Postpartum Depression

October 9, 2012

First, let me get this out of the way. There is technically no disorder called Postpartum Depression, at least in the DSM which is the manual used to diagnose mental health disorders. It is actually Major Depressive Disorde with Postpartum Onset, but since that is long and everyone knows it by Postpartum Depression, I will be using that or PPD for short.

PPD is a mental health disorder in which a woman becomes clinically depressed within one year of childbirth. It may be hard for some people to tell the difference at first between typical baby blues and PPD. PPD is characterized by feelings of sadness, loneliness, depression, helplessness, hopelessness, mood swings, changes in appetite and sleeping, loss of interests and loss of energy. You may also experience anxiety, tearfulness, feelings of vulnerability, irritability, and feel disconnected from your baby but these are also symptoms of the baby blues.  You do not have to have all symptoms but would need to be experiencing some of these symptoms and they must last for over 3 weeks.  Some of the differences are that the baby blues will start a few days to one month after childbirth instead of anytime during the first year, and will last less than 3 weeks. There is also differences in severity, the first list of symptoms are not as likely with the baby blues.

Women who have a history of depression, meaning that they have already experienced a depressive episode in the past are much more likely to experience PPD. Other factors that could increase your risk of PPD are low self-esteem, history of anxiety, lack of social support, history of eating disorders, and a family history of depression. If you have experienced any of these you may want to look into taking precautions to reduce your risk of PPD. I will provide a list in upcoming blog entries with things you can do to reduce your risk but one thing that I have already mentioned is increasing your support such as through a group as the pregnancy support group that I started.

Some of the possible effects of experiencing PPD for mom and the baby include a feeling of detachment and being disconnected as mom is not as interested in taking care of the baby and may shy away from her responsibilities or just be unable to perform them during this time. This can effect the bond of mom and baby, although it can always be recovered later. It will also increase the amount of stress and anxiety the baby feels, will increase crying, will make it more difficult for the baby to self-regulate and self-soothe themselves, and they are likely to show signs of decreased social engagement. A woman’s milk supply can also be effected negatively. As I stated already, once a person experiences depression they are more likely to have another episode in the future and this applies to when a woman experiences PPD.

If you are experiencing PPD, there are two therapies available, medication and counseling/therapy. I’m no expert on medication so you would need to weigh the pros and cons out with your doctor and decide on an individual basis about whether medication will be right for you. Whether you take medication or not, however, counseling is a good idea. A therapist can help you identify thinking patterns and behaviors that might be able to be changed in order to alleviate the symptoms of your depression and end the depressive episode.


Importance of Support During and After Pregnancy

September 25, 2012

Ok quick announcement before I get started with the regularly scheduled blog for today. For all my loyal followers (I know there are a few of you out there) I have had to make the executive decision to switch my blogging day from Monday to Tuesday due to my little guy deciding he no longer needs naps and being in a preschool program on Tuesday mornings. So from now on, look for blog posts on Tuesday, end of announcement!

I don’t think I have really posted much on here about the new group that I have started. I was lucky enough to get to present to the Space Coast Birth Network on this subject on Friday and wanted to finish the presentation before I started posting about all my research (I feel a blog series coming!) If you haven’t already guessed, my new group is a pregnancy support group. In Brevard County, where I am, there are no support groups and only a few programs in place for pregnant women, especially ones who are not having a high risk pregnancy or at high risk for other things. So obviously there was a void in the area but why might you ask did I feel the need to fill it? Well, it was due to research that I had been reading.

To recap some of the research very quickly, a new field has emerged called fetal origins that states that everything a woman is exposed to while pregnant can effect her baby’s health and mental health throughout the baby’s entire lifespan. Of course I’m no medical doctor but I found this to be amazing and wanted to do something to help women create healthier individuals. So, the mental health piece of this for me is stress, or helping women to reduce the amount of stress they are exposed to as a result of circumstances, depression, anxiety and so forth through relaxation techniques and support in order to minimize the amount of cortisol the fetus is exposed to. Fetal origins is still pretty new to the research scene and there haven’t been a lot of studies on these specific factors but here is one article that talks about how extreme levels of cortisol effect the fetus.

Another related topic that has been studied is how to prevent mental health disorders during and after pregnancy. The childbearing years for women is when they are most likely to experience anxiety and depression. I will go a bit more in detail in another blog entry but suffice it to say that hormones can play a big part in flipping the switch for some women who are predisposed to these disorders. When a women becomes pregnant or shortly after she has her baby, she is especially likely to experience a mood episode or a bout of anxiety as well as other possible disorders. Knowing that we cannot change one of the main causes, hormones, it has been important to find other ways to reduce the chances of these disorders being experienced by pregnant and postnatal women.

One of the biggest factors that has been proven to be helpful in greatly reducing this risk is support during and after pregnancy. Think about it, it can be a very stressful time in one’s life with a multitude of changes ocurring and other people having strong views and not always correct information and this can cause a lot of pressure for a soon to be or new mom. Add to the mix that mom is likely to be home, trying to keep baby away from germs and dad will go back to work within a short amount of time and she is likely to feel lonely and isolated. Combine this with the hormone changes and it can very well be a recipe for depression and anxiety. As I stated, however, women who have an increased amount of support are better able to deal with this and are less likely to feel lonely and isolated. Support starts becoming a protective factor during pregnancy in order to reduce the likelihood of postpartum depression. This is very important considering once a person experiences an episode of major depression they are more likely to experience another one in the future. You can get this support from friends, family, church, or a formal group such as the one I have started.

My pregnancy support group is designed to specifically help create the sense of support needed to reduce the risk of postpartum depression when attended regularly. The group begins with a guided imagery or relaxation technique and then is opened up for each member to have a chance to talk about whatever they desire and to receive feedback and advice from the group as needed. The group then closes with an assignment that will help to increase the level of mother-fetal bonding. If you are in the Brevard County area, you can attend this group on Thursdays from 6-7pm at Discovery Institute, P.A. in Rockledge. The first session is free and each additional session is $10. No need to R.S.V.P., you can just stop in!

The Many Masks of Mood Disorders

October 31, 2011

Realizing that today is Halloween, I wanted to relate my post to this spooky holiday but at first was unsure of how I would do that. Then it hit me like a cave full of bats flying out of the darkness. I know for those of you who have never experienced a mood disorder or have not worked with those who have (and sadly even many people that work in a variety of positions in the mental health field) just do not understand what it’s like to live with such a disorder. I hear from my clients that their loved ones make comments telling them to snap or pull themselves out of it, as if it were really that easy. Mental health disorders such as major depressive disorder or bipolar disorder are not like wearing a costume that you can easily take off. To have a little fun, I am going to compare what its like having a mental disorder with being something for halloween.

1. As I already said, a halloween costume you can take off at any time. A person who has a mood disorder does not have as much control over it. Don’t get me wrong, I don’t like to use diagnoses as an excuse, but it normally takes a lot of time, work, and someone else’s help to get out of it (I guess some costumes may work that way too though!)

2. People living with mood disorders have to put on a “mask” to deal with other people in their lives frequently. I have clients that talk about how it is exhausting having to pretend and put on a happy face when they are around other people that they do not feel comfortable enough with to be honest about what they are going through.

3. Going through day to day life with a mood disorder can feel like living your life as another person. You may not recognize who you are and many times, even those closest to you do not as well.

4. Even as you dress up for halloween and play the part of a different character, you have control over the way you act because everything you do is still coming through your own filter. Mood disorders seem to hijack a person’s filter as their thoughts, feelings, and actions are expressed throug the lens of depression or mania.

5. For those on the outside, it may seem like someone with depression has been converted to a vampire lifestyle (minus the blood sucking). They like it to be dark and they sleep a lot (or in some cases are unable to sleep and are up all night). One of the ways to keep vampires away is also helpful for those with depression, let the bright light in!

6. Depression may look like living like a vampire, but those experiencing it feel more like a zombie.

There are many other ways that you can compare and contrast Halloween and living with a mood disorder. I would love to hear your ideas on this as well!

Dealing with Life Transitions

September 19, 2011

It seems as though every day we are hit with a new struggle. Sometimes it is life’s little things such as the craziness of dealing with young children or a difficult boss and other times it is the big things, such as a serious illness or job loss. Even the positive things in life can be a big struggle such as a pregnancy or a job promotion. No matter whether it is a happy or difficult change, change is still tough for most people while they adjust and learn how to function appropriately with the new facts of life. This is becoming a big reality for many people now with the state of the economy as it is, especially in Florida’s Space Coast where I live, because of the changes in the space program. For that reason I was asked to talk to a group of moms today on this very subject. I thought it was such an important topic that I decided that I would like to share it with more than the 30 or so moms that I talked with today, especially since these are the reasons that most people walk through the door for counseling.

You probably already know everything I am about to say either consciously or unconsciously. It is not hard to understand but it is easy to forget, especially when you are the person dealing with the loss of a loved one or not knowing where your child’s next meal is going to come from.  As I stated earlier, all changes have the potential to create stress and this stress can multiply as you try to figure out how to cope. If you are having a difficult time coping, the effects can roll over into other parts of your life, causing waves that grow increasingly bigger until you feel as though you are drowning under the intense pressure of a tidal wave.  For some people you may not see a big difference, others begin experiencing symptoms of anxiety, depression or what could even look like Posttraumatic Stress Disorder.

In this first entry, I would like to help you understand what this looks like so you are better able to identify how life transitions impact us and those around us. One woman came to me after an immediate family member died. She had been trying to deal with the effects of the death on her own and found herself to be overwhelmed. Due to her emotional reaction to the death she was unable to work, was arguing frequently with her spouse, felt isolated from her friends and like no one understood or cared for her, and no longer even felt as though she knew herself. She was unsure of how to proceed with life after this death. It was hard enough for her to be dealing with the grief over her loss but then to have to deal with the uncertainty in other parts of her life such as work and her marriage was just more than she could handle on her own and she began to feel depressed.

Another woman came to me for counseling about a year after her son was born. She was trying to adjust to all the changes that come with being a mom and taking care of someone else while also moving to new areas twice during that time. She lacked support, connections with others, and a sense of who she was as she adjusted to motherhood and what that meant for her. She loved her son dearly but she began to feel overwhelmed by the changes and her stress manifested itself into anxiety over something happening to him or to another family member. She expressed that she would experience “breakdowns” for a few days at a time and be unable to care for herself or her child.

Now that you have an idea of the effect life changes can have on an individual and what it can look like in real life situations, in the next few entries I will discuss ways in which you can work to combat the negative effects of both positive and difficult life changes. So don’t forget to check back next week!

The Deceiving Act of Suicide

August 1, 2011

        Please note that I did not know Jeret Peterson personally or have any insider information about him. I am simply using what I have found about him online in order to explain how life experiences can impact a person’s life and mental health.

        Olympian Jeret “Speedy” Peterson committed suicide last week. To outsiders, this final act to end one’s life seems quite mysterious since it appears as though he had it all. Peterson won the silver medal for freestyle skiing in the 2010 Olympic Games and stated “I know that a lot of people go through a lot of things in their life, and I just want them to realize they can overcome anything. There’s light at the end of the tunnel and mine was silver, and I love it.” The silver light was not enough to make a lasting change in the internal demons he continued to face since childhood, however. 

       As a child, Peterson was sexually abused and also dealt with the loss of his sister in a car accident. Both of these experiences can be very difficult for anyone, especially children to go through. Although children are highly resilient, they still need help to work through these experiences. I am going to assume that Peterson did not receive this help as he has carried the negative effects from the experiences throughout his life. It has been reported that he has had problems with alcohol and depression, both of which are consistent with his experiences. Depression does seem to have a genetic link, but not everyone that is predisposed actually ends up with major depressive disorder. It is believed that some experiences can activate the gene of depression, which was likely the case with Peterson. In addition, alcohol is a depressant and can exacerbate the symptoms of depression.

       Peterson also experienced other risk factors related to suicide. Months before the Turin Olympic games, a friend shot himself in front of Peterson. Not only another traumatic event for Peterson, but having friends or family members that commit or attempt suicide increases an individuals risks as well. Other reports state that he was “born with the heart of a gambler” as he won $550,000 in one night playing black jack. I have not read anything indicating that he was addicted to gambling as well but it would not be surprising as it sounds as though he had an addictive personality as he was addicted to alcohol and adrenaline (the body’s natural high).

        But how did he manage to stay so driven after these experiences and struggling with depression and alcohol abuse? When people have had such traumatic experiences as Peterson did, there seems to be two options until they receive the help needed and work through them. You can either wallow in their experiences and depression, turning inside, or you can go forward full speed ahead. It sounds as though Peterson chose to go full speed ahead to try to outrun his depression as it has been reported that he only had two speeds, stop and go. No matter how fast he moved, how high he flew, or how much adrenaline coursed through his body, he could never escape his experiences, thoughts, and feelings, however. Although it may have appeared that this man was on top of the world and was outgoing and happy, these do not protect anyone from suicide. In fact, it is important to note that it is sometimes hard to figure out who is hurting the most emotionally as they find different ways of hiding it, whether it be by using substances, denial, putting all efforts somewhere else, or just plain acting.

       So what is the take home lesson here? Even if your loved one is successful and happy, it doesn’t mean that they are immune to tragedy and suicide. Pay attention closely to their behavior, especially if you know they have experienced traumatic events or mental health issues in the past. If you know of someone that has been depressed and all of a sudden is happy, this may just be a sign that they have decided on a plan to end their life.

Plugged In, Tuned Out

May 10, 2011

         I know this is not a new phenomenon. Slowly over the past several years, Americans have started to use technology more and more as the technology has evolved further. We now have smart phones that people carry with them everywhere, supposedly making our lives easier. While it may be making it easier for us to get things done, I’m not convinced that it is enriching our lives.

            Over the past several weeks I have been noticing how these smart phones are causing people to lose touch with the real world. Just while at an exercise class I noticed a 12 year old girl “attempting” to work out while really playing on her phone and then two younger girls glued to their own phones. I think what really did it for me though was while walking on the beach on Mother’s Day, I watched another mom push her child in a stroller and her eyes were glued to her phone. She was at the beach and instead of enjoying her child or the beach, she decided to be on her phone. 

            This technology has become so addictive that it takes us away from our other priorities. It consumes much of our day and we spend less time with friends, family, and doing things we used to enjoy. Although we feel more connected with our phones in the short run, in the long run it will only leave us feeling more disconnected to the world around us. I urge you to think about your use and how it affects your life. Try implementing rules for when use of technology is and is not acceptable. Make more of an effort to turn off the phone or computer and enjoy the outside world, whether that means going out with friends, enjoying your family, or reveling in nature. Whatever you choose to do, make sure some of your time is technology free! I’m sure down the road research will show that overuse of technology can be a detriment to our mental health, take steps now to prevent it!

Teens and Facebook

April 7, 2011

Jessica Stebbins, M.S., Registered Marriage and Family Therapist Intern
IMT 1258
Discovery Institute, P.A. Rockledge, FL
Serving Brevard County

       In a previous post I discussed the link between facebook and depression. Parents should especially be on the lookout for signs in their teens for even more reasons than were previously discussed. First, they are at an increased risk of having the social comparison effect impact them due to many teens having lower self esteem. They tend to compare themselves to other people in order to help determine who they are and where they stand socially. Many teenagers get a great deal of their self-worth from social situations, friends, and looks, all which they have a greater risk of finding lacking compared to others due to the networking site.
       An even bigger issue than social comparison, bullying has become a large problem on facebook. No more are the days when individuals were able to escape teasing and other verbal bullying when they were not in the presence of the perpetrator. With facebook making everything public, there is no place to hide. This makes the impact of the bullying even more intense. We have all been hearing on the news about incidents of bullying occurring on this social networking site, including one I mentioned in a previous post about girls posting nude photos stating that they were of someone they actually were not. The effects can be huge for both the victims and the perpetrator in these instances.
       What can you do about this as parents? You need to facilitate open communication with your teenagers. Teens have a habit of not wanting to talk to parents which can make it difficult and the harder that parents push, the less teens want to talk. Let your teens know that you are there to talk about anything that they may need to talk about. Also, try not to be judgmental and they may be willing to talk to you more. It may also be helpful to talk to your teens about some of the incidents in the news. For instance, talk about the incident with the nude photos and be sure to mention all the criminal charges those girls received. Make it an informative instead of a lecturing session and they just may be willing to listen. Teens tend to not realize the gravity of their actions and how it not only affects others but can also affect them.
      If you are looking for a Brevard County counselor or therapist give me a call. My office is located in Rockledge and I would be more than happy to talk with you.