Stories Link Copied 05.10.23

Just Some Important Reminders for Anyone Feeling a Lot of Emotions This Mother’s Day

You’re not weird or broken if you don’t feel like celebrating. ByClaire Gillespie

If the constant stream of Mother’s Day messages in emails, advertisements, and social media posts are making you feel anything but seen lately, just know that you’re not alone. Despite what the flower companies would lead you to believe, not everyone is excited to celebrate or be celebrated on this day. 

“Motherhood is about as sanctified a role as there is in our culture, and Mother’s Day, as an annual celebration of that role, is almost impossible to escape from,” says psychotherapist Matt Lundquist, LCSW, founder and clinical director of Tribeca Therapy. Many people simply can’t relate to the experience that is so celebrated on that day—for a multitude of reasons. 

“It’s also important to note that, in spite of how cherished motherhood is, society—in many ways—fails to support mothers,” Lundquist notes. So it can also feel understandably trite and insincere to see so many companies pushing roses and scented candles when what you could really use is affordable childcare, health care, and paid parental leave. 

So, If Mother’s Day is a tough one for you—and it’s not just one day, of course, because the hype starts weeks before, right?—know that there is nothing wrong with you or the way you choose to get through this time of year. Here are a few validating reminders from people who know exactly what it’s like to be overwhelmed by complicated emotions around this time. 

For the person who lost their mother: 

“My mother died when I was a teenager, and Mother’s Day used to be unbearable. But a few years ago, I decided to reframe my thinking. Mom isn’t here with me, but that doesn’t mean I can’t celebrate her. I stay off social media so that I don’t compare my experience to anyone else’s, and spend the day watching her favorite movies, looking at old photographs of her, and just thinking about the brave, kind, inspiring woman she was.” —Lynda T., 40. 

“For those who have lost their mother, Mother’s Day can feel like an unavoidable reminder of the loss of someone who has had a profound impact on them. Whether the relationship was once close or strained, feeling the absence of a mother on this day can stir up complicated emotions and grief. Grief does not have an end date, and it is often in those joyful moments or holidays that the loss can feel most intense.

Anticipate that strong emotions will likely come, and give yourself the space to feel your emotions without self-judgment. Spend the day in a way that honors your relationship with your mother. If your mother loved chocolate cake, treat yourself to cake. If you loved to bring her flowers, pick out those flowers for yourself. Consider something you enjoyed doing together and incorporate it in your plan for every Mother’s Day to come. Observe Mother’s Day as a celebration of what you received from your mother. You can even write a letter to your mother, thanking her for the parts of yourself that remind you of her. Remember, this day will pass. You will get through it.” —Lilit Lewis, MA, LMFT, therapist in South Orange County, California 

For the person who is estranged from their mother: 

“On Mother’s Day, I try to be the mother to myself that I’ve never had. I ask myself what I need and give myself permission to feel however I feel in the moment. I might want to spend the day alone, taking a long walk or going to the spa. Or if I feel like company, I’ll do something with my closest friends—the people I feel safe with. I don’t need them to relate to how I feel or offer advice, just listen.” —Anna W., 28 

“In the case of estrangement, there is a double grief of sorts: The mother’s absence from one’s life but also the grief of incompletely receiving the kind of love and care a mother is meant to give, the very love and care celebrated on that day.

A whole lot fewer people have good relationships with their mothers than the world would have you believe. You’re not so alone in having conflicts today—or in simply not having a mother who is safe or available to call.” —Matt Lundquist, LCSW, founder and clinical director of Tribeca Therapy

For the person who is trying so hard to become a mother: 

“Be gentle with yourself knowing that the day itself will bring up emotions you may not be anticipating. If you think Mother’s Day may be a heavy day for you, make a plan ahead of time for how you will spend the day and who you will spend it with. For some, social media posts may be particularly triggering of painful emotions, and if that is the case, make a plan to stay off social media that day. 

It will also be imperative to ask for what you need ahead of time and on the day from loved ones, whether that means extra space or increased support. Lastly, validate your own emotions by acknowledging that there is a reason this day is hard for you instead of trying to fight it.” —Lilit Lewis, MA, LMFT, therapist in South Orange County, California 

For the person who is struggling with motherhood:

“As a single mom of two kids under age 5, Mother’s Day isn’t all that different from any other day. Like the rest of the year, I’m flying solo—cooking, cleaning, entertaining, and trying to keep the peace. It’s round-the-clock and exhausting and hard not to envy other moms who’re being spoiled that day, or, at the very least, getting a couple hours of precious ‘me time.’” —Helen G., 38 

“Since Mother’s Day is marked as a celebration of the wonderful qualities of mothers, those who are struggling with their role as a mother can feel internal conflict about disappointment or not feeling good enough. Many mothers feel overloaded with pressures to ‘do it all,’ and silently struggle with feelings of failure, loss of identity, exhaustion, or loneliness in their role. 

To make Mother’s Day easier, take inventory of things you have enjoyed in the past and the types of things that make you feel most like yourself. Make a plan for incorporating these things into your day. Consider your expectations for Mother’s Day and what you feel like you need most right now vs. how you feel like you ‘should’ spend this day. Whether you need rest, time away, or a day at home alone without any expectations, it will be essential for you to communicate these things to those who are participants in caring for your children with you. If you feel lost about what you need, ask a loved one to help you with suggestions and implement a plan for the day. 

There is nothing you have to do to earn this day. You are worthy of being a mother regardless of how you feel in this moment. Use this day to thank yourself for doing your best.” —Lilit Lewis, MA, LMFT, therapist in South Orange County, California 

For the person who lost a child: 

“The labeling or title of ‘mother’ is applied when one has a child. So when someone who has experienced a child’s death hears the term ‘mother,’ proclaimed with such joy and loving excitement on Mother’s Day, it can be triggering and add to her awareness that she would have been a mother had the loss not occurred. 

As in all holidays in which grief may be present, you should check in with yourself, your needs and your mood, and do whatever feels most comfortable. If that means honoring that you are still a mother to that child, then lighting a candle would be appropriate. If it means staying out of the public eye for the day, that’s OK—whatever makes the day as smooth as it can be to get through. If you have a particularly connected relationship in which you nurture or ‘mother’ another child, friend, or relative, you might celebrate that role as well and reach out to them on Mother’s Day. 

If you find the holiday triggering, it might also be helpful to remind yourself that Mother’s Day is a commercially created holiday. If you approach it from that perspective, you might just be able to ignore it altogether.” —Jill Cohen, family grief counselor

The post Just Some Important Reminders for Anyone Feeling a Lot of Emotions This Mother’s Day appeared first on Wondermind.

Explainer Link Copied 12.21.22

‘Harry & Meghan’ Got Us Talking About Suicidal Ideation During Pregnancy

If you can’t stop thinking about Meghan Markle’s experience, here’s a little more info on the causes and how to get help. ByClaire Gillespie

If you’re still digesting the six hours of content Meghan Markle and Prince Harry dropped this month in their Netflix docuseries Harry & Meghan, that tracks. Between the straight-up racist tabloid coverage of Meghan and a monarchy that seems pretty unwilling to do much about it, there’s a lot to unpack. The thread through all of it though: Being part of “the institution” was not great for Meghan’s mental health.  

In the final three episodes, which dropped late last week, Meghan talks about having suicidal thoughts while pregnant with her son Archie—something she first spoke about during the couple’s interview with Oprah Winfrey in 2021. “Look, I was really ashamed to say it at the time and ashamed to have to admit it to Harry especially, because I know how much loss he has suffered, but I knew that if I didn’t say it, then I would do it,” Meghan told Winfrey. “I just didn’t want to be alive anymore.”

The new docuseries seems to imply that Meghan’s mental health was damaged, at least in part, by the inescapable media criticism, much of which was rooted in racism. “All of this will stop if I’m not here,” Meghan says in the latest episodes. “And that was the scariest thing about it—it was such clear thinking.” 

Meghan’s experience may seem unique to her situation under the royal microscope, but it actually isn’t. Unfortunately, suicidal ideation during pregnancy isn’t something all OB-GYNs consistently screen for, so it’s difficult to know exactly how many people are affected. But, according to one 2016 review of research, between 3% and 33% of pregnant people around the world have thought about suicide. (FWIW, those rates seem to be particularly high in the U.S. and in general among low-income women and those with a history of trauma.)

And while Meghan didn’t share a ton of details about her mental health status leading up to the negative tabloid coverage, what she did open up about can help shine a light on the risk factors of suicidal ideation during pregnancy.

Why do suicidal thoughts happen during pregnancy? 

Because suicidal ideation in pregnant people isn’t studied much, it’s hard to say exactly why it happens. And, honestly, researchers still don’t know a ton about why people have suicidal thoughts at any given time in their lives. That said, there’s some evidence that certain factors can increase a pregnant person’s risk, some of which Meghan might have experienced. 

For starters, many researchers believe that suicidal thoughts can be a manifestation of depression, says psychiatrist Thalia Robakis, MD, PhD, associate clinical professor at Icahn School of Medicine at Mount Sinai. “People who are depressed often see the world in an extremely negative light and may have distorted thoughts, such as thinking that others would be better off without them,” explains Dr. Robakis, who studies perinatal mood disorders. Sometimes people feel there is no other way out, she adds. 

Stress can also contribute to suicidal ideation during pregnancy, says board-certified psychiatrist and neurologist Elisabeth Netherton, MD, a regional medical director with Mindpath Health. “Thoughts of suicide can come up when folks are feeling really overwhelmed, and pregnancy can certainly be overwhelming,” Dr. Netherton says. 

Hormonal changes and internal stressors caused by things like a lack of sleep can increase pregnant people’s risk for mood or anxiety challenges too, says Dr. Netherton. Suicidal thoughts can also be part of that picture, she adds.

So, basically, suicidal thoughts during pregnancy could be triggered by a combination of internal and external factors, but keep in mind that every situation is different. 

What you can do about suicidal ideation during pregnancy

One of the most important steps you can take if you’re thinking about suicide during pregnancy (or really anytime these thoughts cross your mind) is to tell someone about it. “Don’t keep them to yourself—tell someone and get help. There is always a better way,” says Dr. Robakis. 

In Harry & Meghan, Meghan reveals that she told her mom and Harry that she was thinking about taking her life because she felt like if she didn’t do that, she’d be putting herself at risk.

If you’re concerned about your mood or your thinking during pregnancy, Dr. Netherton recommends seeking psychiatric care from a psychiatrist trained to care for people during pregnancy. A good place to start is often with a health care provider you know and trust, like your OB-GYN or midwife, who may be able to refer you to another professional.  

In the docuseries, Meghan doesn’t share if she ever received care for her mental health during her pregnancy, but she told Winfrey in 2021 that she tried to get it. “I went to the institution and said that I needed to go somewhere to get help, said that I’ve never felt this way before, and I need to go somewhere, and they said I couldn’t, that it wouldn’t be good for the institution.” 

If you’re worried about a friend, partner, or just someone you care about, remember that you can’t always tell if they’re experiencing suicidal ideation. In the docuseries, Meghan talks about carrying out royal duties while feeling awful but putting on a smile to get through it. Obviously, if you can’t tell that they’re struggling, it can be difficult to get a loved one the help and support they need. 

Still, if you suspect a pregnant friend or relative is struggling with their mental health, the best thing you can do for them is encourage them to seek help, says Dr. Netherton. “If they’re currently unsafe, the most important thing is to get them to safety by taking them to the emergency room or calling 911,” she adds. But don’t try to deal with it yourself, says Dr. Robakis. Be supportive, but make sure they’re in the hands of qualified mental health professionals. 

If you or someone you know is experiencing suicidal thoughts or struggling with any mental health issue during pregnancy, the 988 Suicide and Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline), is available 24 hours a day in English and Spanish. There’s also the National Maternal Mental Health Hotline (1-833-9-HELP4MOMS) and the Postpartum Support International Helpline (1-800-944-4773). 

The post ‘Harry & Meghan’ Got Us Talking About Suicidal Ideation During Pregnancy appeared first on Wondermind.

Explainer Link Copied 09.14.22

Let’s Talk About Peripartum Depression

Think postpartum depression but…earlier. ByClaire Gillespie

When I was diagnosed with postpartum depression after the birth of my first child, it was 2008 and the condition wasn’t exactly a hot topic of conversation at the new baby classes I attended, within my wider circle of mom friends, or even in the media. But, still, I knew what it was. I’d been through the questionnaire with my midwife as part of my postpartum checks (and the result was pretty conclusive). Plus I had a history of depression, so none of my symptoms were actually new to me. It was a case of finally admitting that it was more than just sleep deprivation or the “baby blues,” and that I needed some help if I was going to show up for my son every day. 

Things were a little different two years later when I was pregnant with my daughter. My depression symptoms—anxiety, overwhelming sadness, and an inability to sleep—were back, but I didn’t have my baby in my arms yet. I was only a few weeks into my pregnancy, so it couldn’t possibly be postpartum depression. That came after the birth, right? 

So, what is peripartum depression? 

It turns out that postpartum depression is pretty off-base as a name for a serious mental health condition that can actually strike at any point before the baby is born. And the medical community finally decided to acknowledge that in recent years—hence the name change. In 2013, the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) officially recognized the fact that depression associated with having a baby often begins during  pregnancy. 

Today, you’ll probably hear these words used interchangeably: postpartum depression (PPD), peripartum depression, perinatal depression, and major depressive disorder with peripartum onset. The DSM-5 calls it a subtype of depression that occurs during pregnancy or in the first four weeks after delivery, but people are actually at risk for developing depression up to several months following delivery, per the American Psychiatric Association (APA). 

“Peripartum depression is a more accurate descriptor of what we see clinically: Women can start experiencing symptoms of depression at any point during pregnancy or the postpartum period,” says board-certified psychiatrist and neurologist Elisabeth Netherton, MD, who is the regional medical director with Mindpath Health and specializes in maternal mental health issues and psychiatric treatment before, during, and after the birth of a baby.

More and more people are aware of postpartum depression, Dr. Netherton adds, but we might need to do a better job of talking about symptoms that start during  the actual pregnancy. 

What are the symptoms of peripartum depression?  

So, how do you know if what you’re experiencing actually meets the criteria for peripartum depression? This is a super common question because most pregnant people or new parents are drowning in unsolicited opinions and advice that can often make it sound like constant exhaustion, overwhelm, and crying are just kind of par for the course. But that’s not really the case. 

According to the APA, symptoms of peripartum depression can include things like depressed mood, loss of interest in things you used to enjoy, changes in sleep or appetite, crying for no apparent reason, feeling really anxious or detached from the baby, feeling like you’re worthless or a bad parent, fear of harming yourself or the baby, and thoughts of death or suicide. 

While it’s a good idea to keep an eye out for these symptoms, you shouldn’t feel pressure to self-diagnose before you seek out help, says Dr. Netherton. “We are highly trained in working with mothers and assessing them for symptoms of depression (among many other things), as well as telling the difference between concerning symptoms and what may be more routine difficulties adjusting to having a new baby,” she explains. 

“Women are often culturally taught to minimize their symptoms, or wonder if they’re really suffering ‘enough’ to warrant seeking care for themselves,” Dr. Netherton says. “Rather than trying to find a one-size-fits-all benchmark for whether to seek guidance, I would say that if you’re wondering whether your symptoms meet criteria, that is in and of itself enough of a reason to see someone.” So if you have any doubts or concerns, it’s always a good idea to get a professional opinion from a psychiatrist or therapist who is trained in caring for pregnant and postpartum mothers, or from your ob-gyn or midwife. 

What are the risk factors for peripartum depression? 

Peripartum depression is probably more common than you think. According to the DSM-5, about 9% of people will experience a major depressive episode while pregnant, and about 7% will experience it in the first year after they give birth. And while peripartum depression doesn’t discriminate. certain things may put someone at a higher risk for peripartum depression, says Thalia Robakis, MD, PhD, associate clinical professor at Icahn School of Medicine at Mount Sinai, New York, who specializes in perinatal mood disorders. 

Some of those risk factors include: age (younger parents are at a higher risk), a history of depression or other mental health conditions, relationship issues, experiencing poverty or other major stressors, and a family history of peripartum depression, explains Dr. Robakis.

Social support (or lack thereof) is another huge factor, says Dr. Netherton. And support from a partner is particularly crucial. One study found that mothers who have a good deal of social support, in general, but none from their partner showed significant risk for postpartum depression.

Having these factors don’t mean you’re doomed to experience depression during or after your pregnancy, but knowing your risk might help you beef up some protective factors too. For instance, you could try to make your mental health just as much of a priority as your physical health during pregnancy—and beyond. Sleep habits, in particular, are super important, says Dr. Robakis. Aim for at least five hours of consecutive, uninterrupted sleep each night, and when baby is born, get someone to help you feed the baby overnight if you can. It’s also not a bad idea to check in with a mental health provider before or during your pregnancy if you think you could develop peripartum depression. After having peripartum depression with my first two pregnancies, I made sure I got plenty of rest, relied on my social support system more than ever (both practically and emotionally), and scheduled regular sessions with my counselor—things I know from experience help keep my mental health in good shape. 

How can you get help for peripartum depression? 

If you think you have any symptoms of peripartum depression, reach out for help. And it’s important to know that you don’t have to be “sure” you meet the criteria for depression to speak with someone about it, says Dr. Netherton. 

“The best people to see are mental health care providers with a focus on reproductive mental health—this can be an MD, PhD, PsyD, or LCSW,” says Dr. Robakis. If you’ve never seen anyone for mental health care before and are having trouble locating someone, your ob-gyn, midwife, or doula may be able to help out with a recommendation. 

Postpartum Support International is one great resource that maintains an online database of providers and offers both local and online support groups, adds Dr. Netherton. There’s also the National Maternal Mental Health Hotline (1-833-9-HELP4MOMS), which offers a free, confidential hotline for pregnant and new moms 24/7 in English and Spanish. 

“There is no one best place for help with perinatal mental health,” Dr. Netherton points out. “What is important is that your provider is comfortable working with pregnant and postpartum moms and maintains a nonjudgmental space for you to seek support.” So if you can’t afford or access a licensed mental health provider, maybe you can find a local support group or community health center that provides you with a safe space to vent and ask for help. And don’t be afraid to talk to other new parents you know to see if something worked for them (just because their experience looks incredibly easy and carefree on social media doesn’t mean it actually is). 

Treatment for peripartum depression may look different from person to person since it’ll take into account your unique symptoms, circumstance, and medical history. “Some moms might do well with therapy as an additional support and some moms might benefit from starting medication in addition to therapy,” says Dr. Netherton.  

And yes, taking mental health medications while pregnant or breastfeeding is recommended for some people, and there are many options that are safe and effective to use during this period. So while it’s normal to have some apprehension about anything you’re putting into your body while pregnant or breastfeeding, chatting with your doctor can help put your concerns at ease and find the right option for you.

It’s also important to highlight that depression isn’t the only peripartum mental health concern. “Anxiety disorders are also very common among pregnant or postpartum moms, as are symptoms of obsessive-compulsive disorder, post-traumatic stress disorder, and other mood disorders,” says Dr. Netherton. “A trained clinician can help guide you to the right diagnosis and treatment for each.”  

The bottom line: It’s great that we’re finally starting to recognize that the “baby blues” might actually be a serious (and treatable!) mental health condition. But it’s just as important to recognize that these symptoms often start well before your due date. If you have a hunch that you might be experiencing peripartum depression, check in with a health care provider sooner rather than later for support.

The post Let’s Talk About Peripartum Depression appeared first on Wondermind.