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Speaker 1: Welcome to Stuff Mom Never Told You from how stupp

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Speaker 1: works dot com. Hello, and welcome to the podcast. I'm

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Speaker 1: Kristen and I'm Caroline, and today we are talking about

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Speaker 1: three and postpartum depression and pregnancy. And it's taken us

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Speaker 1: a long time on the podcast to get around to

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Speaker 1: this topic, even though it's certainly come up in other

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Speaker 1: conversations that we've had around women's mental health and motherhood. UM.

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Speaker 1: But I am glad that we're talking about it right

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Speaker 1: now when this podcast is coming out during the holidays, because,

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Speaker 1: as with any type of mental health challenge, the holidays

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Speaker 1: tend to compound feelings of isolation and loneliness. Well. Sure,

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Speaker 1: and I mean the holidays are a huge each time

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Speaker 1: when you're already facing social stigma or feel that you

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Speaker 1: might face social stigma if you're not reveling in the

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Speaker 1: joy and the lights and the presence and the time

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Speaker 1: with people. Um. And the same kind of goes for

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Speaker 1: the conversation around postpartum depression. Uh, that women feel a

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Speaker 1: lot of stigma if they do experience anything other than

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Speaker 1: sheer joy throughout their pregnancy and after, and it can

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Speaker 1: be very isolating. Yeah, I mean a lot of This

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Speaker 1: speaks to the constructive motherhood that we have established that

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Speaker 1: says women um are allowed to express really nothing other

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Speaker 1: than pure joy um. That it's unacceptable and uncomfortable for

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Speaker 1: a new mom to say that she is not instantly

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Speaker 1: in love with her baby and that she doesn't want

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Speaker 1: to spend every waking moment with it um. But that

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Speaker 1: is a reality for a lot of women UM. And

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Speaker 1: it's only been in the past twenty years that postpartum

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Speaker 1: depression has really started coming out of the shadows, and

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Speaker 1: they're being a growing movement to destigmatize it. But really

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Speaker 1: it's only been in the last couple of years that

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Speaker 1: we are starting to learn and talk more about issues

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Speaker 1: of prenatal depression and also things distinct from postpartum depression,

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Speaker 1: like postpartum anxiety. Right. Yeah, maternal mental health for some reason,

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Speaker 1: for well, for several reasons, is really not well understood,

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Speaker 1: and that's kind of shocking. But one aspect that goes

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Speaker 1: into that that contributes to our poor understanding of both

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Speaker 1: prenatal and postpartum depression and anxiety is the fact that

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Speaker 1: it is unethical to do any sort of testing or

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Speaker 1: experimentation on pregnant women and their fetus. Now, you can

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Speaker 1: have studies like voluntary voluntary studies where uh, pregnant women

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Speaker 1: maybe some of them are on antidepressants or have been,

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Speaker 1: and some who are not will will join a study

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Speaker 1: and describe their experiences. But you don't have a whole

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Speaker 1: lot of studies out there, um because of this whole

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Speaker 1: ethical issue. And so I think that not only the

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Speaker 1: question of ethical studies, but also what we were just

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Speaker 1: talking about about, this stigma against women admitting to feeling

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Speaker 1: less than stellar about their pregnancy or their baby really

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Speaker 1: contributes to sort of a lack of information. Yeah. I mean,

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Speaker 1: there there's no way that you could set up a controlled,

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Speaker 1: randomized study, which is more of the gold standard of research,

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Speaker 1: where you bring in say fifty pregnant women and you

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Speaker 1: give twenty five of them this antidepressant or s s

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Speaker 1: R I of some sort that might help, and then

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Speaker 1: give the rest of placebo and hope that both grew

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Speaker 1: and both groups babies. Fair Okay, I mean you just

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Speaker 1: quickly get into really dicey territory there. So this is

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Speaker 1: a challenge not only for us as a society and

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Speaker 1: how we look at women and how we um treat mothers,

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Speaker 1: and also what we how we allow mothers to feel

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Speaker 1: maybe more that more than one emotion, which is joy um.

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Speaker 1: And also on the flip side of that, there's this

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Speaker 1: medical community that's grappling with the realities of all of

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Speaker 1: these constraints but also these very real needs, because what

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Speaker 1: we've known for a long time is that, yes, giving

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Speaker 1: birth often affects our mental health, whether it is temporarily

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Speaker 1: or for a longer period of time. Yeah, and I

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Speaker 1: would like to offer a bit of a disclaimer right

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Speaker 1: up front, um that a lot of the postpartum depression

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Speaker 1: research that is out there is very well estern centric, Um,

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Speaker 1: and the way that we are going to be talking

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Speaker 1: about uh mental health is very Western centric, because you

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Speaker 1: have to keep in mind that things like depression, mental health, childbirth,

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Speaker 1: and issues of family support in general really aren't necessarily

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Speaker 1: treated or viewed the same in all cultures across the world.

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Speaker 1: So we can't always even ask the same study questions

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Speaker 1: the same way to women who are in diametrically opposite

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Speaker 1: or very very different cultures. And so for today's episode,

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Speaker 1: we will definitely be focusing more on that Western based research. Yeah,

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Speaker 1: with with the caveat in mind that cultures of Uh,

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Speaker 1: childbirth and motherhood um are very different depending on where

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Speaker 1: you are. Uh. But if we look more at just

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Speaker 1: the basic science of postpartum effective disorders, the three main

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Speaker 1: types that have been highlighted start with baby blues, which

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Speaker 1: talk about our real marginalizing term. That was even the

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Speaker 1: name of a comic strip that I used to read

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Speaker 1: in the Sunday Funnies. Oh, i could see baby Kristen

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Speaker 1: sitting there with the newspaper un lap with her glasses.

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Speaker 1: I've got my little half spectacles thinking that's an awfully

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Speaker 1: marginalizing term for a name for a comic. Well, baby blues,

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Speaker 1: I mean that that tends to be the thing that

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Speaker 1: new moms are warned about more often, Like you might

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Speaker 1: feel a little weird the first couple of days, which

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Speaker 1: shake it off, you'll feel fine. And I mean, for

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Speaker 1: the most part, the women who do experience the so

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Speaker 1: called baby blues, that is true. I mean it's it's

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Speaker 1: this feeling that usually begins in the first couple of

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Speaker 1: days after birth and can last up to two weeks.

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Speaker 1: And you might feel mood swings or crying spells and anxiety.

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Speaker 1: You might have difficulties sleeping, but it does tend to

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Speaker 1: go away with a good support system, reassurance, help from

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Speaker 1: a partner for the rest of your family. But about

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Speaker 1: twenty of women new moms who experience these so called

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Speaker 1: baby blues, which I'm like, seriously, do we not have

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Speaker 1: a different name for this, um will see it turn

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Speaker 1: into postpartum depression and remaining briefly on baby blues, all

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Speaker 1: of those symptoms that you just cited are so much

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Speaker 1: more also than feeling weird, because even if our brains

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Speaker 1: in the delivery room or wherever you delivered were the

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Speaker 1: back of a pickup truck, even if our brains were

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Speaker 1: in beyond tiptop shape. Allah Bradley Cooper in the film Limitless,

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Speaker 1: which if you haven't seen it, I don't recommend it.

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Speaker 1: Just save your save your time. He like takes a

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Speaker 1: pill and it makes them super smart. It's like at

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Speaker 1: all times a billion anyway. So even if we had

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Speaker 1: Bradley Cooper's brain hashtag jelly um. Even that aside, like

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Speaker 1: just having a new baby all of a sudden being

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Speaker 1: a mother, like whatever trauma your body has gone through,

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Speaker 1: toss on that mood swings, crying spells. If I just

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Speaker 1: randomly have crying spells, I don't feel just weird. I

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Speaker 1: feel like something is completely off in my life. So

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Speaker 1: I mean, just again, I'm I'm astonished that this term

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Speaker 1: um exists because it's so obviously misleading and it's also

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Speaker 1: kind of patronizing. Exactly. Yeah, if a woman is complaining

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Speaker 1: of not feeling well, as has happened to women in

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Speaker 1: my life, the first thing that they're told is that

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Speaker 1: it will go away. It's nothing, it's just baby blue

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Speaker 1: or more. It won't. And when it doesn't, you can

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Speaker 1: develop postpartum depression. And you know, we are kind of

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Speaker 1: zeroing in on postpartum depression. But in saying that we're

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Speaker 1: zeroing in on postpartum depression today, it's a little bit

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Speaker 1: misleading because one thing that's really not often talk about

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Speaker 1: is this thing that we know as postpartum depression, where

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Speaker 1: those symptoms are so much more intense, can last so

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Speaker 1: much longer, can really interfere with your ability to care

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Speaker 1: for your baby and handle this daily tasks. A lot

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Speaker 1: of times those issues develop either before pregnancy, so they're

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Speaker 1: pre existing depression or anxiety, or they can be this

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Speaker 1: thing called pre natal depression. And so this is a

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Speaker 1: thing that I didn't actually know much about now granted

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Speaker 1: I've never been pregnant, but you hear about postpartum depression.

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Speaker 1: You don't really hear about prenatal depression or anxiety, things

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Speaker 1: that develop while you are pregnant and then affect you

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Speaker 1: after which, as I was reading up on this, and

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Speaker 1: this is a lot of the info that we're now

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Speaker 1: getting about prenatal depression, um and even pre existing depression

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Speaker 1: leading up to pregnancy. Uh, it blows my mind that

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Speaker 1: this is such new information and new conversations that we're having,

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Speaker 1: because how long have we known that women get depressed

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Speaker 1: and anxious at rates higher than men, Like I've never

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Speaker 1: been pregnant, but I've been depressed, I've I have clinical anxiety,

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Speaker 1: Like why why is this suddenly like oh my god? Well,

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Speaker 1: and the age at which a lot of women start

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Speaker 1: experiencing clinical depression or clinical anxiety his childbirth age, typical

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Speaker 1: childbirth age. Well, even think about before that, when you

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Speaker 1: start to see the gender gap and mental health start

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Speaker 1: to widen. It's when we get our first period. So

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Speaker 1: you would think that from the get go, medicine would

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Speaker 1: be paying closer attention to the interaction of our mental

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Speaker 1: health and our reproductive health. Well, and this is why

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Speaker 1: it's so important that we're talking about this stuff today

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Speaker 1: and highlighting the fact that more women are talking about

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Speaker 1: this UM. We read a column Kristen I believe he

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Speaker 1: sent it to me from cause Mo, where a woman

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Speaker 1: who had experienced UM both prenatal and postpartum depression. This

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Speaker 1: woman named Jane Marie wrote an essay in Cosmo about

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Speaker 1: how she had been managing depression and anxiety since she

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Speaker 1: was very young when she experienced with traumatic brain injury

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Speaker 1: and because of that had um been on antidepressants for years.

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Speaker 1: But as soon as she UM got engaged and knew

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Speaker 1: that she was getting married, knew she wanted to have

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Speaker 1: a baby as soon as possible because she was thirty four,

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Speaker 1: and UM, I just wanted to do it before, you know,

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Speaker 1: before the old cobwebs started moving into our uteruses. Um,

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Speaker 1: it's hormonal cobwebs. And it was such an eye opener

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Speaker 1: for me, not necessarily because I have baby fever at

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Speaker 1: the moment, but because I am someone who does take

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Speaker 1: daily medication that has totally changed my life for the

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Speaker 1: better to manage my clinical anxiety. And the thought as

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Speaker 1: I'm reading this of having to go off of that

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Speaker 1: and then having to go through the experience of both

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Speaker 1: pregnancy and childbirth without it. Uh, terrifies me, completely, terrifies me. UM.

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Speaker 1: And I even posted it at the time on the

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Speaker 1: Stuff I've Never Told You Facebook page, and it sparked

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Speaker 1: a really massive conversation of a lot of women saying, oh,

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Speaker 1: thank God, like, this is something that I'm scared about too, uh,

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Speaker 1: for people who hadn't been pregnant before and women who

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Speaker 1: had been through it and had to deal with all

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Speaker 1: of this stuff, but in the shadows, because it's taboo

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Speaker 1: to talk about, Oh you you, you're depressed and you're pregnant,

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Speaker 1: and we might have some medication mixed in there. Like, because,

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Speaker 1: as we've talked about on the podcast before, once you

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Speaker 1: are maignant, everybody has an opinion about you, your body,

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Speaker 1: your baby, decisions you make. It's like the floodgates open

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Speaker 1: up into every nosy person in the world. Well, and

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Speaker 1: that's a great point that Andrew Solomon raised over at

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Speaker 1: The New York Times UM magazine in a end depth

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Speaker 1: piece that he did looking more at prenatal depression that

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Speaker 1: develops during pregnancy, whether you had existing pre existing depression

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Speaker 1: or not, and He pointed out how often we strive

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Speaker 1: in our culture to make our mental health and particularly

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Speaker 1: depression and anxiety a private emotion, but once you're pregnant,

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Speaker 1: it becomes so public, not only because people are gonna

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Speaker 1: have opinions on all sides, but also you have to

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Speaker 1: be forthright about it. You know, you need a team

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Speaker 1: of caregivers from your obi gu i am, but also

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Speaker 1: to a fair pist and even um. Maternal psychiatry is

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Speaker 1: a developing field now, yeah, and I mean, thank god

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Speaker 1: it is. And I thought that Andrew Solomon put it

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Speaker 1: really well in describing these issues of postpartum depression and

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Speaker 1: prenatal depression. Uh. He says that for some expected mothers

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Speaker 1: and new parents, love seems to be automatic. It wafts

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Speaker 1: them instantly up to a new level of consciousness. Others

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Speaker 1: have to climb a very steep staircase to reach the

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Speaker 1: same heights. The fact that the exercise can be agonizing

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Speaker 1: and that some women cannot quite make it does not

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Speaker 1: dull the intent behind it. And so for a look

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Speaker 1: at what some of these women are experiencing, who experienced

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Speaker 1: prenatal and postpartum depression, you're of course going to experience

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Speaker 1: things like depressed or severe mood swings, again, excessive crying,

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Speaker 1: feelings of worthlessness, shame, guilt, or inadequacy. A lot of

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Speaker 1: what we read from women's first person accounts of dealing

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Speaker 1: with this were issues of like suddenly they'd wake up

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Speaker 1: at two am thinking I'm gonna be a terrible mother,

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Speaker 1: I'm gonna end up hurting my baby, or or I'm

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Speaker 1: I'm not going to be worthy of raising this child. UM.

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Speaker 1: You know, you might also experience insomnia, sleeping too much,

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Speaker 1: overwhelming fatigue, UH, diminished ability to think clearly or concentrate. UM.

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Speaker 1: And once the baby is here, UH, moms might experience

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Speaker 1: difficulty bonding with the baby, thoughts of harming themselves or

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Speaker 1: the baby. But it is worth noting that those intrusive

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Speaker 1: thoughts are very common, and so it's important to normalize

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Speaker 1: this topic and these health issues because again, it is

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Speaker 1: so isolating. If you're sitting there thinking that you might

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Speaker 1: harm yourself or your child, or that you're going to

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Speaker 1: be a terrible mother. It's okay to talk to someone,

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Speaker 1: it's okay to ask for help. And if you are

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Speaker 1: one of those women who experiences prenatal depression UH for

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Speaker 1: about fifty of those women, it does turn into postpartum depression,

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Speaker 1: and you might experience actually more intense feelings of sadness

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Speaker 1: and paranoia. So tracking and talking about your mental health

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Speaker 1: and those feelings and those emotions throughout and after your

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Speaker 1: pregnancy is so important. And if we move farther along

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Speaker 1: on the spectrum of postpartum mood disorders, you have postpartum psychosis,

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Speaker 1: which is a rare condition that typically develops within the

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Speaker 1: first week after delivery. And essentially you take all of

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Speaker 1: the hallmarks of postpartum depression and amplify them, so you

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Speaker 1: may experience things like disorientation, hallucinations, delusions, sleep disturbances, and

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Speaker 1: paranoia and and potentially attempts to harm yourself or your baby.

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Speaker 1: But something that's far more common, sort of back on

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Speaker 1: the spectrum a little bit than postpartum psychosis, this is

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Speaker 1: postpartum anxiety. And this is another one of those effective

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Speaker 1: mood disorders that we are only recently learning about and

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Speaker 1: only recently um seeing more clinical investigation. And this is

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Speaker 1: extremely important because y'all, we hear all the time about

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Speaker 1: postparm depression and in fact not enough um, so I'm

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Speaker 1: in no way being dismissive of that, But we need

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Speaker 1: to talk about postpartum anxiety because it is distinct from PPD,

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Speaker 1: and this emerging research is suggesting that it's even more

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Speaker 1: common than postpartum depression. But because it's not postpartum depression,

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Speaker 1: it's often written off as oh, these are just the

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Speaker 1: baby blues, Oh, you know, just worried about being a

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Speaker 1: good mom. Right and um. There was a study from

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Speaker 1: and Pediatrics which found that out of its sample population

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Speaker 1: of a thousand new moms, nine percent experienced postparmu depression

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Speaker 1: and seventeen per scent experienced postpartum anxiety. And they experienced

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Speaker 1: p P a longer term than PPD. Uh, and I

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Speaker 1: have a hunch that at least part of that longer

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Speaker 1: term effect is our lack of knowledge and understanding around it,

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Speaker 1: even terminology around it. Um. So, something that in in

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Speaker 1: very basic terms distinguishes postpartum anxiety from depression is sort

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Speaker 1: of the level of energy. So you might see a

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Speaker 1: lot of overlapping symptoms like a loss of appetite and

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Speaker 1: concern over your baby, but whereas depressive symptoms sap your energy.

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Speaker 1: You don't want to get out of bed, you're low, low,

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Speaker 1: low anxiety is all a jumble of energy that you

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Speaker 1: don't know what to do with. It's often linked to

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Speaker 1: O c D type habits, um really intrusive thoughts which

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Speaker 1: may possibly involve harming yourself or your child. So UM,

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Speaker 1: it's it's definitely a distinct thing that I really hope,

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Speaker 1: I really hope it's helpful for people listening UM because

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Speaker 1: I only recently learned about it because a good friend

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Speaker 1: of mine went through it. She went through post part

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Speaker 1: of anxiety, yes, yes, and it took her so long

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Speaker 1: even her gynecologist didn't get it right. It really took

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Speaker 1: her getting involved with organizations like Postpartum International UM who

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Speaker 1: connected with other mothers who were going through this UM.

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Speaker 1: But also, you know, are are helping to champion you know,

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Speaker 1: this all of the spectrum of maternal mental health that

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Speaker 1: we're just not paying close enough attention to. And I

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Speaker 1: mean it is crazy that we are not talking more

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Speaker 1: about it because non psychotic postpartum issues, depression, and anxiety

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Speaker 1: are the most common complication of child bearing, and studies

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Speaker 1: have shown that a woman has a greatly increased risk

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Speaker 1: of being admitted to a psychiatric hospital within the first

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Speaker 1: month after giving birth. Then at any other time in

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Speaker 1: her life. UM up to fifteen percent of women experience

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Speaker 1: that anti natal depression that we talked about, that depression

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Speaker 1: that manifests during pregnancy before childbirth uh and between twelve

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Speaker 1: and of women will develop symptoms of depression, anxiety, bipolar

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Speaker 1: disorder O c D, or a combination of these things

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Speaker 1: during or after pregnancy UM and ten to fient of

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Speaker 1: women might experience a major depressive episode within three months

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Speaker 1: after giving birth. But the thing is, if you have

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Speaker 1: it during one pregnancy, you might not have it during

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Speaker 1: the next, or if you don't in your first, then

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Speaker 1: you might develop it in the next one. It's there.

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Speaker 1: There are no constants, there are no guarantees. Well, one

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Speaker 1: thing though, that could absolutely distinguish your mental health experience

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Speaker 1: with your first pregnancy that results in traumatizing uh P,

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Speaker 1: p A or pp D, whatever whatever it might be.

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Speaker 1: One thing that could um alleviate a lot of that

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Speaker 1: for a second pregnancy is actually going into pregnancy understanding

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Speaker 1: more about how our bodies and respond to pregnancy. I

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Speaker 1: mean that, and that's and that's what you hear from

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Speaker 1: a lot of women who go through this, particularly the

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Speaker 1: prenatal depression where it just feels like it's out of nowhere.

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Speaker 1: No one ever told them this was a possibility. Like

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Speaker 1: this is also an issue of total failing when it

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Speaker 1: comes to educating women about our body basics, but also

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Speaker 1: about the range of scenarios that happened with pregnancy and childbirth.

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Speaker 1: And I mean it's not for a lack of trying

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Speaker 1: on a lot of male doctor's parts. In the history

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Speaker 1: of medicine. Oh yeah, guys have had a lot of

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Speaker 1: a lot of ideas. I mean, Dave old the oldie dude.

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Speaker 1: Doctors have known that women get cranky, you know, she

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Speaker 1: got a case of the baby blues for centuries um,

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Speaker 1: but they basically just thought it was our like what

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Speaker 1: uterus fluid getting into our heads. Yeah, so if you

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Speaker 1: go back to Hippocrates, this is the same guy that

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Speaker 1: thought that women had such gorgeous, lustrous hair because it

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Speaker 1: was just filled with semen um. He just figured in

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Speaker 1: back in the fifth century BC, that fluid from the

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Speaker 1: uterus could flow to the head after childbirth and cause

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Speaker 1: you to be delirious. And one of his contemporaries said, yes,

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Speaker 1: terrific idea. Let me jump on that and say, you

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Speaker 1: know why they cry so much because that fluid covers

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Speaker 1: their eyes and runs out like tears. Yeah. I actually

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Speaker 1: had to pause when I read that and was like,

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Speaker 1: I'm not a doctor, but I feel like that's not

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Speaker 1: the first thing I would go for. The idea wise,

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Speaker 1: my uterine or cervical or any sort of inner fluid

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Speaker 1: just leaking out over my brain and through my eye holes. Well,

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Speaker 1: I'm glad that you would be such an advanced ancient physician, Caroline. Yeah,

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Speaker 1: they probably murder me as a witch, which honestly leads

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Speaker 1: us to our next thing that does not cause postpartum depression,

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Speaker 1: which is witchcraft. Of course, people in the Middle Ages

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Speaker 1: viewed postpartum symptoms as a sign that you were a witch,

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Speaker 1: so there was just really no winning honestly, and um,

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Speaker 1: it's also not caused by milk suppression. A nineteenth century

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Speaker 1: French psychiatrist said insanity manifests itself most frequently among women

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Speaker 1: who do not nurse, which is funny because just a

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Speaker 1: few decades later, a British physician said that it was

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Speaker 1: insanity of lactation that caused that was caused by anemia

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Speaker 1: brought about by prolonged suckling or by the mother making

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Speaker 1: undue efforts to nurse and so over taxing her strength.

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Speaker 1: So just within a couple of decades in the nineteenth century,

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Speaker 1: you had people who were like, oh my god, she's

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Speaker 1: not nursing enough, and other people being like, oh my god,

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Speaker 1: she's over nursing and making herself crazy. And isn't it

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Speaker 1: such a relief that there's like no pressure on women

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Speaker 1: anymore about whether breast is best from all of those that,

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Speaker 1: because that doesn't compound any any negative feelings and insecurities

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Speaker 1: depression that you might be having. I'm being sarcastic, folks,

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Speaker 1: But who was not being sarcastic was Freud? Yeah, what's wrong?

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Speaker 1: I mean, actually, hang on, time out here, Zach Morris,

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Speaker 1: time out. What if Freud had been sarcastic the whole time,

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Speaker 1: you know, he was like, oh yeah, it's an complex

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Speaker 1: and we just didn't pick it up. We thought it

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Speaker 1: was a quote when really he was putting sarcastic quotes

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Speaker 1: around things. Yeah, and so we've we've built pipes and

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Speaker 1: tunnels so many psychoanalytical uh fundamentals that really Freud just

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Speaker 1: meant as a flick off to our poor intellect. Well, yeah,

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Speaker 1: and I mean postpartum depression certainly was not left out

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Speaker 1: of Freudian theories. Uh. There were some Freudian inspired theories

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Speaker 1: in the nineteen twenties suggesting that postpartum symptoms were a

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Speaker 1: result of things like frigidity because you know, women suppressed homosexuality,

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Speaker 1: or good old and sestuous urges. But see again, what

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Speaker 1: if he were being sarcastic, like, oh yeah, it's definitely rigidity, right, guys, Right,

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Speaker 1: I think I'd like him more, but would probably grow

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Speaker 1: tired of him faster if that were the case. Yeah, yeah,

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Speaker 1: like futtle Freud. And then like ten minutes into your

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Speaker 1: first drink at the bar, you're like, all right, someone,

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Speaker 1: get this guy out of here. Can you just beat

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Speaker 1: Can you just say it with a straight face? Freud? Yeah,

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Speaker 1: I'm very confused as our decades and decades of other people. Um,

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Speaker 1: and after a quick break, we're going to tell you

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Speaker 1: some of the things that actually contribute to postpartum symptoms. Well,

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Speaker 1: actually I'm still Freud at the bar. Sorry, you'll go now.

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Speaker 1: So it's no news that our hormones spike quite a

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Speaker 1: bit during pregnancy and especially during childbirth. Um. Depending on

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00:27:02,640 --> 00:27:07,240
Speaker 1: the hormones we're talking about levels might escalate more than

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Speaker 1: a hundred fold, especially with things like estrogen, progesterone, and

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00:27:12,680 --> 00:27:17,440
Speaker 1: prolactin um, all of which are intended to help your

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00:27:17,480 --> 00:27:21,520
Speaker 1: body get a baby out of it, also helps said

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00:27:21,800 --> 00:27:24,440
Speaker 1: body bond to this thing. That's just put you through

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00:27:24,480 --> 00:27:29,480
Speaker 1: a lot of physical pain. Um, which is good. That's

399
00:27:29,520 --> 00:27:35,040
Speaker 1: smart evolution, good job. But for every action, there's a reaction.

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Speaker 1: There's like a Newtonian post maternal law here where when

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00:27:40,920 --> 00:27:45,840
Speaker 1: those hormones go up, they eventually go back down. Hormone

402
00:27:45,880 --> 00:27:49,640
Speaker 1: gravity total sense. Your hormones are shaped like apples. That's

403
00:27:49,760 --> 00:27:51,840
Speaker 1: that's a lie. Please don't write that down. And that's

404
00:27:51,880 --> 00:27:58,440
Speaker 1: the ovaries tiny little minor fiji um after birth. Estrogen

405
00:27:58,560 --> 00:28:04,520
Speaker 1: and progesterone a plummet after having spiked really hard during pregnancy,

406
00:28:04,680 --> 00:28:08,119
Speaker 1: and not so surprisingly, this can sort of disrupt your

407
00:28:08,160 --> 00:28:11,280
Speaker 1: brain chemistry a little bit. Other hormones produced by your

408
00:28:11,320 --> 00:28:14,359
Speaker 1: thyroid also may drop sharply, and that can leave you

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Speaker 1: feeling super tired, sluggish, and depressed. Not to mention, testing

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00:28:18,359 --> 00:28:22,119
Speaker 1: positive for thyroid antibodies during pregnancy does put you in

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Speaker 1: an elevated risk of postpartum depression. And I have a

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Speaker 1: thyroid condition, and every time I go see any doctor

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Speaker 1: because I just turned thirty three, they're all like, so,

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00:28:32,080 --> 00:28:33,879
Speaker 1: what are your baby plants? Do you have any baby plans?

415
00:28:33,960 --> 00:28:36,159
Speaker 1: Because you know your thyroid, you you really need to

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00:28:36,160 --> 00:28:38,560
Speaker 1: be on lebo thyroxine if you're going to get pregnant

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00:28:38,680 --> 00:28:45,280
Speaker 1: and testing positive for those thyroid antibodies would potentially be

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Speaker 1: linked to postpartum depression down the road because of the

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00:28:49,160 --> 00:28:53,040
Speaker 1: critical role that our thyroid plays in hormone production. Yeah,

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Speaker 1: I mean, there's there's your Your thyroid is obviously a

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00:28:56,200 --> 00:28:58,760
Speaker 1: critical part of your innocrine system, and there's all sorts

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00:28:58,920 --> 00:29:02,200
Speaker 1: of things whether you are pregnant or not, that it

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00:29:02,240 --> 00:29:06,080
Speaker 1: can affect. But studies have shown that, for instance, if

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00:29:06,160 --> 00:29:10,840
Speaker 1: you have poorly controlled hyper thyroidism during pregnancy, you might

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00:29:11,000 --> 00:29:13,520
Speaker 1: have an increased risk of things like miscarriage and still birth,

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Speaker 1: um preterm birth, maternal heart failure. I mean, the connection

427
00:29:18,960 --> 00:29:22,640
Speaker 1: with postpartum depression is just one factor of so many

428
00:29:22,800 --> 00:29:26,680
Speaker 1: things that potentially could go wrong if you have uncontrolled

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00:29:27,000 --> 00:29:29,680
Speaker 1: fire right issues when you are pregnant. And so my,

430
00:29:30,360 --> 00:29:32,800
Speaker 1: when I went to a terrible indo chronologist who like

431
00:29:32,880 --> 00:29:35,680
Speaker 1: did all sorts of shamy behaviors. One of the things

432
00:29:35,760 --> 00:29:37,600
Speaker 1: that she did tell me was that if I, if

433
00:29:37,640 --> 00:29:39,280
Speaker 1: I were to get pregnant, I would need to go

434
00:29:39,520 --> 00:29:43,280
Speaker 1: back on thyroid medication to counteract any of those potential

435
00:29:43,360 --> 00:29:47,000
Speaker 1: negative effects that my hype both thyroidism and Hoshi Meadows

436
00:29:47,000 --> 00:29:52,520
Speaker 1: disease could lead to gotcha. Um. There's also uh potential

437
00:29:52,720 --> 00:29:57,400
Speaker 1: genetic component, no surprise. Uh. Some women are just genetically

438
00:29:57,600 --> 00:30:01,920
Speaker 1: predisposed to being more sense tive to hormone changes, whether

439
00:30:02,160 --> 00:30:07,960
Speaker 1: it's happening during puberty, menopause, menstruation, if you are on

440
00:30:08,120 --> 00:30:12,640
Speaker 1: treatments with fertility drugs, some of our brains are just

441
00:30:13,120 --> 00:30:17,200
Speaker 1: a little more like, oh whoa, hey there, Hey, they're progesterone.

442
00:30:19,640 --> 00:30:23,080
Speaker 1: Is the progester um tickling the brain, Just make it

443
00:30:23,080 --> 00:30:26,120
Speaker 1: a little nervous, Just just goose in it a lot. Yeah,

444
00:30:27,080 --> 00:30:29,560
Speaker 1: because you don't really know what it's gonna do. It's

445
00:30:29,560 --> 00:30:33,400
Speaker 1: got those pig mickey mouse hands. Who knows um and

446
00:30:33,520 --> 00:30:36,480
Speaker 1: yeah there. There have been a couple of different studies

447
00:30:36,560 --> 00:30:42,080
Speaker 1: looking into specifically genetic links between um our hormones and

448
00:30:42,240 --> 00:30:48,200
Speaker 1: postpartum and researchers are hoping that through this research, within

449
00:30:48,320 --> 00:30:52,160
Speaker 1: the next twenty years we might have a genetic test

450
00:30:52,280 --> 00:30:56,480
Speaker 1: for PPD, even though we've realized that this is some

451
00:30:56,640 --> 00:31:00,600
Speaker 1: kind of issue since Hippocrates is his day. This is

452
00:31:00,840 --> 00:31:05,960
Speaker 1: indeed that's listeners. Am I alone and being dumbfounded by that?

453
00:31:06,800 --> 00:31:08,680
Speaker 1: I don't. I don't think so at all. But Christen,

454
00:31:08,720 --> 00:31:11,719
Speaker 1: it doesn't stop there. There is more hormone fun uh

455
00:31:11,760 --> 00:31:16,280
Speaker 1: and two separate studies, levels of placential cortico trope and

456
00:31:16,360 --> 00:31:20,880
Speaker 1: releasing hormone, which is a peptide hormone and neurotransmitter involved

457
00:31:20,920 --> 00:31:26,920
Speaker 1: in your stretch response stress respection, and the hormone beta endorphin,

458
00:31:27,360 --> 00:31:30,480
Speaker 1: which dolls pain after a traumatic event and which causes

459
00:31:30,520 --> 00:31:35,440
Speaker 1: that runners high thing experiencing those during pregnancy may predict

460
00:31:35,520 --> 00:31:40,440
Speaker 1: weather women develop PPD. But again, that's two studies, you know,

461
00:31:40,520 --> 00:31:43,640
Speaker 1: And I'm sure there are more studies prodding and poking

462
00:31:43,680 --> 00:31:47,520
Speaker 1: at these ideas. But I included that not because I'm

463
00:31:47,680 --> 00:31:51,200
Speaker 1: so sure of what this means, but to illustrate, like, yes,

464
00:31:51,280 --> 00:31:54,200
Speaker 1: there are possible links, we just don't know for sure

465
00:31:54,320 --> 00:31:58,320
Speaker 1: yet um. And so researchers are now looking into how

466
00:31:58,560 --> 00:32:02,640
Speaker 1: stressed during pregnancy affects these hormones that will then affect

467
00:32:02,760 --> 00:32:06,480
Speaker 1: like a domino effect. Uh. Postpartum anxiety and depression, and

468
00:32:06,600 --> 00:32:12,120
Speaker 1: how something like even yoga practice might protect against some

469
00:32:12,320 --> 00:32:14,960
Speaker 1: of these hormonal imbalances. And we also need to mention

470
00:32:15,120 --> 00:32:20,320
Speaker 1: how hormonal issues are extremely pertinent for transgender men who

471
00:32:20,440 --> 00:32:23,720
Speaker 1: get pregnant because a lot of the time they will

472
00:32:24,280 --> 00:32:29,080
Speaker 1: have to stop hormone therapy during pregnancy, which can potentially

473
00:32:29,200 --> 00:32:36,160
Speaker 1: lead to gender dysphoria UM. And since trans people on

474
00:32:36,280 --> 00:32:41,600
Speaker 1: the whole have a higher rate of depression and suicidality

475
00:32:42,240 --> 00:32:44,320
Speaker 1: UM O, B g U, I, N S and researchers

476
00:32:44,320 --> 00:32:47,840
Speaker 1: who are starting to really look into the kind of

477
00:32:48,040 --> 00:32:54,160
Speaker 1: tailored care specifically for UM trans pre and postnatal patients

478
00:32:54,720 --> 00:32:59,440
Speaker 1: UM are focusing on the right way to sort of

479
00:32:59,520 --> 00:33:03,920
Speaker 1: manage these hormonal transitions for them both you know, during

480
00:33:04,000 --> 00:33:07,400
Speaker 1: pregnancy and then after, like how once you segue back

481
00:33:07,480 --> 00:33:13,400
Speaker 1: onto UM hormonal treatments UM while also you know, bonding

482
00:33:13,440 --> 00:33:18,200
Speaker 1: initially with the infant. Yeah, And I mean there's also

483
00:33:18,320 --> 00:33:21,360
Speaker 1: so many obvious emotional issues going on too that can

484
00:33:21,400 --> 00:33:25,000
Speaker 1: contribute to feelings of anxiety and depression during and after birth.

485
00:33:25,080 --> 00:33:28,400
Speaker 1: I mean, you're already sleep deprived and overwhelmed. Uh, You're

486
00:33:28,440 --> 00:33:32,240
Speaker 1: already potentially having trouble handling even minor problems that arise.

487
00:33:32,720 --> 00:33:35,920
Speaker 1: You're probably going to feel anxious about that ability to

488
00:33:36,000 --> 00:33:40,680
Speaker 1: care for a newborn. Uh. But also you know you've

489
00:33:40,720 --> 00:33:44,120
Speaker 1: just had a major life shift, right, You've had a baby. Um,

490
00:33:45,600 --> 00:33:48,560
Speaker 1: I don't know, but I mean, like that throws your

491
00:33:49,240 --> 00:33:55,520
Speaker 1: identity not into crisis, but definitely into like complete reevaluation.

492
00:33:55,960 --> 00:33:59,880
Speaker 1: Uh projecting here, it would throw my identity majorly in

493
00:34:00,040 --> 00:34:05,240
Speaker 1: the crisis completely. Like you go, especially if you have

494
00:34:06,080 --> 00:34:08,680
Speaker 1: you know, a sexual partner who's like there with you,

495
00:34:09,000 --> 00:34:12,920
Speaker 1: like sexual for life partner who's there with you. Um,

496
00:34:13,840 --> 00:34:18,239
Speaker 1: becoming a mother and just the physical trauma that can

497
00:34:18,360 --> 00:34:26,359
Speaker 1: happen uh, and all of the difficulties sometimes with babies, uh,

498
00:34:26,560 --> 00:34:29,160
Speaker 1: latching on or not latching in, the pain that can

499
00:34:29,200 --> 00:34:35,080
Speaker 1: come along with breastfeeding, and just that entire shift of

500
00:34:36,000 --> 00:34:44,160
Speaker 1: transitioning into becoming a mother again. Like, Uh, this episode

501
00:34:44,200 --> 00:34:47,319
Speaker 1: honestly has made me realize a lot of childbirth fears

502
00:34:47,320 --> 00:34:49,239
Speaker 1: I didn't realize that I had because I just I

503
00:34:49,480 --> 00:34:54,120
Speaker 1: can't imagine like even just that conceptualizing that identity shift. Yeah,

504
00:34:54,520 --> 00:34:57,120
Speaker 1: And I mean again, that goes back to so many discussions,

505
00:34:57,160 --> 00:35:00,279
Speaker 1: even like celebrity interviews and magazines you know, you it's

506
00:35:00,880 --> 00:35:05,000
Speaker 1: so common to read these quotes about like, oh, I've

507
00:35:05,080 --> 00:35:08,399
Speaker 1: never loved like this before. You know, my life has

508
00:35:08,480 --> 00:35:11,239
Speaker 1: new meaning blah blah blah. So you can imagine it's

509
00:35:11,320 --> 00:35:14,279
Speaker 1: that much harder for a person who doesn't feel that

510
00:35:14,680 --> 00:35:17,120
Speaker 1: to feel that they can come forward and talk about

511
00:35:17,200 --> 00:35:20,000
Speaker 1: it because they I'm sure that feelings of shame will

512
00:35:20,040 --> 00:35:22,480
Speaker 1: come along with that, feelings of not being normal, of

513
00:35:22,640 --> 00:35:26,640
Speaker 1: of feeling something that might be taboo or just not

514
00:35:26,960 --> 00:35:31,040
Speaker 1: talked about because everyone around you is waiting for your joy. Yeah,

515
00:35:31,239 --> 00:35:34,240
Speaker 1: you know, I mean, there is there's a script essentially

516
00:35:34,400 --> 00:35:36,920
Speaker 1: that we could print out in hand to you for

517
00:35:37,080 --> 00:35:41,080
Speaker 1: what for the way that we expect new mothers and

518
00:35:41,160 --> 00:35:44,759
Speaker 1: new parents to be reacting. And it's very it's a

519
00:35:44,880 --> 00:35:47,960
Speaker 1: very limited role, yeah, exactly. And the thing is, I mean,

520
00:35:48,040 --> 00:35:52,480
Speaker 1: postpartum depression and anxiety can just like a depression and

521
00:35:52,560 --> 00:35:56,080
Speaker 1: anxiety can really strike any woman of any age, ethnicity,

522
00:35:56,280 --> 00:36:00,520
Speaker 1: socio economic background, education, whatever. It doesn't discriminate, but there

523
00:36:00,560 --> 00:36:03,279
Speaker 1: are some things that put you at higher risk. UM

524
00:36:03,440 --> 00:36:06,080
Speaker 1: if you have a personal or family history of depression

525
00:36:06,200 --> 00:36:09,759
Speaker 1: or bipolar disorder. UM, if you've experienced stressful events in

526
00:36:09,840 --> 00:36:14,480
Speaker 1: the past year, maybe you've had pregnancy complications, illness, financial problems, UM,

527
00:36:15,280 --> 00:36:17,800
Speaker 1: if you're having problems with your significant other or have

528
00:36:17,920 --> 00:36:22,279
Speaker 1: a weak support system, or if you've had difficulty breastfeeding. UM.

529
00:36:22,560 --> 00:36:25,920
Speaker 1: There's also a lot of links between an unplanned or

530
00:36:26,000 --> 00:36:30,040
Speaker 1: unwanted pregnancy and postpartum depression. Or if your baby is

531
00:36:30,120 --> 00:36:33,080
Speaker 1: experiencing health problems or other special needs, or if your

532
00:36:33,160 --> 00:36:38,279
Speaker 1: doctor made you go off all of your antidepressants and

533
00:36:38,360 --> 00:36:44,440
Speaker 1: mood stabilizers. Yeah, well yeah, exactly. So the good news

534
00:36:45,040 --> 00:36:50,560
Speaker 1: in this is that screening is starting to be a

535
00:36:50,760 --> 00:36:54,600
Speaker 1: more common and even required practice. But when we talk

536
00:36:54,640 --> 00:36:59,319
Speaker 1: about screening, we're only talking about postpartum depression. There still

537
00:36:59,480 --> 00:37:03,920
Speaker 1: is not enough screening um, if at all, for postpartum anxiety.

538
00:37:04,880 --> 00:37:06,320
Speaker 1: And I mean, you've got to keep in mind that

539
00:37:06,560 --> 00:37:09,200
Speaker 1: screening can be difficult because a lot of the symptoms

540
00:37:09,239 --> 00:37:13,600
Speaker 1: that we've talked about also overlap with just having a baby.

541
00:37:13,960 --> 00:37:18,399
Speaker 1: You're tired, you're anxious, I mean, your whole life has

542
00:37:18,440 --> 00:37:22,839
Speaker 1: just changed, your identity has shifted. UM. And also it's

543
00:37:22,880 --> 00:37:27,520
Speaker 1: worth noting that screening tools in general poorly represent the

544
00:37:27,640 --> 00:37:32,040
Speaker 1: diverse cultures that exist in America alone. UH and studies

545
00:37:32,080 --> 00:37:38,040
Speaker 1: have traditionally been on white women. So again, yeah, childbirth, motherhood,

546
00:37:38,239 --> 00:37:41,160
Speaker 1: mental health, they all are thought about and talked about

547
00:37:41,200 --> 00:37:43,560
Speaker 1: differently around the world, but even here in America, these

548
00:37:43,640 --> 00:37:46,719
Speaker 1: issues are thought of and talked about differently. You know.

549
00:37:46,800 --> 00:37:50,640
Speaker 1: We read some pieces from women of color who had

550
00:37:50,719 --> 00:37:55,040
Speaker 1: experienced either postpartum depression or anxiety, and their friends told

551
00:37:55,080 --> 00:37:57,840
Speaker 1: them that's a white woman's disease, Like get over it.

552
00:37:57,960 --> 00:38:00,560
Speaker 1: You need to be a strong mother. Um. And so

553
00:38:00,760 --> 00:38:05,560
Speaker 1: screening for postpartum depression specifically is mandatory in just one

554
00:38:05,680 --> 00:38:09,759
Speaker 1: state in the United States, it's New Jersey. But research

555
00:38:09,960 --> 00:38:12,959
Speaker 1: on this mandatory screening that was following low income women

556
00:38:13,080 --> 00:38:16,960
Speaker 1: shows that it didn't really contribute to higher rates of treatment,

557
00:38:17,040 --> 00:38:19,320
Speaker 1: which you would think would be the goal of Like, Okay,

558
00:38:19,640 --> 00:38:22,000
Speaker 1: we're screening you, you have some risk factors. Let's get

559
00:38:22,080 --> 00:38:25,960
Speaker 1: you monitored and treated. But all of this feels like

560
00:38:26,480 --> 00:38:30,640
Speaker 1: too little, too late. Um. Not not to discount the

561
00:38:30,719 --> 00:38:34,719
Speaker 1: importance of screening, but I'm just saying there is more

562
00:38:34,800 --> 00:38:37,399
Speaker 1: screen that we should be doing before the baby even

563
00:38:37,520 --> 00:38:41,440
Speaker 1: comes out. So The New York Times reported in January

564
00:38:42,800 --> 00:38:47,279
Speaker 1: that a federal panel recommended that all pregnant women and

565
00:38:47,800 --> 00:38:52,799
Speaker 1: new moms or dads should be screened for depression. Um.

566
00:38:53,719 --> 00:38:57,399
Speaker 1: But here's the thing that piece in the Washington Post

567
00:38:57,520 --> 00:39:04,040
Speaker 1: noted is that the postpartment depression screening is usually conducted

568
00:39:04,239 --> 00:39:08,800
Speaker 1: with something called the Edinburgh Postnatal Depression Scale, which is

569
00:39:09,480 --> 00:39:15,920
Speaker 1: uh ten item questionnaire that only assesses symptoms for the

570
00:39:16,080 --> 00:39:20,839
Speaker 1: past seven days. Uh. So that doesn't take into account, uh,

571
00:39:20,960 --> 00:39:25,000
Speaker 1: the length of your mental anguish you might have been

572
00:39:25,040 --> 00:39:29,040
Speaker 1: going through discomfort, nor does it account for symptoms severity.

573
00:39:29,360 --> 00:39:33,840
Speaker 1: So even even with this screening, there could be a

574
00:39:34,080 --> 00:39:37,719
Speaker 1: lot a lot of people who are being missed. Yeah.

575
00:39:37,920 --> 00:39:41,320
Speaker 1: And then of course you have issues of insurance and

576
00:39:42,280 --> 00:39:47,680
Speaker 1: coverage and support especially that are arising now with the

577
00:39:47,800 --> 00:39:52,520
Speaker 1: changing administration and calls to dismantle Obamacare. I mean, Obamacare

578
00:39:52,640 --> 00:39:57,400
Speaker 1: has called for more funds for postpartum depression research, education

579
00:39:57,600 --> 00:40:02,560
Speaker 1: and support services, but Congress didn't appropriate them, and frankly,

580
00:40:02,640 --> 00:40:06,960
Speaker 1: if I get a little editorially, I doubt that they

581
00:40:07,040 --> 00:40:10,520
Speaker 1: will appropriate them now. But one of the consequences of

582
00:40:10,680 --> 00:40:16,759
Speaker 1: being screened for postpartum depression is that life and disability

583
00:40:16,800 --> 00:40:20,440
Speaker 1: insurance providers have sometimes penalized women with these mental illnesses

584
00:40:20,760 --> 00:40:24,960
Speaker 1: by charging them more money. Uh. They might exclude mental

585
00:40:25,000 --> 00:40:28,080
Speaker 1: illness from coverage or decline to cover them at all,

586
00:40:28,200 --> 00:40:31,080
Speaker 1: And so basically, life insurance companies are like, are you

587
00:40:31,200 --> 00:40:35,000
Speaker 1: going to kill yourself? And disability insurers are trying to

588
00:40:35,080 --> 00:40:37,600
Speaker 1: guess your likelihood of being unable to work because of

589
00:40:37,680 --> 00:40:41,960
Speaker 1: mental illness, and like, another layer of terrible in all

590
00:40:42,040 --> 00:40:47,000
Speaker 1: of this is because pregnant women who are experiencing symptoms

591
00:40:47,040 --> 00:40:50,840
Speaker 1: of depression or anxiety tend to get lumped in with

592
00:40:51,040 --> 00:40:55,120
Speaker 1: the larger pool of people in general diagnosed with these issues,

593
00:40:55,360 --> 00:40:58,400
Speaker 1: which means that people with mild or moderate cases or

594
00:40:58,440 --> 00:41:02,640
Speaker 1: cases that have already cleared up might be facing higher rates.

595
00:41:02,800 --> 00:41:06,480
Speaker 1: And what is contributing to all this is really part

596
00:41:06,520 --> 00:41:09,720
Speaker 1: of why we're talking about it today. It's the underdiagnosis

597
00:41:10,520 --> 00:41:14,400
Speaker 1: and really under discussion of postpartum depression that means that

598
00:41:14,480 --> 00:41:17,960
Speaker 1: insurance companies simply do not have a ton of long

599
00:41:18,080 --> 00:41:20,279
Speaker 1: term data to base their rates on. There basing their

600
00:41:20,360 --> 00:41:24,400
Speaker 1: rates on all of the other people in their networks

601
00:41:24,480 --> 00:41:27,080
Speaker 1: that are depressed or anxious and have to go on

602
00:41:27,200 --> 00:41:31,120
Speaker 1: medicine or seek therapy or or whatever um and so

603
00:41:32,080 --> 00:41:36,320
Speaker 1: these companies are just not really sure what has happened,

604
00:41:36,360 --> 00:41:39,760
Speaker 1: what has gone on to happen with pregnancy related mental

605
00:41:39,800 --> 00:41:41,640
Speaker 1: health issues down the road. And if there are any

606
00:41:41,719 --> 00:41:46,040
Speaker 1: listeners with expertise on this who could phillis in on

607
00:41:46,280 --> 00:41:49,800
Speaker 1: on why this could or could not be a question

608
00:41:49,880 --> 00:41:54,400
Speaker 1: that I have is why more innovative, say insurance companies

609
00:41:54,480 --> 00:41:59,399
Speaker 1: aren't looking into treating this more as preventative care, both

610
00:41:59,520 --> 00:42:05,000
Speaker 1: for the person giving birth and also for the baby

611
00:42:05,080 --> 00:42:07,400
Speaker 1: that was just birth. And you have to wonder if

612
00:42:07,440 --> 00:42:10,040
Speaker 1: it's not linked though that particular issue. And again I

613
00:42:10,080 --> 00:42:11,600
Speaker 1: would love to hear from listeners too, but you have

614
00:42:11,680 --> 00:42:14,680
Speaker 1: to wonder if that's not linked to earlier studies and

615
00:42:14,840 --> 00:42:18,600
Speaker 1: standard advice telling women to get off all medications, whether

616
00:42:18,719 --> 00:42:21,520
Speaker 1: it is an antidepressant or whether it's like cholesterol medication,

617
00:42:21,640 --> 00:42:26,840
Speaker 1: you know, like um. The standard advice has been don't smoke,

618
00:42:26,920 --> 00:42:29,480
Speaker 1: don't drink, don't take any drugs, whether they're illegal or

619
00:42:29,520 --> 00:42:33,279
Speaker 1: prescription or freaking coughs, r up or whatever, um. And

620
00:42:33,520 --> 00:42:36,640
Speaker 1: so many women are so understandably anxious about not wanting

621
00:42:36,680 --> 00:42:40,319
Speaker 1: to harm their fetus that a lot of them are

622
00:42:40,440 --> 00:42:43,680
Speaker 1: willing to go off even if it does mean experiencing

623
00:42:43,719 --> 00:42:47,080
Speaker 1: these horrific consequences. And after we come back from a

624
00:42:47,160 --> 00:42:49,239
Speaker 1: quick break we are going to get more into that

625
00:42:49,440 --> 00:43:07,160
Speaker 1: issue of pregnancy and antidepressants. So the prevailing advice for

626
00:43:08,040 --> 00:43:13,240
Speaker 1: women wanting to get pregnant who have been on antidepressants,

627
00:43:13,600 --> 00:43:18,840
Speaker 1: SSR eyes, mood stabilizers, et cetera, is that they gotta

628
00:43:18,840 --> 00:43:23,719
Speaker 1: get off them. The best thing for the fetus is

629
00:43:24,920 --> 00:43:31,000
Speaker 1: a medication free body, and ultimately in terms of completely

630
00:43:31,040 --> 00:43:38,239
Speaker 1: and totally mitigating risks, yes, um, getting off medication can

631
00:43:38,960 --> 00:43:44,160
Speaker 1: do that, but logic around that is changing because of

632
00:43:44,360 --> 00:43:46,680
Speaker 1: all of these issues that we're talking about in terms

633
00:43:46,800 --> 00:43:51,360
Speaker 1: of the very real issue of needing to manage moms,

634
00:43:51,840 --> 00:43:59,160
Speaker 1: moms to bees mental and maternal health. Yeah. So again,

635
00:43:59,239 --> 00:44:02,080
Speaker 1: you know, we mentioned earlier in the podcast that research

636
00:44:03,000 --> 00:44:06,400
Speaker 1: between mental health, S s R eyes and pregnancy and

637
00:44:06,760 --> 00:44:10,759
Speaker 1: PPD has been stymy because again, you can't do these

638
00:44:11,000 --> 00:44:15,480
Speaker 1: blind tests on pregnant mothers. So even though there have

639
00:44:15,640 --> 00:44:17,279
Speaker 1: been a lot of there has been a lot of

640
00:44:17,320 --> 00:44:20,840
Speaker 1: research into S s R eyes, some of the questions

641
00:44:20,880 --> 00:44:23,520
Speaker 1: are like, is it the S s R I causing

642
00:44:24,040 --> 00:44:28,640
Speaker 1: potential issues with the fetus? Is the depression itself causing it?

643
00:44:28,880 --> 00:44:31,920
Speaker 1: The erratic behaviors that can come along with severe depression,

644
00:44:32,040 --> 00:44:36,040
Speaker 1: things like risky behavior, smoking, drinking, uh, not treating yourself well,

645
00:44:36,160 --> 00:44:40,719
Speaker 1: missing appointments, sleeping irregularly, just a stressed body. Yeah, exactly,

646
00:44:40,880 --> 00:44:43,560
Speaker 1: and so um they do know researchers, do you know

647
00:44:43,680 --> 00:44:46,560
Speaker 1: that S S R, E, s UM don't cause a

648
00:44:46,680 --> 00:44:51,719
Speaker 1: clinically significant risk of major birth effects? Your risk from miscarriage,

649
00:44:51,800 --> 00:44:55,440
Speaker 1: preterm birth, and low birth weight are somewhat heightened, and

650
00:44:55,520 --> 00:44:59,080
Speaker 1: they slightly increase the risk for pulmonary hypertension in newborns.

651
00:44:59,160 --> 00:45:04,160
Speaker 1: But here's the thing, ing like, what's worse because untreated

652
00:45:04,800 --> 00:45:10,759
Speaker 1: depression and anxiety during pregnancy has also been linked to miscarriage,

653
00:45:11,080 --> 00:45:15,080
Speaker 1: pre eclampsi, a pre term birth, neonatal complications, and smaller

654
00:45:16,000 --> 00:45:20,319
Speaker 1: newborns in general. And Elizabeth Fiddleson, who is over at

655
00:45:20,360 --> 00:45:24,000
Speaker 1: Columbia University, said that for about ten percent of my patients,

656
00:45:24,080 --> 00:45:26,200
Speaker 1: I can readily say that they don't need medication and

657
00:45:26,200 --> 00:45:30,359
Speaker 1: should go off of it. Another absolutely have to stay

658
00:45:30,520 --> 00:45:33,480
Speaker 1: on medication people who have made a suicide attempt every

659
00:45:33,520 --> 00:45:39,080
Speaker 1: time they've been unmedicated. For the remaining seventy percent, it's

660
00:45:39,120 --> 00:45:43,840
Speaker 1: a venture into the unknowable. That's frightening, that almost feels

661
00:45:43,960 --> 00:45:47,359
Speaker 1: chilling to read that that, like, we don't know enough,

662
00:45:47,400 --> 00:45:51,360
Speaker 1: because again, everybody is different, every hormonal makeup is different,

663
00:45:51,800 --> 00:45:55,080
Speaker 1: every pregnancy is different, and so the fact that like, yes,

664
00:45:55,600 --> 00:45:57,520
Speaker 1: you can go off and be safe, you have to

665
00:45:57,560 --> 00:46:00,320
Speaker 1: stay on to stay safe. But for the most of you,

666
00:46:01,440 --> 00:46:06,080
Speaker 1: anything could happen. And I'm not surprised at all that

667
00:46:07,160 --> 00:46:13,600
Speaker 1: in it's still a venture into the unknowable UM, because

668
00:46:14,040 --> 00:46:16,200
Speaker 1: a like, I think that for us to even get

669
00:46:16,280 --> 00:46:21,840
Speaker 1: to this point to where women would be afforded the

670
00:46:21,960 --> 00:46:29,000
Speaker 1: possibility that their mental health might um deserve as much

671
00:46:29,040 --> 00:46:33,960
Speaker 1: attention as fetal health, say, UM, is a reflection of

672
00:46:34,200 --> 00:46:38,680
Speaker 1: and had to be preceded by gender equality, you know,

673
00:46:38,840 --> 00:46:42,680
Speaker 1: and women's rising role in society and also in medicine

674
00:46:42,719 --> 00:46:45,320
Speaker 1: in general. UM. I don't think that we would be

675
00:46:45,400 --> 00:46:47,279
Speaker 1: talking about this if it were still the old days

676
00:46:47,440 --> 00:46:49,440
Speaker 1: of only dude doctors who thought that it was just

677
00:46:49,640 --> 00:46:52,960
Speaker 1: like you know, uterus juice in our eyes causing all

678
00:46:53,000 --> 00:46:58,280
Speaker 1: of this. UM. Because also up until now, up until

679
00:46:58,760 --> 00:47:02,719
Speaker 1: you know, women have of really become more of their

680
00:47:02,760 --> 00:47:08,040
Speaker 1: own health advocates more loudly, UM, and also doctors speaking

681
00:47:08,080 --> 00:47:12,000
Speaker 1: out on our behalf as well. UM. Again, part of

682
00:47:12,080 --> 00:47:17,080
Speaker 1: that motherhood's script is that you will sacrifice everything for

683
00:47:18,360 --> 00:47:20,200
Speaker 1: the good of your baby. I mean, it's it's it

684
00:47:20,280 --> 00:47:24,440
Speaker 1: goes to um. The conversation that we had a while

685
00:47:24,560 --> 00:47:29,680
Speaker 1: back with Longest Shortest Time host Hilary Frank and how

686
00:47:30,760 --> 00:47:35,680
Speaker 1: women who are experiencing anxiety, trauma, or depression around their

687
00:47:35,800 --> 00:47:39,279
Speaker 1: birth are helped in no way by people saying, well,

688
00:47:39,320 --> 00:47:41,279
Speaker 1: at least the baby was healthy. The only thing that

689
00:47:41,320 --> 00:47:44,160
Speaker 1: matters is that you have a healthy baby, And that's

690
00:47:44,200 --> 00:47:47,319
Speaker 1: been the prevailing mindset. UM. But the more we are

691
00:47:47,360 --> 00:47:50,840
Speaker 1: now learning and destigmatizing these kinds of health care issues,

692
00:47:52,120 --> 00:47:56,279
Speaker 1: we are having to question how true that really is.

693
00:47:56,600 --> 00:47:59,400
Speaker 1: And this is nothing against babies, y'all. I'm all for

694
00:47:59,520 --> 00:48:03,520
Speaker 1: healthy all the babies listening. You're okay, but don't write

695
00:48:03,600 --> 00:48:06,960
Speaker 1: us letters. But the healthier, the healthier parents can be

696
00:48:07,120 --> 00:48:10,640
Speaker 1: as well, the healthier that baby is probably going to

697
00:48:10,719 --> 00:48:12,880
Speaker 1: be developed mentally, I would I would think, I mean,

698
00:48:12,960 --> 00:48:16,560
Speaker 1: generally speaking, broad strokes, I mean, that's that's literally true.

699
00:48:17,000 --> 00:48:21,000
Speaker 1: Christina Hibbert, who's the founder of the Arizona Postpartum Wellness Coalition,

700
00:48:21,200 --> 00:48:25,400
Speaker 1: calls PPD a familial disease because when it's untreated, it

701
00:48:25,440 --> 00:48:28,839
Speaker 1: can interfere with bonding and cause massive family stress. Uh

702
00:48:28,920 --> 00:48:32,960
Speaker 1: and mothers to start. Untreated PPD increases the risk not

703
00:48:33,080 --> 00:48:36,520
Speaker 1: surprisingly a future episodes of major depression. Moms might be

704
00:48:36,680 --> 00:48:40,560
Speaker 1: less likely to initiate or maintain breastfeeding. Infanticide, though of

705
00:48:40,640 --> 00:48:44,040
Speaker 1: course it's rare, can occur because of neglect or abuse.

706
00:48:44,280 --> 00:48:48,080
Speaker 1: UM In partners of women with PPD, the risk of

707
00:48:48,120 --> 00:48:52,120
Speaker 1: depression increases. If we're talking and heteronormative couple terms. Up

708
00:48:52,160 --> 00:48:55,040
Speaker 1: to ten pc of new fathers may experience pp D

709
00:48:55,239 --> 00:49:01,680
Speaker 1: along with their female partners, and in the children children

710
00:49:01,760 --> 00:49:06,320
Speaker 1: of moms who experience untreated PPD can experience emotional and

711
00:49:06,400 --> 00:49:10,080
Speaker 1: behavioral issues like sleeping and eating disorders, excessive crying, a

712
00:49:10,239 --> 00:49:12,920
Speaker 1: d h D, and language development delays. They're all more

713
00:49:13,000 --> 00:49:18,239
Speaker 1: common than in children of mothers without depression, but the effects,

714
00:49:18,719 --> 00:49:22,880
Speaker 1: though negative, are really long term, usually only if the

715
00:49:22,960 --> 00:49:26,160
Speaker 1: mother's depression is chronic or entreated so she gets the

716
00:49:26,200 --> 00:49:28,120
Speaker 1: help she needs. If she gets the support she needs

717
00:49:28,320 --> 00:49:31,640
Speaker 1: and can be a better parent to her child, UM,

718
00:49:32,080 --> 00:49:36,240
Speaker 1: that child's negative effects are are likely to be UM lessened.

719
00:49:37,120 --> 00:49:41,279
Speaker 1: And this reminds me of of that Facebook conversation that

720
00:49:41,400 --> 00:49:46,640
Speaker 1: was sparked UM that I mentioned earlier around the essay

721
00:49:46,760 --> 00:49:51,200
Speaker 1: in Cosmopolitan about the struggle of having to go off

722
00:49:51,239 --> 00:49:54,120
Speaker 1: of in a depressants UM during pregnancy and how to

723
00:49:54,200 --> 00:49:56,960
Speaker 1: go back on them. And one thing that really struck

724
00:49:57,080 --> 00:50:00,440
Speaker 1: me in a number of comments that I saw UM

725
00:50:00,600 --> 00:50:03,600
Speaker 1: from women was that, hey, you know what if if

726
00:50:03,840 --> 00:50:08,240
Speaker 1: you know that you have a mood disorder, don't get pregnant,

727
00:50:08,719 --> 00:50:12,719
Speaker 1: don't pass that along potentially to your child. And I

728
00:50:12,800 --> 00:50:15,800
Speaker 1: wanted to raise that issue, UM, to to open this

729
00:50:15,960 --> 00:50:23,040
Speaker 1: up to listeners, because UM, that's that's not a that's

730
00:50:23,080 --> 00:50:27,319
Speaker 1: not a solution in my mind too, I think it's

731
00:50:27,400 --> 00:50:32,120
Speaker 1: unrealistic and unfair and also like I don't need your

732
00:50:32,120 --> 00:50:37,640
Speaker 1: opinion about my body. Yes, and again it also seems

733
00:50:37,719 --> 00:50:43,040
Speaker 1: to reinforce this hierarchy of you know, good mothers versus

734
00:50:43,719 --> 00:50:45,960
Speaker 1: all the way down with like unfit mothers women, you

735
00:50:46,000 --> 00:50:49,480
Speaker 1: have no business being pregnant, UM, And that kind of

736
00:50:49,560 --> 00:50:54,360
Speaker 1: pregnancy shaming UM is absolutely interrelated with all of these

737
00:50:55,200 --> 00:50:57,919
Speaker 1: mental health issues. So UM, I just wanted to toss

738
00:50:58,000 --> 00:51:03,920
Speaker 1: that out there for listeners, whichever side of of that

739
00:51:04,280 --> 00:51:09,759
Speaker 1: argument you might be on, UM, because I I don't know.

740
00:51:09,880 --> 00:51:11,600
Speaker 1: To me, it was just a really it seemed like

741
00:51:11,640 --> 00:51:13,759
Speaker 1: a really cruel thing to say. But I'm also sitting

742
00:51:13,840 --> 00:51:18,759
Speaker 1: here as someone who has a mood disorder, and I, uh,

743
00:51:19,640 --> 00:51:22,880
Speaker 1: I don't know, I would just I would never like,

744
00:51:22,960 --> 00:51:24,880
Speaker 1: why why are you telling me what to do with

745
00:51:25,000 --> 00:51:29,439
Speaker 1: my uterus? But recognizing my own bias, I am saying

746
00:51:29,560 --> 00:51:34,000
Speaker 1: this as someone sitting here with a mood disorder. Well, again,

747
00:51:34,440 --> 00:51:38,960
Speaker 1: as we said, pregnancy is what sparks everybody to have opinions.

748
00:51:39,360 --> 00:51:43,879
Speaker 1: So and you know we mentioned earlier that UM pp

749
00:51:44,000 --> 00:51:46,880
Speaker 1: D and p p A can really strike anyone um

750
00:51:47,000 --> 00:51:49,720
Speaker 1: of any background. But there have been some studies looking

751
00:51:49,840 --> 00:51:52,600
Speaker 1: at different groups in America. There was a a New

752
00:51:52,680 --> 00:51:56,360
Speaker 1: York study looking at Asian Pacific Islander women and found

753
00:51:56,480 --> 00:51:59,200
Speaker 1: that these women were more likely to receive a diagnosis

754
00:52:00,160 --> 00:52:03,279
Speaker 1: after their providers talked to them about their depressed mood,

755
00:52:03,760 --> 00:52:05,960
Speaker 1: but they were less likely than other groups to have

756
00:52:06,080 --> 00:52:10,200
Speaker 1: had this conversation UM. And the significance is that Asian

757
00:52:10,200 --> 00:52:12,960
Speaker 1: and Pacific Islander women who were between fifteen and twenty

758
00:52:13,040 --> 00:52:17,040
Speaker 1: four have the highest rate of depression and suicidality compared

759
00:52:17,080 --> 00:52:20,760
Speaker 1: to any other ethnicity, gender, or age in this country.

760
00:52:20,840 --> 00:52:24,680
Speaker 1: And when it comes to postpartum depression, researchers have found

761
00:52:24,719 --> 00:52:27,520
Speaker 1: that they seemed to have higher rates than black, White,

762
00:52:27,600 --> 00:52:31,160
Speaker 1: and Latina women and are more likely to have had

763
00:52:31,680 --> 00:52:37,400
Speaker 1: pre natal depression. Um. There was another study from Arizona

764
00:52:37,480 --> 00:52:42,480
Speaker 1: State psychologist Linda Leeueken who was researching low income Mexican

765
00:52:42,520 --> 00:52:46,960
Speaker 1: American women and the health disparities that they experienced compared

766
00:52:47,040 --> 00:52:50,200
Speaker 1: with white, middle class women, and they found she found

767
00:52:50,239 --> 00:52:55,560
Speaker 1: that the Mexican American women experience particularly high rates of

768
00:52:55,680 --> 00:53:00,640
Speaker 1: postpartum depression, as much as thirty three percent of new mothers.

769
00:53:00,680 --> 00:53:03,640
Speaker 1: And you know, we mentioned those those average stats earlier

770
00:53:03,680 --> 00:53:06,160
Speaker 1: in the podcast, which hovered around like ten to fifteen,

771
00:53:06,239 --> 00:53:09,920
Speaker 1: and so this is significantly higher. But lou i Can

772
00:53:10,000 --> 00:53:14,120
Speaker 1: found that despite these high rates, this population also sees

773
00:53:14,360 --> 00:53:18,800
Speaker 1: certain protective factors like strong family ties, which keep depression

774
00:53:18,880 --> 00:53:24,400
Speaker 1: rates lower than they would be otherwise among low income mothers. So,

775
00:53:24,840 --> 00:53:27,839
Speaker 1: I mean, yeah, we talked about how there are these

776
00:53:27,880 --> 00:53:31,279
Speaker 1: emotional aspects, not only hormonal and physical going on, but

777
00:53:31,360 --> 00:53:34,520
Speaker 1: also emotional aspects tied up in PPD and p p A,

778
00:53:35,120 --> 00:53:40,080
Speaker 1: and having those strong family supports and ties are so important,

779
00:53:40,200 --> 00:53:43,000
Speaker 1: I mean when it comes to childbirth in general and

780
00:53:43,200 --> 00:53:45,680
Speaker 1: raising children in general, and having a strong family to

781
00:53:45,840 --> 00:53:48,920
Speaker 1: help you but also to support your mental health in

782
00:53:49,000 --> 00:53:52,240
Speaker 1: this case, to quote Hillary Clinton, it takes a village,

783
00:53:52,680 --> 00:53:55,759
Speaker 1: and that's especially true. I've stopped quoting Hillary Clinton at

784
00:53:55,800 --> 00:54:01,680
Speaker 1: this point. That's especially true for low income women. There

785
00:54:01,920 --> 00:54:07,040
Speaker 1: is some ongoing research looking at the connections between postpartum

786
00:54:07,200 --> 00:54:12,799
Speaker 1: depressions specifically and its prevalence among lower income women. UM.

787
00:54:13,080 --> 00:54:16,600
Speaker 1: So the research has found so far that there tends

788
00:54:16,640 --> 00:54:19,959
Speaker 1: to be a higher incidence rate, which makes sense because

789
00:54:20,000 --> 00:54:25,320
Speaker 1: you're coming into this pregnancy likely with more financial stress

790
00:54:25,680 --> 00:54:29,919
Speaker 1: um than you would otherwise. UM. But at the same time,

791
00:54:30,000 --> 00:54:35,560
Speaker 1: like when that's also compounded by ethnicity, Black and Latina

792
00:54:35,640 --> 00:54:41,520
Speaker 1: women had the lowest rates of PPD treatment initiation, which

793
00:54:41,560 --> 00:54:44,560
Speaker 1: didn't necessarily mean that they didn't need it, they simply

794
00:54:44,600 --> 00:54:49,120
Speaker 1: weren't accessing it. And when they did initiate treatment compared

795
00:54:49,160 --> 00:54:52,320
Speaker 1: to white women, they had lower rates of follow ups

796
00:54:52,880 --> 00:54:58,640
Speaker 1: or lower rates of refilling antidepressant prescriptions. UM. And all

797
00:54:58,719 --> 00:55:01,520
Speaker 1: of this is not necessar severally saying like, oh, they're

798
00:55:01,560 --> 00:55:04,359
Speaker 1: so irresponsible. No, this is when we have to pull

799
00:55:04,440 --> 00:55:07,080
Speaker 1: the lens back even farther and look at the barriers

800
00:55:07,200 --> 00:55:12,960
Speaker 1: to care, such as social stigma, communication problems, logistical issues

801
00:55:13,680 --> 00:55:20,080
Speaker 1: like insurance coverage, time constraints, transportation. Um, sometimes mental health

802
00:55:20,200 --> 00:55:23,120
Speaker 1: is simply not accessible. I mean it just you. You

803
00:55:23,320 --> 00:55:28,239
Speaker 1: cannot make it happen. Yeah, And previous studies have suggested

804
00:55:28,320 --> 00:55:32,880
Speaker 1: that addressing those types of logistical challenges and cultural beliefs

805
00:55:32,960 --> 00:55:38,120
Speaker 1: about mental health and addressing communication between patients and providers

806
00:55:38,280 --> 00:55:42,440
Speaker 1: can be helpful in meeting mental health treatment needs in general,

807
00:55:43,320 --> 00:55:46,640
Speaker 1: but also of course that applies to seeking treatment for

808
00:55:47,360 --> 00:55:51,120
Speaker 1: PPD and p p A. And the good news with

809
00:55:51,280 --> 00:55:55,520
Speaker 1: all of this is that we're actually knowing, you know,

810
00:55:55,680 --> 00:55:58,000
Speaker 1: the things that we've just talked about for the past hour.

811
00:55:58,200 --> 00:56:01,000
Speaker 1: You know, it is becoming more common and knowledge clinicians

812
00:56:01,040 --> 00:56:04,560
Speaker 1: are paying closer attention to it. Um. Women are now

813
00:56:04,880 --> 00:56:09,920
Speaker 1: being set up, when possible, with teams of not just

814
00:56:10,440 --> 00:56:17,360
Speaker 1: your delivery doctor, but also perhaps your maternal psychiatrist or

815
00:56:17,640 --> 00:56:19,759
Speaker 1: and and your duel and whoever else it is. You know,

816
00:56:20,520 --> 00:56:24,040
Speaker 1: everyone really needs, like a childbirth squad. It seems like,

817
00:56:24,200 --> 00:56:25,719
Speaker 1: can mine have a dog on it? I'm not going

818
00:56:25,800 --> 00:56:27,440
Speaker 1: to give birth, but I feel like if I had

819
00:56:27,480 --> 00:56:30,279
Speaker 1: a childbirth squad, it would include like a golden retriever. Oh,

820
00:56:31,160 --> 00:56:35,120
Speaker 1: a golden retriever, like a sensible one named like Dr Barbara. Yeah,

821
00:56:35,600 --> 00:56:38,359
Speaker 1: like a therapy golden retriever named Dr Barbara who has

822
00:56:38,520 --> 00:56:42,000
Speaker 1: UM some like thick like Warby Parker style glasses Yeah,

823
00:56:42,040 --> 00:56:45,040
Speaker 1: and a clipboard yeah, because she's I mean, she might

824
00:56:45,080 --> 00:56:48,520
Speaker 1: write with crayons, but she knows what she's talking about. UM.

825
00:56:49,040 --> 00:56:54,560
Speaker 1: And in addition to Dr Barbara's groundbreaking research, UM which

826
00:56:54,640 --> 00:56:58,839
Speaker 1: is just mostly digging holes behind the hospital, but there

827
00:56:59,000 --> 00:57:02,320
Speaker 1: is treatment for PPD and a lot of it starts

828
00:57:03,040 --> 00:57:07,799
Speaker 1: for it, and UM Prenatal and postnatal anxiety as well

829
00:57:09,320 --> 00:57:13,960
Speaker 1: is uh just the awareness and education. It starts with

830
00:57:15,840 --> 00:57:18,880
Speaker 1: having someone that you can talk to or being even

831
00:57:18,960 --> 00:57:22,680
Speaker 1: aware that these are symptoms of something other than oh

832
00:57:22,960 --> 00:57:27,320
Speaker 1: they're just the baby blues don't go away. UM because

833
00:57:27,520 --> 00:57:33,320
Speaker 1: talk therapy and support groups like Postpartum International and Postpartum

834
00:57:33,400 --> 00:57:40,920
Speaker 1: Progress are extremely, extremely vital to helping new parents who

835
00:57:41,000 --> 00:57:45,280
Speaker 1: are dealing with these issues. UM. In fact, medications are

836
00:57:45,560 --> 00:57:50,200
Speaker 1: certainly available and certainly UM vital for some folks. UM.

837
00:57:50,520 --> 00:57:54,200
Speaker 1: But in addition to that, a lot of doctors suggests,

838
00:57:54,400 --> 00:57:58,360
Speaker 1: you know, talk therapy being the first line treatment even

839
00:57:58,520 --> 00:58:02,480
Speaker 1: even if medication and is necessary, you still want to

840
00:58:02,560 --> 00:58:06,920
Speaker 1: include some of that more cognitive behavioral therapy and just

841
00:58:08,280 --> 00:58:11,320
Speaker 1: hanging out and being able to talk to and share

842
00:58:11,440 --> 00:58:13,960
Speaker 1: with people who are going through the same kind of

843
00:58:14,080 --> 00:58:17,280
Speaker 1: thing you are, because it's so isolating. Oh sure, yeah,

844
00:58:17,360 --> 00:58:21,560
Speaker 1: Like I had every Thanksgiving my aunt it was like, so,

845
00:58:21,840 --> 00:58:25,440
Speaker 1: I your mother told me you're in therapy. What do

846
00:58:25,520 --> 00:58:27,680
Speaker 1: you need to go to therapy for? And I was like,

847
00:58:28,000 --> 00:58:34,400
Speaker 1: what what? Everyone needs to go to therapy because I'm

848
00:58:34,440 --> 00:58:38,120
Speaker 1: not just like radically changing the subject. Talking with a

849
00:58:38,200 --> 00:58:41,400
Speaker 1: therapist can really help you find ways to cope with

850
00:58:41,440 --> 00:58:45,200
Speaker 1: how you're feeling, to help you solve problems, set realistic goals,

851
00:58:45,400 --> 00:58:49,720
Speaker 1: and learn how to respond positively. Um And of course,

852
00:58:50,840 --> 00:58:53,720
Speaker 1: don't forget the benefits of couples therapy because, like we

853
00:58:53,800 --> 00:58:57,720
Speaker 1: pointed out earlier, postpartum depression and anxiety can really rattle

854
00:58:57,800 --> 00:59:01,240
Speaker 1: the whole family. And that's right if you're doing the work,

855
00:59:01,280 --> 00:59:04,680
Speaker 1: whether it is therapy or medication or a combination, but

856
00:59:04,840 --> 00:59:08,520
Speaker 1: if the people around you are unaware of how they

857
00:59:08,600 --> 00:59:11,600
Speaker 1: can be helping and changing their behaviors as well, it

858
00:59:11,720 --> 00:59:15,160
Speaker 1: might not be as effective. Um And I did think

859
00:59:15,200 --> 00:59:18,640
Speaker 1: it was interesting slash unfortunate that the United States actually

860
00:59:18,720 --> 00:59:21,760
Speaker 1: lags behind Europe in Australia and creating these things called

861
00:59:21,840 --> 00:59:25,880
Speaker 1: mother baby psychiatric units, and those allow the moms to

862
00:59:26,800 --> 00:59:31,240
Speaker 1: deal with the hormonal and mental health fallout of giving

863
00:59:31,320 --> 00:59:34,720
Speaker 1: birth UM, but it allows them to continue breastfeeding. It

864
00:59:34,880 --> 00:59:39,040
Speaker 1: permits direct doctor observation of the mom and baby interacting,

865
00:59:39,280 --> 00:59:44,480
Speaker 1: and it allows for immediate and constant support. And I

866
00:59:44,640 --> 00:59:46,760
Speaker 1: have a feeling that the type of support that the

867
00:59:46,880 --> 00:59:48,800
Speaker 1: US would need in order to catch up to Europe

868
00:59:48,840 --> 00:59:53,720
Speaker 1: in Australia is um subsidized healthcare, especially if we're talking

869
00:59:53,720 --> 00:59:59,040
Speaker 1: about support for everybody UM. And one bit of advice

870
00:59:59,360 --> 01:00:02,840
Speaker 1: that just came to mind Caroline, that I heard when

871
01:00:03,000 --> 01:00:08,200
Speaker 1: interviewing a few months back a maternal psychiatrist is get

872
01:00:08,280 --> 01:00:16,120
Speaker 1: off the ENDT. So aside from specific organization sites like

873
01:00:16,440 --> 01:00:20,720
Speaker 1: Postpartum Support International, which is at postpartum dot net or

874
01:00:20,840 --> 01:00:25,560
Speaker 1: Postpartum Progress which is at Postpartum progress dot org, a

875
01:00:25,720 --> 01:00:30,520
Speaker 1: lot of what you will find if you are experiencing

876
01:00:31,400 --> 01:00:35,440
Speaker 1: what you think might be uh postpartum anxiety or prepartum

877
01:00:35,480 --> 01:00:39,560
Speaker 1: anxiety or depression. UM, you're gonna want to stay away

878
01:00:39,600 --> 01:00:42,680
Speaker 1: from those message boards and comment threads. They're bad enough

879
01:00:42,760 --> 01:00:45,600
Speaker 1: for like my stomach aches, you know, I can't imagine.

880
01:00:45,880 --> 01:00:48,720
Speaker 1: I mean, the stuff about pregnancy and postpartum issues and

881
01:00:49,320 --> 01:00:53,400
Speaker 1: fetal development. Like there's a lot of judgment in there,

882
01:00:53,560 --> 01:00:57,560
Speaker 1: and there's a lot of very biased and personal opinions,

883
01:00:57,640 --> 01:01:01,240
Speaker 1: and so it is I'm passing along to you doctor

884
01:01:01,360 --> 01:01:05,000
Speaker 1: recommended advice, um to stay off the internet and you know,

885
01:01:05,200 --> 01:01:08,320
Speaker 1: really seek out those support groups you can offer more

886
01:01:08,920 --> 01:01:13,240
Speaker 1: face to face support for you. And having talked to

887
01:01:13,480 --> 01:01:18,640
Speaker 1: people who are part of both postpartum support and national

888
01:01:18,720 --> 01:01:22,320
Speaker 1: and postpartum Progress, I can also tell you, um, from

889
01:01:22,480 --> 01:01:26,040
Speaker 1: from my experience with them, they are so so so

890
01:01:26,280 --> 01:01:30,200
Speaker 1: passionate about what they do because most of them have

891
01:01:30,360 --> 01:01:32,840
Speaker 1: been through this and have seen so many women in

892
01:01:32,920 --> 01:01:37,120
Speaker 1: particular go through this and feel so lost and so alone,

893
01:01:37,280 --> 01:01:39,760
Speaker 1: and they realize that this is just a vital part

894
01:01:39,880 --> 01:01:47,520
Speaker 1: of our health care that's often so inaccessible, even invisible. Um.

895
01:01:47,680 --> 01:01:53,240
Speaker 1: So I'm so grateful to the women out there who

896
01:01:53,920 --> 01:01:59,000
Speaker 1: have been through this and are saying not again, never again,

897
01:01:59,080 --> 01:02:04,320
Speaker 1: who are using their traumatic experiences to energize them to

898
01:02:04,520 --> 01:02:08,680
Speaker 1: become advocates and educators for other women, you know, and

899
01:02:08,800 --> 01:02:12,800
Speaker 1: also the folks in the medical community who have made

900
01:02:13,360 --> 01:02:18,040
Speaker 1: this maternal health care you know, really a cornerstone of

901
01:02:18,080 --> 01:02:21,000
Speaker 1: their work. Yeah, and I would just add, like kind

902
01:02:21,040 --> 01:02:24,040
Speaker 1: of jumping off your earlier points about the Facebook conversation

903
01:02:24,120 --> 01:02:27,080
Speaker 1: that was happening, I would just add, UM that whether

904
01:02:27,280 --> 01:02:31,360
Speaker 1: you have been, will be, or will never be pregnant ever, UM,

905
01:02:32,160 --> 01:02:36,280
Speaker 1: it's you're not helping anyone by passing judgment. UH. You're

906
01:02:36,320 --> 01:02:39,560
Speaker 1: not helping anyone by saying that someone should or should

907
01:02:39,640 --> 01:02:42,120
Speaker 1: not have kids, or is going to be a good

908
01:02:42,240 --> 01:02:45,960
Speaker 1: or a bad mother, or you know whatever. UM. I

909
01:02:46,000 --> 01:02:49,640
Speaker 1: would argue to just be an empathetic, real and kind

910
01:02:49,840 --> 01:02:53,760
Speaker 1: human UM, so that we don't have to deal with

911
01:02:53,920 --> 01:02:58,360
Speaker 1: so much mental health stigma and shame. And with that, UM, listeners,

912
01:02:58,440 --> 01:03:01,160
Speaker 1: we would love to hear from you and UM if

913
01:03:01,320 --> 01:03:03,840
Speaker 1: you would like to remain anonymous, of course we will

914
01:03:03,880 --> 01:03:05,960
Speaker 1: always respect that. Just make a note of it in

915
01:03:06,320 --> 01:03:09,600
Speaker 1: your letter or message. UM. You can email us at

916
01:03:09,680 --> 01:03:12,400
Speaker 1: mom Stuff at how stuff works dot com. You can

917
01:03:12,440 --> 01:03:16,600
Speaker 1: also tweet us at mom stuff, podcasts or messages from Facebook.

918
01:03:17,080 --> 01:03:20,320
Speaker 1: UM and also partners of people who have experienced this,

919
01:03:20,480 --> 01:03:23,240
Speaker 1: family members of people who have experienced this. UM. This

920
01:03:23,360 --> 01:03:26,640
Speaker 1: affects you as well, and there are often questions of

921
01:03:27,160 --> 01:03:29,280
Speaker 1: how to be the very best support that you can

922
01:03:29,320 --> 01:03:32,480
Speaker 1: be for someone who is going through UH. Post or

923
01:03:32,640 --> 01:03:37,080
Speaker 1: prepart um anxiety or depression. UM, so we would love

924
01:03:37,160 --> 01:03:41,480
Speaker 1: to hear your experiences and insights as well. You can

925
01:03:41,520 --> 01:03:44,800
Speaker 1: also tweet Caroline and me directly if you prefer. I'm

926
01:03:44,840 --> 01:03:48,600
Speaker 1: at Kristin Conger, I'm at the Caroline HERV and we've

927
01:03:48,640 --> 01:03:57,200
Speaker 1: got a couple of messages to share with you right now. Well,

928
01:03:57,280 --> 01:03:59,680
Speaker 1: I have a letter here from Lindsay in response to

929
01:03:59,720 --> 01:04:03,600
Speaker 1: our charitable Burnout episode. She said, your recent episode on

930
01:04:03,720 --> 01:04:06,439
Speaker 1: nonprofit burnout really spoke to me. As I spent ten

931
01:04:06,640 --> 01:04:09,960
Speaker 1: years in nonprofits, working my way into a senior position

932
01:04:10,040 --> 01:04:12,480
Speaker 1: at a small arts institution for the last four and

933
01:04:12,520 --> 01:04:15,520
Speaker 1: a half years with an operating budget under five hundred

934
01:04:15,600 --> 01:04:18,640
Speaker 1: thousand a year, I felt compelled to write to share

935
01:04:18,720 --> 01:04:23,600
Speaker 1: two things. First, regarding the lack of diversity in many nonprofits.

936
01:04:23,720 --> 01:04:27,000
Speaker 1: From my albeit anecdotal experience, this problem starts with many

937
01:04:27,120 --> 01:04:30,200
Speaker 1: internship programs. A number of programs, such as the one

938
01:04:30,240 --> 01:04:34,120
Speaker 1: I administered, are unpaid. Even as it complied with federal

939
01:04:34,200 --> 01:04:36,880
Speaker 1: law for unpaid internships and was part time, many college

940
01:04:36,920 --> 01:04:39,439
Speaker 1: students and recent grads of color did not go after

941
01:04:39,520 --> 01:04:42,000
Speaker 1: the opportunity or turn it down when weighing it against

942
01:04:42,040 --> 01:04:45,080
Speaker 1: paid positions. I also saw this with white applicants who

943
01:04:45,160 --> 01:04:48,480
Speaker 1: came from lower income backgrounds. When those individuals did become interns,

944
01:04:48,560 --> 01:04:52,120
Speaker 1: I noticed some of them had less external support emotional, personal,

945
01:04:52,240 --> 01:04:57,360
Speaker 1: or financial than other more affluent interns. This is wildly unfortunate. Second,

946
01:04:57,440 --> 01:04:59,400
Speaker 1: I wanted to share with you ladies that I was

947
01:04:59,520 --> 01:05:02,320
Speaker 1: the first woman to have a baby while at this nonprofit.

948
01:05:02,640 --> 01:05:05,840
Speaker 1: At the time, the nonprofit was thirty six years old.

949
01:05:06,360 --> 01:05:09,480
Speaker 1: The organization had to dust off a maternity leave policy

950
01:05:09,520 --> 01:05:12,160
Speaker 1: from the nineteen eighties and bring it into the twenty

951
01:05:12,200 --> 01:05:15,120
Speaker 1: one century. I ended up with twelve weeks off, partially

952
01:05:15,120 --> 01:05:19,040
Speaker 1: paid thanks to New York State disability, and saved vacation time.

953
01:05:19,440 --> 01:05:22,120
Speaker 1: As my salary could not nearly cover full time daycare,

954
01:05:22,160 --> 01:05:24,919
Speaker 1: I negotiated what I thought, while pregnant would be great,

955
01:05:25,160 --> 01:05:26,880
Speaker 1: bringing my son to work with me two days a

956
01:05:26,920 --> 01:05:29,080
Speaker 1: week till he was six months old, and working from

957
01:05:29,120 --> 01:05:31,320
Speaker 1: home two days per week till he was ten months old.

958
01:05:31,800 --> 01:05:34,560
Speaker 1: My boss agreed. I look back at this time and say,

959
01:05:34,840 --> 01:05:38,720
Speaker 1: what I so appreciated this extra time to physically be

960
01:05:39,000 --> 01:05:41,120
Speaker 1: with my infant son, but it was an insane time

961
01:05:41,200 --> 01:05:43,440
Speaker 1: for me, my husband, and I'm sure my co workers.

962
01:05:43,760 --> 01:05:47,040
Speaker 1: As I primarily worked doing educational public programming, I had

963
01:05:47,120 --> 01:05:49,600
Speaker 1: extra work and life challenges. Once a baby was in

964
01:05:49,680 --> 01:05:52,200
Speaker 1: the mix, I realized about a month after returning to

965
01:05:52,280 --> 01:05:54,800
Speaker 1: work that a change was necessary. It took me about

966
01:05:54,800 --> 01:05:56,960
Speaker 1: a year of emotional soul searching and feeling like I

967
01:05:57,080 --> 01:05:59,880
Speaker 1: was privately divorcing my career, but I ended up trans

968
01:06:00,000 --> 01:06:01,920
Speaker 1: asitioning to a job at a tech company when my

969
01:06:02,000 --> 01:06:04,400
Speaker 1: son was just over a year old. This was terrifying

970
01:06:04,560 --> 01:06:06,960
Speaker 1: and in many ways heartbreaking, but was necessary for my

971
01:06:07,040 --> 01:06:09,280
Speaker 1: own well being in that in my family. Two plus

972
01:06:09,400 --> 01:06:11,960
Speaker 1: years out of nonprofits and at that tech company, and

973
01:06:12,040 --> 01:06:14,680
Speaker 1: I cannot believe how happy and fulfilled I am. I

974
01:06:14,800 --> 01:06:18,880
Speaker 1: do miss nonprofit work sometimes do I miss wearing thirty hats,

975
01:06:18,960 --> 01:06:21,479
Speaker 1: the long hours and never really being able to leave work.

976
01:06:21,920 --> 01:06:25,600
Speaker 1: Absolutely not. Thank you for your wonderful work and keep

977
01:06:25,640 --> 01:06:27,840
Speaker 1: it up. At lindsay you keep up your wonderful work.

978
01:06:28,280 --> 01:06:30,880
Speaker 1: And I have a letter here from Ashley, also about

979
01:06:30,920 --> 01:06:34,520
Speaker 1: our charitable burnout episode. She writes, as I sit here

980
01:06:34,600 --> 01:06:37,520
Speaker 1: in my office at a nonprofit listening to your charitable

981
01:06:37,560 --> 01:06:41,880
Speaker 1: burnout episode, I can't help think but yes, yes, yes.

982
01:06:42,640 --> 01:06:45,640
Speaker 1: Having spent my entire career thus far in the nonprofit sector,

983
01:06:45,680 --> 01:06:49,480
Speaker 1: it's several different organizations. I've seen everything you've discussed on

984
01:06:49,520 --> 01:06:51,920
Speaker 1: the podcast. In my first full time job out of

985
01:06:52,000 --> 01:06:54,920
Speaker 1: college at a nonprofit helping families in poverty, I was

986
01:06:55,080 --> 01:06:58,800
Speaker 1: paid actual minimum wage. The irony of working at a

987
01:06:58,840 --> 01:07:02,800
Speaker 1: poverty fighting organization for poverty level wages was not lost

988
01:07:02,880 --> 01:07:05,800
Speaker 1: on me, but it was expected that employees would be

989
01:07:05,880 --> 01:07:08,919
Speaker 1: okay with it because of the opportunity to quote help

990
01:07:09,000 --> 01:07:12,200
Speaker 1: the kids, and I completely bought into it as a

991
01:07:12,240 --> 01:07:14,680
Speaker 1: new graduate with storry i'd hope for the future. I

992
01:07:14,760 --> 01:07:17,280
Speaker 1: was willing to expect far less than I was worth

993
01:07:17,400 --> 01:07:20,400
Speaker 1: for the experience and the chance to help others. Looking back,

994
01:07:20,480 --> 01:07:23,520
Speaker 1: I was completely being taken advantage of the level of

995
01:07:23,600 --> 01:07:27,000
Speaker 1: burnout I saw employees experience there as well as in

996
01:07:27,160 --> 01:07:30,400
Speaker 1: my subsequent organizations is so high, and I have to

997
01:07:30,480 --> 01:07:33,360
Speaker 1: think that feeling devalued financially or otherwise is a big

998
01:07:33,440 --> 01:07:37,000
Speaker 1: part of that. In my current role managing a volunteer program,

999
01:07:37,200 --> 01:07:39,360
Speaker 1: I also see race and gender play out in my

1000
01:07:39,480 --> 01:07:42,680
Speaker 1: pool of volunteers. While there may be equity between men

1001
01:07:42,720 --> 01:07:46,360
Speaker 1: and women and volunteerism here anyway, our volunteer pool is

1002
01:07:46,480 --> 01:07:49,480
Speaker 1: overwhelmingly white. My manager and I have been trying to

1003
01:07:49,600 --> 01:07:51,920
Speaker 1: increase the number of people of color serving with us,

1004
01:07:52,080 --> 01:07:54,200
Speaker 1: but it's an uphill battle. I would love to see

1005
01:07:54,200 --> 01:07:57,880
Speaker 1: an episode on the race, class, gender politics of volunteerism

1006
01:07:57,960 --> 01:08:00,040
Speaker 1: one day. Thank you again for all you do you

1007
01:08:00,160 --> 01:08:03,880
Speaker 1: and for thinking of us in the nonprofit sector. Well, actually,

1008
01:08:03,960 --> 01:08:07,280
Speaker 1: thank you for all that you do and UM that

1009
01:08:07,400 --> 01:08:13,400
Speaker 1: episode suggestion on volunteerism is a terrific one. UM, and listeners,

1010
01:08:13,520 --> 01:08:17,000
Speaker 1: if you have thoughts experiences that you would like to

1011
01:08:17,080 --> 01:08:20,559
Speaker 1: share with us, Mom stuff at how stuff works dot com.

1012
01:08:20,680 --> 01:08:24,560
Speaker 1: Again is our email address. And Caroline, do you have

1013
01:08:24,600 --> 01:08:26,559
Speaker 1: anything you want to plug of how people can get

1014
01:08:26,600 --> 01:08:28,960
Speaker 1: in touch with you? Well, if you don't want to

1015
01:08:29,040 --> 01:08:31,479
Speaker 1: tweet me at the Caroline herv, you can always go

1016
01:08:31,560 --> 01:08:35,800
Speaker 1: over to my personal website at Caroline Irvan dot co.

1017
01:08:36,400 --> 01:08:39,599
Speaker 1: Because I'm too cool for the m Caroline, too cool

1018
01:08:39,640 --> 01:08:41,840
Speaker 1: for the m Irvin. That's right, that's what people call me.

1019
01:08:42,080 --> 01:08:45,240
Speaker 1: Maybe that's the r L I'm gonna buy awfully long.

1020
01:08:46,000 --> 01:08:47,760
Speaker 1: If you want to keep up with me, yeah, you

1021
01:08:47,760 --> 01:08:50,840
Speaker 1: can find me on Twitter at Kristen Conger and you

1022
01:08:50,920 --> 01:08:56,120
Speaker 1: can also go to tiny letter dot com slash Kristen

1023
01:08:56,240 --> 01:09:00,479
Speaker 1: and that's Kristen c R I S T e N.

1024
01:09:01,120 --> 01:09:04,960
Speaker 1: I spell it because it's often misspelled, I understand. Um.

1025
01:09:05,200 --> 01:09:07,920
Speaker 1: You can sign up there for a weekly newsletter I've

1026
01:09:07,960 --> 01:09:11,880
Speaker 1: been doing, called the Do Better Dispatch. It's pretty cool

1027
01:09:12,560 --> 01:09:15,639
Speaker 1: And if you are interested in learning more about stuff

1028
01:09:15,680 --> 01:09:17,400
Speaker 1: Mom Never told you and want to find all of

1029
01:09:17,479 --> 01:09:21,639
Speaker 1: our social media blogs, videos, and podcasts with our sources,

1030
01:09:21,800 --> 01:09:24,080
Speaker 1: the one place to go for all of that is

1031
01:09:24,160 --> 01:09:31,600
Speaker 1: stuff Mom Never told You dot com. For more on

1032
01:09:31,680 --> 01:09:34,400
Speaker 1: this and thousands of other topics, visit how Stuff Works

1033
01:09:34,439 --> 01:09:34,800
Speaker 1: dot com