Monday, August 17, 2015

Not what I envisioned... Part 1

When I was inspired by this topic, I realized that I could take this post in two different directions. And since I am not a professional writer, I decided it would make more sense to my readers for me to break this subject up into two different blog posts.

With my specialty in perinatal mental health, I work with many people who feel shame about their emotions as they navigate new parenthood. Women especially grow up with an image in their heads about what being a mom was going to look like. They envisioned being blissfully pregnant, then having an unmedicated, vaginal birth, followed by a beautiful mother/baby bond that nobody could break. They would hold their baby and attend to every need, knowing exactly what to do.

I have never met anyone who actually had this experience. Have you?

Processing this involves grieving, which means stepping outside of your shame and embarrassment, and learning to accept that you will not get your dreamed of parenthood experience. And that this is OK. Normal, for lack of a better word. There are three main tasks involved in this process, although not everyone will go through these at the same rate, time, and even order. It is also helpful to note that if your partner has his/her emotions about becoming a new parent, s/he may not feel the same way that you do. And this is OK. Talk about it anyways.

Task 1: Getting angry. Many people are raised to feel that anger is not acceptable. You "shouldn't" feel this way, or anger is bad. Anger is not the problem. And anger is fueled by fear and anxiety. So take some time- a day, a week, a month- to understand your anger rather than judge it. Are you angry that you were robbed of your envisioned experience? Are you angry at someone in your life who contributed to this? Let yourself feel that. Journal about it. Write therapeutic letters to the people who you feel have wronged you, or to yourself (note: do NOT send these letters, at least not right now!). Talk about it with a trusted person or therapist. Just don't keep it locked inside, stuffed down by shame.

Task 2: Allowing sadness in. This is another toughie for people. Sadness is often associated with depression, when really- sadness is a normal human emotion. Many men, especially, don't know how to express sadness, as they are raised to believe that it is not OK for boys to cry. Women tend to be more comfortable with sadness, but may feel guilty that they feel sad about their experience- they "should" just be happy that they have a healthy baby now. But reality is, that this is a process, and the more you fight sadness, the longer it will take. So feel it- again, journaling and letter writing can be helpful. Crying to a trusted friend or family member or therapist can also be helpful. Don't resist.

Task 3: Acceptance. First, we must define acceptance. Acceptance does not mean that you are happy with the way things went or turned out. It just means that you accept it. It is what it is. And you may have moments of feeling sad or angry at times, but you find that these are fewer and far between. You don't feel guilty for your feelings any longer. You have a new meaning for your experience, and some people use this meaning to help others.

There is no timeline for these tasks, and they will go more smoothly if you don't fight them. We are all a work in progress!




If you have recently had a baby, and you are finding it overwhelming to parent, help is available! My, and several other MN resources, information are all part of Pregnancy and Postpartum Support MN. See the resource list at www.ppsupportmn.org, or call the PPSM Helpline at 612/787-7776. You are not alone!



Thursday, May 28, 2015

What about dad's village?


I have spent a lot of time this past month focused on maternal mental health. We had the Daisy Dash 5K (our annual fundraiser for PPSM) mid-May, a screening of a documentary on maternal mental health, Dark Side of the Full Moon, and today, spent the day at the Beyond the Baby Blues conference.
When people discuss perinatal mental health, much of the focus is on moms. This is definitely important, as statistics show that 1 in 5 moms will struggle with some form of perinatal mood or anxiety disorder. The numbers may be even higher.

But did you know... dads can also get postpartum depression (PPD)? Depending on which site you are looking at, stats are roughly 1 in 10 dads. That is way more than many people realize, and WAY more than we are talking about.

Why is this?

Men with depression look very different from women with depression. Men are not weepy, sad, or talking about their feelings (in general). They tend to become withdrawn and easy to anger, and pour themselves into their jobs, hobbies, and, sometimes, substances (alcohol or drugs). The odds of depression increase further if the dad has ever experienced depression in the past, and if his partner is depressed.

We need to talk about this. Dads need a "village" too. But their village may look very different, so it's important to recognize this.

Here are some ideas for dads who are struggling postpartum, and really need an outlet for that:


  • Self care is important. Aside from sleeping as well as possible, and eating, other things like exercise and time for yourself are key. Is it harder with an infant? Yes. But not impossible. If your partner is struggling too, have a discussion about how you are both going to take care of yourselves. It would benefit you to work out a plan or schedule for this. It may also be necessary to enlist help of others- such as friends or family members who can come be with your partner, so that you do not feel guilty taking time to go to the gym or going out with friends. It may mean asking someone to take the baby for an hour or two so you can go have a date with your significant other. 
  • Support... while there is definitely a shortage of men's mental health resources, especially postpartum, it is not impossible to find. Below, I will list some specific resources geared towards men, some specifically for depression, but others just more about the challenges of being a dad. Feeling at times like you don't know what you're doing. Feeling like you aren't sure what to do with a newborn who eats, sleeps, cries and poops. Wondering what happened to your partner.... while men tend to not talk about feelings, it is OK to share your story and speak your truth. 
  • Professional help may be a good idea. In my practice, it seems that men have an easier time accepting the idea of taking medication for depression versus going to therapy. AND THIS IS PERFECTLY FINE. If you have felt depressed, down, hopeless, angry, or having thoughts of running away or harming yourself, medication may be an option to explore. If you do decide you would like to talk with someone, whether that is therapy or a support group, it is really important to find someone who is trained in perinatal mental health or understands male depression. Resources like Postpartum Support International, and in Minnesota, Pregnancy and Postpartum Support MN, are great places to look to find people who will get it. It is hard to open up to a stranger about what is supposed to be the greatest event of your life, so make sure you have someone who understands. It is also an option to attend some sessions with your partner. If she is going to therapy, ask if you can come along sometime. She will probably LOVE that, and it is very helpful as a therapist to get both perspectives, and for me to assess depression or anxiety in both members of the couple. 
Dads are SO important. Your relationship with your baby matters too!

Resources:

Locally (in Minnesota):

Dads groups can be hit or miss. But some places to check are http://www.meetup.com/ and Facebook. PSI also has phone chats for men, and PPSM has a free HelpLine for all new parents and their providers who are in need of resources and support. 

Books:
P.S-- there are NO books specifically for dads with PPD!!!

Sunday, May 3, 2015

Mothers Day is great... except when it's not

Don't get me wrong. I LOVE Mothers Day. One of two days of the whole year that is just for me. However, there was a time when Mothers Day was one of the worst days of the year- when I was going through infertility. Since that experience, I work hard to be mindful that Mothers Day can be very painful to some. 

In my practice, as a therapist who specializes in perinatal mental health, there are three common categories of women that Mothers Day is hard for (and some men too!). 

1. Women going through infertility (and their partners)
About 12% of women (1 in 8) and couples struggle to get pregnant. It makes sense that a day that celebrates being a mom can be difficult for these people. We need to be aware of how painful it can be for a woman who so desperately wants to be a mom cannot escape that our culture defines success as a woman as being a mom. You can't escape it, especially around this time of year. Go to Target, and right when you walk in the door is the HUGE sign above the card display for Mother's Day. Commercials on TV. Pregnant women with their bellies and young babies going out on walks, as the weather warms. I remember wanting to just stay in bed with a blanket over my head for the month of May. But we have to live. So, if you know someone in your life who is struggling to get pregnant, make sure you acknowledge that Mothers Day is hard for them. Offer to get together and do something fun anyways. Or let her talk, cry, yell about how unfair it all is. And if you or your partner are struggling, it is OK to let people know you are sad. It is OK to be sad for you and happy for the women in your life who are mothers. 

2. Women who have had a pregnancy or infant loss (and their partners)
Here are some statistics from www.hiringforhope.org:
  • 90,000 children die annually in the United States before their first birthday.
  • Nearly 2,500 babies are lost/year in the United States due to S.I.D.S.
  • Nearly 30,000 babies a year are born stillborn. The number of stillbirths that occur worldwide jumps to more than 4.5 million/year.
  • More babies die as a result of stillbirth than all other causes of infant death combined.
  • Stillbirth occurs ten times more frequently than S.I.D.S.
  • 15-20% of all clinically recognized pregnancies end in miscarriage each year.
This means that it is very likely that you have experienced or know someone who has had a miscarriage or lost a baby. For the same kinds of reasons mentioned with infertility, pregnancy and infant loss is invisible. You can't tell just by looking at someone if they don't have kids by choice or not. And there is still a lot of misinformation and ignorance that some people don't consider miscarriage "a baby", or if a family has had other children, the one that was lost is forgotten. But moms don't forget. Moms remember every year how old that child would have been. Or how differently their family would have looked if that child had survived. So again, be kind, because we don't know what anyone's story is. But if you DO know someone, remembering that baby to them can be so so kind. Tell them Happy Mothers Day. Validate their sadness. And if you are a partner, talk with her about how she wants to acknowledge Mothers Day. Please don't ignore it or pretend it's not happening. 

3. Those who have lost their own mother, or have a poor relationship with their mother 
Stepping outside our own feelings of Mothers Day, about if we are a mom or not, and remember that we all have a mom somewhere. Some of our moms have died. Some of our moms are cut out of our lives for numerous reasons. And some of us still have our mom with us, but the relationship is very complicated and makes Mothers Day a challenge. 
If you have lost your mom, the first Mothers Day will be particularly difficult. Think about how you would like to spend this day, and honor your mom. Share this with your partner or a close friend. Don't go through it alone. 
If you have relationship challenges, make a plan. Do you need your partner or a close friend to take you out and keep you distracted? Let you share your emotions about it? And if you do still see your mom on Mothers Day, set very clear boundaries. It is OK to limit the amount of time that you spend with your mom. It is OK to feel sad, hurt, angry, or frustrated (or all of the above) that you don't get a happy Mothers Day with your mom. Try to plan something to do afterwards to vent and debrief. 

This post is not intended to take away from the joy that Mothers Day brings. If you are a mom, you are to be celebrated. Just know that it is a very emotional day for many people, and to be kind, because we never know what people's story is.