Depression During Pregnancy

October 28, 2012

Kelly remembers experiencing depression during her first pregnancy.  Although she did not identify what she was experiencing at the time, looking back she realizes that she was depressed during her pregnancy.  She had so many life changes going on that it is no wonder she was overwhelmed.  Kelly got pregnant in August, started a job in September, got married in October and moved in December.  If that was not enough, when she was 7 months pregnant her best friend died unexpectedly.  Kelly new she was experiencing difficulties but she didn’t know she needed help.

Kelly is not alone.  According to the American Congress of Obstetricians and Gynecologists (ACOG), between 14 to 23% of women will struggle with some symptoms of depression during pregnancy.  Because one to four women will experience depression at some time during their lives, it is not surprising that pregnancy can be one of those times.

The American Pregnancy Association is a national health organization committed to promoting reproductive and pregnancy wellness through education, research, advocacy, and community awareness.  The Association states that depression during pregnancy is not properly diagnosed because people think it is just another type of hormonal imbalance.

In the case of Anglena, she had experienced postpartum depression after the birth of her first child but was stable when she got pregnant with her second child.  Anglena had a history of Anxiety and Obsessive Compulsive Disorder prior to her pregnancies but both seemed to be under control when she was pregnant with her second child.  However, when she was 5 1/2 months pregnant, she began to have difficulty sleeping.  This led to irritability, agitation and guilt.  All of which can be symptoms of depression.  She did not identify them as such and dismissed them as hormonal and pregnancy related.

Thankfully, in Kelly’s and Anglena’s cases, they eventually got help but not until things escalated and got worse after the their babies were born.  It seems that often the symptoms of depression and anxiety during pregnancy are often dismissed as “normal” or related to changes in hormones.  But, in reality, if a pregnant woman is experiencing any of the following symptoms, she should seek professional help, preferably professionals with experiencing treating women experiencing mental health issues related to childbearing.

  • Trouble sleeping
  • Sleeping too much
  • Lack of interest
  • Feelings of guilt
  • Loss of energy
  • Difficulty concentrating
  • Changes in appetite
  • Restlessness, agitation or slowed movement
  • Thoughts or ideas about suicide

So if you are pregnant and experiencing any of the symptoms mentioned above, please know that there is help available.  You should not feel ashamed or guilty because you are not to blame and you are not alone.

 

The information on this site is not intended to diagnose or treat any medical or psychological condition. Please consult with your healthcare provider for individual advice regarding your own situation.

RESOURCES AND ADDITIONAL READING:

American Pregnancy Association: Depression During Pregnancy

March of Dimes: Pregnancy Complications

Depression during and after pregnancy fact sheet

Coping With Depression During Pregnancy

Depression During Pregnancy & Postpartum

Postpartum Support International

Mental Illness and the Law

October 21, 2012

Mental illness and the Law is a sensitive topic but a topic that I believe needs to be addressed.  With recent tragedies of mass shootings, it would appear that people with mental illness are more violent and more likely to commit a crime.  Is that really true?

According to an Overview of Violence and Mental Illness published in June 2003 in World Psychiatry, the official journal of the World Psychiatric Association, “mental illnesses are neither necessary, nor sufficient causes of violence.”  In fact, “the major determinants of violence continue to be socio-demographic and socio-economic factors such as being young, male, and of lower socio-economic status.”

Additional conclusions are

  • “Members of the public undoubtedly exaggerate both the strength of the relationship between major mental disorders and violence, as well as their own personal risk from the severely mentally ill.”  The fact is that it is far more likely that people with a serious mental illness will be the victim of violence rather than the perpetrator of violence.
  • “Substance abuse appears to be a major determinant of violence and this is true whether it occurs in the context of a concurrent mental illness or not. Those with substance disorders are major contributors to community violence, perhaps accounting for as much as a third of self-reported violent acts, and seven out of every 10 crimes of violence among mentally disordered offenders.”
  • “It appears that too much past research has focused on the person with the mental illness, rather than the nature of the social interchange that led up to the violence. “

Now that it is established that mental illness alone is not associated with more violence and crime, in my opinion, the more prevalent question is how the Law interacts with individuals with mental illness?

I have found that the best outcome depends on the training among law enforcement officers, the understanding of mental illness in a community and the access to mental health services.

Although I have never been violent or committed a crime, I have had experience with the law as a result of my illness.  When I was struck with postpartum psychosis, the law enforcement officers that responded, automatically assumed that I had taken illegal drugs.  It was primarily due to the response of my family and physician that I was treated for a medical condition.

During the process of my recovery, my experience has included being forcibly handcuffed (still have a scar on my wrist as a result), having my rights and voluntary request for treatment ignored as well as not being provided with emergency care when I had comprehensive health insurance.  The experiences I had not only caused pain and suffering, it also caused post-traumatic stress for years to follow.

The most positive experiences I had with the Law was when there was a trained crisis intervention officer as well as female officer present.  It is of utmost importance that the responders are properly trained in the area of mental health.  My experiences revealed there was prejudice and ignorance in the handling of an individual with a mental illness, who was in crisis.  I have heard of others having similar experiences.  So how can this be prevented?

In my opinion, the most important preventative measure is education.  Increasing awareness and education of mental illness not only for law enforcement officers but the community in general helps lead to more positive outcomes.  Having access to mental health services in every community can help those with a mental illness get through their crisis.  Sadly, often budget cuts and lack of priority for mental health services makes access to care difficult in many communities.

I know this is a tough topic to discuss but please share your insight and opinions on mental illness and the law.  Positive or negative, I want to hear from you and, if comfortable, share your own experiences.

Resources and additional reading:

Violence and delusions: data from the MacArthur Violence Risk Assessment Study

NAMI: Legal Support

Violence and mental illness: an overview

Law Enforcement Responses to People with Mental Illnesses

Mental Illness and the Law – Minds on the Edge

 

Thank you for taking the time to read my blog.  Remember to also follow me on twitter @moyerjennifer and “like” my facebook page at www.facebook.com/jenniferhmoyer

Interview with Cheryl Jazzar, MHR, Founder of Wellpostpartum Consulting

October 13, 2012

Cheryl Jazzar, MHR is the founder of WellPostpartum Consulting.  She has supported thousands of new mothers since 1998. Her background is in psychology, counseling and women’s studies with a Master’s degree in Human Relations.  I recently interviewed her for my blog.  I hope you find the interview as informative as I did.

1.   Can you tell us a little bit about yourself?   My husband and I are homeschooling parents of four wonderful kids.  I run WellPostpartum Consulting full time while traveling and shuttling my kids to their various activities.  I am a survivor of both a terrible psychosis for which I was hospitalized for 6 weeks, and a severe postpartum depression.  I have since had another child and experienced a great postpartum period with very little symptoms.  I’m grateful that I haven’t used any psychiatric medications in over 18 years.

I’ve studied alternative health for 20 years, ever since I realized my first baby had chronic ear infections.  I was extraordinarily skeptical of what I felt was “hippie medicine”.  Boy did I learn otherwise when my daughter’s ear infections stopped abruptly.  She had been suffering for over a year.

 2.   How did you first learn about postpartum depression and postpartum psychosis?    When my first daughter was nearly 2 years old I was hospitalized with a brief-reactive psychosis.  It was horrible- I lost everything including custody of my baby.  Interestingly, that episode was linked to mercury exposure from dental materials and a now-banned body building supplement containing Ephedra and Mau Huang.  I felt I was “damaged goods” for some time.  When I met my new husband we quickly became pregnant and I suffered with a severe, lethargic postpartum depression.

 3.  Why did you decide to focus your attention on helping women who are dealing with mental health issues related to childbearing?   When I first looked for help for my own PPD I quickly found local support through Postpartum Support International.  The woman who helped me knew about supplements and natural progesterone, so I asked her to explain how and why they worked.  That day my husband brought me what she had suggested and I felt a great deal better.  For some time I thought that reaction must have been a placebo effect- nothing could work that quickly.  I learned about a handful of alternative practitioners who use similar methods during PSI conferences.  One therapist, a former PSI president, told me she sees that reaction regularly among her clients who choose to use nutrients to address their symptoms.

 4.    What helped you overcome your own experience with postpartum depression and postpartum psychosis?   Of course, the fact that using nutritional supplements and natural progesterone helped me so quickly was wonderful.  It led me to become curious about how many people knew how effective these methods were; and why they worked so well.  I began to research all known data on the subject and blogged about my findings at WellPostpartum.org.

5.   What services do you offer through WellPostpartum Consulting?  I serve women who do not wish to use psychiatric medications at the international level.  I offer The Ultimate Pregnancy Program to address past birth trauma, lower risks of common pregnancy complications, provide natural fertility support and also help women find care providers who will respect their wishes.

The Mother’s Renewal Program provides information on specific nutritional supplements and hormones typically lacking in postpartum women, a lifestyle review to address causes of nutrient deficiency and hormone imbalance, and referrals to supportive resources.  The majority of my clients turn around within 3 or 4 days of starting the program.

The Well Mother’s Circle is a private support group for women who are incorporating lasting changes into their wellness routine.  Most of these women are profoundly aware of the pain and stigma associated with perinatal mood and anxiety issues, but they experience freedom in knowing about the biological roots of these illnesses, and overcoming them.

 6.   What message would you like to share with mothers and families facing mental health issues related to childbearing?  There are options.  Research shows us that up to ½ of all moms with PPD are opposed to the use of psychiatric medications for one reason or another.  Some will not seek help at all if they feel medications are their only option.  Many will suffer in silence- or get worse.

These issues are truly not a woman’s fault.  Americans regularly suffer from subclinical nutrient deficiencies.  And, as humans we are constantly assaulted by environmental toxins that impede wellness.  This can become painfully apparent during pregnancy when biological challenges come to a head.

7.   How has your professional experience/expertise helped you in your own life?  One main help has been finding roots to my own illness through years of research into the etiology of mental illness.  This, in turn, has helped me become a better provider to many women by realizing various underlying issues that may be contributing to their illness.  I knew I was called to do this work within a few months of my recovery.  Nearly 15 years of supporting women has been a gift for me, personally, as the joy I get in return when women recover quickly can never be quantified. 

8.    What are your top 3 tips for moms facing mental health issues related to childbearing? 

1.  Buy top quality prenatal, or postnatal vitamins that separate the minerals from the iron.  If any of us goes to the cabinet right now and looks at the amount of calcium and magnesium in their prenatal; they will be very surprised.  When I realized all the problems with prenatal vitamins, I actually cried because I knew how important nutrition is to mental wellbeing. My choice is: After Baby Boost by Sound Formulas.   http://www.soundformulas.com/cgi-soundformulas/sb/ref.cgi?storeid=*2808b2a9ae7c77512fba9eb644a27d061850c0f790be&name=wellpostpartum

2.  Address general toxicity of the body before becoming pregnant, starting with the mouth.  Toxic heavy metals like mercury, present in most “silver fillings” block the absorption of minerals, making growing a baby that much harder.  On average, fetal cord blood has nearly 300 toxins in it according to a study by The Environmental Working Group.  Clearing the body has a direct impact on our health, and that of our babies.

3. Hire a doula.  The world of childbearing can be compared to a minefield.  I can say that as a person who has heard countless horrifying, traumatic birth stories for many years.  A doula can help a woman get both the birth that she wants, and the postpartum care she deserves.  The information doulas provide can be invaluable.

 9.   Is there any other information you would like to shareBringing a baby into the world is a profound experience that is firmly of the physical realm- and also a 100% spiritual endeavor.  It will change you in ways you never imagined possible.  God Himself has blessed you with a baby by creating a family for you.  Don’t try to do it without His help and guidance. The Message version of Psalms 127:3-5 says don’t you see that children are God’s best gift?  The fruit of the womb is His generous legacy.  Like a warrior’s fistful of arrows are the children of a vigorous youth.  Oh, how blessed are you parents, with your quivers full of children!  Your enemies don’t stand a chance against you; you’ll sweep them right off your doorstep.

10.  If anyone is interested in more information, how can they follow-up with you?   At WellPostpartum.com women can take The Emotional Wellness Quiz for prompt care from a compassionate consultant.  My direct email is cjazzar@wellpostpartum.com and our toll-free number is 888-886-1962.

Cheryl, I thank you for taking the time for this interview.  You are offering much needed services and alternatives to helping women facing mental health issues related to childbearing.

Thank you, Jennifer.   You are certainly doing the same by your work on this blog.  Keep it up.   You will never know how many lives you will bless.

 

The interview questions are prepared by Jennifer Moyer for her website/blog and answers are published on her website, www.jennifermoyer.com, with permission from Cheryl Jazzar, MHR.

The Importance of Having a Good Relationship with Your Health Care Provider

September 30, 2012

How many of you are comfortable talking to your healthcare provider?  Do you feel the provider respects you, listens to you and addresses your questions and concerns?  If you answered “no” to either of these questions, I hope the following information is helpful to you in turning the answers from “no” to “yes.”

I believe it is essential that you have a good relationship with your healthcare provider.  In the area of mental health, I have found that the relationship between a patient and a healthcare provider directly impacts the success of treatment and recovery.

I have discovered, in my own situation, that the times I struggled the most with my treatment and recovery, where the times that I did not have a healthcare provider that I was compatible or that I believed accurately understood my condition.  As a result, I have discovered the following things in establishing a good relationship with a healthcare provider.

  • Education is Essential.

The times I had the best relationship with my healthcare provider were the times that I was educated on my condition.  Over the years, there were times that my healthcare provider never told me what he or she believed my diagnosis was.  In fact, several of the providers, particularly the inpatient hospital providers did not even explain why I needed medication or how the medication would help me.  I often was left on my own to try to understand what was happening to me.  It was when I received education about my condition from qualified healthcare providers that I began to better understand what I was facing.

  • Asking Questions is a Necessity.

When it comes to understanding your condition and subsequent treatment, you must ask questions.  I know it is often difficult to concentrate or remember what questions you need to ask so the best thing I have found is to write them down before seeing the provider.  Keep a notebook and write the answers and information down so you can refer to it.  If that is not possible, having an advocate or trusted person that can ask questions for you, is helpful, particularly when in crisis.

  • Working Together as a Team is Critical.

It may not seem possible to work as a team with healthcare providers but it is critical to successful treatment and recovery.  Often, especially when vulnerable, we feel intimidated or inferior to healthcare providers but they are there to work with you.  A good relationship takes cooperation.  This means both sides need to work together to achieve the best outcome.  I think most would agree that the primary goal is to receive proper care and treatment striving for the best possible outcome.  So the provider should strive to achieve the best course of action for you.  He or she should encourage your input in developing a plan.  Keeping in mind that this involves both sides working together, cooperating and listening to each other.  Recognize that there is trial and error involved in coming up with a plan that works best.

  • Recognizing There are Limitations Helps Achieve Success.

No one is capable of meeting all of another person’s needs.  Healthcare may be a science but everyone is unique and different so what works for one person may not work for another person.  There is no perfect healthcare provider or perfect person.  We all have limitations.  Even though each one of us has abilities and talents, it helps to find others that can support us in areas that we are less capable of handling.  But in doing so, we must realize everyone has strengths and weaknesses.  When it comes to healthcare, especially mental health, recognize that providers have limitations and do not have knowledge in every area.  Looking for a provider that has all of the answers or expecting the provider to do all the work will only frustrate you.

  • Receiving Proper Care and Treatment is Your Right.

In my own experience, I have not always received the proper care and treatment.  There were times, early on in my treatment, that I was incapable of seeking out proper care and treatment.  I was ignorant to what my rights were, especially when I had never been hospitalized in a mental health facility before I was struck with postpartum psychosis.  In a crisis situation or when little resources are available, we often do not receive the most appropriate care and treatment.  But hopefully, we have an advocate, whether a family member, trusted friend or other person that can navigate us through the often murky waters of mental health care.  In my own situation, I did, which enabled me to find the healthcare provider that ultimately recognized and diagnosed my condition.   It took time but I gradually learned that I had rights even if I was diagnosed with a mental health condition.

I learned through many trials and tribulations to not give up on myself.  Even during the times it seemed impossible, I held on to the hope that I would ultimately find the proper care and treatment and what would work best for me in my own situation.

I recognize that some of the readers of this blog do not have access to healthcare at all, let alone have access to a healthcare provider that you can have a trusting relationship.  If that is the case for you, I encourage you to take care of yourself in the best way that you can.  Seek out resources that can help you. If you can not do it on your own, find someone that can help you.  There are many organizations and programs that provide assistance in the area of mental health.  Remember that whether or not it seems like it at the time, you are your own best advocate so do not give up on yourself.

I welcome comments and feedback as we can learn through the experiences of others.

Sources and Additional Reading:

Communicate With Your Health Care Team

Talking With Your Healthcare Provider

How to Talk to Your Healthcare Provider

Why Developing Trust with Your Doctor is Important

List of Resources

Bipolar Disorder and Pregnancy

September 23, 2012

I was recently interviewed for an upcoming production that will address bipolar disorder and pregnancy.  As a result, I thought it would be an appropriate time to share my thoughts on bipolar disorder and pregnancy.  The pressing question is can a woman with bipolar disorder have a successful pregnancy and postpartum period?

I believe the answer to this question is yes but there seems to be debate over whether or not a woman with bipolar disorder should even become pregnant let alone have a successful pregnancy.

In my opinion, the decision to become pregnant and have children is a decision that is up to the woman with bipolar disorder.  Of course, I believe she should consult with her physician, who hopefully has experience in mental illness related to childbearing, specifically in treating women with bipolar disorder.  She should also take in the consideration the level of social, emotional and practical support available to her.

I do not believe she should be told “do not get pregnant” but rather she should be told “if you choose to get pregnant, be sure to have a comprehensive plan in place to address prevention, treatment and recovery.”  It seems the better prepared a woman is, the better the outcome will be.

But even when the woman has everything in place, a relapse can still occur.  For this reason, I believe having a plan in place to address a relapse, can help her become stabilized more quickly.  The treatment plan usually involves medication, therapy, and support.

Often women are reluctant to take medication during pregnancy or when they are breastfeeding.  I can certainly understand why but there is always a risk/benefit analysis when it comes to taking medication.  It is for this reason that a pregnant bipolar woman work closely with her physician before, during and after the pregnancy.  I also suggest consulting with her pharmacist, who has tremendous knowledge about medications, to determine what is the best option during her pregnancy and after the baby is born.  In my opinion, the USA can definitely learn from the United Kingdom in addressing the support needs of postpartum women.

Of course, there is always risk in pregnancy, whether or not there is a history of mental illness.  For me, personally, I did not have a prior history of mental illness yet I was still stricken with postpartum psychosis, a rare but serious mental illness related to childbearing.  Although postpartum psychosis can strike any woman after the birth of a baby, there is a much greater risk for women, who have a history of bipolar disorder.

In my case, I would eventually be given the diagnosis of bipolar disorder, postpartum onset.  Thankfully, after many trials, tribulations and attempts at treatment, I have been in remission for six years.  Unfortunately, I have not been able to have a successful subsequent pregnancy.  Yes, as difficult as the illnesses have been, I have no regrets and would do it all again.  The blessings of motherhood and having my son in my life have been worth it all.

I welcome feedback and comments on my blog.  I would love to hear about the experiences of other women and those that provide treatment to women with bipolar disorder.  Please be sure to write your comment below.  I look forward to hearing from you.

Also, please consider “liking” my Facebook page.  You will find it under Mental Health Advocate Jennifer Moyer.

Resources and additional reading:

Do Pregnancy and Bipolar Disorder Mix?

Pregnancy with Bipolar Disorder-Stay on Medications or Not?

Managing Bipolar Disorder and Pregnancy

Management of Bipolar Disorder During Pregnancy and the Postpartum Period

Postpartum psychosis: Affected parents speak out

5 Ways I Reduce Stress and Boost My Mental Health

September 15, 2012

The past few weeks have been stressful for me.  It is when I am under the most stress that I find it hard to reduce my stress and boost my mental health.  However, when I do not do the following things, I am quickly reminded to get back to incorporating them in my life.

1.  Exercise

I have found that regular exercise is one of the best ways to reduce my stress and boost my mental health.  It is not always easy to find the time or to get motivated to exercise BUT I have found it can bring me out of a down and difficult time.  Sometimes all I can do is jump 10 to 15 minutes on my Rebounder (mini-trampoline).  When I do my blood gets pumping and my mood improves.  Whenever I have the time, I incorporate strength training as well.

2.  Prayer and Meditation

I always start my day with prayer.  I find that it puts my day in perspective and balances my mind and spirit.   If I did not have my faith, I would not see my higher purpose.  If it was not for prayer and the prayers of those around me, I literally would not be able to write this blog or help others.

3.  Spending Time with My Family and Friends

When things are not going well and I find myself feeling down, I reach out to my family and friends for encouragement and support.  I do not live close to my family but they are always a phone call away.  If family is not available, I reach out to my friends.  I am blessed to be able to get together regularly with a group of my female friends.  They are always willing to listen and encourage me when I need it the most.  For me, when I feel isolated, it can be hard to pick-up the phone and call a friend but I do it anyway.  I feel better when I reach out to others.

4.  Keeping a Schedule or Routine

This can be a tough one but when I get out of my schedule and routine, I find I am more susceptible to feeling overwhelmed, stressed or depressed.  Sometimes life gets hectic and things do not always get done when they need to get done.  But if I stick to a routine, I can prioritize my day.  If my day does not go as expected, I try not to be critical of myself.  I have learned that some things can wait and sometimes the unexpected turns out to be a blessing.  I find schedules to be a guideline and that they need to be flexible.

5.  Keeping a Healthy Diet

I have found that when I eat foods that are fatty and high in sugar, it may be a comfort at first, but then it makes me sluggish and tired.  Eating healthy during times of stress can be a challenge.  It is so much easier when time is limited to grab fast food or unhealthy snacks.  Sadly, such food is so readily available that it can be hard to make the healthiest food choices.  Thankfully, there are now healthier options even when you have to eat on the run.  There are times, when I am stressed, that I have to force myself to make the best food choices.  If I get off track, I do not beat myself up but rather make healthier choices the next day.  I have found that taking regular vitamins and nutritional supplements help me, especially during the times when I am stressed and not able to make the healthiest food choices.

No matter what the situation, I have found that eventually things improve before the next trial comes my way.  The 5 things I have listed above are what works for me.  I would love to hear from others on what works for them.  Please comment on my blog below.  I look forward to hearing from you.

Grieving is a Normal Part of Life

September 2, 2012

In Memory of my sister (10/1963 to 8/2012)

I know this blog is straying from my usual format but it has been a difficult week.  Funny thing is that all week I knew I had to write my blog but I just couldn’t bring myself to getting in the right frame of mind.  It was a struggle to want to write as I knew this would probably be the last week for my sister, who had been battling rare appendix cancer for several years.

Of course, I didn’t know exactly when she would breath her last breath but it wasn’t until I awoke the day after her passing that I felt compelled to write again.

My sister fought hard and strong to overcome this dreaded disease but the aggressive, rare cancer ultimately took over.  She fought the battle like no one I have seen before.  She loved her family tremendously.  Every family has its ups and downs but she was grateful that in the end our family grew closer.  For, as dreaded as her disease was, it did bring our family closer.

Grieving is a normal part of life.  We all experience it in someway.  Whether a death of a loved one, a divorce or broken relationship, or loss of anything that is meaningful to us.

Many of us are familiar with Elizabeth Kubler-Ross‘ book, “On Death and Dying.” In it, she identified five stages that a dying patient experiences when informed of their terminal prognosis.  Kubler-Ross identified the following states:

  • Denial (this isn’t happening to me!)
  • Anger (why is this happening to me?)
  • Bargaining (I promise I’ll be a better person if…)
  • Depression (I don’t care anymore)
  • Acceptance (I’m ready for whatever comes)

 

Many people believe that these stages of grief are also experienced by others when they have lost a loved one.

Although there may be typical stages of grief, the process is different for everyone.  Whether sudden or expected, grieving is a necessary process in our lives.  I believe one’s faith is an important part of how they deal with anything in life but especially during times of loss.

For me, I remember my sister as a strong, joyful, caring person.  Her faith, family and friends were essential in her life but most important to her was her faith. Her faith became stronger through her illness and carried her through the difficult times.  This same faith is what will carry me through in dealing with her no longer living with me on this earth.

I am blessed to have a large network of family and friends to get me through this difficult time.  But if I didn’t, I would turn to the outside resources that are available to the loved ones left behind.  For those grieving now and for those that will be grieving one day, I hope this blog post will help in some way to encourage you along your journey.

Coping with Grief and Loss

What Resources Are Available in the Community to Assist Grieving Families Cope With Their Loss?

Shades of Grief: When Does Mourning Become a Mental Illness?

 

Is ECT (Electroshock Therapy) an Effective Treatment?

August 19, 2012

Is Electroshock Therapy or Electroconvulsive Therapy (ECT) an effective treatment?  There seems to be some debate about the effectiveness of what seems like an outdated or cruel treatment for severe cases of mental illness, particularly depression. Surprisingly, it is also sometimes used to treat postpartum psychosis.

What is Electroshock Therapy or “ECT”?  According to the National Institute of Mental Health, ECT was first developed in 1938.  With ECT, electrodes are put on the patient’s scalp and a finely controlled electric current is applied while the patient is under general anesthesia. The current causes a brief seizure in the brain. According to WebMed.com, ECT is one of the fastest ways to relieve symptoms in severely depressed or suicidal patients. It’s also very effective for patients who suffer from mania or other mental illnesses.  It does sound cruel but the patient is sedated and should not feel anything during the procedure.

My own personal experience with ECT was very frightening.  In 1997, I had been struggling with the after effects of postpartum psychosis and depression for over a year.  I was in no state to make an informed decision about having the ECT treatment but it was recommended so I had it administered.  I remember each time the procedure would start I would feel a strong buzzing in my head for several seconds.  I did not remember anything after that until I was back in my hospital room.  Once back in the room, I would feel nauseous and vomit.  This was the pattern I would experience several times a week for what seemed liked forever but was actually only a couple weeks.

But the question is was the ECT treatment effective?  Honestly, in my case, I can not say for sure because it would go on to be another year with additional treatments administered before I began feeling better.  I had some memory loss which, in my case, subsided.  It doesn’t always for others.

Regardless of my own experience, what does the research say about the effectiveness of ECT treatment?  In a study published by the National Academy of Sciences in March 2012, ECT treatment was found to significantly reduce depressive symptoms.  The fact is that it can be an effective form of treatment for some people with severe depression when administered by a properly trained medical professional.

If you have had ECT treatment, please consider commenting about your own experience.  It is helpful to others to get feedback on the effectiveness of specific treatments.

 

Sources and additional reading:

Study explains how shock therapy might ease severe depression

The effectiveness of electroconvulsive therapy in treatment-resistant depression: a naturalistic study.

‘Shock therapy’ still used for depression, postpartum psychosis

Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder

 

Mental Illness in the Classroom

 August 12, 2012

With the summer winding down and the start of a new school year around the corner, I have been thinking about the challenges of mental illness in the classroom. The mental health of children is something that can not be ignored.

Did you know that, according to the National Prevention, Health Promotion and Public Health Council, about one in five youths experience a mental, emotional, or behavior disorder at some point in their lifetime?

With that many youth experiencing some type of mental, emotional, or behavior disorder, it is impossible not to address the impact of mental illness in the classroom.  The challenges are great.  Budget cuts, teacher shortages, classroom overcrowding, lack of mental health training in teachers and school administrators can all contribute to an inability to properly address mental illness in the classroom.

If your child has a mental illness, what can you do to assist in your child’s education?  The National Institute of Mental Health addresses several questions for parents related to the treatment of mental illness in children and school.  I have listed them below.

Q. How do I work with my child’s school?

A. If your child is having problems in school, or if a teacher raises concerns, you can work with the school to find a solution. You may ask the school to conduct an evaluation to determine whether your child qualifies for special education services. However, not all children diagnosed with a mental illness qualify for these services.

Start by speaking with your child’s teacher, school counselor, school nurse, or the school’s parent organization. These professionals can help you get an evaluation started. Also, each state has a Parent Training and Information Center and a Protection and Advocacy Agency that can help you request the evaluation. The evaluation must be conducted by a team of professionals who assess all areas related to the suspected disability using a variety of tools and measures.

Q. What resources are available from the school?

A. Once your child has been evaluated, there are several options for him or her, depending on the specific needs. If special education services are needed, and if your child is eligible under the Individuals with Disabilities Education Act (IDEA), the school district must develop an “individualized education program” specifically for your child within 30 days.

If your child is not eligible for special education services, he or she is still entitled to “free appropriate public education,” available to all public school children with disabilities under Section 504 of the Rehabilitation Act of 1973. Your child is entitled to this regardless of the nature or severity of his or her disability.

The U.S. Department of Education’s Office for Civil Rights enforces Section 504 in programs and activities that receive Federal education funds. Visit programs for children with disabilities for more information.

Q. What special challenges can school present?

A. Each school year brings a new teacher and new schoolwork. This change can be difficult for some children. Inform the teachers that your child has a mental illness when he or she starts school or moves to a new class. Additional support will help your child adjust to the change.

Q. What else can I do to help my child?

A. Children with mental illness need guidance and understanding from their parents and teachers. This support can help your child achieve his or her full potential and succeed in school. Before a child is diagnosed, frustration, blame, and anger may have built up within a family. Parents and children may need special help to undo these unhealthy interaction patterns. Mental health professionals can counsel the child and family to help everyone develop new skills, attitudes, and ways of relating to each other.

Parents can also help by taking part in parenting skills training. This helps parents learn how to handle difficult situations and behaviors. Training encourages parents to share a pleasant or relaxing activity with their child, to notice and point out what their child does well, and to praise their child’s strengths and abilities. Parents may also learn to arrange family situations in more positive ways. Also, parents may benefit from learning stress-management techniques to help them deal with frustration and respond calmly to their child’s behavior.

Sometimes, the whole family may need counseling. Therapists can help family members find better ways to handle disruptive behaviors and encourage behavior changes. Finally, support groups help parents and families connect with others who have similar problems and concerns. Groups often meet regularly to share frustrations and successes, to exchange information about recommended specialists and strategies, and to talk with experts.

Source: National Institute of Mental Health-Treatment of Children with Mental Illness

 

I have several friends that can attest to the importance of parental involvement in the education of children with mental illness.  They are model parents in being proactive in this often challenging situation.  Ideally, parents should be involved but this may not always happen.  What if parents do not recognize that their child has a problem? What if parents do not know how to handle their child? Or what if the parent may not have the ability or resources to assist their child?

On the flip side, what if a teacher or school administrator does not know how to handle a child with a mental illness? What if the child is “labeled” as a discipline problem when, in fact, he or she has a disorder?  Or what if the school and classroom environment is not one of acceptance but rather stigma and bullying?

I wish I had all the answers to these questions but I do not.  All of these situations create an even greater challenge in the schooling of a child with a mental illness or disorder. But they are all situations that can be overcome.  It may take time, patience, perseverance, effective communication between the school and the parent(s) and, most importantly, training and education on mental illness.

If you are a parent with a child that has a mental illness or a teacher teaching children with mental illness, I ask you what has worked best in your situation?  What has caused the most difficulty?  Please comment on this post.  Your insights and comments can help others in a similar situation.

Additional reading:

School Materials for a Mental Health Friendly Classroom: Eliminating Barriers for Learning: An Administrator’s Guide

How Does Mental Illness Affect The Classroom?

Teaching about Mental Illness in the Classroom

How does mental illness interfere with school performance?

Issues in Mental Health: Mental Illness Awareness

Mental and Emotional Well-being

Our Physical Surroundings Impact Our Mental Health

August 6, 2012

I just returned from a trip to visit family.  I was blessed to stay at a place on the beach.  I, personally, love the beach.  It is so peaceful and serene.  No matter what is going on in my life, I can get a new perspective when I am near the water.  My own experience got me thinking about how our physical surroundings impact our mental health.

I know how my physical surroundings impact my own mental health so it seems only logical that it would impact everyone’s mental health.  We all should have our basic needs, such as housing, food, water, and safety met.  Sadly, that is not the case for many people throughout the world.  How can our mental health be strong if we do not know where our next meal will come from or where we will find shelter from the elements?  I believe not knowing the answer to these basic questions causes one to live in a constant state of anxiety.

In fact, one of the findings of a study published in September 2008 by the Government Office for Science was that our sensory stimulation, that is what we see, smell, touch, taste and hear are significant factors contributing to our mental well-being.  These factors impact every one of us.

I am thankful that I no longer live in a state of anxiety as I once did.  I am blessed that I have come to a place of healing and recovery.  If it was not for the support of family and friends, I would not have achieved the basic needs required for me to overcome my own situation.  I thank God every day for the many blessings in my life.  It has not always been easy.  When I look back, I see how the difficulties in my physical surroundings made it hard for me to grasp that things would get better.  Perseverance, faith and hope carried me along the way.  They still do.

If your own circumstances look grim, I encourage you to not give up.  Rather, persevere and reach out for help wherever help is available.  In time, things can change for the better.

Sources and additional reading:

Mental Capital and Wellbeing and the Physical Environment

Environmental Connections: A Deeper Look into Mental Illness

How the environment affects mental health

Mental Health and the environment

Wellbeing: Mental health and the environment

What causes mental illness?

Does What We Eat Affect Our Mood?

July 21, 2012

Does what we eat affect our mood?  It is very likely that foods we eat can affect our mood.  Our diet is very important in maintaining good health.  Although the diet is important, there is no absolute proof that a specific food or diet that can cure mental illness.  However, there is research that shows that our diet can affect our mood and aggravate existing mental conditions.

According to WebMed.com, a healthy diet may help in overall treatment of depression.  Foods that are rich in vitamins, minerals, carbohydrates, and a small amount of healthy fat can help alleviate depression symptoms.  Deficiency in foods rich in these nutrients can cause our body to not work at is full-capacity and can even cause illness.

In fact, according to the Better Health Channel, a lack of B vitamins, magnesium and calcium can increase the symptoms of depression and anxiety.  Foods rich in magnesium include halibut, almonds, cashews, spinach and whole grains such as oatmeal and whole grain breads. You can get B vitamins from fish, meat, poultry, eggs and dairy sources such as milk and foods fortified with B vitamins such as cereals and breads. You can find calcium in dairy products, fortified foods such as cereals and juices, sardines, salmon and leafy green vegetables such as collards and spinach.

There also are things we should avoid in out diet, especially if experiencing anxiety or stress.  Alcohol and caffeine can trigger the release of the stress hormone, adrenaline, which can aggravate the symptoms of anxiety, according to The Anxiety and Depression Disorders Association of America.  The Association also recommends avoiding high energy drinks as well.  Sadly, many individuals turn to alcohol and caffeine when experiencing stress and anxiety.

Sugar causes the blood sugar to fluctuate so it can increase the symptoms of depression.  Eating fresh fruits and vegetables as well as lean sources of protein instead of fast food is highly recommended.  Personally, I have found that the busier I am, the less likely I am to eat a healthy diet.  Stress can make it hard to adhere to a diet that is best for our health, both physical and mental health.  For me, the key to keeping a healthy diet is planning meals in advance.

I love my Crockpot.  The Crockpot is a good way to prepare a meal when you do not have time to cook a meal.  I often put a lean roast and vegetables in the Crockpot.  I am busy during the day so it is great that by dinner time it is ready to eat.  I have made fresh homemade chili, spaghetti sauce and soups all in advance using the Crockpot.  I also keep fresh fruit and vegetables on hand, preferably organic, that can be eaten any time.  I love eating fish as well.

The University of Maryland Medical Center recommends eating foods rich in omega-3 fatty acids, such as salmon, tuna and nuts.  Ongoing research is showing that omega-3 rich foods may assist in the treatment of depression. Research is also showing the importance of Vitamin D.  There is a higher rate of depression among individuals with a deficiency in Vitamin D.

Research supports eating a Mediterranean diet that includes plenty of fruits, vegetables, healthy cereals, legumes and fish. Such a diet can help alleviate symptoms of depression.  Although research is ongoing in the area of diet and mental health, it definitely indicates that what we eat affects our mood. Foods that are already recommended we eat (fresh fruits, vegetables, fish, nuts, etc.) for staying healthy physically, appear to also help keep us mentally healthy as well.  So I, personally, will do my best to keep a healthy diet for both my body and my mind.  I hope you will too.

Sources and additional reading:

Foods That Fight Anxiety & Depression

 

Depression and Diet

 

Depression – Food for the Brain

 

Mediterranean Diet and Depression

Can Postpartum Psychosis Be Prevented?

July 10, 2012

Can postpartum psychosis be prevented?  This is a tough question but one that I think needs to be addressed.  I, personally, have seen that postpartum psychosis can be prevented.

As a Volunteer Coordinator with Postpartum Support International, I provided emotional and informational support to many moms experiencing mental illness related to childbearing.  I recall, one mom, who was high risk for experiencing postpartum psychosis since she experienced postpartum psychosis with her first birth.  Mothers, who have experienced postpartum psychosis with previous births or have a history of bipolar disorder are most at risk.  The mom, who I gave support to, went on to have a successful second pregnancy and postpartum period without any incidence of postpartum psychosis or depression.  She worked closely with her doctor and support team in preventing a recurrence.

Another mother I gave support to began exhibiting early warning signs of postpartum psychosis a few days after the birth of her first child but with early intervention, there was no progression of postpartum psychosis.  The key for her was that I knew her personally.  She was aware of the possibility of experiencing problems so she contacted me as soon as she exhibited symptoms.  Her family and I got her the help she needed before the symptoms escalated.  She went on to have a second child without any problems.

I, personally, have seen that postpartum psychosis can be prevented and with early intervention can be stopped.  But what does the research indicate?

According to an article published in The American Journal of Psychiatry, a study of the prevention of postpartum psychosis and mania in women at high risk, concluded that it is recommended that appropriate preventative medication be initiated immediately postpartum in women with a history of psychosis limited to the postpartum period in order to prevent postpartum psychosis.  In addition, the study concluded that patients with bipolar disorder require continuous preventative medication throughout pregnancy and the postpartum period to reduce late pregnancy or the first few months postpartum relapse risk.

The bottom line in prevention is that women, who are at high risk of experiencing postpartum psychosis, should work very closely with a medical professional, properly trained in the area of mental health related to childbearing, during their pregnancy and postpartum period.  Having a plan in place for receiving emotional and practical support during pregnancy and the postpartum period is also highly recommended.

Despite having everything in place, a woman can still experience postpartum psychosis.  The risk can be greatly reduced but not always prevented.  Early intervention is critical in the onset of postpartum psychosis.  The more we talk about the illness and recognize that it can be properly treated, the more it will be prevented.

In my case, I was never blessed to have another child but if I would have, I would have been better equipped because I never knew that postpartum psychosis even existed when my son was born.  There is now better awareness of postpartum psychosis but still there is ignorance and misunderstanding of the illness that needs to be overcome.

Sources and additional information:

Subsequent Pregnancy in Women with a History of Postpartum Psychosis

The Prevention of Postpartum Psychosis and Mania in Women at High Risk

Postpartum Support International

An Illness That Can Attack Mothers

The Symptoms of Postpartum Psychosis

APP Network: Action Postpartum Psychosis

The Thyroid and Mental Health

June 29, 2012

I recently learned from my routine annual blood test that my thyroid is hyperactive.  Since getting the results, questions have been running through my mind as to what could be causing my thyroid to overwork.  My thyroid has been checked regularly over the years and the results have been fine so why am I having the problem now?

I was aware that an overactive thyroid can cause symptoms of anxiety disorder.  I was also aware that an underactive thyroid can cause symptoms of depression.  I knew that mothers experiencing postpartum mood disorders should always have their thyroid checked but I did not realize how intertwined mental health and the thyroid are until I began researching my own situation.

According to emedecinehealth.com, the thyroid gland is located on the front part of the neck below the thyroid cartilage (Adam’s apple). The gland produces thyroid hormones, which regulate body metabolism. Thyroid hormones are important in regulating body energy, the body’s use of other hormones and vitamins, and the growth and maturation of body tissues.

Diseases of the thyroid gland can result in either production of too much (overactive thyroid disease or hyperthyroidism), too little (underactive thyroid disease or hypothyroidism) thyroid hormone, thyroid nodules, and/or goiter. All types of thyroid problems in women are much more common than thyroid problems in men.

The more I learned about the thyroid, the more I realized its importance in our health including our mental health.  According to an article published by the Thyroid Foundation of Canada, attention has been given to the relationship between thyroid function and mental disorders for the following reasons:

  • Thyroid disorders, such as hyperthyroidism and hypothyroidism, can be accompanied by prominent mental abnormalities.
  • Thyroid hormones have been used in the treatment of certain psychiatric conditions.
  • Some drugs used for the treatment of mental illness can have an effect on the thyroid gland.

 

The article goes on to discuss the mental abnormalities associated with thyroid disorders.  In the case of hyperthyroidism (overactive), common psychological symptoms are anxiety and tension; mood changes; irritability and impatience; overactivity; sensitivity to noise. Psychological symptoms of hypothyroidism (underactive) are slowing of mental processing; loss of initiative and interest; memory difficulties; muddled thinking; depression.

Of course these symptoms may be associated with mental illness when there is not a thyroid disorder but most definitely, anyone experiencing such symptoms should have their doctor order blood work to rule out a thyroid disorder.  In addition, some psychiatric drugs have been found to affect the thyroid so anyone taking psychiatric drugs should have their thyroid regularly monitored.  Hence, the reason for the discovery of my hyperactive thyroid.

In my case, the psychological symptoms are not present.  Instead, I have only been dealing with the physical symptoms of an overactive thyroid, such as a rapid heartbeat, increased sensitivity to heat, bowel changes and sleep disturbances.

Since the exact cause of my overactive thyroid is uncertain at this time (although I suspect it is related to diet and supplement use), I will try to calm my overactive thyroid with some nutritional and natural remedies that I learned about while doing my research.  I figure it can not hurt to try while I wait the three months it is going to take to get in to see the endocrinologist.

Sadly, I learned that individuals with an overactive thyroid should avoid chocolate, coffee, salt, and black tea.  All things I enjoy.  But I will be able to drink lots of green tea and lemon balm tea.  I will increase my intake of broccoli, brussel sprouts, cauliflower, cabbage, peaches, onions and spinach.  The diet changes won’t be difficult since I love those foods anyway but I will miss coffee and chocolate.

I would love to hear from anyone who has had an overactive thyroid and to learn what has worked for them in getting it regulated.  Please be sure to comment on my blog page.

An Illness that Can Attack Mothers

June 16, 2012

(Some names have been changed to protect identity)

In early 1996, eight weeks after the birth of my son, I was struck with postpartum psychosis, a rare, life-threatening illness, the most serious mood and anxiety disorder associated with childbearing. My son was just 8 weeks old when I went three nights without sleep.  I never thought I could experience such a frightening and consuming illness.  I had no prior history of mental illness and was unaware that postpartum psychosis even existed.  Perinatal (includes pregnancy and the first year after a baby is born) mood and anxiety disorders include a spectrum of disorders.  The disorders affect women of every culture, age, income level and race.  Postpartum psychosis can strike 1.1 to 4 out of 1,000 deliveries (Gaynes et.al, 2005).

My first pregnancy ended in miscarriage and I experienced a long and difficult labor and delivery.  Both of which can be risk factors for a mood and anxiety disorder associated with childbearing.

By six weeks my son began sleeping through the night but I could not.  By seven weeks, I was feeling sleep deprived and agitated.  I believed I would soon die.  It was an unexplained feeling but very real.  I found myself so frightened that I could not sleep at all.  The next thing I knew, I was afraid someone was going to kill me and take my baby.  I would learn much later, that I was having a delusion or strange belief, which is a symptom of postpartum psychosis.  But at the time it seemed very real and not at all false.  After the third night without sleep, I was so frightened that I would not even let my husband, the baby’s father, hold our son.

Kelly’s son was nine months old when she knew she wasn’t feeling well but couldn’t describe nor understood what was happening.  She knew she was feeling depressed as she had been away from her baby for a week.  After she returned from her business trip she was struck with postpartum psychosis.  She experienced extreme anxiety, false and delusional thinking and great fear.  Kelly also did not have a prior history of mental illness.  Kelly would go on to experience postpartum psychosis with the birth of her second child.  The second time Kelly experienced postpartum psychosis, it came on very suddenly.  She was taken to the hospital by her husband but she was sent home with just a mild sleep medicine.  By the time she was taken to the hospital again she was not even aware of her surroundings.  Both times Kelly experienced postpartum psychosis she was forced to stop breastfeeding while in the hospital.

The single most predictor or risk factor for a mood and anxiety disorder associated with childbearing is a previous occurrence.  Kelly did not know this as she was not educated about her illness the first time she experienced postpartum psychosis.

Jessica new something was wrong while still in the hospital after giving birth to her first child.  She knew something happening but the nurses didn’t listen and no one explained to her what to expect.  Jessica also experienced some medical problems while still in the hospital.   Once the doctor learned what was happening, she was given an antidepressant.  Soon after she started taking the medicine, she realized that she was going to die but thought it would be okay.  In the night, she began imagining that angels were coming for her.  She even passed out.  The next day her family took her to the doctor.  She tried to escape from the car several times.  After taken to the doctor, she was forcibly hospitalized.  The doctor did not know what was wrong with her.

Postpartum psychosis is often misdiagnosed.  In fact, it is often thought to be postpartum depression.  Postpartum depression is a less serious mood disorder than postpartum psychosis but is more common.  About 20% of mothers experience postpartum depression after the birth of a baby.  In both Jessica and my case, we were thought to have postpartum depression.   Many doctors are not familiar with postpartum psychosis hence the misdiagnosis.  Jessica, Kelly nor I had a prior history of mental illness prior to our pregnancies.  Having a history of mental illness makes a woman at much greater risk for a mood disorder associated with childbearing.  That was the case with Amanda.

Amanda had been diagnosed with bipolar disorder about five years prior to having her son.  She had been stable on medication during that time.  She was off her medicine prior to and during her pregnancy up until the final month of her pregnancy.  She was planning to breastfeed so she was taken off her medicine again after her son was born.  It was not until her son was about three or four months old that she recalls having trouble sleeping after feeding her son at night.  She had gone back to work when her son was eight weeks old.    She told her husband about her sleeping problems so he offered to take over one of the feedings.  It was too late.  She soon began feeling as if people where talking about her and following her.  It heightened into her threatening her husband with a knife and thinking he was trying to take her son from her.  Amanda was aware that she was at a greater risk for some kind of relapse after the birth of her baby since she would be off her medication.  Although she was never actually diagnosed with postpartum psychosis, a link between postpartum psychosis and bipolar disorder has been found.

In the November 2003, the Journal of Clinical Psychiatry published a review.  The review reported a link between postpartum psychosis and bipolar disorder.  The review concluded that understanding the relationship between postpartum psychosis and bipolar disorder has implications for childbearing related treatment as well as long-term treatment.  In fact, the review indicates that similar treatment should be given to women experiencing postpartum psychosis as women experiencing bipolar disorder.  Although Amanda recovered from her postpartum episode, she still undergoes treatment for her bipolar disorder.  Jessica fully recovered from her postpartum psychosis and with preventive measures in place, went on to have a successful second pregnancy and postpartum period.  Kelly and I both were eventually diagnosed with bipolar disorder, postpartum onset.  The recovery period for all of the women was different but treatment with medication, therapy, as well as emotional and spiritual support was necessary for our recovery.

Although mental illness related to childbearing is now better known and understood, there is still ignorance and prejudice surrounding these illnesses as well as mental illnesses, in general.  Mental illness is not a character flaw or a punishment from God.  Mental illness has biological, emotional and spiritual aspects.  All aspects should be addressed in recovery.  Unfortunately, very often all aspects are not addressed.  In the cases of Jessica, Kelly, Amanda and I, if it was not for proper medical care and support from others, the outcome of our stories may have been very different as there is a 5% rate of suicide/infanticide with postpartum psychosis.  It is for this reason that immediate medical attention is required.  If you or someone you know is pregnant or has recently given birth, please offer them practical and emotional support.  If they are experiencing any symptoms of depression or psychosis, advise them to seek medical attention as soon as possible.

Are Psychiatric Medications Prescribed too Frequently?

June 10, 2012

This is a challenging question to answer.  There has definitely been an increase in the number of psychiatric medications prescribed but is this a result of better identification of mental illness or is it as a result of the medications being pushed by doctors and pharmaceutical companies?

I guess it is difficult to determine a definitive reason why there is an increase in the use of mental health medications.  There seems to be research and opinions that support both the better identification of mental illness and that medications are being pushed by doctors and pharmaceutical companies.  I, personally, believe it is a combination of both reasons.

According to a Wall Street Journal article published in November 2011, overall use of psychiatric medications among adults grew 22% from 2001 to 2010.  The percentage is based on prescription-drug pharmacy claims of two million insured U.S. adults and children reported by MedCo Health Solutions, Inc., a pharmacy-benefit manger (click on graph above to see more percentages).

The Wall Street Journal article goes on to state that psychiatric medications are among the most widely-prescribed and biggest-selling drugs in the United States.  Of course, whether the psychiatric drugs are used appropriately or not has been an ongoing concern and debate among the medical community and policy makers.  In my opinion, as an experienced marketing professional, I believe the increase in direct consumer advertising of medications, in particular psychiatric medications, should be a concern.  The advertising influences the consumer’s perception and demand of the medications, whether or not they are necessary.  Although many find benefits from taking medication, it is important to be aware that the pharmaceutical companies are profit-driven.  Yes, there is excellent research conducted by the companies but remember, that they look at whether or not the financial benefits of a medication will be greater than the risks.

So, in my opinion, there is no easy answer to the question of whether or not psychiatric medications are prescribed too frequently.  My recommendation is that individuals do their own research and educate themselves about the diagnosis being given to them.  Medications may not always be necessary and other treatments can be effective.  When medication is recommended, finding the right one can be challenging.  Research the medication and understand the benefits and risks.  Remember that your doctor works for you and you have the right to be a partner in your care and treatment.

I would love to hear what others think on this topic so I encourage comments.

Also, I recently discovered that my subscribe feature on my blog page was not working properly.  Unfortunately, I lost some subscribers.  The problem is now fixed.  If you subscribed to my blog between the end of March and the first week in June, please resubscribe.  I apologize for the inconvenience.

I hope you find the information I provide helpful and informative.  I appreciate you taking the time to read my blogs.

Additional Informational Resources:

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker

Treating Depression: Is there a placebo effect?

MedWatch: The FDA Safety Information and Adverse Event Reporting Program

Antidepressant drug sales plummet as patents expire and patients flee to safer alternatives

How FDA and Big Pharma mislead millions into taking dangerous anti-depressants

Citizens Commission on Human Rights

Post-Traumatic Stress Disorder

May 26, 2012

How many of us have experienced a traumatic life event?  I am sure most of us can answer yes.  But when that event causes ongoing distress and disruption of an individual’s life for more than a month after the event, there could be something more going on than normal stress.  According the Hazelden Foundation, research indicates that 7 to 12 percent of people develop post-traumatic stress disorder (PTSD) at some point in their lives.  Women are more likely than men to develop the disorder.

What is a traumatic event?  A traumatic event can include combat or military experiences, sexual or physical abuse or assault.  It can also include experiencing a serious accident or natural disaster.  Even witnessing someone else experience a traumatic event can cause post-traumatic stress disorder (PTSD).  In fact, according to Postpartum Support International, 1% to 6% of women experience postpartum post-traumatic stress disorder after giving birth to a child.

What are some of the symptoms of Post-Traumatic Stress Disorder (PTSD)?  According the the Mayo Clinic, symptoms usually start within three months of the trauma but in a some cases symptoms may not appear for years after the event.  If you are experiencing some of the following symptoms continually after a traumatic event, it is very possible that you have Post-Traumatic Stress Disorder (PTSD).

Some of the symptoms may include:

  • Flashbacks, or reliving the traumatic event for minutes or even days at a time
  • Upsetting dreams about the traumatic event
  • Trying to avoid thinking or talking about the traumatic event
  • Feeling emotionally numb
  • Avoiding activities you once enjoyed
  • Hopelessness about the future
  • Memory problems
  • Trouble concentrating
  • Difficulty maintaining close relationships
  • Irritability or anger
  • Overwhelming guilt or shame
  • Self-destructive behavior, such as drinking too much
  • Trouble sleeping
  • Being easily startled or frightened
  • Hearing or seeing things that aren’t thereThese symptoms may be sporadic.  Dealing with stress or reminders of the event may increase the symptoms.  It is important that if you believe you may be experiencing Post-Traumatic Stress Disorder (PTSD), that you seek help.

 

What type of help is available?  According to the National Center for PTSD, there are effective treatments for Post-Traumatic Stress Disorder available.  Therapy and medication have been found to be effective treatments for Post-Traumatic Stress Disorder (PTSD).  In particular, Cognitive Behavioral Therapy (CBT) appears to be the most effective treatment for the disorder.  In this type of therapy, your therapist helps you learn to understand and change your thoughts about your trauma and its aftermath.  There are other therapies, such as group therapy and family therapy, that can also help in the treatment of the disorder.

I, personally, have found the benefits of therapy to be invaluable to my recovery from the trauma I experienced relating to the onset of postpartum psychosis and my subsequent hospitalizations.  There is hope for those experiencing post-traumatic stress.  Remember you are not alone, you are not to blame, and things will get better with proper care and treatment.

Many of us recognize that soldiers are at risk for experiencing Post-Traumatic Stress Disorder (PTSD).  As we celebrate Memorial Day, I honor all of the soldiers, both past and present, including my own father, who was a World War II pilot, that have made sacrifices for our freedom.  May we never forget!

What treatments have helped best for those who have experienced post-traumatic stress disorder?  Please share your thoughts and experiences.

 

Physical Problems and Mental Health

May 5, 2012

It appears that individuals with mental illness have higher rates of physical problems, at least according to an U.S. Government report released last month (April 2012).  But do physical problems cause an increased risk of mental illness or does mental illness cause an increased risk of physical problems?

In regard to mental illness being tied to a greater increase in physical problems, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) report released, in April 2012, indicates that adults aged 18 and older who had any type of mental illness in the past year had higher rates of high blood pressure, asthma, diabetes, heart disease and stroke.  Some of the findings in the recent U.S. Government report are:

  • People with major depression in the past year had higher rates of the following chronic health problems than those without major depression: high blood pressure (24 percent vs. 20 percent); asthma (17 percent vs. 11 percent); diabetes (9 percent vs. 7 percent); heart disease (7 percent vs. 5 percent); and stroke (3 percent vs. 1 percent).
  • 22 percent of adults with any type of mental illness in the past year had high blood pressure and nearly 16 percent had asthma. The rates in adults without mental illness were about 18 percent and 11 percent, respectively.
  •  People with mental illness had higher rates of emergency-department use and hospitalization, according to the report. Rates of emergency department use were nearly 48 percent for people with a serious mental illness in the past year and 31 percent for those without a serious mental illness.
  • Hospitalization rates were more than 20 percent for those with a serious mental illness in the past year and less than 12 percent for those without a serious mental illness.

 

Although the report indicates increased risk, in my opinion, the percentages are not drastically different.  Also, the report doesn’t investigate the possible causes of the physical symptoms such as medication side-effects, stress, access to care or if patients with mental illness are treated differently than patients without mental illness.  I am sure some or all of these come into play.  In my own past personal experience, my physical symptoms were often overlooked or placed secondary due to my mental illness diagnosis.  I guess, in that case, the percentages of physical ailments in individuals with mental illness may be even higher.

According to one opinion in an article in World Psychiatry (v.6(1); Feb 2007), in many countries psychiatrists have forgotten that they are medical doctors.  The author of the article believes that “sadly only a small proportion of psychiatrists have an interest in dealing in a comprehensive manner with people struck by physical illness…Despite having a medical diploma, only a few among the psychiatrists are sufficiently well trained in medicine to be able to deal with patients who have a mental and a physical disease at the same time.”  This seems like harsh words but often many doctors push you out the door with a prescription before really investigating and discussing your health and well-being.  Whatever the case, it seems it is necessary that more research be conducted to unravel the puzzle of higher rates of physical illness in people with mental disorders.

 

But what about the other scenario of physical problems increasing the risk of mental illness?  It appears that they do.  For instance, a study by researchers at Brigham and Women’s Hospital in Boston, suggests that women with any history of migraines were about 40 percent more likely to develop depression than women without a similar history.  Also, in many cases, living with chronic physical illness can cause anxiety.

 

A 2006 study completed at the University of Manitoba, showed a higher rate of anxiety in participants that suffered from a physical illness but even higher rates showed in those with respiratory and gastrointestinal diseases, arthritis, allergies, thyroid diseases and migraine headaches.  Debate is ongoing about what comes first the illness or the anxiety because living with chronic stress can also cause physical problems.  According to an article in the August 5, 2008, Harvard Health Publications, regardless of what comes first, people living with chronic physical illness that have untreated anxiety may have an increase in symptoms and the physical illness may become harder to treat.

It may seem that it has to be one way or another but research indicates that mental illness can cause an increased risk of physical symptoms and physical symptoms can cause an increased risk of mental illness, specifically depression and anxiety.

There is no denying the mind and body connection.  If the body can suffer from pseudoseizures, as was the case with me, then I know the line between mental and physical illness is a fine one.  I imagine as more and more research is conducted, the finer the line will become between the two.

If any of you have any further insight or research in this area, I would love to hear about it.  Please comment on my blog post below as it helps bring further insight and understanding.

I hope you find my blogs of interest and helpful.  If you haven’t already done so, please subscribe to future blog email notifications by entering your email address on my blog page.  Also please share my site with a friend or others that you think may find it helpful and of interest.  At the bottom of the posts, there are quick links to share the posts directly through social networks such as Facebook, LinkedIn, Twitter and others.

Thank you for your continued interest and inspiration.

Sources and Links:

Migraines May Raise a Woman’s Odds of Depression

 

Mental Illness Tied to Higher Rates of Physical Problems: Report

 

Physical illness and mental health

 

Depression and physical illness

 

Separating anxiety from physical illness

 

The Link Between Anxiety Disorders and Physical Illness

Mental Health and the Workplace

April 28, 2012

Mental Health and The Workplace

Have you ever been frustrated and overwhelmed with your job?  Have you ever had to work with a difficult co-worker or supervisor?  I imagine most workers can answer yes to these questions.  If you can answer yes to these questions, you probably already know that the environment of the workplace can affect a worker’s well-being and mental health.  According to the Canadian Centre for Occupational Health and Safety, several key issues have been shown to have a significant effect on employee mental health. The following factors not only impact the health of the individual employees, they also impact the health of the organization and the organization’s financial bottom line.

  • Psychological Support
  • Organizational Culture
  • Clear Leadership & Expectations
  • Civility & Respect
  • Psychological Job Fit
  • Growth & Development
  • Recognition & Reward
  • Involvement & Influence
  • Workload Management
  • Engagement
  • Balance
  • Psychological Protection

 

There are several other workplace issues that can affect mental health including stigma and discrimination; demand and reward relationships; job burnout; harassment, violence, and bullying; substance use, misuse and abuse at work.  Organizations should consider all these factors in their efforts to create a mentally healthy workplace.

According to Workplace Mental Health Promotion,there are eight workplace strategies that can positively affect mental health in the workplace.  These include the following:

  1. Encouraging active employee participation and decision making
  2. Clearly defining employees’ duties and responsibilities
  3. Promoting work-life balance
  4. Encouraging respectful and non-derogatory behaviors
  5. Managing workloads
  6. Allowing continuous learning
  7. Having conflict resolution practices in place
  8. Recognizing employees’ contributions effectively

 

Achieving some of these strategies are more challenging than others because organizations are made up of individuals with many personalities and backgrounds.  The differences can make working together difficult.  In general, employees want to feel appreciated, respected and treated as a team player.  Working in a positive environment is so important for positive well-being.

The impact a boss or supervisor has in the workplace environment is huge.  In fact, an online study published in the Journal of Business and Psychology found employees who said their supervisors were coercive, pressuring and authoritarian, or non-supportive, felt their needs weren’t being met and had lower levels of well-being.  And the way an employee feels at work can account for more than a quarter of the differences in work performance between individuals, according to the authors of the study.

The American Psychological Association offers tips for managing your boss which I encourage anyone that is experiencing difficulties with their boss to read.  In my own life, I have been a worker and a boss.  Overall, I have had positive experiences as both.  I have found that stress in the workplace as well as stress in our personal life needs to be managed.  For me, exercise, a healthy diet, counseling, support from family and friends, as well as a healthy spiritual life have all contributed to the healthy well-being, I now maintain.

Have you ever experienced stress in the workplace?  Have you ever had a difficult boss?  If so, what helped or hurt the situation?  I would love for you to share your comments below.

I hope you find this information helpful and consider sharing it with others by clicking on the social network links below.  If you haven’t yet, be sure to provide your email above to receive notification of future blogs.

Interview with Dr. Christina Hibbert

April 24, 2012

1.  Can you tell us a little bit about yourself?  I am first and foremost Wife of OJ (not Simpson) and Mom to Braxton (15 ½ ), Tre (15), Colton (13), Brody (11), Kennedy (8), and Sydney (4). In my “spare time” (ha!) I’m also a Clinical Psychologist in Private Practice specializing in Perinatal Emotional Health, Parenting, Women’s Emotions Across the Lifespan, and Grief/Loss, and I run a weekly Pregnancy & Postpartum Adjustment group too. I’m the Founder/President of the AZ Postpartum Wellness Coalition (Est. 2005) and a Posptartum Support International (PSI) co-coordinator for Arizona. I’m also a frequent speaker and educator, and the Producer of the Postpartum Couples DVD. Most recently, I am a blogger for my new website, www.drchristinahibbert.com, and an author working my tail off to get my first book, This is How We Grow, published soon! Oh, and I’m also a singer-songwriter when I get the chanceJ.

2.  When did you decide you wanted to become a psychologist and focus on mental health related to childbearing?  I knew I wanted to become a psychologist my sophomore year of college, after my 8 year-old sister died. I went through a couple months of counseling that really helped me through my grief. I also had this amazing Intro to Psych teacher that semester who was a mom, a professor, and had a private practice. She inspired me to believe I could do the same.

It wasn’t until I had graduated with my Bachelor’s, was married, and had my first son that I knew I wanted to go back to school to focus my doctoral studies on perinatal mental health. (see next answer for more)

3.  How did you first learn about postpartum depression?   I had always wanted to be a mother, so when we found out I was pregnant I was ecstatic. But after a tricky birth and plenty of sleep deprivation, I was floored by postpartum depression. My husband and I lived with my Mom and Dad, on their living room floor for several weeks as I tried to find help for whatever was happening to me. My OB just sent me a pamphlet on “The Baby Blues;” others said, “Oh, it’s nothing. You’re just tired.” All I wanted was for someone to recognize what I was feeling was real and to tell me, “Yeah. I felt that way too.”

Two and a half years later, when my second son was born, I was prepared (or so I thought).  I’d researched postpartum depression and I had a plan, but it was still a huge challenge for me and I still had no outside support (though my husband was great). I started grad school when that baby was 4 months and my oldest was 3 and that’s when I found Jane Honikman and Postpartum Support International (PSI). I started volunteering with PSI in 2000. I took every course I could on perinatal mood disorders and read every book. Then I did my dissertation on “Postpartum Mood Disorders: The Couple’s Experience,” and produced the Postpartum Couples DVD along with it.

I graduated with my Psy.D. on a Sunday, gave birth to our first baby girl the next Sunday, and moved home to Arizona the next Friday. Being an “expert” on Perinatal Mental Health at that point did help: I was very well connected and had incredible supports in place. But it didn’t prevent my third experience with postpartum depression and anxiety; it only made it a little easier to get through. (I might have also had PPD with my fourth baby, but considering I’d just inherited two kids weeks before giving birth, it was tough to say what was what! See below for more details).

4.  What helped you overcome your own experience with postpartum depression?  1)  Allowing practical help when people offered (help with kids, home, etc) and letting go of the idea that I had to do it all on my own.

2)  Recognizing the importance of sleep! I know now that when I am too tired I simply cannot be nice. I learned to prioritize sleep by taking naps or letting my husband help in the night so I could occasionally sleep through—I’ve even gone away to a hotel for a night just to sleep!

3)   Reaching out for emotional support from others who understand and have “been there”. Though there wasn’t a warmline around when I had my babies, I learned to call on friends, family, colleagues and other PSI volunteers just to talk and feel supported. (That’s one reason I’m very proud of our AZ warmline I co-founded in 2003 that is still going strong! Now no one in AZ needs to feel alone like I did!)

4)   Being real about it helps too. Learning to let go of unrealistic expectations is huge and saved me from so much unnecessary suffering! It was important for me to understand and really believe that having PPD didn’t make me a “bad” mom or any kind of mom—it was simply an illness that was preventing me from feeling like the kind of mom I wanted to be (and actually was), like clouds preventing me from seeing the sun on a rainy day. It helped me learn to give myself credit for all I was doing and who I was becoming through those difficult experiences with PPD.

5.  What do you think is the best way of educating others about mental illness related to childbearing?  Talk about it. To your friends, family, doctors, women at the park and the grocery store. Talk away! For too long it’s been a “secret,” something women and families have felt ashamed of, something they’ve felt afraid to admit. But the more we talk, the more we can accept that perinatal mental illness is real, not our fault, and doesn’t mean anything about who we are. Speaking up shows others that it’s ok (and even better) to be open about how we’re feeling, for this allows us to seek help and feel better so much sooner.

And we need to not only talk to moms. We must talk to dads and other family members and not only because dads can have PPD too, but more so because this is a familial disease—it affects all parties involved with mom and baby.

Of course, providers need to talk about it too. In medical and mental health practices this discussion needs to become a routine part of the childbearing experience. “Describe your emotional health” should be part of every intake form and monthly perinatal visit at doctors’ offices, and “Tell me about your childbearing experience” should be part of every mental health intake form and counseling session with new moms (and dads!).

If every mother, father, friend, grandparent, doctor, nurse, counselor, lactation consultant, (you get my drift) routinely discussed perinatal mental illness with pregnant and postpartum families, imagine what difference that would make!

6.  What message would you like to share with mothers and families facing mental illness related to childbearing?  I really believe in the PSI message and wish every mother, father, and family could not only hear it but believe it: You are not alone. You are not to blame. With help, you will be well.

I would also tell them, as a multiple PPD survivor and now a mom of older kids and teenagers (who are bigger than I am!) that it’s all worth it. All the heartache and suffering and hard work to get well is absolutely worth it. You will have years upon years to enjoy your kiddos, but you have to let yourself seek out whatever help you need to get well first.

And for those who are finally feeling “better,” I would add, don’t just get better. Choose to become even better than better by growing through PPD. I don’t say this to put any pressure on—quite the opposite. I say this as a message of hope that there is so much joy in you to uncover if you will let yourself work to uncover it. I certainly never dreamed up the life I am now living, thanks to the detour handed me by PPD. But choosing to grow through the difficult experiences I’ve been given has made all the difference. Who knows where your PPD experience will one day take you!

7.  How has your professional experience/expertise helped you in your own life?   One reason I was drawn to psychology is because everything I learn can be applied in my own life. I am passionate about becoming the best I can be and then helping others do the same, so I guess you could say my professional experiences help me each and every day as I overcome, become, and flourish in my own life.

But the most profound time when my professional experiences have helped me have been the years after my sister and brother-in-law died in 2007, when we inherited my nephews and had a baby, going from three to six kids in just three weeks. Here I was, an “expert” on Postpartum and Women’s Emotional Health, Parenting, and & Grief and Loss, faced with putting together a new family through grief and loss while “postpartum” myself.  It’s interesting, isn’t it, how we are each prepared for the challenging circumstances that come our way. I was definitely prepared to put this family together. It’s been an indescribable journey for all of us, but the boys are now adopted and we have not only overcome our trials, we are flourishing! (You can read about my experiences  in my upcoming book, This is How We Grow).

8.  What are your top 3 tips for maintaining positive emotional health?

1)  Take good care of your body through sleep, nutrition, and exercise. Good physical health is the foundation for your emotional well-being.

2)  Learn all you can (through books, therapy, classes, etc) about how to overcome your personal emotional health challenges. Do you struggle with depression, anxiety, low sense of self-worth, or something else? Seek out wisdom and practical tools that you can use to overcome whatever seeks to bring you down.

3)  Don’t stop at overcoming. Focus on who you wish to become. Create a vision for your life and who you desire to be. Fill your mind and heart with all the good things you desire, including healthy thoughts and emotions. Remember, only you can create the life you envision, so don’t wait around for it to be created for you. Get out there and build it yourself. This is the path to emotional health and, even more so, the path to flourishing!

(Can you tell my tagline is “Overcoming, becoming, flourishing”?!)

 9.  I understand you are sometimes called the “singing psychologist” so, in your opinion, how does music play a role in one’s emotional health?  Personally, music is huge for my emotional health. When I am writing a song, singing, or playing the guitar or piano, I know I am emotionally well, for music lights me up. It fills me with creative energy that carries throughout my day.

I know not everyone creates or plays music, but listening to music can have a similar effect on our emotional health, for music can create emotion in us. Listening to uplifting music brings a smile to our faces. Listening to sad music can bring us to tears. We can use music to change our mood or to keep us stuck in a mood. Music speaks to us in a language that is quick and deep, and reaches a place that is often hard for us to reach—our soul.

So when your soul needs a lift, put on uplifting music. When you need to know you’re not alone, put on a song that sings straight to you. Avoid filling yourself with music that is contrary to who you are working to be, and instead fill yourself with music that helps you create the emotional well-being you desire. It’s a fabulous tool!

10.  How can readers follow-up with you and is there any other information you would like to share?  I would love for readers to join me and my community of “Really Great People” on my website, www.drchristinahibbert.com, where they can subscribe to my blog, use the resources provided, and connect with me personally too. I would also love to connect on Facebook (www.facebook.com/drchibbert), Twitter (@DrCHibbert), Pinterest (Christina Hibbert), or Goodreads (Dr. Christina Hibbert).

Thank you, Jennifer, for all the incredible work you are doing to help our perinatal families! I appreciate you having me as your guest.

I would love to end with one of my favorite quotes by Karen Kaiser Clark and a question to take with you and ponder:

“Life is change. Growth is optional. Choose wisely.” What will your choice be?

The interview questions are prepared by Jennifer Moyer for her website/blog and answers are published on her website, www.jennifermoyer.com, with permission from Christina Hibbert, Psy.D.

 

 

Please leave your comments below.  You can subscribe to future blogs by entering your email address above.

 

Can Men Suffer From Postpartum Depression?

April 17, 2012

Many people are familiar with postpartum depression in women but postpartum depression in men is hardly ever talked about.  A new baby is a wonderful blessing but the demands of parenthood are very stressful and can be overwhelming to both parents.  Mothers and fathers share many of the same stresses.

According to one of the few studies in the area of paternal depression, in general, 14% of American men develop depression either during their partner’s pregnancy or during the first year postpartum. About 8% of fathers in other countries develop paternal depression.  The problem seems to heighten when babies are 3 to 6 months old.  During this time, 25% of new fathers and 42% of mothers report depression.  If a mother experiences postpartum depression, the father is at much greater risk of experiencing depression as well.

Sleep deprivation is a strong contributor to depression.  Research shows that any healthy adult that goes without good sleep for a month, is at increased risk for experiencing depression.  In addition, the hormonal changes that occur after childbirth can cause depression in both women and men.  Women experience a sharp decline in progesterone and estrogen but men also experience a decline in testosterone.

Unfortunately, fathers experiencing depression are less likely to seek help then mothers.  Mainly because, in general, men avoid treatment for mental health.  Also men experiencing depression often have symptoms that are unique from women.  Some of the symptoms of depression in men may include:

  • Increased anger and conflict with others
  • Increased use of alcohol or other drugs
  • Frustration or irritability
  • Violent behavior
  • Losing weight without trying
  • Isolation from family and friends
  • Being easily stressed
  • Impulsiveness and taking risks, like reckless driving and extramarital sex
  • Feeling discouraged
  • Increases in complaints about physical problems
  • Ongoing physical symptoms, like headaches, digestion problems or pain
  • Problems with concentration and motivation
  • Loss of interest in work, hobbies and sex
  • Working constantly
  • Frustration or irritability
  • Misuse of prescription medication
  • Increased concerns about productivity and functioning at school or work
  • Fatigue
  • Experiencing conflict between how you think you should be as a man and how you actually are
  • Thoughts of suicide

 

Some men may only experience a few symptoms and others may experience many.  What ever the case, it is important to know that the symptoms are treatable and help is available.  For more information see the links below.

 

Sources and Additional Links:

Postpartum Depression Hits as Many Dads as Moms

Prenatal and Postpartum Depression in Fathers and Its Association With Maternal Depression

Helping Men Beat the Baby Blues and Overcome Depression

Postpartum Depression in Men | Video – ABC News

Postpartum Depression in Men: It’s Real

Postpartum Depression Strikes New Fathers, Too

Resources for Fathers

Postpartummen.com

Resources

Information on this web site is for educational purposes only.  It should not substitute for a comprehensive evaluation by a licensed mental health professional.