following ways:

  • Recurrent and intrusive distressing recollections of the event.
  • Recurrent distressing dreams of the event.
  • Acting or feeling as though the event were recurring (including flashbacks when waking or intoxicated).
  • Intense psychological stress at exposure to events that symbolize or resemble an aspect of the event.

The mother can have nightmares about her birth, images and flashbacks can come to her during the day at random moments or when she looks at her baby.

C. Persistent avoidance of stimuli associated with the trauma or numbing of general responsiveness (not present before the event) as indicated by at least three of the following:

  • Effort to avoid thoughts or feelings associated with the event.
  • Efforts to avoid activities or situations which arouse recollections of the event.
  • Inability to recall an important aspect of the event (psychogenic amnesia.)
  • Markedly diminished interest in significant activities, such as hobby or leisure time activity.
  • Feeling of detachment or estrangement from others.
  • Restricted range of affect; eg, inability to experience emotions such as feelings of love.
  • Sense of a foreshortened future such as not expecting to have a career, more children or a long life.

This can present several way. Moms may skip their postpartum checkup in an effort to avoid the doctor or midwife. If asked about her birth, she may not want to talk about it. She avoids parenting groups or birth class reunions. She avoids the hospital or birth center.

D. Persistent symptoms of increased arousal (not present before the event) as indicated by at least two of the following:

  • Difficulty in falling or staying asleep.
  • Irritability or outbursts of anger.
  • Difficulty concentrating.
  • Hyper-vigilance.
  • Exaggerated startle response.
  • Physiological reactivity on exposure to events that resemble an aspect of the event, eg breaking into a sweat or palpitations.

Moms may have an anxiety reaction when driving past their birth centers or hospitals. They may get anxious when discussing the birth or when birth stories come up in conversation.  They may also feel detached from their baby, partner, family, or friends.

E. B, C, and D must be present for at least one month after the traumatic event.

F. The traumatic event caused clinically significant distress or dysfunction in the individual’s social, occupational, and family functioning or in other important areas of functioning.

Like postpartum depression, PTSD is highly treatable, meaning the woman can get better, sometimes very quickly. Treatment options include

  • talk therapies such as cognitive-behavioral therapy
  • medications and herbs
  • acupuncture
  • body therapies such as Eye Movement Desensitization and Reprocessing (EMDR), biofeedback, and hypnosis

The important part is recognizing what is going on and then getting some help. Many women feel like they’re saying they don’t love their babies if they admit that their births were less than ideal. After all, numerous people probably said to her, “a healthy baby is the most important thing.” Yes, but the two issues are completely separate. It doesn’t negate how her birth went or what she’s going through now.

To learn more about PTSD after childbirth, check out the site PTSD Childbirth.

What does “Perinatal” mean?

I attended Postpartum Support International’s (PSI) seminar this last weekend in Tampa and was blown away by the presentations. The main presenter was Birdie Gunyon Meyer, the current president of PSI. Her committment and knowledge of the area of perinatal support is just incredible. And she was funny, which always makes a seminar or conference more enjoyable.

Most people are not familiar with the term “perinatal.” It covers the period from prenatal to postpartum, so is all inclusive. People tend to think of depression and anxiety as only occurring during the postpartum period, after someone has the baby. But there is a significant amount of women (about 10%) who experience depression and anxiety during pregnancy. If untreated, it puts them at higher risk for postpartum depression as well, but it should be acknowledged and treated during pregnancy.

PSI works to raise the awareness of the emotional changes that women experience during the entire perinatal period.