Save Women's Lives and Hearts

"A beautiful young mother of two has been missing in Rhode Island now for more than a month.

Her name is Katie Corcoran and she is suffering from postpartum psychosis.  She was supposed to be released from the hospital to her family, but on September 5th, in some kind of mix-up, she was sent off in a taxi instead.  Her husband, small children, family and friends haven't seen or heard from her since."

This is a quote from the blog Postpartum Progress, a blog by Katherine Stone that collects information and support for women suffering from postpartum mood disorders. Katherine, along with BlogHer and Postpartum Support International are asking bloggers to spread the word today about the MOTHERS Act:

What is the MOTHERS Act?  The Moms Opportunity to Access Help, Education, Research and Support for Postpartum Depression Act, or MOTHERS Act (S. 3529), will ensure that new mothers and their families are educated about postpartum depression, screened for symptoms and provided with essential services.  In addition, it will increase research into the causes, diagnoses and treatments for postpartum depression.  The bill is sponsored by Senators Menendez and Durbin.

This is important. Really important. AS many as 800,000 American women every year get PPD or another postpartum mood disorder, and only 15% of them will be assessed or treated. That's tragic, and we shouldn't fall through the cracks.

I'm going to ask you to do three things:

1. If you're an American or live in the US, call your senators' office today to ask them to support the MOTHERS Act (S. 3529). Find your senators' contact info by going to www.senate.gov and using the drop-down box in the top right corner to find your state.

2. Start talking about PPD. If you experienced it, share your experience. When you see other new moms out and about, ask how they are, and really look at them when they answer. You might be a vital part of the safety net we should have in place.

3. I've posted a PDF of "14 Tips to Prevent Postpartum Depression" over there on the left-hand side of this page. Please download it and print it out, and give it to the pregnant women and new moms you know. (If you want more than five copies or to reprint it, please email me about rights.) It's better to prevent PPD than to try to battle it, so let's make sure women know there are things they can do to lessen their likelihood of getting serious PPD.

Comments

[holly]

You are awesome! Will do.

[sue]

Can't wait to see the pdf. I have a friend who's terrified she'll get PPD (she's prone to depression) and so is considering not breastfeeding at all in case she needs to take antidepressants. She could probably really use this...

[paola]

I suffered PPD with my first and talked about it with everyone ( well not details, but how I was feeling etc) and it turns out soooo many other mothers had experienced it too, but didn't talk about it until someone else did. So I really agree with Moxie, share ( as much as you can /want to), so at least there won't be so much of a stigma attached to PPD

[bec 37]

This discussion brings back a scene from just after the birth of my first nephew in 1995. I was hanging out at the hospital with my sister, and a nurse (let's call her Kelly) came and sat down to have a serious discussion with her. Apparently Kelly's sister had suffered from PPD, to the point of having thoughts of harming herself or her child, and Kelly had taken it upon herself not to let a new mom leave the hospital without giving them her little shpiel. I remember she talked about how it was okay to put a crying baby down in a safe place and walk away for a few minutes, and that my sister should not hesitate or be ashamed to call me or my mother and say, "I need you to come and take the baby." I remember thinking that this education should be a regular thing. I asked around and discovered that it was, in fact, an anomaly. And when I had my own kids, no one said anything about PPD in the hospital (although it may have been discussed in the childbirth class, I don't remember and I missed the last class). I had a talk with my husband, telling him: if I start acting weird or saying odd things after the baby is born, do something right away, don't wait, and don't even consult me about it.

All of this is just to say: it is about freaking time.

[Treena]

I found the hospital staff to be very careful about this when I had my son, to the point that it was actually starting to bug me. He was born at 34 weeks and was in the hospital for two weeks, so I was around a lot. I was really coping just fine, but I have a pretty flat affect, so I guess the nurses felt they couldn't get a good read on me and kept asking if I was OK. They even asked my husband and my mom when they were visiting, and had a social worker come visit with me. Even though I didn't need the attention, I'm glad they're so careful about it. I guess some people really need to be asked 100 times if they're OK and will only tell you they're not the 100th time.

With my first kid (who was not a preemie) the midwife asked about it at the 2-week postpartum visit and then again at the 6-week. I actually cancelled the 2-week postpartum after the preemie because I was so tired of having to convince people that I was really doing OK.

[pnuts mama]

moxie, you summarized this beautifully, but the entire paragraph actually raised the hair on the back of my neck:
"Postpartum depression is a serious and disabling condition that affects up to 20 percent of new mothers -- as much as 800,000 American women each year. Yet only 15 percent of these women will receive any assessment or treatment. Let me repeat. With all we know and as smart as we are, only 15% of 800,000 women will get diagnosed and treated. That is so wrong on so many levels. Women are not being diagnosed because they're not being educated and they're not being screened. Untreated, the consequences of maternal mood disorders range from chronic, disabling depression to death. The impact of untreated maternal depression on infants/children ranges from behavioral and learning disabilities to depression and, in the worst case scenarios, death from infanticide."

i know we definitely got the talk/video about never shaking the baby when we were in the hospital with pnut, but i can't remember a word about PPD. what a shame. what a real disservice to all of ourselves and our children...

i know my OB was pretty good about asking me how things were going, at our checkups, but, i don't know, a checklist probably would have been helpful at the time- a lot easier to check yes or no vs. answering a question face-to-face sometimes. off to write to hillary and chuck...

[hedra]

PPD seems to get minor surges of attention in the media, but PREVENTION approaches like Moxie's just do not exist.

Moxie, I'll email you to discuss giving it to my midwives - I'm sure they'd like to put it in their pregnancy book (like a big journal they give to each mom). Up to now, I've just sent everyone I know to your site. Which isn't a bad plan, either! But ... well, handouts cover different territory.

[MrsHaley]

For wahtever reason (I don't know, sex, maybe) I know a lot of pregnant women right now. They will each be getting a copy of Moxie's PDF.

My experience after giving birth was very similar to bec 37's. I had some complications after delivery and was personally not ready to go home at the 48-hour mark. I was afraid they were going to discharge me anyway and got a little hysterical about it to my DH and BFF. My doctor walked in just then and was very alarmed! She had a big sit-down with the 3 of us -- me sobbing and heaving, DH and BFF trying to explain what I was so upset about -- and after hearing of my hisotry of anxiety & depression, prescribed a psych consult and gave a very detailed, very scary lecture to DH and BFF about symptoms to watch for etc., etc.

Turns out, all I needed was an extended stay. I got it, went home when I was ready and have been fine since. I wish all new mothers had such a contientious doctor and persistent partners and friends ... between the two of them (DH and BFF), I had to give detailed psychological updates daily!! I will try to be that friend to the pregnant moms I know, starting with Moxie's list.

[SarcastiCarrie]

My insurance carrier at the time (Blue Cross/Blue Shield of Illinois...who incidentally cover IVF at 100% coverage levels), called me at 1 week, 2 weeks, 6 weeks, 3 months, sent me flyers and yes/no questionnaires and had a 24-hour toll free number with nurses and counselors on staff to answer all my PPD questions. One of the brochures they sent said something like "We are sending you this because your recent claim activity indicates you may just have had a baby. If you did not, please disregard this."

Like Treena, by the 100th time, I was getting annoyed, but then again, I didn't have PPD (just normal hysterical crying baby blues).

[Allison]

I love my Senator (Durbin)!

[robin]

I live in Chicago, and am currently getting help through a state funded PPD program. I found this website when I googled PPD Chicago Resources: http://www.ppdil.org/ppdhelp.htm
It has been a tremendous help to me. I just had an appointment this morning, in fact. I will definitely pass this PDF along to my pregnant friends and also to my midwife & doula. Maybe because I chose a kind of offbeat approach to prenatal care & birth, the subject of PPD was always present, even from my first appointment at 9 weeks.

[emily]

I was just hearing Valerie Plame Wilson on NPR yesterday, and she talked for a long time about her PPD - how she was sure she could handle twins because they were dearly wanted and she knew she was a very tough cookie in her professional world, up for anything - and then she felt totally and utterly overwhelmed when they came. And she talked about how baffled she was that with all of her education, and means, and good fortune at that time, she had never even heard of PPD and had no idea what hit her.

[caramama]

Moxie: Thanks once again. You rock.

sue: I was/have been worried about PPD, which is why I worked so hard to make breastfeeding work. The hormones that are released when you breastfeed are very beneficial for those who might suffer from depression, and it helps keep a bond with your child even during PPD (Brooke Sheilds talks about this in her book about her PPD, Down Came the Rain). Your friend should look into that; I believe it's helped me.

Something I know about PPD is that the onset can occur any time during the first 12 months or so. Not necessarily right after the birth.

So, question for the group: How do I know if what I'm feeling is my normal Seasonal Affective Disorder exhaustion/depression (which I get every year) or if it's PPD? Is there a distinction at this point? Should I do more than my normal light therapy? I will now search Moxie's archives... I know she has some stuff. But any opinions on this would be appreciated. TIA!

[mel]

I won't even pretend that I came close to PPD, but I feel certain a friend had it. At one point we were talking 3x a day on the phone (Just stuff like, "Put DS in the crib, and go take a shower/put on clean clothes/stand on the back porch and get some sunshine. It's not going to hurt him to cry." She wouldn't tell her hubby (but never asked me not to tell him, so I would call him as soon as she and I got off the phone so he was in the loop). When I finally convinced her to say something to one of her drs, they adjusted her meds and she came through like a champ.

At about 4 months PP for me, I started having horrible nightmares about myself and DD. I happened to have a dr appt that week with my OB/GYN and he asked how I was doing, and I told him about the nightmares (very graphic violent ones to be honest) and he blew me off. Said it was nothing that any mom didn't experience. (Yet another reason I am firing him.) I never had a thought of hurting DD during the day, only at night. I made a point of waking up the hubby every time I had one so we could talk it through.

[Marian]

Thanks for bringing up this topic. My daughter is 8 months old now but I'll never forget how close I came to PPD. My hospital made a point of asking several times, made us watch a PPD video, etc. but I never thought it would happen to me. Only that my mom saw the video in the hospital with me, did she insist that I was not myself and realize it was not normal baby blues. At the time, I thought it was totally normal to think "I'm a bad mother, she'd be better off with someone else; I should give her up for adoption..." My doctor was no help. Couldn't she see that I'd lost 30 lbs in 2 weeks at my 1st checkup??? Isn't that a major sign??? Its so annoying now that she didn't make an issue of it, but the point is, that my mom did and I was able to see a therapist and get through it no worse for the wear.
Anyway, thanks for bringing it up and giving a copy of the pdf to pregnant women is a fantastic idea.

[Karlark]

Hi...

This is my first time posting, but I've been reading the blog since we adopted our little treasure of a boy five months ago. Moxie, your blog has definitely given me a lot to think about.

We had a very rough transition that first month home with little treasure. I wanted to remind everyone to share PPD information wtih friends and family who have adopted. The path may be different, but those emotions are still the same. And I found it very difficult to find any informaton on feeling overwhelmed post-adoption. Couple that with not getting the same level of support and care from friends and family (I guess because we weren't physically exhausted after a birth?!!?) and it can be pretty rough going. I've talked to several Moms who adopted who had the same experience.

I don't think I had PPD and after a month we hit our groove as a family. But, it did make me realize how little is out there for those new adoptive Moms.

Thanks!

[Nutmeg]

In my state (NJ) the state medical board requires screening of all women for post-partum depression by ALL doctors that they might be seeing in the year after having the baby. My husband (who REALLY has nothing to do with women's health) received a letter at our home about his obligations with regard to this and it included the survey of questions he is supposed to address with the patient.

So, another route to go would be through the state medical board, though obviously national legislation would make the process uniform.

As someone with a major depressive disorder and serious PMDD, I was terrified of the specter of PPD. I had my prescription all filled and ready to go should I need meds. And all turned out well, thank god, since taking care of the colicky bub for 4 months was enough.

Thanks, Moxie.

[Menita]

Thanks for this, M, and will do.
As you know, I had PPD with both my children, though it was worst with my first. I make a point of making some kind of connection when I meet new mothers.
Wish I could vote.

[kelly]

Ditto Menita: wish I could vote. That said, thank you for this, Moxie. I will print it up, show it to hubs, and pass it on to fellow pregnant women.

[julie]

Done, done, and done. Thank you Moxie for keeping me updated on and involved in events outside the world of Sesame Street.

[Sherry]

OK, I'll do this, because I had PPD. I've been depressed before, so it wasn't a surprise. It was just horrible. I am on Wellbutrin and breastfeeding. I've done lots of research as well as consulting with several doctors and psychiatrists, and I really believe it's safe. It has maybe, possibly (probably not) caused a seizure in one baby, and that was at a really high dosage. There's a chance it has lessened my milk supply. Hard to tell, because working full-time has certainly taken a toll on my supply. But I've read that there's anecdotal evidence that it does lessen supply. But it's so much better, in my opinion, than the alternative drugs. Just wanted to share in case it helps someone.

[Jill]

I had PPD with my second child and was asked 100 times if I was ok, answering that I was fine. I just thought I could handle it. Then one morning, FIVE MONTHS LATER, I realized I just could not get out of bed, could not stop crying and could not take care of my children that day.

I knew about PPD, and I knew I wasn't feeling myself, but I couldn't remember what "myself" was supposed to feel like. I had a difficult second baby and thought my feelings were just in relation to having so many problems with him. I also thought that I would need to research a psychologist and I just didn't have the energy to do it. I went to a friend who had been very vocal about her PPD and found out my own Ob-Gyn could treat me! I was on medication 24 hours later and finally remembered what it felt to feel like "Myself" again! I tell other women as often as I can, hoping they'll get help sooner than I did.

Thanks Moxie

[Samantha]

I've been mulling this over all day since I'm currently struggling with PPD. I also saw on Lifehacker today that sleep deprivation has been clinically proven to dramatically screw up your emotional reaction to things and make you overwhelmingly negative. Wonder if the two could be related? :-)

[Katherine Stone]

Moxie, you rock! Thank you so much for writing about this today. If your readers haven't had a chance to call their Senators yet, I hope you will encourage them to do it before the end of this week. Each call is SO important. On behalf of all women who experience PPD and related disorders, I thank you.

[z]

I was really worried about PPD because of my previous history of anxiety and depression but i discovered that having my baby had the opposite effect on me. Initially it grounded me and gave me the security that was missing from life. I think that's what got me through the craziness and still gets me through the craziness.

But as months went by one thought that i could never get out of my head and that i still have recurring nightmares about (13+ months later) leaving the baby at home alone. in my dream i see myself at X place thinking that i am only out for a few minutes and he'll be okay.

I guess i write this to reiterate like many others that PPD, depression, mild depression,anxiety etc can strike anytime between birth and first year and last for longer than that 1 year period.

[anon]

Can PPD come on later? My second son is almost 7 months old, and the last few weeks I find myself getting increasingly impatient with him, to the point where I'm actually feeling angry at him. Of course, I feel horribly guilty about it afterward, but I can't help but wonder if something's going on in this little head of mine. He's a beautiful little boy, but I've actually found myself thinking it would be easier if we didn't have him. Awful, I know.

[SarcastiCarrie]

Anon, what you are going through sounds normal enough. We all have days like that, but if it is worrying you, keep in mind that PPD can strike up to a year later (though I think if they are still not sleeping through the night or if you are still nursing, it can strike even later). It can't hurt to talk to someone or take one of the yes/no questionnaires. Help is so readily available, that there is no reason for you to be worried or scared. And your thoughts are not awful. Most of us have had that thought (sometimes fleeting, sometimes not so fleeting).

[hedra]

Anon, PPD 'typically' has onset ANY time in the first 12 months after childbirth (and adoption, thanks for the reminder on that!). BUT, 'maternal depression' can be triggered at any challenging period of the child's life (confluence of factors including sleep disruption, crash in dietary balance/content, forgetting supplements, increased stress, increased inter-parental stress, etc., etc.).

If you're wondering, it is worth examining.

Granted, at any sleep regression/fussy stage, 'mom feeling totally CRAZY and frustrated and overwhelmed' is technically normal. IIRC, 7 months-ish is one of those stages. (Refer to The Wonder Weeks if you can find a copy. Check Moxie's sleep regressions posts, in either case.)

[Suzanne]

When I was in the last week of my pregnancy my cousin committed suicide - she had been suffering from PPD and left behind a two month old baby girl. Now that I have a child I know that she must have been in horrible pain to see death as a relief and to leave behind her child. We all need to be educated about PPD especially those of us who are moms and have some reference point to identify in friends, sisters, etc. when help might be needed.

[SJ]

Moxie, you are awesome.

I probably had PPD, am hoping to avoid it this time around with the help of your tips and an excellent therapist. I have made a point of talking about it with friends and particularly pregnant friends - one difficulty I have with pregnant friends is finding the balance between sharing my experience and scaring them.

[AmyinMotown]

Had a mild case, and the nurse pracitionier at my doctor's office, who I loved even before this, sat with me fo the longest time and listened to me talk. She said, basically, it's normal to be grieving your old life and it had only been two weeks so it was okay to not be adjusted, but here's a giant stack of Zoloft samples just in case. I'm still, three years later, so grateful to her--she was one of the only people who made me feel it was okay to NOT be loving this just yet, and still made sure I had meds if I needed them..

[Kate]

I suffered from postpartum depression and then postpartum psychosis after my son was born in December 2004. The first year of his life- which should have been the happiest time- was the worst time of our lives. The PPD/PPP almost destroyed my marriage. I can't even begin to put into words the horrible things I thought, did, and said. About four months after my son was born, I finally had my husband take me to the ER where they told me that the Psycho ward was "no bed and breakfast and to go home and take it easy."

After coming *this* close to dying after ingesting over 300 anti-psychotic, anti-anxiety, and anti-depressants the next day (ironically, Mother's Day) the medical community finally took me seriously. It took three days in the Cardiac ICU, two weeks of inpatient treatment, and 5 rounds of outpatient electroconvulsive therapy (shock treatments, basically) before I could home.

You can read my story in the May/June/July 2005 archives at http://babybrody.typepad.com

[anonymous as well]

@caramama: in my experience, PPD is full of ups and downs compared to garden-variety depression. All those hormones. Even postpartum bipolar disorder is daily ups and downs instead of months at a time. It's a lot more complicated than that, of course, but for me, that's the big difference. And it's a big part of why people don't get help, especially women with a history of depression. It doesn't feel like depression they've had before, they have good moments, even good days . . .

@Suzanne: Your cousin may not have found it a relief to leave behind the baby. I've been amazed at how many women I've now met with PPD and PPpsychosis who honestly felt that they were the worst mother on earth, that their child was better off without them. PPD screws with your head so much, it can seem like the most loving and sensible thing in the world to leave your children motherless, or even to take them out with you. I don't want to say anything that would increase your pain, but I'm throwing this out there in case it helps you to remember her that way. Not as so wrapped up in her own pain that she could leave her child, but as as loving her child so much, she wanted what was best for her, the disease just convinced her that that was killing herself. I'm so sorry for your loss.

[caramama]

anonymous as well: Thanks for the information. I REALLY needed to know that after these past couple of days when I've been feeling great (after a couple good nights of sleep). Now, I'm even more glad that I've made an appointment.

Sherry: Thanks for the info on Wellbutrin.

Thanks to everyone else who shared their stories.

[MGH Center for Women's Mental Health]

Thanks for your support of the MOTHERS Act. Too often postpartum depression is a problem that goes unnoticed, and most women with PPD never receive any type of treatment. PPD is a treatable illness, and it is essential that we continue to educate ourselves and others about this important issue.

For more information on PPD, visit us at womensmentalhealth.org

[Christi]

Really late with this, but I have a friend currently suffering from what sounds to me like a really bad bout of major depression, and it brought this experience back. (He's male, so doesn't have PPD, though.)

Moxie, I don't know if anyone will see this comment or want to look, but I figured I'd post back here just in case. Also, if you ever want to compile a book about PPD experiences (in your spare time, ha ha) I'd be glad to help.

Thanks.

http://ladyperegrine.livejournal.com/326623.html

[Jessica]

LOVE this. I can really retlae. I was "better" (i.e., back to normal me) exactly 12 days after starting meds, feeling fabulous in terms of emotional health about a year later, and then another year later IN LOVE with being a mom, which I wasn't sure would ever happen for me. A lot of it, for me, was entering into the preschool years. I found a lot of childcare in the infancy stages pretty monotonous, but really love the challenges and growth associated with slightly older kids...that and finally having a real sense of knowing this new life of mom-hood, finally being ready for it...finally know I could do it...

[Yolanda]

Postpartum Depression and Anxiety is much much more frequent than Psychosis. 1 in 10 women have Postpartum Depression!Psychosis is very rare as you mtnnioeed.But all what you wrote is right for Depression as well, so great video. Just wanted to mention this as it might be a bit confusing. Women might think: Wait a minute, I don't hear voices, so I might not have Postpartum Depression can be very severe too.

[Nkugwa]

This was beautifully put teteghor and I pray that you received an A for all of your hard work. It pointed out that women need help after giving birth. We may not want to ask or say that we do but it is a hard job being a full time mother. A job that little credit is given.

[Elina]

unfortunately, yes their are some bad side effects to antitepressands, but it is a physiological chemical imbalance in the brain which causes the changes in mentation. Hormones are also known to be harmful and can in fact cause cancer even at low doses, and unfortunately they don't change the chemical imbalance