Thank God for the internet and blogging.  Else how would we get to read all of these great stories and share in other women's triumphs over perinatal mood and anxiety disorders.  Here are some amazing women.

Sophie in the Moonlight on the holidays, postpartum depression, and NOT being Suuuuupermom:

If the postpartum depression had won and my spectacular suicide attempt had been successful, I would not be here making magnets out of 29-cent wood cutouts, cheap acrylic paint, and sparkly beads with my boys.  The kitchen counter has been covered with craft projects for two weeks.  I never even remove the brown paper bags I opened up and taped down to save my counter.  We simply sweep off the mess of the day and leave stuff ready for the next day.  If the PPD had won, I would have missed out on the gazillion foamy sticker cards we've made.  Foamy sticker ROCK!! OMG, the boys never get tired of them.

Medicated In Minnesota on the anniversary of her hospitalization and her daughter's second birthday:

I feel that my [postpartum depression] experience was almost two years ago and seriously, I should just get over it. But then I think, "why?" Why should I just get over it? It was a fully traumatic experience being hospitalized and away from my child. It was a traumatic experience to fear being a mother even though it was reality for me.

The Adventures of Anxiety Girl on how Stevie Wonder helped her through postpartum anxiety: 

Dancing with Stevie became a family affair & helped get me out of my head & into my body. Many mornings, I'd set the alarm clock to wake us up to this music. At 7 o'clock the horns would begin, and even if I woke up feeling off, my legs would start twitching to move and I would get myself up to dance. Slowly the other sleepy heads who had made their way into our bed in the wee hours would begin dancing, too, and it was a party. My 6 yr. old always wanted to hear "Signed Sealed Delivered" & we would shout out the lyrics as we swung around the room.

I feel the exact same way about Stevie Wonder.

So here's my little teensy gift to you for Christmas - some blog bling.  I just love bling, don't you?  It's nothing big, but I think they're fun.

With the help of Ink Studio, I've created Warrior Mom badges that you can post on your own blog or website (you can find them to the left of your screen if you scroll down).  If you're a survivor of a perinatal mood or anxiety disorder, I hope you'll "wear" one of them with pride!  There are different ones for each illness. 

Be an inspiration in this coming year.  Let women know that YOU made it and they can too!  You can slap one (or more) of these into your sidebar, and then anyone who chooses to click on them will be directed to Postpartum Progress, where I hope they will find information and encouragement.  Use the code underneath each one to get the badge.

And let me know if you display a badge on your site so I can keep a list of Warrior Moms with badges.

Speaking of fathers and postpartum depression, I thought you might want to see this post by Dan Scott from the Life As Best I Remember It blog.  He shares his experience with his wife when she had PPD.

If you didn't see it last week, here are five things new fathers can do to help their wives or partners through postpartum depression and anxiety. [corrected link]

A few weeks ago I shared with you a story by Lesley Alderman at the New York Times on making the most of your mental health insurance benefits.  But what about those of you who have postpartum depression or a related illness and who don't have insurance?  What if you have very limited mental health benefits?  Alderman has written a follow-up column entitled "How to Find Mental Health Care When Money Is Tight".  She writes:

"According to a recent survey by the federal Substance Abuse and Mental Health Services Administration (Samhsa, pronounced SAM-suh), the leading reason that people with mental health issues don’t seek treatment is cost. They fear the fees."

If you've been reading Postpartum Progress for any length of time, you know that avoiding getting help is not an option when it comes to perinatal mood and anxiety disorders.  Thankfully there are things that you can do that are low-cost or even no-cost.

One of Alderman's suggestions is to join a support group.  These are most often free, and peer support has been shown to lessen the symptoms of postpartum depression.  You can click here for Postpartum Progress' list of postpartum depression support groups, and here for the list compiled by Postpartum Support International. 

Alderman also lists free crisis lines like 1-800-273-TALK.  Some states offer crisis hotlines specific to postpartum depression.  In Illinois, the Jennifer Mudd Houghtaling Foundation has a crisis hotline for people in certain area codes (312, 773, 847, 708, 630, 815) at 1-866-364-MOMS.  New Jersey also has a Postpartum Depression Family Healthline at 1-800-328-3838.  And Postpartum Support International has a warm-line at 1-800-944-4PPD where you can ask questions during business hours.

I'd like to add a couple of things to Alderman's suggestions.  One is to check into clinical trials.  If there is one in your area and you are willing to participate, your care is often free during the period of the trial.  You can search for clinical trials on perinatal mood and anxiety disorders here.

Additionally, there are books that you may find helpful.  One, called the "Pregnancy & Postpartum Anxiety Workbook" by Pamela Weigartz helps you work through feelings of anxiety with the help of easy exercises and worksheets.  The book "This Isn't What I Expected: Overcoming Postpartum Depression" by Karen Kleiman also offers brief self-help worksheets and exercises.

To read Alderman's entire column and see more of her suggestions, click here.

Speaking of the alternative treatment methods for postpartum depression I wrote about yesterday, I forgot to mention the endless self-help gurus who sell you their wares as the key to getting a fulfilled life, happiness, the perfect weight, the perfect husband and a great car.  I was reminded of these by a new story on CNN.com by Jason Hanna called "Good, Bad and Ugly Self-Help: How Can You Tell?".

"Self-help is a multibillion-dollar-a-year unregulated industry in the United States, according to John C. Norcross, professor of psychology at the University of Scranton.

Norcross says hundreds of quality, research-supported self-help programs on career growth, health and self-esteem exist. But he and other critics say some gurus, promising secrets to greater happiness and wealth, offer advice that at best isn't proven effective and at worst could send someone down a poorly suited or dangerous path."

I was fooled into buying the book "The Secret" by Rhonda Byrne after Oprah promoted it so heavily on her show a couple of years back.  Don't get me wrong -- I definitely believe in the power of positive thinking and ridding oneself of hurtful thought processes.  (In fact, here's a story that just came out about the effectiveness of mindfulness on depression and anxiety, based on research.) But when I started seeing the parts of the book where they talk about envisioning the stuff you want and then getting it, when I started seeing how much of the book was about materialism, I got pretty pissed off and threw it out.  Byrne had a kernel of a good idea, in my own little opinion, but then blew it with all the focus on getting things. 

Plus, I worried about the people who have an illness, like, say, postpartum depression.  What if someone believed that just by thinking it away they could get rid of PPD and thus refused any other type of treatment?  Not that the book says to do precisely that, but you could see how people might fall into that line of thinking.  They might blame themselves if they don't get better and fall into an even worse depression.

As Tim Watkin wrote in the Washington Post:

"Still worse is the insidious flip side of Byrne's philosophy: If bad things happen to you, it's all your fault. As surely as your thoughts bring health, wealth and love, they are also responsible for any illness, poverty or misery that comes your way.

That isn't just implied, it's spelled out: 'The only reason why people do not have what they want is because they are thinking more about what they don't want than what they do want.' By this logic, Holocaust victims brought it on themselves, as did those who lost their homes in Hurricane Katrina. Come on, New Orleans, get over it! Think positive!

'Imperfect thoughts are the cause of humanity's ills,' Byrne asserts, in a stunning sentence that had me pondering how to perfect my thoughts, pronto.

Poverty? 'The only reason any person does not have enough money is because they are blocking money from coming to them with their thoughts.'

Illness? 'You cannot 'catch' anything unless you think you can. . . . You are also inviting illness if you are listening to people talking about their illness.' So . . . got any sick friends who need a shoulder to cry on? Tell 'em to bug off!"

I just can't go there.  I don't think I attracted my postpartum OCD, or asked for it, or that it was my fault that it took a while to get over it.  And thank God my friends didn't avoid me in order not to be contaminated with my mental-illness-germ-filled words.

How we think is crucial to our recovery from mental illness.  Having a positive attitude and believing that we WILL get better is key.  We have to eliminate our unhelpful thought processes.  Getting help from professionals is important, but so is taking responsibility for ourselves, and this is where self-care can contribute mightily to getting better.  But it's also important to be aware of those who are more concerned about lining their own pockets than about you as an individual and how best to help you heal. 

Self-help is not wrong or bad.  It's good.  You just need to be wary of the people out there who are selling you a bunch of hooey.  Unfortunately, they're mixed in with the good guys.  The CNN.com article suggests 5 things you should watch out for when considering different self-help therapies.  Check them out.

Related story:  Beyond Blue: Mindfulness Doesn't Mean Anti-Medication

While doing my daily required reading of articles, blog posts, tweets and other assorted media across the web about postpartum depression and related illnesses, I came across a question a while back posted on Mamapedia by a mom with postpartum anxiety.  She was looking for advice on natural treatments because she didn't want to take the Prozac prescribed by her doctor.

She received 22 answers by other mothers, many warning vehemently against taking any medication.  These are some of the things she was told by the moms:

For many people, postpartum anxiety is caused by a deficiency of omega-3s and a lack of coping mechanisms.  Read the book Feeling Good and take omega-3s.

Acupuncture works.

If he is suggesting serotonin imbalance, then speak to your herbologist again. Don't go on medication! You have to take too much time to wean off. There are many things that will help the levels naturally

If you don't want to take Prozac, then ask for something less dramatic. (something less dramatic? huh?)

I highly recommend contacting Dr. ____ who is truly an amazing Chiropractor and Nutritionist and would definitely be able to help you naturally.

Please don't settle for drugs that will be only partially successful in masking your issue and give you the side-effects galore. There are so many safe and effective homeopathic remedies.

I don't know the mom who posed the question.  I don't know if her anxiety is mild or severe.  I don't know whether she has a history of mental illness.  I don't know if she's had suicidal thoughts.  I don't know if she's taken antidepressant medication before and it didn't work or caused unacceptable side effects for her.  I don't know if she's tried therapy.  All I know is that she has received advice from people with no medical training, some of whom have a bias against medication but claim to know what will work to fix her postpartum anxiety. 

To be sure, there were women who responded to the Mamapedia question who I felt had some good suggestions, including reaching out to other moms for support, getting your thyroid checked and getting adequate sleep, nutrition and exercise.  Medicine is not the only answer, and it's not the answer for every person.  But that doesn't mean it's evil incarnate, and that going to your "herbologist" is the right answer for people with moderate to severe perinatal mood and anxiety disorders.

I see this all the time.  Natural is better, right?  You'd think so if you watch Oprah (thereby ensuring I will never be asked to appear on the Oprah Winfrey show) or surf the internet.  But here's what you need to know.  It's not just pharmaceutical companies that have an agenda to sell you their drugs.  There are also lots of people who are trying to sell you their unproven, often untested remedies.

Alternative medicine is highly unregulated and not necessarily any more effective, or safer, than mainstream medicine.  According to the Associated Press in a story this year on alternative medicine:

"Ten years ago the government set out to test herbal and other alternative health remedies to find the ones that work. After spending $2.5 billion, the disappointing answer seems to be that almost none of them do.

Echinacea for colds. Ginkgo biloba for memory. Glucosamine and chondroitin for arthritis. Black cohosh for menopausal hot flashes. Saw palmetto for prostate problems. Shark cartilage for cancer. All proved no better than dummy pills in big studies funded by the National Center for Complementary and Alternative Medicine."

You probably didn't hear about that, because it's not a positive outcome for such a popular concept.  If you were aware, you likely heard proponents argue that the research wasn't conducted correctly.  You were probably told that the fact that many alternative health remedies work no better than placebo is no different than the fact that some prescription medicines are found to work no better than placebo.

Antidepressants, in fact, have been found in certain studies to work no better than placebo.  After reviewing those studies, Dr. Steve Novella, who writes the blog Science-Based Medicine, wrote a great piece about this called "Do Antidepressants Work?  The Effect of Publication Bias". 

"At this time it is premature to conclude that modern antidepressant medications do not work. There is sufficient evidence for efficacy to continue to use medication as part of the overall treatment approach to depression. The current consensus is that therapy is also a critical component of the long term treatment of depression, and therefore looking at the use of medications in isolation may not reflect their actual clinical use. Multiple studies have now shown that combination treatment (medications and therapy) are better than either alone. There is also evidence that medication treatment is more successful when multiple agents are tried in order to find the optimal treatment."

I like Dr. Novella's blog because he gives everybody the "business" if they don't get their science right, whether it's claims made about homeopathy or antidepressants. He explains his belief that the problem with Complementary and Alternative Medicine (CAM) is " ... that they aggressively market CAM as 'harmless' and 'natural.' They point to the warning labels and informed consents associated with science-based medicines as evidence that the alternative must be safer. In reality, many alternative practices are less effective, and can carry serious risks (usually undisclosed to the patient)."

We need more research on what causes postpartum depression and what the most effective methods are to treat it.  This should include looking more closely at alternative forms of treatment, whether it's acupuncture or yoga or light therapy or omega-3s, to make sure that we aren't missing anything.  Unfortunately, there's just not a whole lot of information available on that yet, especially for moms who are breastfeeding.

One interesting piece, the best I've found so far, took a look at the more common natural treatments suggested to women with postpartum depression.  It was published in the Journal of Midwifery and Women's Health in 2004 and looks at both pros and cons. Their conclusion?

"Especially for women with moderate to severe symptoms, complementary and alternative medicine is a complement to conventional treatments, not a replacement for it."

So what should you do?  One of the MDs who writes the blog Denialism suggests the following in his post "There is No Such Thing As Alternative Medicine":

"When someone offers you an 'alternative therapy', ask them what it is an alternative to. Does it work better than something else? Is it safer? How do you know? Why should I believe you?"

Then, talk to your doctor.

Update to this piece:  I think some readers are getting the impression I think alternative treatments are bad.  That's not my point at all.  I simply think we should always look at both sides of any treatment suggested.  Everything has side effects of some sort.  Everything has risks and benefits. Just because a treatment method is "natural" doesn't necessarily mean it is safer or more effective.  That's all.  If you want to try an alternative method, you should.  That's why I report on them here and here whenever research comes out.  I want you to know everything that's available.  You have to make your own choices.

For related articles on this topic, you might want to check out the following blog posts:

Psych Central: Consumer Reports on Antidepressants

Mamapedia: The Postpartum Prozac Roller Coaster

Mayo Clinic: Postpartum Depression and Alternative Treatments

Dr. Shoshana Bennett: Natural and Alternative Treatments for Perinatal Mood Disorders

MGH Center for Women's Mental Health: Fish Oil and Postpartum Depression and Using Omega-3 Fatty Acids to Treat Depression During Pregnancy and Can Estrogen Be Used to Treat Postpartum Depression?

Psych Central: Alternative Practices May Complement Western Medicine 
 

This week, as part of the debate over healthcare reform, the U.S. Senate passed an amendment to Senator Harry Reid's healthcare bill that would support funding for postpartum depression screening.

This amendment, led by Senator Barbara Mikulski (D-MD), is unrelated to and separate from the Melanie Blocker Stokes MOTHERS Act, which does not include screening for postpartum depression among its provisions.  (The Melanie Blocker Stokes MOTHERS Act was passed by the U.S. House by is still stuck in committee in the Senate.)

As reported in the New York Times yesterday:

"Under Ms. Mikulski’s proposal, a federal agency, the Health Resources and Services Administration, would develop “comprehensive guidelines” recommending preventive care and screenings for women, and insurers would have to cover the services without any cost-sharing.

Ms. Mikulski said the services would include screenings for breast, cervical, ovarian and lung cancer, heart disease and diabetes, as well as postpartum depression and domestic violence."

Thanks to Sara R. and Jennifer L. for sending me their photos for the Surviving & Thriving Mothers Photo Album!  It's an awesome thing to see pictures of smiling faces when I know that not so long ago those same faces were filled with despair.  You both are an inspiration to mothers suffering from postpartum depression, anxiety and psychosis. 

If you are someone who suffered from depression during pregnancy and survived, or from post-adoption depression, please know we want your photos as well!  Send them to me at stonecallis@msn.com!

Brooke Shields recently received an advocacy award from the Hope for Depression Research Foundation in Manhattan.  At the event, she spoke about her experience with postpartum depression and about the stigma of mental illness.

People magazine covered the event here.  Of interest to me was this bit about her treatment for depression:

"Shields was prescribed medication, though she stopping taking it one point, thinking she didn't need them. 'That was the week I almost did not resist driving my car straight into a wall on the side of the freeway,' she told the crowd. 'My baby was in the back seat and that even pissed me off because I thought she's even ruining this for me. I just wanted to drive into the wall and my friend stayed on the phone with me and made me safely get home.'

She later called her doctor to ask for more help, and was eventually diagnosed with a chemical imbalance. 'I learned what was going on inside my body and what was going on inside my brain,' she said. 'I learned I wasn't doing anything wrong to feel that way. That it was actually out of my control.'  

Two things. 

One, I don't think People magazine got it right when they wrote that Brooke Shields was diagnosed with a chemical imbalance.  People don't get diagnosed with a chemical imbalance.  It's not like there's a test given in your physician's office, like swabbing your throat or having you pee on a stick or something, that tells you whether your neurotransmitters are messed up. 

Shields would have been diagnosed with postpartum depression, which has, as far as we know at this moment, several causes including both genetic, biological and environmental factors.  As Dr. John Grohol at Psych Central has often stated:

"Sorry, mental disorders such as depression and bipolar disorder are not simply 'brain illnesses,' without any significant psychological or social components that must also be treated. They are complex disorders that involve genes, biology, personality, social development, environment, relationships, and a whole lot more in most people. Buying into the simplistic and discredited model of 'brain chemical imbalance' isn’t something that’s beneficial for research or public advocacy or policy."

Does this mean the serotinin or dopamine in your brain aren't involved somehow with your postpartum depression?  No.  Does this mean that there isn't some portion of the illness you're experiencing that is indeed out of your control?  No.  Does this mean it's your fault if your illness isn't biochemical?  No.  But it does mean it's way too simplistic to say you simply have a "chemical imbalance". 

This Just In:  I checked two MDs who are specialists in perinatal mood and anxiety disorders this afternoon just to make sure I'm not making this up and they said what I've written is correct.  There are no consistently identified biomarkers for depression.   There is a test that can be done of cerebrospinal fluid apparently, but it is invasive and not necessarily diagnostic.

In fact, that kind of terminology sometimes frustrates me because in some way I feel it adds to the stigma of mental illness.  Rather than as an evidence-based, medically acceptable diagnosis, I think the term "chemical imbalance" is often used by the media as a sugarcoated, societally acceptable way of referring to depression or postpartum depression. We can't just say we have a mental illness, because that's too hard to prove, supposedly?  Can't be seen on an X-ray?  Too hard for people to believe?  But if we use the phrase "chemical imbalance" then that's acceptable?  That makes it all okay?  I don't know why we have to wordsmith the truth.  I hope someday that stating you have a mental illness like postpartum depression won't require any sort of PR spin.

Now that I got that off my chest, the second thing I wanted to point out is this:  I'm glad to see that Shields spoke so openly about something I hear about quite a lot from moms -- this idea of deciding you should be your own doctor and quit your meds whenever you feel like you don't need them.  Bad idea.  You can see what can happen when you do that, as described by Brooke in the quote above.  Whatever form of treatment you are undergoing, talk with your healthcare provider about whether you should end it, and when and how you should go about doing that.  It's for your own good.