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Last week my colleage Marisol and I attended a two day training called Perinatal Mood Disorders: Components of Care. The training was led by four professionals including  Birdie Gunyon Meyer and Pec Indman, whom are both well-established experts in the field, and who are also on the Board of Directors at  Postpartum Support International.

During the training, the facilitators discussed the role that perfectionism, and the myths that we all believe before becoming mothers play in contributing to Perinatal Mood and Anxiety Disorders.  Naturally, this discussion led to the topic of mothers who return to work  vs. stay-at-home moms. I found this topic to be of great interest, because it is highly relevant to our client population. This particular topic creates a great deal of stress for the women we serve in our program, because A) Even if they wanted to, many of our participants would be unable to return to work after birth of a new child (due to financial restrictions and role expectations), and B) What constitutes “Work” is often hotly debated among our clients and their spouses.

In my opinion, one of the main factors that contributes to the development of depression and anxiety in many of our clients is that they have an overwhelming un-met need for free time away from their children and household duties. Many are not granted any opportunities to be away from their kids because they “don’t work,” and their spouses wrongly assume that they don’t need (and perhaps don’t deserve any) time away from their children.

I have often found myself in discussions with both men and women (usually those who have never cared for children for long periods of time) who assume that being a stay-at-home mother (SAHM) is a very joyful time filled with fun and relaxation. Having been a live-in nanny in a former life I firmly believe that caring for children is the most demanding, exausting, and difficult work I have ever done. And when I think about tripling the work I did (since I was only working with the kids 1/3 of a 24-hour period) it sincerely makes my head spin.

Raising children is an unfathomably difficult task. The thing that SAHM critics don’t understand is that your shift never ends. You never clock out at the end of the day. You don’t get paid. You don’t get sick days or vacation. And, what hurts the most is that (if you’re like many of our participants) you probably don’t even get an hour a day to grab a cup of coffee or chat with one of your adult friends. You might not even have 30 minutes to take a shower.

Imagine this: You wake up at 5am to one of your young children crying, and you must respond because it’s your job. You’ve only just fallen asleep at 3am because you had to feed your baby. Your entire day starts in that moment. You have no guarantee that you will sleep more than 3 hours the following night. Your energy reserves are already beyond depleted because you have been doing this routine (without a break, not even on weekends) for five or more years. Every single one of your days consists of grooming,  dressing, feeding, soothing, entertaining, transporting, disciplining, teaching, nurturing and guiding your children. If you turn your back for more than 5 minutes at a time, your children could easily hurt themselves or one another, or undo the cleaning you just completed, or break something, or eat something they shouldn’t. Not only must you be vigilant of the children’s whereabouts and wellbeing at every moment, but you’re also responsible for cooking, cleaning, laundry, grocery shopping, etc. All of this, and your spouse gets home at the end of the work day, asks for dinner, watches some TV, and goes off to bed. If you ask your spouse for help, he or she might say, “I’ve been at work all day. You’ve been with the kids relaxing around the house. I make the money and you get to stay home, so no, I won’t help you. This is my time off.”

What about your time off? In the eyes of those who don’t understand, you simply don’t get to have any. But as a human being, you still have basic physiological needs for adequate sleep and relaxation. You still need to indulge yourself in activities that fulfill yourself as an individual. And you still have emotional needs to feel understood, to have time to connect with other adults, and most importantly to have your partner value your hard work enough to know that you deserve time to dedicate your beautiful, hard-working self.

This discussion reminded me of a very clever article I saw making the rounds on facebook a couple of years ago. It was an advice column titled, “TELL ME ABOUT IT: Why Don’t Friends with Kids Have Time?” An anonymous writer asks the columnist why her friends who work as stay-at-home moms don’t have time to call her, and whether being a stay-at-home mom is “an excuse to relax and enjoy.” The columnist’s response is so spot-on it’s unbelievable. You can read the full article below. And if you know someone who doesn’t understand how hard the job of a stay-at-home mom is, share this with them!

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In 2009, Postpartum Support International conducted a study that examined the incidence of Perinatal Mood Disorders among Latina women. The study found that around 32% of pregnant Latinas experience depressive symptoms congruent with PPMD, while 36% of pregnant Mexican females experience PPMD symptoms. This shocking number is nearly double the percentage of the general female population diagnosed with PPMD.

Statistical data in the PPMD field has clearly shown that a woman’s race or ethnicity does not determine whether she is more likely to get PPMD. Women of every race or ethnicity are equally at risk. So how is it that such a specific group has a much higher incidence rate of PPMD?

In order to understand how this is possible, we have to look at known risk factors for developing Perinatal Mood and Anxiety Disorders. According to Karen Kleiman, author of Therapy and The Postpartum Woman, risk factors include (but are not limited to):

1. Sensitivity to hormonal changes (History of significant PMS)
2. Hormonal Imbalance
3. Sleep Deprivation
4. Family History of Depression
5. Perfectionistic Personality Type (“control freak”)
6. Previous History of Anxiety or Depression (or Bipolar, OCD, etc.)
7. Obstetrical Complications
8. An unsupportive spouse
9. History of Trauma
10. Moving to a new location
11. Job change or loss
12. Socioeconomic Stressors
13. Lack of adequate support system (family and friends)

As a clinician who works with mostly Latina women, I am very much aware that risk factors numbers 8-13 on the above list are particularly prevalent among Latinas (though the others are often involved). Cultural implications unique to Hispanic families may contribute to the presence of these risk factors (such as traditional roles and expectations among men and women in marriage), as well as dynamics introduced during immigration: Immigration trauma, adaptation to foreign customs and a new language, employment and economic challenges, and barriers to accessing social and medical support. These are all elements that can be prevalent among Latinas, and can greatly increase a woman’s risk of developing PPMD.

What can we do to improve social support among Latinas with PPMD?

Since we know that social support and access to resources are important in combatting PPMD, we at HAS believe that one way to address these issues is to focus on increasing social connectivity and access to vital resources. Therefore, the PPD Program at HAS offers drop-in group therapy, which is particularly helpful to women who lack support at home. These groups offer opportunities for our participants to come together and share their experiences while developing bonds with others, and gaining information regarding helpful resources in the community. We currently offer both English and Spanish groups. If you, or someone you know would benefit from attending groups at the HAS PPD program, please call 773-292-4242.

Anyone who has had a Perinatal Mood or Anxiety Disorder knows that the symptoms of these illnesses affect not only the person suffering from them, but also those nearest and dearest to the afflicted (including children, parents, and spouses). Many women who have experienced PPMD say that one of the greatest challenges of PPMD is the way in which their daily symptoms impact their relationship with their husband or partner.  On the flipside, it is also important to acknowledge that a spouse’s abusive attitude and behavior can increase a woman’s chances of even developing PPMD by 40%.

The Postpartum Stress Center is currently conducting exciting and much-needed  research on the effects of PPMD on relationships. If you have had PPMD, you can participate in this research by filling out this questionnaire.

Thank you!

If I had a dime for every postpartum woman whose worries, fears, and obsessions center primarily around whether she’s mothering “the right way” I would have enough money to buy a copy of this book  for each and every one of them.

But it’s certainly not hard to figure our where women’s feelings of inadequacy and confusion surrounding their role as Mother stem from. Just look at the mixed messages on these popular magazine covers:

I do not intend to say that these magazines are bad. In fact, I personally read them on a fairly regular basis. But when reading (and just looking at the images) I often think some of the content could be curious and confusing—perhaps even threatening to new moms.What stands out most is the way the women look: All gorgeous. All thin. All dressed fashionably. All of their babies are adorable and well-dressed. And words like: Gorgeous, Secure, Perfect, Good, Values, Best, Easy, and Favorite are all over the covers. Although I don’t yet have children, I’ll admit I’m often seduced by the notion that if I follow the advice in these magazines, in the future I will have the perfect pregnancy, birth, baby, and early parenting years. I know I’m not the only one who feels that way.But it’s not just flashy magazine covers, or even the articles inside that might make mothers feel inadequate or confused. Some of the most popular pregnancy and parenting books send messages to women that discourage (and even shame) them from making decisions that don’t follow the status quo.For example, here is a sentence from one of today’s most popular parenting books:“WARNING: If your child does not learn to sleep well, he may become an incurable adult insomniac, chronically disabled from sleepiness and dependent on sleeping pills.”- From Healthy Sleep Habits, Happy Child, by Marc Weissbluth, M.D.When I first read that line, I laughed out loud because I thought Dr. Weissbluth was making a joke. But to my dismay, I quickly realized that he wasn’t. If you’re familiar with Dr. Weissbluth, you know he is a huge believer in the cry-it-out method of sleep training for infants. While I certainly hold no judgment against people who choose this method of sleep for their child (everyone’s family needs are different), I think the above statement is clearly meant to emotionally manipulate new mothers into adhering to his method. All new moms just want what’s best for their children, right? So they are extremely vulnerable to the suggestions of the experts. And the experts do not often agree on what’s best for new babies.So what is really best?Women have asked me this question literally hundreds (maybe thousands) of times.Before I became a therapist in the PPD program at HAS, I spent 4 years working as a labor support and postpartum Doula. I worked with almost 100 different families in their own homes. I cared for upwards of 60 newborns, including 14 sets of twins. So, while I don’t have my own children (and certainly do not pretend to know what that’s like!) I do know about newborn and infant development, the most “popular” parenting methods, and the most significant controversies regarding what is really best for a newborn.Most new mothers quickly find out (the hard way) that they will be judged (by friends and family) for the decisions they make regarding breastfeeding or formula feeding, co-sleeping or crib sleeping, attachment parenting, bonding, childcare, and even the way they bathe or clothe their children.The overall message new mothers receive from books, magazines, and even well-meaning friends and family members is “You’re doing it wrong. I know how to do it better. If you don’t do it my way, you’re going to screw up your kid. And that means you’re a bad mother.”So what is really, truly best?I say this to every new mother I talk to: What’s best for you and your baby is going to be very different from what’s best for someone else and their baby. You may have wanted to breastfeed, and it didn’t work for you either because it was too difficult or you quickly realized you didn’t want to do it. You may have thought you wanted to be a stay-at-home mom and realized that you wanted to go back to work after 12 weeks. You may have ignored your family’s opinions about co-sleeping and chose to do it anyway. You may have longed to co-sleep but chose to put your baby in a crib because of your overwhelming fears for your child’s safety.There is no right way. I really and truly believe that.As long as your baby is safe, fed, nurtured, and happy, there is no wrong way to parent. You are the only person who knows what is right for you and your child.You can pick and choose what you like from each and every method, and throw out what doesn’t resonate for you. It’s your choice, you’re the mom!–By Melina Mejia Stock

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In my work as a program therapist in the Postpartum Depression program at HAS, and also in my former life as a Labor Support and Postpartum Doula, I have often heard mothers (with and without PPMD) say that the first weeks of life with a new baby are very much like having your entire world turned on its head.

In particular, new mothers feel as though their entire identity has changed. Every woman struggles–to some extent–with the process of redefining themselves after becoming “someone’s mommy.” Because, before becoming someone’s mommy, maybe you had a full-time job you loved. Maybe you worked at Target, and maybe you were a lawyer. Maybe you attended a book club. Maybe you spent a lot of time with your family. Maybe you were someone who liked to bake all Sunday. Or maybe you were a singer, an artist, or a basketball player. But you were probably someone who went places. And most importantly, you had a life that was characterized by choices that were entirely yours.

Now, you smell like sour milk. You haven’t showered in days. You haven’t checked your email. You miss work, and you miss your friends. Your life doesn’t resemble the life you had last month, or last year. There are almost no traces of the person you were, and you fear that you’ll never be able to go back to “the way things were.”

The notion that you have changed forever is haunting to some women. And perhaps this contributes to Perinatal Mood and Anxiety disorders for some women. I’ll let you in on a little secret—many new mothers have intermittent fears that having a child may have been a mistake. If you feel that way, you have to know that there is nothing wrong with feeling that way, and you are certainly not alone. And this doesn’t mean you’re a bad mother, and it doesn’t mean you don’t love your child. It just means that your whole life has changed dramatically, and (naturally!) you’re having an emotional reaction!

If you’re feeling depressed about the changes in your lifestyle, your role, and your identity, please know that while your life has indeed been significantly changed by having a child, you WILL learn to integrate your former self into the equation. You will find a balance that feels manageable and healthy for you. Don’t lose hope, and know that you’re not alone, and as always, be sure to seek help if you’re worried about how you feel. Call the HAS PPD program at 773-292-4242 for more information.

For more information on PPMD and your new identity, take a look at all of the wonderful blogs at www.postpartumprogress.org

Stay tuned for Part Two of this blog next week!

By Melina Mejia Stock

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When a woman is pregnant, people tend to nurture her and look out for her well-being more than usual. While some women do not like the extra attention, many welcome the additional support with open arms. Yet, when baby arrives, all the nurturing attention gets shifted onto the new baby, and the new mother’s needs often take a backseat. Newly postpartum mothers often describe going days without showering, eating a home-cooked meal, or having time to take a long, much needed nap.

It’s important to know that a mother whose needs aren’t met is a mother who can’t possibly put her best, most nurturing and balanced self forward. To provide the best care for baby, mother needs to be happy, well fed, well rested, and supported. This is not just her job, but the job of those who surround her—her partner, her family, and her friends.

Here are several things that should be high on the priority list for a new mother. If the new mother is struggling or experiencing signs of a mood disorder, it’s even more important for her loved ones to step up and ensure the following needs are being met:

1. Nurture the Nurturer: One great way to show your postpartum friend or family member that you’re there is to set up a meal-plan. Using a website like www.takethemameal.com allows you to invite friends and family to sign up to bring a hot meal to the family. Many women ask their friends and family to plan to provide 2 or more weeks of meal support while the new mom adjusts to her role. Remember to tell the people delivering the meals to avoid becoming “guests” at meal drop-off time. Many new families express frustration about feeling like they have to “entertain” friends and family who drop by. Be sure to drop the meal off, staying no longer than 30 minutes. And if you’re really inspired to help, wash any dishes in the sink and take out the garbage on the way out! These little things make a big difference to a new family adjusting to huge changes.

2. Sleep: Make sure that the new mom is getting lots of sleep. This means she’ll have to sleep when the baby sleeps, so pre-arrange with friends or family members to take over housekeeping duties. A new mother’s sleep is very important. If the new mom is having diffuculty sleeping, even when baby sleeps, have her talk to her doctor. Sleep loss in the postpartum period can become serious very quickly! Protect the new mom’s sleep time by allowing her to focus only on the baby and herself.

3. Eat Nutritiously: New mothers desperately need a steady stream of nutritious foods. All  of the physical changes she has been through can easily take their toll. She needs to eat healthfully and continuously, especially when breastfeeding. Keep her nightstand stocked with her favorite granola bars or other healthy snacks so she can fill her grumbling stomach at the 2 am feeding without having to get up. She’ll thank you for it!

4. Exercise: Be sure to get out every day for at least 15 minutes for a walk around the block. Take baby with you in a baby sling, but make sure she’s bundled up in the winter months! A little exercise is proven to support a stable mood and swift postpartum recovery.

By Melina Mejia Stock

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According to this article, depression and other mental health disorders affect an equal portion of both Latinos and whites. Research has shown that while up to 60 percent of non-Hispanic whites actively seek treatment when suffering from mental illness, only 36 percent of people of Hispanic descent will reach out for treatment when confronted with a mental illness.

Much like untreated diabetes or cancer, untreated mental illness is a medical condition that can have long-lasting physical, social, and emotional consequences that can greatly worsen over time. While mental illness (like any illness) is not the fault or choice of the sufferer, treatment is a powerful choice an individual can make to greatly improve their situation. In fact, research shows that between 70-90% of people suffering from depression and other mental illnesses improve significantly with a combination of treatments such as medication and/or psychotherapy.  So, why would anyone delay their recovery from a mental illness by avoiding treatment?

There are several serious barriers that exist within the Latino community. Perhaps the most important is the cultural stigma and misunderstanding that often surrounds mental health conditions among Latinos. There is a widely held belief that mental illness is the result of a being weak-willed or crazy, or is perhaps even the result of being spiritually possessed. While it is very important to be sensitive to cultural and spiritual beliefs, it is still important to recognize that science shows us that mental illness is caused by factors that are out of the control of those afflicted. While willpower and folk-healing (such as that provided by espiritualistas) may be an important part of recovery for many, we know that these approaches alone cannot restore imbalances of brain chemistry or integrate traumatic memory. Skilled professionals who have been trained in modern treatment modalities are a vital part of recovery for anyone suffering from mental illness, regardless of cultural or spiritual background. The best treatment for any individual is one that incorporates the support of their social and family group, spiritual community, cultural beliefs, and high quality therapeutic treatment modalities that are medically proven to help.

If you are in need of counseling and/or a mental health evaluation, please visit the Community Counseling Centers of Chicago (C4) website at http://www.c4chicago.org/ or call them at 773-769-0205.

If your needs are related to a Perinatal Mood Disorder, please call HAS at 773-292-4242 to schedule an evaluation today. You will be treated by one of our compassionate, caring and non-judgmental therapists whose main concern is your wellbeing.

By Melina Mejia Stock

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Qualifications:

Must have a high school diploma or its equivalent.

Must have excellent organizational skills.

Candidates must have very good verbal and written skills.

Proficiency in computer skills (Microsoft Office).

Must be willing to work from 9:00 am to 12:00 pm Monday through Friday

Responsibilities:

Answering all internal and external phone calls.

Must greet employees, visitors and participants with a positive friendly manner.

Receives and distributes all incoming faxed documents.

Must assist with general office work.

Bilingual (English/Spanish).

Interested candidates should forward resume with letter of interest to:

Matthew J. Hayes or Ruth Mendoza

HR Department