Thursday, October 27, 2011

NOTE: Please see our response to this posting on our facebook page. This is "most" of her article, some portions have been inadvertently deleted, but the public seems to have lost access to the original article for some reason...

MariaShriver.com

Three Tips for Navigating New Motherhood

By Sheryl Paul

The dominant message in our culture during the preconception through early motherhood stages is that any signs of anxiety or depression indicate that something is “wrong” and needs to be fixed. This message sets women up for unrealistic expectations, which lay the foundation that entrench normal anxiety and depression into clinical levels.

What does it mean to have “normal” anxiety or depression during pregnancy or the postpartum stage? It means that every life change, no matter how positive and life-affirming, is accompanied by loss, fear, and doubt.

Let’s break this down: You’re pregnant. You’ve wanted to be pregnant since you were four years old. But as soon as the pregnancy test revealed a positive result, you heard a door slam shut and felt a pang of loss. You pushed it aside because you thought that’s not what you’re supposed to be feeling at that moment.

You feel fear arise during your first trimester. You’re scared you’re going to lose your baby. You feel scared again during your third trimester and wonder, “What if I won’t be a good mother?” Because you don’t understand how vitally important it is to acknowledge and express these losses and fears, you push them aside and instead focus on buying the right car seat. But the feelings don’t go away. Instead they mutate into anxiety, and your doctor suggests an anti-anxiety medication.

Or you’ve just had your baby and everyone is healthy and thriving. While you’re deeply in love with your magical child, you also feel a profound sense of loss and longing for the familiarity of your old lifestyle and identity. You prepared for childbirth and you took classes on breastfeeding and baby care, but no one prepared you for the normal and necessary sense of loss that most women feel on the other side of the birth threshold.

You wonder what’s wrong with you. You wonder if this means that you’re not cut out to be a mother.. Nothing could be further from the truth, but because you’re not educated about what’s normal, you form false assumptions, which then prevent you from grieving the losses and allowing them to move through you to completion. Thus begins the slippery slope to postpartum depression.

Here’s the good news: Pregnancy anxiety and postpartum depression are avoidable and preventable! They both result from normal thoughts and feelings that are pushed underground because we don’t realize that they’re normal, where they then grow into an unmanageable state.

Here are three tips that I've learned for having an emotionally healthy pregnancy and avoiding postpartum depression:

1. Educate yourself with the truth about what’s normal to feel during pregnancy and early motherhood. Most pregnancy guides pay scant attention to what’s happening emotionally for women and instead focus on the growth of the baby and your body. While this is important information, it won’t facilitate the birth of an emotionally healthy new mother. Here’s what you need to know in a nutshell: it’s normal to feel fear, grief, loss, confusion, ambivalence, uncertainty, terror, and doubt during every stage of this transition (as well as joy and excitement, of course!).

2. Find a safe and compassionate place to express the difficult feelings. This may be with your partner, a friend, a therapist, or in the privacy of your journal. Your feelings are real and need to move out of your body. Most people hold the erroneous belief that so-called “negative” feelings will hurt your growing or newborn baby. The truth is that when you try to stifle these feelings, they’re amplified and that’s when they can harm your little one. So let them out!

3. Find the courage to explore the hidden thoughts that are lurking in your pregnant or new mom mind. Just as the feelings need a place to land, the thoughts also need to be explored and fleshed out. This may be the first time in your life that you learn to work with your anxious or fear-based thoughts effectively, and there is no practice more worthy of your time! Whatever you learn now will serve you for the rest of your life as a mom, and as a human being.

Taking these three simple steps can be the deciding factor that determines whether your normal fear and loss descend into anxiety and depression or transform into serenity and an empowered transition into motherhood.

Sheryl Paul, M.A., is regarded as an international expert in transitions. Since 1998, she has counseled thousands of people worldwide through life transitions via her private practice, her bestselling books, her website, http://conscious-transitions.com, and her home study program, Birthing a New Mother: A Roadmap from Preconception through the First Year to Calm Your Anxiety, Fortify Your Marriage, and Prevent Postpartum Depression, which can be found at http://birthinganewmother.com. She lives in Boulder, Colorado with her husband and two sons.

Friday, October 21, 2011

Be sure to check out our facebook page for ongoing updates and our blog on Psychology Today:This Isn't What I Expected

Thursday, September 29, 2011

Read about why women are hesitant to ask for help and WHY THEY SHOULD.


Saturday, September 10, 2011

"The greatest mistake you can make in life is to be continually fearing you will make one." ~ Elbert Hubbard

Fabulous training weekend with incredibly warm, passionate hard-working clinicians. I absolutely love being a part of this process at the early stages of their professional expansion and inspiration! Thanks to Amy, Kayla, Aimee, Romy, Patrice, Glenn, Michelle, Rachel and Rebecca! The PPD community is fortunate to have you in their corner.

Saturday, July 16, 2011

Thinking some of you might enjoy the distraction and creative outlet of an awesome coloring book for adults. (hint: colored pencils are good, but thin markers are better!)

ENJOY.... it's good for the brain.

Wednesday, July 06, 2011

PERFECTLY postPartum…

When being a good enough mother doesn’t feel good enough

If you’ve recently had a baby, do you…

c Compare yourself to other mothers?

c Feel increasingly angry with your partner?

c Wonder if are or will be a good enough mother?

c Think you should be doing a better job as a mother?

c Miss who you were before you had a baby?

c Make sure you look “just right” in front of others, particularly if you’re not feeling so well?

c Feel better if your bed is made, the kitchen is clean, the toys are put away, the laundry is done?

c Feel unsettled if things are out of order or not the way you want them to be in the house?

c Feel as though you are being judged or criticized?

c Think you are being especially hard on yourself?

c Secretly wish you had your old life back again?

c Worry that if you let someone know how you’re really feeling, they won’t understand at all?

c Resent the fact that you’re the only one doing everything that needs to be done?

c Obsess about things that never used to bother you?

c Feel misunderstood, that no one appreciates how much you are doing and why you feel so overwhelmed?

c Think you are the one who is most capable and best qualified to take care of the baby and the household?

c Wonder what would happen if you decided not to do so much?

c Sometimes feel you are simply going through the motions?

c Fear that you haven’t bonded to your baby the way you think you should have by now?

c Doubt that you will ever feel attractive or interested in sex again?

c Reply “fine” every time anyone asks you how are you feeling regardless of how you are feeling?

c Wish you could find the joy in motherhood instead of focusing on how you should be doing things better?

c Wonder if you will ever be as good at this mothering thing as everyone else seems to be?

c Worry that you will never feel in control of your life again?

Copyright ©2003 by The Postpartum Stress Center, LLC

Postpartumstress.com



Saturday, June 04, 2011

Take a peek into our advance training class for clinicians and see/feel how the small group format works. We are now accepting applications for our Sept class. Check the website for details.



Another super weekend training. Thank you Rachel, Cindy, Sarah, Michelle, Deena, Melina, Amy, Lindsey, Gerry. Your participation was especially inspiring and fun. ;)

Wednesday, May 11, 2011

Dietary Tips When Depressed

As per Sparks.com (thanks, Kate!)

DO structure your meals. Eat at approximately the same times each day and don't skip meals. Enjoy three well-balanced meals and plan snacks between meals. This will help insure that your body is getting the right nutrients throughout the course of the day.

DO eat quality nutrients. Dieting itself is a stress on the body. Individuals who are trying to lose weight and have a history of depression must work to eat foods that are good for the body and the brain. Try incorporating more whole foods, fruits and veggies, and healthy fats by starting with this list of super foods.

DO eat plenty of calories, even if you are trying to lose weight. Extremely low-calorie diets alter your metabolism and increase your risk of malnutrition. Eating less than 1,000 calories per day reduces the amount of tryptophan (an essential amino acid that is needed to produce serotonin) in your body. As a result, serotonin levels drop, which increases symptoms of depression and its chances of recurring. If you have trouble meeting your calorie needs, read Calorie-Boosting Tips.

DO consume plenty of Omega-3s. While some studies have failed to show a connection between omega-3 fatty acid intake and depression symptoms, others suggest that consuming more of these heart-healthy fats may help with depression-especially when taken along with conventional antidepressants. Epidemiological research also shows that populations who eat more fish have lower rates of depression. Foods rich in omega-3s include cold-water fish (salmon, sardines, and mackerel), soybeans, walnuts, eggs fortified with omega-3s, and ground flaxseed.

DO cut back on caffeine. Caffeine acts as a stimulant, making you feel anxious and interfering with sleep patterns. Consume no more than 200- 300 milligrams of caffeine daily.

DO avoid alcohol and drugs. Alcohol and illicit drugs can interact with antidepressant medications and other over-the-counter medications. For many, depression and substance abuse are already closely connected. If you think you have a problem, seek help. Addictive or abusive behaviors can prevent you from a full recovery.

DO eat plenty of "good" carbohydrates, which increase the amount of serotonin in the brain. High serotonin levels can improve mood and decrease symptoms of depression. At minimum, aim for at least 130 grams of carbohydrates each day. And try to forgo the processed, "white" carbs (white rice, white bread, white flour, etc.) in favor of less processed foods like whole grains (brown rice, whole wheat bread and whole grain cereals), fruits and veggies.







Thursday, May 05, 2011

Parenting Services for Families

NEW! SPRING Parent/Infant/Toddler Group

Newborn to 3 Years

Parents: Providing an Emotionally Secure Environment for your Baby.

A place to talk & reflect on topics & questions about the early years.

Sleep, Attachment, Behavior, Feelings, Separations.

What your child needs you to understand about development.

Children: experience playing and growing together

Tuesdays, 10AM

Presidential Apartments, Philadelphia

Questions or to Register: 215.879.4030

Elaine Frank, MSW • Denise Rowe, BA

www.parentingprograms.com


Tuesday, May 03, 2011

It's official! April's issue of The Journal of Women's Health is now out,
featuring our new screening tool (PDM).

On to phase 2 of the research.....

Thursday, April 07, 2011






Dropping the Baby and Other Scary Thoughts

This 7 hour course is usually priced at $27.93. Until April 15th, it will only cost $19.99. (Just enter the code baby at checkout.)


Dropping the Baby and Other Scary Thoughts provides essential information for both the client and the treating therapist when dealing with postpartum distress. This book addresses the nature of intrusive, negative, and unwanted thoughts that pregnant and postpartum women can experience when anxiety is high. It offers information and interventions for clients and clinicians who must confront these negative cognitions by outlining what these thoughts are, why they are there, and what can be done about them.

Therapy and the Postpartum Woman: Notes on Healing Postpartum Depression for Clinicians and the Women Who Seek Their Help

8 credits for only $31.92

Therapy and the Postpartum Woman provides valuable information on providing effective therapy to women with postpartum depression. The book is written in an engaging manner with many relevant case studies.




Monday, April 04, 2011

Medline OBGYN & Women's Health News:
"University of Pittsburgh Medical Center (UPMC) psychiatrist Katherine L. Wisner, MD, MS, a pioneer in the study of postpartum depression in women, is the recipient of the 2011 Women in Science Award from the American Medical Women's Association. The award, given to a female physician who has made exceptional contributions to medical science, especially in women's health, through research, publications, and leadership, was bestowed at the association's annual meeting in Washington, DC, on April 2. "I am excited and honored to receive this award," Dr. Wisner told Medscape Medical News. "I entered medicine at a time when little was known about perinatal mental health, and I accept the award in honor of the many women who have participated in studies that have advanced our knowledge about perinatal mental disorders and treatments."

Congrats, Katherine!!
I love this:

"Hugs can be magical. Really. Research has shown that if you engage in a 20 second full body contact hug, oxytocin can be released in both partners. 'Oxytocin is the hormone of safety and trust, bonding and attachment, calm and connect,' according to Linda Graham, MFT and author of a slew of articles on neuroscience, resilience and adult attachment. If you find yourself at odds with your partner, a 20 second oxytocin-producing body hug is a great way to calm the body and brain – and increases the relationship connection in the moment."

Excerpted from LisaKifttherapy.com

Tuesday, March 22, 2011

New brief screening tool awaits further study

Here's our the abstract for our paper on a new brief screening tool for postpartum distress (which includes anxiety measurement) YAY!!!

J Womens Health (Larchmt). 2011 Mar 17. [Epub ahead of print]
Development of a Brief Measure of Postpartum Distress.

Allison KC, Wenzel A, Kleiman K, Sarwer DB.

1 University of Pennsylvania School of Medicine , Department of Psychiatry, Philadelphia, Pennsylvania.
Abstract

Abstract Background: Previous measures of postpartum distress have focused on depressed mood despite evidence that postpartum anxiety is just as prevalent. The purpose of this study was to develop a new, brief screening measure to identify postpartum distress, defined as symptoms of depression and anxiety. Methods: In Study 1, potential items were assembled focusing on depressed mood and a variety of anxiety domains to develop a new postpartum distress scale. Women up to 12 months postpartum (n=289) completed the new scale items, the Edinburgh Postpartum Depression Scale (EPDS), and the Mood and Anxiety Symptom Questionnaire (MASQ) on the Internet. In Study 2, women up to 12 months postpartum (n=139) completed the new Postpartum Distress Measure (PDM), the EPDS, the Obsessive-Compulsive Inventory-Revised (OCI-R), and the Relationship Assessment Scale (RAS) to validate the new measure. Results: Data from Study 1 yielded a two-factor solution, and 10 items were selected for the new PDM. Six items were chosen for the PDM general distress scale, and four items for the PDM obsessive-compulsive scale. Data from Study 2 again yielded a two-factor solution, supporting both the general distress and obsessive-compulsive components. Psychometric data suggested that the measure had adequate internal consistency and construct validity. Conclusions: The 10-item PDM comprises general distress and obsessive-compulsive factors that were obtained from a wider pool of depressive and anxiety items. These data suggest that the PDM may be a helpful tool in identifying a broader range of postpartum distress, including obsessive-compulsive symptoms that were formerly neglected in clinical screening measures. More studies are needed to confirm its clinical utility.

Tuesday, March 15, 2011

Clinician Note:

PPSC news update:

Interesting post by MGH Blog on the difficult decision to make regarding antidepressant medication during pregnancy.

Fathers and PPD?
Relating depression to negative parenting behaviors in the journal of Pediatrics.

New study shows a relationship between seasons and depression but not when it comes to suicidality.

"Preventing PPD"
New article with good information.

Saturday, March 12, 2011

Postapartum Depression, Suicide and the Seasons...

New research by Katherine Wisner, MD (Seasonal Effects on Depression Risk and suicdidal Symptoms in Postpartum Women, Sit D, Seltman H, Wisner KL.) reports that effects of seasonal light changes may influence the risk for depression, but not suicidal ideation of postpartum women.

The study showed that the risk for postpartum Depression varied significantly throughout the 12-months of the year, with the risk of depression highest in December. The authors state there was no seasonal variation with respect to suicidality.



Thursday, March 10, 2011

PPSC News

New Psychology Today post: 10 Things to Avoid if You've Just Had a Baby

The PPSC will be answering questions at CafeMom.com next week. All week Christian Rivel and Trish McGarrigle will be available to address your concerns. Post your questions to Christian and Trish so you can get accurate information about topics that may be worrying you.

Our spring PPD support group is starting April 6, Wednesday. Please contact Trish at 610.525.7527, ext 7 for details.

New FDA warning regarding the use of antipsychotic medications during pregnancy as reported by the MGH Center for Women's Mental Health

Sunday, March 06, 2011

Great weekend with another super group of clinicians who gathered from all ends of the US and Canada to share their personal stories and professional passions. The PPD community will be overflowing with awesome experts who are dedicated to providing the best care possible!

Thanks Beth, Becky, Pam, Leanne, Alison, Jen and Paula! It was really great. Let me know how you are doing and of course, if there is anything you need from me.

A Clinician's Experience


Dear Karen:

I am a licensed counselor working in the mental health field for the past 11 years. In February, 2010, I gave birth to my daughter. I had my first intrusive thoughts about harming her 36 hours later.

My initial diagnosis was PPD, but that confused me because I was really not depressed, I was just scared out of my mind. I could still shower everyday, take care of my daughter and keep our house clean. I was terrified about being alone with my baby, and did everything I could to ensure that would not happen.

After a lot of time, therapy, med changes and self-help books, I have reached a stable state of recovery. As you well know, my search for books that would help me understand what was happening to me and/or give me access to other women who have experienced this came up mostly empty. The first book that really addressed this issue was Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood.

This is a wonderful book, and has served to reinforce all the learning I did on my own as I poured though books that were aimed at general OCD symptoms. I want to offer my sincere thanks for this badly needed source of support.

Thursday, March 03, 2011

New study in the Journal of Women's Health (Change in Depressive Symptoms Over 0-9 Months Postpartum) indicates that symptoms of PPD are most prevalent in the first month pp and then seem to peak again at 9 mos pp. Further research is needed to understand why this happens.

Additionally, the study supports the use of the PDQ-9 (Patient Health Questionnaire) for PPD screening. This is helpful information because many primary care settings do use the PDQ as a general screening tool.

Clinician Note: The EPDS (Edinburgh) is still considered significantly more effective in identifying postpartum depression when used 6-8 weeks postpartum.