Postpartum depression

Surviving Postpartum with Twins

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The first in my guest blog series is all about the postpartum experience with twins written by therapist and twin mom, Lindsey Lowrance. Enjoy!


It’s Twins! (Gulp, Faint, Whaa?) Here’s What You Need to Know

What’s different about having twins?

While helping twin moms go from drained and distracted to powerful and fulfilled, I’ve learned that there are some things that are very different for parents of twins and multiples. I’m a twin mom myself and can also speak from personal experience. The question on everyone’s mind when this comes up is ‘what’s the difference?’ Isn’t it just an extra baby in the mix?

Actually, there’s a lot more to it than that. When one parent is on their own with both babies (whether this is running an errand or staying at home while the other parent works), they are outnumbered and often overwhelmed. Many moms of twins stress that they can’t do all the bonding activities that moms of single babies do, partially because of logistics and partially because there is so much extra work and attention that needs to be divided. Can you imagine taking two babies to a Mommy and Me class?

Logistics are one of the hardest obstacles new parents of twins have to conquer. Here are some examples: how will I get both babies in and out of the car at the same time? How will I feed both babies at the same time (or do I feed them one at a time while the second one screams impatiently and this doubles the time it takes me at each feeding)? What if I’m out in public and they both are crying- how can I help them both at the same time without an extra set of hands? Will people think I’m a bad parent because I don’t have time to shower or get dressed for the day and my babies keep crying while I take care of one and then the other back and forth in a frenzy?

Many moms of twins can feel envious of other moms that get to peacefully hold and rock just one baby the whole time they are in public, or gaze lovingly into their baby’s eyes without having any distractions (like a twin baby needing mom’s attention). First time parents usually try hard to do everything perfectly according to their parenting plans and ideals, but with twin parents they often have to quickly throw out any ideas of perfection, timeliness or organization and learn to accept the chaos.  

Don’t get me wrong, having twins is something so special and magical in its own way. While we often hear what is hard about it, there are so many wonderful things too like twins being best friends, or having a unique bond from the get-go. I’m happy to be a part of the twin community because I get a front row seat at the cool twin life and to witness their incredible relationships. I wouldn’t change it for the world! But there certainly are differences and challenges that are worth hearing about so you know that you aren’t alone.

What’s Different About Postpartum with Twins?

  Newborns take a lot of work and it can be stressful adjusting to huge life changes like this.

Parents with newborn twins are usually in survival mode, chugging away at tasks day and night to keep those little babies fed, clean, and healthy. Many couples assume it will be miserable the first 6 months or so because they’ve been warned that the first 6 months (or year) of having twins will be SO HARD. Parents of multiples also sometimes hear that the divorce rates are higher and that raising twins/ multiples is very tough on relationships.

It doesn’t HAVE to be miserable! Yes- it’s a lot of work and so many things change, but having twins CAN be wonderful in its own right.

What many parents of twins/ multiples don’t realize is that postpartum mood disorders are actually more common given all the stress and financial strains of having more than one newborn. Postpartum depression/anxiety tends to happen in the midst of chaos and sleep deprivation that it can be hard to notice that you are not dealing with the “normal” amount of stress. Let’s face it, it’s hard to know exactly what is normal when managing two or more babies at once!

How can we tell when we are dealing with a ‘normal’ and expected amount of stress or when there is something more going on?

While pregnant, we all imagine having these wonderful, magical bonding moments with our new babies and soaking it all in. We dream happily of the beautiful connection that moms have with their new babies and all the adorable little baby toes and fingers.

What if you don’t get those magical moments with your newborns? What if it’s all hard work and you don’t feel those happy, blissful moments when the babies are here?

It turns out that postpartum mood disorders (depression, anxiety, PTSD, and OCD) are all too common in the twin world, but we don’t really talk about it. Twin parents (yes partners too) are at a much higher risk of having a mood disorder in that first year. Why is that?

When having twins or triplets, there are some extra stressors that a couple deals with that put them at higher risk of postpartum moods.

·         Financial strain (2 babies equals 2 of everything, not to mention daycare costs and hospital bills)

·         Extra hormones from pregnancy & postpartum due to physically carrying more than one baby (Yes, your body is impacted more and has an increase in hormones and blood flow than a woman carrying one baby)

·         Extra stress! (It’s not just twice as much work, it’s the lack of breaks/ rest and being out-numbered when one parent goes to work or runs errands)

·         Little to no support from family or friends (it’s hard to keep in touch when you’re run ragged on baby tasks and little sleep. Unfortunately, many don’t have family nearby and can’t afford to hire help, which leaves them really strained to do it all without help)

·         Many parents of multiples experienced infertility or complications with pregnancy, birth or breastfeeding (When there are 2 babies the pregnancy gets more complicated and is treated as high risk. Birth can feel like it’s totally out of your control when medical teams decide what’s best and take charge.)

Each of these factors increase your chance of having depression, anxiety, or other impacts on your mood.

Baby Blues: The first 4 weeks after giving birth, it is completely normal to have extreme emotions and hormonal mood swings because your body is going through major changes. Any woman going through the intensity of hormone changes in her body will have some adjustment period. It is not necessarily depression or anxiety. If it continues, then it can be helpful to check in on how you’re really doing.

Did you Know:

·         If you have ever experienced depression, anxiety or any mental health issue before pregnancy that you have a much higher chance of developing postpartum (or prenatal) mood disorders?

·         High risk pregnancies, pregnancy complications, NICU time, and problems with breastfeeding can lead to more struggles with mood?

·         Perfectionists &/or people with high expectations are more likely to suffer?

 

Here is a checklist of some common things to look for so that you know if your struggles cross the point of needing something more.

Checklist for Postpartum (or during pregnancy) Mood Issues:

o   Zoned out or distant

o   Irritated very easily

o   Overwhelmed most of the time

o   Not feeling connected to kids/babies, partner

o   Feel like you’re just barely surviving day to day

o   Worried about _____ most days or for long periods of time

o   Fighting with your partner more than usual

o   Yelling at your kids often

o   Feeling like a failure

o   So much guilt!

o   It’s hard to be around other people

o   Not interested in things you usually enjoy

o   Scared that something bad will happen to your babies

o   Trouble sleeping even when the babies are sleeping

Checked a couple things on the list? It may be time to talk with your doctor, OBGYN/ midwife, or call a therapist to figure out how to make things better.

You CAN feel good while surviving the chaos of newborn twins, and you CAN enjoy moments with them and feel like yourself! It’s a big adjustment Momma, and you may need some extra support. There’s nothing wrong with that.


Brought to you by twin mom & maternal mental health specialist Lindsey Lowrance at Twin Mom Power. Lindsey is passionate about helping twin moms Go from Drained & Distracted to Powerful & Fulfilled! For more information & resources on surviving & thriving the twin life go to: www.lindseycounseling.com or Email: lindsey@exploringinnerpeace.com Phone: 720-243-3993

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Myths of Motherhood: Part Three

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Myth #3: Since breastfeeding is natural it should be easy!!

NO WAY! Breastfeeding is NOT easy. So many moms get caught by the idea that since breastfeeding is natural it should come….well, naturally. But the thing is, breastfeeding is a learned skill for both you and your baby! Both of you are new to this, it can be messy, uncomfortable, and sometimes even painful. When moms struggle they often feel like this is some sort of failure on their part, but I assure you it is not.

There are so many variables that that determine the level of success or struggle that comes with breastfeeding. First let’s account for the fact that your baby is a complete stranger to you. You (hopefully!) wouldn’t walk up to someone on the street and offer your breast to them, so why would it feel any less awkward to do it with this brand new little person in your life???

Second, unfortunately, there isn’t a lot of support readily available to a new breastfeeding mom. In the hospital it is often a labor and delivery nurse who supervises the first breastfeeding session. Then you move to the maternity ward where you have another new nurse, or multiple new nurses with shift changes. In my personal experience a lactation consultant didn’t visit me until the day after my daughter was born and she completely contradicted what I had been told by the nurses! If after you go home you need additional support you need to seek it out and find it for yourself. Talk about stressful when you’ve got scabby, leaky nipples dripping with milk and a crying hungry baby!

Third, the sense of urgency and duty that comes with breastfeeding can often set you up for failure. Although the benefits of breastfeeding are undeniable, I feel we have gone a little off the deep end with all the “Breast is Best” campaigns. When a mom struggles to (or just plain chooses to not) breastfeed, they can often feel like they are somehow shortchanging their baby. They often try to muscle through the process, which can really have a negative impact on their moods, creating an even more risky situation for both mom AND baby.

Finally, you can’t force your body to do something it just isn’t able to do. I am aware of a lactation consultant who had all the training and resources around breastfeeding at her fingertips and she just didn’t produce enough milk to sustain her baby. No amount of breastfeeding cookies, biscuits or teas can overcome this biological barrier for some and it is not a reflection of you as a mom. All it means is that breastfeeding wasn’t a fit for you by no fault of your own.

What I know for sure is having support is going to set you up for the best chance at success. Consider taking a breastfeeding class when you are pregnant, hiring a postpartum doula for after baby comes (many are well versed in breastfeeding, are breastfeeding educators or lactation consultants themselves), and be sure you have the names and numbers of local lactation consultants handy BEFORE you need them. And as always, if you are experiencing a significant amount of distress around breastfeeding or other issues please reach out for help. You can click here to contact me.

               

               

Myths of Motherhood: Part Two

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Last week I started a series on the “Myths of Motherhood”. We continue the series this week with myth #2

Myth #2: Bonding with a baby is instantaneous

Before I start first I want to ask you to Google the word “mother” and look up the images. What do you see? The majority of the images show beautiful, smiling, women, who are well dressed with their make-up on holding their newborn babies. Talk to just about any mother and they’ll tell you that the day their baby was born was the happiest day of their life and they felt instant love. I’m here to call “BS” on both!

The messages we receive communicate to us that these first days of motherhood should be blissful, and that as our babies are born the heavens part and angels descend showering us with a love greater than any other we’ve experienced. But the truth is, it’s very common and perfectly normal to feel the exact opposite, but many women are afraid to share their real feelings for fear of judgment from others.

The reality is that even though this baby is of you and your partner, they are still a complete STRANGER to you (and you to them!) It’s going to take time for you both to figure these new roles out. Not to mention the fact that you are doing it while you are bleeding, leaking, sore and sleep deprived. Especially with young infants, the relationship is very one-sided with parents giving, giving, giving and getting very little in return, it can be very difficult to feel connected.

So what do you do when you have a baby and you just aren’t quite feeling the love yet? The first thing is to give it time. Don’t put pressure on yourself to feel a certain way and just let it develop naturally. If however in additional to the lack of bonding you are noticing other things happening like excessive crying, sadness, irritability, sleep or appetite changes, a lack of interest or pleasure in things, or just plain not feeling like yourself you may be experiencing a perinatal mood or anxiety disorder like postpartum depression. This requires additional support and attention from a medical or counseling professional (or both!). If you or someone you know are experiencing these symptoms it is important to reach out. Feel free to connect with me if you have any additional questions or comments related to this topic, and stay tuned for Myth #3 next week!

Blog Series: Myths of Motherhood

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Today I’m starting a five part blog series on the “Myths of Motherhood”. So many of my clients walk into sessions with a number of “shoulds” on their mind. This pattern of thinking tells them what a good mother should feel, say and do. These shoulds tell them how motherhood is supposed to be. The problem is that most of the time these ideas are unrealistic and based on their own distorted or unhelpful patterns of thinking. As a famous therapist Albert Ellis once said….Stop shoulding on yourself!! As you can imagine, it can make a real mess emotionally, behaviorally and relationally.

My goal with this series is to debunk some of these myths of motherhood to help you rethink the expectations you may be placing on yourself, help you realize you are not alone, drop the shoulds and maybe even extend a little self-compassion your way.

Myth #1: Every pregnancy is expected, wanted, excitement is the only acceptable emotion

Nope, they are not! In fact, the national average of unplanned pregnancies floats around 50%. That just goes to show you there are plenty of surprise babies walking around our streets every day (you might even be one of them!). The fact that a pregnancy was unplanned or even initially unwanted is NOT an indicator of whether or not you’ll be a good mother.

The thing is whether planned or not, pregnancies come with a ton of change, transition, loss and even grief. YES!  The “happiest time of your life” can include feelings of grief around the loss of your body, identity, freedom, spousal connection, work identity, finances, sex life, sense of self and SO MUCH MORE! Pregnancy can be delightful, or it can be really challenging. Just because you don’t love every minute (or ANY minute) of it does not make you a bad mom. This can be ESPECIALLY hard to accept for women who worked really hard to become pregnant. They often carry a sense that they should be grateful for every hemorrhoid and vericose vein that accompanies their pregnancy. I’m here to tell you….there AIN’T NOBODY WHO IS GRATEFUL FOR HEMORRHOIDS!

What’s really troubling is that we don’t get this kind of messaging as moms. The expectation by society, family, friends, and the media is the opposite. Images of happy, glowing moms flood our social media or Pinterest feeds. People ask leading questions like, “Aren’t you so excited?" or “Don’t you love being pregnant?”, with certain expectations for a happy, upbeat answer. You are frequently asked how you’re feeling but rarely is anyone is asking about your mental or emotional health. This puts a lot of pressure on moms to “perform”, often not being fully honest about how they are really feeling.

If you’ve ever watched “Sex and the City”, you might remember the episode where the character Miranda “fakes” her sonogram. When she finds out she’s having a boy the technician reacts with jubilation and expects Miranda to do the same. She follows suit, even though it’s not how she really feels. I’m sure anyone who has been pregnant before can identify with this pressure to be, or feel, or do to some extent.

Hopefully the acknowledgement of this idea as a myth allows you to be able to release the expectations and “shoulds” you are holding yourself to. If you find this difficult, or if your thoughts around this idea are interfering with your ability to function, you may benefit from getting some professional support on how to change this way of thinking. Feel free to reach out to me on my contact page for more information or support. Stay tuned for Myth #2 next week!!

                                                                                                 

Good Moms Have Scary Thoughts: A book review

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Remember that song by Usher, “These are my confessions”??? Well here is my confession, it’s quite shocking…..I HATE TO READ. I really do. Even though I love to learn and find tremendous value in reading, I just don’t care for it (and don’t try and convince me to try audio books, because I just can’t absorb the information the same way in audio format!). But when this book by my hero, social worker and postpartum expert Karen Kleiman came out, I had to suck it up, purchase the book and dive in.

First a word about scary thoughts:

Most if not all new mothers will experience scary thoughts regarding the safety of their baby. These thoughts can be intrusive, vivid, and even violent at times, hence the name “scary thoughts”. These thoughts DO NOT mean that the mother is at risk of hurting her baby or herself. In fact, the distress caused by these thoughts, although quite unpleasant is a good sign to a therapist that the mother will not act on them. Unfortunately, moms are often terrified to share that they experience these thoughts for fear of being judged as “crazy” or even having their baby taken away.

The book is a great resource to provide education about these scary thoughts, normalize the experience and reduce the stigma around them. It is written in a lighthearted way with comics style illustrations depicting the types of secret scary thoughts moms experience while caring for their baby and in their everyday interactions.

In addition to the illustrations, the opposing pages have valuable information about what the thoughts mean, affirmations for moms, and even action steps for how to manage that particular thought or subject matter. The chapters address the different types of thoughts moms can have including general thoughts about motherhood, safety, the transition to parenthood, unsolicited advice from others, comparison, breastfeeding and much more.

Just because scary thoughts are common, what typically needs to be addressed in treatment is the distress that they cause. The book does a good job helping moms understand when and how to get help. The back of the book also has resources to access including helpful websites, how to find a trained therapist, and additional reading.

What I like about the book is that the information is delivered in small "bites”, which are much easier to digest, not just for a non-reader like me but certainly for a busy and overwhelmed new mom. The information, while covering a serious topic is presented with a lighthearted tone which helps it to be accessible to everyone who reads it. The book rings in at about twelve bucks and change on Amazon which comes in way under some of Kleiman’s other works.

I highly recommend this book for any mom. I think it would make a great baby shower or new mom gift. I’m a big fan of the adage “an ounce of prevention if worth a pound of cure”, so if a mom read this book before she experienced any scary or anxious thoughts she may be less likely to be blindsided by them and more likely to talk about them or reach out for help. I also think the book can be a tremendous resource for the partners, family, and others who support new moms.

If you or someone you know are having scary thoughts that are causing a lot of distress or interference in their life. It may be time to get some help. Feel free to reach out to me on the “Contact Me” page for more information.

And click here to order your copy of “Good Moms Have Scary Thoughts”.

Postpartum Depression: NOT Just the Baby Blues

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Having a baby is hard. Whether it’s your first or your fifth, the transition after bringing baby home can be challenging at best. And although that transition can come with a lot of emotional fluctuations, frequently referred to as the “baby blues”, Postpartum Depression is a whole other animal.

Frequently, when sitting across from a new mother in my office they share about their efforts to reach out for help. Maybe it’s to a family member, friend or medical provider (OB, Midwife or Primary Care Physician). What boggles my mind is how often they are told that what they are experiencing is “normal”. While unfortunately Perinatal Mood and Anxiety Disorders (PMADs) such as depression, anxiety, OCD, PTSD or bi-polar is very common affecting approximately 20% of mothers (and 10% of fathers and non-gestational parents) it is NOT normal.

I would like to share what differentiates the baby blues from a PMAD so in the event you or someone you care about is affected you will know when it’s time to reach out and get the right kind of help to feel better faster.

Baby Blues:

  • Transient mood shifts throughout the day marked by tearfulness or irritability

  • First 2 to 3 weeks (at most)

  • Influenced significantly by hormonal shifts and sleep deprivation

  • Does not significantly affect functioning

  • Affects 70-80% of new mothers

  • Not a mental health condition

  • Resolves itself over time

PMAD (Postpartum Depression or Anxiety):

  • Excessive sadness or worry most of the day for most days

  • Extends past the first couple of weeks

  • Impacts functioning for example, inability to sleep (even when baby sleeps), decreased appetite, unable to concentrate, decreased enjoyment in things

  • Scary, vivid and intrusive thoughts about harm coming to baby (both intentional or accidental)

  • Disconnection from or excessive clinginess to baby

  • Feelings of guilt, shame, inadequacy, worthlessness and/or hopelessness (“Bad mother”)

  • Low or no motivation to complete even simple tasks

  • Just not feeling like yourself

  • Does not get better over time

If you or someone you know are experiencing the symptoms of a PMAD it is imperative you reach out to a medical or mental health provider to get the appropriate help. Prognosis for recovery is much better the quicker the symptoms are recognized and appropriately treated. If your provider tells you it’s “normal”, and just take a walk or get some more sleep and you still feel like something is just not right, keep reaching out until someone listens! A wonderful resource is the Postpartum Support International helpline at 1-800-944-4773. You can speak with someone who can get you connected with providers in your area that can get you the support you need.

If you are local to Syracuse or the Central New York area and think you may be suffering from Postpartum Depression, feel free to reach out to me through my website or call me at 315-552-0180. You are not alone and you can get better with help!

I'm Writing a Blog!!

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Welcome!

I am so glad you are here. One of my professional goals for 2019 is to write a blog in the area of reproductive and maternal mental health. The purpose of the blog will to be to provide education through posts, book reviews, links to resources and guest blogs!

Some topics that will be covered are:

  • The difference between baby blues and postpartum mood and anxiety disorders (postpartum depression)

  • How to recognize and manage anxiety

  • Self-Care

  • Finding and maintaining social support

  • Infertility and loss

  • Postpartum planning

  • Getting sleep

  • Grief of parenthood

And so many more!

Please feel free to comment below on any additional topics you want to hear about and stay tuned!!!