The Afterglow Support Group has Landed at the Nurturing Nest

Great news! I’m thrilled to announce my partnership with the Nurturing Nest, Reno’s premier education center for parents. I’ll be facilitating a new session of the Afterglow Postpartum Depression & Anxiety Support Group every Tuesday for six weeks, starting November 7th from 2-3:30pm through December 12th. We have space for eight moms… please share with anyone who you think might be interested!

We will cover topics related to coping tools, self-care, what to expect, questions to ask your provider when considering medication, communicating with your partner, and attachment with your baby despite this illness, as well as provide a safe, confidential, and non-judgmental space to process with each other. Babies are welcome of course!

Sign up through their website: https://nurturingnest.pike13.com/events/3352028

Always remember, you are not alone. There is hope. With treatment, you will be well.

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Honored to be a Guest on the Motherhood Radio Podcast!

Dr. Christina Hibbert is an incredible author, speaker, and maternal mental health advocate who I had the pleasure of connecting with at Postpartum Support International’s conference last year!

I’m super excited to be a guest on her podcast, Motherhood Radio, this morning! We’ll be talking about psychologically preparing for motherhood and finding your new equilibrium as a mother, as well as my book. The show airs October 16th! You can download or subscribe to her podcast here on itunes.

Also, check out her facebook group: https://www.facebook.com/groups/growingthroughmotherhood/

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Did You Know: Medicaid Reimburses for PMAD Screening

The fun thing about joining the Nevada Maternal & Child Health Coalition is learning new things!

Did you know: If you have Medicaid, you can ask your pediatrician to screen you for postpartum depression during your first year of well-child visits.

Knowledge is POWER!

Nevada Medicaid reimburses Physicians, Special Clinics, Advanced Practice Registered Nurses (APRNs) and Physician’s Assistants (PAs) for postpartum depression health risk assessments for mothers of a covered child as a service billed to the child’s Medicaid, on its own claim line.

Providers bill their evaluation and management codes, on a separate line as CPT Code 96161. This should be billed separately, under the baby’s name. No modifier is needed.

In case they don’t have an Edinburgh Postnatal Depression Scale handy, you can ask them to use this first link that scores for you, or this second link if they want to score it manually:

https://psychology-tools.com/epds/

Click to access EPDS.pdf

Sometimes, we have to be our own health advocates. We can. And we will!

Plus, you  never know how many other mamas you could help by educating your doctors about screening for postpartum depression!

(Refer to Medicaid Service Manual Chapter 1500 online at http://dhcfp.nv.gov for additional Healthy Kids EPSDT program information.)

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Essential Oils for a Quick Jolt of…Calm!

Aaaahhhh, the topic that keeps coming up over and over with moms, dads, and well, everyone it seems lately is self-care. How do we take care of ourselves when the world seems to be spinning out of control, when so much is uncertain, and when there’s no time?

When time is of the essence, essential oils are one of my favorite ways to get a “jolt of calm.” Yes, there are other more meaningful and lasting ways to take care of yourself, but a lot of them are no longer an option after having kiddos!

I found it much more obvious and attainable pre-baby to do self-care; let’s face it, I had the freedom to move about without acquiring childcare first! So I could workout, dance, have meaningful conversations late into the night with friends, read, journal, go out in nature, and do other things that feed my soul– but now, not so much. Do you ever find yourself comparing to your former, pre-child life? How does that comparison make you feel?  I try to keep it really simple and I aim for doing one thing for  self-care each day so that I don’t feel dragged down by that tempting comparison trap.

Sometimes, that one thing is deciding to eat breakfast before noon! Lately, as EV has gotten older and more self-sufficient, the one self-care thing per day has been more spacious, like reading for 10 minutes before bed, going to yoga once a week, breathing deeply while I drink my tea in the morning, meditating for a few minutes during her nap. Basically, when I aim small and try to make simple things sacred, I’m a lot more fulfilled and satisfied with my life than if I compare to what I used to be able to do.

But, when I am short on time or patience or sleep! and I need some help NOW,  I diffuse peppermint oil into the air and I immediately perk up, feel more energized and focused. Other times, I turn to a little spray bottle of distilled water with lavender and chamomile oils that I spritz in the air, like a reset button when I’m feeling stressed.  Another mom pro-tip I learned from my sweet older sister was to spray a blend of essential oils (lavender, chamomile, and tea tree oil in fractionated coconut oil as the carrier oil) on baby’s bottom to ward off diaper rash. Every time I change a diaper, I’m reminded to breathe and let go of stress.

If you’re thinking, I don’t even have the time to look into how/when/where to get into this essential oil thing, here are some links to take the guess work out of it. One of my favorite healthy mom inspiration websites, www.wellnessmama.com has great tips and amazon.com has all the supplies you need, delivered right to your door.

Chamomile link on amazon:

https://www.amazon.com/gp/product/B00X8FZODW/ref=oh_aui_detailpage_o00_s00?ie=UTF8&psc=1

Lavender link on amazon:

https://www.amazon.com/gp/product/B00ZFAKV7C/ref=oh_aui_detailpage_o02_s00?ie=UTF8&psc=1

Coconut oil link on amazon:

https://www.amazon.com/gp/product/B00TKPGHDK/ref=oh_aui_detailpage_o01_s00?ie=UTF8&psc=1

I used little spray bottles like these:

https://www.amazon.com/gp/product/B010YFKO4W/ref=oh_aui_detailpage_o00_s00?ie=UTF8&psc=1

Add 40 drops each of Lavender and Roman Chamomile. Once you put the oils in then you fill the rest with fractionated coconut oil, spritz, breathe, and let go of stress. 

And if you’re feeling creative, you can experiment with these other lovely essential oils for anxiety, too!  Dr. Axe’s website has a fantastic infographic and citations to articles about how these oils can help alleviate anxiety.

I would LOVE to hear how you use essential oils, or what your one, small, sacred act of self-care was today, or what you plan to do for your own self-care tomorrow!

 

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Honored to be a Featured Story on Maternal Mental Health NOW

Did you know…

“in Los Angeles, 130,000 women give birth every year…. 20% of these women experience depression, with even higher rates in low-income communities. But, fewer than 1 in 4 new moms are actually screened. At Maternal Mental Health NOW, we want all new moms to be screened for maternal depression and anxiety and for those who are suffering to receive proper treatment.”

Before we move away from LA, I have to give a huge shoutout to Maternal Mental Health NOW for all the training, resources, and services they provide to moms as well as clinicians of all kinds who strive to help moms have access to good mental health care.

I’m honored to be included on their stories page. The more we share our stories of HOW we got better, the more we can reduce stigma, encourage others share theirs and get the help that they need. There is hope…and with treatment, you can be well!

The best part of their website is the provider locator tool at the bottom of their homepage so that moms can search by zip code and distance to find a therapist who is certified and trained in maternal mental health by themselves, and or Postpartum Support International. Imagine what it would be like if ALL cities had a coalition like this and trained providers in every zip code? A girl can dream…and get to work when we move to Reno!
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The FLOW Exercise

While doing a walking meditation, focusing on the beauty of nature around me–the golden hills dotted with majestic live oak trees and unexpected splashes of color from wildflowers popping out of the brush–it dawned on me that the avoidance I sometimes feel towards my feelings is a truly ineffective defense mechanism! Has anyone else noticed how if you try to ignore or avoid them, they’ll patiently follow you, tapping you on the shoulder until you acknowledge them? Or, if you do successfully stuff them down for the time being, they like to interrupt you later when it’s really, really inconvenient.

What if, instead of avoiding for fear of the pain they might cause, I could choose to be curious and open to the full range of human experience? What if, instead of running from them or trying to ignore them unsuccessfully, I could free myself from them by choosing where I focus my attention? What if I could feel them, call them by name, and let them float in front of me without fixating on them? I believe I am more than a sum of my thoughts and feelings–they do not define me, but they will if I give them more attention than they deserve. On that note, I came up with the acronym FLOW, to help me remember my intentions…

FLOW

Feel it

Label it (without judging)

Open the

Window to let it go

 

This visual was so freeing to me! I don’t have to be afraid of painful feelings. I can wonder where that thought came from and if I want to keep it. I can watch it flow on by. Or, if I’m in a more cantankerous mood, I can be righteously indignant like a lawyer and cross-examine my thoughts that are not helpful or kind to me. At least that’s a more entertaining way to do Cognitive Behavioral Therapy on myself. 😉

Have you found that when you allow yourself to feel what you momentarily feel without judging it as good or bad that it dissipates more quickly or at least has less power over you? Is that something you would like to practice?

 

 

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The Support Group Curriculum is Live on Amazon!

The Afterglow: A Perinatal Mood & Anxiety Disorder Support Group Curriculum  is live on Amazon…and I feel like I’ve given birth, i.e. elated and like I’ve been run over by a truck!

It’s been a long journey to get all the way here. Last June at the Postpartum Support International Conference, I looked around the bookstore and realized I didn’t see a support group curriculum. Hmmm, that seems odd. I know there are people out there facilitating support groups…What are they using?  A few conversations with social workers running groups confirmed they didn’t have an evidence-based tool. And others that I talked to had the desire and were highly qualified to lead support groups, but didn’t have the confidence to do so because they didn’t know where to start.

That’s when I got the bug to write this. Oftentimes in life, when you look around and think, someone should do this! The answer is: YOU do it. I read, researched, interviewed others, and drew from my own experience. What I realized along the way is that parenthood requires a complete reinvention of the self and the whole gamut of coping skills: holistic, Cognitive Behavioral, mindfulness, meditation, art, music, finding your parenting tribe, and yes, sometimes medication. And as I facilitated this group with many mamas (and a few papas), we thought about and discussed what that process of reinvention looks like while also trying to figure out how the heck to parent. At the same time. Did  I mention…it’s a lot.

Why the Afterglow, you might be wondering? As I went through Postpartum Depression and Anxiety myself, the image kept coming to mind of the light that lingers after the sun sets, radiant yet casting shadows. Expectations weigh heavy on new parents, especially the expectation to be the “perfect parent” and to happy all the time. Society seems to expect a mother to bask in the afterglow of having given birth, but for some, it is traumatic; and while it is an accomplishment beyond words’ ability to express, it can also leave some parents feeling like a shadow of their former selves. The afterglow is not enough. What is required is  reinvention of ourselves as parents… and a continual choice to turn towards the light. No small feat! But the afterglow is hopeful, too, for though the sun sets each night, leaving us in the dark, it also promises to rise each day. So this group is about sitting in the shadows together, taking the small but necessary bits of time to grieve their dark presence. Only by properly grieving losses can we create space to learn new tools so that we can appreciate, harness, and bask in the light again.

My hope in publishing this resource is to place it in the hands of people who will use it to help as many mothers with a PMAD as possible. Together, we can lighten their burden, give them hope, help them realize they are not alone, and guide them as part of a comprehensive treatment team towards 100% recovery— not merely surviving, but thriving together with their partners and their little ones.

 

“[Motherhood is] the biggest gamble in the world.

It is the glorious life force.

It’s huge and scary—

it’s an act of infinite optimism.”

-Gilda Radner

 

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Why the Afterglow?

I found this painting and fell in love with the name, of course, but mostly the interplay of light and shadow. I want to create my own version of it to hang on a wall somewhere in our new house, to inspire me whenever I see it to keep spreading light each day. Orange gives me energy. 🙂

Afterglow, by Seda Baghdasari

Why call the support group the Afterglow? As I went through the shadow of Postpartum Depression and Anxiety myself, the image kept coming to mind of the light that lingers after the sun sets, radiant yet casting shadows.

Expectations weigh heavy on new parents, especially the expectation to be happy all the time. Society seems to expect a mother to simply bask in the afterglow of having given birth, when actually, it can be physically traumatic; and while creating new life is an accomplishment beyond words’ ability to express, it can also leave some parents feeling like a shadow of their former selves.

The afterglow is not enough. What is required is a complete reinvention of ourselves as parents… and a continual choice to turn towards the light. No small feat!

 But the afterglow is hopeful, too, for though the sun sets each night, leaving us in the dark, it also promises to rise each day, giving us hope that the light will return.

So this group is about sitting in the shadows together, taking the small but necessary bits of time to grieve their dark presence. Only by properly grieving losses can we create space to learn new tools so that we can appreciate, harness, and bask in the light again.

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My Go-To Cognitive Behavioral Therapy Coping Tools

One of the hardest things to hear as a parent who is struggling with depression or anxiety is, “Oh yeah, I had postpartum depression and it just went away.” That’s great, but tell me HOW. How did it go away? Maybe her hormones evened out, or financial stressors resolved, or the baby started sleeping through the night, but when you’re deep in in, you need some tools you can pull out of your toolbox to get you through the day. Let’s talk about some specific Cognitive Behavioral Therapy coping tools for dealing with postpartum depression and anxiety, or you know, the stress of plain old life:

All of these strategies require you to stop, breathe, and think, which helps calm you out of “fight or flight,” aka panic, mode. You might already use some of these techniques! I don’t know about you, but sometimes, I need to be reminded of what I already know is true. The goal is not to stress about mastering all of them, but to pick one and commit to giving it a shot today, or this week. So here we go:

  • Generate Alternatives: How often do we immediately jump to the worst-case scenario in our minds? Instead of believing the worst-case scenario outright, you play with and question it. For example, “What’s the worst-case scenario? (Don’t stay here.) Ok, now what’s the best-case scenario? What is the most plausible scenario? What are two other possible scenarios?” You come to realize as you ask yourself about alternative scenarios that your fear-based predictions are not guaranteed to come true. Sometimes our friends do this for us, i.e. “Oh that’s not going to happen. Don’t worry about it!” But when we’re more isolated as moms or dads at home with the baby, we don’t always have those sane voices as readily available and we need to learn to start doing this for ourselves. You might have found yourself, on a good day, doing this naturally!

 

  • Empowering or “Anti- Catastrophic” Thinking: Deflate the fear fueling those worst-case scenarios by creating a strategy. Ask yourself, “What’s the worst-case scenario? How likely is that to actually happen? If it did happen, what would I do about it? How would I handle it and get through it?” You come to a place of empowerment as you ask yourself these questions. You are capable of coming up with solutions. You are a fierce mama bear. It’s in your DNA. What’s an example of a time you have done this for a friend or another mama to help her move from a place of helpless worry to empowered action?

 

  • Talk to yourself as a friend: This is one of my favorites because it’s so simple and effective. Challenge an anxious or negative thought by pretending you are talking to a friend instead, and you’ll find you might actually come across as more objective, compassionate, and kind. If you wouldn’t talk to a friend the way you are talking to yourself, or if you wouldn’t accept that from your mother-in-law, then don’t accept it in your own mind. 

 

  • Reframe Worry as Evolutionarily Adaptive: Did you know that anxiety is actually your brain being hyper-vigilant about doing your best for your baby? Dr. Judith Lothian wrote in the Journal of Perinatal Education that “High levels of estrogen and progesterone and their complex interaction with each other and with less well known hormones contribute to the pregnant woman’s increased sensitivity and emotionality, the tendency to be fearful, and heightened concern for her own safety and that of her baby. These changes propel the pregnant woman to seek safe passage for herself and her baby, foster her attachment to her growing baby, and, ultimately, guide her through the important process of giving more and more of herself during first her pregnancy, then labor and birth, then breastfeeding and care of her baby (Buckley, in press; Mercer, 1995; Rubin, 1984).”[1] The point is that intrusive thoughts of harm coming to your baby are not pleasant or something you want to dwell on, but they are nature’s way of helping you be the protective mother hen you need to be. Think about it, we as mothers care for the most helpless, least developed mammals on the planet, and so it makes sense that a switch would be flipped in our brains to turn on those annoying and sometimes horrifying thoughts to warn us to avoid sharp objects, take a wide berth around corners and edges, watch your step on slippery surfaces, dodge the snarling dog in case it lunges at you and your baby. When we have intrusive, worrisome thoughts, instead of being terrified or ashamed of them, we reframe them as evolutionarily adaptive and look for it to be so. Think of it like a good thing gone overboard, and tell someone who will understand in order to take away the power the thought is holding over you. Shame causes us to be secretive sometimes. I will say it again: these thoughts are not pleasant or anything we need to dwell on, but they are intended to be helpful. Brush away the worry that you are going crazy like an annoying fly buzzing about your head. Thoughts come and go. Only when we focus our attention on them do we give them an unnecessary amount of power. Then, stop ruminating. Tell your brain, “I got the memo, I will avoid the sharp corner. No need to remind me again.” Print out a sign that says STOP or REDIRECT and put it on your fridge if you need a visual reminder. Or put a coin in your pocket to remind yourself that sometimes our weaknesses are the flip side of the coin of our strengths. I’m sure many of you can relate to this!

 

  • Image Substitution: When a negative image of a worst-case scenario, or an intrusive thought of harm coming to your baby, pops into your head, you literally envision the opposite. Are you worried about waking up in the night to a screaming, colicky baby? Then you envision yourself cool, calm and collected as you breastfeed her and set her down gently her in her crib where she is now sleeping peacefully. Are you seeing her head come into contact with the corner of the coffee table? Then you envision yourself being aware of the danger and taking a wide berth around the table and placing her safely in her stroller to go outside for a walk. Those thoughts might pop into your head, but you don’t have to give them power by focusing your attention on them. Shift your attention to something you want to happen. Do you think you could try that?

 

  • Progressive Muscle Relaxation: Did any of you hear the phrase growing up, “If you don’t have anything nice to say, don’t say anything at all?” I don’t like that phrase as a counselor, but sometimes when you don’t have good to think, there’s no need to think anything at all. Ground yourself in your physicality, in your body. We are more than our thoughts; we are body, soul, and psyche. If you feel like you can’t turn off the negative or anxious thoughts in your head, or if it’s subtler than that and you just can’t shake those down, blah, moving-in-slow-motion feelings, try this exercise called progressive muscle relaxation. It’s like a guided meditation you can do for yourself, in which you simply tell each of your body parts to clench and let go, and you physically do it. The beauty of it is you can do it sitting down or standing up, whether you’re changing a diaper, washing bottles, driving, showering, or laying in bed. Let’s try it now. Close your eyes if you want to. Starting at your feet, say to yourself, either in your mind or out loud, “Feet, tense up and release. Calves, tense up and release. Thighs, tense up and release. Hips, tense up and release. Stomach, tense up and release. Chest, tense up and release. Hands, tense up and release. Arms, tense up and release. Shoulders, tense up and release. Neck, tense up and release. Jaw, tense up and release. Head, tense up and release. Eyes, close and open up.” And while you’re at it, your OB would appreciate it if you would throw in a few Kegel exercises! How do you feel now? 🙂

My Stop, Breath and Think meditation for the day: Relax, Ground & Clear. Will you join me? #sbt

[1] (Lothian, 2008)

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