PPD

PPD Changed This Mom’s Life—Here’s What She Wants You to Know

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

The following is an interview with The Motherhood Center’s co-founder Paige Bellenbaum.

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.

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.


Trauma Informed Care (TIC) in the Perinatal Period

Traumatic Experiences and PTSD

Approximately 70% of people will be exposed to at least one traumatic event during the course of their life and from that 8% will develop Post Traumatic Stress Disorder (PTSD). PTSD is marked by unwanted, intrusive memories of a traumatic event(s), increased emotional or physical distress and reactivity, feelings of being on high alert, difficulty sleeping and concentrating, as well as avoidance of reminders of the event(s). While most people who experience traumatic events don’t develop PTSD, women are two times more likely than men to experience a traumatic stress response, and approximately 1 in 10 women will be diagnosed with PTSD in their lifetime.

Trauma and PMADs

One quarter of women will experience physical or sexual abuse or neglect over the course of their life. A history of trauma or a traumatic childbirth increases the risk that a woman will develop complications during pregnancy or postpartum, including developing a Perinatal Mood or Anxiety Disorder. Three percent of pregnant women and 4% of postpartum women are diagnosed with PTSD, though many more experience the emotional, psychological, and behavioral impact of traumatic events. The effects of trauma can “flare” at times of transition and change, and the perinatal period is a time of profound emotional, physical, social and interpersonal transformation for a woman. While it is difficult to differentiate whether previous experiences or a traumatic birth contributes to the development of PTSD in the postpartum period, it nevertheless requires attention because of the vulnerability of mom and baby during this time.

Trauma Informed Care in the Perinatal Period

Trauma Informed Care (TIC) is a framework and set a of practices and principles that address the ways in which traumatic events shape, color and influence a person’s experience in the world and over the course of their life. TIC care shifts the question from “What is wrong with you?” to “What happened to you?” as a way to remove stigma and blame from survivors of trauma.

As both an individual practice and organizational model, Trauma Informed Care (TIC) addresses the following:

  • Acknowledges that traumatic events have the potential to create a ripple effect across social/relational, emotional, behavioral, and physical domains.

  • Provides screening for trauma as standard clinical practice.

  • Educates survivors and all providers (even non-clinical staff) about the ways in which trauma negatively impacts individuals, families, and systems.

  • Seeks to minimize power dynamics and the potential for re-traumatization by providers and systems by promoting trust, safety, collaboration, and choice helps individuals cultivate a sense of resilience, empowerment, and control uses evidence-based treatment interventions to address the impact of trauma.

  • Engages other providers and organizations to holistically approach each individual.

In addition to the above, Trauma Informed Care in the perinatal period draws specific attention to the potential intersection of previous adverse life experiences and the transition into motherhood - physically, emotionally, psychologically, and interpersonally. The TIC model is at best vital and worst helpful - not just in the field of maternal mental health, but perhaps even more so for providers attending to the physical health of pregnant and new mothers, and their children.

For all mothers, pregnancy and the postpartum period can be a destabilizing, emotional time that involves the feeling of loss of control and a sense of being more “tuned in” to threats of danger, while feeling unskilled in attending to the developmental needs of their baby. In the perinatal period these feelings can be amplified by experiences of trauma, which can impact the ongoing experience of both mother and baby. Being a survivor of trauma is not a determinate and with the elements of TIC, moms can access new experiences that help shift unhelpful narratives they have around themselves, their relationships, and the transition to motherhood, so that they make more conscious choices in coping and healing.


If you or someone you know is suffering from PPD, we encourage you to contact a member of our team at The Motherhood Center. We can help provide support in the form of counseling, consultations, group meeting, seminars, and an extended network of resources. Additional info about our support programs can also be found here.


About the Author

Meredith Carlisle is a therapist in The Motherhood Center’s Day Program, and a Licensed Clinical Social Worker with a Master’s Degree from Columbia University School of Social Work. Meredith trained in trauma informed cognitive behavioral therapy and dialectical behavioral therapy, and has practiced in residential, day treatment and out-patient settings. In the aftermath of the Sandy Hook tragedy, Meredith provided volunteer mental health services at Newtown Youth and Family Services, Inc. in Connecticut. Meredith earned her Bachelor of Arts from Ithaca College. She is a member of the National Association of Social Workers, Postpartum Support International, and ZERO TO THREE.

What is PostPartum Psychosis?

Postpartum Psychosis is a rare and severe form of mental illness that occurs after having a baby in approximately 1 to 2 out of every 1,000 deliveries. While these statistics may sound small, its effects are anything but: Women experiencing PPP have lost touch with reality and are in danger of hurting themselves or their children due to this psychiatric illness. This uncommon form of postpartum illness is considered the most severe type and almost invariably requires hospitalization. Read on for facts about how to identify and address it.
 

Risk Factors

The most significant risk factors for Postpartum Psychosis are a personal or family history of bipolar disorder, or a previous psychotic episode. The illness normally begins in the first few days to weeks after childbirth. In some instances, it can begin immediately after delivery. It can become very acute quickly and should be treated as a medical emergency.
 

Symptoms of Postpartum Psychosis

There are a variety of symptoms that women with Postpartum Psychosis can experience:

  • Confusion

  • Delusions or strange beliefs

  • Hallucinations (seeing or hearing things that aren’t there)

  • Irritability

  • Hyperactivity

  • Decreased need for or inability to sleep

  • Paranoia and suspiciousness

  • Rapid mood swings

  • Difficulty communicating at times


It is also important to know that many survivors of Postpartum Psychosis never experienced hallucinations containing violent commands. Most women who experience Postpartum Psychosis do not harm themselves or anyone else. However, there is always the risk of danger because psychosis includes delusional thinking and irrational judgment. This is precisely why women with this illness must be quickly assessed, treated, and carefully monitored by trained mental healthcare professionals.
 

Treatment

A woman experiencing Postpartum Psychosis is almost always psychiatrically hospitalized for safety reasons. Treatments during the psychotic episode include medications to reduce psychosis and stabilize moods, as well as psychotherapy for the patient, and psychoeducation for their family and loved ones.

Examples of medications used during an episode of PPP include:

  • Antipsychotics: These medications reduce hallucinations, delusions and paranoia. Examples include quetiapine (Seroquel), risperidone (Risperdal), olanzapine (Zyprexa), and aripiprazole (Abilify).

  • Mood stabilizers: These medications reduce the highs and lows of a bipolar episode. Examples include lithium (Lithobid) and lamotrigine (Lamictal).

  • Anti-anxiety medications: These medications can help decrease acute anxiety and insomnia experienced during psychotic episodes. Examples include clonazepam (Klonapin) and lorazepam (Ativan).

Often, a woman experiencing PPP requires a combination of the above medications.

Postpartum Psychosis can be frightening and shocking for both the woman experiencing it and her loved ones. With the right treatment, women with PPP can recover and fully experience motherhood.
 

There’s more to the story…

In September 2012, at 40 years old, Bangs gave birth to her beautiful daughter Adelaide. A month later, dramatically hormone depleted and sleep deprived, Melissa is admitted to the Providence Psychiatric Facilities in a complete manic state. After nearly a month, she is sent home with a bipolar diagnosis and on lithium. What comes next is an extraordinary journey.

Photo courtesy of: MICHAEL GALLACHER / MISSOULIAN

Photo courtesy of: MICHAEL GALLACHER / MISSOULIAN

 

On her path back to wholeness, one of the things Bangs did was read her entire 100 plus page hospital record. Somewhere, around page 87, there is a nurse’s note that looks as if it were scribbled late at night after a long shift. It reads, “Patient says she will do comedy on this experience.”

The psych team couldn’t have possibly known that Bangs has been a storyteller her entire life and did comedy for a stint, as a student, at the Upright Citizens’ Brigade in New York City. They couldn't have known that transforming details from the most painful experience of her life into a room full of laughter would prove healing for so many.


If you think you have PPD, Call The Motherhood Center - 347-343-4257. 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. With the right treatment, EVERYONE feels better.