Mom and Mind | Pregnancy and Postpartum Depression & Anxiety

Latest Episodes:

176: Mother Burnout May 11, 2020

Show notes

In honoring Maternal Mental Health Awareness Month, today’s topic is mother burnout. It’s something a lot of us moms feel, but we often don’t recognize it until it’s too late. Let’s learn more!

Diana Spalding is Digital Education Editor at Motherly, along with being a certified nurse-midwife, pediatric nurse, and mother of three. She wrote The Motherly Guide to Becoming Mama, which was just released. We’ll discuss what burnout means, why it’s important to pay attention, how to recognize the early signs, and what to do from there.

Show Highlights:

How Diana became interested in burnout
The facts: 85% of moms don’t feel supported by society
The “occupational phenomenon” of burnout, which is a diagnosable condition with real consequences
Characteristics of burnout: fatigue, exhaustion, negativism, cynicism, and not feeling like you’re doing a good job
Good mom, bad mom, and how we judge ourselves and each other
Contributing factors to mother burnout
How and when burnout begins
Why parents don’t trust themselves, and how we can empower them
How to recognize signs of burnout and be aware of your mental health
The importance of reaching out for help and finding connection
How certain factors related to the current pandemic contribute to burnout, like isolation, lack of support, and unreasonable demands
How our culture teaches us to deal with uncomfortable feelings
How our capacity for empathy and sympathy is stretched
Long-term effects of chronic stress
Diana’s book, a new resource with a holistic focus on mental health

Resources:

Motherly

Instagram: Motherly

Facebook: Motherly Media

The Motherly Guide to Becoming Mama: Redefining the Pregnancy, Birth, and Postpartum Journey by Diana Spalding, Jill Koziol, and LIz Tenety

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175: Mom Genes Fight Postpartum Depression May 06, 2020

Show notes

May is Maternal Mental Health Awareness Month, and today, May 6, happens to be World Maternal Mental Health Day. It’s a fitting day to bring you this show with an expert who is the driving force behind a pioneering study to help diagnose postpartum depression earlier and get moms the treatment they need.

Dr. Samantha Meltzer-Brody, MD, MPH, is co-principal investigator of the Mom Genes Fight PPD research study, as well as the Assad Meymandi Distinguished Professor and Chair of the UNC Department of Psychiatry and director of the UNC Center for Women’s Mood Disorders. Her funded research is focused on understanding the genetic signature of postpartum depression and investigating novel technologies and treatment modalities to optimize and personalize treatment for women with perinatal depression. Most recently, this has included the MOM GENES app and the brexanolone clinical trials, the first FDA-approved medication for postpartum depression. She knows a lot, and she’s done a lot with her significant work in perinatal mental health.

Show Highlights:

What postpartum depression is and why Dr. Meltzer-Brody is studying it
The MOM GENES study that began in 2016 (learn how you can participate)
How the study can help us identify who is at risk so intervention can happen earlier
Who can participate in the study
The confidentiality and anonymity of the study
The availability of resources for participants in the study
How the DNA samples are collected and pooled together
How the genetic information will be used to determine treatment and outcomes
The preliminary findings: not all women have the same types of postpartum depression
Why women with co-occurring anxiety disorders are encouraged to apply for the study
Examples of postpartum depression and the signals that mean someone needs to seek help
How the study and the app have already helped people in many ways

Resources:

Mom Genes Fight PPD Learn how you can join the study from the comfort of your own home.

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174: Perinatal Mental Health en Español - Salud Mental Materna Apr 20, 2020

Show notes

Emilia Ortega-Jara, LCSW is a psychotherapist, Founder and Clinical Director of Corazon Counseling Service Inc., a holistic culturally-rooted community-based counseling center that focuses on all things Preconception, Pregnancy, Birth, and Postpartum! Emilia has over 20 years’ experience working in the mental health field and has been a longtime advocate for culturally and linguistically appropriate mental health services in the Latinx community. She has worked with various social justice organizations and community based mental health agencies throughout California. After the birth of her son, Emilia took special interest in developing her clinical expertise in the treatment of perinatal mood and anxiety distress among Chicana/Indigenous and Latinx communities. She is Certified as a Perinatal Mental Health Specialist through Postpartum Support International and is trained in EMDR, she uses EMDR techniques in the treatment of Perinatal Loss and Birth Trauma. Emilia is passionate about supporting and empowering parents at all stages of their parenting journey through the use of traditional ancestral knowledge and modern trauma-informed psychotherapy. Emilia is a mother to a spirited and emotionally attuned 8-year-old who loves the fact that mommy helps other mommies not be sad, and wife to the most supportive and socially conscious husband.

Nayeli Corona-Zitney is a bilingual, licensed clinical social worker whose private practice in Rancho Cucamonga, CA, specializes in Perinatal Mental Health. Her experience includes therapeutic work with adolescents, families, and new parents experiencing perinatal mood disorders. Nayeli is an active member of Postpartum International (PSI) and currently volunteers as PSI’s support coordinator for Riverside and San Bernardino Counties in California. Nayeli is committed to offering her expertise to the community. She does this through her private practice and also by facilitating pregnancy and postpartum support groups in the community in both English and Spanish. Nayeli is a wife, mother of two, and Perinatal Mental Health Advocate who integrates a social justice framework, which recognizes how migration and historical socio-political policies can negatively impact certain groups.

Puntos destacados del podcast:

Es de vital importancia cuidar la salud mental de las madres durante el parto y posparto.
Por la situación de incertidumbre actual, el estrés en la mujer es especialmente difícil para las embarazadas y para las que acaban de dar a luz.
Hay que garantizar el bienestar de las madres, cuidarlas y darles el apoyo emocional que necesitan, siendo tan vulnerables y sensibles en esta etapa.
Depresión y ansiedad en la etapa perinatal, Nayeli se especializó en esta fase porque durante el embarazo de su hija tuvo un parto traumático y le tuvieron que hacer una cesárea de emergencia.
deben ser lo suficientemente fuertes como para hacerlo ellas solas.
La obligación de dar y recibir apoyo no solo recae sobre la madre sino a todo el mundo de su alrededor.

Recursos:

Consejería Terapia del Diálogo:

Terapia cognitiva conductal
Terapia interpersonal
Desensibilización y deprocesamiento por medio de movimientos oculares.

Grupos de terapia del Hospital Columbia Valley: 2 veces al mes, el primer y tercer miércoles de cada mes.
Grupos de apoyo PSI (Postpartum Support International)
Corazón counselling
Nayeli LCSW

Corazon Counseling

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173: Holding Both: When Therapists Who Are Affected Are Supporting Others Apr 06, 2020

Show notes

One challenge that every therapist faces is helping clients through a difficulty that hits very close to home. For instance, when you’ve experienced a personal perinatal mental health challenge, then it can be triggering to provide support for others. Today’s guest has found a way to handle those difficult moments and turn her experience into commitment and advocacy for others.

Bridget Cross is a Licensed Clinical Social Worker, certified perinatal mental health professional, and mom to two daughters. She lives in Savannah, Georgia, and works in private practice providing individual, family, and group therapy to new, hopeful, and expectant moms. Bridget is also a volunteer coordinator for the Georgia chapter of Postpartum Support International, and she’s a member of the Maternal Mental Health Collective of Savannah. Bridget’s passion is supporting women in all phases of life, but especially as they encounter and cope with the transition to motherhood. Bridget discusses what it’s like to work as a therapist with pregnant and postpartum moms when going through infertility, and what it’s like working with a perinatal population when going through her pregnancy and postpartum period., Therapists are human, and they have to deal with their own challenges while helping their clients.

Show Highlights:

Bridget’s three-year journey with IUI and IVF to have her first daughter, now 5
The crippling anxiety, anger, intrusive thoughts, and panic that set in quickly and intensely at her daughter’s birth
Why Bridget felt that she “should be stronger than this”
How Bridget found herself in deep, dark depression when her daughter was one month old
How Bridget withdrew from everyone in her life and “hid out”
The external stressors of work, moving to a new city, and career pressure
How Bridget went back to work and became involved with PSI
The moment of relief and recognition for Bridget that brought clarity on her next steps as a therapist
How Bridget covered up and justified her feelings when people tried to help her
The assumption that mental health professionals will know to ask for help if they need it
How hard it is to admit to others that you need help, especially as a mental health professional
When Bridget’s daughter was two, she got pregnant again with IVF, which resulted in an easy pregnancy and wonderful birth
Why Bridget expected postpartum depression with her second daughter’s birth and felt better prepared; she started early medications, therapy, and returned to work in a few weeks
Bridget’s commitment to becoming an advocate for pregnant and postpartum women, knowing this was part of her personal healing journey
The difficult parts of seeing pregnant and postpartum clients even though some stories are triggering and painful
How to handle the tendency to get angry about her own story and clients’ stories
How to hold space for the anger, hopelessness, and helplessness in this community
Why Bridget believes her path has made her a better therapist
Bridget’s message to other therapists: “Try to prioritize taking care of yourself and your feelings. Check your boundaries and notice presenting issues that are just too much to handle. Know when you need to step away. Listen to yourself and get connected to the perinatal mental health community.”

Resources:

Bridget Cross LCSW

Facebook: Bridget Cross LCSW

Listen To Moms

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172: Sex, Stress, and Burnout. Understanding it All with Emily Nagoski, Ph.D. Mar 23, 2020

Show notes

The focus of our chat is on sex, but it’s also about relationships and stress and how our brains work. Our guest Emily Nagoski, Ph.D. shares her brilliant wisdom with us in this episode. Given the current state of the world, we are living in times of unprecedented stress, which absolutely affects how we relate to each other. I’m excited for you to hear this episode and learn more about your brain, sex and stress, especially postpartum. (FYI, sex related body parts, sex related words are used in our chat).

Emily Nagoski is a sex educator and the author of Come As You Are: The Surprising New Science That Will Transform Your Sex LIfe and Burnout: The Secret to Unlocking the Stress Cycle. Her job is to travel all over the world, training therapists, medical professionals, college students, and the general public about the science of women’s sexual wellbeing.

Show Highlights:

The dual control model of how your brain perceives and processes sex
Why you might feel judgment about your sexual response, which “hits the brakes”--not the accelerator
Why the magical six-week timeline doesn’t work for most women
How your brain responds to the physical changes that come with giving birth
The best perspective on the six-week timeline
Steps to take in the chaos:
Identify what is causing you to hit the brakes
Have non-sexual sharing and touching
Why Emily doesn’t use the term “libido”
Why sexual desire differential is the #1 reason people seek sex therapy
The secrets of sexuality in long-term relationships
Why desire does NOT come first
Why you need to identify the sex you want---and don’t want
Why “pleasure is the measure” of your sexual wellbeing
Why Emily reads her own audiobook versions
Creating the ultimate sex-positive context through kindness and compassion
The difference in confidence and joy

Resources:

Emily Nagoski

Come As You Are: The Surprising New Science That Will Transform Your Sex Life by Emily Nagoski

Burnout: The Secret to Unlocking the Stress Cycle by Emily Nagoski

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171: Fighting for Nora. PostpartumPsychosis Through the Eyes of a Mother and an Advocate Mar 09, 2020

Show notes

Today’s show is a special episode with difficult and sensitive topics. We’ll be hearing about Nora and her story of postpartum psychosis and filicide. We have the honor of hearing from Nora’s mother, Kathryn Gahl. She will share from her perspective as a mother and what it’s been like to see what Nora has been through and continues to experience in her imprisonment after filicide. We’ll also hear from Dr. Brooke Laufer, a clinical psychologist who picked up on this case and has followed it closely. Nora has given her permission for us to have this conversation with Brooke and Kathryn about her case. The goal is to get information out in the public about postpartum psychosis, its detection, and treatment. Join us to hear the mother’s perspective, the clinical perspective, and what’s going on in Nora’s life right now.

Nora’s mother, Kathryn Gahl, became a widely-published, multi-genre writer after a long career as a nurse manager. She is the mother of a daughter and a son, and in 2004, she lost her young grandson to filicide. Now, her bookshelves sag with letters from her imprisoned daughter, who is also a registered nurse. Kathryn believes in the transformative power of dance, dark chocolate, and red lipstick to help her get through life.

Brooke Laufer has been a practicing psychologist since 2005. She began her clinical work in psychiatric wards with severely mentally ill patients and then worked in schools with adolescents and their families. She is currently in private practice doing psychoanalytic psychotherapy. After having her first child, Brooke had a disturbing postpartum OCD experience, which inspired her to begin researching, understanding, and specializing in the area of perinatal mental illness. She recently started working as an expert witness for women who have committed a crime in a postpartum episode. Brooke has two children of her own, along with a Golden Retriever and a loyal husband; they live, work, and play in Evanston, Illinois.

Show Highlights:

The overview of Nora’s story, from Kathryn
Nora’s experience: suffocating her 14-month-old son, Leo, and then attempting suicide because of her postpartum psychosis
Circumstances that contributed to Leo’s death
Nora’s psychiatric diagnoses: major depressive disorder severe with paranoid ideation, excessive-compulsive personality disorder, and PTSD
What these events were like for Kathryn
How Kathryn’s writing and dancing have helped her cope with these horrifying events
How Kathryn was surprised at the people evaporated from her life and those who stepped up to support and help her
How Brooke got involved through corresponding with Nora because of a childhood connection
Why Nora believed she deserved to suffer and be punished
Altruistic filicide (defined as believing that bringing death to the child is better than if the child survives) is an apt label for Nora
What it’s like to be in a state like Wisconsin, where a case like this gets very little support and legal consideration
Why Nora made the decision to plead guilty
The main issue is how poorly we treat mental health issues in our US legal system that is deeply flawed
How other countries deal with mental health, motherhood, and postpartum psychosis
How Kathryn dealt with this experience with only one bout of depression
Why postpartum psychosis is an issue that shows the failure of our culture
A message from Brooke: “We need to understand that motherhood is equally dark and light. We need to ask for good help when we need it.”
Why family members need to speak up when a mom seems “off”
A message from Kathryn: “Trust your hunch.”
The dire need for more postpartum screening

Resources:

Dr. Brooke Laufer

Kathryn Gahl

Gahlstone

Twitter: @kathryngahl

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170: Infant Mental Health Feb 24, 2020

Show notes

Perinatal mental health is the focus of many Mom & Mind episodes, but infant mental health is often overlooked in our discussions. It’s fascinating to see the intersection of infant mental health and perinatal health, and research shows that we need to consider how these two systems work together to bring mental health to both parents and their babies. We are jumping into this interesting topic with today’s guest.

Meyleen Velasquez is a psychotherapist who specializes in infant and perinatal mental health. Her practice supports individuals identifying as women and clinicians working on practicing from an anti-oppressive framework. In today’s episode, we’ll talk about what infant mental health is and why it’s important to consider--along with perinatal mental health. Many moms worry about not doing the right thing for their child, so they fall into the traps of modern parenthood. Meyleen talks about the reality of parenthood, assuring you that you aren’t messing up your kids if you don’t attend to them ALL the time.

Show Highlights:

What infant mental health and why it’s important
The intersection of infant mental health and perinatal mental health: infants need a caregiver to provide calming, soothing, focused attention, and the caregiver needs a safe space to express emotions
Why there isn’t much focus on the crossover between infant mental health and perinatal mental health
The need to share information with parents in the space of compassion and gentleness
In the parent/child relationship, a basic need is that struggling parents need support
Why an infant who doesn’t show a full range of emotions is cause for concern, but those emotions can’t be overinterpreted
The need to be “good enough,” and look at parenting as a whole and not just what happened in one day
Why parents need at least 30 min./day to take care of themselves
The red flag of developmentally inappropriate regression in young children
Overinterpretation vs. under interpretation
Myths and misconceptions about infant mental health
How we can help an infant learn to co-regulate
Why parents need to take breaks to soothe themselves
How babies respond differently in different settings and relationships
Hopeful messages for parents: “Infants and young children are extremely resilient. If parents can get the support they need, then babies can bounce back. Nothing is a forever situation because we can be good enough and create healthy, thriving babies with relationships that we also enjoy.”

Resources:

Hummingbird Counseling

Facebook: Hummingbird Counseling

Zeroththree

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169: Birth, Trauma, Breastfeeding and Mental Health Feb 10, 2020

Show notes

We talk about a lot of things that people don’t want to talk about or even hear. Still, they are very real, challenging, and difficult circumstances surrounding pregnancy, birth, and postpartum. It’s important to share these stories because these difficulties become a reality for many people. Today’s show focuses on birth trauma and breastfeeding as we hear our guest’s personal account.

Erin Northrup is a mom of four busy children, ranging in age from 2-10. She lives in Atlantic Canada, where she enjoys spending time in nature with her family. With the birth of her oldest child, Jack, she experienced birth trauma, and this experience sparked her passion for researching trauma. Erin holds a bachelor’s in Psychology and is currently pursuing a Master’s in Health Services Research. Her current research explores the experience of breastfeeding after birth trauma. Her own experience of breastfeeding after birth trauma inspired her to become a volunteer with a breastfeeding support organization offering community-based, peer to peer breastfeeding support. She is committed to raising awareness of the intersection of birth trauma, breastfeeding, and perinatal mental health.

Show Highlights:

Erin’s birth trauma experience with the birth of her son, Jack, now 10
How her Ob prepared her to have a C-section because of an ambiguous condition
How Erin’s water broke a week early, and her spinal didn’t take, so the C-section proceeded under general anesthesia, while Erin felt dissociated from the entire experience
In recovery, she was told that her son was taken to the NICU because of low blood sugar, and she couldn’t see him yet
How Erin’s mom, a physician, stepped in to advocate for Erin to see her son
While eating breakfast a few hours after the birth, Erin felt a popping sensation in her incision and felt a gush of blood
Erin was rushed back to the OR, and the spinal worked this time while Erin cried on the table--all of this was before she had even held her baby
How Erin was repeatedly spoken about like she wasn’t even in the room; she felt like her input wasn’t even important
When Erin got home, survival mode kicked in, and she regretted not advocating more strongly for herself
How Erin questioned whether or not her son was even the right baby, worrying that a mix-up could have occurred in the hospital because neither she nor her husband witnessed his birth
How she determined to “make it up” to her son by breastfeeding him
How the Ob told her at two months postpartum that her condition should not have warranted a C-section in the first place---which just made everything worse
How Erin felt an erosion of trust in her doctors and the medical system
How Erin asked where the growth and meaning was in her situation and how she could use her experience to help others
Erin applied to a Master’s program and went on to have three more kids with positive birth experiences
How Erin found support for breastfeeding
What Erin has found in her research by asking mothers about their experience with birth trauma and breastfeeding
The magnitude of the response she has received, but the difficulty in hearing the painful stories of birth trauma
The results from Erin’s research: Birth trauma is destabilizing to the breastfeeding process because of the physical and emotional pain in childbirth and the postpartum from mistreatment
The importance of trauma-informed care
How women with these experiences feel like the trauma is somehow their fault
What care providers should be aware of in their work

Resources:

Instagram: Live Learn Lactate

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168: Thyroid, Infertility, and mental Health Jan 27, 2020

Show notes

We know that our body systems are complicated. There’s no way we can understand everything we need to know to have a healthy pregnancy and postpartum, but the more we know how the brain and body work together, the more prepared we can be. Today’s show focuses on the thyroid, the small--but mighty--organ that impacts fertility, loss, pregnancy, and postpartum.

Dr. Hilary Mandzik is a licensed psychologist in private practice in Cary, NC. She also sees clients remotely throughout North Carolina and Virginia. Hilary holds a doctorate in clinical psychology from George Washington University and a Master’s in Education from Harvard. In addition, she has advanced clinical training in perinatal mental health. Hilary is passionate about supporting parents in their journey from conception and onward. She wants to help parents and children feel connected to each other and live their best lives as individuals and as a family unit. In today’s show, Hilary tells us about how her thyroid condition impacted her fertility journey. We’ll discuss other clinical aspects to consider concerning the thyroid, as well as what you need to know if you’re working toward pregnancy. You’ll learn that many people have thyroid conditions and don’t even know it.

Show Highlights:

Hilary’s personal story of two pregnancies and a missed miscarriage, which clued her in to possible thyroid issues
How Hilary didn’t fit the typical thyroid symptom profile
How Hilary’s midwife discovered her thyroid issues
With research, Hilary discovered that thyroid imbalance is a well-known cause of miscarriage, infertility, anxiety, and depression
Why TSH and other hormone levels should be checked routinely in pregnancy
How Hilary changed doctors five times within the first six weeks of her third pregnancy, refusing to see a doctor who would dismiss her thyroid issues
How pregnancy is a major trigger for autoimmune issues
The big difference between normal and optimal in lab ranges
How Hilary’s experience has changed how she views perinatal mental health
The partnership Hilary feels with functional medicine practitioners
How thyroid conditions are often overlooked
What tests to ask for from your provider
The important role of mental health clinicians to help address health issues and refer clients
Why we should take care not to stereotype people with thyroid issues
Hilary’s advice to those struggling to get pregnant: educate yourself, connect with doctors who listen to you, and advocate for yourself
How the thyroid can impact other systems in the body
How the support of a mental health clinician can help you cope
How Hilary went on to have a healthy pregnancy after finding and treating her thyroid issues

Resources:

Hilary Mandzik

Stop the Thyroid Madness book

Stop the Thyroid Madness website

Stop the Thyroid Madness 2 book

Hangry book: 5 Simple Steps to Balance Your Hormones and Restore Your Joy (Including a Customizable Paleo/Mediterranean Plan!)

The Sarah & Dr. Brooke Show podcast

The Autoimmune Solution book by Dr. Amy Myers

The Root Cause book by Dr. Isabella Wentz

The Hashimoto’s Protocol book by Dr. Isabella Wentz

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167: When Your Own Thoughts and Feelings are Overwhelming Jan 13, 2020

Show notes

Welcome to a new year! This is a monumental year for me, as it marks ten years since I was pregnant with my daughter and experienced postpartum depression, anxiety, and OCD. I never dreamed back then that I would be where I am today, trying to help moms and families because of my personal mental health experience. In today’s show, I’ll reflect on those thoughts and feelings that were so overwhelming for me.

Show Highlights:

As I look back, it’s easier to have compassion and a lighter heart about my experiences than it was a few years ago
My planned and wanted pregnancy was actually a break for me from the ups and downs of PMS
How I realized with reflection that anxiety was present in my life even before my pregnancy
How it felt like I had done something wrong when I experienced a bleeding episode during my pregnancy
Why positive and negative experiences get woven together as you reflect on the past
The shame and guilt that came with my mental health condition
Because of our deepest vulnerabilities, we don’t want to feel our feelings or talk about them
The shame, anger, and fear that make you feel alone
How scary and intrusive thoughts become traumatizing
Why good, specific therapy is crucial
My favorite parts of therapy in helping moms realize they aren’t crazy
Why I urge you to see a perinatal mental health specialist, join a support group, or find resources to get the help you need
The year I spent in an emotional freak-out space, feeling broken and alone
Finding a safe person to talk to who will understand
Why I am 100% sure that you can get better, too

Resources:

Postpartum

PSI Directory

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