Fighting PPD is A Marathon Not A Sprint

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In the hospital, I thought I loved my baby. I thought I wanted to bring him home and be his mother. Then I got home and my thoughts drastically changed. I wanted nothing to do with my new son. I decided I had made a terrible mistake becoming a mother.

With these new, irrational thoughts came a feeling of heaviness on my chest as if an elephant had all of a sudden taken up residence there. I couldn’t breathe. The feeling creeped into my throat. It woke me up at three am every morning. It exhausted me to the point where all I wanted to do was sleep forever yet I could never fall asleep because the anxiety made my heart feel as if it would leap out of my chest.

What was happening to me? Why do I feel this way? Where did this overwhelming anxiety come from? Why won’t the tears stop? Why don’t I want to get out of my bed when there is a healthy, beautiful baby boy in the next room who needs his mother? How do I make it all stop? 

Tell me exactly what to do. I will do it. Drugs? I will take them. Talk to someone? Okay fine. Just promise me, it will all stop. Promise me I will feel better. Promise me I will feel connected to my son. Promise me motherhood will be filled with all the love and magic and excitement, Pinterest crafts and rainbows and unicorns I had pictured when I was pregnant.

If only it could be that simple. As I write this (and if any mom who is suffering is reading this), I wish I could tell you that there is a magical formula. That if you do X, Y, and Z, you will be better. That there is a set amount of time before you will start to feel like your old self again. But I can’t. There is no one-size-fits-all when it comes to postpartum depression. The treatment and recovery process should be taken one day at a time and no two are alike.

When I was in the throes of my postpartum depression battle I was lucky to find a therapist who specialized in postpartum mood disorders right away, but every week when I sat on that faded red love seat in her office, all I could focus on was when I would feel like myself again. I wanted to know exactly when I would feel happy again and what I had to do to get there.

Every week, my therapist would tell me the feelings were temporary. She had the proof in hundreds of former patients she treated with the same illness I had. Some took three months. Some six months. Others more than a year. I always thought she was lying. I felt like I would stay in that awful hell forever, so if I was going to get better, it needed to happen in the next five minutes.

All I could do was have patience, (which has never been my strength). The phrase I remember my own mom yelling at me most throughout my childhood was, “JENNIFER, BE PATIENT!” As cliché as it to tell someone to “be patient” and “give it time,” it’s also the truth when it comes to fighting postpartum depression and getting through to the other side. Slowly, the right medication started to work and I began having more good days than bad.

Then after several good days, I would relapse back into that helpless girl overcome by tears and anxiety who couldn’t get out of bed and function like a human, like a mother. Even though my therapist warned me this could happen, I would get frustrated and forget about all the good days that came before. I needed to be better NOW.

But that’s the thing about this mental illness that affects hundreds of thousands of new moms each year. It doesn’t stick to any pattern. It doesn’t follow any rules. The only thing you can do is hang in there while following your treatment plan, because postpartum depression is temporary with treatment. I wish I could tell you how temporary, but all I can honestly say is that it’s a marathon, not a sprint. I’m now included in the proof my therapist uses when a new mom comes to see her for the first time. I got better running the marathon and I’m a stronger, more patient, and one-hell of a badass mother for it. 

This post originally appeared at Motherlucker.

Written for Suburban Misfit Mom: Today I Went Back to Therapy

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Today I went back to therapy and it felt fucking amazing. The last time I sat on that comfy red couch in my therapist’s office was over three years ago, when we decided I could take a break because I finally found myself on the other side of postpartum depression hell. I had survived. I had gotten better. I had become better than I was before. I had become Mason’s mommy and I was finally happy about that. I thought I would be okay going forward and I have been. But life is messy and complicated and hard and sometimes you just need someone to talk to about it. And I’ve recently come to realize that I need someone to talk to about it. Someone who isn’t your friend. Someone who isn’t your husband. Someone who isn’t your sister. Someone who isn’t your own mother. Someone who you can talk to without any filter. Someone you can talk to about all those people. Someone who you can say to all the things you aren’t supposed to say. Things about motherhood, marriage, and family. Because as you get older, life and relationships get even more messy, complicated, and hard.

I had been thinking about going back for a while. It’s extremely difficult to navigate through the chaos of being the mom of a toddler and the responsibilities of being a wife, daughter, sister, daughter-in-law, and sister-in-law while also trying to maintain my own independence, identity, and happiness. I’m not sure there are enough hours in the day for all of that. And lately, I’m struggling to balance it all and I feel a bit lost. It was actually my mother who noticed this and suggested I call my therapist and start seeing her again. Don’t you hate how your own mother is always right?

It’s no secret I’m not in love with where I live, but I’d like to figure out how to be. My best friend just moved back to the west coast and I’m devastated and also jealous she lives five minutes from a Soul Cycle. My best friends from growing up and college already live that close to Soul Cycles. And for some reason it’s really hard to find a good iced decaf coffee or latte in this town. I know that sounds ridiculous, but who doesn’t carry decaf espresso? I guess what I’m really trying to say is that I miss New York.

All Soul Cycle and coffee envy aside, the demands of motherhood are enough to drain anyone’s spirit. On some days, my three-year old can be an angel with the most incredible sense of humor and curiosity, the light of my life, my little helper, and I feel like I’m nailing this parenthood thing. And other days he is smearing shit on his walls, refusing to sleep, throwing his toys at me, and laying face down on the floor, kicking and screaming because he doesn’t want pasta for dinner, after I just cooked the pasta he asked me to make for him 15 minutes ago. Those are the trying moments. The moments that make me want to scream when my husband comes home and say, “Here you go, he’s all yours.” And then I lock myself in our bedroom with a glass of wine. But it’s not like my husband didn’t just work a long, stressful day.

And that’s where the demands of motherhood and marriage crash into each other and it can be overwhelming for both parties at times. I feel overwhelmed at times. I’m raising a toddler to hopefully be decent human being while keeping an eight-year marriage strong, traveling way too much for family obligations and Jewish holidays, trying to carve out some time for myself to write, relax, exercise, socialize, and maintain some sense of independence and calm. It can feel so routine and takes work and some days it takes more out of me then I have to give. I’m exhausted. So why not talk to someone about it and figure out how to make it work for me?

My therapist never judges. She doesn’t make me feel inadequate or like a failure. She only accepts me. That couch is a safety net that catches me when I sit in her office ranting for an hour about whatever it is that is on my mind in that moment. And on this first day, it was just a mouthful of everything I have going on in my life and how I’m just so exhausted and need a break. We didn’t necessarily solve everything in that hour, but just being able to talk, without holding anything back, made me feel so much lighter. I know going forward, that I will look forward to that hour in my week to decompress and re-charge. It will help me find balance.

I know by writing this that I will worry some of my close friends and family members—especially the ones who I haven’t told about going back to therapy. Some people know. Others don’t.  Going back to therapy doesn’t make me weak. It makes me strong. It makes me brave. It means life is a rollercoaster of ups and downs and maybe I just happened to hit one of the downs right now. I want to be proactive and talk about it. Figure out how to move through it and get back to the up part. I have a hard time believing that every mom is happy 100 percent of every day. I’m not. I can be happy for most of the day, but the whole day, everyday? If you are, please share your secret with the rest of us.

I’m not ashamed to admit any of this. This is me and I completely own who I am, imperfections, flaws, and all. And just because I’m in a funk and need to talk to someone, doesn’t mean that there still aren’t lots of good parts. There is taking my son to Central Park for the first time, screaming the words to Hamilton and Newsies with him because he loves musicals just as much as his mommy, family dinners, showers, weddings, babies, and family road trips to the zoo and aquarium. My son has more grandparents than most and more aunts and uncles than I can count. There is so much love to go around.

I’m exhausted and overwhelmed, but I’m also grateful for the life I have and the people in it, including my supportive husband, beautiful, healthy son, and wonderful family and friends. Even the trips we take that leave me feeling depleted as if I need a vacation after my vacation. I just need a breather right now and I’m taking it in the form of weekly therapy sessions.

I also write this article to help and empower other women who might need or want to talk to someone, but haven’t followed through for whatever reason. Again, life is messy, complicated, and hard, and sometimes we all just need a neutral, judgment-free person to talk to about it and help us push through. And therapy is like Vegas or college spring break. What happens on that couch stays on that couch.

This post was originally published at The Suburban Misfit Mom on September 7, 2016.

An Interview With My Therapist -- Part Three

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Today Dr. Thorne discusses postpartum depression and anxiety and the importance of therapy as well as what husbands and other family members can do to support mom, and how we can lessen the stigma attached to this illness. The Necessity of Therapy

I want therapy to help my patients to stop being self-punitive and really understand how they got here. If there is a good part of PPD, and this is something we work on in therapy, it usually makes women more flexible. Their personalities become more flexible and it helps them to cope with more things. Believe me, I don’t want any new mom to suffer like that but sometimes going through it and having children, you have to learn to be more flexible. I work on this with my moms and get to see a lot of it happen in a positive way. I also try to meet my moms where they are at.  Sometimes moms feel like the only thing they can give the baby is their breast milk, especially if the baby is in the NICU or there are bonding issues. So I will just say, let’s see how this goes. Especially when they are in the beginning just trying it out.

Another thing is that women, career women are having babies later. They go from thinking they want to stay home no matter what when what they don’t realize is so much of their identities are tied to their occupation, getting a paycheck, and talking to other adults. Sometimes going from work to home is totally devastating. It’s not anything like people think it’s going to be. And some women need to go back to work earlier. The schedule and the structure helps them. You just have to know your self and learn not to judge yourself for what you need. Therapy can really help with this. Even myself all those years ago--I was working a 60-hour internship, gained 52 pounds, was the at the highest productivity level, worked until 10pm every night and I thought, “What can be harder than this?”  It was a devastating difference. I just didn’t think that would happen to me, just like all my women don’t think it will happen to them. I mean I had my doctorate in this field when I got mine.

Some Words of Wisdom

I heard somebody say this once and it has always stuck with me. Women nowadays feel like they have to be moms of the 1950s and moms of the 2000s at the same time and it’s an impossible mission. We can’t possibly be both this wonderful, intelligent, smart career woman, have everything and be a 1950s mom too. it’s an impossible feat, especially without a tribe. My grandparents lived 20 minutes away from my parents--both sets. Everybody lived on the same block. And everyone in my neighborhood stayed. People rarely moved and they knew each other for years. Here in Charlotte, it's a very transient city with people coming and going. The patient calls I get on my office phone have MA, GA, VA, NY, etc. area codes. Not many are from here and connected.

Postpartum Depression is a Different Animal

There are so many individual differences when it comes to treating PPD. PPD is an umbrella term that encompasses other disorders. A woman could have this symptom and that symptom and a piece of this and a piece of that and it’s not one single thing. It’s different for everybody. Some people have bonding issues. Some people don’t. Even when it comes to taking medicine--let’s say a woman took one drug for her flat depression in her late twenties and now she has an agitated anxious depression now. Some doctors will put her back on that same drug as before but that isn’t the best medicine and might make the anxiety worse. You have to treat PPD like it’s a brand new illness. Your baby hasn’t been here that long and you’re sick.

Advice for Families

We don’t want to wear a mom out when she’s already worn out. Often women on their good days will do way too much and then the next day is bound to be bad. Even when you’re feeling good, don’t over do it. That’s why I think education with the family is most important. If they are willing, I try to get the husband to educate the family-- especially about what to say and what not to say. Sometimes relatives can say things that are crushing. I’ve also had moms come to therapy sessions and bring other family members with them.

Also, everyone always comes down in the beginning., but you can be running on adrenaline during the first three weeks and feel fine. Have family members come at the three month mark too. Have your husband take off another week from work then and not all at the beginning because that’s when you’re the most exhausted. I’ve even sent people and their babies to their families in another state to stay with them. That’s sometimes hard to explain to the husbands because they’re leaving, but to get this woman well, we need the family support. If we can get as many people to get down here to help and be supportive but not judgmental, that is best. People tend to do what they want to do for you and not what you need them to do so make a list and put it on the refrigerator or have your husband do it. They might want to take care of the baby or do errands and you might just need them to sit with you.

Helping the Husbands "Get It"

It’s hard for husbands too because they don’t always understand. They want to know, “Where did my wife go?” It can be a shock for them because their wives’ personalities are so different. I’ve heard some say that you need to just pull yourself up by the bootstraps and it doesn’t work that way. I want the husbands in my office by the second or third session. An outlet is good for the husbands, but It’s just a balance. If in the beginning your wife didn’t want to be away from you because she is so raw and panicked, just give me some time, we will get you back there. I know you need your time and your outlet, but if it’s just you two, we have to try to do this for right now. Most husbands are really supportive and understand that their wives are not themselves right now and might need a little more from them.

I also like to talk to couples about intimacy. A lot of my women who breastfeed all the time or are just taking care of the baby all the time feel like they need to breathe. They feel suffocated. They don’t need any more touch. Many husbands will feel rejected by that. So sometimes we have to really educate them on the intimacy aspect of that. I’m all for a couple has to connect but sometimes these women will even stay up later just to be by themselves. They just need to have no skin to skin for a bit. It feels suffocating. I try to explain to the husbands that It’s not a personal. Don’t personalize it--even the depression. She will get better. This will get better. We’re going to work towards connecting again. 

Educating Moms to Recognize the Symptoms

I’ve also had women coming in during pregnancy now, which is great because they can be predictive. You can have risk factors in pregnancy. Most people feel like it can’t happen to them. My own mother would say to me, “I think your having some hormonal issues,” but no one understood. And I was up every 2 hours for 8 months. That’s another thing. Sleep is enormous. I know they are an infant, but if there is any way we can get one stretch of five hours just a few times a week, that would help immensely. There is a lot of controversy around that because of care for the baby vs. care for the mother. The self care part has gone out the window. It’s not my style to say do 1,2,3,4,5 and you will get better, but if you take care of yourself, your family life will get better. So even if you don’t want to do it for yourself, do it for the others. 

A Few Words on Anxiety

The thing with anxiety, which is usually part of most postpartum mood disorders is that it’s irrational. People don’t understand that part. And as much as you can logically tell people, the baby is not going to get stolen out of the back seat when you’re at a stop sign, when that emotion hits and you’re that raw, you can’t do anything about it right then. Some women say they don’t want medicine, but after a while I tell them you have to get your body settled down. You are in fight or flight all the time and you’re not going to take in the information from therapy if we don’t get your body calmed down. I’m all for alternative ways to control the anxiety, but it also depends on your symptomatology. There has been a lot of research on light therapy, yoga, relaxation training, and acupuncture. Most of these don’t have as much research behind it as medicine and therapy do though. I also often say you don’t have to be here forever. You can get better and move on or you can stay in treatment if you want to, but my job is to get you better from this.

The other thing that’s really important to understand is that most people who have generalized anxiety disorder do not know it. Most of these women I see have had generalized anxiety disorder but they’ve put their life in so much order that they’ve kept it under control. I ask, “Were you a worrier before? Did you have trouble going through transitions in life? Even if it was a good transition?”  Most of them say yes. My mother always says, that’s just their personality. They compensated. They think that’s their normal.  And then the baby comes and throws everything out of whack.

The Matter of Medication

It’s often that first step of taking it or not wanting to. And I need to stay with the woman where she is. If she doesn’t want to take medicine, I have to stay with her. We try to do everything else and if she’s not getting better we need to revisit it. The other tough thing is pushing on people’s values. I say this is what I think would be best but I also want to respect their values—that’s the boundary. If someone is suffering terribly and they need medicine that isn’t compatible with breastfeeding or some of these women have never even touched a Tylenol, I leave it more to them. Some of these women have never been on medicine before. We have to really look at individual differences and understand. If you’re freaking out and anxious and you’re afraid of medicine, all you need to have is one side effect and you’re going to think, “I’m never taking medicine again.” And we don’t want you like that either. We don’t want you sick. We don’t want you a zombie. We just want you without depression and anxiety. If there are enough risk factors and I’m seeing enough symptoms that say this is going to be indicative of when you get to three months that this is going to get worse, I’m going to bring up the medication.

On Psychiatrists

Psychiatrists are the best for prescribing medicine, but often times, especially where we live, I feel like we need to know a lot about medicine because we are dealing with family doctors and obstetricians. When I call my doctors they get on the phone with me and we will discuss it because they can prescribe. Certainly psychiatrists would be the best avenue but we have limited amounts of good ones and limited ones on insurance. In a perfect world, you would be going to a psychiatrist, but in our world, we have to lean on the others.  I often say make a psychiatric appointment because sometimes it takes three months to get in. We can always cancel it.  And the ones that are self-pay, I say I know it’s expensive, but if we need to go to a psychiatrist, it’s worth it. They know this much where your OB and family doctor only know this much. 

On Support Groups

I’m very reluctant at first. In my experience, if women are over the hump and they are starting to feel better then we can do a group. If they are in the beginning of their illness, they are raw and so anxious. If we have five of them in a room together, they feed off one another—Oh my God, she has had it for 9 months. Will I be sick that long? She has this symptom. Am I going to get that too? I don’t find it helpful. I prefer what I do which is a support sponsor. I have a few women who have gotten better and I match them up with moms currently suffering. If you say to me, “I’m never going to get better,” I have someone well who will talk to you.

Lessening the Stigma Surrounding Postpartum Depression

We need to educate and put it out there. The Mothers Act, if that every comes to fruition is that Postpartum Support International has trained us to educate the OBs, so if that happens we will be going out and educating doctors. With mental illness in general, the point is to understand it more because we don’t treat it like we treat another sickness. You can’t always see mental illness just by looking at someone, especially if they are pretending it’s not there. There are certain people in certain cultures who are not going to believe in it no matter what we do. There are some states that are better than others. Some have clergy trained to recognize and help new moms. In certain other countries they check in with moms at certain times after birth. Because we know the risk factors, we can identify them before pregnancy. Everyone assumes it must be low income or people who have had battled mental illness their whole life are the ones who get postpartum depression. Or its not postpartum depression unless you are thinking of throwing your baby out the window. If you had diabetes would you be deprived of insulin? If you had cancer, would you be expected to give everything to your husband and baby? PPD is no different. As you get well, you will bond more with your baby because you will have more in you. And most of these women are doing everything they are supposed to do. They are just judging how they are feeling about it. They want to feel happy and excited and joyful about changing the diaper, but they just can’t in that moment. And if you leave me and get pregnant again, I want to check in with you during each trimester. Let’s check your symptoms before so we can be proactive during and after.

Doctors on Demand

Doctors on Demand is an app founded by Dr. Phil McGraw and his son Jay McGraw, creator of the TV series, The Doctors, that allows you to virtually see a board certified doctor. They started with medical doctors, but now there are 300 psychologists across the country that have joined the network.  I am one of them and although I am considered a general practitioner on their site, my bio talks about specializing in postpartum mood disorders. I can now reach people who are stuck in because of various reasons. They are licensing me in eight other states so I will be licensed in nine states for video therapy. And for people who feel more ashamed, this is a great first start.Their blog is also a great resource and so informative. I’ve written about PPD for the blog and now I have the opportunity to reach more and more people because there aren’t many psychologists who specialize in it. 

Final Thoughts

Try not to get alarmed if a mom says I don’t like my baby right now or I don’t feel connected. Even in the typical population, to say my life was very different before I had a baby and sometimes I want to go back there is so normal. There is so much pressure and too much reading material. This is not a typical environment. You only have two people. If you have to sleep in another room so you can get sleep, there’s nothing wrong with your marriage.  This is self-preservation.

I want to call attention to  The Semi Colon Project , an organization that I support, which brings awareness to mental health. The semi colon symbolizes that your story isn’t over yet. You are the author and the story is your life.   

Lastly, I want to say that this is how I feel about all my patients and this seems to be a big relief for them. What they are going through is to be understood. It’s not to be judged. So if they have incompatible or unhealthy mechanisms of coping when their baby is born, it doesn’t mean they were always bad. They helped in someway at some point along the way. They just don’t fit right now. I just see the relief on their faces—it’s like “thank you. I’m not defective or horrible. I’m not a bad person.”

unnamed copy 3BIO: Dr. Judith M. Thorne practices as a Licensed Clinical Psychologist Charlotte, NC. She possesses an MA in Applied Psychology (1989), an MS in Applied Psychology (1993) and a Doctorate in Clinical Psychology (1997). She has served on the board of “NC depression after delivery”, has been a resource for “NC moms supporting moms” and has received certification from Postpartum Support International. Dr. Thorne has been in private practice for over 18 years, treating children, adolescents, adults and couples. Over the last 17 years, she has become an expert in perinatal anxiety, mood and psychotic disorders. She also treats those who have experienced infertility and loss. Dr. Thorne has taught at the University level, has conducted continuing education, appeared on local news to provide information and has acted as a supervisor to both psychologists and social workers. She personally experienced a postpartum adjustment after the birth of her first child and is passionate about helping others to navigate through this difficult experience.

An Interview With My Therapist -- Part Two

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Welcome back to part two of my interview with Dr. Thorne. Today Dr. Thorne goes into great detail about the beast that is postpartum depression including the risk factors and how to find the right therapist.  The Risk Factors

The number one risk factor is having postpartum depression with a previous child. A big non-biological factor is husband or partner issues. Yet, most of my patients have great husbands and great babies which makes them feel even more guilty. I’ve had doctors say to me,” I never thought that one would get PPD.” Those are the ones that get it. Those type A, high functioning women. They are shocked because they’ve done everything right and achieved everything in life. I always say, if you are that personality type (and other personality types get PPD too), and this is to be understood and not judged, but those mechanisms and coping skills that you put in place got you this far in life--to be in control, to be organized, to do, to accomplish--they aren’t bad, they got you this far. But when that baby comes, those coping mechanisms don’t work anymore and you are emotionally naked. The baby is running the whole show. You can’t make a list and feel better. There can be a genetic component if you have mental illness in your family. Risk factors will be different for everyone. You can have one, three, or seven risk factors. It’s not one size fits all.

Talking to New Patients

I give each new patient a check list of various risk factors and the Edinburgh Postnatal Depression Scale to fill out. I look at the scores and responses and where they are on the spectrum and we go over it together. This takes the ownership off the patient and places it more on the risk factors. I let the mom know I’m not surprised at what’s going on because look at your risk factors. I always want to know if my patients have family and social support because so many couples move away from their support network when pregnant. It’s a huge risk factor even though it’s not the number one. This power couple is together, living their lives and doing great. So they think, we can move away because everything is wonderful. Then they do, have a baby and it’s like why did we move away. One baby is too much for two people. We need more. If we need to hire a tribe, make a family, then let’s do that. Some people have the funds and some don’t. 15 years ago I would have told you day care isn’t the best option. Today, I would tell you that’s your tribe if you need it to be--whatever you have to do.

Deciding Between the Baby Blues and Something More Serious

The textbook answer for when to call it a postpartum mood disorder is usually 10 – 14 days, but if the symptoms are excessive or severe even in those two weeks, you need to get them checked out. If you take the Edinburgh Postnatal Depression Scale and you score anything over a 10, you get checked out. What we want to do, and some doctors have started doing it at the six week check up, is follow up with the mother. Your answers on the Edinburgh while at the hospital can look very different from your answers once you’ve gone home or even at the three month mark. The environments are completely different and the support network has changed.

 Postpartum Depression Manifesting Later On

PPD doesn’t have to hit right away. It can come months later and could also be triggered by something such as difficulty breastfeeding or even weaning, I treated a mom who lost her job and her baby was about a year old. She was stopping breastfeeding and lost her job at the same time. That was a huge trigger for her and it didn’t happen within the typical time period. Generally speaking, it can be diagnosed all the way up through the first year, but then after that it would be considered maternal depression or anxiety. I’ve had women come to me with their second one, both children are very close in age, and they feel like they’ve had PPD since their first one and never really got better or felt right.

 How Long Postpartum Depression Lasts

I had this woman in yesterday who is brilliant. As a therapist, I like to ask, “What do you think?”  So many of the brilliant, accomplished women I see want you to tell them what to do. A lot of these type A women coming in want to get better and just get it done They want to do A, B, and C, and then they will be better. It’s not just these women who suffer from PPD, but I say this because one of the most difficult things for these and all women with PPD is that they have done everything by the rules so they want you to say do this, this, and this, and then you will be better. It doesn’t always work that way and that’s the hardest part to understand.

I even remember 20 years ago coming home from the mall at 2pm so exhausted and I was so mad that I was that exhausted at 2 o’clock--that this is my new normal and feeling like this is horrible—that I’m going to be like this all the time. And It doesn’t make sense if you thought about it logically because you’re not going to be like that forever. Babies grow and change, but the feeling is so bad then that it’s too hard to think otherwise. I’ve had patients leave saying, "Dr. Thorne doesn’t know what she’s talking about. I’m never going to get better." I wish I could promise a certain length for recovery rather than a simple promise that you will better, but there are just so many variables and each woman is different.   

 Why Postpartum Depression Goes Untreated

If PPD goes untreated, you can get better, but it’s going to take much longer and there are things you might still have difficulty with. And who knows what will happen in that span to yourself, your family, and your baby. The biggest problem is that people don’t know what the symptomatology is. PPD is different. It's usually an agitated, anxious, irritable depression. People will tell others with typical depression to exercise, go out, get your nails or hair done, and you will feel better. No. It’s not that way with this. PPD is like any other sickness. Take pneumonia for example. We need to get you well first, then you can do those things. We need to first nurture mom. Get her healthy again and her head above water. The other difficulty is that you can have good days and bad days. It’s a very up and down disorder until you get better. The good thing is women are coming in earlier. 15 years ago women white knuckled it for eight months or longer--living with intrusive thoughts, etc.

Finding the Right Therapist

It’s so important to see the right person. PPD must be treated by a therapist who specializes in it because it is its own animal. Sometimes, women will go to three people before they get to me. You might often start with someone in your insurance network, but that doesn’t mean they are the best fit or a specialist. At our practice, The Prenatal and Postpartum Center of the Carolinas, there are four of us and we really try hard not to turn anyone away and do some pro-bono and sliding scale work. We can’t do it with everyone, but we have all made that commitment. Another thing I want to point out is that most of the psychiatrists and psychologists writing the books about PPD all had some form of it. Patients will also identify more with those who have experienced it too.

Join me Friday for the final part on our Interview. Dr. Thorne will be sharing all about the importance of therapy for treating postpartum depression and anxiety, what husbands and other family members can do to support mom, and how we can lessen the stigma surrounding this illness. Subscribe below so you don’t miss it!

unnamed copy 3BIO: Dr. Judith M. Thorne practices as a Licensed Clinical Psychologist in Charlotte, NC. She possesses an MA in Applied Psychology (1989), an MS in Applied Psychology (1993) and a Doctorate in Clinical Psychology (1997). She has served on the board of “NC depression after delivery”, has been a resource for “NC moms supporting moms” and has received certification from Postpartum Support International. Dr. Thorne has been in private practice for over 18 years, treating children, adolescents, adults and couples. Over the last 17 years, she has become an expert in perinatal anxiety, mood and psychotic disorders. She also treats those who have experienced infertility and loss. Dr. Thorne has taught at the University level, has conducted continuing education, appeared on local news to provide information and has acted as a supervisor to both psychologists and social workers. She personally experienced a postpartum adjustment after the birth of her first child and is passionate about helping others to navigate through this difficult experience.

An Interview With My Therapist -- Part One

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I spent my first year of motherhood in therapy (crying hysterically during most sessions) thanks to postpartum depression. My therapist not only helped me get better, but taught me how to accept, embrace, and celebrate the mom I am, not the one I had envisioned I would be before I actually became a mom. She helped me realize that I was normal, not alone, not a horrible person for feeling the things I felt, and that I would get better in time. Now it's time for me to give back. I want all new moms to know that postpartum depression can happen to anyone and there is nothing to feel guilty or ashamed about. That education, recognizing the risk factors, and talking openly about this sickness is the best way to reduce the stigma so all women feel brave enough to ask for help and seek treatment.

This is why I've decided to interview my therapist. Our talk had so much valuable information that I had to break it in to three parts, posting today, Wednesday and Friday. Trust me, you don't want to miss any of it. And it if you know someone this interview might help, please pass it on.

So here she is, the amazing Dr. Thorne--a clinical psychologist specializing in perinatal mood disorders and the woman largely responsible for my recovery from postpartum depression.

A Clinical Psychologist Specializing in Postpartum Depression

The way I got here was that I had postpartum depression with my first child and that was 20 years ago. I also watched my best friend suffer through postpartum psychosis four times—four pregnancies, all four times. Back then, no one knew what I had so I pretty much suffered silently. No one really knew what was going on with me. I also had a really difficult birth. I probably had more of an adjustment disorder.

Postpartum Depression (PPD) 20 Years Ago

It was diagnosed back then, but Postpartum Support International was pretty small then. I called the president and actually talked to her on the phone. I told her (it felt like it was in secret) that I got depressed after I breastfed. She whispered back, “Yeah that could happen.”  It was as if we knew it existed but we couldn’t really talk about it. Now that is called D-MER (Dysphoric Milk Ejection Reflex). There is a diagnosis attached. I had to really investigate on my own about what was going on with me. I didn’t take medicine. I got better but it took over a year. I also remember going to a PPD conference when I was 8 months postpartum. They were talking about infanticide and I got overwhelmed with all these feelings, so I asked a question--what does a therapist do with those feelings? They had no answer for me. They thought it was kind of odd.

Postpartum Depression the Second Time Around

I only had postpartum depression with my daughter. With the first, I moved to Charlotte, North Carolina at eight months pregnant without any friends or family close by. I left everybody and thought I would just be fine. With the second, my son, I had more of a support network and consistent life. I did go on medication shortly after I had him because of the irritability I had towards my family. That’s what can really push people in that situation--when they get irritable or angry--they won’t do something about it for themselves as mothers, but they will do it for their children. If mom goes down, the whole ship goes down.

The Most Challenging Part of Motherhood

Boundaries and over giving. I felt like with my PPD, I gave too much of myself to my baby and there was nothing left. She was my total world. I still feel like if we over give we aren’t allowing that time four ourselves. That’s why I love how you do things. “This is who I am. This is how I’m doing things.” That’s much better. The more flexible our personalities, the better we will do for ourselves, and the better off we are. The more rigid and attached to all these societal standards, the worse off we become.

What Should Be Celebrated Most About Motherhood

Individual differences. Would you breastfeed if you didn’t feel the pressure to breastfeed? Do you even like it? Some women hate it. We don’t all have to do it the same way. And we shouldn’t be guilted or shamed into it. We shouldn’t adhere to every book’s philosophy and expert opinion. It’s okay to do it your way.

Join me Wednesday when Dr. Thorne and I really delve into the beast that is postpartum depression. Subscribe below so you don’t miss it!

unnamed copy 3BIO: Dr. Judith M. Thorne practices as a Licensed Clinical Psychologist in Charlotte, NC. She possesses an MA in Applied Psychology (1989), an MS in Applied Psychology (1993) and a Doctorate in Clinical Psychology (1997). She has served on the board of “NC depression after delivery”, has been a resource for “NC moms supporting moms” and has received certification from Postpartum Support International. Dr. Thorne has been in private practice for over 18 years, treating children, adolescents, adults and couples. Over the last 17 years, she has become an expert in perinatal anxiety, mood and psychotic disorders. She also treats those who have experienced infertility and loss. Dr. Thorne has taught at the University level, has conducted continuing education, appeared on local news to provide information and has acted as a supervisor to both psychologists and social workers. She personally experienced a postpartum adjustment after the birth of her first child and is passionate about helping others to navigate through this difficult experience.