Postpartum Depression: What You & Your Doctor Should Know



PP Depression: It’s been around for a while.

New guidelines calling for pregnant women and women who recently gave birth to be screened for postpartum depression came out this week. Well it’s about time, I thought.

Honestly, I’m a bit confused that the frequency of postpartum depression is presented by the media as some kind of revelation. For ages it’s been known that the majority of new mothers report lowered mood after giving birth. The majority! Back in 2009, when I wrote “Bad Mommy! The Baby Blues & Postpartum Depression,” the Mayo Clinic reported as many as 80% of mothers said they experienced the baby blues and that postpartum depression occurred in 10-20% of women after giving birth. Today it’s like, Wow! a whole new finding that “one in eight and as many as one in five women” develop symptoms of postpartum depression. Which, btw, translates to 10-20%.

Whatever! When it comes to women’s health the sands of awareness and change are slow indeed! At least in this case we are going in the right direction.

“Depression is among the leading causes of disability in persons fifteen years and older. It affects individuals, families, businesses, and society and is common in patients seeking care in the primary care setting. Depression is also common in postpartum and pregnant women and affects not only the woman but her child as well.

The preamble to the latest recommendation statement from the U.S. Preventive Services Task Force is clear. It would be a good thing for medical professions who care for women to know about postpartum depression and make an assessment for it part of their routine exam.

Please, medical professionals, get some training in how to do this from a behavioral health professional! Sensitivity is just as important as a valid screening tool. Women may be reluctant to report their lowered mood because she ‘should be happy’ about her new baby. Anything less would be failure.

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When Snowmageddon Comes, Be At Home



Buffalo, NY Dec 2001. Courtesy of Mikail A.M. Flickr

Buffalo, NY Dec 2001. Courtesy of Mikail A.M. Flickr

My plans to go to NYC this weekend were caboshed by Jonas. The aspect of snow itself didn’t bother me. The City is beautiful in the snow, hushed and glistening. But the thought of being stuck at an airport all weekend waiting for a flight that never came was too much. I hardly had to bother canceling, the City decided to shut down all by itself.

My colleagues on the Eastern Seaboard, bracing for the blizzard of 2016, said, “You should be used to this,” as if two feet of snow is like a bad smell. No, you don’t necessarily get used to it, but you do learn not to fight it. Some of us even learn to enjoy the forced time off. Dolce far niente!

In Case of Blizzard, Do Nothing, by former Buffalonian David Dudley, says it very well:

“There’s something cartoonish about the menace of a blizzard, in which nature’s wrath assumes a fluffy, roly-poly form and tries to kill you. It’s the meteorological equivalent of getting smothered in Tribbles, or attacked by the Stay-Puft Marshmallow Man. And yet, kill it does, via car accidents and heart attacks and other misadventures, usually involving people trying, unwisely, to do something.”

So to my friends downstate, hunker down, make yourself some popcorn, a hot chocolate or well-laced Irish coffee, and read the whole article. What else do you have to do today?

9 Ways To Help Teen Girls Find Their Voice



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Whoever said being a 14 year old girl is easy probably hasn’t been a 14 year old girl!  The struggle she has to go through to find her True Self and still be accepted can cause many a teen girl to lose her voice.

The article How Can We Help Young Girls Stay Assertive, describes research on adolescent girls “losing their voice” resulting in low self-esteem and lack of assertiveness. This phenomenon can cause teen girls to feel like they don’t belong, leading to isolation, even self-harming thoughts and/or behaviors.

Anyone who is a parent of a teen girl, a counselor or teacher accepts the job to help them feel more secure and to speak up for themselves! Here are some suggestions to help. The first five are from the article. The last four are from my work with teen girls:

1. Encourage her interests. Support her in her pursuits, whatever they are.  Linda Hoke-Sinex, Indiana University Bloomington, says, “When she [the teen] has an area in which she feels confident, it can act as a touchstone to build confidence in other areas of her life.”

2. Point out pressure from social media. Unrealistic media images and the pressure on women to look and act in certain ways is constantly in young people’s faces. Girls may be subject to brutal criticism or bullying on social media because of how they look or act. Unless parents monitor interactions on social media they might miss communication that contributes to corrosive self-doubt.

3. Watch your own talk. Dr. Mendez-Baldwin of Manhattan College says, “Sometimes, women inadvertently send messages to their daughters by focusing on their weight and their appearance. [They say] ‘Oh I need to lose weight’ or ‘I don’t look good’ or ‘I need to get Botox to remove these wrinkles,’ and then that sends a message to the girls that they need to focus on their appearance and that their self-worth is connected to their appearance.”

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Happy Holidays!



 

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Wishing you and yours a joyous holiday season

and a New Year filled with

Peace, Love and Happiness!

Life, Love & Money



7027601297_5e90a918e2_zTo my great delight my friend Amy Jo Lauber, CFP® of Lauber Financial Planning, and I joined forces to co-write a bi-weekly column on the practical, spiritual and emotional challenges of personal finance. Here’s our inaugural article!

Dear Life, Love & Money: I’m so distracted by all of the terrible things going on in the world, how can I focus on money?

Amy Jo: I hear you, it is an enormous challenge to live for today while also being worried about what tomorrow may bring. Let us share some thoughts that may help you.

First, allow yourself some time to process and perhaps limit the information coming at you. Dr. Elvira Aletta recently tweeted “To the highly sensitive: it’s ok to turn off the tv, get off the websites, yes, even Twitter. Be kind to your heart & soul. #Paris”

Give yourself permission to experience the emotions that are a very real aspect of being human, and also give yourself permission to set them aside and move forward.

Dr. A: I agree with Amy Jo, taking a media break is an act of self-compassion, not avoidance…

To read the entire article click here!

Photo courtesy of Tax Credits

Happy Thanksgiving!



 

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Happy Thanksgiving, Everyone! And if you are cooking, baking or grilling today, try not to stress!

Remember this quote that is attributed to everyone

from Escoffier to Julia Child.

And as we gather our loved ones together,

remember those who are far away 

and those who have passed on.

May we be filled with peace, love and gratitude. 

Paris



 

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As our hearts break, we find hope in the good that is called up from the ashes. People who did not run away but stopped to hold the hand of the injured so in shock they couldn’t move, the cabbies who shut off their meters and transformed into ambulance drivers, the soccer fans singing Le Marseilles as they evacuated the stadium, people who opened up their homes to help the stranded.

“When I was a boy and I would see scary things in the news, my mother would say to me, ‘Look for the helpers: You will always find people who are helping.”

~Mr. Rogers

 

Seven Rules for Surviving an Abusive Boss



A few years ago I wrote this piece originally for PsychCentral. The message is still relevant today.

~***~

At the interview for my first professional job, my future boss asked me, “I notice you’re married. Are you planning to get pregnant?” After I picked my jaw off the floor I stammered, “Uh… no?”

It was a totally illegal question and the shocker was it came from a woman. What I should have done was run screaming for the nearest exit. But the job was offered, I took it and three years later I quit with a raging case of Post-Traumatic Boss Disorder.

Rule #1: How you are treated from ‘go’ is a good indicator of how you will be treated on the job. The first phone call, your interview, how an offer is made and how negotiations are handled…

My boss made me think I was her confidant. She gave me the plum jobs and ‘confided’ to me that everyone else was inferior. I was young, naive and, frankly, full of myself. For two years my feet hardly touched the ground.

It didn’t last. The Boss-zilla is a soul-sucking manipulator of narcissistic proportions. He hooks you in with compliments and seductive ‘let’s be friends’ invitations. First you are the golden child, held above all others and then he tears out your heart and shows it to you while it’s still pumping..… uh… Did I say that out loud?

Rule #2: Keep a healthy distance. You cannot be friends with your boss.

Into the third year, my work was bounced back to me bleeding red edits. My boss started calling me into her office for ‘feedback’ sessions that got more and more humiliating. How did I lose my touch? Answer: I didn’t. I was the same hard-working nerd I always was; it was my boss’s attitude toward me that had changed.

Rule #3: You are neither all good nor all bad.

My co-workers hated me. As long as I was the ‘good’ one I didn’t care. When things went south I couldn’t take being isolated anymore and I started talking with other staff. Generously they forgave me and shared their own horror stories of abuse from my boss. What an eye opener!

Rule #4: Keep open diplomacy among co-workers.

They don’t have to be your friends but you should be able to compare notes just like siblings do about their parents. Dysfunctional bosses often use the old divide and conquer game to keep staff malleable.

Once I realized it wasn’t me, that it was a sick, dysfunctional corporate culture that allowed my boss to be abusive, I had a decision to make. My moment of truth came when I realized I had become someone I didn’t recognize and didn’t like. Depressed, obsequious, timid, who was this person? I wanted my spirit back and the only way for me was to leave. So I quit. That sounds easy. It wasn’t. It took months to find a job that felt like a good move, not a big step backwards.

Rule #5: Learn to define yourself by who are, not what you do.

Or “Don’t forget to have a life.” A lot of us were raised to think our end-all and be-all is our occupation. The first thing we tend to ask each other after being introduced is, “So what do you do?” I’ve had clients, grown men miserable in their jobs, shrink from the idea of quitting primarily because they have no idea who they are without the job. Family and friends (my husband was great at this) help us remember we are parents, church and temple members, coaches, thinkers, readers, spouses, travelers, life adventurers and more. These roles are constant no matter what the job is.

Rule #6: Always remember you have options; quitting is only one of them.

If you think you don’t, you will become depressed, a burnt-out shadow of your former self. Find a psychologist, life coach or career counselor to help you regain the perspective you’ve lost in abusive boss hell.

I don’t know anyone who doesn’t have at least one Boss-zilla story. A power-mad night supervisor at Taco Bell or a VP at a Fortune 500 company, it’s all the same. Post-traumatic Boss Disorder (PTBD) is no joke. It took me a good year to stop shaking every time my new boss asked me to his office for a conference.

Rule #7: Living well is the best revenge.

Giving notice to Boss-zilla was as bad as I thought it was going to be. She called me ungrateful; I was told my poor performance would follow me wherever I went. What kept me calm throughout her tantrum was knowing my new job was at a very prestigious institution, which had to be killing her. She didn’t need to know there was no salary increase.

PTBD struck again many years later. Older and wiser, I recognized the signs early and took action quicker than before. From then on I’ve been self-employed. Today I’m happy to say my boss is usually pretty reasonable.

Originally published on PsychCentral

Hello Invisible Illness Awareness Week 2015!



Screenshot 2015-09-28 10.10.29If you’ve ever heard anyone say, “You don’t look sick,” while you are battling the pain and fear of a chronic illness you know what Invisible Illness means. September 28th through October 4th is one week in the year specifically focusing on the challenges of having a serious condition that no one easily sees.

Check out the wonderful Invisible Illness Week website for a treasure chest of resources, inspiring, useful and commiserating. Pass it on to friends and family!

And you’ve got to see this, too, What You Say To Someone With Chronic Pain And What They Hear, by Lara Parker and Charlotte Gomez on Buzzfeed. It’s funny and dismayingly accurate at the same time.

Related Post: 10 Things To Say To A Sick Friend

Mental Health Diagnoses & the ICD-10



October 1 looms large for us mental health and medical professionals in the US. From that date on we’re required to switch from using the DSM V or ICD-9 codes for illness to the International Codes for Disease tenth edition (ICD-10 for short).

This is already feeling like too much for a blog post so I’ll try to make my point fast.

If you are a consumer of mental health services the switch doesn’t change much of anything. Your treatment, therapy, medication and general care doesn’t change one bit. The ICD-10, like the DSM V, is a code that is primarily used for third party payment claims, like for insurance or medicare. That’s it really, but if you have questions ask your behavioral healthcare professional.

If you’re a mental health professional I suggest you start by referring to your specific local, state or national professional organization for guidance, the American Psychological Association, American Psychiatric Association, National Association of Social Workers, the American Mental Health Counselors Association to name a few. The good news is that the DSM V did most of the heavy lifting for us so that conversion from DSM V to ICD-10 for mental illness diagnoses is fairly seamless.

The good health care professional makes sure everyone from the direct care provider to the billing manager is up to date on stuff like this. Even if it is a pain in the patootie.

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