Speaker 1: 0:10

Hey guys, welcome back to Preview Alliance podcast.

Speaker 2: 0:13

This is Sarah, and we have your favorite reproductive psychiatry doctor, dr Claire Smith, who we love, and she is here today. We have so much more to talk about, but today we're talking about intrusive thoughts, or how we're going to talk about scary thoughts that 99% of moms will have at some point, and we just want to normalize it, claire. Thank you Welcome. Thank you, good morning. Good morning. Okay, let's just dive into it, because I think this is the type of conversation we're not going to skirt around it, because moms need to know what they are going to experience is common.

Speaker 2: 0:55

They're not a monster right that this is something that needs to be spoken about, but it's one of those topics that people get weird. Let's just be honest. They get uncomfortable.

Speaker 3: 1:04

Yeah, they do. It's helpful to start to make a few different definitions. Maybe Intrusive thoughts, like you said, are really really, really common and so really it's not even 99.9. It's 100. Yeah, so half of moms and probably parents in general, but we're specifically talking about moms here will have intrusive, upsetting thoughts about harm coming to their baby accidentally. Now half of moms will have intrusive, upsetting thoughts about harm coming to their baby intentionally by themselves. That's a very, very high number that.

Speaker 3: 1:51

I think a lot of people don't truly realize both you know, quote regular people, but also doctors too it's not something that's discussed the whole lot, even though we are discussing these post-harmonic issues more and more, which is great this is one of the things that's lagging, and so intrusive thoughts are very common, and then we can talk about this more if you'd like. But there's something called postpartum OCD which involves these intrusive thoughts. That is also at a higher prevalence in the postpartum period as compared to the general population. That is not 50%. Intrusive thoughts do not necessarily mean postpartum OCD or some other specific disorder, but postpartum OCD is one thing that can present in that way and be quite severe in the nature of those thoughts. So I can speak to that as well.

Speaker 2: 2:43

Yeah, okay, so I'm going to talk about the postpartum. The first way I was ever explained to intrusive thought is I was carrying my baby right Walking down the stairs and I see us falling right and I clay it out of my head right, I see us tripping, falling, baby getting hurt. And or you know, if you've ever went to like the Grand Canyon, right, and you're on the edge and you're like what's my jump over? Or what's if I fell over? And you're just like why would I ever think that? And then you realize, or if you're driving right over a bridge, you're just like what's if the car went over? Or what's if I drove the car over? Right, and from how I was explained please correct me is that it is almost like a protection mechanism, like we don't want to do that right, like we don't want that to happen, but like we almost remind go there as a way for it, not to happen essentially.

Speaker 2: 3:42

Tell me where I'm wrong or right there.

Speaker 3: 3:44

No, I mean brains are very complicated and complex. People are very complicated and complex. I talk about this a lot with our medical students who are rotating through psychiatry, because when we are evaluating somebody kind of stepping out from the perinatal period, but just generally speaking, and we talk about you know this clinical where their mental status exam, or you know how are they presenting to you, how does their thought process, how do they look, you know what does their affect look like, and so on and so forth, and we talk about thought content. And so what you're talking about is different types of thought content and you're exactly right. You step on the grand can and you think just walk over the edge.

Speaker 2: 4:26

Yeah.

Speaker 3: 4:27

Why? Why did I think that I am not suicidal? That doesn't mean that I am suicidal, but that is certainly would be a suicidal act. And so it can be a funny line between the things our brains think about because we're complicated beings and the difference between that and the things that we can't help but think about, that consume our thoughts. That is when things become more concerning. So if you are consumed with the thoughts of blank, that's more of a discussion piece and more of a. Let's try to figure this out and what's, what's the broader context of how you're feeling and what else is going on. But yeah, we're just complicated beings. I don't think there's an explanation for every single thing, every single thought process we have.

Speaker 2: 5:11

Yeah, and you know, something I've had to come to terms with. It is a thought as a thought, right, it doesn't define me, it's not a character for all, right. And I think, in motherhood, what makes this so hard with intrusive thoughts is, I think we all are grown up to believe and engraved to us, whatever you want to say that, like our innate intuition is to care for this baby, protect this baby. So when we have a thought of the opposite happening and are that 50% us doing that, then we feel like monsters.

Speaker 3: 5:43

Yeah, it can be really scary to experience those thoughts. I certainly have patients who are very afraid to voice it, or I'll ask them, because it's a question I ask pretty much everybody about, and they'll say, well, they might be currently pregnant and they were having those thoughts after the birth of their first and they suffered alone in silence and were told anybody, because they were terrified that somebody is going to misunderstand and call child protective services and have their children taken away, or that they're going to think that they are psychotic, like the women they see in the news sometimes and some horrible thing is going to happen. Or they're just so afraid of having the thoughts in general that they think, you're right, that they have turned into some sort of a monster and some sort of a violent person overnight. But yeah, they can be really really scary.

Speaker 2: 6:36

So let's talk through some different scenarios, and one of the research articles I was reading for this podcast is called Blenders, knives and Hammers and as hard as that is to talk about that in the terms of being a mother, it was talking about that 50% of thoughts of where the mom sees herself doing something to the baby. It's like maybe the baby is crying, crying and she has that visual of shaking the baby right, or she has the visual of throwing the baby, or she's had a visual of something sexually happening with the child and those thoughts are not discussed. That's not in your normal prenatal visits, right? It's like you could experience one of these thoughts and then when that does happen to you and I have had one of those thoughts before and I did not share with anybody that thought and once I had that thought I was like is it going to happen again? Is this going to be more?

Speaker 3: 7:39

like is almost as much as I try to suppress that Like it kept feeling, like it was coming my way Right right, don't think about the pink elephant thing, yeah, and all you think about is the pink elephant, right, right, yeah, so, and I guess I'll preface this by saying that I know for you know, we were just talking that there's a you want to be conscientious of not scaring people but also not sugarcoating it, because that's part of the problem is that people do sugarcoat it, and as a psychiatrist, in general I'm used to talking about pretty sensitive subjects and as a perinatal psychiatrist, I'm used to asking about these things and talking about this pretty regularly. So, just as sort of a I don't know if trigger warning is the right word, but I will speak pretty bluntly and plainly about it, and if anybody thinks that might be distressing for them to hear, then you can maybe skip over, but, like I said, super bluntly. So these are all examples that women have said to me. They have intrusive images of stabbing their baby with a pair of scissors, smothering them with a pillow, throwing them out the window, throwing them down the stairs.

Speaker 3: 8:48

As you already mentioned, sexually explicit thoughts towards their baby were almost like on the loop, the referral to their baby in their minds, using like derogatory or obscene language that they can like. It won't stop. And it's very, very distressing, of course. And it can get to the point that a mom feels like she is a danger like we already talked about a danger to her baby, to where she feels like she can't be alone with the baby or it's not safe for her to change the diaper alone, because what if she just all of a sudden acts on one of these explicit thoughts, even though she has no desire or intent whatsoever to? And that's where it can start to really impact somebody's life, when they feel like they aren't safe, not because they have, like I said, any plan or intent or desire to do so, because they can't trust their own thought process.

Speaker 2: 9:46

Yeah, and then if you add in that mom, if we think you know she's made this hormonal drops period, right the greatest hormonal drop any human's going experience is during postpartum.

Speaker 2: 9:57

She's not sleeping right, her body has just gave birth, right she is all these exterior factors that if we just had that thought and we were mentally physically sound, perfect, great, living our best lives, that'd be really distressing. But when you're honestly everything's set up to make it harder for you and you have this thought, it's really hard to kind of point out how do I change this right or how does this stop, because you're like I don't know if I need sleep, I don't know if I need water, I don't know if I'm a monster, like you know. It's just so complicated for moms.

Speaker 3: 10:33

It is. I can speak a little bit about postpartum OCD.

Speaker 2: 10:36

If now is a good time, yeah, I think people get confused with intrusive thoughts, postpartum OCD and postpartum psychoses. I think they all are even providers I think don't have. It's not to their fault, it's just not a conversation that they are a part of a lot.

Speaker 3: 10:52

Right, because it's not discussed openly so much. And then especially something like postpartum psychosis. I already mentioned this, but when you've got those really significant cases that make the news, in reality it's pretty rare about one in a thousand deliveries. But anyway it says. To rewind a little bit, ocd itself, I think, is not the best understood illness. Certainly, applied to the postpartum period, it's going to be even more misunderstood. But OCD is not I like things to be clean or I like things a certain way. That can't be part of OCD. But that's called being type A, that's called being a little rigid, maybe.

Speaker 3: 11:40

Ocd is typically a pretty debilitating illness or can be pretty debilitating. You need to have the O's, which is obsessions, and the C's, which are compulsions. The common themes that everybody typically is aware of are things like symmetry, cleanliness, contamination and so on that can apply to the postpartum period. An example would be this obsession over baby getting sick, and so the compulsion is taking their temperature 30 times a day. That I've seen that before. That is something that most people could be able to label as well. That sounds like this thing OCD I've heard about. Now postpartum OCD is related to what we're talking about is more so with the intrusive thoughts. It's not as well understood, I think, by most people that OCD can include really intrusive thoughts even outside of the perineatal period, about death, about people dying, about yourself dying, and that's your obsession and your compulsion is in response to that. In postpartum this is typically hyper-focused on the baby. The postpartum OCD would be this sort of moderate to severe level of these intrusive thoughts that we're talking about, with the subsequent compulsions going along with it. Sometimes it's quote just intrusive thoughts, but sometimes it's an actual disorder known as postpartum OCD, which is around 6 or 7 percent in the postpartum period, which is not a small prevalence. When you think about things that are 7 percent likelihood, I know that seems small, but it's not Particularly compared to around 2 percent 2 to 3 percent in the general population. So the risk goes up much higher in the postpartum period.

Speaker 3: 13:28

And the key part when you are thinking about or assessing for a postpartum OCD is and we've already mentioned this a little bit but the fact that it is highly distressing. So that's what's called ego-destonic is a term that maybe some of the listeners have heard before but maybe some have not. So ego-destonic means that the thought that you are having is at direct odds with how you actually feel. You know it's repulsive, it's repugnant, it's not something you want to do, it's not something you're interested in doing. That is ego-destonic where ego-syntonic would be, where postpartum psychosis would lie.

Speaker 3: 14:08

So that would be thoughts that do make sense with your core thought process about whatever is going on because that person is whether they're paranoid, they're delusional or hearing voices or whatever it is, even though on paper, having thoughts of hurting their child you know that creates a lot of alarm bells and gets people really freaked out but truly just a couple of fault questions of how do you feel about having those thoughts. You know how are the thoughts coming to you If somebody says they are scaring the crap out of me. They are so upsetting, I feel so guilty. I don't know what's going on with me. I feel like I'm going crazy. That's totally different than well I'm hearing God tell me this is what I need to do to save their souls. Like no, that is psychotic thought process and thought content. That is nothing to do with intrusive thoughts and postpartum OCD.

Speaker 2: 15:03

If that makes sense. That makes a lot of sense because when I had those intrusive thoughts, I never wanted that to happen, right, and I was sick over, honestly, and I felt that shame and like this is not me and I could recognize that versus, like we're saying, in the psychotic mom or the postpartum psychosis mom who she is being, it's almost like I feel like it's an alternate universe for her, right, like she is being, she is, it makes sense because she's being told, she's being commanded, it is the right thing to do, she's convinced of that. And it is completely opposite from that mom who's living honestly in shame right now, thinking, oh my gosh, I had this thought and the shame and she fills means she doesn't want to do it right, it's not like, okay, I'm going to you know, I'm on a mission, I'm going to accomplish this because it's being told to me is isolated, shameful feeling, distressing, like you said, and I think women don't talk about this because you mentioned it earlier You're afraid they're going to take your child away, right, because no one's talking about it and research also tells us that we're not going to act on that if we don't. You know these. We're not talking about psychoses or psychotic breaks. We're talking about the intrusive thoughts and we're not going to act on that. Because you think that that's not like I'm going to go do this. And no one said that to them, you know, like no one said. Because you think this and then you're this is upsetting to you, like you don't want to do this, you're not going to do it, right, right?

Speaker 2: 16:38

I mean, it's just this horrific feeling that you're this new mom, right, and like you have this thought and you're just like, oh my God, you know it shakes you to your core and it's not like you're going to say, I mean you could have friendships that are great. Like, honestly, if I was pregnant, I would have called Claire and been like Claire, let's talk for a minute, you know, but not everybody has that. So they feel in your OB's offices is not the place that they say how are you feeling, sarah, from me to go. Well, you know what? When he was screaming at 3am for the past 10 hours, a thought came through my head. Right, you know, you're not going to say that.

Speaker 1: 17:18

Right.

Speaker 3: 17:19

And I wish it was easy to say you can just communicate this and people will understand, and just be open and honest and it's okay. I think that's a little bit naive. I mean, obviously I don't practice in Alabama so I can't speak to any experiences there, but I have never, ever seen anybody call we have DSS here is what it's called DSS on anybody who was reporting anything like that. So that kind of outcome is highly unlikely. However, it would be unfair to say that a misunderstanding of what you say is impossible. Yeah, that still can happen and does happen.

Speaker 2: 18:01

And then I think too, it's just you don't want someone to think you're a bad mom. Yeah, of course, and you know, I think that is our underlying we all want to be a good mom. So, having this conversation now, let's say I'm pregnant and I said, claire, run it down to me. What would you tell me about when I may experience these intrusive thoughts? Let's just say I haven't in pregnancy yet, which we do know you can experience them in pregnancy.

Speaker 2: 18:28

Let's say I haven't yet and I'm fixing to give birth what would be my little kept talk of. Like you would want to kind of forewarn me and give me some guidance of when I need to reach out and who would I reach out.

Speaker 3: 18:42

So good question, and it's probably different for different people. I mean, I would just explain super bluntly what can happen, that it is not unusual, but there are varying degrees of it. It's not always as scary as the examples I've given, of course, but it can be, and that doesn't mean these things we've already talked about. You didn't become a pedophile overnight. You didn't become a dangerous person overnight. You are still who you are. So I would normalize it and do some normalization and advance. And then, in terms of how to talk about it, I would say, whether it's a OB, whether it's your pediatrician, whether it's whoever it is that you feel like you do have a good relationship with in terms of they know you and understand you and you would feel comfortable sharing. That's probably the first person I would go to to talk about it and.

Speaker 3: 19:37

I'll honestly say something. Like you know, I've heard about this and I know that it's not uncommon and I have no concerns that I want to actually hurt my child in any way.

Speaker 3: 19:46

I know that, but it's so. It's so hard to still be experiencing it and I wanted to tell somebody in and hear if they have any recommendations or a therapist I can see or whatever, because that's really what it is. I mean, it's this, it's anxiety, and I think that's part of OCD. Maybe it's something that could benefit definitely from therapy and then maybe plus minus medication, depending on what you think it is. So it's sharing it and getting it off your chest is really, really helpful. I found that experience pretty across the board just somebody getting it out of their head, you know, and into space, and somebody reacting in a way. They're like, oh, I'm calling the police right now and I hear somebody. Okay, I, you know, I, yes, I've seen this before. Nothing to be super duper scared about. You're going to be fine. Let's talk about what might be helpful for you for this moving forward, and that conversation can be really, really helpful for people. So whoever that is in your life, that's who I would go to first.

Speaker 2: 20:50

Then let's just play a little scenario for our preview alliance providers who's listening? We have a lot of people who they are social workers, obes that listen to us as well. Let's say a mom opened up and said they're coming in for six weeks follow-up appointment. Claire, I'm feeling this way. It's really upsetting to me, but they're very uncomfortable with this topic. They're in their head still thinking okay, well, what's if it is psychoses? What are some baseline? We're not going to get into the full extent of an evaluation on the podcast, but what's some baseline questions that someone could ask to help you. Like we explained earlier, versus they want to do it, versus they don't.

Speaker 3: 21:34

Right your most basic risk assessment, I would A. I would always start from a place of normalization, always of okay. Thank you for letting me know as scary as this feels for you. This actually is not uncommon. Let's talk it out a little bit more so if I have some more information we can figure out the best next steps.

Speaker 3: 21:57

Tell me more about the thoughts. How often are you having them and what are really the details of the thoughts? Just get a little bit more information. How do you feel about having those thoughts? Are they upsetting to you? Getting a better idea of the level of distress, and is it dystonic?

Speaker 3: 22:14

I know this doesn't always come a second nature to non-psychiatrist, but if you're talking to someone and you're having a regular back and forth conversation, that person is not psychotic. You'd also certainly want to screen for other symptoms mom might be having In addition to the intrusive thoughts, which can happen on their own. But otherwise, how is her mood? Is she struggling with depression at all? If mom is feeling herself suicidal or having even like this, passive suicidal ideation, that would increase risk. Still not to the extent that they need to be emergently hospitalized.

Speaker 3: 22:53

Right, that second necessarily, but that would be an indication of. Okay, the risk is slightly heightened here, just in general. So normalization how are they feeling about the thoughts? More description of the thoughts, once you've established that this is a safe space, so you can get the full extent of like how often it's happening and what scenarios is it happening and what is the content of the thoughts. Then mom's own mood level, her own anxiety level and the presence of if she's having suicidal thoughts or not. Those would probably be the basic steps to start with.

Speaker 2: 23:28

I'm glad we walked through that because our moms, who are listeners, my hope and, honestly, my prayer for them is that they will have a provider who does what you just did. So if they have an experience, that is not that where you are vulnerable and you are shut down or you're ignored or you're shamed. That is not the care that you're needing to receive, because sometimes we don't know what the care is that we're supposed to be receiving if we've never heard it or seen it or experienced it.

Speaker 2: 23:58

So, thank you for talking through that, because that is something I want moms listening. If you're not able to have this type of conversation with your provider and have that response from them when you share a concern of your mental health or your physical health, that is your sign to find a new provider.

Speaker 3: 24:14

Right. Just to be clear, just because things aren't rare doesn't mean it's like, okay, you're having these thoughts, we don't think you're gonna do anything, but goodbye, see you next year for your annual. It still is something that's important that you want to address. That means that someone isn't doing the best that they could be, and how can we help them and support them more through this? So again, normalization, but also like with a plan. So how are we gonna address this to make sure she doesn't get worse or decompensate further or something doesn't become a true safety concern or risk issue?

Speaker 2: 24:51

And so if she was in there and obviously we with Previous Alliance we believe in therapy, we believe in next level of care, which is you, but unfortunately in our state we do not have reproductive psychiatrists but we have psychiatrists that we're working with. But essentially she wants to get better and she wants a plan. So we know therapy would be a great option. If she's concerned about medication, how that's gonna come into play, what kind of ways could she self advocate to create a plan If the OB say doesn't know we're really where to go with this? Because, to be honest, a lot of people don't know where to go with this, right yeah yeah, that's a difficult question.

Speaker 3: 25:35

I think that I would advocate for myself to what are the resources for therapy? Do you have anybody that you can refer me to? Or, even if they don't have any names, just how even to do like general referrals for their non-pregnant patients? I mean, obs are kind of the frontline and the primary care for a lot of women, unfortunately, even though that's not truly their job, and so I would think that therapy and mental health care would come up otherwise in guiding visits or their annual visits and things like that as well. So do they have anybody in the clinic, like a social worker, who might have more knowledge of that in the area or in the state? For telehealth services, they can often be a great resource and I know that this is not gonna be new information to your listeners, but still, postpartum support international PSI, is a great resource that you can utilize on your own and you don't need the help of a provider, and they have a hotline that's non-emergent, you can call in and you can talk to someone.

Speaker 2: 26:36

And they also have a provider directory, which is great, that you can put in your SIP code and you can find maternal mental health, trained therapist or psychiatrist, reproductive psychiatrist, like can kind of do that. But I think what I would want the listener to know is like you don't have to live that way. Like you know, if it's just dressing, it's impacting your daily life, it's making you feel depressed, it's giving you more anxiety. You don't have to just bear and grin it. You deserve to enjoy motherhood, enjoy postpartum, to be yourself. And it is that first step of having that really vulnerable conversation and saying this is a really scary, distressing thought. I had right, but normalizing, like we're doing, is just so important. And I want to touch on, before we close sleep. How do you feel like sleep with these intrusive thoughts? And OCD come into play, because we know moms lose a great bit of sleep in the first year of life with a child.

Speaker 3: 27:34

Oh sleep. Everything comes back to sleep, it's.

Speaker 2: 27:37

Yeah.

Speaker 3: 27:38

And it is something that is such a problem, but I think providers frequently feel so helpless when it comes to sleep that the default is like I don't even really want to ask about it because I don't want to tell them to do about it, and I understand the frustration from providers and from patients. You know, screening for sleep with someone who has a newborn feels sort of silly, or you know the quality of sleep. However, there's always a conversation that can be had around sleep, whether it's around medications or not. Sleep is an independent risk factor for depression. It's an independent risk factor for the severity of psychiatric illnesses, independent risk factor for all of that.

Speaker 3: 28:23

So you're exactly correct, it plays a huge role in a lot of this, and whether it's about what's the schedule of sleep overnight, is it up and down? Up and down versus shifts, versus I think we already talked about this sort of this piece of advice that women hate sleep while the baby is sleeping. You know all of that. However, when the baby is asleep, say at night, when you would be expected to be sleeping, and you can't, why is that? What is it that's keeping you from sleeping? You know those kinds of more pointed questions to get you at the details of the sleep problems, beyond just them obviously getting up in the middle of the night. Why are you asking me about sleep? Of course it's terrible. That might be it, but there might also be other layers to the sleep issues that can be addressed.

Speaker 2: 29:17

And mine was because I kept fearing, especially if Will, that he would die in a sleep. Honestly, I thought if I closed my eyes that he would not make it, and I got the outlet and that did help.

Speaker 3: 29:30

But it wasn't until I was in therapy that it really got better.

Speaker 2: 29:33

But I just thought I mean, people are like go and just lay him down and go to sleep.

Speaker 3: 29:37

But I'm just like, but I feel like he's gonna die if I go to sleep.

Speaker 2: 29:41

I remember I said this to someone. They're like well, you're a new mom, like that's just a fear, and I'm like I know, because I see other people sleeping and I can't sleep you know, yeah, right, right, you mean well, but that's wrong and it doesn't help me, and then I got worse, you know. So I just think, mom, so we don't ask those questions that you just said, like why aren't you sleeping? Is it the thoughts? Is it? Do you feel like you have to be doing something?

Speaker 3: 30:07

Is it Right? Is it racing thoughts? Is it? My mind won't shut off, is it? Well, if the baby's asleep, I gotta be doing laundry. I gotta be washing this, I gotta be doing that. Is it that you know? I don't know that there's so many different reasons under the sun. And I'm not saying there's a solution to every single problem, but you need to find out that information to even have somewhere to start.

Speaker 2: 30:28

Yeah, and then I'm a big fan. We didn't learn this till our second trial. But shifts, sleep moves, shifts. You mentioned that Insane. And we like to tell our premium mom ideally a four hour stretch is like the minimum you should get at night and some things that me and Bill worked out again second time around. You know this is things we learned from me. Having severe post-bar and abduction was we put the baby down at seven. I would go to bed till like 11 or 12, whatever stretch I could. When I was breastfeeding I had a red pump and he had that bottle when they were on formula. He could make that bottle, you know. But I got that uninterrupted sleep, like if he had to take the baby walk around then both cry.

Speaker 3: 31:11

That's what needed to happen you know, yeah, yeah, and that's something that I talked to.

Speaker 3: 31:16

A lot of people think that, or maybe not think that, but just assume, or it seems like the natural thing to do, seems like we take terms I get up, then you get up, I get up, then you get up and there isn't a one size fits all. But generally speaking, if I'm just starting somewhere to gauge possible things that might help, I generally always recommend, if possible for you, you know, in your home situation, to do shifts, as you're talking about, because uninterrupted sleep is I'll just use the vague word better, just to not go into, to avoid too much detail overload is better than actually more hours of interrupted sleep. So if you are up and down, up and down, up and down and technically sleep I don't know six hours over the course of a night, it's actually better to sleep for one chunk of four and a half or five, because when you're up and down, up and down, your sleep cycle is severely disturbed and you're not getting any kind of quality restlessly. That actually helps your brain recover.

Speaker 2: 32:22

And then one final thing. I experienced this, and I call it bedread, but it's like almost when the start of setting.

Speaker 1: 32:28

Start to get dormant yeah.

Speaker 2: 32:31

And you're in newborn days, or maybe your kids are in their regression and you feel pressed or anxiety about the night because you know you're not gonna get sleep.

Speaker 3: 32:40

I know, yeah, very common, super, super common.

Speaker 2: 32:44

I felt that with both and honestly, it's like when the sun would rise I'd be like we made it, but then I would have doom and gloom and despair. Honestly, I was like I did not want the night to come and I didn't know there was a name, that other women experienced it until I started in the synopthy.

Speaker 1: 33:04

Oh, my gosh.

Speaker 2: 33:05

I wish someone would have told me that too.

Speaker 3: 33:07

I know, I know someone needs to create a book. Just find all the other books out there. Maybe not, maybe not, because books stress people out, never mind. Yeah, I'm sort of. Here is the way it really is, God, and I know that there's some out there that are more along those lines that people have found to be super helpful.

Speaker 2: 33:25

Well, the more we talk, especially with you, and just normalize and what we're saying, we're not seeing Claire have alarm bells go off. We're not seeing her jump out of her chair going. I'm upset about this. It's not normal. This is just a very normal conversation. She sees this every single day. And women get better. I think that's something we haven't touched on. They don't always have these thoughts. They don't always feel this way. Our goal is to get them better.

Speaker 3: 33:51

Yes, yeah, exactly, I think that's a great place to end.

Speaker 2: 33:55

That's perfect, Okay, guys. Thank you so much. If you guys have more questions for Claire, send it to us DMS on Instagram, send us an email and we'll answer them, but we hope you guys have a wonderful day. Thank you, Claire.

Speaker 3: 34:08

Thank you, you're welcome.

Speaker 1: 34:12

Maternal mental health is as important as physical health. The previous Alliance podcast was created for and by moms dealing with postpartum depression and all its variables, like anxiety, anger and even apathy. Hosted by CEO founder Sarah Parkhurst and licensed clinical social worker Whitney Gay, each episode focuses on specific issues relevant to pregnancy and postpartum. Join us and hear how other moms have overcome mental health challenges, as well as access tips and suggestions on dealing with your own challenges as moms. You can also browse our podcast library and listen to previous episodes at any time. Please know you're not alone on this journey. We're here to help.