by Cassie Harrison, Yoga Team Leader RYT
June is pride month and festivities are already underway in Chicago and its suburbs. We were lucky enough to have our own Pride parade near us in Buffalo Grove, IL. Regardless of how you identify, you will need support through your journey. Finding community early in the process will help make it more manageable and maybe even enjoyable. What’s often forgotten, at least in the beginning and not until after one faces setbacks, is to take care of oneself. Often I get students in my Yoga for Fertility class who are yoga novices and come to me with an attitude of “well it can’t hurt to try yoga.” Darn right, you should’ve been here from the start! If you’re going to carry a baby, are you (or your partner) preparing your body to support a pregnancy? Whoever is involved in the process to create a family will need community/emotional support, nutrition, exercise, and self-care.
Community is priceless. I felt very alone during my fertility struggle and it wasn’t until I found a community that I realized how much I needed it. One’s path to parenthood is a personal journey, with or without problems. With problems, it just makes it harder to keep it personal and/or private. Schedules getting disrupted by always needing to go appointments, taking medications (that may or may not make one crazy), and add in the emotional roller coaster … well you get the idea. Go. Now. Find your community.
Here are a few resources to get you started:
- Yoga Events: Joins us for Yoga for Fertility in Chicago starting June 25th and in Highland Park starting July 1st! The FREE Weekend Wine Down in Chicago will be July 25th, save your spot and bring a friend!
- Shine Fertility: Join us at the Shine Bright event on July 10th and/or the next Shine Together Meet-up at PDtM Chicago on July 23rd!
- Path to Parenthood: Every Journey Begins With The First Step
- The Broken Brown Egg: Awareness. Hope. Activism
Additionally, below are a few LGBQT+ resources available to those in the Chicago area:
And what I thought was an nice article from a lesbian couple struggling with infertility:
Enjoy some food and yoga tips today at:
- Food is medicine, eat better. Period. EWG.org has a list of fruits and vegetables high in pesticides to stay away from, called the dirty dozen. They also test consumer products and rate them, most important to stay away from are endocrine disruptors. Start there to help decide when to go Organic and identify products in your home that could hurt your fertility.
- Hello Yoga. It’s both exercise and self care wrapped up in one beautiful package. Yoga connects the mind and body, a moving meditation. It supports the physical body by promoting hormonal balance, improving blood flow, and helping support tissue detoxification. Not to mention self-massage (drink plenty of water after a practice!). A few of my favorite yoga postures (that anyone can do, yes that includes you!). These poses require focus, which settles the mind. Find a quiet space inside or out, and practice Eagle, Reclined Figure Four, Warrior (I, II, III) and Camel.
Have a great summer. Make time for yourself, the kind that fills your bucket! Find your community, eat well, and practice (key word here) yoga.
By Christina Thompson Olson, RYT
Has your fertility journey created a disconnect between you and your partner or loved one? Whether you’re going through this together or on your own, trying to conceive can feel isolating and lonely. Partners, family members and/or friends may have the best intentions of supporting us on our TTC journey, but sometimes it takes a little creativity to find ways to reconnect with our loved one — consider partners yoga!
Keep It Simple
If you hear partners yoga and immediately picture yourself trying to balance in the air on your partner’s legs, not to worry. I’m not talking about acro yoga; just some simple yoga poses you can practice with a partner to enjoy a relaxing time together. These are safe during most times of your cycle or treatments, but always check with your doctor if you’re unsure. Try these poses in your living room or maybe even outdoors now that the weather is getting nicer! Start by sitting cross legged with your back against your partner’s back, noticing your breath and your partners breath, and feeling the support of their back against yours.
Partners yoga can build intimacy and trust by opening the lines of communication. Even just the simple and honest communication required while coordinating movements can help us reconnect with ourselves and our partner, no matter what else is going on that day/week/month. For the next pose, stay seated back and extend your legs out in front of you for a supported forward fold. One partner will fold forward towards their legs while the other partner gently leans back; then come back through center, maintaining contact as you switch. Move slowly with your breath, making sure to communicate your comfort level during this one!
In yoga we link breath and movement which helps to relieve stress and tension in the body and mind. Practicing yoga poses with a loved one allows you both to feel the centering, grounding effects of yoga. One more seated pose where you’ll reap these benefits is the gentle seated twist, practiced back to back. You and your partner will each start by placing your right hand on your left knee and reaching your left hand back to your partner’s leg or hip; lengthen up through the crown of the head on your inhale and twist a little deeper to the left on your exhale, looking over your shoulder if it’s comfortable for your neck. Continue to breathe, coming back through center when you’re ready, then take this twist to the right.
Support during TTC and beyond
Practicing yoga with your partner is a great way to connect and feel supported during your TTC journey, after getting pregnant, and beyond. Make your way to a standing position, allowing your partner to help you up from the floor, and face each other standing within arms reach. Step your feet out wider than hip-width distance, taking the toes out and bending the knees into a goddess squat. Ground down through the feet as your shoulders stack over your hips, then reach your arms towards your partner and clasp forearms. You can decide how intense to make this squat by bending more deeply, or lessen the intensity by gently swaying side to side, straightening one leg and the other as you maintain eye contact.
Don’t forget to have fun with these poses and try others from your yoga practice! Balancing postures are a great reminder to not take ourselves too seriously. Try a tree pose standing next to your partner, balancing on one foot as you draw the sole of the other foot towards your calf or upper thigh, and offering support with an arm behind your partners back, or interlacing the hands closest to each other as you reach overhead. Feel your standing feet rooting into the earth as your arms reach tall overhead, and enjoy this shared experience together!
Call us to schedule a private yoga session in Chicago or Highland Park for you and your partner at: 312-321-0004.
Join Pulling Down the Moon on Saturday, July 6th at 12pm for a FREE special event! Space is limited, reserve your spot for Connecting with Thai Massage: An Introductory Partner Workshop today!
by Rickie Kostiner RYT, Clinical Intern
I took a good hard look one morning at the piles of stuff that had accumulated between my jeans and sweaters. It was a misshapen pile that had peculiar characteristics including big dark spots and glimpses of shimmer, it was hard and jagged around the edges but soft and mushy inside. No, it wasn’t loose socks, empty boxes, or unopened mail, it was me. I wasn’t dreaming, but I swore that I could see myself in physical and metaphysical form in my closet that day. My heart sank and slouched to the ground. Knees to chin I rocked back and forth for what seemed like an entire day wondering how I got there. How did I end up on that shelf and how could I find my way back into my own body. My body, I shrieked. What. Is. A. Body and why can’t I feel any part of mine? I touched my toes, not painted calloused soles. I licked my lips, cracked, and broken. I ran my fingers through my hair, rough and thin. I closed my eyes and tried to breathe but every breath stopped short in my chest. What was happening? How did I get this way? I somehow managed to pull myself off the dirty carpet that day and I continued to move through the rest of my day. That’s all I did, I moved through places, interactions, workouts, meals. There were no feelings, because I wasn’t there. I was still on that shelf.
How do I get off the shelf? Am I ever going to feel anything ever again. I walked past a yoga studio everyday to get on the train. One day a sign out front of the studio read, “come inside and feel your body! Baby, it’s cold outside.” Okay, I thought, this is it, I’ll try it. That first yoga class was weird, I couldn’t explain how it made me feel but I went back. I went back three more times and then five more times after that and pretty soon I was practicing six times a week, but I still couldn’t tell you why. I practiced for two years, completed my first 200 hour teacher training, and had started teaching and I still couldn’t tell you why.
It was a Sunday, I had been teaching yoga for about four months. A dear friend and fellow yoga instructor told me she was going to take my class. Immediately, I felt shocks of nerves zooming through my body. “I’m nervous!” I said to her. She replied, “Rickie, I am here for whatever you have to give.” Wow. Right? Think about it, I am here for whatever you have to give. That level of flexibility is something I could only dream about achieving. For the first time since I started practicing yoga I felt something other than those adjectives that I was “supposed” to be feeling (tired, strong, healthy etc.) I felt safe. I went home that day and opened my closet to see that the pile of stuff was smaller. The parts that were black began to fade and the parts that were shimmering glistened a little more. As I continued to take in what my friend had said, ideas began to click in my head. In teacher training our leaders told us that yoga was much more than the physical practice, it is a much deeper and broader philosophy that encourages and encompasses a way to live, a way to treat one another, and most importantly, a way to treat the self.
I started to listen, and I started to observe. I took a step back from the rigid expectations I had of myself as a teacher and student and allowed the philosophy to manifest within. The true intention behind the practice and philosophy of yoga is to find stillness, both in the mind and body. The physical, asana, practice of yoga is done in order to help the body sit still. Handstand means nothing if the body cannot rest. Slowly, yoga finally began to make sense. The reason I came to yoga each day was because I was allowed simply to be.
Everyone has their unique reasons for finding and pursuing yoga. If you approach your practice with intention that is truth and that is real. Yoga changed my life by giving me a safe space to uncover layers of myself and were buried beneath many years of neglect. Today, as I continue my studies and research further into the dimensions of counseling and psychology, I am reminded every time I step on my mat that I have everything I already need within to heal. A perspective that took me a long time to actualize, but once I did, other pieces of my life fell into place. The piles of stuff in my closet slowly transformed into significant pieces of my life that I began to recognize as relationship, family, self. I was there all along, buried beneath the layers of stuff, patiently waiting to be uncovered. As you begin to uncover layers of self that have been buried remember to trust in the process that the practice of yoga can bring. Now, I practice both on and off my mat with the intention of, I am just a voice, the yoga does the work.
During Mental Health Awareness, we encourage finding support in whatever format works best for you-whether yoga, acupuncture, visiting a support group specific to your needs for infertility support, trying again after loss, or single parenthood), meditation, and/or speaking with your doctor. Resources, such as, Resolve (866-NOT-ALONE), Star Legacy Foundation, and the Women’s Professional Health Networking Group of clinicians supporting patients going through fertility treatments, pregnancy after loss, struggling in their relationships on the journey, perinatal anxiety, depression, and more (consult with your practitioner at PDtM for more information about these trusted contacts including Alison Lautz below).
Join Pulling Down the Moon for the FREE Webinar Hope & Healing: Simple, Practical Techniques for Coping with Disappointment & Loss on June 3rd at 6pm CST.
Author: Rickie Kostiner RYT, Clinical Intern Supervisor: Alison Lautz, LCSW Therapist & Life Coach www.alisonlautz.com 815-341-9244 email@example.com
By Christine Davis, Acupuncture Director
Everyone has advice for you: Do this, do more of this, don’t do that, do less of that. This is the only thing that works. Everyone is different, so nothing works for everyone. Eat more of this. Eat less of that. Exercise more. Exercise less. Weigh more. Weigh less.
I think that, particularly because of the internet, you can find information to support every theory out there on literally everything. It’s hard to know what to trust, what is actually true. While it can take some time to find the things that work for us to stay healthy or find balance, I do think there are a few things that we can universally take as truth.
Here’s what I’ve found:
- Slow Down. I started with this one because it helps to make all the rest possible. We hear this a lot, right? Take time for yourself, relax, find ways to unwind. But how do YOU do that? I think it’s necessary to take some time every single day to be quiet and listen to what your body, your mind, and your heart are telling you. Some days, you might have more time, some days, it’s only 2 minutes. But this has to be a priority like any other. When you take time to be still, whether in meditation, taking a walk, listening to quiet music, doing yoga, or even in an acupuncture session, this is time to hear yourself: your thoughts, how your body feels, where your mind is. What works for one person may not work for another. Remember there’s a reason that we call meditation a “practice.” It’s a process, not a destination. It recharges you, helps you find yourself and your goals, and strengthens your ability to cope with the challenges that life throws your way.
- Eat Well. There are so many theories out there about how to eat, what to eat, where to eat. It can all get very confusing! But I think we all know what things don’t feel right – whether it’s refined sugars/carbs, greasy/fried foods, too much salt, portions that are too large, etc, so staying clear of those as much as possible is critical. The more I go through life and doing the work I do, the more I realize just how important these things are. A study that came out last month showed that unhealthy diets are responsible for 1 in 5 deaths worldwide. Even if our diets are only “kind of” unhealthy, those foods could be contributing at the very least to inflammation, endocrine dysfunction, and thereby problems with fertility. If you are feeling lost in the woods about where to start, make an appointment for Nutritional Counseling with one of our amazing Dietitians.
- Sleep. Oh this is a hard one. We all think we can get away with sleep deficiency, but it always catches up to us in the end! The key is to try to stay consistent, even if you can’t be perfect every night. Aim for 7-8 hours, as close as possible to the same time to bed every night and wake up every morning. Of course, you will have special events, travel, and other things that try to throw a wrench in the works, but the more you condition yourself to stay consistent, the more your body will be prepared to sleep well when it’s time. Other things to try:
- Stop drinking anything caffeinated after 10am if you plan to go to bed by 10pm. Caffeine can stay in your body for up to 16(!!!) hours, so plan accordingly.
- Try a simple chamomile tea about 30-45 min before bedtime – steep in 4oz or less of water so you won’t have to get up to use the restroom during the night.
- Stay away from devices 45-60 min before bed. It’s tempting to try to catch up on emails, surf Instagram or space out to some Netflix, but trust me on this, sleep is way more important!
- Clear clutter from your house in general, but definitely from around your sleeping area. There should be nothing that reminds you of stressful situations or work. Keep your sleeping area as simple and comfortable as possible to invite relaxation and rest.
- If you are still struggling to fall and stay asleep, try acupuncture to help regulate your diurnal cycle.
- Exercise. This is another one that gets pretty complicated, but the bottom line is that you need to move your body on the regular. Medicated IVF cycles notwithstanding (when walking and gentle yoga are safe, as well as, recommended), getting your heart rate up and doing some resistance (free weights, muscular isolation, etc) exercise are necessary for us as humans. Our driving, sitting lifestyle has caused us to not have to do these things for basic needs, so we have to go out of our way to find them. If you love going to the gym, then do it! If you hate going to the gym, then find what works for you – yoga, martial arts, ballroom dancing… If you enjoy it, you’re more likely to stay with it. I had a personal trainer as a patient one time. I remember asking him what the best kind of exercise was. Do you know what he said? He said, “The best kind? That’s the one that you DO.” 100% accurate. If you are someone who has strayed away from exercise or maybe never had a regular practice, it’s time to make friends with the feeling of moving your body to make it strong and healthy. Find what works for YOU.
- >I want to make one side note here to say that you may be someone who exercises TOO much which can also have adverse effects on your body. It can be difficult to let go of an ideal of weight, shape, or status. If you are dealing with a BMI that is below optimum, consider discussing what’s going on with your MD, Dietitian, and acupuncturist.
That’s it. That’s all I know. None of this is new. But this stuff does work – tried and true. Some of it takes real willpower, but setting the wheels in motion now can help you find your healthiest self for life.
Try Acupuncture for only $75 in May! Learn more about holistic health options for the journey for you and your partner at the Shine Together In Person Meet-up with Pulling Down the Moon’s very own Christine Davis presenting on Tuesday, June 11th at 6:00-7:30pm at our Chicago office. Register to save your spot today!
Infertility – it affects 7.3 million people…that’s as if infertility took over New York City. That is how big it is!
This is a special post to honor to National Infertility Awareness Month.
It is a time to dedicate a post to all those currently dealing with infertility and for those who have overcome their infertility to reflect back, and remember how that time has forever changed you.
When you experience something powerful in your life, like infertility, it leaves a mark with you. You aren’t the same person that you were before.
And that can be a good thing.
I’ll admit, sometimes I can be a bit stubborn, especially when it comes to goals and reaching them. I truly believe that if you put your mind to something you can achieve it. Getting pregnant and the dream to be a mom however is different. It is a goal that you can work at and work at and still never achieve [without needing help, or rewriting what the journey looks like to reach that goal].
I thought I did everything right. Got married, worked to feel stable in my career, lived a healthy lifestyle, and truly waited until I was “ready”. I stopped taking the pill and we tried [and tried and waited and waited] and nothing happened, no period and no pregnancy.
Things weren’t happening according to “plan”, which for me as type A person wasn’t ok.
My husband and I went to go meet with a reproductive endocrinologist to formulate a plan. I had to get my period coming regularly before we could even discuss trying to get pregnant.
Fast forward one year, FINALLY after every hormone drug you could think of, my stubborn period came. It never stayed, I always had to be stimulated to get it, but once I finally got it we could start taking the next step in the plan, trying to get pregnant. At this point I was still strong, pushing forward trying to achieve “the goal”.
After our IUI tries we were starting to feel defeated. I started making back-up plans to our alternative plans, it became obsessive. We decided to move forward with IVF. IVF felt more serious, there were more drugs, more monitoring appointments, more everything.
I was starting to feel the effects of the two-year plus on this journey. My body, my mind, everything, my body didn’t feel like me anymore, I was bloated all the time, stressed out, and frustrated.
But we kept pushing forward, and thank god we did, our first IVF attempt was a success. The moment my doctor called to tell me we were pregnant will be a moment that I will remember forever [vividly, down to the very last detail].
It made all the struggles, all the doubt, all the everything worth it.
So if you are reading this, just starting out on your journey, know that the journey may be hard, it may be stressful on your mind and body, but you will get there, the path may take a couple different turns, but it will end, and you will be stronger than you ever thought possible before you started!
By: Katie O’Connor, Founder of the non-profit Shine: A Light on Fertility: inspiring fertility empowerment by sharing the journey. We provide free support, mentoring and advocacy for fertility health.
*Join Katie on Thurs, April 25th at 6:30pm for Shine Fertility’s NIAW Panel Event!
by Alison Lautz RYT
Is it over! Winter? Have we made it out of the trenches or is it going to snow again in May? One will never know in this city! Flowers and vegetation will start to grow (we hope), the birds MAY sing, and Chicagoans will start to strip off their boots and puffy coats. Spring is in the air! Now how can we bring spring and a new vibe into our yoga practice? I love spring…. it signifies a time of letting go of our old tired way to make room for the new and another chance to re-start, like a second chance on new year’s resolutions or intentions that we made four months ago. The spring energy is all around us, and these four tips will help you awaken the spirit of spring in your yoga practice.
Awaken new vibrations
Spring is full of spiritual energy and more energy vibrations than any other season. This may be because the earth is working to shed the drab of winter and cultivate a more lively state of being. You may find that this is contagious, like when you see a coworker putting some colors into their outfit, you may want to do the same. Open up your energy to the season by having an open mind to any positive changes or the opportunity to try something new outside of your comfort zone. Try Journaling for the Journey!
Let’s celebrate the fact that we can roll our mats outside of the four walls that we spend most of our days within. It does not matter if it’s in your backyard, on a roof deck, or on a small balcony in a city high rise. Any of these options presents a great chance to connect to nature. Breathe in the fresh air and celebrate the ability to get out of the house. My favorite pose to do outside is Vrkasana (Tree Pose). I truly feel how rooted I am to the earth in this pose from my feet to the crown of my head. Learn more about how to use your breath to reduce stress with this FREE Prana webinar!
Detox your gut
April and May are the perfect time for some big spring cleaning. Most of us hold our old habits, negative emotions, and holiday/winter vacation indulgences in our gut. Try some twists in your yoga practice. Change your diet around a little bit. Drink more water with lemon, try some kombucha…and as always EAT MORE GREENS.
During spring, joy and fun are all around as new life begins. Watch the birds above or lay with your dog or cat in the grass! New life inspires a sense of playfulness that we can embrace in yoga practice as well. Embody playfulness in your practice by going for poses you normally skip and try some laughing instead of cringing whenever you fall out of a pose. Take everything even the TTC journey a little less seriously because we will all get through this. Come check out Yoga for Fertility at Pulling Down the Moon to work on some serious spring awakening. Meet new friends and a whole community of other women working on conceiving! Join the next Yoga for Fertility series on Wednesday, April 24th at 7pm or online starting on Monday, April 29th at 6pm! During National Infertility Awareness in April, try Yoga for Fertility and get 50% off!
By Brooke Laufer, Psy.D.
Motherhood, Not What You Thought
Mental health issues are among the most common complications related to childbearing, and yet it is still a topic that is largely misunderstood. A conversation I had with my dentist recently reminded me how little the general public knows about perinatal mental health issues. “Oh,” she said, “I just thought women cried a little bit, but you know, they’re usually just so happy to be mothers, right?!” We want to believe becoming a mother is an absolute joy. Motherhood is expected to be a fulfilling time for a woman, when a woman is in her most natural role–the role she was meant to play as suggested by film and other media–when her true purpose is determined. In reality, having a child is a profound, frightening, and exhilarating experience at the boundary of life, from which one comes back a transformed person. Most women bear this monumental transition to motherhood with some hardship. Experiences range from tearfulness, exasperation, and nervousness to more extreme feelings of obsessiveness, helplessness, and even murderous fantasies. While many women will have what is labeled the Baby Blues, 20% of women will have a Perinatal Mood and Anxiety Disorder, a debilitating psychological experience that interrupts their lives. With a growing amount of research and education, we begin to clearly see what distinguishes a true Perinatal Mood and Anxiety Disorder from the non-clinical experience of the Baby Blues.
10 years ago I was as unaware as my dentist of what could happen to a woman’s state of mind when she was faced with childrearing, so after my daughter was born I learned in a shocking and destabilizing way–the way most women learn–what a Perinatal Anxiety Disorder was. For me, it started with anxiety attacks while in my third trimester. I shook uncontrollably in the evenings and experienced an overwhelming sensation of claustrophobia during the day. I found a good psychiatrist who helped me understand that taking an SSRI (the one I’d gone off when I got pregnant) would relieve my anxiety and would not hurt my baby. Then after a fairly uncomplicated birth, I was supposed to be thrilled, but I had a new baby who didn’t sleep well. I loved her, but I wasn’t completely attached to her; I was also ragged and jumpy. When she was 4 months old, I started having intrusive thoughts that deeply disturbed me. At first they were like small blips on a radar, like thoughts from the periphery of my mind that I could barely hear. But then the blips grew larger and included images. I could clearly hear thoughts telling me that harm would come to the baby. I could see my baby being sexually violated. I had thoughts that my husband and I would be the ones to sexually harm our baby daughter. I could barely tolerate these thoughts as they began popping in with greater frequency. Luckily, my psychiatrist answered his phone the day I called beside myself in tears. He calmly told me that what I was experiencing was Postpartum OCD, he told me about Karen Kleiman’s book This Isn’t What I Expected, and he raised the dosage of my Sertraline. I was a therapist, a clinical psychologist, and I was learning for the first time what a Perinatal Mood and Anxiety Disorder was; this was not the Baby Blues. I recovered from my Postpartum OCD, but my life was changed forever. Since that time I have done what I can to research perinatal mental health, to immerse myself in the literature and new information we have on this condition, and to talk about it. Talk to women, to friends, to family, and especially to my clients, letting them know they are not alone, they are not crazy, and they can still be the mothers they want to be.
The term ‘Baby Blues,’ first used in Nicholson J. Eastman’s 1940 best-selling baby care book Expectant Motherhood, is an umbrella term referring to any emotional experience a woman has in the period after bringing home the baby. It is no surprise this massive life transition, along with sleep disturbance, disruption of routine, and emotions from the childbirth experience itself will contribute to how a mom feels. Her experience is also affected by the hormone changes that occur first during pregnancy, and again after a baby is born. The levels of progesterone and allopregnanolone rise during pregnancy and plummet after childbirth, and this drop is thought to contribute to emotional dysregulation. These short-term postpartum symptoms include weepiness or crying for no apparent reason, impatience, irritability, restlessness, anxiety, fatigue, sadness, mood changes, and poor concentration.The informal diagnosis of Baby Blues requires that these symptoms last no more than 2-4 weeks, occurring for a few minutes up to a few hours each day, and typically going away with rest, support, and time. Baby Blues rarely get in the way of daily life or need intervention from a medical provider.
“A baby opens you up, is the problem. No way around it unless you want to pay someone else to have it for you. There’s before and there’s after. To live in your body before is one thing. To live in your body after is another. Some deal by attempting to micromanage; some go crazy; some zone right the hell on out. Or all of the above. A blessed few resist any of these, and when you meet her, you’ll know her immediately by the look in her eyes: weary, humbled, wobbly but still standing. Present, if faintly.” Elisa Albert, After Birth (2015)
Perinatal Mood and Anxiety Disorders
When a disturbing emotional state lasts beyond 2-4 weeks, clinicians should start to assess for a perinatal mood and anxiety disorder (PMAD). Formerly referred to as Postpartum Depression, or simply “postpartum,” we now use the term “Perinatal” because the symptoms can occur not only one year postpartum, but also during pregnancy, or after a pregnancy loss. We say “Mood and Anxiety Disorders” instead of “depression” because it more accurately covers the range of experiences women have. These include major depression, generalized anxiety, OCD, PTSD, and postpartum psychosis.
Although there is no clear indicator of who will experience a PMAD, previous mental health issues, trauma, and lack of resources are some of the risk factors. Important to note: PMADs do not affect just biological mothers. Growing research shows us that men experience postpartum anxiety and depression. In fact a client of mine came in a few weeks after her baby was born and reported that her husband was acting strangely: yelling a lot, throwing pillows at the wall when the baby cried, uncontrollably crying, and openly fantasizing about leaving the baby out in the snow. We were able to get him in for a session with her and help him understand that he needed help. The couple was surprised that he was having postpartum rage, while she was adapting well. He actively resented his child for destroying their former life, while she’d become protective of the child. Eventually, with months of treatment, he was able to love and attach to his daughter.
Similarly, adoptive parents may report symptoms of PMADs: it can be particularly confusing to resent or feel disconnected to an adopted baby whom you wanted and planned for and possibly spent much or most of your savings on. Likewise, LGBTQ families who may have worked for years on fertility treatments or with a surrogate to finally bring home a baby are also vulnerable to PMADs and should not be ignored as a population worth assessing.
Perinatal depression mimics that of a major depressive disorder but with certain symptoms specific to mothering. A woman may be withdrawn from the baby and her family, not want to hold the baby or have difficulty bonding, have a flatness of facial expression and voice, exhibit excessive tearfulness, or severe self loathing. She may have a belief that she can’t handle motherhood or be a good mother, she may be unable to enjoy most of her life, or she may believe her family would be better off without her.
A client of mine described feeling like she couldn’t see herself in the family picture. She vacillated between dissociation and depression. This mom had twin baby girls with whom she was not bonding. She felt like a machine part going through the mechanical motions of caretaking. After her first session of unburdening herself of the sadness and shame she carried, she was able to start to locate herself. Her experience points to the invisibility some women feel as mothers. The erasure of self to motherhood is well noted by the poet Alice Notley:
“For two years, there’s no me here….
Two years later I obliterate myself again
having another child” (1972)
Perinatal Anxiety and PTSD
Perinatal anxiety, or anxiety during and after pregnancy, has received little attention compared to its well-known cousin, postpartum depression, yet anxiety symptoms are more frequently reported. Worrying, of course, is a normal part of new motherhood–checking that the car seat is secure or that the baby is still breathing, for example–but if it interferes with a woman’s life so that she cannot think about other things or take care of herself or her baby, then it verges on mental illness.
For women who are prone to anxiety, the information-saturated era we live in is loaded with potential stressors about conceiving, being pregnant, and parenting, requiring women to be vigilant about what information she is exposed to. An anxiety disorder can be spotted in the repetitive fears and questions moms have, in extreme over-protectiveness such as not letting anyone hold the new baby, or in the too well put-together mask some moms wear, hiding an internal world out of control.
Post-Traumatic Stress Disorder (PTSD) in the perinatal period refers to past trauma resurfacing during the perinatal period, including flashbacks and nervous system responses (freeze, flee, fight) that can interrupt caring for a new baby. What many doctors do not realize is that women who have experienced sexual trauma may have fear of a baby coming out of the vaginal canal, a fear of male providers, and/or a fear of being alone with baby.
Perinatal Obsessive-Compulsive Disorder
Obsessive compulsive disorders are possibly the most insidious of the postpartum conditions because they include the intrusive thoughts that haunt many mothers. Intrusive thoughts are thoughts that happen frequently and randomly, feel uncontrollable, and are often disturbing. These disturbing thoughts, or obsessions, can lead moms to engage in repetitive behaviors, or compulsions, to try to ease their anxiety. Many moms with OCD are plagued by repetitive fears of harm coming to their babies, possibly due to the extreme helplessness of a newborn baby. It is horrifying for mothers to have uncontrollable thoughts and images of their baby tumbling down the stairs or falling out a window, or images of themselves smothering the baby or sexually abusing their own child. Because of the disturbing nature of these thoughts, it can be the most difficult disorder to admit, yet, as was my experience, by breaking the silence women can find tremendous relief in the normalization of Perinatal OCD.
Postpartum Psychosis is the most rare of perinatal conditions, occurring in .1% of moms, but it is the most dangerous. Psychosis is a break from reality that can happen over time but can also become a medical emergency very quickly. As with Postpartum OCD, a mom may experience intrusive and paranoid thoughts, but instead of being disturbed by them, she may begin to identify with them. For example, a new mother may have the thought that someone is going to steal her baby, so she acts on it by hiding the baby or running away with the baby. Unfortunately, it is typically after a postpartum psychotic episode has ended badly that the media gives it attention. Just a few years ago a woman who I know from my hometown was arrested for the death of her 14 month old boy. After months of working full time, bad day care experiences for her baby, an unstable partner, and increasing symptoms of OCD and paranoia, she came to believe she and her son would be better off dead. After she suffocated her baby she attempted to overdose on medications, but she survived. Even though the she had an expert forensic psychiatrist diagnosed her with Altruistic Filicide, deeming her Not Guilty By Mental Defect, she was sentenced to 25 years in prison. Unfortunately, there is still little understanding or mitigation done for mothers convicted of infanticide, resulting in excruciating treatment and excessive sentencing.
Women may find it difficult to reach out for help, as it is taboo to admit you are unhappy or unnatural at motherhood. To the extent that women in our society are still seen as playing their most natural role as mothers, to acknowledge unhappiness or discomfort may have high stakes relating to women’s own identities and how others may see them. A mom may fear being seen as a “bad mother,” which would ostracize her from mainstream society. With more education and awareness around the frequency and epidemiology of perinatal mental health issues, much of this silencing can be alleviated. What is essential to understand is that a woman herself should not be blamed–not by her providers, her family, or herself–for a perinatal condition. We often have little control over the occurrence of a Perinatal Mood and Anxiety Disorder, but we can do much about its treatment.
Psychotherapy and Medication
With a proper diagnosis of a Perinatal Mood and Anxiety Disorder, good treatment can support a full recovery. The best form of treatment is individual psychotherapy that reduces stigma and shame and normalizes the client’s experience. Besides reassuring women that it’s normal to feel ambivalent during pregnancy and motherhood, I also educate each woman about her particular diagnosis. Women often feel desperately alone and deeply ashamed when they experience PMAD symptoms, especially ones that are less talked about like rage or intrusive thoughts. I reassure my clients that these inner experiences don’t indicate their worthiness as mothers but are instead treatable symptoms of common disorders. Women express tremendous relief when they realize that their scariest and most shameful symptom is something others also experience–and something we know how to treat. Helping women accept all the parts of themselves will reduce symptoms of anxiety and depression. One important goal I look to when working with PMADs is helping women regain a sense of self. It may not be the self they knew before the baby but a new self that emerges in the transformation. Questions we consider: How does having a baby disrupt a mother’s sense of who she is, of her body, her understanding of life and death, her relation to the world and to her sense of independence, her experience of fear and hope and time, and the structure of her experience altogether?
Therapy may include the new baby, so that I can support a secure attachment and help the mom experience the infant’s behavior without insecure projection and negative interpretation. I may recommend infant massage or, inversely, setting the baby down for an extended period. Therapy may also include the partner or other family members. Marital disharmony is the most commonly cited non-biological cause and consequence of PMADs, so by bringing in and educating the partner on PMADs, a mom is more able to be understood and get her needs met at home. Group therapy, such as a moms support group, can be an excellent way to reduce shame and isolation, as it can provide universality, catharsis, socialization, and good information.
Additionally, psychopharmacology is an effective form of treatment for Perinatal Mood and Anxiety Disorders. Current research and an updated classification system (no longer the A, B, C labels for medications that were often misleading) suggest many medications are safe during pregnancy and breastfeeding. There is still damaging stigma around medication and pregnancy that needs to be fought with accurate information. Reducing a previously prescribed medication for pregnancy or changing a medication during breastfeeding are potentially misguided recommendations that can put a women at risk of relapse. The American College of Obstetricians and Gynecologists and the American Medical Association agree that treating the mother’s health is the priority; the trace amounts of medication that a fetus or nursing baby will receive should not keep a mother from the medical treatment she needs.
Although public awareness of postpartum depression has increased in recent years thanks to celebrities like Brooke Shields and Serena Williams, many people–including therapists–are still learning that PMADs are serious and pervasive experiences. When I started talking about my Postpartum OCD experience one of my aunts told me the story of my grandmother, who had three children in four years. The day after they brought home the third baby my grandfather got in his car to go to work, as he started to pull out of the driveway my grandmother came running outside and threw herself on the hood of his car. She spent the next 7 months in a sanitarium, a nicer version of an asylum in a neighboring state, and came home to her children who were being cared for by a strict German nanny. It’s possible my grandmother was experiencing depression or anxiety or even psychosis, they sent her away and no one discussed it. Although awareness and treatment have improved since the harsh days of my dear grandmother, perinatal mental health is still overdue for the attention it deserves, considering women are doing some of the most laborious and important work of our world.
Brooke Laufer is a Clinical Psychologist who has been practicing psychotherapy since 2005. Brooke began her clinical work in psychiatric wards and then in schools with adolescents and their families. After having her first child Brooke had a disturbing Postpartum OCD experience, which inspired her to begin researching, understanding, and specializing in the treatment of perinatal mental illness. She has a private practice in Evanston, where she continues to treat adolescents and adults, specializing in perinatal mental health issues.Brooke Laufer, Psy.D.
By Cathy McCauley, LMT
Spring arrives this month, and with it, more cold days (perhaps even snow)! But March also brings the promise of new life. I love this time of year. The ground starts to smell fresh and ripe. Small green buds begin to swell from the earth reaching up, up, up. Birds chatter in the trees. The sun stays in the sky a little longer each day. After a long, cold winter of hibernation, spring restores nature’s beauty.
Spring inspires us to restore ourselves, too and these self-care techniques will lead you to restoration of mind, body and spirit.
—Hydrate. Drink a glass or two of water first thing in the morning. Keeping yourself hydrated helps boost your mood, improves brain power and protects you against disease.
—Make a gratitude list. Spending just a few minutes a day writing down what you are grateful for can dramatically shift your day. The more gratitude you have, the more open to abundance you become.
—Breathe. Set aside a few minutes each day to practice breathing. There are so many benefits! Among them, diaphragmatic breathing alleviates stress, reduces pain, strengthens internal muscles and moves blood to organs and tissues. If you’re not sure how to get started, schedule an Open the Breath (™) massage to receive some hands-on breath work coaching.
—Stretch. Five to 10 minutes of stretching in the morning increases energy levels, enhances circulation, reduces injury and centers your mind. Even better is a regular yoga practice. Pulling Down the Moon’s yoga classes can give you a jump start!
—Eliminate something from your diet that isn’t serving you. Instead of overhauling your entire diet, start by taking out one food that doesn’t nourish your body. Replace it with a different item that supports your desire for restoration. Learn even more by working with a nutritionist!
Do you have ideas on how to restore yourself or tips for others? Please share them! I look forward to seeing you in the center. Many wishes for a beautiful spring!
by Marie Davidson, Ph.D.
As I write this it is actually the Feast of the Epiphany, celebrated in Christian tradition as the day the Wise Men arrived from the East after the birth of Christ, led to their destination by a star. The Merriam Webster Dictionary also offers these definitions of epiphany: “A sudden perception of the essential meaning of something;” an intuitive grasp of reality through something simple or striking;” and “an illuminating realization.”
Many years ago, as measured in ordinary time, but not all that long ago as measured in emotional impact, I experienced an epiphany that made all the difference to me as a suffering fertility patient. I dwelled in distress much of the time, my thoughts haunted by the many challenges of treatment, the succession of disappointments, and, worst of all, the complete absence of any certainty about how this fertility drama would turn out.
One morning, my moment of epiphany arrived quite suddenly. No wise men or wise women arrived, and no guiding star appeared, just a swiftly dawning realization of what I was really going through—right now—in my life. To this day I cannot say for sure what brought on this intuitive grasp of reality at that particular moment. I suppose it was the result of many, many months of efforts to not embrace my situation. My distress had served to only highlight my sadness and anger and to keep me from moving past that. It was just no longer a reasonable option to keep this exhausting process going. So, I had a serious, mildly humorous chat with myself.
This is what I said:
“OK, Marie, this is what’s going on in your life right now—you and your husband have been in a battle against infertility (and against each other, truthfully.) Infertility sucks, but it’s what you’ve got. You didn’t cause it, and you may or may not overcome it in the way you hope. You don’t know the end of this drama you are in because the screenplay isn’t finished. But there is something you can do, and that is to accept the role you’ve been assigned and act it out as skillfully and graciously as you can. Inhabit the script! Be the star in your own drama, dammit!”
Or something like that, it’s pretty close to the internal conversation I had. I definitely know I made a conscious decision to star in my own story. I would be the guiding star leading me to my unknown destination.
My life improved after that. Far from wonderful and still plenty of stress and anxiety, but I had a peace of mind that had eluded me for a long time. I rather think I excelled in playing myself—the woman who happened to be an infertility patient; the woman who accepted her inability to control the next act in the play I was starring in; the woman who was now able to experience the other parts of her life without the dark film of infertility blocking the view.
I did not know then that my life’s work would be a career counseling fertility patients. What a privilege it has been. A number of years ago, I met a woman who had come to talk about family-building options. She’d been through a lot of treatment with no success. I noticed how even-keeled she was as she spoke of her history and I commented, “You seem to be handling all of this pretty well.” She said, “Well, you should have seen me a year ago, when I was a complete basket-case.” I asked, “So, what happened?” Her answer was, “One day I decided to accept the basic background reality of my life.” I smiled. “You had an epiphany.”
Over the years, I have found it very useful to apply the same kind of epiphany to other life situations—the ones you can’t control but must live in and through. Whatever it is I struggle with, I try my best to be as skilled and gracious as I can be, even if I won’t win any Golden Globes. Strangely, the experience of an infertility journey can give you a valuable perspective on how to deal with the inevitable brick-bats of life.
Marie Davidson, Ph.D.
Fertility Centers of Illinois
Dr. Marie Davidson is a licensed clinical psychologist and patient educator. She specializes in counseling individuals and couples who are coping with infertility, and has provided counseling services to patients, donors, and surrogates since 1992. Dr. Davidson earned her doctoral degree at the University of Illinois in 1988. She facilitates patient education seminars on numerous topics such as considering egg donation and cracking the door to adoption, leads several women and couples support groups, and is widely published in the fertility field. She has been an invited speaker at many professional meetings.
Her personalized care and detailed understanding of the treatment process have been a welcome and supportive resource to many couples and individuals as they seek to grow a family.
by Melissa Hinshaw LMTIt’s that time of year when everyone is moving and shaking and buying and baking and trying to make all the parties and give families equal time. Whether you are single, married, divorced, or in between, you know what I am referring to. During this festive, yet chaotic time of year, how do we hold on to ourselves and what we deem important? What do each of us hope for the holidays and what traditions do we want to hold fast to our hearts when the pace is so fast and we are trying to please so many?The pressure of the holiday season can be both exhilarating and stressful. In my younger years, two small children at my hip, one with Autism and not interested at all in Christmas, presents, Santa, or family gatherings, by the end of the season I used to feel completely wiped out, angry, resentful, and grateful that it was all over with. I realized I had no boundaries during this time of year and I went with the flow and did what was expected socially and and within my own family even though it was, at times, not good for me or my family at all. I wanted my younger son, who was ecstatic about Christmas, and presents, and Santa to experience the magic that I had growing up. My childhood home was a wonderland of smells, and tastes, and decorations and presents and nervous excitement while my four brothers and sisters and I awaited Santa’s visit. Looking back, we rarely traveled around from this house to that house or attended gatherings that my parents felt pressured to attend or did much anything stressful except for getting the lights on the damn Christmas tree. My mom was a pro…I think because she loved this time of year and you knew it when you were at my house. I longed for this feeling again. The feeling of holiday joy and giving and singing and snow. I wanted it to be simple. I wanted to love Christmas again and I wanted my children to love it too.After many stressful and disappointing holidays with depression looming each and every year beginning with Thanksgiving. After many tearful conversations on the phone with my mom, having a glass of wine when the whole thing was finally over, and asking her, “How do I do this mom? I used to love this time of year. How do I make it special like you did, for my boys, one who could care a less and often falls apart over the holiday break, and one who couldn’t get enough?” “Melissa my dear, create your own traditions. Do what works for your family. Say, No, when you need to.” She was right. I needed to create Melissa traditions, Melissa style, and engage both of my children at their individual levels yet do holiday things we could enjoy as a family. I took her advice. I created a few simple traditions that we have stuck with over the years. My youngest loves it while my older son complains and requires lots of cheerleading, but we do our activities together and it makes us feel like we are a part of the holidays. We have pictures to remind us that we have done this before and we will do it again this year. This is a big deal for me and I cannot completely explain my reasons. I just know that being swallowed up by others’ rituals and rules and schedules doesn’t bring me joy. It brings me sadness and stress. Of course I enjoy celebrating with other people and sharing what makes the holidays special for them, but that is reserved for a very few. It is ok to have quiet during this time of year. It is ok to find peace and joy in the simple.I encourage everyone to find one special thing to do with your partner, your kid or kids, or your best friend that brings you to a special place. Something that you can do each and every year…something to look forward to. Something that you decide feels good and brings joy. Something you can share a photo of to remind you what you’ve done and to remind you that you you will do it again.If you need to break that is okay, too. We are here for you, take time for a massage before or after the holidays or start the New Year off with a cleanse!
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