Perinatal mood disorders

Mamas on Bedrest: You Are Perfect!

March 9th, 2015

My daughter 1 day old in NICU.

I never get tired of looking at babies.

Babies of all sorts are the most miraculous creatures to me, but of course, my favorites are human babies. Whenever I look at a newborn, look at the tiny fingers and toes all perfectly formed, the fingernails, eyelashes, tiny little nostrils…all I see is perfection. It never ceases to amaze me that this tiny little being has all that it needs to inhabit this earth for the next several decades, and in the case of little girl babies, to create other human beings!

Mamas, let’s not forget that we all started out as “little girl babies” and as such, we too have everything that we need to create a little life within us and to bring that life forth. It breaks my heart when I hear Mamas on Bedrest, time and time again, disparage their bodies. I know that having a pregnancy complication is scary. I know all too well how disappointing it is to have all your pregnancy plans, hopes and dreams shattered when the Bedrest prescription is issued. Yet, when I witness women’s discontent and disappointment with statements such as,

“My body is broken”

“My Body has let me (and my husband, baby and family) down.”

“I feel like such a failure”

“I’m less than” or “Not as much of a woman as other women I know”

I’m deeply saddened. Mamas, bed rest or not, you are perfect!

My kids just days after the birth of my son.

My kids just days after the birth of my son.

Mamas, It’s time we reclaim our “divine feminine”. Our culture would like us to believe that our value is in our appearance, in establishing perfect careers, creating perfect families and bringing forth our children via transcendent, medication and complication fee vaginal births. While I am sure that we all strive to look and be our best, and we’d all love to have uncomplicated, spontaneous vaginal births, sometimes life happens. Sometimes life is just downright messy. But does that make it any less good? And because we are not exactly like everyone else, does that really make us less than?? Heck, it takes a lot of strength and fortitude to endure week after week of bed rest and I know plenty of women who would cave. You are stronger than you realize. Remember that! Besides, would you disparage and chastise a diabetic for being diabetic, for not being able to metabolize and utilize sugars?? Do you feel that a diabetic is somehow broken, less than? What about people with heart disease? Autoimmune diseases? Each and everyone of us is on a journey and comparing one person’s journey to another typically results in disappointment and feelings of inadequacy. I say, just don’t do it!

Mamas, I want to invite you to take a deep breath, let it out, and take this in: There is nothing wrong with you. That’s right, I’m saying it, “THERE IS NOTHING WRONG WITH YOU, YOU ARE PERFECT!!!” Your body has a different way of reacting to THIS PREGNANCY. It needs some assistance and for now, the treatments that your obstetrician is providing, including bed rest is that assistance. You may never have pregnancy complications ever again or you may be prescribed bed rest with each of your pregnancies. That is your “normal”. That is your perfection! No it isn’t like the vast majority. But why not be an original?? No it isn’t fun. But that doesn’t make you wrong, or broken or somehow less than other women. You are you, perfect in every way!!

The elder women in my family always say, “God doesn’t give you more than you can handle, and that the reason you have trials is so that you can overcome and bless someone else”. So mamas, as you are on bed rest, preparing for your beautiful bundle of joy, consider reframing this experience. Instead of disparaging yourself and seeing all the negatives, ask yourself, “How can I use this experience in later life for good?” Believe me, it’s a game changer. Of that I know firsthand.

So what did you come up with? What positives could come from this experience? Share those in the comments section below. Just can’t get there? Still feeling overwhelmed? Lost? Let’s talk about it in a free 3o minute Bedrest Breakthrough session! Simply e-mail and we’ll get you scheduled

Mamas on Bedrest: Self Care is not a Luxury!

May 12th, 2014

Greetings Mamas!

Today we finish up the series presented by Kathy Morelli, LPC on hormones and mood disorders. Once again I’d like to thank Kathy for such a well written and informative series. I am also very grateful that she allowed me to share the series with Mamas on Bedrest.

The final installment of the series is Post Partum: How Women’s Brain Biology, Hormones and Mood Relate! 

002_02“After giving birth, a woman’s hormone levels drastically plummet.  The literature says within one to five days after birth, estrogen levels drop to the level of a normal menstrual cycle. A woman’s body needs time to adapt to all of the physical changes.   Remember that estrogen precedes serotonin, the mood stabilizer, in the brain. And a steep drop in progesterone has a depressive effect as well. There’s a big chance for dysregulation in the brain-gland feedback loop (Sichel and Driscoll, 1999).”

“Other hormones that come into play postpartum and have an effect on the HPA and mood are prolactin and oxytocin. Prolactin is produced in the pituitary gland and is the milk-producing hormone. Prolactin levels rise during pregnancy and while breastfeeding. Some studies indicate prolactin is protective of postpartum depression, but others indicate prolactin causes vigilance, appropriate to a protective mother, but this feeling can morph into anxiety and irritability. The presence of prolactin varies whether or not a woman chooses to breastfeed (Donaldson-Myers, 2012).”

“Oxytocin is another neuro-hormone with a big effect on mood and happiness. Oxytocin is synthesized in the hypothalamus and released by the pituitary gland. Oxytocin is secreted during breastfeeding. Research has shown that oxytocin induces feelings of calm and bonding (Donaldson-Myers, 2012). And the presence of oxytocin varies whether or not a woman chooses to breastfeed (Donaldson-Myers, 2012).”

 Women’s hormonal levels go from such highs at the end of pregnancy and then plummet to such lows with labor and delivery it’s a wonder that not all women become depressed. Kathy shares that

“85% of women suffer from the baby blues and 20% suffer from a form of postpartum mood disorders”

so clearly these hormonal fluctuations are indeed significant. And let’s not forget that Mamas on Bedrest are at an even greater risk of perinatal mood disorders because of bed rest, so these numbers may not reflect the full scope of perinatal mood disorders. 

woman-drinking-water 01So much more research is being done on hormones, mood disorders and the lifestages of women. When considering the mental health of post partum women, we also have to take into account their support system, their ability to take time to rest and recover from pregnancy (and bed rest!) labor and delivery, the family situation and interpersonal relationships. All these factors-along with the “pre-wiring” in a woman’s genetic make up will determine how well a woman fares emotionally after pregnancy. Mamas, Take this information, think it over and use it as a catalyst to take exquisite care of yourselves! A woman’s body is designed to do extraordinary things-not the least of which is create new life-but that feat is not without its consequences. In order to be able to successfully reproduce, mamas must take exceptional care of themselves-eat nurtritious meals, drink plenty of water, rest, regular exercise, safe secure home and financial security. Mamas, self care is not a luxury-IT IS A MUST if you want good health for yourself, your baby and your family!

Mamas on Bedrest: How pregnancy triggers physiologic and emotional responses in women

May 9th, 2014

Hey Mamas!

PregnantwomanonballI’m bringing you Part II of Kathy Morelli’s series on physical and hormonal influences on women’s mental health. In Part II she focuses on the changes that occur during pregnancy. Kathy breaks down the emotional responses to pregnancy this way:

Emotional. What if the pregnancy was unplanned? What if this pregnancy follows a stillbirth or miscarriage? What if her primary relationship with the baby’s father is not going well? There is also job stress, financial factors and a whole host of other life stressors that combined can make the news of a pregnancy hard to take and All of these emotional considerations require attention and adjustment. We clinicians and birth workers must be aware of these potential life stressors and be sure that we are as vigilant in addressing these emotional needs of the women that we serve as we are addressing their physical needs.

Physiologic/Hormonal. By the first six weeks of pregnancy, estrogen levels rise to three times more than during the menstrual cycle! Progesterone levels also rise quickly and Progesterone is also implicated in depressive moods. As the pregnancy progresses through the second and third trimester, along with elevated estrogen and progesterone levels, the hormones cortisol, prolactin and oxytocin rise. Cortisol is a strong player in the HPA feedback loop. High levels of cortisol are also associated with depression. And prolactin is also associated with anxiety, anger and irritability. Oxytocin is known as the bonding and happiness hormone. Natural oxytocin causes nutrition absorption, uterine contractions, pair-bonding, mother-infant bonding, pain amnesia, calmness and feelings of belonging and happiness. Now add in bed rest! Mamas on Bedrest are at increased risk of developing perinatal mood disorders because in addition to the normal hormonal fluctuations of pregnancy, the stress of being on bed rest and the unsurety of the pregnancy stimulate the “fight or flight” response, releasing additional cortisol and neurotransmitters that will affect Mamas’ mood.

During an uninterrupted birth, there is a surge of oxytocin, beta-endorphin, adrenaline, noradrenaline and prolactin. These hormones all combine to orchestrate the event of birth and positive emotional outcome. Oxytocin for uterine contractions, calmness, love.  Beta-endorphins for a protective emotional high during a peak physical activity.  Adrenaline rush for energy and the final push of the fetal ejection reflex.  And high prolactin levels to consolidate breast milk production and breastfeeding. However, if there is medical intervention of any sort during labor and delivery; an epidural, episiotiomy, forceps/vacuum extraction or cesarean section, this natural hormonal protection and mood enhancement is disrupted and often lost resulting in birth trauma, post tramautic stress disorder and post partum depression. The extent of the trauma is different for every woman and typically correlates to the level of intervention. Researchers are just beginning to understand the delicate interaction between hormones, labor and deliver and a women’s mental health, and as more research is done, we will have better understanding of this complex interaction and how best to care for women during pregnancy labor and delivery to protect their mental and as much as possible, minimize negative emotional effects.

In Part III, Kathy looks at hormones and post partum!