Speaker 1: 0:10

Hi guys, Welcome back to Preview Alliance Podcast. This is Sarah, and I'm with your favorite therapist, Whitney.

Speaker 2: 0:14

Hi Whitney.

Speaker 1: 0:15

Hey friends, we are in Maternal Mental Health Month, whitney, and I thought it would be really good. I know we've done more in-depth series and we will refer to this and if you guys are new to us, we encourage you after this episode. Or if you're not even new, you just want a nice refresher for this month so you can be educated and help, support and advocate. We have a really great what Is series that we did a couple of days ago that will go more in detail of each PMAD or perinatal mood anxiety disorder. But today, whitney, I thought we should just hit a high overview for those who are new to us again are just refreshers of you know we talk about maternal mental health, but what kind of pathways and diagnosis and conditions are we actually talking about?

Speaker 2: 0:58

So when we look at maternal mental health or a maternal mental illness diagnosis, you got to think that it could be anything that you see out in the world that's even not associated with motherhood or postpartum. So you hear people talk about depression, anxiety, ptsd, an OCD type thing, a psychosis. Those can exist out in the world, out in the real world, if we're going to use that lingo. And then it can also exist in motherhood via pregnancy or postpartum. So when we think about PPD or postpartum depression, that is when someone who has delivered so we're not looking at the pregnancy spectrum right now, we're looking at postpartum they have had their baby either via c-section or vaginal delivery. They are most likely going to start having their symptoms last longer than the week that we give baby blues.

Speaker 2: 1:51

Now, mind you, postpartum depression can be on set. As soon as delivery is done. We can start to see the ease of crying or that I'm not good enough for this we can start to see those symptoms pop up. You know we give it that week for the baby blues because that is more hormonally influenced and it is hard to decipher. So that's where that timeline is very crucial for us to diagnose between baby blues versus a postpartum depression.

Speaker 2: 2:20

Similarly, we can see that with postpartum anxiety or PPA. You think anxiety is going to be more keyed up. A lot of hypervigilance of did I change the baby, is it time to feed the baby, did I do this, Did I do that? And we can still have some of that self-deprecating talk of I'm not good enough, I'm not up to snuff for this, those kinds of things. But then the mom is starting to think, well, what can I do differently? And we might see overcompensation take place and again that can be onset as soon as delivery takes place. But we give it that weak window to be able to decipher between baby blues versus that postpartum anxiety.

Speaker 1: 3:00

Right, ok, and I know a baby blues, I think to me the time frame, for me personally, would seemed like that three days post-delivery, five days, even seven days, almost like peaks and comes down. But the key differentiation is that it should not be. Baby blues, is not going to be when your baby's a month old. That's not baby blues, honestly, you know we're thinking if it's lasting more than two weeks. That's something that we want you to start asking yourself. You know it's a blur. I tell people it's like a hamster wheel. You can't get off as soon as birth because it's feed change, try to sleep. You know you get time gets lost. So I think it's helpful to know ahead of time, like how am I going to check in with myself? How am I going to track a time and say I am feeling really sad on this day or I'm feeling I'm noticing these anxious thoughts, because you can't wake up two months later and go oh my gosh, it's been two months and I thought it's just been a week.

Speaker 2: 3:52

Right, exactly. So again, that key differentiation from baby blues to any postpartum diagnoses is that timeframe. If we are post seven days and these symptoms are continuing or they are new onset, that's when we need to explore a postpartum diagnosis and baby blues can be ruled out. So that is something to be aware of. Also, baby blues is more hormonally influenced, so you may find yourself crying easily over things that you're saying. That is not that big of a deal. So to tell on myself, after my first daughter was born, I was, I'm going to say, about three or four days postpartum. I knocked over the cat food bowl and I burst into tears. And when I tell you not postpartum, whitney would not cry about that. I might be inconvenienced, I'd be annoyed that I have to clean it up. I would not be sobbing and I was. So we have to realize too that baby blues, we're going to be crying over things that wouldn't typically make us cry. Yeah.

Speaker 1: 4:52

We're feeling of just heavy sadness and I know I've heard people say it's like it lifts and you do. You feel it kind of lift off you and again with that hormonal balancing. And then what would be kind of some of the statements with postpartum depression that you would be red flags for you as a therapist or that you've heard that would help, kind of zero in of, hey, this might be something that they're experiencing.

Speaker 2: 5:16

There's so many there, so I'm going to try and nutshell some of these. I'm not good enough. My baby deserves better. I am unable to care or feed for my child. I don't want to care or feed my child, and so with that you see, a lack of motivation. They may be taking care of the baby because they're obligated to. It is not out of this mothering, nurturing sense. It is because they know they have to for the baby to survive, but it's not because of a, I guess, philanthropic type motivation because of that nurturing that you would think that would be there.

Speaker 2: 5:54

So we're going to see a lot of, I mean, I guess you can do that for the baby. You know you might hear a lot of flat tones. That's one thing to be aware of. And again, we have to consider sleep deprivation being a huge proponent of this, because when you're exhausted you're probably not going to be chirpy. Yeah, so it is one of those. If someone says, oh, my baby was just so colicky last night and you can hear the tired in their voice but they're not saying, well, I don't want to take care of my baby, they may say I'm exhausted because I was up with the baby all night and couldn't settle them. Okay, that's not a red flag for depression or anxiety. But they may be saying, well, yeah, I mean, I do feed them and that's it. That would be a little more concerning.

Speaker 1: 6:37

Yeah, it's the loss of hope, it's the I should have never been a mom. My family would be better off without me. And then it can be physical as well. Right, depression can present physically where you're feeling like you're sleeping so much right, or you feel like sluggish or you're having body aches and pains that are coming out. It is the big one, you know, because moms are like well, I don't know the last time I ate. Well, there's a difference between not knowing because you're so busy versus you have an opportunity to eat the food you would normally eat.

Speaker 2: 7:11

Yeah, you have no appetite for that. Right, it's one of those you have no desire to eat or and I'm going to say we need to be careful with this one you want to overeat as a comfort, not because you are hungrier, because you're postpartum and your body's recovering and it needs that fuel, or because you're breastfeeding and you need an uptick in calories to maintain or kind of start that supply. There's a difference. So if you have a genuine physical hunger cue, you honor that. If it is one of those, you can tell that you feel very, very sad and you're like you know what? Where's very, very sad? And you're like you know what? Where's the M&Ms? And you eat like a whole shareable family size bag of them in one sitting. We're concerned. We're concerned because that's not a typical behavior.

Speaker 1: 7:56

You're avoiding, perhaps like the things you used to find pleasure in, or joy, and granted, your whole world has shifted. But you have an opportunity to go out, get your nails done with your friend. Hey, you know, somebody you trust is watching the baby. I don't want to go out, I don't want to do anything, I want to stay inside. You don't find that joy, that pleasure. I've heard people describe it's like I'm like outside my body, watching myself, almost just being like I don't recognize me.

Speaker 1: 8:22

Yep, so that is the depression. Again, any part of postpartum depression is like what you said. It can start from immediately post-birth and thus can evolve in person any time that first year postpartum. So it's not like you get to the three months mark and you're fine. This is a conversation in signs and symptoms. We need to begin watching from until baby's at least one, and some even argue further.

Speaker 2: 8:45

I was about to say, I've actually seen some data coming out suggesting 18 months. So just be aware, like 12 months is maybe not this magical finish line If you're like, okay, I'm never going to struggle with it. Like it might even be able to hit at 14, 15, up to 18 months.

Speaker 1: 9:06

As long as it's not an external factor contributing Right. And there is correlation too with if you are breastfeeding when you stop breastfeeding.

Speaker 1: 9:10

We've seen several moms that they were unprepared, that when they stop they start weaning, those hormones again come into play and that can at times cause the onset of that depression. Or maybe she had a baseline and this kind of pushed it up to that next level. So that's a good, a good kind of overview of depression. Now let's talk a little bit more about anxiety, because some people can be like, well, my baseline isn't anxious, that is fine, you know. And I think it is those type A moms, the perfectionist moms, that sometimes fall bear trap to the postpartum anxiety. It's often not as talked about, even though it's just as common, as more common than postpartum depression. So what is some kind of things a postpartum anxiety mom would say to you, or things you may be noticing that she's doing when she's describing her day? That would be some red flags for you.

Speaker 2: 9:59

So and I'm going to tell on myself because you know, hindsight gives us so much clarification, so I'm going to tell on myself when I had postpartum anxiety with my oldest, that wasn't recognized as quickly as hopefully it should be for somebody else, but the hypervigilance is huge. You know the fear because mine was SIDS induced and I know that. So I thought if I go to sleep she will die of SIDS. Now, mind you, was I following all the SIDS safety rules, Absolutely. She was also not a preemie baby. She was born at 39 weeks and two days, so she was not a preemie at all. She had no lung problems or heart problems that we knew about, no genetic problems that would put her at a greater risk of SIDS. But in my mind I was like I know she's sleeping, but if I fall asleep she'll die of SIDS. It was a guarantee in my brain. So if you have the mom, that's like no, I have to watch my child sleep so they don't die.

Speaker 2: 10:52

Red flag, huge red flag for that. You find them. They're talking about cleaning their whole house daily, or multiple times a day or week. Huge red flag because they cannot be still, because they feel like they have to constantly be doing something to satiate the anxiety and that's one of the ways that they're trying to also increase self-worth. That's a big one.

Speaker 2: 11:18

They're too afraid to leave their baby with anybody that they typically and previously have a good, trusting relationship with. So that would be me saying yeah, my mom's coming over today and she's going to bring lunch and you invite me to go get my nails done and you know, I've got a good relationship with mom, I have no worries. She's telling me that she will follow all the rules that I put out and I'm like no, because if I leave, something bad will happen to my baby, Not because I genuinely think my mom would hurt the baby, but because if I'm not there, something bad happens. And that can kind of border some OCD type thoughts where we think if I don't follow through with this act or compulsion, something bad happens. So we have that obsessive thought if I do or don't do this act, which is the compulsion, something catastrophic will happen.

Speaker 1: 12:10

And we see postpartum OCD, even pregnancy OCD, and I do think it gets mixed in with anxiety. But you know it's an intrusive thought. So I guess this is a good time to talk about intrusive thoughts, which we know. Research tells us almost every mom at some point will have an intrusive thought, a scary thought that will come into your mind and you may have not really ever experienced them.

Speaker 1: 12:32

You know, the thing that I always think is that sometimes you know, say, if you're visiting some places super up, high, right and Grand Canyon or whatever you're walking, you're just like you have this like visual of like oh my gosh, like what's my jump job? Or oh my gosh, I don't want somebody push me off right, and like you're not going to do that. It's almost like your body is saying we're going to keep you safe. This is a you know and it's a protection mechanism. So for scary thoughts for moms in the postpartum period, if you've never been told, hey, you can have an intrusive thought. This is what intrusive thought is. It's very alarming. I remember I first had them and I thought I'm going crazy and I was scared to share about them. So what is an intrusive thought?

Speaker 2: 13:12

So an intrusive thought is a thought that comes in unprompted by you. It is unwanted unprompted by you. It is meant to be there for protection, but you know, we kind of think about a kid whose imagination runs away with them. Intrusive thoughts and anxiety work the same way. So the best example I know to give because I think so many moms experience this is you're at the top of a staircase and you're holding baby and all of a sudden you think, oh my God, what if I drop the baby down the stairs? Or what if I fall down the stairs with my baby? Naturally, we don't want either of those to happen, right. So that thought is there to say, hey, don't go too quick. Or hey, watch your step, be aware of your surroundings.

Speaker 2: 13:54

Well, that's not bad inherently, but where it becomes intrusive is we think of it like a snowball. Is we think, oh my God, what if I fall down the stairs with my baby? Instead of saying, ok, well, let me change this and do this and be safer, we think, and then what if they get injured? And then what if they're in ICU? And then what if they die from it? Like we go from point A to point P very quickly, very, very quickly, in a matter of seconds.

Speaker 2: 14:18

And so when an intrusive thought hits, that is when I need you to take a moment and say let that air out. You exhale and you say you know what? I need to remind myself that this is not a reality, this has not happened. Ground yourself, get yourself back in this moment and then say what can I do to prevent my intrusive thought from being reality? And that is where you say you know what? Maybe I just need to make sure I've got a better grip on baby. Maybe I need to hold the rail and just take it one step at a time. If it's so bad you can't do those things, sit on your bottom and scoot down the stairs, because you know what. It takes you a whopping 20 seconds more to do it that way. Yeah, so take your time. Take your time. It doesn't have to happen like that.

Speaker 1: 15:04

I will say we have. We go way more in depth on intrusive thoughts and different types and examples of intrusive thoughts. We have a really great episode called good moms have scary thoughts, so you can go back and you listen to that more, where we deep dive on intrusive thoughts, because intrusive thoughts can be scary and they can become more severe than the, you know, falling down the stairs, which is a very real fear that we all have. But and then if those are coming at you out of you know, if you're noticing I'm having intrusive thoughts, I'm having thoughts that I don't want to think necessarily they're not, you know they're coming in, they're alarming to me. I would not act upon those.

Speaker 1: 15:38

Research also says that you're not going to act upon those, right, and so that is something we would want you to talk to, get a therapist to talk to you about, talk to your OB provider, because that does go hand in hand with anxiety. Absolutely it does. So we need to. So that is something that we want you A to be aware, because you're going to probably experience it. We still, I still experience it now I'm almost seven years postpartum, you know, and it's like you unlock a part of your brain as being a mom, of loving these little humans. So much of dangers and fears. Right, that again is that protection mechanism. But now we, I can say, sarah, that's an intrusive thought.

Speaker 2: 16:12

We're going to call it for what it is Exactly and we're able to kind of when we identify things and we know what they are, it is easier to address them and tackle them. We identify things and we know what they are, it is easier to address them and tackle them.

Speaker 1: 16:23

The unknown makes it so much harder. Oh, and we try to control it. And I will say anxiety for me too and maybe I was veering a little bit into the OCD was to the minute for sleep schedules. That's how I was showing it would be. You need to lay him down at 1239. If it's at 1240, we got a problem. I would fixate on ounces that he was receiving, like what I would pump it. You know it had to be 5.4.

Speaker 1: 16:49

You know, it was a obsessiveness of like, detailness for me, of like. I'm trying to again control that. I was very rigid and the control really came over. But again I had the same fear. I wouldn't sleep if, unless someone was watching him, because I same sense fear was with me. And then another one that I think, anxiousness. You know anxiety is sometimes you self-medicate, that Right, and that comes into play as well. So if you're noticing, you know well, I'm so on edge and I'm drinking more to numbness. I'm seeking this outlet more. Those are things we want you to ask yourself as well. Oh, we got to call ourselves out. I still hear Whitney's voice. I'll be in. I hear you, whitney, if I'm doom scrolling a little too long on Instagram, which I just came off a really big fast of Instagram, which I think is helpful for everybody, especially in the postpartum period.

Speaker 3: 17:45

I, which I think is helpful for everybody especially in the postpartum period, I think is a time to.

Speaker 1: 17:47

I mean, I don't know what good can come from just scrolling endlessly when we're feeding our baby at 3am. That in Amazon orders is a problem, but yeah, the doom scroll because we're like you're disassociating from your own reality to focus in on something different. Right, I hear you saying you're doom scrolling. Let's take a break. Let's set a timer. I hear those things and I take it from it. So now Whitney, a little bit more serious one, but still needs to be known, about postpartum psychosis.

Speaker 2: 18:11

Okay, and this one, I will say, is maybe the trickier of them to kind of spot or diagnose more often than not and I will say you're always going to have the exception to the rule, so please keep that in mind Postpartum psychosis is going to be onset very quickly postpartum Typically it is two weeks or less. Now we have seen those few, a very small percentage maybe like 1% of your psychosis cases where it actually got onset like a couple of months postpartum. I will say that it's highly rare, highly rare. It can happen, but it's rare. So keep in mind we're looking at two to three weeks postpartum and psychosis is exactly what you think it is, where somebody hears things that aren't there, whether it's voices or just sounds. It believes that a higher being or a deity or God is telling them to harm their baby or themselves because that's what's better for the baby. So you know, some people have thought that their babies were aliens and this has been a couple of years ago and you can help me remember the details a little more clearly, sarah but there was a case where mom, I want to say, was like six months postpartum, ish, and she had actually been in a facility getting treatment.

Speaker 2: 19:32

Okay, so something had been identified early on in postpartum for her. Dad was working from home. They had three children, so six months, I'm going to say maybe about a two or three year old, and then like a five or six year old, and dad said I'm going to go out and grab takeout. I'll be back in 15, 20 minutes. When he came back home, mom had killed all three of the children and she had jumped from a second story window. If I'm not mistaken, she did not pass away from her injuries and she was hospitalized and I think later on charged with multiple offenses, and so I don't know what her thought process was in that moment with postpartum depression, anxiety, ocd, even a PTSD is not going to have a thought process of I need to kill my children and myself because that's what is going to be pleasing to this deity that's telling me to do so, or I have to save us from the world ending and things of that nature. So that is where a psychosis. We see these very severe thoughts, very severe.

Speaker 1: 20:40

And there is the hallucinations, delusions. It is really like you. I know two people personally who has experienced it and you know they were not themselves and this is a medical condition. It's in a medical emergency, so it's important for people to. It is why it is they call it rare. It's really not rare in the sense of one to two out of a thousand. They're saying so.

Speaker 1: 21:00

It's a please be aware of, to know the signs and symptoms. She is not going to act like herself. Um, she may not be sleeping at all. It's almost like that manic, just energy phase. She is going to be like hearing voices, like what he said, or it's an alternate universe of like. You know she's living in something that's just not like. She's the way she talks, going to be a lot different the way she acts, but in the beginning it can slowly kind of present itself and you know the two people I know personally about it.

Speaker 1: 21:29

I don't think the signs of them it was not recognized immediately, right, until you know they both got treatment and it is something that you would call 911, go to the ER. If you or a loved one is experiencing that, that you do need medical intervention, you do need medicine because there is a huge risk of harm to mom and baby. Again, it is something that we hear in the news right, we hear these sudden tragic stories and we kind of comes to talking point, but it's something that needs to be educated on Absolutely, and we have a whole episode on postpartum psychosis too. We go deeper on it. So refer back to that, and you mentioned it traumatic birth, ptsd after birth. So I saw a study recently that said 50% of moms now would state that their birth to them was traumatic or had symptoms of PTSD. And people may say I associate PTSD perhaps with, like, a sexual assault victim or a veteran. So what do you mean? Pregnancy and PTSD or birth trauma? Let's talk about that for a minute.

Speaker 2: 22:31

So we'll hone in on pregnancy first and then we'll kind of progress over to LND postpartum. So pregnancy PTSD can come from. If someone experiences HG or hypergravitam where they cannot stop throwing up, you know they are constantly in the hospital getting IV fluids enzofran and Finnergan. They cannot lead a normal life during their pregnancy. So with that you look at a lot of grief impacts. You look at. You know potentially. You know medical neglect or malpractice as far as like getting diagnosed or maybe even the treatment that they get from staff when they're having to get these infusions. You know really having to advocate for themselves if their staff is not listening to them. You know. You also want to look at if someone has experienced any type of bleeding or threatened miscarriage during their pregnancy or if they have a history of miscarriages and they're constantly wondering when am I going to lose this baby as well? Then you want to go into if someone has experienced preeclampsia and they have a preterm delivery. So preterm delivery is any delivery up until 38 weeks. So you're looking at a viable pregnancy. So viability is typically at about 24 weeks. Uab has had a handful of cases at 22 and 23, but more often than not we look at 24 weeks of viability to 38 weeks. That is a 14 week gap. Yeah, that is three and a half months where you are at risk of a preterm delivery.

Speaker 2: 24:04

Typically, when we see that preterm delivery, it is not a vaginal delivery. Usually you have something like HG or preeclampsia or coliostasis taking place and you have to have a stat C-section. So clearly it is unplanned. Even if it's a repeat C-section, having it during that gestation is unplanned. That is what makes it emergent. So with that you're getting rushed into the OR. Things get very clinical. It's not warm and fuzzy. You've got staff yelling all kinds of medical jargon and terms around you and you're like I don't even know what's happening, I don't even know what color the sky is right now, and so you've got that rushing around. You've got the stat C-section, you've got the preterm delivery Also, all the while knowing that NICU is going to be happening. Admittedly, when baby is 35 to 37 weeks, nicu is not as guaranteed. I will say there's that little sliver right there where a NICU stay is not guaranteed, but that's still a pretty big gap from 24 to 35 weeks of a guaranteed NICU stay.

Speaker 1: 25:10

And you know it's too. I've experienced two traumatic births and we have other episodes that talk more into the detail. But it is really. You know I do EMDR therapy. I've did it for Will and I'm doing it now currently for James, because the births are very triggering to me.

Speaker 1: 25:24

So this could be you could be saying, well, I don't know if it was traumatic to me, was it against, not what you really wanted? Did it happen very fast? Did you feel it was out of control? You know, it really to me felt like I wasn't being heard. I wasn't. Again, it was just I had no control of it. I was very scared.

Speaker 1: 25:40

And again it's like could be like you were all set for a vaginal birth. You're fixing the push. Something happened to the baby, you had to go to a stat C section, or something very traumatic happened to you during the delivery of a vaginal birth, right, or the way you were treated or your baby was treated immediately after, and it will resonate to you because then you will have kind of those flashbacks, you'll be triggered. It's a manic reaction, right. It's like you feel it in your body, like you can feel like panic attacks, you can feel heavy. It almost is like floods over you the memories, like it's not like just one memory, it's like the whole story just replays. And I remember, especially with Will's birth, like it was like a videotape of the birth that I could not stop in my head.

Speaker 2: 26:20

Right, replaying it and some of that is your brain trying to process everything. It's also you trying to figure out what could I have done differently, so kind of taking some of the guilt with that. And I'm not going to say accountability because you didn't do anything wrong. Yeah, accountability is not the right word, but there's some guilt there and also a feeling of helplessness, and that's where you're trying to figure out what could I have done differently to fix it.

Speaker 1: 26:44

And it's complicated and 50% of women saying that it's very important again to talk about it, and I believe depression follows that very quickly and anxiety can follow through that. And the last one we could talk about is rage, which can again occur during pregnancy and postpartum. That I see personally, you know I have with my youngest was postpartum rage and now I'm correlating to a lot of that was from again experiencing a second traumatic birth experience. I had no control, I wasn't heard, I didn't feel like my needs were being met. Talk a little bit about that, cause I think that's a big taboo. I wasn't heard, I didn't feel like my needs were being met. Talk a little bit about that, because I think that's a big taboo. I think pregnancy rage and postpartum rage you know, especially in the South, we're supposed to be blessed and best thing ever to be a mom and this new little thing and how dare we ever show anger?

Speaker 2: 27:32

So rage is a big thing, and I think especially with moms, because we are hyper aware of all the things we're responsible for. We don't have our autonomy anymore for a long time after our babies are born and so we are automatically the default parent. And a lot of that comes because, you know, we birthed the child, we feed the child, we do all the research, we do all the things, we know the schedule, we know all the tips and tricks to get that baby to sleep. So some of it is we feel a little bit bitter or resentful to our partners because they're not able to do those things. You know, there's the joke of you know, the man always has the useless nipples. Well, they do.

Speaker 2: 28:10

Yeah they do, and so they can't help feed the child in that capacity. And now you know my formula feeding moms. I'm with you where we are able to share that responsibility to an extent, but we still have to what? Figure out the formula, right? Yeah, we got to figure out how much can they eat.

Speaker 1: 28:28

We're in charge of the pediatrician appointments, the nipple sizes that? Have you ordered stuff to clean the bottles? I mean it just did. The endless list that goes upon.

Speaker 2: 28:35

And then you know keeping stock of did they outgrow their clothes? What about diapers? What about wipes? You know, if you're doing daycare for your child, like we've done, you know finding the daycare center, are you on the wait list, like all the things that come in with that mom is responsible for? And then mom is responsible more often than not for household management. Then if you work outside of the home, or even if you have a work from home job, well, you have to do your FMLA paperwork. You have to stay on top of that as well. So there's a lot of demands. Sleep deprivation, naturally, is going to make things worse. And then you know sensory overload.

Speaker 3: 29:12

Yeah.

Speaker 2: 29:13

It makes it so much harder. And then when you have multiple children, you probably have a toddler or preschooler that's saying mommy, mommy, mommy, while you've got a baby screaming and you're trying to get separate together and the dog is crying and your husband says what are we having for dinner? And you just want to throw everything out the window. Yeah, and it is.

Speaker 1: 29:32

It comes on so quickly, rage on some people. It's not the same, as you know, just like anger, like it engulfs you, it's like fire rage. You would snap, like you snap that the irritability is all high. I mean, I remember I tossed something at my husband's head, you know, like it was just. You know. People say you know I took something, I broke it. I've never done that my whole entire life. I yelled at my kid. I never do that. You know all these things and it's rage and anger is usually telling us a deeper story, right? So again, go back to that. What Is series? We do have a Rage one as well, but often it is, you know, depression and rage can go together and PTSD and rage. So know that. And finally, whitney. So we're going to give this wonderful overview. We again encourage you guys to go listen back to the other series. We're really deep dive. But if you are recognizing these symptoms in yourself or a loved one, how can you get help? What is the next steps? What would you advise?

Speaker 2: 30:27

So, especially for you, fresh postpartum mamas, please seek out your OBGYN or midwife, because if you want to do medication, they are going to be the ones to prescribe it and kind of assess what might be the better fit for you. Right, if you are already on a medication, talk to that prescribing doctor and see if a dosage change is needed. I would also encourage you, get on with a therapist. Hopefully there is one that specializes in maternal mental health. Hopefully that is near you. I highly encourage you to one.

Speaker 2: 30:59

Go to psychologytodaycom. You have to look for your state All counselors and social workers. We are licensed for our own state so I cannot see someone in Tennessee or California or Maine. I can only see those that live in the state of Alabama. So put in your location. Realize we do service the whole state so I have people that live across the state, that they are within the state lines. I can do telehealth with them. So put in your location. Put in things like perinatal pregnancy, postpartum motherhood, put in those kind of keywords. See what that gives you. If that doesn't give you anything that you're really thinking kind of jives or fits for you, your insurance company can also tell you who is in network and if they have a preferred provider for that.

Speaker 1: 31:49

And there is the Maternal Mental Health Hotline, which is a great place. It's 24-7 that you can call and is 1-833-TLC-MAMA. So there's Licensed Counselors Day. That's a good starting point too. If you find yourself 3 am and you're just like I'm not okay, I want to call and talk to someone. That's a great place you can turn to. Post. Farm Support International has a great provider direction.

Speaker 1: 32:16

Long years ago. That's how I found Whitney was through that, that she had that certification. We connected and started this wonderful journey together. What's really important, too, is we hope that you are being screened for depression and anxiety, not just in postpartum but through pregnancy, so you again get comfortable with some of the questions. Because if you've never seen a depression screening or anxiety screening which majority of moms have not, because this is a generation that we don't have primary care, really our OB is and you really just see them if you're trying to get pregnant or not get pregnant, so you need to get familiarized with screening.

Speaker 1: 32:52

So if your provider's not screening, a great way to say is like I want to talk about what we can do to screen me for my risk factors or for depression or for anxiety. I want to know my baseline and kind of use that as a talking point. You can also find those free online the Edinburgh Postpartum Depression Scale or the PHQ-9 or GAD-7. Those are all kind of different ones. If you're curious yourself and you're like I would like just to see these questions, you can look those up. But May is Maternal Mental Health Awareness Month, is the most common complication of pregnancy, so we have to be talking about it. We have to be open about it. We have to be supportive about it.

Speaker 2: 33:27

Absolutely. And, mamas, you're not alone. You're not alone. More moms experience this than what I think. Even the data tells us.

Speaker 1: 33:35

Exactly, and I always say you know, people ask what I do and start sharing. More times than not it's themselves or someone they've known who's experienced it, and it really does take that one person to start the conversation. So if it's not you, but you know someone who's pregnant or postpartum, be that person that they can be a safe place and check into.

Speaker 2: 33:54

Absolutely.

Speaker 1: 33:55

Okay, guys, thank you so much. We really appreciate it. Again, anything we touched on dive back in. We have over hundreds of episodes at this point that you can go back and see what resonates with you, what makes sense, that you want to learn more, and if you ever want to hear something specific, you can message us on Instagram and let us know. But, whitney, we'll be back next time. Sounds good. Bye, guys.

Speaker 3: 34:20

Maternal mental health is as important as physical health. The Preview 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.