When the Starting is the Hardest Part

I just read this thoughtful post on Heather Armstrong's blog Doocewww.dooce.com, and thought her story really captures what it's like to face the day when depression tries its best to make sure you stay buried beneath the blankets.  So now I'm wondering, what gets you out of bed on those mornings when it feels so hard to start?

Surviving Out Loud

Getting a mood disorder is like getting the flu.  It strikes seemingly at random.  No one is to blame.    No one should feel ashamed or guilty that they have it.  There's no vaccine or miracle cure, but there is hope. It sucks, but it will get better with treatment and care.

That's why I love Katherine Stone's album of postpartum mood survivors over on her great Postpartum Progress site.  Just beautiful families who have overcome great hardship to survive and thrive.  As Stone says, "We aren’t defective. We aren’t strange or unusual. We are great moms who were waylaid temporarily by a terrible illness."  And there's nothing shameful in being laid up by a terrible illness.  Indeed, in the same way that catching the flu can make a body more resistant to future illness, surviving a postpartum mood disorder makes a family tougher and more resilient in the face of future struggles. 

No More Shame: Postpartum Support International of Washington's Executive Director, Heidi Koss, Speaks on Ending PPMD Stigma on NPR

My esteemed colleague and friend Heidi Koss, Executive Director of Postpartum Support International of Washington is featured in an interview with NPR's Joanne Silberner. Heidi Koss shares her personal struggle with Postpartum Depression, and her personal quest to end the stigma that prevents women from seeking treament for a highly treatable illness. Please share with every new and expecting parent you know.

The Importance of the Postpartum Partner (for Gwyneth Paltrow and Non-Celebs Alike)

While reading this interview with Gwyneth Paltrow in People I realized that there's an all-too-common misconception about Postpartum Mood Disorders: that a person must be crying all the time in order to be diagnosed. Not so! The symptoms are often subtler, yet no less serious. That sense of being "cut off" from one's emotions is a common symptom of PPMDs. And it's often one's partner who notices these sometimes subtle, internal shifts. Sometimes it takes an attuned partner (such as Chris Martin) to know when something sounds a little off in ourselves.

Because You are (or You Know) a Mom who Needs a Night Out

All right, ladies, bring on the sequins and taffeta: It's prom time! (Only this time it's for a cause better than overcoming awkwardness and proving your date's got nothing on your dance moves.)


THE MOM PROM:
DANCING, DRINKS, DESSERT
FOR A GREAT CAUSE

8 P.M. TO MIDNIGHT
APRIL 10
NAVAL RESERVE BUILDING, SOUTH LAKE UNION

ADVANCE TICKETS: $35
(that includes 2 drinks)
www.seattlemomprom.com

"I started thinking about putting together the Seattle Mom Prom when I became a parent and realized how crucial having a solid support system is for mothers. I wanted to organize an event for women to honor and celebrate moms, and support a great organization like Postpartum Support International of Washington," said Myla Rugge, founder of the Seattle Mom Prom.

All proceeds from the Seattle Mom Prom will directly benefit Postpartum Support International (PSI) of Washington, a non-profit organization designed to support and educate women, families and professionals about Postpartum Mood Disorders (PPMD). For more information about PSI of WA, please contact 1-888-404-PPMD (7763) or visit www.ppmdsupport.com.

No one Needs to Suffer Alone

Alexa Aguilar, a freelance reporter for the Chicago Tribune, wrote a recent piece urging women who are suffering symptoms of a postpartum mood disorder to get help.

Firstly, amen, Alexa, amen!

Secondly, I was caught off-guard by this sentence: "At the hospital, we were all handed information about the warning signs of postpartum depression and anxiety."

Now, I remember getting lots of information about baby care at the hospital, but nothing about ppmds, or was I just too groggy to remember? Or is Seattle just behind Chicago on this issue?

Regardless, yes, Alexa is right: help is out there! (In Washington state, check www.ppmdsupport.com for resources near you.)

Raising Orchid Children

I just finished reading a fantastic article in The Atlantic by David Dobbs entitled, "Orchid Children." The "orchid hypothesis" of child development, as Dobbs explains, is quite similar to my own hypothesis about postpartum mood disorders: "Genetics loads the gun; environment pulls the trigger." In other words, genes are responsible for our sensitivity to mood problems, but it's the particular ecosystem in which we live that determines if mood problems develop.

Let me try to explain this "orchid hypothesis" that Dobbs reported on in the article. We all know someone who survived some terrible childhood trauma. This person may have survived verbal, physical, and/or sexual abuse. These people should be complete emotional messes as adults. And yet, maybe with therapy, maybe without therapy, they are pretty well-functioning adults. There's a whole sub-genre of memoirs out there written by such people. ("Once in a House on Fire" by Andrea Ashworth is a fine and much-recommended example.) These people, according to the hypothesis, would be called dandelions. They flourish under all kinds or stresses and in adverse environments, much like the dandelions in lawns--chemically-treated and otherwise--everywhere.

And then you have the orchids. Orchids are much more sensitive to their enviroment. They are highly reactive to even seemingly small amounts of stress. In children, they may be quick to throw tantrums; cry easily; hit, kick, punch or bite their parents or caregivers. In adults, "orchid-ness" often manifests itself as anxiety or depression.

So then, the theory goes, there are 2 types of the same gene that determines whether you have a "dandelion" or "orchid" temperment. You may be thinking it's better to get the "dandelion" variation over the "orchid" form, but it's not quite so simple.

A well-tended "orchid" when it blooms, blooms magnificently. When "orchids" are raised in highly responsive, stable, and emotionally-attunded ecosystems (which includes every caregiver with whom the child has contact), these children channel their propensity for risk and excitement in, well, exciting ways. You may know some of these people, too. They take on interesting and creative projects. They maintain a network of fun, diverse friends. They may be empathic beyond the norm. They have that vision thing, seeing possibilities where most see nothing at all.

So, this hypothesis has got me excited for all kinds of reasons. Here are some of the possible implications I've been thinking about: What if the orchid hypothesis also applies to parents who suffer postpartum mood disorders? Does being an "orchid parent" mean that recovery from ppmds or baby blues makes one a more intuitive, sensitive parent in the long run? In raising "orchid children," how do we best help them succeed? In successfully raising an orchid, do "dandelion siblings" reap benefits, or does the dandelion-parent bond suffer?

In my coming posts, I hope to explore all these (and more) questions further. In the meantime, peace to all the dandelions and orchids out there.

Postpartum Support International of Washington Celebrates 20 Years

Congratulations to PSI of WA for reaching its 20 year milestone. To celebrate, PSI of WA is hosting a luncheon on Wed. October 28 at the Hilton in Seattle. Dr. Shoshana Bennett, whose books I've cited in this blog, will be the keynote speaker. Bennett is the author of "Postpartum Depression For Dummies" and co-author (with Pec Indman) of "Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression." Her latest book, "Pregnant on Prozac," was released in January. Click here for details and tickets.

When the "Baby Blues" Strikes Dads

Sex therapist and relationship counselor Ian Kerner, PhD recently wrote about his own experience of depression after the birth of his first son in this article. He very astutely points out that for him, as well as for many new dads experiencing depression, he turned to the liquor cabinet as way of coping. Alcohol, being a depressant itself, further exacerbates depressive symptoms.

Kerner also lists other warning signs to look out for if a new dad you know seems to be struggling to cope with the transition to parenthood, including: changes in libido, putting up a good front, isolating himself, difficulties sleeping (even when feeling tired), family history of depression, or self-medicating. I would also note that the term "self-medicating" often refers to drugs or alcohol, but in some men, could also mean food, internet, or pornography.

Katherine Stone Corrects the Record on The MOTHERS Act

Recently, Time magazine did a story about the "controversy" surrounding postpartum mood disorder screening, which is advocated by a pending piece of legislation called The Mothers Act. Katherine Stone of the Postpartum Progress blog wrote this response to help educate journalists and the rest of us what this piece of legislation is intended to do.

Postpartum Phone Support Available for Dads

I've written here before about the mounting evidence that fathers experience postpartum mood disorders at about the same rates as mothers: approximately one in ten. The resources available for treatment, however, are much more oriented toward a mother's needs and experiences.

Postpartum Support International is working to correct this imbalance. PSI hosts a weekly "Chat With an Expert" every Monday for men who are experiencing symptoms of PPMD or for others who care about someone who is. Will Courtney, PhD, and Susan Dowd Stone, MSW, LCSW, will be taking calls to answer your questions.

When the "Home Game" Isn't Dad's "A Game"

I heard Michael Lewis, author of "Home Game," interviewed on Charlie Rose today. While a number of women have come forward about their feelings of numbness after the birth of their children (Brooke Shields, most notably, comes to mind), men have been virtually silent on the issue. It was so refreshing to hear this interview where Lewis confesses, despite the social pressure to remain silent, that he did not feel instant love for his newborn. He shares how he eventually came to love his baby, but only after the fog of sleep deprivation and new parent anxiety lifted. An important new book has arrived just in time for Father's Day.

MOTHERS Act Passes in the House of Representatives

Now on to the Senate! A very kind woman named Susan Stone is compiling a list of people who support the passing of this legislation to support postpartum parents. If you'd like to lend your name in support, please email her at susanstonelcsw@aol.com with your name, state, and credentials (if appropriate).

Gotta love democracy in action!

New Study Reveals PPMDs Are Treatable and Potentially Preventable With Counseling

I watched a documentary on PBS recently about Parkinson's Disease, entitled "My Father, My Brother, and Me". One of the researchers interviewed said of the disease, "Genetics loads the gun; environment pulls the trigger."

This metaphor seems apt for post-partum mood disorders, as two recent studies point out. Some women may be genetically predisposed to PPMDs, but they still might escape its effects if it weren't for a colicky baby, a weak support network, or other "trigger." Similarly, strengthening the environment through supportive communication with a mental health professional or other trained helper can speed healing or even innoculate against PPMDs.

I find this new research especially exciting because it means a "talking cure" for PPMDs really exists, as long parents are connected with a trusted, knowledgeable counselor.

Postpartum Support International of Washington Support Groups

Since I've been on my own maternity leave these past 3 months, it occurs to me that now is good time to post the newest listing of postpartum support groups in Washington (where I live). Don't live in Washington State? Check the Postpartum Support International Web site here to find a group in your neck of the woods.

Tell President Obama Your Health Care Ideas

President Obama is asking for our ideas about improving health care in this country. I have too many to mention here (though universal screening for post-partum mood disorders and decriminalizing drug offenses in exchange for treatment immediately spring to my mind), and I suspect you, dear reader, have some pet issues of your own. Here's your chance to let your voice be heard. Click on this link to be taken to the Obama health care page.

Can we change health care delivery in this country? Yes we can, indeed!

How to Be a Supportive Partner to a Person with a Mood Disorder

Jon (whose wife Heather writes the very popular "Dooce" blog) wrote an insightful post about how he's learned to care for himself and his family when depression tries to get the best of Heather (and in turn, the rest of their family). His story is a must-read for partners who want to be supportive but aren't sure how best to go about it.

Alternative Treatments for Mood Disorders

With the days growing shorter here in Seattle, it's hard not to notice the way the changing seasons can affect one's mood. Coupled with the recent terrible financial crisis news, there's lots of grist out there for anxiety's and depression's mill.

I've also been thinking about the growing numbers of people who have been laid off (or are due to be laid off) from their jobs, and will be going without health insurance. Without such insurance, the cost of psychopharmacological interventions can be prohibitive. With that in mind, here are a few ideas for (potentially) lower cost alternatives:

Light Therapy: Long recommended as a treatment for Seasonal Affective Disorder (SAD), there is growing evidence (as in this meta-analysis by Gjerdingen) that it can be effective for treating antenatal and postpartum mood disorders. And while phototherapy equipment isn't cheap (I think they go for $250, or thereabouts), it's still less expensive than a month-long trip to Hawaii (which, in my opinion, the government should subsidize for us in the far northern reaches of the U.S., don't you agree?)

Massage Therapy: Gjerdingen also points out that massage therapy has been effective in reducing stress and anxiety symptoms in teenage mothers (a notoriously stressed-out group). Yes, massage therapy can become pricey quickly. It's worth asking at your local massage school or community college about their rates for student massages. (Many charge little or nothing at all in exchange for helping out a massage student.)

Yoga: I've written lots about yoga's beneficial effects on anxiety and depression in this blog. Please see my previous posts for evidence of its efficacy, and particular poses to try for various mood problems.

I'm sure lots of you have ideas about inexpensive ways of coping when mood problems set in. You are welcome to post them in the comments section, so we may all learn from each other's experience and wisdom.

The latest on PPMD research

The July 31 issue of Neuron reported some promising news for PPMD treatment. I'll do my best to put the researcher's findings in lay terms.

The researchers found (in mice) that when the brain has dysregulated levels of GABA receptors, mice showed more signs of anxiety and depression after birth and had a higher pup mortality rate. When the mice were treated with Gaboxadol, a drug originally designed to treat sleep disorders, the GABA-recptor-affected mice had fewer PPMD-like symptoms, as with those mice with well-regulated GABA receptors.

The researchers, thus, believe that (in humans) post-partum mood disorders and potentially premenstrual syndrome and premenstrual dysphoric disorder may be caused by impaired trafficking of GABA receptors, and not by fluctuations in hormonal levels, as previously believed.

Let's hope this latest research brings us one step closer to finding a successful treatment for PPMDs and other health concerns.