Postpartum Progress – postpartum depression and postpartum …

I couldnt leave the house yesterday.

Thats really hard to admit. Im a Warrior Mom Ambassador. I run the Facebook group for our Warrior Mom Conference attendees. I lead a support group. I help coach women through pregnancies after a PMAD. I am the strong one, the one you count on, the one with the resources and the answers and the shoulder to cry on.

Im also a black woman, mother to a black son, daughter to a black father, sister, friend, cousin, aunt. I grew up hearing stories of my father registering people to vote across the South. They were stories of terror in broad daylight and nights spent driving with no headlights on. I grew up on the narrative that my parents, and their parents, and everyone who made me possible had paid a debt so that I could be free, so that I could be safe in this country.

Last year I was followed and harassed by a police officer here in my home town. I was pregnant with my second child at the time and had just made it to what I considered my new normal after battling postpartum depression and anxiety. I didnt know then that I also had PTSD. All I knew was that I was vomiting, sobbing, and shaking in a parking lot and praising the lord that I was alive.

My daughter is eight months old. Ive been so lucky to not experience any major relapses in my postpartum depression or anxiety and to have my PTSD under control. I see a therapist every week. I take my medication every day. I practice self-care and I reach out for help when I need it.

I have so many privileges: financial, educational, heterosexual, light skin, in a relationship with a white partner. And still. Ive spent the last two nights unable to sleep. First because I couldnt get the voice a four year old girl trying to comfort her mother out of my head. Then last night it really felt like the world was falling apart.

As I write this we still dont have details on the sniper(s) in Dallas. I know that one is dead and the others are in custody. The officers who killed Alton Sterling and Philando Castile are both on paid administrative leave. They havent been arrested. I have no reason to believe there will be any arrests, convictions, or any type of punishment at all for the deaths of those men. Or for the murders of scores of boys and girls, men and women of color before them. Or for me if an officer decides to take my tone of voice, my reaching for my license, my skin color as a threat.

When I say #BlackLivesMatter, it is in desperation and defiance. I say it because I see no evidence that it is believed to be true in this country. I say it because after everything my father went through, after everything his father, and his, and his went through so that I could live free I still dont feel safe.

I know that I am more fragile than I seem from the outside. We all know that you cant see postpartum depression or anxiety. You cant see PTSD. When the panic attacks came at the thought of leaving the house and taking my son to camp, I had a choice to make. I chose to be honest with my partner about how I was feeling. I chose to reach out to my therapist and let her know I was not okay. I chose to keep my kids home with me, where I feel safe. We watched Disney movies and played with the baby, and dumped way too much bubble bath into the tub. I jumped at every sound and shook when sirens passed my house. I touched base with my relatives and made sure that I knew they were all safe. I tried my best not to get sucked into debates online.

This morning I left the house. I drove my son to camp. When I got home I fell apart. Then I put myself back together and sat down to start work.

I want to be the strong one. The one with the answers, and the resources and the shoulder to cry on. I want to be an ambassador, and a moderator, and a coach. I want to be the strong black woman that I am expected to be.

But Im not. Im scared. Im scared that I will never feel free. Im scared that someone I love will be the next hashtag. Im scared that I will be the next hashtag. Im scared that I will forever be shouting #BlackLivesMatter into the world and it will never, ever be true.

At Postpartum Progress, we believe Black Lives Matter. While not all readers will initially understand the importance of this movement or statement, we believe it matters to say this out loud and up front. We care deeply and equally for every mom suffering from a PMAD. In light of the traumatic events of this week, we are especially worried and grieved for women of color with PMADs and women mothering children of color. We stand in solidarity with you.

We are committed to caring for the most vulnerable members of our PMAD community because we believe the improved well-being of those who suffer most due to systemic racism is the improved well-being of us all.

Were a community. When one suffers, we all suffer. Were in this together. We stand with our moms of color and mothers of Black children.

We understand the unique issues our mothers of color and those parenting children of color experience while battling maternal mental illnesses. The heightened worry about your childs future combined with issues of access to care by clinicians who look like you and understand the complexities of mothering while Black make your recovery different and difficult. We understand and support your desire to speak up, to go into quiet grieving, or to do what you need to do at this time. We just want you to be safe, no matter what that entails.

We are thinking of all the pregnant and new moms who are fighting postpartum depression and anxiety while also living with the acculturative stress and trauma of this week and want to remind you that you are worthy of love, respect, wellness, and safety. We want you to know that we are here to provide support and connect you to help, and that we stand with you and by you. You can email help@postpartumprogress.org or send a Private Message to our Facebook page.

We see you. We hear you. Our hearts break for and with yours as you navigate the news as it unfolds. Were holding space for you in our hearts.

Sincerely, Postpartum Progress Staff

[Editors Note: Todays guest post comes from a Warrior Mom who experienced Postpartum OCD. She shares her journey with intrusive thoughts so that other moms might feel less aloneand also so others will understand that side of OCD. Some thoughts might feel triggering for moms in vulnerable places, so please only read if you are feeling safe today. -Jenna]

Ive found that no one really understands what OCD is in general. I hear a lot of things.

Oh, so you wash your hands a lot. Oh, you check the locks and stuff. Oh, I used to clean the house all the time, too, but I got over that.

Do people who suffer from OCD just wash their hands, check the locks, clean? NO. They perform rituals and compulsions like these far more often than the non-sufferer, and theres always a thought behind itusually an unpleasant onefueling what they do. Think: Im sure my mom will die if I dont wash my hands exactly seven times every hour in the same exact order.

Whats more is people really dont know about Pure O OCD and the intrusive thoughts that plague us. Its impossible to explain to someone who doesnt have it or get them.

Ill be honest: It sounds ridiculous to even try and say it out loud to someone. Throw in the fact that theres no visualcracked bleeding hands arent evident, someone you can see counting the times they touched the lock to make sure it is in fact really lockedand you have one big misunderstanding of this special kind of torture.

When I try to explain to a non-sufferer, Ive been told but thats just a thought, you wont do that, or the opposite, oh God, so you were like one of those women who wanted to hurt their kid. So I thought a post about thoughts that were constantly going through my mind when I suffered from Postpartum OCD might shed some insight.

When I say constantly, there is no exaggeration. I had intrusive thoughts and thoughts surrounding them every waking minute. I had them while I was knee deep in reports for work that required concentration. I had them while I was having full blown conversations with someone else. I never not had them.

On a good day I had a 10-15 second break in between.

Its amazing how you can be having a running horror movie in your head at any given time and no one knew or understood how, since you looked and acted so normal. Its much easier to talk about the latest episode of Greys Anatomy than say, Sorry my eating my apple is so loud. I couldnt cut it up this morning before I came because I was at home alone with the baby and what if

Who I was wasnt normal around was my husband. He received the full force of my confessing of the intrusive thoughts and reassurance seeking that I was not crazy or going to act on my thoughts, because as a person with OCD, you think, why else would you have them, right?

So heres a blip of a very typical night in the mind of my PPOCD experience.

Its 4:30, 4:30, 4:30. Thats only 15 more minutes until hes home. 15 minutes. Thats not too long. You can do this. You are fine. 15 minutes.

Thats enough time to hurt him. Oh God what if I hurt him.

Who thinks that? Whats wrong with me? What if he comes home and hes dead? Why would he be dead?

Dont be ridiculous. Youre fine. This is just OCD. You are not your thoughts.

Only 14 minutes. Just start dinner. Just start dinner. Man, it was easier to get dinner ready without a baby around.

Does that mean I dont want him? Does that mean I want to get rid of him? I know how people do that.

Oh God, Im going to be one of those people on the news.

Stop it. Just stop it. This is only OCD. Of course, it was easier without kids.

Thats the truth. Your therapist told you to look at the truth. Why isnt that calming me down? I KNOW thats the truth but I dont believe it. Only 13 minutes. Ill ask him when he gets here if he thought it was easier without a baby too.

He promised to tell me if I scared him with what I said. What if Im just good at acting like I have OCD and Im really a monster.

Stop it. Thats your OCD talking. Remember what your therapist said.

Only 12 minutes.

What can I make without a knife? I know its in the dishwasher. What if I grab it and

STOP picturing it. STOP.STOP STOP.

Noodles. I can make noodles. If hes in the other room, I wont hurt him.

Is he really in the other room. Yes, you see him damn it. Just stir your stupid noodles. Stir. Stirring. Stirrrriiiiing. Keep singing that like a song. If you sing it out loud, it will curb your thoughts.

Shit. Its not working. Wait, is he still in the other room?

YES, hes home. 4.3.2.1.

I swear I put him in the other room while I was cooking so hes okay. I didnt really want to hurt him. But I dont know, maybe I did. Why else would I put him so far away? I also opened the dishwasher just to check but I didnt touch the knife I swear. I thought it was easier without him but that doesnt mean I dont want him right? Does that mean I want to get rid of him? What if he went missing and no one looked for him because they know Im seeing a therapist. What if he really was taken and ended up really dying because they never looked for him. How would I explain this to the police? They dont know what OCD is. Maybe my doctors would tell them. What if they really do think Im crazy and havent told me yet? Oh Jesus, do YOU think Im crazy!? Im so sorry you have to deal with me.

Um. No, youre not crazy. This is OCD. You know that. You know what your doctors have told you. Yes, it was easier without him. No that doesnt mean anything other than it was easier without him. I see were having noodles, again. Do you need me to unload the dishwasher tonight?

And this goes on. And on and on and on and on. All night.

I need you to cut up that watermelon. Actually I need you to take him in the other room while I do it because you can keep him safe from me.

I need you to give him a bath. But I can do the diaper first. Wait, what if I touch something accidentally when Im wiping him.

I need to work on my OCD workbook the therapist gave me, but what if someone sees what Im writing? They will take him from me. I know you said we can just burn it when Im done but that also gives me bad thoughts. Actually can we just use the oil furnace while youre not home? Just in case I flip my shit. I mean I know its OCD but still, what if its not?

No matter how many doctors told me the truth, that THIS WAS OCD and I WAS NOT MY THOUGHTS; no matter how many posts I read and Google searches I did; no matter how often I heard EVERYONE has random bizarre thoughts pop in to their head, they just go in one side and out the other not bothering them, its just us OCDers that get fixated on them; I had a very hard time accepting I was not a monster. I kept my distance from my son because the what ifs plagued me.

But after a long battle, I got help. I got medication that allowed me work on techniques to control my mind and to go from a run on sentence of thoughts to having them every 30 seconds.

Then every minute.

To eventually not even noticing/reacting to them like the normal person. I finally believed that this was OCD and that just because I wasnt familiar with what OCD really was before this blindsided me, didnt mean it wasnt true and my actual diagnosis.

So next time you say I was SO OCD this weekend and cleaned out my closet remember how lucky you are that cleaning out your closet was only a small chunk of your day with a perfectionist streaknot a horror movie with no commercial breaks in your mind that is OCD.

Chimamanda Adichie calls attention to the danger of a single story in her TED Talk.

Women of color find themselves lost and erased when the intersection of maternal mental health and minority maternal mental health is on the table because, among other things, the strong Black woman trope is at play. Stigma is very much the product of a single story.

Stigma is a mark of disgrace or negative judgment surrounding a certain circumstance. Stigma concerning mental illness isnt imagined. The controlling factor of stigma is shame.

Shame is a a statement that assumes that the judgment cast on a person is because the person is intrinsically flawed. Stigma and shame work together to keep folks struggling with mental illness believe they are bad and at fault for their suffering. This is especially true for women of color.

Bren Brown helped the general public by re-igniting the conversation around shame versus vulnerability. Brown asserted that becoming shame resistant means being vulnerable and authentic in our own stories.

While I tend to agree with Bren, I also understand that women of color take much greater risks in their attempts at engaging authenticity through sharing their most vulnerable life experiences. Black women are taught to be strong, that they dont have postpartum depression or any other mental illness, less they be perceived as a welfare queen or a trashy baby momma who had children she couldnt care for in the first place.

Generally speaking, people facing diagnosis of mental illness face significant difficulties around the stigmatization of being mental health conditions. When we factor in minority statues, especially multiple overlapping minority identities, the stigma becomes heavier and far more damaging. This is what it means when activists and experts reference that African American and Black women are at the greatest risk in the maternal mental health discussion.

Much of the stigma that many women of color experience is also built into tropes and archetypes that many women of color have internalized. For the sake of this discussion, we can evaluate the archetypes surrounding the Black female/femme experience that impact the stigma within maternal mental health. We can answer the question of why arent more Black women talking about their mental health issues by evaluating the stereotypes that confound the issue.

The projection of the strong Black woman is a roadblock to Black women obtaining care for mental illnesses like PPD. While empowering the culture of stigma around mental illness, the strong black woman isnt inclined to tell her story. * Openly suffering from mental illness is something that is highly tabooed in the cultural relations of Black women (Schreiber et al). Among researchers of Black womens experiences with depression, being strong repeatedly emerges as a key factor in their experiences (Beauboeuf-LaFontant, You have to Show Strength 35). Because of Black womens history of subjugation, often Black communities may possess the idea that due to their long history overcoming racism and discrimination, which attacked their mental states as inferior, Black women have the ability to muster through adversity (Hooks 70).

This trope is very unique to Black communities and should be taken into consideration anytime one wishes to provide support for Black women who may be suffering with mental illness. Black women are taught that we have inborn abilities to face struggle and hardship without showing wear mentally or physically.

While some of the initial construction of this image can be traced back to rejecting controlling images created by the white elite to oppress Black women (Hill Collins). The strong Black woman image is problematic because of its emphasis on caring for others and attaching the stigma of failure to any woman who exposes her mental health status attests that the Black woman is the mule of the world (Neale Hurston 1937).

So we find that it our work to simultaneously put to rest the strong Black woman myth by creating safe space for Black women to tell the stories of their mental health struggles.

For more posts in this series on Minority Mental Health:

References Beauboeuf-LaFontant, Tamara. You Have to Show Strength: An Exploration of Gender, Race, and Depression. Gender & Society 21.1 (2007): 28-51. Web. 14 Jan. 2013.

Hooks, Bell. Sisters of the Yam: Black Women and Self-Recovery. Boston, MA: South End, 1993. Print.

Neale Hurston, Zora. Their Eyes Were Watching God: A Novel. New York: Perennial Library, 1990. Print.

Schreiber, Rita, Phyllis Noerager Stern, and Charmaine Wilson. Being Strong: How Black West-Indian Canadian Women Manage Depression and Its Stigma. Journal of Nursing Scholarship 32.1 (2000): 39-45. Web. 26 Feb. 2013.

Did you ever wonder if you were suffering from postpartum depression because a friend talked to you about their experience? Did you read a book that reflected your experiences? If you found a narrative that fit with your experience, did you have access to health care because you had a treatment team that believed you?

Often times women dealing with postpartum depression or anxiety will report their difficulties finding a diagnosis and/or helpful treatment and support. Everyone is still working hard to understand PPD and other perinatal mood and anxiety disorders.

As part of this conversation, though, there are two key words that are often overlooked: Exposure and access. These two words are important factors that impact the well-being of protected classes of people. Protected classes of people often have double the difficulty when dealing with maternal mental illness, because in order to obtain help, you have to be exposed to stories and informationthat reflect your experience, and then you need access to the processes that allow you to obtain help.

Postpartum depression is a serious, debilitating illness that affects approximately 10-20% of women. This statistic, though, is a measure of women who were able to identify what they were going through. Imagine the womenfor instance, women of colorwho arent added to this statistic because they dont have exposure and access to understand what they are suffering with?

A psychiatric study by Katy Backes Kozhimannil and her colleagues yielded results that concluded that:

there were significant racial-ethnic differences in depression-related mental health care after delivery.

These results outline a stark reality for women of color: They areless likely to be screened for PPD and less likely to get treatment and receive follow-up care. The results also showed that it was more likely for treatment teams to attribute symptoms of Black and Latin women to other ailments and not PPD.

To make it plain, while many women are never screened, women of color are bypassed in the screening process even more so, and when they do display symptoms of PPD, other factors are often blamed. So these moms wont get the help they really need. This reality means it is vital for women who are at risk for perinatal mood disorders to be strong self-advocates.

How, the question becomes, can one advocate for something that you havent been made aware of? If you have been exposed, how then does one self-create access in a system that either doesnt offer access to people who look like you or offers less-effective help or many fewer options?

Awareness for postpartum depression is increasing, yet there are still women who are falling through the cracks due to systemic oppression and racism. We must care for the most vulnerable among us. The postpartum depression conversation should involve early intervention, treatment, and awareness for ALL women.

The study I mentioned above also cited:

The differences in initiation and continuation of care uncovered in this study imply that a disproportionate number of black women and Latinas who suffer from postpartum depression do not receive needed services. These differences represent stark racial-ethnic disparities potentially related to outreach, detection, service provision, quality, and processes of postpartum mental health care. Although suboptimal detection and treatment rates are not uncommon for this condition or in this population (7,42,43), these results emphasize that postpartum depression remains an underrecognized [sic] and undertreated [sic] condition for all low-income women, especially for those from racial and ethnic minority groups.

During July, which is Minority Mental Health Month, Ill be having leading a conversation here at Postpartum Progress about ways to improve the conversation as it relates to women of color and postpartum depression. We will talk about stigma, social constraints, patient-provider communication, and involving more women of color in the change agency efforts.

Postpartum Progress means progress for ALL women, which means some difficult and important conversations. I hope youll join me.

[Founders Note: One of the goals at Postpartum Progress is to expand our reach and support so that all women are getting the information and help they need. As you all know, in general most women with perinatal mood and anxiety disorders are not getting the right help. It is also true, though, that women of color get even less access and have even fewer options than the general population. Ive been an advocate for more than a decade now and I know this to be true because I have seen it with my own eyes. Im thrilled that Jasmine is joining us to share her experience and knowledge so that we can open our eyes to what all types of women are experiencing and figure out what we can do better. -Katherine]

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Postpartum Progress - postpartum depression and postpartum ...