Stories Link Copied 02.26.25

15 People Get Real About Mental Health Medication

The harmful stigma around medication and mental health needs to end. ByCarina Hsieh Additional Reporting ByCasey Gueren

If it seems like the stigma around mental health medications is suddenly getting worse, you’re not wrong. Medications like SSRIs (selective serotonin reuptake inhibitors), mood stabilizers, anti-anxiety meds, and others have been the subject of some wild claims from Robert F. Kennedy Jr., newly appointed U.S. Secretary of Health & Human Services. During and since his confirmation hearing, RFK Jr. spread harmful misconceptions about these evidence-based mental health medications used to treat conditions like depression, anxiety, ADHD, and bipolar disorder. 

“Research has continuously demonstrated the safety and efficacy of antidepressants and antipsychotics,” Chase T.M. Anderson, MD, MS, assistant professor in child and adolescent psychiatrist at University of California at San Francisco, tells Wondermind. “Every medication has benefits and risks, so physicians have a ‘risks and benefits’ talk before prescribing and allow space for questions. After prescribing, we monitor for adverse events with regular appointments. With the children, adolescents, and young adults I work with, we meet a few days or a week after. As time goes on and symptoms improve, we space check-ins out more so they can be off living their lives.” 

Despite the fact that RFK Jr.’s criticism of these meds isn’t based in science (more on that here), spreading misinformation can lead to increased stigma and stereotypes about mental health medications and the people who take them. 

If you think you might benefit from mental health medication, it’s worth talking to your primary care provider or a mental health professional to address any concerns floating in the back of your mind. In the meantime, here’s what 15 people had to say about their experiences with mental health meds, including how medicine helped life become more vibrant again and the lowdown on side effects.

1. Think of it like any other medicine you’d need…  

“I’ve been taking [medication] to treat my OCD for about 10 years and had tried other medications when I was in high school. I used to be super embarrassed—especially in high school—that people would judge me for it, and I also [had] fears about what taking medicine meant about me. Once my condition got worse, I had a therapist tell me that it was just like taking medicine to treat anything else. Now I am so fucking grateful for it because I don’t think I would be here without it, and I certainly wouldn’t have the life that I do. It’s easy to get caught up in the idea that you shouldn’t need it, but it doesn’t make you weak.” —Olivia L., 29

2. …Or like a doctor-prescribed safety net. 

“I was on a variety of antidepressants for roughly a decade, from age 14. There were obviously downsides and side effects, but the medication provided a really important safety net whilst I sorted out [my life]. I was fortunate to have doctors who were receptive when I wanted to try different medications, especially as there is no perfect antidepressant. Being a really young person on mental health medication often gets strange looks, but I knew it was the right choice because of the difference it made.” —Oliver A.*, 25 

3. Remember that feeling 100% perfect isn’t the goal… 

“While dealing with postpartum depression and anxiety, I hit my absolute bottom. I experienced huge bouts of rage directed at myself and others, had panic attacks every single day, and was ready to pack up my car and leave my husband and baby without any notice. I talked to my doctor about being put on an antidepressant, and since then, I honestly feel more comfortable in my own skin. I’m nowhere near 100% all the time, but being on medication takes the edge off and makes me feel like I can be around people without a panic attack brewing. Since going on medication, I have had only two panic attacks, which is a win for me—I was having at least one a day for months before.” —Kori B., 29 

4. …And that it’s OK if you get frustrated. 

“I have been on psychiatric medications for a variety of mental health issues since I was 16. I haven’t felt the stigma about taking mental health medications (thankfully, I have an amazing family and support system), but I have had to go on a journey within myself to accept that I will probably be on these medications for the rest of my life and that I have a chemical imbalance in my brain that will always need this extra attention and care. 

As much as I sometimes hate that I’m taking six to eight pills a day, I know how horrible I felt all the time when I wasn’t on my medications. I truly feel like I deserve a happier, more fulfilled life than that. I have had the darkest depths of depression and the highest highs of manic episodes, but I am blissfully in the middle with this particular cocktail of medications I’m on right now. I still get to experience the full range of human emotion, and I don’t have to be a victim of my mind or scared of my thoughts. These advances in medicine are to make sure we all have the best lives possible, so why not embrace the fact that, yeah, I might be a little ‘off’ on my own, but I have so many resources available to me that can make my life so much better.” —Morgan S., 28 

5. Sometimes therapy isn’t enough.  

“I just started taking medication for depression this year, and I can’t believe I was living for years with the condition and its anxious symptoms when I didn’t have to. As an Asian American, mental health—and especially medication for it—isn’t something that’s talked about in my family. My parents thought I just needed to learn stress relief techniques and go to therapy, but that wasn’t enough. I realized [medication] was a viable and not uncommon option once my partner pointed out that many of my friends were on antidepressants and I asked them about their positive experiences with medication. I cried the first time I took a pill because I felt I was broken, but now I feel I can get so much more of my work done and enjoy being present with others without the compulsion to stay in my room and cry over stressful scenarios I’ve made up in my mind.” —Lauren C., 24 

6. It might take some time to get used to the medication…

“The process of deciding whether or not to start using medication to treat my anxiety and depression was stressful, but my psychiatrist, therapist, and close friends reassured me that it was a valid option to take on, seeing as my condition was worsening earlier in the year. What held me back the most was being seen as weak or broken. I felt like it was my fault for making choices that led me to become ill. But with time, I began to accept the fact that it was just biology, like how diabetics take insulin shots to regulate their blood sugar…taking a selective serotonin reuptake inhibitor (SSRI) would help regulate the chemicals in my brain too. Adjusting to the medication was difficult for me—I dealt with nausea, poor sleep, and stomach problems while getting used to it and changing my dosage. But ultimately, even though the process wasn’t easy, it was also easily one of the best decisions I made all year.” —Rachel H.*, 23, 

7. …And one day, you and your doc might decide to switch it up. 

“I started taking an antidepressant back in 2017 while I was dealing with an excessive amount of panic and anxiety attacks. At first, I was skeptical that a small pill could take away my anxiety attacks, which had been causing me so much stress in my life. I took it anyway, starting off at a low dose and having the dosage raised by a small amount every month. I had a negative experience when my dose reached a certain level, but eventually, my body adjusted. It took a few months to really feel the positive effects of this SSRI, but when I did, it significantly improved my mental health, albeit with the occasional depressive episode. Antidepressants affect everyone differently, and for the most part it truly helped ease the cloud of excessive panic and anxiety attacks that followed me around. I’ve since stopped taking medication after speaking with my provider.” —Nina B., 29 

8. You might have to make some sacrifices… 

“My Sunday scaries used to involve a weekly panic attack about going back to work and the upcoming week ahead. Post medication, I haven’t had any panic attacks and can rationalize that anxiety in a realistic manner without spiraling into a panic. My sex drive and motivation are shot, but my Sunday evenings are better.” —Sera T. 29

9. …But the benefits can be worth it.  

“I avoided getting medicated for potential ADHD for years because my parents didn’t want ‘yet another thing wrong about me.’ I eventually got diagnosed at 30, and since taking medication, I am SO much more productive and honest with people. Some people think medication is a trap that makes you weak. I would say it makes me a stronger person who wants to live their life.” —Rin B., 31

10. It could save your life. 

“I have been lucky in my experience with medications to treat my depression. In high school, I was suicidal, and my mom forced me to see a doctor, which I resented, but it undoubtedly saved my life. I had the fortunate experience of the first med I tried working for me. It took time to find the right dose, but I’ve been on it for a decade now and can’t imagine my life without it. I grew up in a very small town where I think there was likely a lot of mental health stigma, but I have always been very open about it, and I think that worked to my advantage as a teenager and into adulthood. I feel awful on the rare occasions I forget my meds, but, in general, they make me feel like the life I want to build is possible.” —Lexie N., 26

11. It can help you tick off that to-do list.  

“When I actually remember to take my [ADHD meds], I feel like I log back into reality. I have combined type ADHD (as well as autism), and I didn’t realize how much I mentally checked out to cope with the simultaneously buzzing and boring world around me. So much of my body suddenly switched on [the first time I took my meds], and I was finally capable of putting my mind to something and doing it.” —Gates H.*, 27

12. It doesn’t make you weak. 

“In January 2022, I took a leave of absence from grad school for my mental health and began taking psychiatric medications. I spun a harmful narrative about myself that taking a break meant I was less intelligent and capable. The stigma surrounding medications certainly contributed, given the stereotype that if you take meds, you lack ‘mental toughness.’ Now, I’m happy to share my experiences with meds and how they have helped me build stability and resilience.” —Paige T., 26

13. And life might become more vibrant.  

“In 2015, during a period of depression and anxiety, my doctor told me that the most effective treatment for anxiety and depression was talk therapy in tandem with medication, so I started off on a low dose of medication. It was incredibly affirming to be diagnosed with generalized anxiety disorder (GAD) and depression because it suggested my pain wasn’t all in my head and was valid. Even so, I was so ashamed that they prescribed psychiatric medication. About two weeks after taking my meds, I felt a 180-degree shift in my mental state. I describe in my book how colors started looking brighter, music started to sound better, and I felt taller both physically and emotionally. Seven years later, I’m in the process of successfully tapering off, but I’ll always be grateful for the way medication rewired some of the chemistry in my brain in a way I wasn’t able to do on my own.” —Marissa M., 30

14. And you can dedicate more energy to other areas of your life.

“I was diagnosed with GAD and depression in late 2019. My psychiatrist placed me on medication as a form of treatment, but I felt the effects of my diagnoses long before then. After years of reducing my symptoms to a ‘personality trait,’ getting a psychiatric diagnosis, treatment, and validation led to what felt like an alteration in my worldview. My depressive symptoms and severe anxiety became much more manageable, and my medication gave me the opportunity to dedicate more time and energy to practicing other forms of mental health and wellness that enhanced the effects of my medication.” —Noelle S., 23 

15. High achievers can benefit from it too. 

“When I was 25, I was a thriving, high-achieving, successful student turned post-grad professional, but my anxiety was crippling me. My primary care doctor prescribed medication to treat generalized anxiety and depression, which at the time, sounded absolutely terrifying. I begrudgingly took my prescribed dosage, which initially felt like admitting ‘defeat.’ 

Once I [found the right dosage], I felt like the medication had finally taken the edge off of life that my brain chemistry so deeply wanted. I’m deeply fortunate that the first prescribed medication worked for me, as I know it can take frustrating trial and error to find what works best for you.” —Taylor O., 32

*Name has been changed. 

Quotes have been edited and condensed for length and clarity.

The post 15 People Get Real About Mental Health Medication appeared first on Wondermind.

Essay Link Copied 09.20.23

Calling All New Parents: You’re Allowed to Really Hate This Sometimes

You can stop faking it now. ByKaty Huie Harrison, PhD

When you get two new parents in a room together, one of two things is likely to happen: Either they’ll exchange pleasantries and say little else because they’re too exhausted to keep up the conversation, or they’ll get incredibly honest. 

During the early days of my cousin Emily’s journey into parenthood, we got together with her tiny baby and mine for a “playdate,” or really just an excuse to catch up and blow off steam. While we were hanging out, she told me that another mom had reached out to check in and said, “I’m glad to hear you’re doing well, and I also want you to know how completely normal it is if you sometimes feel like you’ve made a huge mistake.”

Even retelling the story, Emily seemed relieved. Honestly, I was surprised by her reaction since, to me, she was crushing the new parent life. But also, as I listened to that passed-down advice, my eyes welled up. I felt completely seen.

To put it lightly, bringing a new baby home is a massive paradigm shift, one that’s nearly impossible to comprehend until you’re fully in it. Even seasoned parents have to make huge life adjustments for more little humans. A new baby often comes with trepidation, fear, or anxiety amid the excitement. 

But you wouldn’t really know that based on the way our culture talks about becoming a parent or perinatal mental health. So when my cousin dropped this truth bomb on me, I finally felt like I wasn’t the only one who’d felt uncomfortable emotions after having my baby.  We can both love and hate what we’re going through at the same time, and having permission to feel all of that at once is ultimately a kind of power. 

The complicated emotions of new parenthood

Turns out, a majority of parents likely feel this exact thing. Actually, 62% of parents say that having kids is harder than they expected it to be, according to a 2023 survey by the Pew Research Center. As someone who’s made a career out of supporting new moms through the transition from pregnant to parent, that number honestly seems low. 

Every human relationship is characterized by having contradictory feelings, says reproductive psychiatrist Jennifer Okwerekwu, MD, but when it comes to your relationship with a newborn, our society feels weird about mentioning anything other than bliss and exhaustion. Still, it’s completely normal to experience feelings of elation and adoration while also feeling overwhelmed, incompetent, or longing for the freedom you had before bringing a baby home, explains Dr. Okwerekwu. 

In other words, you can love that peach fuzz on top of your baby’s head and inhale deep breaths of that addictive newborn scent just before your baby spits up all over you—and you maybe, probably cry over another dirty shirt, sleeplessness, and the lack of autonomy. You’re not weird. You’re not a monster. Your feelings make a lot of sense.

What happens when we can’t be honest about our feelings

Unfortunately, not everybody gets that. When I polled my Undefining Motherhood Instagram community about the worst advice they’d received, one member shared being dismissed when she expressed disliking the newborn stage. “Who decided that it’s an either/or thing?” she asked. “Why can’t I hate it now while still knowing I’ll miss this in the future?” 

Thing is, if we can’t be honest about how we feel when we’re in the thick of it, we’re likely to feel lonely, guilty, shameful, and confused, explains psychologist Jessica Zucker, PhD, who specializes in reproductive mental health. 

Obviously, that’s not great in the short term, but what’s more concerning is that holding these emotions in can affect your mental health, says Dr. Okwerekwu. When you experience normal negative thoughts or emotions but think they’re abnormal, “it might impact your self-esteem.” Plus, “left alone with other contributing factors, those feelings can influence the development of perinatal mood and anxiety disorders,” she adds.

This was certainly my experience. After recurrent miscarriages, I had endured so much emotionally, physically, and financially to finally bring a baby home. The guilt I experienced when I didn’t love every moment catapulted me into a terrible state of mental health, including a postpartum anxiety diagnosis. 

How to deal with those not-great feels

Being honest about and sitting with your emotional reality can be transformative, says Dr. Zucker. Whether you’re happy, angry, frustrated, or all of the above, remember “feelings are not facts,” she adds. Aside from reflecting on what’s going on internally, there are some external supportive steps you can take when those I actually hate this feelings pop up. 

First, Dr. Zucker recommends taking a minute to prioritize one of your basic needs when you’re in the thick of it, like showering, opening a window or a silly little mental health walk, changing your clothes, or eating something. Reaching out to a friend to talk about your feelings or something totally unrelated can also help.

When overwhelm hits, it’s fine to place your baby down safely for a minute so you can regroup and take a short breather—or even embrace the life-changing magic of noise-canceling headphones, no judgment.

Whether you’re struggling right now or suspect you could soon, leverage your in-person support. Family, friends, or chosen fam can help with little things like walking the dog or making a grocery run. If you can find a minute, make a list of chores people who want to help can refer to. That’ll cut back on your physical and mental load too.  

When things calm down a little, find your moments of me-time so you can prevent emotional and physical caregiver burnout. Maybe it’s a stroller walk outside, anxiety journaling, an extra minute in the shower, or just reflecting on your emotions. 

When to enlist the professionals

All of those steps—especially embracing the uncomfortable emotions—are great ways to manage the hurricane that is being a new parent—but they’re not always enough.

Dr. Okwerekwu says that any thoughts of harming yourself or others does not mean you’re a bad parent, but it does indicate that you could be dealing with a treatable perinatal mental health disorder that warrants immediate medical attention.

While negative thoughts that enter into your mind suddenly (aka intrusive thoughts) are completely normal, try to notice how you respond to them, suggests Dr. Okwerekwu. 

For example: If you’re suddenly visualizing yourself falling down the stairs with your baby, holding onto the railing is a healthy response. But if you avoid the stairs entirely, “That becomes a functional impairment. That’s where we start to assess for a perinatal mood and anxiety disorder.”

If that happens, remember that this isn’t your fault, and mental health professionals are trained to empathize with and treat this exact situation—not judge it. 

After one particularly terrifying middle-of-the-night episode of fear, regret, and panic when my son was three days old, I knew I needed urgent support. I found a mental health pro and started therapy and taking antidepressants within a week of giving birth. After a few weeks, I started to feel more like myself. 

While you could call a therapist or health care provider as soon as you start to feel out of control, you can also keep an eye on how long your uncomfortable emotions last and if they get worse. If it’s been two weeks and you can’t shake feelings like anxiety or depression—or they’re intensifying—that could be a sign of a perinatal mood disorder, and you should reach out to a healthcare provider right away, suggests Dr. Zucker, author of I Had a Miscarriage: A Memoir, a Movement. 

The Postpartum Support International Provider Directory is a great tool for finding a provider. You can filter for things like specialty, age, insurance providers, and languages to help you find the right fit. This makes it so much easier to find affordable care that fits your comfort level and criteria. But wherever you search for care, words like “perinatal” or “reproductive” indicate expertise in whatever you’re going through.

So go on. Feel the whole range of feelings: love, hate, repulsion, adoration, exhilaration, and exhaustion. And I’ll pass down the permission slip that was given to me with a little extra on top: You’re allowed to be ambivalent too.

The post Calling All New Parents: You’re Allowed to Really Hate This Sometimes appeared first on Wondermind.

Stories Link Copied 01.31.23

8 People Share What Really Helped Them With Peripartum Depression

"Just because you feel bad doesn't mean you are bad." BySam Brodsky

If you’re going through it, peripartum depression can seem like a thing no one really warned you about, but it’s actually pretty common. About 9% of women experience depression in pregnancy—and around 7% go through a depressive episode within the first 12 months after giving birth, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). (It’s worth noting here that people of different gender identities can give birth, but these stats from the DSM-5-TR  were gathered in a way that doesn’t seem to have taken that into consideration.)

For those unfamiliar with the term, peripartum depression refers to depression that happens during or after pregnancy. You may have also heard it called postpartum depression or perinatal depression, or, more generally, referred to as part of perinatal mood and anxiety disorders (PMADs). In the DSM-5-TR, it’s listed as “major depressive disorder with peripartum onset.” The phrasing may change a bit depending on who you’re talking to, but the overall gist is the same. 

Peripartum depression can feel like you’re “paddling as hard as you can to keep your head above water. You’re just waiting and waiting and waiting for someone to throw you a life preserver and pull you out on the shore and save you,” says licensed social worker Paige Bellenbaum, LMSW, founding director and chief external relations officer at The Motherhood Center of New York. 

The exact symptoms can vary from person to person, though you may feel sad, worthless, or fatigued, and your sleeping schedule and appetite might also be off. That might sound like it’s just par for the course of being a sleep-deprived new parent, but, in the case of peripartum depression, these symptoms are debilitating and long-lasting, going far beyond what most consider to be the “baby blues.” 

In a lot of cases, there’s also an added layer of guilt since you’re in charge of this brand new human at a time that’s “supposed” to be THE best (whatever that means), says perinatal psychologist Katayune Kaeni, PsyD, PMH-C. Remember this though: “What you’re going through [does not mean anything] about who you are. It’s about being under high stress during this major life transition. Just because you feel bad doesn’t mean you are bad,” Dr. Kaeni assures. 

Many people’s peripartum depression symptoms begin during pregnancy or within the first four weeks following delivery, according to the DSM-5-TR,  but they can start up anytime within the first year of giving birth, and, if left untreated, may last for years, says Dr. Kaeni. Other types of PMADs can happen alongside depression, whether that’s OCD, an anxiety disorder, or postpartum psychosis, Dr. Kaeni explains. (And just so you know, partners of people who’ve given birth can experience postpartum depression too, says Dr. Kaeni.)

The recovery process may be slow, but treatments like therapy and antidepressants, along with support from your loved ones and those who’ve been there, can help. “When you’re on the road to recovery, it’s never a straight line to the finish line. But there comes a time where you look back and say, ‘I’m past it,’” Bellenbaum says. She knows because she’s been through it—and so has Dr. Kaeni. Ahead, you’ll hear from both of these mental health pros and other parents about what helped them navigate this type of depression. 

Heads up: There’s some discussion around suicidal ideation below.

1. Therapy and meds.

“When my daughter was about 12 months, I started feeling it. There was so much excitement and new changes with her that I relished in. Then, there was a shift—whether gradual or overnight I couldn’t say—where I would look at her do something cute and know I should smile or photograph this and be excited, but I just couldn’t. Then guilt and shame would set in because all I wanted was to be a mom and now it seemed like I didn’t like it.  

Luckily, my general practitioner listened to me when I broke down in his office. He gave me a prescription for antidepressants and encouraged me to go back to counseling. The medication gave me a boost and the counseling helped change my perspective. I was doing a lot of circular thinking by comparing myself to other moms (including celebrities) and feeling like a failure. Counseling helped me practice gratitude for what I had, celebrate what I was doing, and not do the comparison thing. I could feel myself reconnecting with some of the simple moments. I found my rhythm and balance of life. I no longer felt like an outsider to our family.” —Amanda T., 45

2. Faking it till I made it.

“After my first pregnancy, I had suicidal thoughts and was going through severe anxiety and depression, but I didn’t realize what was going on. When I expected my second child, I prepared with regular therapy sessions. I thought I avoided postpartum depression until I hit rock bottom when my baby was 5 months old.

What has helped me is dialectical behavior therapy—specifically a skill I learned from it, called opposite action, where you do the opposite of what your emotions urge you to do. For example, I was terrified of traveling because it felt like a mountain of things could go wrong and hurt my kids. I checked the facts, made a safety plan with my husband, and traveled. At first I didn’t enjoy it. I was stressed, tired, and numb. But after a few trips, I started feeling joy again. 

The exposure is the key. If I fear something, I check the facts about it. If my fear is not justified, then I do the opposite. It’s like faking it until you make it.” —Anonymous

3. Doing things I liked.

“I experienced depression both during and after my pregnancy. During my pregnancy, feelings crept up on me. I would experience heavy thoughts one day, a normal day or so would pass, and then I would feel a desire for extreme isolation away from everyone. In mentioning these thoughts and feelings to my therapist and doctor, they advised that this was clinically diagnosable as depression. 

After birth, the depression hit me like a train. My sleep was impacted; my mood was impacted; and the ability to feel like a present mother, friend, sister, and employee all became a struggle. So did attending social events and simple tasks such as getting dressed or brushing my hair.

Aside from prescribed medication, fresh air, and alone time, participating in activities that I enjoyed before pregnancy, such as watching gymnastics and coaching when physically able, helped. I returned to coaching a few months after giving birth, and it did help my mood significantly. Being active and outside of the house made a world of difference when I had the strength, because it gave me an opportunity to do something I love and be around people.” —Indira, P., 27

4. Reaching out for help.

“My symptoms started during pregnancy, but it wasn’t until about six weeks postpartum where I really crashed. I became increasingly anxious and convinced that something terrible was going to happen to my son. At the apogee of that anxiety, I also became incredibly depressed. I stopped taking care of myself. I wasn’t able to sleep at all. I stopped eating. I felt hopeless. I felt helpless. I felt like I’d made a huge mistake. I felt like I didn’t like my baby and I didn’t want him. I wanted to run away somewhere and never come back. I had nothing to look forward to. I was convinced that this is what my life was going to look like forever.

The critical point for me was when I was pushing my son in a stroller one day. I hadn’t been outside in a long, long time. As I was approaching the corner, I just felt like I was surrounded by this gray, depressing fog. I saw this bus starting to pass in front of me, and every part of my body wanted to just end my life. I remember looking at the reflection of myself in the glass and not recognizing who I saw. That’s when I made the decision to get the help I needed.

I had been in therapy, but I found a therapist who specialized in perinatal mood and anxiety disorders. I had been on an antidepressant prior, and I went back on one. As with any medication, I started to feel better slowly. At one point, I went to a support group for women experiencing postpartum depression, which I thought to be incredibly empowering and validating and normalizing—to realize I wasn’t alone.” —Paige Bellenbaum, LMSW, 49

5. Leaning into self-compassion.

“The thing that was the scariest for me about experiencing postpartum depression with my first child was that it didn’t show up like ‘normal’ depression. I didn’t notice that the intrusive thoughts had taken a permanent residence in my brain. I thought crying all day and berating myself for not being a better mom was just a normal part of being a new parent. I think this was compounded by the messages I was receiving in American culture about how this should be the best time in my life.

The biggest lesson during my first round of PMAD was that I needed to be kinder to myself. Motherhood is an ancient practice that takes time and tenderness to learn. I expected to master sleep schedules and keep my career going while raising a baby full time. When those things didn’t happen as planned, it felt like my life and my identity in the world was crashing all around me. But, in reality, I was building a new life. I was learning new priorities, new routines, and how to live with a brand new person in the world. 

The second time, I had to learn to cope with anxiety and panic attacks as well as my depressive episodes. One practice that’s helped me is to talk to my anxiety and tell her that everything is OK and ‘I got this.’ Once I allow her the space to feel safe, I feel more grounded and able to move through the panic attack quickly or avoid it altogether.” —Erin B., 35

6. Getting support.

“I experienced depression and anxiety following the birth of both of my girls, and, as I look back, there’s an incredible amount I didn’t know. The most heartbreaking thing was that I didn’t think anything was wrong and I definitely didn’t feel comfortable speaking up about it. That truly almost cost me absolutely everything when I went through postpartum psychosis and spent two weeks in a psychiatric unit. I went completely outside of reality and, at times, didn’t recognize my husband. 

Essentially, being forced to get help enabled me to understand how important self-care, being honest, and asking for (and accepting) help was. Having a support system and people to help you is absolutely imperative. 

My husband had to work during my episode and immediately became the full-time caregiver to our two kids (age 2 and 5 months at the time) and to me. Our families would alternate weeks to come help, and I wouldn’t have made it without everyone’s support.” —Kristina D., 37

7. Approaching the day in bite-sized bits.

“I developed my postpartum depression nine months after I gave birth to my daughter. I chalked my symptoms up to life stressors. But once those events passed, I was left feeling so alone and sad.

Every morning was grueling. I knew I needed to get up to take care of my baby and myself, but my body was fighting my mind. It felt like every little task and chore was so overwhelming. It was exhausting knowing everything I needed to do to provide for my little one but feeling so sad and wanting to cry. It was also incredibly hard to ask for help—from anyone. I opened up to my husband a little bit, but he had his plate full too and he was already so incredible in helping me whenever he could. I felt guilty adding anything more. Secretly, I was screaming for help in my head and wishing anyone would offer any ounce of help at all.

I really took some time at the start of the day to mentally prepare. That meant waking up an hour earlier than I normally would to allow myself to lay there, watch a show, and hype myself up. Another small thing I did was break down my day into 10-minute increments. I wouldn’t think about all the things I needed to do that day all at once. I would say to myself, ‘In the next 10 minutes, all you need to do is change her diaper.’ It helped in the long run.” —Joy K., 27

8. Challenging my thoughts.

“It took me about a year to realize what was going on because, as a therapist, there was this additional layer of pressure that I should have been able to figure this out. There’s also a little bit of denial. I did not want to be depressed. So, for me, the light bulb came on when I decided to just honestly sit down and fill out a depression screening myself so that I could objectively see: OK, yeah, you are actually dealing with something. Seeing that objectively on that piece of paper really made me see that I needed help.

So I went back to therapy. They were helpful, but it wasn’t a great fit, so I decided to use the skills that I know—and help people learn—to change my thought process. 

I had a colleague that used a catchphrase to describe this process: ‘Catch it, check it, change it.’ The first part is essentially building an awareness of your own thought process and trying to catch your negative self-judgmental thoughts. Checking it is: Is that really a true statement? Is it a true thought or feeling about something that’s happening? And then changing it is offering yourself an alternative. So let’s say I’m feeling like I’m a bad mom, and I catch myself saying that to myself. I check it: Am I really a bad mom? What are the things I’m doing to help my child?  Then, change it to something that’s either neutral or positive like, I’m doing my best right now. Or even a positive one would be, I am a good mom.” —Katayune Kaeni, PsyD, PMH-C, 44

These quotes have been edited and condensed for length and clarity.

The post 8 People Share What Really Helped Them With Peripartum Depression appeared first on Wondermind.

Explainer Link Copied 01.20.23

How Long Does Depression Typically Last?

If you can’t remember your last good day, this is for you. ByColleen Stinchcombe

Depression can feel like a dark cloud, a heavy backpack, perpetual exhaustion. When you’re in the thick of it, it’s natural for you—or a loved one—to wonder: Seriously, when does depression go away? The unfortunate reality is that depression can last varying amounts of time for everyone—and it can come back again in the future. That’s why treatment is key, both to lessen your immediate suffering and also to bring the light back a little sooner. Here’s what you should know about how long depression lasts.

First, a quick refresher on depression. 

For those unfamiliar with the Big Sad, clinical depression (otherwise known as major depression or major depressive disorder) is a mood disorder that affects about 1 in 5 people at some point in their life, according to a 2018 national survey published by JAMA Psychiatry. 

When we say “depression” we’re mostly talking about major depressive disorder, which means you’ve had symptoms lasting for at least two weeks that are seriously interfering with your life, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). But there are a few different types of depression you can be diagnosed with, depending on the pattern or timing of your symptoms, according to the National Institute of Mental Health (NIMH). For instance, there’s peripartum depression (which happens during or right after pregnancy), there’s seasonal depression (also known as seasonal affective disorder), there’s persistent depressive disorder (also known as dysthymia, where you have less severe symptoms for at least two years), the list goes on.  

And, contrary to what most people think, depression can come with both mood symptoms and physical symptoms, says Karen Swartz, MD, professor of clinical psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. You might feel sad, irritable, or even emotionally numb. It might be hard to feel excited. You could see big changes to your sleep, hunger, and energy. You might also struggle with focus and concentration. And the physical symptoms can take the form of headaches, stomach aches, digestive problems, or other rogue pains. 

Another frustrating symptom is what Dr. Swartz calls “self-attitude” changes, which are changes in “how you feel about yourself, your sense of confidence, your belief in yourself, and your view of the future.” People often feel hopeless or think that everyone would be better off without them. “That’s part of what we call cognitive distortions, where your thoughts get twisted by the illness,” she says. 

Exactly what combination of symptoms a person experiences really depends on the person. “Depression is entirely individual,” Dr. Swartz says. For some people, depression seems to arise out of nowhere. For others, it can be triggered by something specific, like substance abuse, or medical problems, she explains.

Depression often comes in episodes. 

A key characteristic of major depressive disorder is that it comes in waves or episodes—and for most people who experience depression, they’ll get hit by more than one wave in their lifetime, Dr. Swartz says. 

In a lot of cases, depression slowly descends and takes a while to resolve. “If you were to follow most people, they will slide into depressions over time, be in the depression for a period of time then sort of crawl out of it,” she says. “That change day to day is often so subtle,” she explains. So subtle that you might brush off the early signs of depression.

Each episode might be a little different from the last, too. For example, if you had a depressive episode when you were a teenager, and have another post-college, those experiences might seem quite different, Dr. Swartz says.

And an episode might not mean you’re knee-deep in misery every moment of the day. “That would be only the most severe form of illness,” Dr. Swartz says. Instead, daily fluctuations in how you feel are common. “Many people have what we call that diurnal mood variation—there’s a time of day where they feel a little better,” she explains. Typically, it’s later in the day that people feel better—which can then start affecting people’s sleep schedules, which can further contribute to depression. So keep in mind that a depressive episode can have some variation.  

How long does an episode of depression typically last?

As you might have guessed, there’s not an exact number to this. “Some studies say that it’s about six to nine months. Other studies say 80% will have episodes less than a year and there are about 20% that last more than a year. It’s highly variable study to study,” says Dr. Swartz. 

As we mentioned earlier, major depressive disorder has to last at least two weeks in order to be classified as depression, but some forms of depression can last much longer than that (like the aptly named persistent depressive disorder). 

“What I can tell you is that there are some people that have short episodes and come out of them with treatment or not. And then there are other people that have really long episodes that are much tougher to treat,” Dr. Swartz says.

What is apparent, Dr. Swartz explains, is that it’s very rare for depression to only last a week or two, like a cold. It’s often six months or more. That could be a whole semester or longer for a young person, or enough time to start dramatically impacting someone’s performance at work. 

So, when should you get help? 

The short answer: As soon as possible. Ideally you would seek out treatment as soon as you start noticing yourself feeling depressed, but there are many reasons why that doesn’t always happen. For starters, finding (and paying for) mental health care can often be an uphill battle lined with stigma and barriers.  

In fact, it usually takes years before a person seeks help for their depression, Dr. Swartz says. She offers this not-uncommon scenario as an example: A person has a depressive episode in high school, but it’s written off as being a moody teenager. Maybe they have another episode in college, and they cope by drinking and partying. It’s not until later—when they’re an adult trying to keep a job, take care of themselves, or care for their family—that they realize they might need some help.

While some mild forms of depression might be soothed by lifestyle modifications, the classic treatment for depression involves therapy, medication, or both. “Once you get to moderate to severe episodes, the combination of psychotherapy and medication has been shown to be superior in nearly every study,” Dr. Swartz says. And there’s absolutely no reason to feel embarrassed or ashamed about seeking treatment—no matter how mild or severe you think your depression is. Other treatments for depression are also being developed, including transcranial magnetic stimulation, ketamine, and psilocybin, Dr. Swartz says. 

And treatment really is the best option—not waiting it out. “The whole goal of treatment is to reduce the intensity of the symptoms and shorten the length of the episode,” Dr. Swartz says. Keep in mind that timing is pretty clutch when it comes to taking medication for your depression. Unlike an aspirin, which might get rid of a headache within an hour, antidepressants take four to six weeks to take effect—and they may need to be increased over time in order to avoid side effects. “A lot of people give up and they say, ‘Well, this isn’t working,’” Dr. Swartz says. That’s why other supportive measures, like therapy, are important as you find the right dose.

Speaking of which, if you’ve been on antidepressants for a while and you’re not feeling relief, don’t be afraid to reach out to your care team. If your antidepressant isn’t helping anymore, it might be that your dose isn’t right—or that it’s time to try something else, Dr. Swartz says.

The bottom line: There are no prizes for waiting out a depressive episode without help. Depression may come and go on its own schedule, but you don’t have to suffer through it. “Depression is very treatable,” Dr. Swartz says. “You deserve treatment.”

The post How Long Does Depression Typically Last? 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.