Perinatal

Waves

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Waves and its synonym “curve” have been used many times as we all have tried to understand this “novel” coronavirus, its impact on the world, and our influence, yet lack of control, over so much now. 

We were introduced to the concept of “flatten the curve” as “social distancing” and “shelter at home” were explained: the curve, or wave, reflecting the numbers of severe illnesses likely to lead to unnecessary deaths from an overwhelmed healthcare system.

Then, we were informed that we could expect future “waves” in which the numbers increase again when “shelter at home” guidelines relax. 

There are many calculations about how high, wide and far apart these waves will occur, reflecting how many will become ill, how long the higher infection rate will occur, and how many months before the next sharp increase of infections, and finally, “How long will this go on?”. 

There are other waves, less discussed and yet so powerful: waves that knock you over, toss you, and threaten to pull you under. I want to share some of these waves that I and other mental health professionals experience, and hope to inspire hope that together we can learn to ride the waves, or at least to float, until they pass over.

In January my husband and I took the trip of a lifetime to celebrate his milestone birthday. As we waited for a connection the news reported a new virus spreading in China; excited for our trip, we barely thought about it. Returning two weeks later, I noticed a sign at customs indicating those traveling from China would be directed elsewhere-again, just a notice, not a worry.  Upon our return, we immediately were immersed in the many details of moving our group practice for a March 1 move, “7 minutes” away, yet, after 28 years, a major move.  We didn’t notice any threat of the approaching storm which would create waves upon waves, upon waves.

We moved, and a week later learned that the number of COVID-19 cases were increasing exponentially in New York. Small waves of concern swept through my patients, but I and most of them were comforted with the “this has the same infection rate as the flu” and “it doesn’t affect children” and “only the very elderly and compromised become seriously ill”.

Then, larger waves of recognition as New York health systems struggled with managing the ill and we first heard of “sheltering at home” as a solution to save lives. In less than two weeks the storm was upon us as in rapid succession schools shut down and a series of executive orders shut down most business and activity in the state. We were “battening the hatches” and very afraid. 

Waves of fear: how will I meet my clients’ needs? Will my clients, my children, my parents be safe? Will I be safe? How will my clients deliver their babies safely, and how can they be assured their families are safe from infection? 

Waves of confusion: How can I practice-what is the safest, most private platforms for Telehealth, and how do I use them? Will Telehealth be adequate when subtle communication is so important in psychotherapy?  Will insurance really pay as promised? 

Waves of grief: For the loss of life, for the loss of a sense of security, for the loss of freedom to go where I need/want, for the loss of connection with friends, for the loss of hugs and kisses, for the loss of community celebrations and for the loss of community memorials.

Waves of sadness: As my loving children tell me one by one they will not be able to visit out of fear that I will lose my life and they will be left without me. As my healthcare clients share their terror that they will bring home the virus to their children or their parents. As I learn of unintentional infections, transmissions, and guilt of survivor transmitters.

Waves of compassion: As I plot out with clients back up plans for the delivery of their babies and for the care of their other children. As I help parents manage the incredible juggle of working remotely from home while caring for their babies, toddlers and home-schooling older children.

Sometimes the waves subside, and I experience a few days, even a week or so, in which the intensity is lower, and I feel strong, competent, and able to navigate these rough waters, even very briefly, to rise above them. And then another wave comes, and I feel like I am drowning, completely overwhelmed.

Sometimes the wave comes from within, sometimes from a particularly traumatic or sad session with a client, and sometimes from my life partner, since we are literally in the same boat, riding this out together. The ever-present undertow of profound knowledge of our utter lack of control threatens to pull us under, into indulging in self-destructive coping strategies for intense feelings of fear, sadness, anger, irritability, and depression. 

In between the intense waves it is much easier to practice what I preach: to practice self-care habits-filling my pitcher so I can pour into others’ cups. I have been best about the habit of meditating, fairly good at nutrition, (with the exception of too much ice cream!) and OK at exercising and getting outside. I know I have to be better than “OK” with the exercise, my ability to be pain-free and healthy depends upon it; so I work to increase my steps. Breath practice helps between clients as well as in the middle of the waves.  I have found great satisfaction and joy with being outside gardening, and connecting with friends via zoom and socially distant walks have been tremendously restorative. I kept a gratitude journal after my twin sons’ births, and I think now is the time to use that tool again to maintain balance in the waves.

This is tremendously hard. Acknowledging and accepting this reality may be the most important tool you and I have. Because when we accept our reality rather than fight it, just as when we surrender and float on waves, we save our energy for where it can be used.

May you be healthy, happy, and at peace.

Sharon Thomason, Ph.d., PMH-C (Perinatal Mental Health Certified) is a Psychologist who delights in helping Moms and Dads grow their families with less stress and great joy!

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Climbing Mountains to Support Families of Connecticut

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By Amanda Salvo

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Amanda Salvo is a homemaker, mother of two beautiful children. She serves as a Volunteer Facilitator for the Adjustment to Baby Challenges Support Circle of Southington, is a member of PSI-CT and a member of the PSI-CT Support Group Committee.

On June 23rd I participated in my first fundraising climb-the “Climb Out of the Darkness” climb benefitting the Connecticut Chapter of Postpartum Support International (PSI-CT).  There were three climbs throughout the state that day, and one climb in Fairfield County was postponed until July 14th due to thunderstorms. From our climb at Talcott Mountain in Simsbury, we raised over $3,000 to raise awareness and support for families struggling to overcome perinatal mood and anxiety disorders (PMADs). While this may seem like a small amount, when it comes to battling a PMAD, any little amount helps.

I know, because I have needed help. As a new mom, five years ago I was diagnosed with postpartum depression following the birth of my first child. At the time it was not something that I wanted to admit. Trying to tackle it independent of help only made things harder. Admitting I was suffering at the time to me was like admitting defeat; and being sucked into a category of being “crazy”. When I finally came to terms with myself and sought help through therapy and a support group like those which PSI-CT works hard to develop, I was finally able to beat it. With help I was well.  I realized that my own fears too in tackling this obstacle were tackling social stigmas. The enormous mountain of expectations and social criticisms that accompany motherhood and parenting soon became surmountable.

For more than two years now I have been running free support groups as a volunteer facilitator to help moms through the challenges, the good and the hard. I want moms and families everywhere to know that postpartum depression is temporary, and it doesn’t happen with every pregnancy, and things do get better!

This climb was for me symbolic of the struggles we face as parents and those who suffer terribly from a PMAD.  The Simsbury hike was categorized by avid hikers as an “easy climb”. But when you start the trek on the yellow path to the tower at the top it starts as a relatively steep incline. Hiking with my husband, five- year old daughter and six-month old in carrier, we very soon stopped to catch our breaths.  My daughter claimed that she was tired when we only just began. The two of us commenting on the steepness, best footing to reduce slippage on rocks, and how we wished we were a little more fit or a little more prepared for the exertion (for again an “easy climb”), only paralleled the conversations of so many people we heard along the way, including our fellow hikers. The more we cheered each other on and encouraged each other to get to the top “just a little more to go, you can do it”, “when you get to the top you will see the tower,” “we’re almost there,” the easier it became.  It really became easier, and as the rain lightly cooled us we were able to stop along the way to take in the view.

The payoff at the top was a tour of a beautiful historic home, an open sky (albeit a little wet at the time); and knowing that as a family we had made it. Surrounded by others who shared in the journey feels like a success. Moms and dads, kids, families, friends and strangers all hiked together for one cause. It is much like a parent’s life. You’re never fully prepared for the obstacles that pregnancy, delivery and parenthood bring. You have days when you are at the bottom of a mountain and getting to the top seems impossible, or days when you scale it with ease. For those who suffer from a PMAD, know that there is a light at the top of your great big mountain, and we are with you every step of the way.

You can still donate! Click the links below to donate and support PSI-CT supporting Connecticut perinatal families!

DONATE This Year to the Simsbury Team 

DONATE to the Mystic Team

DONATE to the Fairfield Team

DONATE to the Mansfield Team

Come As You Are: What Happens In a Perinatal Support Group?

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Annie Keating-Scherer, LCSW is the Support Group Committee Chairwoman of PSI-CT and is the co-founder of the Adjustment to Baby Challenges Support Circle, formerly the Blue Mamas group, in West Hartford, CT. Annie maintains a private therapy practice in West Hartford and is the mother of two wonderful little girls.

“This is a judgement-free zone,” we tell the women as they settle into their chairs. “It’s ALL in here.”  The pregnant and postpartum mamas, understandably, often seem a bit nervous at the start of their first support group, unaware of what to make of this hour together. My co-facilitator and I try to put them at ease as quickly as possible, to know that this is a safe place, one with very few expectations or rules, and one where we hope moms can truly be themselves. We encourage every mama to simply “come as you are.”

Coming together  

Twice a month, our perinatal support group serves as a gathering place where moms come together to share. We invite moms to recount, “the good, the bad and the UGLY,” as they discuss their personal experiences around motherhood, and to receive respect and acknowledgment for their individual journeys. Moms joining this group may be going through depression and anxiety in pregnancy or the postpartum period.  They may be sleep-deprived, worn out, feeling stressed or unsupported.  They may have been referred by their therapists or seen a flyer at the OB or the local library. There is no one unique challenge shared by the women in this group. Nor is there a specific path that leads them to the group. Yet, through our diversity in thought and experience, we create a mutually supportive community that is open to all.  

My co-facilitator and I hope moms can put their inner-critics on hold for this hour, or at least a few minutes of the hour. There is no expectation that anyone arrives on time, or changes out of pajamas. We invite breastfeeding and bottle-feeding. We invite diaper changing, and we certainly invite crying babies (and mamas). The group is a place for moms who need to talk and for moms who would rather sit back and listen, and though we would love it if women showed up to every group, it’s also totally okay to drop-in once in a while.

Confidentiality

Truly, one of our only rules is that what happens in this room stays in this room. We take confidentiality seriously, knowing the vulnerability and bravery it takes to show up. Moms sign a simple contract at the start of their first group acknowledging that they will keep to themselves the names, identities and stories in the room.  We think of this hour together as sacred space.
Feeling Understood: Someone else has been there!

It can feel so good to not feel alone. Motherhood can be a very isolating experience, whether being home alone with a baby, or around others but not feeling comfortable sharing true thoughts and feelings. One of the magical moments in a support group happens when a mom is talking and we see nodding around the room, or the verbal acknowledgment of, “Yes! I have been there.” Whether a mom is struggling with depression, feeding issues, pregnancy after loss, or any other issue she is often met with someone in group who gets it. As a facilitator, I see a weight lifting in these moments of solidarity.

Helping Others Helps Us

While group members are encouraged not to tell other moms what to do, or give outright advice (as we get enough “advice” outside of group), we do share what works for us individually. As a group member, it can feel downright awesome to tell another struggling mom that some form of self-care helped you feel better, or that you struggled and got through a similar challenge. I love watching a mom come back week-after-week and growing in her own self-confidence in motherhood. Perhaps in her first group she felt she was only able to receive support, but as time goes on, she is recognizing that she’s helping others through her own growth and healing.

Finding the Light

It may seem counterintuitive, but we laugh a lot.  Motherhood is hard but also hilarious. Hardly a group goes by that there isn’t an eruption of laughter over some shared baby or pregnancy moment.

It’s more-than-okay if a mom can’t get to laughter, though. It’s okay if she hasn’t smiled in a while. We welcome her no matter what. We want the group to be a safe place to land during the upheaval and identity changes that equal motherhood. Our group offers a time to slowly start to feel oneself again. It’s an honor to be part of that journey.

 

 

 

Sleep? With a new baby?! Protected Sleep as an aspect of self-care

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Cory Bernard, LCSW, is a mom of two boys, aged 2 and 7.
She has worked in psychiatric social work for 12 years.  
And currently has a private practice in Bloomfield, CT with a specialty working with women during pregnancy, postpartum, and when experiencing the loss of a baby or during other life transitions. Cory is a founding member of PSI-CT Chapter and currently serves as the Treasurer as well as the chair of Fundraising & Events and Membership Committee, and as a member of the Resources and Professional Development Committee.

By Cory Bernard

Prioritizing good sleep is good self love.

What is protected sleep?

Sleep is important to all humans; it’s one of our primary sources of energy. Sleep deprivation will affect all other areas of functioning . . . physical, mental and emotional.  Uninterrupted sleep is essential to the recovery of a new mom or dad, particularly if they are suffering from postpartum depression, anxiety or other mood disorder. This is not to say that sleep alone will “cure” their emotional distress, but it can be key in helping them on the road to recovery. Being well rested will improve their ability to think clearly, analyze rationally and make decisions. When these abilities are negatively affected by lack of sleep, feelings of confusion, frustration, sadness, anxiousness and guilt can follow, further complicating the situation.

 

Protected sleep is a term that refers to the idea that the person (often but not always the mom) suffering from emotional dysregulation gets uninterrupted sleep. Her sleep time is “protected” in any number of ways by both herself and those around her. The following information, guidelines and suggestions refer to ideal situations. Even if ideal cannot be reached, any improvement in a mother’s sleep will be helpful in regulating her emotions, functioning and care for herself and her child(ren).

I sleep when the baby sleeps, isn’t that good enough?

While sleeping when the baby sleeps is what we are taught to do, and sometimes babies are good sleepers so this might be enough for a mom, often it is just not enough. Many babies sleep in 1-4 hour windows which means mom is getting less time than that per opportunity to sleep. This is barely enough for a nap, never mind full, rejuvenating sleep cycles. Also, frequently mothers have other obligations (self-imposed or otherwise) which they attend to when the baby does sleep for longer. These can include caring for older children, cooking, cleaning or working. The goal is for mothers to get at least 5 hours (more if/when possible) of uninterrupted sleep. This does not include time needed to get ready to go to bed or fall asleep, it only applies to time asleep.

How am I supposed to do THAT?

A common question when the discussion of protected sleep comes up. The answer takes a team effort, consistency and practice. A mom may not sleep as long as hoped the first several times. Perhaps she is having anxiety about the changes being made or her body is adjusting to being “allowed” to sleep. Even in these early attempts, having quiet rest time is beneficial to mom. Here are the basics on protected sleep, some tips and other ideas…

First, protected sleep means the mom is “off duty”…completely. This means she does not have other expectations or obligations, and there is another trusted adult who is responsible for the baby and other children during the protected sleep time. Preferably protected sleep will happen at night to maintain regular sleep cycles but, particularly when baby is young, this may be difficult. If daytime is the only time someone can be available, take it! Even getting a full night “off” once a week can really help.

The baby’s other parent is often the “go to” when looking for someone to care for baby/children during mom’s protected sleep time. But what if that person is not available? Sometimes there is no partner or the partner works nights.

  • If partner works nights, have a conversation about how mom can get protected sleep time during the day when they are there and awake.
  • Try another family member such as a sibling of mom or partner, parent, cousin, or a friend you trust. Anyone can have their sleep interrupted for a night. It’s not as much of an imposition as you would be inclined to think. Remember, they don’t sleep in your house with a new born every night so being there once a week or a couple nights in a row will not cause them the distress that your lack of sleep is causing you. If they can not spend the night, enlist their help during the day to get some sleep.
  • Not everyone has friends or family in the area. In these cases, partner may be the only option and there may need to be a conversation about both of you losing “some” sleep.
  • Hire a postpartum doula, night nurse or babysitter. If you have the means, this can be a wonderful resource when it comes to sleep.

***Be sure whoever is caring for baby has questions answered and a resource other than mom to contact if something comes up. This prevents mom being woken with questions during her sleep time.

Second, when protected sleep time comes, prepare for sleep. Some people are very deep sleepers and once they fall asleep, noise won’t bother them, but this is not the norm for new moms. Put your phone away in another room, take a shower or relaxing bath, drink some calming tea, listen to calm music or a guided sleep meditation (consult with doctor before doing meditation), journal or use other methods to calm and empty your mind to prepare it for sleep. None of this may be necessary if you are exhausted but it’s good to establish a sleep routine if needed.

In order to “protect” sleep time, put as much space and buffer between you and baby as possible.

  • Close doors (as many as are between you and baby)
  • Sleep on a different floor if possible (basement rooms are particularly good for insulating noise)
  • Put on an air conditioner, fan or other “white noise” machine
  • Put on soft music, spoken word (mundane book or podcast) either out loud in the room or through headphones if you can sleep with them.
  • Use earplugs

Since space is a luxury not everyone has, you can also remove baby from the home in order to create the buffer.

  • Have a trusted adult take baby out of the house completely (even if it is just in the yard). They can go to the library, a playground or a long walk. Once you have had time to fall asleep they may be able to come home put baby down for a nap, read books or play quietly if you are a deep sleeper or have some buffer abilities. Try to protect sleep for as long as possible.

But I’m breastfeeding….

One of the most common concerns or roadblocks to consecutive sleep is a breastfeeding mom. While it may be particularly difficult to fit in protected sleep in early weeks, it will become easier as baby feeds less often. There are also ways to work around breastfeeding to limit the amount of time mom is awake.

  • You may not be able to get “uninterrupted sleep” but you can still protect your sleep by asking your partner to change the baby before bringing her in for feeding and then to take baby back out of the room to rock and put back to sleep right after feeding. As baby gets bigger and feeds less, you will get more protected sleep.
  • You can also prepare a bottle for one feeding a night and just wake up, pump and go back to sleep. Keep a cooler in the bedroom to store the milk or ask you partner to come in when up with the baby to get the milk and put it in the fridge/freezer.

While all of this may seem like more work, in the end, it pays off and you will get into a routine. Remember: The ultimate goal is to stay in bed, asleep as many hours as possible (within reason) to give your brain and body time to rejuvenate, refresh and recover. 😊

 

  “I Didn’t Think it was THAT bad”:  Seeking Help from a Therapist

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Sharon
Sharon Thomason, Ph.D. is a founder of PSI-CT and has served as the PSI-CT President, chair of the Communications Committee and continues to serve families of Connecticut as a member of the Communications Committee and perinatal Psychologist. She specializes in Perinatal challenges and grief.

“I didn’t think it was THAT bad!” is a statement I’ve heard in many permutations from so many moms when they explain why they didn’t seek therapy sooner. Often they have waited until it is REALLY bad. Other times they have have sought treatment during the second pregnancy, because during the first pregnancy they had not sought treatment for Postpartum Depression and Anxiety and they do not want to suffer again.

I am often curious what is meant by “THAT bad.”   When we explore it, sometimes it means that what they’ve heard about postpartum/perinatal depression is that “moms who have it don’t feel bonded to their babies” or “moms who have it try to harm their babies or themselves.” Sometimes “THAT bad” means they believe only very ill people go for therapy/counseling or that only “weak” people go, or only those who don’t have enough faith in God need this kind of help.

Many reasons exist for avoiding and delaying help from a therapist: it is hard to take the step to meet with a total stranger and acknowledge, “I’m struggling.” It takes courage to expose our vulnerability, to share our inner world, and to claim the time, space, and cost to seek professional help. It takes energy to make the calls, find the therapist with an opening, make the appointment, find a babysitter or negotiate with partners regarding childcare for older children, negotiate with employers for time off from work. It costs money, at a time when money is often short. It can be overwhelming. So often the thought “well, it’s not THAT bad” just seems the easier way to go.

Seeking professional help does cost time, money, and energy. Seeking help often means receiving “push back” from others who have the resistances described above. These barriers often make it even harder to dig deep for the courage to do what needs to be done: make the call. Don’t wait until it is “THAT” bad.

The old adage “an ounce of prevention is worth a pound of cure” is the theme here. What is often not known is that with help, perinatal anxiety and depression often resolves very quickly! If you don’t feel like yourself, or if the thought arises that “Maybe I have postpartum depression”, then seek help.  If you experience any of the following or ANY other symptom that worries you, please seek help.

  • Feel frightened
  • Feel “wired”
  • Can’t sleep
  • Crying a lot
  • Having scary thoughts that just pop into your head (a sign of perinatal Obsessive Compulsive Disorder, not a sign that you want your thought to happen)
  • Are irritable and “snap” at others
  • Feel down
  • Don’t have energy or motivation to do much
  • Don’t enjoy what you used to enjoy

Sometimes one or two consultations with a perinatal specialist will be sufficient to determine an individualized plan for your recovery. In addition to possible continued individual sessions, a plan may include free support groups, family consultations, a plan for additional practical support and other recommendations to help you feel better as quickly as possible. Seek help as soon as the question arises in your own mind, or others raise it. Sometimes others see cause for concern before we can see it in ourselves.

Your wellbeing is important for you and for your family. Many studies show that perinatal anxiety and depression can have negative effects on the baby as well as the mother. When considering this decision to seek help, remember that this time with your baby and your family is, like the popular commercial says, “priceless”.

Postpartum Support International-Connecticut Chapter is here to help you find the support you need. Go to our website for free support groups and resources, and join us to spread the word that there is no shame in seeking help. Help sought at the right time will benefit not only moms and dads but will benefit our babies, our families, and our future.