PPPSS News & Events

PPPSS support, now via text messaging

For over 40 years Pacific Post Partum Support Society has provided support for parents who are experiencing distress during pregnancy or after the birth or adoption of a child—and now we can text!

Provided by our experienced counsellors, support via text messaging is available to anyone who needs it:

  • Moms and dads (until youngest child is 3)
  • Pregnant women and partners
  • Concerned family and friends
  • Professional and community helpers

During this pilot project, support via text messaging is available from 10 am–3 pm on Wednesdays and Fridays.  Just text 604.256.8088.

  • Don’t have many cell phone minutes and/or no landline?
  • Experiencing spotty reception or dropped calls?
  • Need support, but don’t want to wake the baby sleeping on you or talk about what you are feeling in front of your toddler?

Support through text messaging may be perfect for you!

As always, your safety and privacy are extremely important to us. Text message support will be provided through a secure healthcare text-messaging service already used by many help lines across Canada. This test message support pilot project was made possible through funding from the Integrated Primary and Community Care fund of Vancouver Coastal Health.

Questions? Please contact Jody Perkins at jody@postpartum.org.

Poster to share here: 2015_Texting_flyer.

My Daughter’s Postpartum Depression

By Shawnee Anderson

As mothers, we always hope to have the answers for our children — to have the ability to make their lives better, to be there when they need us, and to guide them in the right direction. I have never felt the level of devastation and despair that I experienced when my daughter suffered postpartum depression.

It has been almost two years since I watched her experience postpartum depression following the birth of her first child—a time when life should have been filled with ultimate joy, happiness and unparalleled hope for the future. Instead, I was overwhelmed with worry, anxiety and debilitating helplessness.

My daughter has always been a person who loved to experience all aspects of life with unlimited energy. Finding out about her pregnancy was a time of great excitement. She experienced a very difficult pregnancy with ongoing nausea and fatigue the entire nine months. My hope was that once the baby was born, she would be back as that person with a strong sense of well-being. Our beautiful granddaughter was born and with that indescribable jubilation, I believed her life would begin to improve.

Our granddaughter was three months old when my daughter and her family relocated to Denver from Vancouver to be closer to home during her husband’s sabbatical. I couldn’t believe they would be here for one year and I had the opportunity to see my granddaughter anytime I wanted and could also be available for my daughter during this adjustment as a new mom. And, of course, babysitting was on the top of my list!

A few months later, I was aware that my daughter was beginning to wean from breastfeeding but being uneducated myself with this process, I remained hopeful this would be yet another transition I could see her through. Shortly following this weaning process, it became very clear that she was developing a deepened depression – a place I had never seen her before.

One very dark Monday morning, we received a call from her husband stating she wasn’t doing well and could we come over to watch the baby so he could take her to the doctor. Little did I know this was the beginning of a very dark and devastating time in her life. Suffering from a small postpartum depression myself, I felt I was somewhat equipped to walk her through this. However, what she was about to experience was something I could never have been prepared for.

As she continued to see different doctors, desperate to find some answers, her depression continued to spiral out of control. The depression, coupled with intense anxiety, became her new reality. The anxiety continued to increase due to her fear she was unable to care for her baby and was she constantly worried that someone would be there to care for her during this time (since she felt she was unequipped to do so). This became a minute-to-minute survival and as her mother, I was polarized.

The reality of how bad it had gotten hit me the day I was talking to her in the kitchen. She looked at her baby’s appointment card hanging on the refrigerator and stated, “Mom, what if I’m not here for her next doctor’s appointment? I might not be. What if I don’t make it?” As she sat, staring out the window, I realized this wasn’t my daughter actually saying this—it was the PPD/A. I sat next to her trying to explain this was temporary but also realizing this was worse than I thought. What I was trying to say to her wasn’t sinking in and at some level I understood that. I did not want to leave her side ever again. She was working so hard to push through this and at the same time unable to comprehend how she would get to the other side – little did she know, I was feeling the same way. I wasn’t just frightened, I was terrified. But I couldn’t let her know that. This, too, had become my new reality.

My daughter’s already strong sense of responsibility was heightened following the birth of her baby. Her commitments made to others were unflappable. Understanding this was her core, I knew I had to take this one day at a time with great patience, love and consistency. I felt responsible for her emotional survival – it was important to find all the positive words I could; to maintain little emotion so she felt safe that I was her strength; to muster the strength of daily encouragement and most of all, to consistently offer unconditional love in every possible way.

As the days rolled by, it was a time of great hope to hear her say those five simple words – ‘I feel a little better.’ I lived for those words. As time passed by, she managed to slowly improve her emotional well-being but it was with much patience and hard work. She persevered through this darkness.

One of the most important lessons I learned during this time was that our daughters who experience pregnancy are not educated well enough on the postpartum period and what to expect. And because my daughter’s depression hit later in the year due to the weaning process, neither of us knew this was a possibility several months later. Had I been better educated about this, I could have developed the tools to help her understand she could get through this without so much suffering. I still feel responsible for not being more resourceful for her during her difficult time.

I cannot begin to understand how so many women experience PPD/A without having close family to support them. How can they be better educated to understand this can happen through any phase following child birth, including weaning from breastfeeding? What support can be offered to those who don’t have family to support them?

I am blessed to say that my daughter is doing well, has overcome great hurdles and has taken part in educating other women on PPD/A and how to help them walk through this period. I hope others who read this can benefit from my story and find ways to help others who suffer from this very serious, silent and misunderstood condition.

 

If you believe that someone you know is experiencing postpartum depression and/or anxiety, click here to read more about how to help.

The Impact of Immigration

By Clare Zeschky

I emigrated to Canada in 2008 from Scotland, a couple of years before my daughter was born. I didn’t expect to feel any sort of culture shock arriving here. After all there’s no language difference, the same TV programs, the same literature, the same music. North American culture was familiar, these were the people I had seen on TV programs and in films my whole life. How different could they be?

Before getting pregnant it was mostly a world of amusing idiosyncrasies, the small differences that make you laugh. There is an overlay of politeness and courtesy that is merely surface. The girl in the bank really doesn’t care how you are, no matter how much she sounds like she does. People, even strangers, ask questions that are more intrusive than we ever would back home, their sense of humour is different. The self-deprecating wit that serves us so well under the gloomy Scottish weather is taken as serious complaints. The answer “Not bad,” to the ubiquitous “How are you, today,” is met with frowns and concern. It’s the simple differences that set cultures apart.

Getting pregnant really compounded those. The medical system is so different. I was fortunate in having a friend who had recently gone through pregnancy and child birth. I got good advice on negotiating the ins and outs of MSP, midwives, doctors, blood tests. Again, it’s the simple small differences that made the experience bewildering. What do you mean I can’t get my blood work done in the doctor’s surgery? I need to go where? And wait how long?

There’s a lot of help out there for immigrants who arrive without English as a first language. A lot of organizations devoted to helping people integrate themselves when they arrive from other lands. Those of us who have the bonus of language are still hindered by vastly different systems that no one can easily explain. Have you tried asking someone to explain taxes to you?

After my daughter was born it seemed as though all those differences became a lot bigger. No one could see through the hearty laugh that follows statements like, “Oh I’m fine! Who needs sleep anyway?” or “Come on, it’s motherhood. We aren’t supposed to enjoy it!” And suddenly I realized how little I had as a support network. I had made friends but they were new friends. They weren’t the friends who had been with me for years, who had seen me at my worst and best, who I could call over for a glass of wine and end up in weeping, blubbery mess knowing they would have the exact right thing to say. There wasn’t family nearby, no mother to come pick up the pieces on a bad day and be that one person I could trust with my precious new baby because she managed to raise me and I am still here and alive and not too screwed up.

The world starts to close in a bit then. When you do try to meet other mums they don’t think like you. They don’t understand your humour, or your way of downplaying things. They don’t ask the right questions or say the right things. Even though they are friends they don’t see what you need. They offer a cup of tea instead of a good laugh, a walk in the park instead of a night in the pub. It’s not that they are wrong, it’s just all so different. So now you end up negotiating how to keep these odd new forms of friendship going when really all you can do is try to keep yourself going. Those things that seemed funny little differences a few months before were massive gaps in understanding.

I’ve always had a lot of social anxiety but the postpartum time became incredibly difficult. Just getting out with a new baby is a challenge but I started to hate going out because I would be so obviously different. Even something as simple as a mum and baby music class was massively stressful. I didn’t know any of the words to these songs that everyone else seemed to remember from their childhood. I found that people had a harder job understanding me because of my accent. It was frustrating. Looking back I realize it’s probably because they were as sleep deprived as I was and tuning in to my quirky words and phrases was probably terribly difficult!

It was incredibly lonely. It still can be at times. We don’t realize that we are so different when we have so much in common. As I have come out of my long postpartum period of depression and anxiety and started speaking to other mothers about their experiences I have come to realize that motherhood is a lot like emigrating. We leave our comfort zone, our place where we knew how everything worked and turned up in a strange and foreign land. So much is the same but we are surrounded by small differences that affect everything. We adapt and we grow and we change. We don’t get it right and we try again. We are lonely even when we are surrounded by people. And slowly we start to find our place, we make connections, figure things out and though we are still treading a new land, a new path for ourselves we accept the differences and learn to love them.

 

Clare Zeschky moved to Canada from Scotland in 2008. After her daughter was born in 2010 she suffered from PPD/A. She came to the Society as a volunteer in 2013 and loves being involved with supporting other mothers.

How Long Does PPD/A Last?

By Andrea Paterson

Many women suffering from Postpartum Depression and Anxiety want to know how long they can expect their symptoms to last. We all wish that there was a magic cut-off time when we could expect our mood to return to “normal” and knowing that the condition is temporary can be healing in and of itself. The length of a PPD/A episode is, however, complicated and there is no single unifying experience. But we can talk about the range of normal experiences in order to provide some context.

PPD/A is generally defined as depression or anxiety arising within the first 4-6 weeks after having a baby. But recent research is suggesting that this timeframe is unrealistic. PPD/A can begin before a baby is born and arise at any time within the first year after having a baby and possibly many years after that. Some new research suggests that maternal depression may be most common around the time your child turns four. Click here to read more about this. The main point is that more and more researchers are realizing that PPD/A is not confined to the time directly after having a baby and there is a wide range of onset periods with a corresponding wide range of resolution periods.

How long it takes to feel better can depend on a huge number of variables including the severity of your PPD/A, how long you waited to reach out for help, whether or not you have a history of anxiety and depression, what your home environment is like, how much support you are receiving, and how dedicated you can be to treatment and self-care practices. The website Postpartumprogress.com has an excellent article on the six major variables that can affect your recovery and I definitely recommend giving it a read. It can be viewed here.

There is a pervasive notion that PPD/A should be over by the time your baby turns one. Know that while research on PPD/A beyond the one year mark is still minimal, research is showing that it’s fairly common for symptoms to persist even when you have older children. This isn’t to say that you will never feel normal again, but it’s important to note that depression and anxiety wax and wane and you may experience relapse of symptoms or persistent low-level symptoms over time. Scientific American has released an article noting that Postpartum Depression might be better categorized as Maternal Depression in order to avoid the assumption that only mothers with very young babies suffer from mood disorders. You can read the article here.

The key thing is that no matter how short-lived or pervasive your PPD/A symptoms are, you can most definitely get better. You will not feel depressed or anxious forever if you receive proper treatment and care. Things that may minimize the amount of time you suffer from PPD/A include:

  • Recognizing the symptoms and getting help early
  • Self-care practices
  • Support Groups
  • Consultation with your doctor about medication options
  • Developing a personal support system that may include a partner, friends, or parents
  • Private counselling services

PPD/A can feel like a never-ending journey. It’s completely normal to be afraid that you will never feel well again. Let me assure you that you will! But it’s a process that involves delving deeply into your own sense of self, and creating the necessary support systems can take a significant amount of time. Be gentle with yourself.

It may also help to see the PPD/A period as a unique opportunity for self-examination and exploration. In his book Dark Nights of the Soul, Thomas Moore attempts to re-frame depression as a necessary period of inward journeying that allows a person to make exciting new discoveries about who they are and who they are destined to be. PPD/A is a period of intense change and transformation but it’s possible, amidst the chaos and pain, to gain very positive benefits from the experience. Many women say that PPD/A made them stronger in the end and put them more deeply in touch with their own needs, desires, and convictions. It’s sometimes hard to see the light at the end of the tunnel when you’re mired in the very centre of PPD/A but know that it’s there waiting for you and the world on the other side might be more glorious and beautiful than you ever imagined.

The Pacific Post Partum Support Society offers telephone support and group support for women suffering from PPD/A. Both support systems are proven to improve outlook for women suffering from PPD/A. Partners of women with PPD/A are also encouraged to use the PPPSS telephone support service. The earlier you reach out the better off you will be! You can contact a telephone support facilitator by calling 604.255.7999 in the Lower Mainland or toll free 855.255.7999. Support facilitators can also provide more information about support groups in the Vancouver area.

 

Andrea Paterson is homemaker and mother to a very active three year old boy. In the spare seconds when she is not chasing her preschooler she works as writer and photographer. She also manages to read voraciously in two page increments throughout the day. Andrea is a grateful prior client of the Pacific Post Partum Support Society and cannot recommend the services of this organization highly enough. That this sort of support is freely available is an extraordinary gift.

Defining Postpartum Psychosis

Image by Andrea Paterson. www.andreapaterson.com

Image by Andrea Paterson. www.andreapaterson.com

Article by Dr. Deirdre Ryan

In this article, Dr. Ryan provides a clinical exploration of the differences between postpartum depression and postpartum psychosis. It’s important to be able to distinguish between the two illnesses and to remember that postpartum psychosis is extremely rare. The Pacific Post Partum Support Society does not have resources to provide support or treatment to those with postpartum psychosis. If you suspect that you, or someone you love, is suffering from postpartum psychosis please contact your family doctor right away to discuss treatment options. If  you don’t have a family doctor, visiting a hospital emergency department is a legitimate option especially if you suspect that harm may come to mother or child.

Newspaper headlines outlining the details of moms who have drowned their babies or thrown themselves and their babies off bridges are horrifying and dismaying. They often hint at ‘Post-partum psychosis’ or ‘postpartum depression’.   If you are pregnant or a new mom, these headlines can be frightening too. Although incidents like these appear to occur often, they are, in fact, very rare and usually the result of untreated postpartum psychosis. Postpartum psychosis is the most severe psychiatric condition that can occur after childbirth and requires immediate treatment, including hospitalization for the new mom. Only 1-2 new moms for every 1000 births will experience it however.

The postpartum period is a vulnerable time for all woman because of physiological changes occurring in her body, especially drops in hormone levels and immunological changes. Some women have a higher risk of postpartum psychosis than others. For those with a prior history of a serious depressive or bipolar disorder or those with a family history of bipolar disorder, the postpartum period, with all its changes, is a particularly vulnerable time, especially for first-time moms.

In the majority of cases, the onset is rapid (within hours) and symptoms usually occur within 4 weeks of delivery. Typically, the new mom may experience insomnia and mood swings, in addition to psychotic symptoms, which might include rambling speech, disorganized behaviour, hallucinations (seeing and hearing things that are not present) and delusions ( false beliefs that are not based in reality). If the mom is hallucinating, she may hear voices telling her to hurt herself or her baby. Often her delusions relate to her infant, typically that the infant is possessed, has special powers or is dead. When a mom is psychotic, she has lost contact with reality. Usually, she has little insight into the fact that she is ill and needs treatment. This creates risks for herself and her infant as untreated postpartum psychosis is associated with an elevated risk of both suicide and infanticide. A woman with postpartum psychosis needs immediate hospitalization for her own safety and the safety of her infant. Often moms with postpartum psychosis   will need certification to ensure that they remain in hospital and get the treatment that they need. The woman will require a full medical workup, including a physical examination and blood tests. This is to make sure that she does not have any infection or medical condition that may be contributing to her symptoms.

Treatment for postpartum psychosis always requires medications, and may include sleep medications, anti-psychotic medications, antidepressants and mood stabilizers. Treatment will also include education and psychotherapy. Rarely, ECT (electroconvulsive therapy) is needed. Ideally, mothers should maintain contact with their babies while they are in hospital to facilitate bonding and attachment. Although postpartum psychosis is a potentially life- threatening condition in the acute phase, most women do very well with treatment and will be able return to their normal activities, including childcare. It is important that their partners understand their illness and ensure that they get the emotional and practical childcare support that they need.

Women who have been diagnosed with a postpartum psychosis need to be aware that they have a greater than 50% risk of developing another postpartum psychotic episode after a subsequent delivery. In all subsequent pregnancies, an integrated treatment plan should be in place which involves the woman, her family supports and her healthcare providers.

Postpartum depression is a more common condition than postpartum psychosis and affects 1 in 8 new moms. Women with a previous history of depression or anxiety or a family history of psychiatric illness are most at risk of developing a postpartum depression. Postpartum depression is often associated with anxiety symptoms, including excessive worry and panic attacks. New moms will complain about feeling sad and anxious with changes in their sleep, appetite and energy levels. They may have difficulty focusing or remembering things. They may also complain of feeling overwhelmed, guilty, worthless or hopeless. Some women may be distressed by thoughts or images of harming their children. In severe cases they may experience thoughts of suicide or may even have plans to harm themselves.

The vast majority of patients with postpartum depression will not experience psychotic symptoms. In particular, they will not experience delusions or hallucinations. Moms with postpartum depression have insight into their illness. They know that they are sad and not functioning as they would like and they are distressed by their symptoms. They don’t want to be sad and they don’t want their sadness to affect their families, especially their infants. In particular, they don’t want to hurt their children. Whereas moms with postpartum psychosis have lost touch with reality, moms with postpartum depression have insight into the fact that they need help.

There are different treatments available for moms with postpartum depression. Unless they are experiencing thoughts of suicide, most moms with postpartum depression will not require hospitalization. Most can be successfully treated by their health care providers in the community. Treatment options may include education, self- care strategies (with an emphasis on nutrition, sleep, exercise, getting time for oneself and mobilizing supports) and psychotherapy, either individually or in groups. For moms with moderate to severe symptoms, medications may be necessary. Medications may include antidepressants or anti-anxiety medications. The most commonly used antidepressants are the SSRIs or Selective Serotonin Reuptake Inhibitors, like Zoloft or Cipralex. When moms are breastfeeding and taking antidepressants, a small amount of the antidepressant is excreted into the breast milk but usually does not cause any side effects in the baby.

Most women will do very well with a combination of self- help strategies, therapy and medications. Unfortunately, women who do not get treatment may develop chronic depressive disorders and their children are at risk of developing learning difficulties, behavioural problems and depressive and anxiety disorders in childhood. Early treatment and support ensures optimal outcome for the mom and ensures that her baby does well in the first year and into toddlerhood and childhood.

 

Dr. Ryan did her medical training in Ireland and her psychiatry training at U.B.C. She has been working in the area of Reproductive Mental Health for the past 20 years. In 2012 she was made Medical Director of the Reproductive Mental Health Program at British Columbia’s Children’s and Women’s Hospital in Vancouver. She has been involved in expanding the Group Therapy Program and updating the Best Practices Guidelines related to Mental Health Disorders in the Perinatal Period. Her areas of interest include treating women with psychiatric illnesses associated with infertility and pregnancy loss. She is a Clinical Assistant Professor at U.B.C. and is actively involved in teaching medical students and residents.