by Christine Davis, LAc MSOM
With each passing year, things seem to get busier. More appointments, more work requirements, more life events, more things to do. Then there’s the well meaning family members and friends: why aren’t you pregnant yet? My friend tried This Thing and it worked for her, so you you should try it, too! Then there’s social media and the internet: EVERYONE seems to be happier and more successful than you – here’s what you SHOULD be doing to do to be happy ALL THE TIME. It’s all a never ending stream of NOISE. Where does it stop? How can you simmer down and quiet the stream of mental debris that constantly stimulates worry, fear, anxiety, and frustration?
Here are my suggestions. They aren’t a complete list, but these are the important ones. It may take time to incorporate them all:
- Say it with me: “No.” “I’m sorry, I’m not available.” It’s ok to put yourself first and say “no” when what is being asked of you will compromise your wellness. Clear a path for your ability to think clearly, breathe, and do the things you need to do to feel balanced. Much like Marie Kondo’s method for clearing physical clutter, you need to decide what’s important in your life mentally and emotionally. Say YES to the things that create the life you want (even though they may be difficult, too, sometimes) and NO to the things that are holding you back from that life.
- Disconnect. Social media has been fun over the past couple of decades, right? There are some good and some (really) bad parts, but study after study emerges showing the negative impact that it can have on your mental and emotional state. If you are having trouble completely disconnecting – especially if work or other interests require you to connect with SM – limit your interactions with these apps/websites. Give yourself a specific time frame in which you allow yourself to use them in a positive, uplifting manner.
- Get help. There is no shame in reaching out to a professional if you need help with mental wellness. This could be a mental health professional, a religious guide, etc. Someone who you trust, who is impartial, who has training in helping to guide you is ideal. This doesn’t mean you are signing up forever – sometimes a few sessions can really help to clarify and ground you. I feel like the best therapists are the ones who hold a “mirror” up, so to speak, so that you can see things as they are, then help you to appreciate the beauty that you see.
- Center yourself. This could be with meditation, prayer, yoga, journaling, long walks by the lake – whatever helps you to focus on one, two, or ten things–instead of the thousands of thoughts that are constantly flooding in otherwise. I like to think of Georgia O’Keefe’s “Sky Above Clouds” painting – the thoughts are just clouds floating past. Try not to hang on to them and instead just observe them and let them float past. There are some amazing smartphone apps: FertiCalm and FertiStrong, Insight Timer, MindfulIVF, Headspace, etc. that have tons of guided meditations for everything from general anxiety to trouble sleeping to going through an IVF cycle.
- Find gratitude. Keeping a Gratitude Journal helps with this. Write just a line or two each day about something you are grateful for. It could be the delicious muffin you had for breakfast, the painless phlebotomist experience, your favorite song coming on the radio, the friend who went out of her way to give you the support you needed. Many studies have shown that focusing on the positive aspects of life actively literally rewires the brain to feel happier and more positive.
- Try Acupuncture. A modality of Traditional Chinese Medicine (TCM), acupuncture is a therapy for the mind, body, and spirit. With regular (once or twice per week, usually) treatment, you will see many aspects of your physical, mental, and emotional self come into balance. Acupuncture is known to be helpful for everything from pain to allergies to digestive stuff to fertility, but it can also be helpful for balancing the mental state and emotions.
Firstly, an acupuncture visit is usually very relaxing! Most who haven’t tried it don’t believe me when I say that, but when else do you take 30 min to just lie still, no phone, not going to sleep (although it’s ok if you do!), not talking or listening (except to quiet music)? This is a deeply restorative time to be quiet, soft, grounded.
Acupuncture has mounting scientific evidence showing that regular treatment can help with reducing anxiety, depression, and other emotional disorders. In TCM, there is a strong connection between the physical state and the emotional state. By creating a state of harmony throughout the physical body, balanced mental/emotional wellness is the natural outcome.
In TCM, fertility is associated with the element of Water. When water is too abundant or too scarce, the earth and all forms of life suffer, including our own bodies. The element of Water shows its emotional imbalance in the form of Fear/Anxiety. When we are in a constant state of stress (life, work, family, infertility, etc), we put ourselves into a constant state of “fight or flight.” This creates a situation in which our bodies focus only on staying alive for the moment rather than long cycles like those required for fertility. By using acupuncture, we are able to break that constant loop of stress, find grounding, and reconnect with our natural cycles which can lead to improved fertility.
Choosing to find serenity in this life takes effort. Just think about when someone says, “Calm down!” or “Relax!” Has anyone ever calmed down or relaxed just by hearing that? I don’t think so. By regularly making the choice to build the space for quiet, for reflection, for balance, you are creating a foundation for the life you are searching for.
By Diana Zic, RPYT, Certified Functional & Integrative Health Coach
Whether you’re starting to plan your family, you’ve been on your journey for a bit, or have had your kiddos; having a conversation with your doctor about Polycystic Ovarian Syndrome (PCOS) can be a good idea if you are having symptoms!
What is PCOS and is who affected?
PCOS it is one of the most common hormonal endocrine disorders in women. It affects 7 million women in the United States alone. In fact, September is PCOS Awareness Month! Statistics show this impacts all races/ethnicities including: Caucasian: 4.8%, African American: 8.0%, Hispanics/Latinas: 13%, as well as, an added concern for teens as obesity increases.
For some women, symptoms can appear as early as their first menstrual cycle. Unfortunately, most women don’t know they have it until they start trying to conceive. PCOS can often looks like what is termed “normal” symptoms to have as a maturing woman. For example, you may have acne, anxiety (reduce anxiety and stress!), depression, or an eating disorder.
PCOS affect 7 million women in the US alone.
What Causes it?
Genetic predisposition appears to be strong with this diagnosis. Many women have mothers and sisters struggling with the same condition!
So, what are gals to do if they suspect PCOS?
Keep reading for tips!
- Talk with your doctor. It’s important to get the appropriate testing done to get clarification! A simple blood test and ultrasound is all you need to get started. You may even be eligible for a free check-up! Learn more here.
- Dietary Changes. Lose the low-fat, high-carbohydrate diets. Choose complex carbs, which are high in fiber and moves through your body more slowly so your blood sugar levels stays level. According to the Mayo Clinic, even a modest reduction in your weight – for instance, losing 5 percent of your body weight – might improve your condition.
- There are also supplements available that may be helpful. See the new research on PCOS and CoQ10 Supplementation today!
Here’s a prior blog of mine for some ideas of foods to start incorporating now.
- Be active. Exercising daily helps to reduce and/or prevent insulin resistance, reduce inflammation and it’s the happy drug for your mind by producing endorphins. It also helps to reset your HPA Axis – reducing stress! Try the Moon Salute Sequence today to see what a difference a few minutes can make! Join Pulling Down the Moon’s 6 Week Yoga for Fertility Series starting September 24th (for those trying to conceive), or CocoonCare’s schedule (for pre/postnatal care) to see for yourself!
- Get support. As I mentioned, 7 million women in the USA have PCOS, so don’t feel like your abnormal or broken beyond repair. We can help you implement these changes, reach out!
Wanna learn more on the root cause approach? Try the You Pick Two Special during PCOS Awareness Month to try two services (Acupuncture, Massage, Yoga for Fertility, or Health Coaching) for only $199!
By Robin Miller, RDN
Polycystic ovary syndrome (PCOS) is one of the most common causes of infertility in women, affecting up to 10% of women of childbearing age. Despite what the name suggests, it is actually a disorder of the endocrine system–think hormones! You can even be diagnosed with PCOS even without having ovarian cysts.
PCOS is characterized by high levels of androgens (“male” hormones), including testosterone, androstenedione, dihydrotestosterone (DHT), dehydroepiandrosteron (DHEA) and DHEA sulfate (DHEA-S). Higher than normal levels of insulin are also common due to to insulin resistance (much like that seen in type 2 diabetes) over time. When you have insulin resistance, your insulin isn’t working as well as it should to signal for glucose to be transported out of the blood and into the cells of the body to be used for energy. To compensate, the pancreas produces more insulin leading to high insulin levels, which seem to drive the higher testosterone levels in PCOS.
A recent study suggests that supplementation of Coenzyme Q10 (CoQ10), has beneficial effects on glucose metabolism as well as serum total and LDL cholesterol levels in people with PCOS. In this study subjects took 100 mg of CoQ10 daily for a 12-week period at the conclusion of the study a notable improvement in overall fasting glucose, insulin resistance, and total and LDL cholesterol was observed in subjects.
So, what is Coezyme Q10? Coenzyme Q10 (CoQ10) is a nutrient that occurs naturally in the body. CoQ10 is also in many foods we eat. CoQ10 is involved in energy production and acts as an antioxidant, which protects cells from damage and plays an important part in the metabolism.
Unfortunately, as we age, naturally occurring levels of CoQ10 in our body decline. Evidence suggests that supplementing CoQ10 may help many different conditions such as high blood pressure and heart failure and most recently PCOS.
Want to learn more about how supplements can help you? Schedule a nutrition consult and work with one of our Registered Dietitians to develop an individualized supplement and treatment plan specifically designed for you!
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!
by Michele Weiss, LMFT
Realistically, I imagine that there were many factors that lead to where I am now 30 weeks pregnant. While I endured over 100 shots in my abdomen and butt, 4 frozen embryo transfers, and countless failures and disappointments, I believe it was something more than the medication and the needles that got me to a healthy pregnancy- or at least kept me going.
I want to share my story because after hearing the stories of many infertility warriors over the years in my private practice, I feel that we need to be open and honest about the real deal. I want to share my story not just so people who have no understanding (or misunderstanding) of infertility’s devastating reach can get a glimpse into our world, but so that those of us in this community of warriors can feel less alone, less damaged and less ashamed.
My husband and I are carriers of a Jewish genetic disorder that lead us to terminate a pregnancy. This is a choice that, I know, evokes intense feelings and convictions in other people. As a woman who longed for, prayed for, and tried mightily for a healthy baby, the choice just felt like a heart string being ripped from my chest. We decided to pursue PGD and IVF after this loss as our route to building a family. However, trying for a child at 38 years old via PGD and IVF proved to be longer and more complicated than we expected.
What helped me through it? There were the practical things like having a doctor and an acupuncturist whom I trusted implicitly and knew were 100% in the trenches with me (Thank you again and again Dr. Eve Feinberg at Northwestern and Kelly Lyons at Pulling Down the Moon). Acupuncture at PDtM was the only place I truly felt I could deeply and fully relax. In the midst of doctor appointments, my medication regimen, diet, meditation, etc., acupuncture helped me slow down and find my center. For me, the holistic approach to treatment helped me feel like I was doing everything within my power to get to a healthy baby.
There were 3 touchstones that kept me going–
1. Stay away from Should’s
2. Small Joys
It was a pretty simple formula, but enormously difficult to implement in the face of failure after failure.
Stay away from Should’s. I decided to keep going until my doctor kicked me out of the clinic. It can feel like insanity to continue treatment in the face of unending loss and trauma. I reminded myself that I still had options if I could just expand the vision of how my journey to baby “should” go. These are not the idyllic narratives recorded in baby books. They are our valid, messy stories of bravery and passion, nonetheless.
Small Joys. I decided that I would not let infertility rob me of all moments of joy that still existed- even when those moments of joy were teeny, tiny. I continued going to SoulCycle in between cycles because I felt happy on that bike. I cuddled in my dog’s fur. I went out with my girlfriends for water and wine (guess who drank what?). I spent way too much money on delicious teas. I went to see my favorite bands in concert, my needles in tow, and shot myself up with medication in First Aid bathroom stalls. I knew I needed to create joy where I could and to stay connected to the parts of my life that made me feel like “me” while living in the crazy world of infertility.
Hope. I am deeply Jewish in my beliefs and spiritual practices. To my own surprise, during my infertility struggles I found hope in an Evangelical preacher. I would listen daily to “my Christian Rabbi”, as I affectionately referred to him. And minus the Jesus part which did not fit into my Jewish value system, this preacher’s message helped me tap into hope in the face of hopelessness and strength in the face of vulnerability. I think that God understands that when we are in the eye of the storm, we need to be a little radical.
Then, there was the woman who checked me in for my daily blood work and ultrasound at the infertility clinic. I think she could tell that I was particularly beaten down one morning. After the standard registration procedure, she slipped me a small blue post-it note that read, “Thanks for always coming in with a warm smile. You make my day and I pray for your family to increase with a new baby. TRUST”. Her kindness touched me and reminded me to always cling to hope. I still carry her note with me in my wallet so that I can get a dose of hope if I ever need it.
Even though I am a therapist who specializes in infertility and perinatal challenges, I do not really believe in advice when it comes to these matters. I have heard enough stories to know that each one of us has our own very unique heartache and very personal struggle. All I can share is what helped me. I was fierce and radical as a means to keep going. I expanded my vision of family-building when it wasn’t going the way I thought it would or should. I sought hope in trusted professionals and strangers, alike (even in unexpected places). As I sit here with my 7 month bump, I feel grateful that mine was the messy, painful, beautiful story that it turned out to be. And I will soon be proud and humbled to write that story in my daughter’s baby book.
Michele Weiss LMFT 3166 N. Lincoln Avenue, Suite 202 Chicago, IL 60657 312-213-4690 email@example.com Monday, Wednesday and Friday appointments available www.mweisstherapy.com
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.
Diana Zic, RPYT, CHC
I am extremely empathetic to those women with endometriosis as I used to suffer from pelvic pain, heavy menstrual flow, and at times vomiting and constipation dating back to the age of 12. Although I haven’t been diagnosed with the disease, I’m pretty sure the rupture of my appendix when I was in 3rd grade paved the way for my discomfort around my menstrual cycle.
For those reading this and are unsure of what endometriosis is exactly, according to Mayo Clinic, “it is often a painful disorder in which tissue that normally lines the inside of your uterus – the endometrium – grows outside your uterus. Often times it spreads to the Fallopian tubes, ovaries and the ligaments that hold the organs in place which may cause trouble when trying to conceive and cause pain.
Many women do not realize that they have it until they are trying to conceive. As it’s hard to diagnose without laparoscopic surgery (which I’ve done and it’s not the greatest experience as you can imagine) though it can help clean up scar tissue temporarily which can relieve discomfort and offer a window to try to conceive, but it’s likely to come back if the root cause isn’t found.
Also, I believe because so many women are suffering from pelvic pain and PMS symptoms it’s become seen as a cliché to have these symptoms so they are brushed off as “normal”.
The symptoms of endometriosis are typically associated with the menstrual cycle and unique to each woman and may include: Pain during sex, extreme cramps that don’t go away with anti-inflammatory support or that impede daily life, bowel and urinary disorders, periods that last longer than seven days, heavy cycle (changing pad or tampon every hour) and nausea or vomiting. YUCK!
Good news! There are ways to decrease symptoms in a non-invasive way FIRST!
- Be mindful. Start to track your symptoms daily: mood, stress levels, diet and exercise to see if there’s a pattern to your pain.
- Try an elimination diet. Certain foods may be triggering inflammation in your body. Read about some recommendations here from our nutrition team.
- Balancing your hormones. High levels of estrogen is connected to endometriosis. Studies show when estrogen is dominant over progesterone, or progesterone is too low, it can set a woman up for pelvic pain. Yoga can ease menstrual pain, improve fertility, and aid in hormonal balance.
- Seek out a pelvic physical therapist with expertise in women’s health and a massage therapist specializing in fertility. This can alleviate pain, symptoms, and aid in hormone balance.
Do you have or think you have endometriosis and are trying to conceive? Do you want support to help guide you to the root cause of your pain and heal your body? Join Diana for Yoga for Fertility with rolling enrollment on Wednesdays in Chicago (through April 10th) and the NEXT SERIES will start on Monday, March 25th at 7pm at Pulling Down the Moon or learn about our March fertility health coaching special with Diana at: 312-321-0004 today!
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!
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