Acupuncture for Postpartum Depression and Anxiety

A Question & Answer with Holly Crafts, The Motherhood Center's Pregnancy and Postpartum Acupuncturist

Acupuncture has been used to address illnesses for over three thousand years. But the western world has only recently discovered and used acupuncture as a tool to promote and restore a healthy self-care routine; and for many great reasons, acupuncture has evolved into being known as one of the best alternative medicinal treatments in the world.

Since its creation, ancient Chinese acupuncture has revolved around Qi, an internal energy force that can regulate your body’s balance and energy. When factors like a stressful commute or family fight disrupt your body’s Qi, it is said to create anxiety, disease, and pain offsetting the body’s median.

In today’s society, our bodies are in a constant fight or flight response. Acupuncture can help relieve that tension and anxiety our bodies feel,

says Holly Crafts, a New York City Acupuncturist and mother of two. Here, at The Motherhood Center, we believe acupuncture can be a wonderful addition to any new or expecting mother’s self-care routine. Below is our interview with Holly Crafts, TMC’s perinatal acupuncturist:

What type of perinatal mood and anxiety disorders does acupuncture help manage?

Acupuncture helps manage several symptoms, but the most common are: anxiety; depression; OCD/ruminative thinking; PTSD; panic disorders and general stress.

From a scientific perspective, how does acupuncture work?

Depending on which body points are targeted and where the needles are inserted, acupuncture can,

  1.   cause the nervous system to produce painkilling chemicals, or neurotransmitters;

  2. jump-start the body’s natural ability to heal itself by resetting the nervous system from its fight or flight activation to rest and digest setting;

  3. and/or stimulate the part of the brain that releases feel-good hormones and controls emotions, including depression and anxiety.

Is acupuncture safe for women while pregnant?

Yes, it is absolutely safe for pregnant women!

If so, does it also treat the baby- as well as the mother?

There’s an old saying in Chinese medicine,

treat the mother, treat the child,

which is to suggest that what is beneficial for the mom, is also beneficial for the baby. Because, acupuncture can promote relaxation by lowering blood pressure, mitigating the release of stress hormones, and promoting healthy circulation in mothers, the same can also benefit the baby. Any good habit you adapt into your lifestyle, like sleeping, exercising, eating nutrient dense foods or getting acupuncture, is just as good for the child as it is for the mother!  

How often should a woman receive acupuncture treatment in order to see health improvements?

Although it depends on the individual, and her health history, generally, the mother should seek treatment for 4-6 weeks in order to see health improvements. This is a great way to create a healthy lifestyle habit and incorporate acupuncture into one’s overall healthy self-care routine.

Besides addressing PMADS, how else is acupuncture helpful?

Acupuncture and Chinese herbal medicine can be an invaluable part of post-labor recovery, helping with lactation promotion; stress management; pain relief; promotion of healthy digestion; improved quality of sleep; addiction, and withdrawal side effects; general immunity, including seasonal allergies; skin issues, in both mother and child; healing of tissues (incision/tearing), post-surgical and wound recovery; improving blood production; and recalibrating hormones as the body transitions from pregnancy through labor and delivery.

Acupuncture and Chinese herbal medicine can also be extremely essential in: the 1st year postpartum by… reducing anxiety, helping promote calm and positive moods; improving the quality of sleep; supporting healthy thyroid & pituitary function to balance hormones; promoting a healthy appetite and digestion; easing body aches and muscle spasms, before they become chronic pain patterns (like the nursing hunch and the “baby back” low back pain); and reducing overall stress.

What is the difference between Chinese acupuncture and western acupuncture?

The essential difference between Western acupuncture or “dry needling” vs Chinese acupuncture, is that the latter is part of a larger philosophy of health, including herbal medicine, manual therapy and lifestyle modifications.

Western acupuncture, including dry needling, can be practiced by non-licensed practitioners (ie. a chiropractor or physical therapist), though this is without the training and experience of a lengthy master’s acupuncture program.

Do they both treat perinatal mood and anxiety disorders?

No, western acupuncture (dry needling) only treats musculoskeletal pain.

Does acupuncture hurt?

Acupuncture needles are solid and so thin that they can be tied into a knot.

The most common response to the first needle is ‘that’s it?!’

Beyond the initial pinch of insertion, there might be warmth, heaviness or a tingling sensation. There could also be a deep and dull, weighted feeling, or ache. However, most commonly, people are surprised by the sensation, expecting it to feel like a shot, but it often doesn’t feel like anything!

If I am pregnant, can my baby feel the needles?

Needles are only inserted right below the skin to the superficial layer of the muscles. As far as we know, your baby can only feel the calming effect of your nervous system response.

How long is a typical session, and do I have to go every week to see improvements?

A typical session lasts between 20-45 minutes. It is recommended to go every week; however, it is not necessary.

Will the more I go the better I feel?

Yes, acupuncture is similar to exercise in that it has a cumulative effect.

Can my toddler get acupuncture with me? Is it safe?

Acupuncture is safe for children as young as 1 day old, though the treatments for children only last a few moments. As long as it will be relaxing for you to have your child nearby, and there is adequate staff on hand, it is fine and safe to have your child in the room.

Do you individually treat women depending on their symptoms?

Yes, each treatment is tailored to the unique presentation and current needs of the individual on that day, at that moment. At the same time, there is also similarity in treatments and point selection across the same health concern or condition.

If I am not experiencing a PMAD, should I still receive acupuncture to help address any symptoms?

Absolutely! Acupuncture is one facet of medical based prevention methods! Supporting the body’s hormones to stay in balance, maintaining healthy blood pressure and appropriately responding to stress, will help prevent any myriad conditions.


The Motherhood Center offers a weekly acupuncture group session with Holly Crafts for pregnant and postpartum women on Mondays from 3 to 4 PM.

Holly is a licensed acupuncturist and received her master’s degree in acupuncture and Chinese herbal medicine from Pacific College of Oriental Medicine in New York.

The Motherhood Center would like to thank Holly Crafts for speaking with us about acupuncture, and allowing us to interview her for this blog post.  

Please find her information and class sign up linked here:


Body-Based Practices in the Perinatal Period

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Body-based practices such as yoga that include movement and breath work can be a powerful skill set for women in the perinatal period. The transition to motherhood includes normal physiological changes that are adaptive to the stages of pregnancy, birth and postpartum. These bodily changes, however, can influence mood and increase the chances of depression or other intense stress reactions. The Restorative Movement group at The Motherhood Center utilizes body-based practices to address this mind-body connection, focusing on skills that seek to decrease arousal and reclaim the bodily experience of emotion.

Most therapies, including psychological and pharmacological, target normalization of the stress response through cognitive processes and brain chemistries. Since physical syndromes and bodily sensations are a part of the symptomology of mood disturbances, engaging with those sensations through interoceptive processes like yoga and other mindfulness practices can be instrumental in resetting the stress response and managing emotions. It is normal to feel “out of control” of our emotions sometimes. By instructing the body and breath in deliberate ways, we can work to establish or re-establish a sense of agency over ourselves.

Working with a PMAD population requires extra sensitivity and is best served by a trauma-informed approach with a focus on safety and autonomy. In this particular setting, less is more when it comes to movement and breath work. Instead, the yoga practice is utilized as a “noticing” practice with lots of options to self-direct and modify, which means moms are free to feel what they feel without becoming overwhelmed, ashamed or collapsed. This kind of self-reflection is a skill that can enhance our ability to not only regulate emotions but perhaps even understand our driving factors.

The easiest example of how yoga can impact emotion regulation is through the effect of yogic breathing. The breath is an automatic function that is necessary for survival. Because of this, information from the respiratory system is noticed and attended to immediately by the brain. We can use this to our advantage by deliberately controlling the breath to effect change in the body. Specifically, it is the act of the exhale that slows the heart rate and activates the “rest and digest” part of our nervous system. In restorative movement, we experiment with different breathing techniques as a way to soothe the body and decrease arousal.

It is not uncommon to hear from moms though that they are too tired or overwhelmed to “work out” with the body. The most important takeaway here is that less is more, especially during this profound period of transition. In fact, focusing less on time and more on frequency is critical to recovery. If we do a little bit of practice every day, we are far more likely to effect change. Like any habit, emotion regulation is a pattern of physiological functions that repeats itself in response to different stimuli or stressors. To change these patterns, it is more important to do one thing consistently over time than to attempt an hour at the gym once a week.

Sometimes the practice is simply acknowledging that we are tired. It is also okay to let the body rest. In fact, short periods of constructive rest throughout the day can deeply impact a mother’s felt experience and replenish her reserves to cope. Instead of working out, we are “tuning in”. By cultivating stillness, we learn that there is an internal sanctuary to which we can retreat at anytime, even if it’s for just three cycles of deliberate breath. This restorative aspect of the yoga practice is an important part of the Restorative Movement group – it provides safe, structured down time for moms to relax and reintroduce feelings of well-being.

These body-based practices are just one part of the integrated approach to healing at The Motherhood Center, which recognizes the importance of engaging the whole person in treatment through a collaborative and interdisciplinary effort. Stress is often multi-dimensional and so it makes sense that supports are equally dimensional in which there are varying opportunities to regain balance. By taking time to nourish and soothe the body through restorative movement, we are supporting our chances of returning to a physiological steady state. From this steady state, moms can begin the process of rebuilding their emotional scaffolding in order to better cope with the transition to motherhood.

TJ Halliday is a certified yoga instructor currently completing a Master’s Degree in Clinical Psychology + Mind Body Connection at Columbia University. She leads yoga for Day Program clients at The Motherhood Center.

#MomBoss: A Conversation with The Bump and TMC's Paige Bellenbaum

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Originally Published November 2018 on The Bump
Read the Original Article Here

TELL US A LITTLE BIT ABOUT YOURSELF

I’m a California girl–born and raised in San Francisco. I moved to New York City in 2000 to attend Columbia University for my Masters in social work. I was all ready to move back to San Francisco, but right before then, I met my husband-to-be. In 2005, after one month of marriage, we found out we were pregnant. I guess I’m fortunate in the sense that my husband only had to look at me for that to happen. After our son Max was born, I was immediately filled with intense anxiety, which led to severe postpartum depression. Catherine Birndorf, MD, co-founder of the Motherhood Center, was actually part of my clinical treatment team, but we didn’t realize this connection until much later!

WHAT ARE SOME FEELINGS YOU EXPERIENCED BEFORE GETTING HELP?

It was the darkest time of my life and I almost lost my life because of it. It’s like being in an ocean and not being able to swim, and just waiting for someone to throw you a life preserver. I couldn’t believe that nobody was talking about it, despite the fact that research suggests 1 in 5 new and expectant mothers experience a perinatal mood and anxiety disorder, otherwise known as postpartum depression (PPD).

IS THAT WHAT MADE YOU BECOME A CHAMPION FOR THE CAUSE?

After I recovered with the help of medication and therapy, I became furious that nobody was talking about how common PPD is. Instead, women like myself feel guilty and ashamed for their feelings and thoughts and keep it to themselves. I worked with a New York state senator to draft legislation requiring new mothers to be educated about PPD before they are discharged from the hospital, and strongly encouraging ob-gyns and pediatricians to screen for PPD.

My primary goal in life is to make sure other women suffering from perinatal depression and anxiety don’t have to suffer silently, which is why I agreed to help open The Motherhood Center with Catherine!

CAN YOU EXPLAIN WHAT THE MOTHERHOOD CENTER IS?

The Motherhood Center is a first-of its-kind clinical treatment facility in New York City for pregnant and new moms suffering from perinatal mood and anxiety disorders (PMADs), otherwise referred to as postpartum depression. We offer various tiers of treatment based on the client’s symptom severity, including:

  • A day program with a nursery for the babies

  • Outpatient therapy and medication management

  • Support groups for new and expectant moms who are having a difficult transition to parenthood

  • Various classes and workshops preparing mothers for childbirth, breastfeeding support, and much more Clients are referred to us primarily by ob-gyns, pediatricians, doulas, psychiatrists and therapists, but we also get a lot of referrals from our social media efforts.

THAT’S INCREDIBLE! WHAT ARE SOME SERVICES IT OFFERS TO NEW AND EXPECTING MOMS?

The Motherhood Center is one of only a handful of “Perinatal Day Programs” in the US. Our Day Program provides clinical treatment for new and expecting mothers with severe PMADs, who are having a very difficult time caring for themselves and/or the baby. Clients of the Day Program are with us five days a week, five hours a day and their babies are cared for in the nursery. Clients participate in therapeutic support groups, mindfulness, meditation, art therapy, yoga and more, and each one is followed by an individual therapist and psychiatrist that specializes in PMADs. What truly differentiates us is that, unlike the handful of other day programs out there, we’re not affiliated with a hospital. We are a standalone center, meaning we have the ability to create a warm, nurturing, non-clinical environment for women receiving treatment. It feels like a giant living room!

HOW HAS THE STIGMA AROUND PPD CHANGED SINCE YOU FIRST GOT INVOLVED?

People are starting to talk about it more! Celebrities like Chrissy TeigenSerena Williams and Adele sharing their personal experiences with postpartum depression gives permission to women everywhere to talk about it and hopefully seek treatment. Many states have legislation on the books, which includes mandatory screening, PMAD education, public awareness campaigns and more. And many national medical associations are strongly recommending screening for PMADs.

HOW CAN SOMEONE SUPPORT A FRIEND WHO’S STRUGGLING WITH PPD?

Ask mom how she is doing. All the attention is on the mom until the baby is born, and then mom is left in the dust. If mom appears to be overly anxious, depressed or easily irritated, is having obsessive thoughts that are running like a hamster wheel in her head or feels helpless or hopeless, she may be suffering from a PMAD.

You can let her know that she’s not alone—more than 20 percent of new moms experience postpartum depression and anxiety, and those are just the ones who talk about it. Tell her it’s not her fault and that she can feel better with the right support and treatment.

IF YOU COULD GO BACK IN TIME, PRE-BABY, WHAT ADVICE WOULD YOU GIVE YOURSELF?

I would have told myself women who have a history of depression and/or anxiety are at a much greater risk of developing a PMAD. I didn’t know that at the time. I would have had a treatment team all set up for me, and I would have warned everyone around me to look out for the signs. I would have screamed in my own face, yelling, “Asking for help does not mean you’re a bad mom! Every new mom needs help! We are one of the only cultures in the world that doesn’t have built-in support for new moms!”

WHAT WAS IT LIKE TO GAVE BIRTH TO YOUR DAUGHTER SO SOON AFTER OVERCOMING PPD?

It was the second hardest thing that happened after my PPD. My daughter was a huge surprise. It honestly compares to the immaculate conception (remember earlier when I told you all my husband has to do is look at me?!).

I was so not ready to have another baby. In fact, I was never going to have another baby after Max was born. I couldn’t tolerate going through that again. But after some serious soul searching (and therapy), I decided that I was not going to let my first experience define me. I took total control over my situation, and I created a plan that covered all the areas I felt had contributed to my PPD the first time. I did everything differently, and it paid off. I did have a PPD relapse when she was 9 months old, but it was less severe and I knew exactly what to do. Antidepressants are wonderful thing.

HOW DOES RAISING ONE CHILD DIFFER FROM TWO?

Going from one to two kids is like going from 1 to 10. My kids are two years apart, so they were both in diapers for a substantial period of time. And sorry, No. 2, but by the time mom gets to you, we have often been through the worst of it with the first one and now we have perspective. The second-born has to figure out a lot of things on her own!

WHAT’S YOUR GUILTY MOM PLEASURE?!

Red wine and binge-watching British crime shows with my 85-pound mama pitbull snuggled up under my chin.

WHAT’S ONE THING YOU THINK ALL NEW PARENTS SHOULD KNOW?

If you or someone you know is suffering from postpartum depression and you live in the New York Tri-State Area, call The Motherhood Center at 212-335-0035 to get the help that’s needed to feel better.

For national resources, visit Postpartum Support International (PSI). PSI has PMAD resources available in every city and town across the US.

When Life After Baby Isn’t All Rainbows & Butterflies: A Discussion with Catherine Birndorf, MD and Cleo

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Many transitions in life are difficult — especially the transition to parenthood — but we tend to talk about the newborn period as one of instant bonding and bliss. For a lot of new moms, that’s not their experience, and that’s 100% normal.

But what’s the line between feeling like “Wow, this is a really tough time. I’m struggling with this adjustment,” and “Hmm. I think I might have perinatal depression (PPD) or anxiety (PPA)”? In this chat, we’re going to be talking with Catherine Birndorf, M.D, a reproductive psychiatrist and co-founder of The Motherhood Center in New York City, about this grey area between “well” and “sick”, when to seek help, what the standard is for a diagnosis of PPD or PPA, and what the research shows about prevention and treatment.

Click Here to Listen

This Discussion was originally recorded on 10/31/2018

The Inaugural "Not Safe For Mom Group” Event

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On the night before Halloween, over 40 women gathered together at The Motherhood Center (TMC) to talk about the kinds of things many people avoid talking about altogether: from mental health and PMADs, to their sex lives, to their feelings about their postpartum bodies, to the deep-rooted biases they experienced in the workplace. Was this a reunion of sorts? An organized meet-up of moms who’ve shared space many times before? Not at all. These women were, almost all of them, strangers — and they opened up because, perhaps for the first time ever — they were invited to.

This invitation came from the joint venture between TMC and the recently launched, Not Safe For Mom Group (NSFMG), a community founded by writer, Alexis Barad-Cutler. NSFMG has quickly gained popularity by its followers as being, “The Mom Group You Didn’t Know You Needed,” where women share stories about the grittier sides of motherhood without fear of judgment or stigma. TMC and NSFMG decided to partner on NSFMG’s inaugural event — the purpose of which, was to bring the same feeling of openness and connection that occurs in the online community, to a real life setting.

The evening was moderated by Alexis Barad-Cutler, and guided by four seasoned and very impressive panelists: Paige Bellenbaum, of TMC; Christy DeGallerie: a writer, activist, and performer; Sarah Lux-Lee, founder of Mindr; and Rachel Hills, author of “The Sex Myth.” The panelists boldly engaged in each topic so that the audience felt brave enough to jump into the conversation. This was no ordinary panel format event — but a true, interactive, panel-meets-audience experience.

Mothers came from Connecticut, New Jersey, the Bronx, and Queens (in addition to Brooklyn and Manhattan) to participate in the evening. For some, it was the first time they had ever left their babies for a night out. For some of the more seasoned moms, TMC was a bittersweet discovery — as they wished it had existed when they had had their own babies. Still, so many attendees were thrilled at the opportunity to learn about the center from inside its walls, and to be able to share information about it with their own circles.

The event went way over time, and barely anyone budged — despite the babysitters, and partners waiting at home. And for those who had some time to spare, there were empanadas (and other Cuban fare), and natural wine to partake of — thanks to sponsors Fooda, and Dry Farm Wines (respectively). We are excited to see what’s in store for this new partnership in 2019. Stay tuned!

Alexis Barad-Cutler is a writer, and the founder of (nsfmg) Not Safe for Mom Group.


WHEN YOU SUSPECT A FRIEND OR LOVED ONE IS SUFFERING FROM PMADs

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The Motherhood Center of New York’s own Paige Bellenbaum joins Deb Flashenberg for the The Prenatal Yoga Center's blog series Yoga | Birth | Babies.

“Have you ever had a friend or family member you suspected was suffering from a Perinatal Mood and Anxiety Disorder and just didn’t know if or how to approach them? With more than 20% of new parents suffering from Perinatal Mood and Anxiety Disorders it is important to have the tools and language to help.

In this episode of Yoga | Birth | Babies, I welcome back licensed social worker and program director of the Motherhood Center, Paige Bellenbaum. Paige discusses how to approach a person you suspect may be suffering from Perinatal Mood and Anxiety Disorders. She offers a way to gently converse with the parent without making them feel probed or awkward. This is a very important episode for birth workers and those supporting a new parent.”

Listen on iTunes

Listen on Stitcher

Listen on The Prenatal Yoga Center’s Website


If you think you have PPD, Call The Motherhood Center at 212-335-0034. We are here to tell you for sure if you have postpartum depression or postpartum anxiety. And more importantly, if you do, we will provide the treatment you need to feel better.

The Important Role Doulas Play in Recognizing Perinatal Mood and Anxiety Disorders 

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In the past five years there has been a flurry of attention given to perinatal mood and anxiety disorders (PMADs) otherwise referred to as postpartum depression. Famous women like Gweneth Paltrow, Chrissy Teigen, Adele, and Adele's friend who just shared her own postpartum psychosis story, have come forward with their personal PMAD struggles. National medical associations like the AAP (American Association of Pediatrics) and ACOG (American College of Obstetricians and Gynecologists) now recommend screening for PMADs during pregnancy, postpartum and at child well visits. These are critical steps in changing the conversation and stigma that have historically surrounded PMADs. 

 

There is one group of providers that are growing in popularity nationwide that can also play a key role in the identification of PMADs in new and expecting mothers – DOULA’s. A Doula is a person who offers non-clinical, judgement free support to others as they transition through major life experiences. Doulas specialize in different areas of perinatal care including labor and birth, postpartum, antepartum and death. 

 

The doula movement arose in response to the lack of postpartum care available from traditional care providers in the U.S. Whereas the relationship between a woman and her OBGYN or her baby's pediatrician are undeniably critical to the physical health and wellbeing of both, a doula establishes a more intimate relationship with the new or expecting mom - allowing her more exposure to mom's emotional health. Often, doulas will come to the home prior to the delivery of the baby and have multiple meetings to establish a relationship and discuss the birth plan with the expecting mother, allowing a bird’s eye view to the woman's immediate environment. In doing so, Doula's are exposed to potential external stressors that may exist in the home or in the couple's relationship - both putting a woman at greater risk for the onset of a PMAD. They can also observe any obvious psychological changes in the woman over the perinatal period and in the immediate postpartum. 

 

Recently, Doula groups like Carriage House Birth in New York City, are working with PMAD treatment providers like TheMotherhood Center to recognize the importance of integrating PMAD awareness into their doula trainings. Doulas need the basic skills to do the following: Recognize when a woman may be experiencing a PMAD; have the conversation with a new or expecting mother that appears to be suffering; and most importantly - refer a woman for support and treatment. 

 

A doula doesn't need to be a professional mental health provider to recognize a PMAD. The signs can be easily detected for someone trained:

·       This woman is excessively worried about her pregnancy or the new baby - contacting the
doula or pediatrician multiple times a day.

·       She is crying frequently and saying that she is a failure, she can't do anything right, or that
she has made a huge mistake.

·       She obsessively washes bottles, does laundry, ruminates about harm coming to the baby

·       She tells you she feels helpless or hopeless - and she refrains from seeing friends and
family or leaving the house.

·       She can't sleep when the baby sleeps at night, or she sleeps all the time - she has no
appetite and is having a hard time caring for herself and/or the baby.

·       She is irritable and angry, sometimes rageful.  

·       In severe cases, she may share that she has thoughts of ending her life or the baby’s life.

 

With proper awareness and training, a doula can feel comfortable and confident recognizing these symptoms and having a conversation about them. She can say, "Becoming a new mother is one of the hardest things a woman can do, we don't talk enough about the hard part. It's very common for new mothers to feel anxious and overwhelmed by this new responsibility – being a new mom can feel like it's too much. What has it been like for you?" If mom says she is really struggling a doula can say: "I have heard so many women say exactly the same thing. You are not alone, and you can feel much better with the right support. I have some resources to help you get through this challenging time, and enjoy being a mother more. Should we make the call together?" Partners and other family members also play a critical role in the mental health of the pregnant or new mom and can be educated on where to go for help. 

If untreated, PMADs can have a negative impact on the baby's development and the bond between mother and child. It's imperative for all providers that come in contact with new and expecting mothers to look out for the signs and symptoms of PMADs. PMADs are the most common birth complication among women. 1 in 5 new and expecting mothers experience a PMAD, and to her - it feels like she is drowning in an endless, dark sea, just waiting for someone to throw her a life preserver.

As seen in Every Mother Counts September 2018

To learn more about PMADs or for resources for women that are struggling visit Postpartum Support International (hyperlink http://www.postpartum.net/). If you are located in the New York Tri-State area call The Motherhood Center at  call 212-335-0034.

Having Another Baby After Postpartum Depression

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16 months after my son Max was born, I felt like I was finally in the clear from my diagnosis of severe postpartum depression (PPD) and anxiety. It had taken months for me to seek treatment and months to get better, but I was finally enjoying the little guy. I remember the 16 month mark because I attended a Local PPD support group, finally feeling strong enough to be around other women’s pain. The group was a cathartic experience; I was able to tell the new moms that were struggling with PPD and anxiety in real time, that they were going to be ok. That I had felt their pain, went on medication, went into therapy and finally felt like myself again–plus one. I left the group feeling so thankful that my dark journey had finally come to an end. 

A few weeks later, I was at a conference for work and realized I hadn’t had my period in a while. I wasn’t super worried because the last time I had sex with my husband barely counted, but I had a pregnancy test in my bag from an earlier scare (I had convinced myself that sex = baby = PPD), and so I decide to take it just to be sure. 

I remember listening to Vampire Weekend in the background (to this day I can’t listen to them because it brings these moments back), and I laid the stick on the counter and started responding to work emails. I forgot about the test for a good 20 minutes, then returned to the bathroom to see the results.

PANIC. Sheer and utter panic as I picked up the stick. I shook it, I turned it around and around trying to make the positive line disappear. This can’t be happening; it must be an expired test. Surely it's wrong because I had it in my bag for some time. This. Isn’t. Happening. 

You see, after postpartum depression with my son, I had no intention whatsoever of having another child. I did not ever want to go back to that place, ever. I couldn’t do this again–so soon –I had just started feeling like myself again.

That night I spent hours curled up in a ball on the bathroom floor holding the stick. I kept looking at it over and over again to see if the line had gone away. It was still there. In the morning, the line was still there and it was beginning to set in that I may actually be pregnant. I decided to call my husband. My postpartum depression with my son had really done a number on us as a couple. While I silently (and not so silently) struggled with becoming a mother, he made it a point to be out as much as possible. He didn’t know what to do to help me, so he self admittedly ran–literally. He began training for triathlons. I worried this news would destroy us as a couple. What should be one of the most exciting phone calls to make felt like the heaviest and darkest call ever. 

I told him I had taken a pregnancy test and it was positive. I told him it was all going to be ok, and we could talk about it in person when I got back from my trip. He was with a friend when I told him the news so his response was infused with his typical dry sense of humor. He said, “Well this is going to be exciting.” 

For the next two days at the conference, I made the mistake of confiding in a colleague who was immediately overjoyed with my news. When I explained to her that I didn’t think I could do it again after the first time, she told me that having two kids was the best thing she ever did, and I should just be thankful for this gift. I ran into the bathroom and cried.

The darkness was coming back. The feelings of hopelessness and helplessness that I had fought so hard to get rid of were creeping back in around the corners.

When I got home, I was happy to see my son, but was also hit with a wave of memories of how hard it had been when he was an infant. I told my husband that I didn’t know what I was going to do yet with this news, and I didn’t want to talk about it until I had a chance to process it. I shut him out and collapsed inside of myself to find the answer.

I called in sick to work for a few days and hid under my covers thinking about what to do. I didn't want this baby, and I didn’t want to have to go through what I went through with my son ever again. I called planned parenthood and made an appointment for the following week. I didn’t tell anyone.

But then, one night, my husband asked me to sit down on his lap. He told me that he knew I was struggling with this decision, and he would support me whatever I decided to do. He just didn’t want to lose me. We cried in each other’s arms, and I knew in that moment that we were going to figure it out–together.

Another baby. Wow. I began to slowly wrap my head around this reality. The more I did, the more I felt determined to have a different experience

I took better emotional care of myself during my second pregnancy. I continued individual therapy and began couples therapy with my husband with a focus on becoming a stronger unit. Many times, on that couch he cried and told me how sorry he was that he didn’t know how to take care of me after Max was born and that he would do a better job the second time. 

I went to acupuncture once a week and exercised and rested as much as I could. I thought a lot about what contributed to my PPD the first time: The isolation day after day alone with my son, feeling completely disconnected from achievements in my professional life, not having a community of like-minded new moms who were not afraid to talk about the dark side of having a baby, and most importantly, an overwhelming sense of shame at having to ask for help.

So I took control. I was going to be in charge of this experience–it wasn’t just going to happen to me. I created a postpartum plan, including all the things I needed the first time, but didn’t know. I had my mother-in-law agree to stay for the first month after the baby came (a mixed bag but she didn’t speak any English so I saw that as a plus) and my mom agreed to stay the month after that. I negotiated a part-time work schedule with my job, allowing me to work as many or as few hours a week as I could to stay connected. I lined up a group of second time expecting moms all due around the same time. I welcomed an epidural as my delivery with my son was physically and emotionally traumatic, all-natural 20 hours of labor that left me a shell of myself. 

Most importantly, I made sure that everyone around me knew how to recognize the warning signs of PMADs with a treatment team at the ready. Karen Kleiman writes in her book, “What Am I Thinking? Having A Baby After Postpartum Depression”: 

“The good news is that with proper preparation and planning and a healthcare team that is mobilized on your behalf, we can intervene in ways that will minimize the likelihood that you will experience a depression to the same degree that you did previously”. 

And you know what? I had a totally different experience the second time around. All of the safety measures I put in place for myself paid off. All the support I lined up, the community I built, and the perspective I had the second time around made it completely different. And most importantly, I asked for help–every day, all the time. 

I can’t imagine what life would be like without Ella. She is a strong-willed, confident, outspoken little terror and I love her madly

I am in no way urging moms who have experienced a PMAD with their first baby to try it again. I just want to plant the seed that for those of us who had a PMAD the first time around, there is hope.  

As seen in the 9/4/2018 Article on ScaryMommy.com

Paige Bellenbaum, LMSW is the Program Director at The Motherhood Center of New York, which provides clinical treatment and support to new and expecting mothers experiencing perinatal mood and anxiety disorders. If you live in the New York City Tri-State area, call The Motherhood Center at 212-335-0034. For resources in other states visit Postpartum Support International.

Postpartum Anxiety: What is it?

Anxiety is a normal emotion for which humans are hardwired to experience. We needed and still need the ‘fight or flight’ response to know how to deal with fearful and life-threatening situations. With anxiety disorders, however, this normal response is the system over-reacting, becoming over-stimulated and developing into an illness which inhibits you from functioning normally in your personal and/or professional life. Women are especially vulnerable to anxiety during the postpartum period. Read on to learn how to recognize the signs of postpartum anxiety and the support systems that are available.