Talking Points About PPD

Last night, I talked to a group of about a dozen therapists about postpartum depression.

Confession: I was nervous AF about this!

But: it was awesome! I talked for about 30 minutes, and when I was done, I felt like I had done a pretty good job of giving the therapists a crash course in helping moms with postpartum depression. I also prepared a handout, and I thought I’d share the information from the handout in case it helps someone else prepare a presentation about maternal mental health. Feel free to copy and paste whatever helps you!

Postpartum Depression Overview

  • Most Common Complication of Childbirth – Approximately 1 out of 7 moms experience PPD, but only 1 out of 3 get treated.
  • Spectrum illness with a range of possible symptoms, including: fatigue, rage, anxiety, insomnia, mood swings, loss of appetite, overeating, difficulty bonding with baby, despair, shame, guilt, restlessness, and intrusive thoughts of hurting oneself or the baby.
  • Risk factors include prior experiences with depression, anxiety or eating disorders; a traumatic pregnancy or birth; miscarriages; giving birth to multiples; history of domestic or sexual abuse; traumatic childhood; troubling relationship with parent; stress like loss of job or moving houses; divorce or relationship issues; lack of social support; low self-esteem; perfectionist tendencies; baby with colic.
  • Hormones often play a huge part in PPD, but dads and adoptive parents can suffer from it as well.

Issues that Distinguish PPD from “Regular” Depression:

  • Hormones!
  • Transition to motherhood
  • Breastfeeding
  • Sleep deprivation
  • Newborn Boot Camp
  • Traumatic birth experiences
  • Mom guilt
  • Pressure to be Super Mom

Universal Message For Moms With PPD

  • You are not alone.
  • You did not do anything wrong.
  • You do not deserve this.
  • With proper support, you can make a full recovery.

What I Found Helpful When I Had PPD

  • Learning about PPD
  • Being told, repeatedly, that it takes a village to raise a child and I needed all the help I could get.
  • Baby gates and safe play areas.
  • Journaling
  • Building my MOMentum
  • Social media fast
  • Learning to separate my sense of identity from my thoughts. “I am not my thoughts.”
  • The airplane analogy: Put on your oxygen mask first before the child’s so you don’t pass out
  • Sharing my story to squelch the shame
  • Connecting with other moms who had similar experiences
  • Bringing my husband to a session with my therapist.
  • Embracing self-care.
  • Figuring out that self-care meant more than bath bombs and pedicures.
  • Anything that let me feel like I was in charge of my recovery.
  • Being told that life would get easier as my kids get older.
  • Brushing up on my mom skills.
  • Learning to leave my child alone.
  • Having fun.
  • It’s okay to be a mom who is not into babies!

What I Found Unhelpful When I Had PPD

  • Being told that I was in “denial” about my depression. I did not even understand what it means to be “depressed” and had to figure this out on my own. I think depression is one of those experiences that is easier to understand in hindsight.
  • Things like gratitude, mindfulness and meditation – I love all of this stuff now, several years after recovering, but when I was in crisis, this was more than my mind could handle.
  • People comparing “baby blues to PPD”
  • People telling me that newborns are like “boot camp” without asking deeper questions about the way I felt.

Pasadena Resources

  • PCC Parent Education classes – free! Awesome!
  • Peer-to-peer support group at The Family Room –
  • Mom’s Club –
  • Huntington Hospital’s weekly breastfeeding support
  • Huntington Hospital’s postpartum outpatient program

Resources Beyond Pasadena

  • Postpartum Support International –
  • Postpartum Depression for Dummies, by Dr. Shoshana Bennett
  • Pregnant on Prozac, by Dr. Shoshana Bennett – for moms concerned about medication
  • PPD in Plain Mama English –
  • com, blog that has tons of old posts from different moms sharing their stories
  • My memoir, Adventures with Postpartum Depression, is available on Amazon.
  • Podcasts: My show, Adventures with Postpartum Depression, shares interviews with moms who have experienced a maternal mood disorder. Another great show is Mom & Mind, hosted by Dr. Kat, a psychologist in Claremont
  • Bottled Up: How the Way We Feed Babies Has Come to Define Motherhood, and Why It Shouldn’t by Suzanne Barston. For any mamas struggling with guilt about breastfeeding.

Episode 78: Emily Souder’s Story

This week, we have an interview with Emily Souder.

Emily is a licensed clinical social worker in Maryland. She offers therapeutic services and healing tools to clients through self-reflection guides, pre-baby and postpartum consultation, workshops, and psychotherapy. She’s married to her best friend (so cheesy, but so true) and has two littles, ages 1 and 3. She likes tea, playing outside, and all of that “woo” spiritual stuff.


Emily is the author of Birth Story Brave, a guide for reflecting on your childbirth experience, and Birth Story Held, a guide for birth doulas, midwives, and OB/GYNs to process their experiences with clients. Both books are available on Emily’s website. Birth Story Brave is also available on Amazon.



You can find Emily in a bunch of places:

She’s also also a MotherHustle (a powerful online publication geared towards mom/entrepreneurs) panelist, and you can find her articles right here:


Emily is running an online workshop in October 2018 for birth workers. Check that out at

Thanks, Emily, for coming on the show!

Episode 77: Brandon’s Story: Supporting Your Wife When She Has Postpartum Depression

Tyra Fainstad shared her story of postpartum depression and postpartum anxiety on Episode 74 of the podcast Adventures With Postpartum Depression. The show notes for Tyra’s episode are right HERE. This week, her husband Brandon shares his side of their story. 

Like Tyra, Brandon is a physician so going into parenthood, he knew about maternal mood disorders. Mostly, though, he had the image of a sad mom hiding in the closet.

Tyra is prone to anxiety by nature. When she became pregnant with their first child, Brandon observed her becoming more and more anxious. The planned c-section was stressful for Brandon, and all of the anxiety of the c-section carried over into the first 48 hours of breastfeeding and figuring out how to soothe a screaming newborn.

Breastfeeding was a huge issue in the early weeks. Brandon is a problem solver and feels energized by action. He wanted to be involved and helpful when breastfeeding was difficult. He attended the meetings with lactation consultants. But he felt powerless. He had so much  energy to take action but he could not actually breastfeed the baby. If he offered to give the baby a bottle, the offer upset Tyra.

One week into parenthood, Tyra took a PPD screening questionnaire and scored highly on the anxiety questions. Brandon knew something was wrong but it was increasingly difficult to help Tyra. His offers to help were seen as unhelpful by Tyra. It was like there was a wall between Tyra and everyone who wanted to help her.

Three months postpartum, Tyra seemed to come out of a fog. She had seemed like a zombie. But their newborn finally came out of the colic phase, and therapy seemed to help Tyra.

A year postpartum, Tyra was pushing for Baby No. 2. It was as if she had amnesia about her postpartum experiences. Or, maybe she wanted to prove that she could be the mother of a newborn the “right” way.

Tyra got pregnant with their second child. Brandon and Tyra’s discussions about breastfeeding were explosive. Brandon wanted an exit strategy, but breastfeeding was a complicated issue for Tyra.

Their son Desi was born and he was a much easier baby. But if you listened to Tyra’s episode, you already know that despite her best efforts, she descended into a second round of postpartum depression.

From Brandon’s perspective, this second round of postpartum depression has been so much easier than the first. Tyra has greater insight and is self-reflective. She is actively trying to solve her problems whereas last time, she didn’t see the problem.

After the birth of their first child, Tyra’s postpartum depression felt very personal to Brandon. He felt like he wasn’t doing the right things to support Tyra. Brandon felt like he was failing his family. He also felt angry and resented Tyra.

This time around, Brandon is helped by the knowledge that this illness has an arc. It helps to know from personal experience that Tyra’s postpartum depression and anxiety will not last forever. He’s not taking things personally. Instead, he’s watching the postpartum depression play out like a movie. He’s not trying to fix things or find solutions.

In Brandon’s experience, his guy friends want to talk about their experiences as new dads. Men want to talk about the way parenthood is affecting their relationships with their wives. There’s a stereotype that men do not want to talk about their feelings, but maybe we are not giving the men we know enough credit.

Thank you, Brandon, so much for coming on the show and sharing your story and perspective.

Write Your Postpartum Story: How Did You Get Pregnant?

First, an apology about terminology. I’m calling this series “Write Your Postpartum Story” but you can call it whatever you want. Maybe you are writing your pregnancy story, or your motherhood story, or your mental health story. It does not matter what you call your story. I wrote a book about POSTPARTUM depression, so I have that word seared across my brain. But you can substitute whatever word works for you.

So with that apology out of the way, let’s move on to our next prompt: How did you get pregnant?

Were you trying to get pregnant? If so, how many months/years did it take?

Did you take your temperature to figure out when you were ovulating? Or did you use an ovulation kit?

Did you talk about the mechanics of getting pregnant with your partner?

Did you need fertility treatments?

If you needed fertility treatments, that might be a fertile area for journaling. (Oh my god. I’m sorry. Worst pun ever. But I’m not deleting it.) Brooke Shields wrote about fertility issues and treatment in her memoir Down Came the Rain. I did not need fertility treatments, so I really can’t dig into this area. But I have known a lot of families who struggled with infertility, and many of them have A LOT to say on the subject. If you needed fertility treatments, that might be a huge part of your postpartum adventures.

Were you able to get pregnant? Did you adopt? Did you know adoptive parents can get postpartum depression?

As you write, there’s no need to answer all of these questions. I’m just throwing out questions to get the wheels in your head turning. Our stories are important. What’s your story?

By the way, I will eventually write some posts about ways to publicly share your story. But if, as you write, you find yourself eager to share your story with the world, please consider sending me a blog post. You can reach me at I’d love to start publishing some guest posts. 

Episode 76: Looking Ahead At The Next School Year and Decade

I have a cold – summer colds are the worst – but I wanted to do an episode this week since it’s been a couple of weeks since I posted Episode 75.

Big personal news: Pippa started kindergarten yesterday! She has entered the Big Leagues of elementary school, and Julian starts preschool at the end of August.

I’m trying to figure out how much time I want to spend volunteering at their respective schools. It’s a difficult balancing act. I want to be involved with their education. I feel called to be involved. But I also feel called to be a writer and storyteller. I want to write a fiction series and keep podcasting – so how do I answer the call of motherhood without suffocating the call of creativity?

I don’t have answers, but I’m paying attention and realizing I will make mistakes as I navigate these new waters.

For instance, at Pippa’s back to school night, I signed up to do ALL the volunteering: to be a room parent; to work with the art and science docent program; and to help run the school carnival.

Eek! Too much!

Talking to a friend today, I realized what I really want to do is be involved with Pippa’s classroom. I am not an event planner. I don’t want to run a school carnival. It’s not my super power!

Instead, I’ll try to help Pippa’s teacher in the ways that make sense to me. I’ll volunteer in her classroom every couple of weeks for a couple of hours so I can see what her days are like.

I’ve been reading a book by Tony Robbins called Awaken the Giant Within. I’m only fifty pages in but damn, I have learned a lot. He talks about how people overestimate what they can do in one year but underestimate what they can accomplish in a decade. We need to plan for the next ten years of our life, because one way or another, they are going to happen. Do you want to live the next decade intentionally or just end up in some random place?

I know where I want to be in ten years. I want to be a healthy writer who has deep relationships with her children and husband. Over the next ten years, I will have more than enough time to write and publish several more fiction and nonfiction books. But realistically, over the next two years, I don’t have the time to publish any more books. That’s okay! When Julian is in the Pre-K program in two years, I will have more than enough time to be the mother and writer I want to be.

But for the next two years, I have less time and need to lower my expectations.

So I won’t be running the school carnival (cough, ever), and I won’t be publishing any books. But here’s what I am going to do:

        • Take a lot of long walks, eat healthy, and lose weight. I can’t be a mother or writer if I don’t have my health.
        • Journal every day. Journaling makes me feel like my best self.
        • Keep producing and sharing podcast episodes as often as possible, but I’m not going to force myself to produce weekly episodes because frankly, that does not feel right.  
        • Write the rough draft of the first novel in my fantasy series.
        • Run the book fair at Julian’s preschool and do my volunteer co-op days.
        • Volunteer in Pippa’s classroom every couple of weeks for 1.5 or 2 hours at a time.
        • Blog almost every day. I don’t know why, but this feels right and my intuition wants me to blog.

As I continue on my motherhood adventures, I am going to keep blogging here but only about things related to mood disorders that arise during pregnancy and the postpartum period. If you are in the immediate crisis of something like postpartum depression, you shouldn’t be worrying about weight loss or the meaning life or all the other things that I want to write about. You just need to focus on beating postpartum depression or whatever maternal mood disorder is your poison.

To allow myself to explore other interests, I have started another website called and that’s where I’m going to publish my blog posts about non-PPD stuff.

Ok, whew, that’s enough rambling! These head colds make me write and write and write… But hey, hitting the pause button and taking stock of my life and dreams feels good. Damn good. 

Post-PPD: You Can Still Have Crap Days

Since recovering from postpartum depression, I have become extra-sensitive to my moods and energy levels. When I feel blah, I immediately worry, Is this depression?

But here’s the thing about life: even after conquering a mood disorder, you are still entitled to the occasional blah day. Not every blah day needs to be seen as a symptom of depression.

Maybe it’s PMS.

Maybe you had a fight with your husband/mom/best friend/whomever.

Or maybe it’s the common cold.

You are allowed to have terrible, horrible, no good, very bad days.

The past couple of days, I was sick in bed with a summer cold. Thursday night, I was feeling tired, grumpy and congested. When I woke up Friday, I felt miserable. Sore throat, muscle aches, exploding sinuses… all I wanted to do was lie in bed and rest.

Rest is good. Like Daniel Tiger says, When you’re sick, rest is best, rest is be-es-st. You’re not supposed to run around like a martyr and act as if you are healthy when your immune system is begging you to take a nap.

And yet, still I worried. It’s been five years since I was diagnosed with postpartum depression. I have been depression-free for over four years. And still, I worry about my mental health when I’m tired.

Is this a relapse?

Is the depression back?

Is the fatigue all in my head? 

I snuggled up on the couch with Julian, pondered, and decided that I was tired because my immune system needed me to rest.

Part of me feels annoyed that I can’t just have a cold without worrying about depression. But as I write this post, I realize my vigilance is good. Mental health is precious. Maybe I expend a little extra energy over-analyzing the common cold, but I think that is better than burying my head in the sand and risking a full relapse.

Postpartum depression changed me, but again and again, I realize those changes were for the best.

Writing Your Postpartum Story: Did You Make the Right Decision?

When did you decide to become a mother? How?

Did you spend a lot of time pondering the decision? Or was it just something you knew and did not have to think about?

Did you think about it enough? Too much? Do you wish you had spent more time reflecting on the decision to be a mother?

And here’s a question you might avoid: was the decision to become a mother the right decision?

Whew. Deep breath. Just think about these things during your morning or afternoon or evening walk. Or while washing dishes or combing the knots out of your hair. Then write about them in your journal. You don’t have to share these questions or answers with ANYONE – not your child; not your mother; not your significant other; not your best friend; not even your therapist or psychiatrist.

But I think we owe it to ourselves to be honest with ourselves in our thoughts and journals.

I speak to a lot of moms who have or had postpartum depression, and a lot of them grapple with these questions: Did I make the right decision? Should I have gotten pregnant? Should I have become a mother?

The questions might seem monstrous.

That’s okay.

This is something I have learned about monsters: its much worse to bury and push them down than it is to actually face them.

My husband and I have talked about the What Ifs. What if we had known what was going to happen when I got pregnant? What if we had known the hell my hormones would drag me through? What if we had known how dark the darkness would get?

We probably would have decided to skip the whole business of parenthood and proceed directly to adopting a herd of small dogs.

That’s the truth and it tears me up inside to think about a life without Pippa and Julian, but it’s also a relief to admit the truth: if I had known, I would have chosen a different life.

Thank goodness I did not know the future when I was contemplating my decision to get pregnant or not. Because even though I know motherhood was absolutely the right decision for me, I also know that it was not. Because it put me through hell. It nearly destroyed me. So depending on your logic, we chose poorly. Very, very poorly.

Somehow. Some way. I don’t know why. But just asking these questions in my journal helps me feel better.

There’s no right or wrong answer to these questions. What you write in your journal has no bearing – no bearing whatsoever – on your worth as a mother.

But asking and face the tough questions gives us the chance to feel fully human.

Learning How To Rest and Relax

Ever since I recovered from postpartum depression, my mental health has been one of my top priorities. I’ve discovered it’s not something I can take for granted. I need to do a lot of different things in order to feel like my best self.

When it comes to feeling like my best self, I tend to focus on the activities and behaviors that keep my momentum strong. Things like:

  • Getting outside,
  • Going new places,
  • Walking,
  • Swimming
  • Making new friends,
  • Crafting and painting,
  • Writing,
  • More writing,
  • Reading,
  • Podcasting,
  • Even more writing,
  • Running a peer support group,
  • Playing with my kids,
  • Going on fun dates with my husband,
  • Cooking and baking,
  • And on and on.

These things are important, but I often overlook an essential part of my mental health: rest and relaxation.

Yesterday was the last day of my cycle, and I was feeling some wicked PMS. It was also 100 degrees in Pasadena. Seemed like a good day to watch a movie, watch some television, and then watch another movie.

Instead, I decided we should get outside and head to Kidspace, a children’s museum that has a massive shady nature area with a stream. I packed up towels and swim diapers and had lots of fun wading around the stream with my kids. It was great.

Then Julian ran away.

It happened after lunch. We were walking from the lunch area back to the main building to partake in some final kid revelry (look at fossils! paint! climb through the ant tunnels!) when Julian disappeared. One second, he was like two inches from my elbow. The next, poof, he was gone. He has sprinted away from me in department stores, but this was worse. He could have gone in a dozen directions – to the bathroom, back to the the lunch area, off to the oversized playing blocks, or, right out the exit. To the parking lot.

Everything seemed to go into slow motion. He was only lost for a couple of minutes, but during that time, I felt as if I was falling down a blackhole, into a world without Julian. It was as if the cells in my body rearranged themselves. Bones became muscles, muscles turned into blood, and when the employee with a walkie talkie asked me to describe my child, I could not speak.

Then someone said there was a little boy in the gift shop, and I ran, and there he was. My boy, my heart, waiting impishly, by the counter, not realizing my world had ended seconds ago. I scooped him up and announced we were done. We were going home. No guilt. Right before Julian bolted, I had told the kids we could stay and play some more, but I knew I was shattered and done for the day.

We got home around 1ish, and I crawled into bed, closed my eyes, and zoned out.

The kids played around me. They crawled into bed and played doctor and then ran off and turned the house into a stuffed animal hospital. I read for a few minutes, but mostly, I just lay in bed, feeling zapped. I knew I had PMS, and the PMS had amplified the “Julian running away incident” and I’d feel better in a few hours, but I also felt as if I’d never get my energy back.

But just as my rational brain had promised, my energy started to return around 4 p.m. I emerged from bed. I snuggled and watched The Incredibles with the kids. (Who were outraged that Incredibles II is still only in theaters.)

And by 7 p.m., I felt human. I ate dinner. I went on a walk. I hung out with Nathan. I went to bed knowing I would feel refreshed and vibrant in the morning.

I was right.

But still, I’m always learning. Learning and relearning lessons that I thought I had already aced.

I have learned so well that I need momentum and activity, but I have some learning to do on the Rest and Relaxation front. Maybe if I pay attention, I can learn from the rhythm of my menstrual cycle. I don’t want to keep pushing myself to the breaking point. I don’t want to be the sort of martyr mom who goes to the children’s museum when it’s hot AF and PMS is raging out of control.

But more important: I want to be compassionate with myself.

So maybe I won’t learn. Maybe I will keep pushing myself a little too hard when I need to slow down and relax. And that’s okay, because I’m going to be compassionate and patient with myself. Maybe I need to push myself a little too much another hundred times in order to perfect the art of compassion. Who knows? Maybe I need to keep “failing” one lesson in order to learn something more important.

Adventures with Mirtazipane Weaning:A PMS Road Bump

I’ve written several posts already about weaning off mirtazipane:

After my post last week, I went to bed without mirtazipane. It went great! I fell asleep easily, slept beautifully, and woke up feeling refreshed and vibrant.

The next night, as planned, I took my tiny dose of 7.5 mg of mirtazipane. Once again, I slept well.

Then the next night, as planned, I went to bed without mirtazipane. And I tossed. I turned. My adrenaline kicked into high gear. Thoughts started racing. Little phantom bugs were crawling up my arms. Fuck, I thought, I guess I need to slow down this process even more.

I got out of bed and fumbled in the dark to find my bottle of pills. Then, I remembered: it was the end of my cycle, and I always have one night of so-so sleep before my period arrives.

I decided to keep taking 7.5 mg of mirtazipane until I got my period and felt my hormones hit the reboot button. So all last week, I kept taking mirtazipane at bedtime. There’s no need to be a hero when I already have PMS.

I’m so glad that I have started paying attention to my cycle. Now when my hormones start to twist and writhe, I can think, Oh, hi, PMS, and then be extra-tender with myself.

My PMS kicked into mega-high gear yesterday afternoon around 4 p.m. I just felt out of sorts and could imagine my hormones spinning like pinwheels during a hurricane. Other times, I felt like a pressure cooker with too much steam. I just could not wait for my period  to arrive and take the lid off the cooker.

I’ve never actually worked with a pressure cooker. Does the analogy work?

I continued to feel out of sorts this morning and afternoon. I was short tempered and spent a few hours reclining in bed while the kids ran around and kept themselves busy. Then, around 4 p.m., I could feel something subsiding. I calmed down (a little) and my energy returned.

My period arrived a few hours later. Bliss! I still feel raw and worn out, so I’ll be taking my mirtazipane tonight, thank you very much. The next few nights, I’ll pay attention and when I’m feeling fully like my best self, I’ll try skipping the mirtazipane again.

Amidst all the uncertainty of weaning, one thing remains constant: this is truly an adventure.

But there’s no need to be a hero. Or rather, there’s no need to try to feel like a hero by weaning myself too quickly off my medication. Because after all my postpartum adventures, I’m already a hero. I have nothing to prove.

Episode 75: Dyane Harwood’s Adventures With Bipolar Disorder

Dyane Harwood is the author of Birth of a New Brain – Healing from Bipolar Disorder and I got to interview her for Episode 75. 

I love Dyane’s memoir so much. As a maternal mental health advocate, it helped me understand bipolar disorder better. But as a woman who had postpartum depression, I related to so many of the themes and issues discussed in the book.

Dyane’s bipolar disorder was “activated” after the birth of her second daughter. She is stable now, but holy mother, she had an epic adventure to get there. She worked with multiple psychiatrists, was hospitalized seven times, and her husband even had to call the police once.

Dyane’s story hits upon so many relatable and important issues, including:

      • money woes because hello, mental health care is not exactly cheap;
      • the difficulty of asking for help;
      • mortification and humiliation from having a mental illness;
      • the difficulty of finding effective medication (I hear about this one from so many moms);
      • the logistical nightmare of finding childcare when mom is suffering but there are babies and toddlers and children who need mom’s attention;
      • prior history of depression before an actual diagnosis;
      • caffeine and sugar and the difficulty of giving up something that you enjoy even when you know its suboptimal for your mental health (I could dedicate an entire blog to this subject);
      • sleep deprivation;
      • weaning off medications;
      • and so much more – my highlighter was so busy while I read this book!

I could write about Dyane and her beautiful book all day, but really, you should just go read it for yourself. I would like to say that Dyane does a wonderful job of weaving clinical information into the story without making it feel too much like tenth grade chemistry (oh let’s not get started on the disaster that was my tenth grade chemistry class!)

Final note: Dyane mentioned during her interview, which sounds like a great resource for letting loved ones know when there’s a medical crisis.

Where you can find Dyane:

Twitter: @DyaneHarwood


Upcoming website:

Her blog Birth of a New Brain (currently on hiatus but the 440+posts remain accessible):

And finally, her beautiful memoir, Birth of a New Brain – Healing from Postpartum Bipolar Disorder is available on Amazon. 

Thanks, Dyane, for all that you do!