Chapter 2 Lies of the Magpie

Postpartum Depression Memoir

Ch. 2 Lies of the Magpie

The story of my journey healing through postpartum depression and chronic illness. 

The thing Aaron remembers most about me from college is my fast-paced walk around campus. His tennis class met at three o’clock at the courts across from my off-campus housing. For weeks he watched me leave my apartment, hurry across the road, rush past the tennis courts, short cut across the grass and disappear into the Humanities Building. His tennis partner noticed him staring and said, “Don’t waste your time. That is Maleah Day. She is the Academic Vice President. Ten bucks says you can’t get her to stop to talk to you. She walks that fast everywhere she goes.”

It was my sophomore year. I was ten years older than the straggly nine-year-old girl from Ms. Wickersham’s fourth grade class. My bean-pole figure had filled out in a few key places. Two years of orthodontic work and contact lenses had tamed my profile, but my ambition—if possible—was still as potent. I’d traded my dream of becoming a firefighter and astronaut to becoming an Airforce pilot and a foreign ambassador. I declared a Political Science major and carried an application for the Peace Corps in my backpack.

Still, I’d never forgotten my dream to become Mrs. Murry from A Wrinkle in Time and have my own kitchen/chemistry lab. My scholarship covered full tuition and fees, regardless of number of credit hours, so in addition to my social science courses, I registered for a Biochemistry Series, Anatomy, Microbiology, and Physiology. These would cover all lab science prerequisites, just in case I changed my mind about Foreign Diplomacy and decided to apply to Medical School. It was a good plan, I thought, to keep both options open.

Play button above to hear the full chapter.

Listen to Chapter 1: https://maleahwarner.com/?p=1258&preview=true&_thumbnail_id=1269

Listen to the Introduction of Lies of the Magpie https://maleahwarner.com/new-summer-series/

 

Book Cover Art by:

Bethany Baker  of Midsummer Studios https://midsummerstudios.weebly.com/

Chapter 1 Lies of the Magpie

Memoir story of my journey healing through postpartum depression and chronic.

Ep.22 The Story of My Healing Journey

The road I’m traveling stretches endlessly ahead across the Sonoran desert winding through a vast panorama of monotony. Each new mile looks exactly like the last.  Faster, I urge the engine forward pressing my foot deeper into the gas pedal of my husband’s car. I’m supposed to be traveling to the Arizona Music Teachers Annual Convention in Tucson, but I haven’t seen another vehicle in at least thirty minutes. This can’t be I-10, there should be more traffic on a major interstate.

The red speedometer needle trembles over ninety miles per hour. Still, the barren scenery passes too slowly. I might as well be a pioneer driving an old wagon pulled by a pair of sauntering mules. The summer heat turns the car into a furnace. I reach over to crank up the air conditioner, but it is already blasting at full power in a futile effort to keep me, and my enlarged belly, from over-heating. So why is it getting hotter in this car?

A tightening pinch begins in my back and wraps around to my front. The contraction pulls and twists causing me to grab my stomach. I grit my teeth and grip the steering wheel to keep from swerving. Breathe, I remind myself, noticing that I’ve only covered  seven miles since the last contraction. I squeeze my eyes shut tight against the pain, then re-open a narrow slit of vision—just enough to make sure my car tires stay on the road. I wince and wait. Two full minutes pass on the digital clock before the pressure releases. Tears burn in the corners of my eyes.

Please, baby, hold on a little longer. 

What’s New On the Podcast This Summer?

New on the Podcast

New Summer Series

I have a confession. I am nervous. My brain is working overtime throwing out all the reasons why I shouldn’t do what I’m planning to do this summer. 

What is it?

I am podcasting my book!!!

Some of you are thinking, “Well, it’s about time.” Others, especially you who are new (welcome, by the way, so nice to have you here) are thinking, “What book?”

Over the past eight years I have been writing the story of my journey through postpartum depression, autoimmune disease, and chronic illness. The manuscript has taken many forms and gone through multiple titles. If you’ve been here since my blogging days, you know the title “Prozac and Prayer.” It has a new title (and it’s a very good title, if I do say so myself).  In today’s episode I’m giving some background on the writing process and why I am so nervous about reading this story, out loud, in my own voice.

Most importantly, I will be presenting the new title and reading the introduction. 

The rest of the summer (through mid-August) I’ll present one (or maybe two) chapters a week. They might be chronological or I might skip around. Likely all 40 chapters won’t fit into one summer. What will you do then? You’ll just have to read the book! (Yes! I’m working to get it published!) 

Thanks for joining me on this journey out of my comfort zone. I hope you enjoy selected chapters from the manuscript formerly titled “Prozac and Prayer.” 

mw

Summer Screen Time: Set It & Forget It

Ep. 20 Summer Screen Time: Set It & Forget It

Why NOT to Limit Summer Screen Time

should i limit my child's screen time?

Ep. 19 Why NOT to Limit Summer Screen Time

Has anybody else out there, like me, been fretting over the question: How am I going to control my kids’ screen time this summer? I know you are because it’s what we’re all talking about in our mom circles: How can I get little Johnnie to stop playing Minecraft? My Jaden is addicted to YouTube. How many hours of TV is too much for a 4 year old? I hear you. 

Summer is barely underway and I’m already seeing instagram photos of zombie children glued to ipads with the caption “Help!” Collectively, as mothers, we are posting questions on FB, “How many hours of Minecraft is too much for a 5 year old?” We are scrolling Pinterest for solutions searching everything from printable chore charts, to cheap summer adventures, and (my personal nemesis) ideas for homemade craft projects to keep kids busy and engaged during the LONG summer days. We have lengthy discussions with our sisters and moms friends about managing screen time. And where are we having these conversations? On Marco Polo.

We are in dire straits. We are in desperate need of advice, guidance, directions. Where do we turn for help? In our moments of crisis, when we need to know how to keep our children off their screens, we, their mothers, turn to our screens. In fact, at this very moment I type these words onto one screen while my children downstairs interact with at least two different screens, and my husband in our bedroom looks into yet another . . .you got it . . . screen.

I Dread Having to Be the Screen Police

I’ve been stewing over this media issue for a month now as summertime approaches. What bothers me about this question—How do I control my kids’ screen time?—is the nagging tug of obligation I feel in my gut that if my family is going to have a successful screen-free summer, it’s going to be up to ME. I’m the one that will have to plan the pinterest-worthy summer outings collecting a representation of local flora and insect life to paste on our poster board panorama. It will be ME spending hours on the computer designing personalized chore charts and graphs of practice and reading time and devising a captivating behavior-based award system with coinciding coinage.

Years ago, in an attempt to control the unscheduled hours of summertime, I devised a form of currency called Warner Bucks. This was money I designed and printed myself (the closest I’ve ever come to running a counterfeit cash operation) and featured faces of family members. The kiddos—all under age 7—could earn Warner Bucks for doing chores and demonstrating good behavior. Then they paid a Warner Buck for every 30 minutes of TV time. Brilliant, huh? It was a disaster. Essentially, I had created several full-time jobs for myself. I was running my own little company and I was in charge of payroll, human resources, management, job descriptions, job trainings, employee performance, and employee evaluations. I was spending all my time giving and collecting crinkled cash, all with the goal to limit screen time. Yet the television was blaring as loudly and for as many hours as ever before. It seemed that every conversation, every action, every motive in our house for that summer centered around buying more screen time.

Limits Increase Want

In her book  Parenting in the Age of Attention Snatchers,. Author and clinical psychologist Lucy Jo Palladino  says “Forbidden fruit is the tastiest. Completely banning screen time may simply double the desire of your kids to get online.”

Marketers use limitation and limited quantity as methods to increase demand. If screen time becomes a dangling carrot, then I actually  WANT MORE SCREEN TIME! But AHA! We’re onto their schemes and trickery and will not fall prey to their tactics. So our objective as parents isn’t to limit screen time, but to help our children discover what they want to do more than they want to stare at a screen. 

Instead of Limiting, Create a Family Plan

We most often default to doing something on a screen because we don’t know what else we would rather do instead. In the moment, making a decision or making plans requires too much effort. It’s easier to click on Candy Crush. So the best method to beat over-indulging in screens is to have plans made in advance. 

Something we’ve done for a couple of summers that has worked (much better than Warner Bucks) has been to create a summer bucket list. We have a family meeting and everyone gets to say things they want to do for the summer. It’s fun and energizing. Suddenly all kinds of possibilities open. The local aquarium that is so awesome but we haven’t visited yet. The special hike to that awesome waterfall. Trying to relocate that secret swimming hole. Picnics at favorite parks. Puzzles. Board games. Outdoor movie nights. Family video game tournaments.

We don’t exclude screens from our summer bucket list. We plan screen time intentionally.  

This year we are creating family and personal summer bucket lists. Our meeting is next Sunday and we prepped our kids a few weeks ago to start brainstorming. Since my kids are older (ranging from age 10 to 19), their personal lists will include 1) Something to practice 2)  something new to learn 3) a daily physical activity and 4) a list of books to read.  My advice for families with young children is to go easy on goals. With younger children, set yourself up for success by scaling back what you think is possible. It’s better to achieve one goal successfully than fail to achieve five goals. Success breeds success.

On Sunday we will pull out colored markers to decorate our summer lists. Basically, we are creating a vision for our summer. Vision and energy are more powerful than limitation.  Instead of focussing on what we can’t do or what we shouldn’t spend too much time doing, we are going to empower ourselves, as a family, with vision, energy, and fun.

You can learn more about the energizing power of desire by listening to Episode 2 “What Do I Want?” It’s one of my most downloaded episodes, I think because so many of us don’t know what we really want or we don’t believe we can have it, so we don’t even try. The best method to get away from screens this summer is to KNOW, ahead of time, what we want more. This helps us to not sacrifice what we want long term for what is easiest right now.

Conclusion

Today we’ve explored the broad principles of why NOT to limit screen time: because limit increases want. And we’ve learned that a more powerful way to embrace summer adventure is to brainstorm, as a family, activities you want to do more than sitting in front of screens.

Next week we’ll dive into the nitty gritty of how to set up this empowered summer. We’ll talk everything from the words you choose in talking about screens to the power of boundaries. Any why boundaries are NOT the same as limits.  These tools help kids and parents feel their screen use is abundant and satisfying rather than feeling left wanting more.

Leaning Into Discomfort

Leaning into Discomfort

Ep. 18 Leaning Into Discomfort

Leaning in is a power principle with multiple applications. Today we’re discussing the power of leaning into discomfort in a specific area. I invite you to stay with me to the end and I have an invitation that I think you’ll accept, even if you never thought you would.

What Does it Mean to "Lean In"?

Have your ever heard the expression, “Lean into the wind?”  

Growing up, my brother and I walked to and from school no matter the weather. Which meant that sometimes we would push forward through fierce storms and arrive at the school building to learn that school was cancelled because buses couldn’t get through the snow. Anyone who has walked in strong wind know that in order to stand up straight in high wind, you can’t just stand up straight, you have to lean forward. You have to lean into the wind. Leaning into the wind means pressing forward in the direction opposite the way the wind blows.

Last summer I did a pioneer handcart reenactment in Wyoming. I don’t know if it has something to do with being near the Continental Divide, but that Wyoming prairie gets a LOT of wind—like blow your tent away in the middle of the night with you in it—kind of wind. And when we were walking and pulling our handcarts, if we wanted to move forward, we had to lean into the wind.

Traditionally lean in has been used in the context of sports to mean “to shift one’s body weight forward or toward someone or something.” In water and snow sports, you can lean into a wave, the wind, a slope, or a turn. You can lean in to a pitch or a throw. You can even lean in to a catch.

The first printed use of the term “leaning into”  comes from Hartley Burr Alexander’s 1906 Poetry and the Individual, where Alexander uses the phrase “leaning into the future” in reference to the power of poetry deriving from its “leaning into the future.” And Facebook COO, Sheryl Sandberg, used “lean in” as the title of her 2013 book, a call for women to embrace challenge and risk in the work place and leadership. All uses of the term “lean in” point to the act of moving forward against an opposing force.

Leaning Into Discomfort

Why would we talk about leaning into discomfort? Why would a nice person like myself, ask you to lean into discomfort?

Episode 12 The Power of Imbalance, has been the most downloaded episode to date. (If you haven’t listened, go there next.)  I think because it strikes a universal instinct in all of us. We don’t like to feel out of balance or out of control or out of our comfort zone. We don’t like to feel uncomfortable. But, as Shawn my personal trainer taught me, growth happens in the zone of imbalance, in the zone of discomfort. If  you never lean into discomfort, you can not grow.

In yoga there is an expression, “Breathe into the stretch.” Yoga instructors emphasize that you shouldn’t push your body to the point of pain, but you should take your body to the point of discomfort, then breathe into that discomfort. Yoga teaches that rather than resisting what feels uncomfortable to move towards it, and in this way your muscles grow. This is opposite our instinct. Our knee-jerk reaction is to move away, to back away, to shy away, or to straight out run away from any discomfort. But, someone the act of leaning into the discomfort, of breathing into it, lessens the discomfort. Keep this in mind as we move to our third point today.

Leaning In to End the Stigma of Mental Illness

Earlier I said I had an invitation that I thought you would accept, if you can stay with me to the end. I invite you (and me) to lean into our discomfort about discussing mental illness.  

When you hear the term “mental illness,” pause to observe your reaction. Do you feel a jolt of resistance? Maybe you really don’t want to hear about it or discuss it. Maybe you feel a strong urge to change the subject or leave the conversation. That’s okay. Whatever reaction you have is okay. I am NOT asking you to change your reaction. I am NOT judging your reaction or saying it is wrong or saying you need to have a different reaction. Not at all. I am simply inviting you to OBSERVE your reaction, your thoughts and feelings, and instead of resisting them, moving away, 0r running away, I am inviting you sit with your discomfort and see what you can learn about yourself. This is an invitation to lean into your emotions. And remember to breathe.

I am assuming that most, if not all of us, have what I would call an averse reaction to hearing the term mental illness. There might be some extremely enlightened yogis and gurus in the world who have no reaction, but most words aren’t neutral. Any word we come in contact with triggers some kind of thought in our brain, which triggers a related emotion. And most of you grew up in the same society I did, with the same social conditioning about mental illness.

And where did that conditioning come from? Movies, stories, experiences.

Did you know that the month of May is National Mental Health Awareness Month and has been since 1949. Congratulations. We are celebrating 70 years of Mental Health Awareness, and you didn’t even know it. I didn’t until this year. Now, think about our social relationship with Mental Illness 70 years ago, 40 years ago, 20 years ago, 10 years ago, (that’s when I was seeing doctors and getting confusing, conflicting, and unsatisfactory explanations about what was going on in my brain), to this year 2019. Good news. There have been a lot of positive changes in diagnosis, treatment and understanding of mental illness, largely due to development in brain science.  I feel optimistic and excited that we will continue to progress forward, AS LONG AS and to the extent that we allow ourselves to LEAN INTO the discomfort of entering conversations and getting educated about Mental Illness.

Misdiagnosed Mental Illness

What if all mental illness was simply misunderstood and misdiagnosed physical illness?

In past years, mental asylums were filled with people merely suffering from asthma, hypoglycemia, or diabetes. One of the most compelling stories to prove the negative consequences of misdiagnosing a physical disease as a mental illness is the story of Susannah Cahalan retold in the book (and Netflix Movie) Brain on Fire. 

At age 21, Susannah worked as a writer for The New York Post. Out of the blue she began to experience hallucinations and hypersensitivity to annoying noises. Coworkers notice her strange behavior. Her parent take her to a doctor, who says that Susannah has probably been partying too much, working too hard and not getting enough sleep. Later, Susannah has a seizure and her parents take her to the emergency room where doctors prescribe anti-psychotic medication. While in the hospital, Susannah goes catatonic and doctors want to move her to a more permanent psychiatric unit where she will be treated for mental illness.

Dr. Souhel Najjar is asked to help investigate her case. Najjar has Susannah draw a clock. She draws it with all of the numbers (1–12) on the right side of the clock, leading Dr. Najjar to believe that the right hemisphere of her brain is swollen and inflamed. Najjar has her undergo a brain biopsy in order to take cells from her brain for diagnosis. It is found that Susannah has anti-NMDA receptor encephalitis, an autoimmune disease where swelling is caused by antibodies.  Dr. Najjar describes it to her parents  as her “brain is on fire.” Dr. Najjar prescribes her a treatment, which leads to a slow, but full recovery of her cognitive abilities.

Here is an example of a regular girl nearly locked away for life in a psychiatric ward to be medicated with anti-psychotics that would only make her worse because they wouldn’t treat the root issue.  Thankfully, one doctor stepped in. One doctor leaned in and fought for her.

So, what if all cases of “mental illness” are really physical issues we don’t yet understand or haven’t correctly diagnosed?

A person acting strangely does not mean they are mentally ill. What is the WHY? behind the strange behavior?  What is happening in the body and brain to cause the unusual behavior? I’m excited for more progress to be made in brain scan technology for these neuro-diagnostic tools to become more available. This is why I want to change the term from mental illness to brain illness in order to emphasize the physical brain issue rather than the stigma of character weakness.

Oprah Winfrey, Prince Harry and Mental Illness

In coming months, we will have increased opportunities to lean into discussions about mental health. This is why I extend the invitation to resist shying away from these important conversations and to lean into our socially-programmed  discomfort. A lot of people and organizations are working to shorten the distance between current misdiagnosis and misunderstanding and future effective diagnosis and treatment. In fact Oprah Winfrey and Prince Harry have teamed up to release a docuseries on mental health.  In April CNN reported that the multi-part documentary series, which will air on the Apple TV platform in 2020, was co-created and produced by the Duke of Sussex and Winfrey.

Prince Harry said,  “I truly believe that good mental health—mental fitness—is the key to powerful leadership, productive communities and a purpose-driven self.” 

Winfrey added, “Our hope is that it will have an impact on reducing the stigma and allowing people to know that they are not alone, allowing people to speak up about it and being able to identify it for themselves and in their friends. We want to blow the stigma out of the water.”

Conclusion

What do you think? Are you willing to take on today’s invitation? The invitation is simply this: when you someone mention “mental illness” or “mental health,” pause and observe your initial reaction. Notice if your instinct is to move away, to shut down, to change the channel. Notice if you instinctually want to move away because you feel uncomfortable. Then, instead of moving away, I invite you to LEAN INTO DISCOMFORT.  Listen to the conversation, stay on the channel, keep engaged. Breathe.  discomfort. Open your heart and mind and be willing to learn and to see a new perspective. 

Postpartum Depression with Amy-Rose White Part 2

mom postpartum depression holds baby

Ep. 17 Conversations on Maternal Mental Health (continued)

Episode 17 presents Part 2 of my conversation with Maternal Mental Health Specialist Amy-Rose White, LCSW. We discuss the importance of modeling emotional healthcare for our children as well as what dads, partners, and families can do to watch out for signs of postpartum health illnesses and steps for preventative care. Exciting changes are happening for Maternal Mental Healthcare in Utah, plus Amy-Rose tells us what changes she still wants to see. 

Did you miss Part 1 of this interview? Click Here for Part 1 

Q: Why Is It Important to Model Emotional Health for Our Children?

A: One way to help end the stigma surrounding mental health is to model healthy emotional needs for our children. We can say to daughters and sons, “I’m not well and I’m going to go get help and I’m going to figure this out.” Often it’s not easy to find the right help, the right team. Show your family that you are willing to keep trying, to keep opening doors and walking through until you feel well again.

Allow your children to see that you need rest and to see that self-care is natural and part of wellness. Know your self-care routine and what recharges your battery.  I expect my sons to contribute as community members now so that when they grow up and have partners, and possibly decide to have children, they will take the responsibility on as well. They will help carry the burden of raising children. Especially this generation of women, the “Millennials,” fight the “Have everything and have it all now”  pressure. Up and coming mothers are such high achievers and have a burden of options. The pressure is high, it really is. So it is essential to model caring for self and caring for emotional and physical health. 

Q: What Is Your Advice for Partners?

In the film about Postpartum Depression, entitled Dark Side of the Full Moon, one husband says, “Watch your wife. Keep your eyes on your partner.” I agree. 

  1. Focus on the basics. First, help mom get that 4-6 consecutive hours of sleep as soon as possible. This might mean paying for night nursing or doula care. Good nutrition and drinking two big pitchers of water a day are musts
  2.  Grounding is an anti-inflammatory measure which entail putting your bare feet in contact with the ground. Even in cold months, getting outside in nature, maybe a brief walk around the neighborhood, is healing. 
  3.  Getting a break from children every day.  My OB gave me a prescription for a daily break and it changed my life. I’d never had a medical provider say, “You matter and you have to nourish yourself and take a break. You’re not just a feeding machine. This is essential for you as a human being.” Mom needs an hour break to herself every day.
  4. Watch the signs. If your partner has history of depression or a history of sensitivity to hormone changes, they are at higher risk for postpartum emotional health complications. Other high risk factors include women who have tried three to five birth control pills before giving up because they all made her feel “crazy.” Or if your partner get PMS or Premenstrual Syndrome, watch them carefully during and after childbirth.

If partners can be educated about the warning and also help mom sleep, eat, drink water, and take breaks, these are preventative measures that can go a long way to prevent emotional health changes. Notice what your partner is going through and make the call with her or for her. Going with her to appointments says, “I love you enough that I want to help you get help and we’re going to figure this out together. There is nothing wrong with you.”

Q: How Can Fathers Keep Themselves Healthy?

Ten percent of  dads will develop postnatal depression, so a man also needs to watch out for himself, especially if mom can’t. Warning signs of postnatal illness in men are typically anger or withdrawal. The best remedy is to reach out to a counselor, which is not a guy thing to do. The language centers for men are different than for women. Men tend to need time alone to decompress. Another warning for dads is to be aware that if his partner has an illness, then his risk increases. Often I see that once a women is in remission and recovered, then her male partner gets the symptoms.

It’s a very sad thing I see in my practice, but sometimes relationships do end because of untreated Postpartum Depression. Divorce can occur during the postpartum period because the husband thinks, “This isn’t the person I fell in love with and I don’t see this ever getting better.” Or sometimes the woman might not be ready to get help, or the husband isn’t ready to get help. Postnatal health complications are challenging on a relationship.

Q: Speak to the Positive Side of Postpartum Struggles. What Growth Do You See?

The hundreds of women I’ve worked in say that even though their postpartum struggle was one of the hardest things they’ve ever endured, they wouldn’t trade the experience because of what they learned and who they became in the process of finding healing. Overall, couples who successfully work through postnatal emotional health complication come out with a deeper sense of empathy and compassion for human beings in general, as well as less judgment for women and for other moms.

The struggle creates a deeper connection for this universal experience on this planet of moms. Every mother in every country worries about essentially the same things: if her baby is eating enough and gaining enough weight and will get the education they need. We have a common thread as human beings that suffering brings to the forefront. 

Another positive outcome I often see, and this was certainly true for myself, is a sense of purpose and a calling to connect with other moms and to help women and families to know they are not alone, they are not to blame, and with help they will be well. Which is the message of Postpartum Support International.

Becoming a parent forces you to become less selfish. With a child, you are instantly integrated into the world of babies, preschool, and school, so you have a vested interest in community, school, safety and what our world is becoming. The process is beneficial for our communities, so it’s not a thing to fear. There is a lot of growth that can come through the journey. Like we’ve mentioned, a deeper sense of strength, connection to the human spirit and to moms and motherhood and that we have more in common than we have different. And a desire to contribute and give back

Another positive outcome of postpartum health struggle is the “unlearning” of false beliefs and patterns. A lot of our role models as women were stoic and muscled through pain and illness, often because they had no other choice.  Our mothers and grandmothers did the best they could, but now we are entering a different era where we can model being self-full. A postpartum health journey can help us to unlearn the conditioning of our ancestors to muscle through. Instead we can learn that when I am healthy, strong and centered, then I can be there in service for my children, my family, and for the planet. 

Therefore, focussing on the personal strength you are developing through your postpartum health journey can be empowering. Though it’s a struggle, it can result in positive life changes including developing personal characteristics of empathy and connection as well as breaking down age-old habits and false beliefs.

Q: What Changes in Maternal Mental Health Are You Excited About?

This February PSI-Utah was successful in getting an appropriations measure passed in the state legislature to receive funding for three years to: 1) fund telehealth services for rural moms, 2) increase public health authority’s ability to screen and refer women, and 3) support the development of a new website through the Department of Health which will be a massive resource referral database where users can click on a geomap in your county and find counselors and support groups in your area that take your insurance.

The Perinatal Mood and Anxiety Disorders Conference is coming up May 31 and June 1, 2019 in Salt Lake City. This is cosponsored by Intermountain Healthcare with keynote speakers and breakout sessions by postpartum health experts. The conference is open to medical professionals as well as the general public. Information and registration found at psiutah.org or click here. 

A State Subcommittee for Maternal Mental Health came out of PSI-Utah. Through the Utah Women & Newborn Quality Improvement Collaborative and the Department of Health, we are educating clinics  and providers how to screen.Primary Care is where that subcommittee is focussing on improving quality measures and outcomes. Neither medical schools nor social work schools teach Perinatal Mental Health.  

A lot of watch guards are hard at work continuing the dialogue about programs that need funding and increasing capacity for care. 

Q: What Are Changes You Want to See for Maternal Mental Health?

  1. For every woman to be educated about the different possible health complications, what the symptoms look like, and how to decrease her own risks. I want every mother to know that it’s in the best  interest for  her baby to take care of symptoms as soon as possible. To know what to look for and where to go. Part of that prevention is to do things while she feels well. Some postpartum symptoms begin during pregnancy, especially the 3rd trimester. 
  2. Have every person who serves and comes into contact with a pregnant woman to be educating and screening her. The conversation conveys the message that mother matter and we want to be involved in helping you feel well.  Even more, for women not just to be given information, but to know what to do and that there is hope. We need to be proactive and not just crossing our fingers and hoping for the best.
  3. For every woman to know about the resources available through Postpartum Support International (PSI) which is Postpartum.net.  You can click on any state and get free social help. There is also international, Spanish speaking, and  LGBTQ support. You can call a local number and speak to one of 8 or 9 volunteer moms who have been where you are.
  4. My biggest want is that women wouldn’t feel ashamed. It is changeable. Education is key. Understanding that it isn’t a character weakness, that there are physiological changes in the body causing the symptoms. This will take everyone telling stories and going to the State Capitol. Speaking up makes a difference.

Resources:

Amy-Rose White, LCSW:  http://www.arwslctherapist.com/

Perinatal Mood and Anxiety Disorders Conference May 31 – June 1, 2019 Salt Lake City Utah:  https://www.psiutah.org/2019-perinatal-mood-anxiety-disorders-conference/

Documentary “Dark Side of the Full Moon” Maternal Mental Health: http://www.darksideofthefullmoon.com/

Postpartum Support International UTAH: www.psiutah.org

Postpartum Support International:    www.postpartum.net

The Emily Effect: https://theemilyeffect.org/

Ep. 16 Postpartum Depression with Amy-Rose White, LCSW

Maternal Mental Health Awarenes

Conversations on Maternal Mental Health

Postpartum Health is a major concern for mothers, fathers, families, and has heavy societal impact. Worldwide, maternal depression is the most common serious health complication of maternity. I speak often about my own experiences with Postpartum Depression and the goal of this podcast is to share the healing principles I learned during my journey to recovery. 

So it’s fitting that on May 1st, 2019, World Maternal Mental Health Awareness Day, I got to sit down with Amy-Rose White, one of the leading voices on maternal mental health policies and treatments.  

Introducing Amy-Rose White, LCSW

Amy-Rose White, LCSW  is a Maternal Mental Health & Couples Counseling Specialist based in Salt lake City. Through her counseling practice she has helped hundreds of couples navigate the enormous stresses related to pregnancy, infertility, miscarriage, loss, birth trauma, the postpartum period, and parenting through early childhood. She has a special interest in the impact of trauma, nutrition, and hormones on physical and emotional health.

In September 2014, she founded Utah’s Maternal Mental Health Collaborative which has joined forces with other maternal health advocacy groups and has become the official state chapter of Postpartum Support International.

Under her leadership, PSIUT has succeeded in passing state legislation to increase awareness, treatment, and funding for postpartum health. They have several project in the works including postpartum educational training materials, postpartum screening, telehealth services for rural areas, and the creation of a massive database of postpartum resources for individuals and providers. 

It was a great privilege to have her as a guest on Power Principles the Podcast to share her knowledge and experiences working with Postpartum Depression/Anxiety, and illnesses currently lumped under the term Perinatal Mood Disorders.

Q: What influenced you to become an advocate for maternal mental health?

A: My own experience. I was in my second year of graduate school working as a medical social worker on a labor and delivery floor having no knowledge at all about the realities of postpartum depression and anxiety. A traumatic birth left me with symptoms that I didn’t recognize, neither did the doctors or colleagues I worked with. 

“It has been a journey of mine to find the support that I couldn’t and to help providers educate and prepare and help prevent, when they can,  maternal emotional health complications. That led me down this path and is why I sit here today.” 

Q: Do the terms "Mood Disorder" and "Depression" prevent people from getting real help?

A: The term “postpartum depression” is a complete misnomer. In fact, I had a history of adolescent depression, so I was bracing myself for an experience like that, but when none of my symptoms were similar, I assumed I didn’t have Postpartum Depression. It wasn’t until years later I realized I had Postpartum PTSD, which I didn’t know was a thing. After my second child I thought I was a terrible mom, but I actually did have depression, but it didn’t look like depression I’d had in the past, or anything anyone had informed me about. 

The reality is that more and more women experience agitation, irritability, anxiety, and insomnia. The term in the field of clinicians was Perinatal Mood and Anxiety Disorders. Now technically our diagnostic bible calls them Mood, Anxiety, Obsessive Compulsive and Trauma Related Disorders, which of course, nobody says.

The verbiage I think is more accurate is Emotional Health Complications. There are seven common diagnoses that happen to women in percentages much higher than gestational diabetes, preterm birth, and preeclampsia which women are educated about. Yet women are not informed about the variety of different emotional health complications.

These various health complication don’t generally present as a women under the covers crying all day, not functioning, feeling really sad and down. Typically women with these illnesses are taking really good care of their children, they are finding a way to get out of bed. They might have passive thoughts about it might be nice to not wake up so this nightmare could be over, but they don’t feel depressed

Q: Does calling a disease after an emotional symptom propagate the stigma? What is the physical cause of these emotional symptoms.

A:  Historically we have in our medical model an unfortunate separation between emotional and mental wellness and physical health. What we now know from the field of neuro psycho immunology is that every thought and feeling has a physical reaction in the body. One answer is an inflammatory response in the body as well as a dysregulation of the stress response processes in the brain in the HPA (Hypothalamic Pituitary Adrenalacdes) access. So most women presenting with the emotional symptoms we’re talking about today have very clear changes in their stress response physical system that results in the emotional or mental health symptoms.

And the average person doesn’t know that, although it’s becoming more and more understood, and I think it’s largely because we have these very siloed fields of mental health, emotional wellness, and physical health. And then within those parameters we have traditional or allopathic western medicine and “alternative medicine” and the language in the way we talk about these symptoms in all those silos is very different.  

Q: How can we change the label so we can change the stigma?

A: Consumers, those of us who care about emotional wellness and are treating it or we are survivors ourselves, we are in charge of that. We as consumers and advocates actually get to determine the labels which hold or don’t hold. I think we are going to see a real shift in that paradigm as a result of women demanding to be screened and treated accurately and given good information. And also that the stigma around emotional health change, because when anyone hears the term mental illness or disorder, I mean, who wants to be disordered? The word “disordered” suggests a permanence. It has the connotation of a character flaw. And that’s what people think of when they hear mental illness is that it’s a weakness, it’s a flaw, you’re not strong or you’re not capable of putting that smile on your face. That’s why the  handouts I make always say Emotional Wellness or Emotional Health Complications.

Q: What impact do thoughts, feelings, and the environment have on emotional health?

A: The field of Cognitive Behavioral Therapy argues that thoughts create feelings and feelings create physiological  responses in the body. It’s difficult to know which came first with someone. 

In this world we have an enormous toxic burden around pollutants, pesticides, plastics, electromagnetic frequencies. Our endocrine systems, I don’t think evolutionarily have caught up. And pregnancy is an inflammatory state, it’s an immunosuppressive state. So during postpartum, if you have a high toxic load  or you have a bunch of viruses in your body, such as Herpes 1 or Epstein Barr Virus,  or viruses and different genes allow our bodies to metabolize toxins at different rates. I think we are going to see that a lot of the physiology around mental health has to do with our bodies grappling with our environment. And if you have a woman who has a hormone sensitive brain, which many of us do, the enormous changes of pregnancy and postpartum tip that over.

Q: What's your advice for expecting mothers?

1. Keep Moms Number One Priority

The top level answer is to continue the same level of care after delivery that a mother experiences during pregnancy. During pregnancy women are considered special, people open doors for us, give us their seats, want us to eat the best food, ask how we are doing.  Then after delivery it becomes all about the baby and the mother is sort of neglected. Keep the mother numero uno. You can’t pour from an empty vessel. The example I use with clients is that cars have to be fueled up and get regular maintenance and oil changes. We don’t neglect changing a car’s oil for ten years, then get angry at the vehicle for breaking down going up a hill. 

In American culture, the mother has tremendous pressure to be perfect, look perfect, to love every minute, do it well, figure out the educational needs and dietary needs and allergies of each child. And if she gets it wrong, she’s a failure, which leads to women neglecting their nutrition, their sleep.

2. Prioritize Sleep 

You have to fight for sleep. During pregnancy, plan for how you can get a 4 to 6 hour stretch of sleep as soon as possible after the baby is born. Most people look like I’m nuts when I say that, but for preventative purposes, sleep is the most important thing you can do. It’s difficult for women to take naps or ask someone else to feed the baby because we feel like people are watching and judging us and expecting us to do it all.

3. Food and Water

Drink a ton of water.  We have an acronym snowball and the s stands for sleep and the n stands for nutrition. Keep your nutrition just as it was during your pregnancy. 

4. Ask For & Accept Help

Get rid of the thought, “If I don’t do this, no one will.” A lot of women over-function. We think, I’m tough. I’m strong. I’m going to bounce back quickly. I’m going to get this done and it will make me feel accomplished. There are a lot of losses of control when we have children. Sometimes overdoing it is one way we compensate and feel like I got something done. We long for that sense of accomplishment, but over-doing doesn’t fill up the tank. This running on empty will burn-out your physiological components and your brain will complain. You will start to see break-through, bleed-through symptoms. Which is why sleep is the most important thing. We don’t know if a woman truly needs medication, if she needs a certain nutrient if she’s not sleeping. Sleep is always the first place to start because sleep can resolve a vast majority of symptoms or at least make them manageable.  

Q: What is the solution for better and more frequent health checkups for new moms?

The policy team at PSI-Utah includes representatives from the American Academy of Pediatrics. One thing we’re working hard on, and this comes from the AAP, are recommendations that at well-baby checks moms also are routinely screened for depression & anxiety and then referred to a qualified therapist or support group, and also given information about nutrition and sleep. I think the pediatrician’s office is the place because most moms do take their children to well-baby checks for at least the first year and often beyond. Whereas a woman might get a six-week obstetrician checkup, then no one sees her again, so the pediatricians are really the only medical eyes on mom.

The benefits of moms being screened by pediatricians beyond that traditional six-week OB postpartum visit are numerous. For one, the well-baby checkups are already on mom’s calendar; it’s not an extra appointment she has to schedule. Also, often symptoms haven’t presented or regulated by six weeks. The first six weeks are pretty rocky anyway, so it’s hard for mom or doctor to know by six weeks what is “normal” postpartum recovery and what are “abnormal” symptoms signaling a more serious postpartum illness. Pregnancy and becoming a mother is such a personal transition anyway, that oftentimes women don’t recognize for three, six, ten, eighteen months that they aren’t themselves. I advise women to pay attention to not feeling “right.” Listen to the intuition that says, “I don’t feel like myself. This is not me.” Instead of defaulting to believing it’s a character weakness, know that there is likely more going on physiologically that can be treated and can get better.

In nearly all cases, although women are at highest risk for emotional health concerns during their reproductive, child-bearing years, women also tend to respond to appropriate treatment far faster than at any other time of their lifespan. When you get the right combination of treatment—talk therapy, sleep, nutrition, social support, medication—women are much better within weeks, not even months. I expect women to have a turn around within a session or two of coming to me. In the vast majority of cases it is totally treatable, completely recoverable. Sometimes I see women who have experienced mild life-long depression or anxiety who, with treatment, feel better than before they had children.

People in general, we settle for not feeling well, and we don’t have to. And we aren’t making the world better for our daughters by not speaking up and expecting better treatment.

Resources:

Postpartum Support International:    www.postpartum.net

Postpartum Support International UTAH: www.psiutah.org

Amy-Rose White, LCSW:  http://www.arwslctherapist.com/

The Emily Effect: https://theemilyeffect.org/

 

 

Ep. 15 Rally for Healthy Mothers

Vibrant Motherhood

Below is a list of resources and opportunities to Rally for Healthy Moms during the month of May. 

World Maternal Mental Health Awareness Day May 1, 2019

Please sign the petition calling on the World Health Assembly and the UN World Health Organization to officially recognize World Maternal Mental Health Day (WMMH Day), to be commemorated annually on the first Wednesday of May. The next day will be Wednesday, May 1, 2019.

Maternal mental health advocates, researchers, academics, clinicians, and people with lived experiences are committed to improving the mental health support for women during and after pregnancy throughout the world.

https://www.change.org/p/world-maternal-mental-health-day

The Emily Effect

Founded in February 2016, theemilyeffect.org is dedicated to support and provide resources for women and families during and after childbirth. After her death from complications of Postpartum Depression/Anxiety, Emily Cook Dyches’ family and friends started TheEmilyEffect as a way to expand the conversation about and end the stigma surrounding Perinatal Mood Disorders. The Letters of Light section is a library of real women’s stories about journeying through Postpartum Illness. Women also share their stories through Videos of Light on TheEmilyEffect YouTube Channel

On today’s podcast episode, I share my story about the twists and turns of life that led me to volunteering with TheEmilyEffect. 

You can read my own Letter of Light herehttps://theemilyeffect.org/project/maleah/

Or watch my Video of Light here: [not yet published]

Climb Out of Darkness

These hikes are the world’s largest fundraising events to support the mental health of new families. Organized through Postpartum Support International (PSI), these local hikes bring women and families together to symbolically climb out of the darkness.

For more info on joining or organizing a hike in your area, visit: https://www.postpartum.net/join-us/climbout/

The Utah Valley Climb Out of Darkness Event will be Saturday, May 11th at 9:30 a.m. at the Battle Creek Falls Trail in Pleasant Grove Utah. The hike is one hour round-trip with a fair amount of incline leading to a beautiful waterfall. The short hike is kid-friendly. Bring your spouse, children, parents, best friend, or a new mom you want to support. 

For details or to donate click here .

Be Your Own Best Advocate

It is up to us as mothers to promote change in postpartum diagnosis and care. No one will solve the problem for us. Speak up. Use your voice. Be clear to doctors and health care providers about what you are experiencing. Demand satisfactory answers. Question diagnoses and treatments that don’t feel right. Ask clinicians to look beyond the “mood disorder” to find, explain, and treat the physical malfunction that is causing the emotional symptoms. 

Ways to Speak Up and Get Involved:

Share Your Story:

 https://wmmhday.postpartum.net/blog/

theemilyeffect/lettersoflight

 

Share Your Story

Ep. 14 What Rumpelstilskin Teaches about Curing Depression

The Power of Naming

The name depression implies personal weakness.

And people would rather be sick in secret than be perceived as weak in public.

Cure "Depression" by Changing its Name

I have an idea. A theory.

I think that one reason Depression (and resulting suicide) is a rampant problem in society is because we are calling it by the wrong name.

And I propose that we will never successfully eradicate  this disease UNTIL we identify and address it by its accurate name.

My thesis for today’s podcast is three-fold.

First: That using the word “Depression” to name a disease is a misnomer.

Second: That calling “Depression” by the wrong name leads to incorrect or insufficient treatment to cure the disease. 

Third: I propose that the simple solution of changing the NAME of the diagnosis from “depression” to a term that more accurately fits the physical causes of the disease will result in a decrease of resulting suicide, length of time suffered, and an increase of pro-active treatment.

Why "Depression" is the Wrong NAME for the Disease

Depression is an inaccurate name because:

  1. Depression is the name of an emotion, not the name of an illness. And not everyone who feels the emotion of depression has the disease the word is attached to. 
  2. Depression is only one of many possible symptoms of the illness.
  3. Not everyone who has this disease will have the one symptom it is named for.
  4. Depression can be a Symptom of Many Different Illnesses

Depression is an Emotion, Not a Disease

Have you ever been depressed? Yes! Depression is a human emotion. Feeling depression doesn’t mean you have the disease that society currently calls “Depression.” Why do we have an illness named for an emotion? The name “Depression” 

Depression is a Possible Symptom, Not the Cause

The term depression doesn’t go far enough. It stops at a symptom and doesn’t continue to address the root of the issue. Depression is an emotion, not a disease. Depression is a possible SYMPTOM of the illness, but it is not the illness. It’s like saying “Jody has low energy” and stopping there. When, if fact, Jody has anemia. Low energy is a symptom, not the cause. Low iron levels in the blood in the cause.  The name “Depression” puts all the focus on a symptom rather than focussing on treating the cause. 

I have had doctors explain to me the physical causes for “depression” such as low levels of brain neurotransmitters or malfunction in chemical absorption by the neuron synapses. So there is a physical cause. There is a malfunction in the body, in the brain specifically, yet we continue to call the disease after an emotion rather than for the physical cause. Diabetes is caused by the body not making enough insulin, but we don’t call the disease Shakiness or Exhaustion, we call is Diabetes.  

The fact that depression is only one of many possible symptoms of this disease increases the confusion caused by this misnomer. Other symptoms can be insomnia, significant weight loss or weight gain, loss of appetite, muscle pain, moving slowly, difficulty concentrating. Furthermore, it is possible for a person to have this “disease currently known as depression” without experiencing the symptom of depression. I did not treat my illness currently known as Postpartum Depression because I didn’t feel depressed. I didn’t feel well. I was exhausted but couldn’t sleep. I ached everywhere and my body felt heavy as if I were made of concrete. I moved slowly. I lost a lot of weight, not in a good way. My head was always foggy. But I didn’t feel “depressed.” And failing to treat the physical causes of my disease caused my overall health to get worse until I also had auto-immune disease and chronic illness. 

The inaccurate label “depression” hindered me from getting correct treatment.

Depression Is a Symptom of Many Illnesses

Another reason that the term “Depression” is a misnomer is that it’s too broad. The feeling of depression can be a symptom for multiple diseases, like head injuries, cancer, or MS. Also we can experience depression without having a physical disease. We can experience depression while grieving a loved-one’s death or after losing a job or because it’s winter and there’s not enough sunlight. Depression is a common and variegated emotion. I can feel depressed in the morning and be happy by afternoon. So to call a real brain illness after such a kaleidoscopic EMOTION, seriously interferes with treating the disease.

Calling it Depression Causes Misdiagnoses and Treatment

The name Depression deters people from seeking treatment and taking steps to heal the disease.

The word “depression” connotes a character flaw. The term “depression” does not separate the person from the illness.  Why? Because we identify with our emotions. Our emotional state is linked with our personality. We describe people by their emotions:  He’s a jolly person, a happy person, an energetic person, she’s a sluggish person. She’s always “down.” We even have a nickname for this personality type: “Debbie Downer”  Calling a disease after an emotional state creates a false perception that a person diagnosed with depression has a bad personality. This is viewed more as a personal weakness than a physical issue.

The equivalent assignation for a person who’s had a stroke would be to say, “He’s a mumbler, you can’t understand when he talks. Mumbling is associated more as a character trait. But we don’t say that. We say, “He had a stroke and it’s affecting his ability to speak.”

In most cases we are good at separating the results of an illness from the character of the person. But not with depression. And the social impact is that many people who have “the illness currently known as depression” don’t say anything, don’t seek treatment because the name Depression insinuates personal weakness. And they would rather be sick in secret than to be perceived as weak in public.

Change its Name

Rumpelstilskin had power to take the Queen’s baby unless she could call him by his true name. Calling a physical disease after one possible emotional symptom is like  calling Rumpelstiltskin by the wrong name and then crying as he steals our baby.

I propose we begin by discontinuing the term “Mental Illness” and instead calling it “Brain disease” or “Brain Illness.” The brain is an organ just like the kidneys, lungs, and heart. When the lungs are sick, you can’t breathe well. When the brain is sick, you can’t think right. Thoughts and emotions are processed in the brain through electrical-chemical reactions. If the electric wires malfunction, the thoughts go dark, just like when power lines go down. If the chemical recipes aren’t right, the emotions come out bad, just like using salt instead of sugar when baking cookies. It’s science, not emotion.

So let’s call it by what it is. Let’s name it for the cause, not after one of the numerous possible symptoms. I don’t have authority or the training to come up with the best name, but I propose it be scientific, sound official, and be related to the root cause of the ailment rather than a resulting emotional symptom.  

For example, the term diabetes is shortened from Diabetes Mellitus which comes from the Greek word diabetes which means to siphon – to pass through and the Latin word mellitus meaning honeyed or sweet. This is because in diabetes excess sugar is found in blood as well as the urine. Excess sugar is siphoned through or passes through the blood. This name helps us to focus on treating the cause of the illness rather than concentrating on the idea that in the United States we currently have over 100 million people who can digest their food properly.

Recently my son was experiencing lack of focus, bouts of anger or depression, head fogginess, and headaches. I dreaded hearing the diagnosis “Depression.”Rather he was diagnosed with Postconcussive Syndrome. That name empowered us. We know to let his brain rest, to cut back on learning new things like memorizing his violin music. He told his school teachers who were understanding and willing to accommodate if he needed extra time for assignments. It was much easier to tell his teachers that he had a concussion than that he had depression.

Currently, this same care and attention isn’t happening with the disease known as depression. The word Depression holds a lot of judgment and misperception. The stigma surrounding depression interferes with accurate diagnosis and treatment. 

To reNAME this disease will empower us to  perceive & understand in a different, more enlightened way. It will help us move out of the space of impatience. The attitude of “Snap out of it” and “This needs to be fixed NOW!”  and into the place of giving people time and  support to heal.