Chapter 2 Lies of the Magpie

Postpartum Depression Memoir

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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/

Postpartum Depression with Amy-Rose White Part 2

mom postpartum depression holds baby

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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

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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

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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 here: https://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

Submit Your Letter of Light