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EP 26: Maternal Mental Health - Diving into Perinatal Depression and Anxiety with Mallory Haney
2.2k Plays2 years ago
What is Perinatal Depression? It’s depression that occurs in women during pregnancy through the first twelve months of the postpartum period and it affects 1 in 7 women. Mallory Haney is a cognitive behavioral therapist focused on perinatal anxiety and depression. She joins the mom group chat this week to share her expertise. Their conversation ranges from how to differentiate depression from the “baby blues”, what symptoms look like, and the stigma that still surrounds perinatal depression and how that makes it so isolating. They also cover how to find help and support, and what treatment can look like.
Even though this is a heavier topic for the pod, this episode feels like a warm hug. At the time of recording, Shannon, Whitney, and Candace were all pregnant, so you better believe they were all ears and eager to learn from Mallory. The conversation gets very raw and personal in a way we hope resonates with others who may be experiencing hard times in the pregnancy or postpartum period. Please enjoy this conversation with Mallory Haney.
Resources for perinatal depression from Postpartum Support International can be found at:
postpartum.net
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Transcript
Introduction and Focus on Perinatal Depression
00:00:07
Speaker
There's no right way to do it.
00:00:12
Speaker
Oh, we're going to get into it. Happy Tuesday moms. This week on the podcast, we are talking about perinatal depression. Perinatal depression is depression that occurs in women during pregnancy through the first 12 months of the postpartum period. If you're like me, you've heard a lot about postpartum anxiety and depression, but less about those symptoms as they occur during pregnancy or are even triggered by pregnancy.
00:00:38
Speaker
Pregnancy is supposed to be the most magical, beautiful, natural time in a woman's life. Or that's what we're told sometimes by society.
Insights from Mallory Haney, Therapist
00:00:50
Speaker
And it feels very confusing and weird to have such negative feelings as depression and anxiety in the time that's supposed to be one of the most magical times of your life. So we felt this was a really important topic to bring awareness to.
00:01:07
Speaker
To help us learn about perinatal mental health, we welcome Mallory Haney to the chat. Mallory is a cognitive behavioral therapist with certifications in perinatal depression. She is a wealth of information on all things maternal mental health. Our conversation ranges from how to differentiate depression from those quote-unquote baby blues
00:01:28
Speaker
what the symptoms look like, the stigma that still surrounds perinatal depression and how that can make it so isolating. We also cover how to find help and support and what treatment can look like. We absolutely loved having Mallory on to share her experience and expertise. Even though this is a heavier topic for the pod, this episode feels like
00:01:49
Speaker
warm hug or a cozy cup of tea. At the time of recording, myself, Candace, and Whitney were all pregnant, so you better believe we were all ears and eager to learn from Mallory. The conversation gets raw and personal in a way that we hope resonates with others who may be experiencing hard times in their pregnancy or postpartum period. Please enjoy our chat with Mallory Haney.
00:02:15
Speaker
Mallory, welcome to the mom group chat. How are you doing? Hi, thank you for having me. We're so excited that you're here. And to get things started, we want you to tell us a little bit about yourself, your background, which please include family life, all that jazz. Tell us about it.
Personal Experiences and Family Dynamics
00:02:34
Speaker
Sure. Well, I'm Mallory. I am a counselor in private practice here in Nashville and work
00:02:41
Speaker
primarily with OCD, anxiety disorders and periodontal mental health. And personally, I am married to a great partner and have two little ones, the oldest will be four and about three weeks and the youngest is four months old and just started daycare last week so I can get back to working outside the home. How was daycare drop off?
00:03:09
Speaker
Uh, you would, you would think it gets easier with the second one. We've done this before. She's got the same teacher she had or my older daughter had.
00:03:20
Speaker
And so we know exactly what to expect. She's been through all of the classes at this point, and I'm still just as much of a sobbing mess dropping her off last week. But she's living her best life. They're doing so much fun stuff with her that I would never even think of doing, like painting in plastic bags. That is so true. I see all those sensory bins and stuff kids have. I'm like, I would have never done that. I'm not a teacher.
00:03:48
Speaker
Yeah. Absolutely not. So do you have two girls? I do. I have two girls. Yeah. I am about to be a two-girl mom. So tell me some amazing things about it. Congratulations.
00:04:02
Speaker
Well, the older one was so excited to have a little sister. She might've been just as excited if it was a little brother. I don't
Recognizing and Understanding Perinatal Depression
00:04:10
Speaker
know. But we've always tried to let her explore her own gender identity and she very strongly identifies as a girl. And so all sorts of girl things excite her. And I think having a baby girl is especially exciting for her. She wants to pick out her clothes and
00:04:29
Speaker
She just adores the baby. We were afraid she might be aggressive or jealous and she is her favorite person now. So she just kind of flies right past mom and dad and wants to see her sister first thing in the morning and she gets home from school. It's her favorite person. They're both so cute.
00:04:47
Speaker
Beautiful blonde hair, beautiful blue eyes. They're gorgeous. Mallory and I go way back to last year. She's my neighbor. She is my neighbor. But when Candice brought up the conversation a few weeks ago about perinatal depression, I thought, oh my gosh, my neighbor Mallory does this for a living.
00:05:14
Speaker
Can you tell us a little bit of what that is? Um, just because I feel like a lot of people don't know that it exists or they only hear about postpartum. So if you could tell us a little bit of what it's, what it's about. Yeah. I think for so many years, all we heard was postpartum depression. And so people didn't realize that it can happen during pregnancy or anywhere along the fertility journey.
00:05:41
Speaker
And so changing to calling it now perinatal mental health, perinatal depression helps us catch then cases that occur during pregnancy. So I think a lot of us probably get screened postpartum for depression, but it's frequently missed during pregnancy. And we know that
00:06:05
Speaker
treating depression anxiety OCD other mental health concerns is so important during pregnancy for both mom and for baby that both have better outcomes when psychiatric symptoms are treated. So thinking just about this journey from
00:06:23
Speaker
conception or really even deciding we want to try to conceive all the way through 12 months postpartum. And that doesn't mean that symptoms just magically go away at 12 months postpartum, but within our limited classification right now, that's how we think about it is up to 12 months postpartum. And then of course, care is still available well beyond that.
00:06:46
Speaker
Is there like, um, I guess how long you mentioned a lot of people haven't thought about it. I didn't even, I've never even heard the term before. Um, just, just talked about it, the experience we have with our friends. So like, how long is the medical community or the psychiatric community been?
00:07:05
Speaker
talking about this? Is there like an uptick in awareness? I think there certainly is a push to increase awareness. So the DSM or the Diagnostic and Statistical Manual is the guide that we use to diagnose any sort of mental health issues. And it wasn't until the fifth revision that we even had an identifier for in the postpartum period.
00:07:35
Speaker
And of course it's time limited, which still I think probably misses a lot of people's symptoms. And I think that's been born out of advocacy work done by perinatal mental health organizations so that hopefully we can have providers who maybe don't specialize in perinatal mental health that can start to catch this in their patients or in their clients who might be seeing them
00:07:59
Speaker
for other things. So is this just like an OB maybe referring you if you're having that conversation or should you, or are you already seeing a therapist? It's like, we maybe need to dive deeper into that. It could be either. It could be both. Obviously OBs are kind of the, they're the most logical point to start because most people are attending their prenatal visits and so, and their postpartum visit. So that's a good place to start. And we certainly want them to screen.
00:08:29
Speaker
A lot of times they don't for whatever reason. It might be because they don't have time. It might be because they don't know where to send people if they scream positive. And certainly if somebody's actively in crisis, now what do we do if we have an untrained provider who's finding that out? It's often pediatricians as well. I know even my daughter's pediatrician
00:08:50
Speaker
Every time we go in in the first year postpartum, I fill out a survey about my mental health so they can be really valuable, but it can be a therapist, it can be a psychiatrist, it can be many different providers. And one of the things we know is that when people are experiencing psychiatric symptoms, they're less likely to attend those appointments.
00:09:11
Speaker
So that might also be a warning sign for providers. You know, if my patient is missing her appointments, yeah, reach out and find out if there's something else going on that's preventing her from being able to even come into the office for prenatal visits or for postpartum visits.
00:09:27
Speaker
The reason I think we're, we're having you on and like where this conversation has come up is just the way I have been feeling this pregnancy. I've been struggling a lot mentally. And one of the things that happened, like not even just, I don't like, not that I was necessarily trying, but I stopped my therapy appointments. Like I just let them fall.
00:09:50
Speaker
to the side and I stopped going for almost two months. And it's funny, like you say that because that's exactly what happened to me, like that I stopped going and it wasn't like a choice. It just kind of happened. I knew I mean, I knew I was going to cry during this episode, but we're all pregnant, Mallory. I don't know. I didn't know that.
00:10:12
Speaker
Okay, I'm 14 ish weeks pregnant and I've been having a tough time and just I would say like last week or two weeks ago I started to talk about it and like kind of Acknowledge how I was feeling and talk to my husband about how I was feeling talk to my mom Those and then I finally went back to my therapist last Friday and we talked about it there and I'm going again tomorrow but
00:10:40
Speaker
It's been one of those things where it's like, I don't really know who I'm supposed to talk to first. Should I reach out to my OB and tell her how I've been feeling? Because in all of my OB visits so far, it's just been so quick. How are you feeling? Good. I'm a little sick, but I haven't really been full on honest about how I've been feeling mentally. It's really just when they ask how I'm feeling, I'm like,
00:11:06
Speaker
I've been sick or I'm tired, but I'm overall pretty good. Part of what I think stopped me from talking about it sooner is I just didn't really know where to start.
Communication and Support Strategies
00:11:19
Speaker
Do I go to my doctor? Do I go to my therapist? Do I go to my mom? I don't know. My mom is just my default for everything. Like you said, I guess it's basically just starting somewhere, therapist or doctor.
00:11:35
Speaker
Yeah. And, and I wish that the burden was not so much on the patient. I wish that providers were asking the question. So not just how are you doing? Well, we all know that what you're supposed to say is good. Yeah. That's exactly what I was going to say. Like I feel just to add on to what Candice was saying, cause I feel like the
00:11:55
Speaker
lot of women probably do this is like, it feels almost like you don't want to be a burden to your doctor. Like, you're just like, I'm not gonna be a problem. You know, I'm feeling pretty good today or like in this moment. So like, what am I gonna do? Like, let them know I had the blues last week? Like, what are they gonna do about it? So oftentimes, even if it has been a rough road,
00:12:21
Speaker
You just in that moment when they're like, how are you? It's like, I don't know that they actually care. I don't want to be a burden. Yeah. Which is its own problem.
00:12:36
Speaker
Yeah. Well, and when you're saying it's so fast paced and it is, those visits are usually five minutes or less. They're in, they're out, you know, they're in a hurry. You don't want to take up too much of their time because they might have somebody with a quote unquote real problem in the next room. Right. And if they can see it on a sonogram or in lab values, then we think of it as a real problem. We think if they can't see it, then I probably just need to deal with it.
00:13:01
Speaker
myself and you don't always have the resources to do that yourself. Sometimes you need their help. And unfortunately,
00:13:09
Speaker
Sometimes you have to advocate for yourself to get that help. Or if you're not being heard, if you have access, seeing a different provider, not everybody has the resources to be able to do that. Even taking someone with you. I know even when I was in the hospital, after I had my first, no one would listen to me when I was describing the problems we were having, what we needed. And it wasn't until my husband spoke up and said, Hey, we need this help us with this, that something happened. And so.
00:13:39
Speaker
It's not fair that sometimes we need someone else to advocate for us. And also, if you have that resource, sometimes it's useful to utilize it and say, hey, actually, can you take a couple more minutes with us? I'm noticing my partner, my daughter, my friend really struggling. Can you help us with that? Or if you can't, can you point us in the direction of somebody who can? And it may or may not be your OB. It might be a therapist who's trained in perinatal mental health or a psychiatrist.
00:14:09
Speaker
And there are also online resources too. Postpartum Support International is a huge organization dedicated to supporting perinatal mental health. And they've got online support groups as well as a provider directory. And that can be really helpful because if you don't know who to start with,
00:14:30
Speaker
then you can find therapists, psychiatrists who are trained, and they also have a helpline too, and I'll make sure and give the phone number for that, that you can call and say, what do I do? And if OBs don't feel comfortable prescribing, there's a psychiatric consultation line that they can call that can give them information about what medications are safe in breastfeeding and in pregnancy so that they can prescribe if medication is something that you find that you're needing. So there should be all of these
00:15:00
Speaker
all of this access to resources, right? You should have access to your OB and your pediatrician and your primary care and a therapist and a psychiatrist, but the reality for a lot of people, especially people with fewer financial resources or in care deserts is that there's just not access to those resources. So what are the signs or symptoms? Is it longevity of how you're feeling? You're sad for a certain amount of time?
00:15:28
Speaker
How do you know to start advocating for yourself if, or are you just calling it like Candice said, like the baby blues, or where do you even start or feel? It's so confusing, right? Because you're warned that you're going to be emotional while you're pregnant or when you're postpartum, so you can just kind of chalk it up to that. I guess it's just what it's like. You're just crying uncontrollably all the time.
00:15:55
Speaker
Exactly. And it's, you know, it's one thing if you tear up at the pet food commercial. It's another thing if
00:16:02
Speaker
you're crying frequently throughout the day or you're feeling hopeless or you're experiencing guilt when you haven't done anything wrong or negative thoughts about yourself or anger and irritability beyond what's typical for you, right? You know, most of us, when we don't feel well, a lot of times you don't feel well pregnant and postpartum and you're not sleeping well, you're irritable, but beyond what you would usually be feeling, blaming yourself unnecessarily when things go wrong.
00:16:33
Speaker
feeling sad, feeling down. And certainly if you start experiencing thoughts of harm to yourself or to others, that's a warning sign that you need to reach out for help. It doesn't mean that you are to use the big scary word crazy. It typically means that you need help, you need treatment and there is treatment available.
00:16:57
Speaker
Yeah, for me, what, like, I think I definitely experienced this with my first pregnancy with Alice, but it was my first pregnancy and like, you don't know what's normal, what's not normal. And you're just, you know, you hear about pregnancy hormones and emotions and you're kind of just like, I don't know. I don't know. This is just, I'm pregnant now and I guess this is just how it is.
00:17:18
Speaker
Now being in this amazing community of moms and talking to other moms, this time around, it felt more intense, to be honest. And I just felt like I was living with a gray cloud over me for weeks. And I felt like it was getting harder and harder for me to feel happy, which is so abnormal for me.
00:17:44
Speaker
I think my biggest question, because this is something I struggle with is like, everyone wants to be normal. I want to be normal. I think that's my biggest question is how common is it? So incredibly common. You're not alone. Studies show that somewhere around one in seven moms and one in 10 dads experience perinatal mental health disorders. And that probably is not even catching everyone because we know that the research is
00:18:14
Speaker
and incredibly biased towards heterosexual individuals where mom is a woman giving birth and dad is a male partner. And so we know that there's probably even more that are being missed, but what we see is about one in seven women and one in 10 men. And it's so isolating. We don't want to talk about it because
00:18:39
Speaker
I, you know, there's all these myths that I should be happy right now. This is a wonderful time in my life. You know, pregnant women have a glow. You're growing a life. This is what you always wanted. This is what you always dreamed of. So many people want this and can't get this. So many people would love to be where you are that you feel like, like,
00:18:59
Speaker
I don't deserve to be unhappy right now. There's nothing wrong. I should be happy. Then enter more guilt because I'm feeling something that I shouldn't be feeling. Does that mean that I'm ungrateful? What does that mean about me? That just intensifies those symptoms, but makes us less likely to talk to other people about it. The more isolated we become, the more intense our depressive symptoms can grow. It's just a self-sustaining cycle.
00:19:28
Speaker
Totally. That is so true. I just feel like what I'm hearing a lot of is probably, in my view, how women deal with their problems generally is try to ignore them, try to be strong. Everything you're saying about needing to feel grateful, wanting to be happy, that's just in our everyday lives, even when we're not pregnant. And one of my questions is,
00:19:58
Speaker
with perinatal specifically, like how much of it is hormonal? Like we've all seen the hormonal charts. Is it the hormones or is it like the life circumstances? It's probably a mixture of both, but where do the hormones play in?
00:20:17
Speaker
So as you said, it's a mix of all of it. So we can think about a model that includes your biology. So your genetic makeup, what's your family history? Have you experienced mental health issues in the past? Because those things are going to put you at higher risk. What hormone changes are you experiencing? Those can contribute. We don't know exactly how much
00:20:42
Speaker
exactly to what extent, but we know that they can contribute. And if we're not feeling well, that's another piece of biology that can add to it. If you are so sick that you're barely able to carry on with your daily activities, then you're not going to find much enjoyment in things. You're probably not going to be very hopeful and you're probably also not going to take very good care of yourself.
00:21:06
Speaker
If you're not able to eat, if you're not able to exercise, if you're not able to sleep, that's going to make it worse. And then we also know that there is a cultural or social component, which is what we just finished talking about and all of those things can contribute. So it's hard to tease out.
00:21:25
Speaker
And there may be some new literature that says, you know, hormones play exactly this much part. I'm not aware of what that is, but we do know that there's a, you know, a mixture of your, your psychology, your biology, and your, your social circumstances or cultural experiences that all play a role and contribute. I was going to say, I feel like for me, I'm feeling better now because I'm almost 22 weeks. So like, I don't feel sick.
00:21:53
Speaker
But when I feel sick, I enter depression because I feel something happens to me where I'm like, I will never get out of this. Like this is my life now. Yeah, like I can say goodbye to my physical fitness. Like my vitality as a person, like basically I'm just going to be like a sick person for the rest of my life. And usually I don't feel sick for weeks on weeks on weeks, but
00:22:21
Speaker
When you're pregnant, you do, and it's tough. It's so tough. Not to mention like watching your body change, which has its own impacts, especially for women, but that's where my mind went. Like I do feel lucky in that I've been on like a good streak, but the first trimester for me was so much harder this time than my first pregnancy.
00:22:46
Speaker
And I was really thrown for a loop because I did not feel sick my first pregnancy. And this time I was like, well, this is me now. I'm, you know, this will never end. It's hard to see past that.
00:22:59
Speaker
Yeah, it feels that way. You know, it's bad enough when you have an illness that you know, it's
Biological and Historical Influences
00:23:07
Speaker
time limited. Okay. I'm going to take this antibiotic and I'll feel better in X number of days. And to know that some people feel better after the first trimester and some people are miserable the whole time. Nine months is a long time to be miserable. And absolutely that can make you feel hopeless.
00:23:26
Speaker
Yeah, it makes me feel so much better and validated to hear you say something about like biology because what I've just been saying to my husband and to people in my life is there's something about the chemistry of pregnancy that like I feel like doesn't mesh well with the chemistry of my makeup.
00:23:49
Speaker
That's the only explanation. That's what my intuition is telling me. It's funny because I have a family member who, of course, we don't have the same exact genes, but we share some genes. She's a cousin of mine who reached out to me after I did talk about it on our Instagram stories and was like, oh my gosh, this happens to me every pregnancy. She's pregnant with her fifth.
00:24:14
Speaker
In my mind, she is the ultimate pregnant woman. You don't do that five times unless you like it in my head. It's validating to hear you say it does have to do with your biology and your family history. I definitely have a family history of depression and mental illness and bipolar disorder and all of those things.
00:24:39
Speaker
It's like just hearing all of that makes it feel validated. I don't know. I'm someone who like sometimes needs to hear like, like it doesn't just feel like for nothing. You know what I mean? Like there are reasons. Absolutely. I mean, we all need to be validated. A lot of times we want to jump to what do I do to make it better? Yeah.
00:25:00
Speaker
And especially family members, partners, friends can jump to you. Okay. How do we make you feel better? Do we need to get you out and go for a walk? Do we need to call the doctor and talk about getting on some medication? What do we need to do? What do you need to do? And a lot of times the starting place is, Hey, I see that you're having a really hard time right now. And I'm sorry that you're having to feel this way. That must be really tough that you're going through this just
00:25:27
Speaker
Some simple validation so that we're not so alone can be a really wonderful starting point, whether that's coming from your partner or whether it's coming from a professional. It's needed for most of us, if not all of us. Yeah. Mal, can you talk us through a little bit? This might sound like a silly question, but how do we bring it up with our partners? Like if we're feeling.
00:25:56
Speaker
This is there and someone's maybe struggling to share the news, even with their partner. Like I know we've talked on the pot a little bit with pregnancy things. Sometimes I feel like it's hard to communicate it to my husband because he'll never experience it. Like talking to girlfriends about it sometimes is easier. So is there any
00:26:21
Speaker
strategy or even just like straight up talk tracks you would recommend to breach the subject with your partner? Sure. There are so many things that we're going to go through that nobody else will ever understand because nobody will ever understand our unique experience. So even if we're talking to other mom friends, maybe you've had difficult pregnancies or they've experienced depression, they're not experiencing the same exact family environment, social environment, job stress that we are.
00:26:51
Speaker
And that's the beautiful thing about empathy is that we are able to say, Hey, I haven't been exactly where you are, but I see that you're having a hard time and I care. And so sometimes letting our partners know you don't have to understand it. I don't expect you to be able to feel what I feel. This is what I need from you.
00:27:13
Speaker
And that's really hard when you're already in a vulnerable place, right? It's so unfair that you're having to tell somebody what you need from them because you don't even know yourself what you need. But if we can say, I don't need you to fix it. I am aware of resources. I am working with my doctor, my therapist, whoever it might be. I've got a self care plan. What I need from you is just to hold me or to let me know that you see that I'm working really hard at this and you appreciate
00:27:43
Speaker
me going through this for our family, it kind of lets them off the hook. And sometimes they can do a better job because they're not having to try to figure out how to fix it. And so even sometimes with my husband, I'll tell him, Hey, you're going into fix the boat right now. I just need you to listen and validate. And he's learned what validate means that it doesn't mean that he has to know and understand exactly what I'm feeling that he can see.
00:28:11
Speaker
and he can hear and he can believe me in what I'm feeling and say, yeah, it must be hard to feel that way. And letting your partner know perhaps in a moment that is not a particularly low moment. Hey, when I reach those moments, this is what I need from you. I need you to comfort me. I need you to hold my hand. I need you to back off. I need you to give me space. I need you to take the kids out for a little bit and give me room, letting them know ahead of time.
00:28:41
Speaker
so that maybe you can even have a code word. And when you say purple, they know what to do. So you're not having to explain everything that's going on for you in the moment and exactly what you need because that's a burden.
00:28:53
Speaker
but they know, oh, okay, this is what this means, and this is what she needs from me right now. I'm so gonna use this postpartum. Like, wow, something you said, I mean, I'm kind of thinking postpartum, because that's where I struggled the most was, I don't know, dealing with all the emotions that way. And it was really hard for me to explain everything to my Chris. She has a Chris also.
00:29:22
Speaker
I feel like that is such a good way to advocate for yourself with your husband. Like, hey, just take the kids for a second. Like, cause mine was more like rage, postpartum rage. Like I got really mad in situations. That's where mine stemmed from. So it's like take the kids or I'm about to blow situation. So maybe my word will be mushroom cloud.
00:29:49
Speaker
I don't know. I like it. But that's so important because then if you blow, then you feel bad about that. And then that comes right back into that cycle of guilt and depression. So if you can recognize, oh, this is about to happen. The answer is not necessarily stop feeling mad. If you could, you would have done that already.
00:30:16
Speaker
But how can I be in a place where I can feel these emotions safely? I can express them safely. And sometimes that means getting away from my toddlers because I know that they're probably going to activate me. And so I may raise my voice, which is something that I don't like to do as a parent. And so I need to be able to feel these emotions.
00:30:37
Speaker
without a toddler around me for a few minutes. I like that you brought up, I think men like to be fixers. That's something I struggle with with my partner is whenever I express a feeling, he immediately gives me like a, like a fix or an answer. He'll be like, like, for example, when we had this conversation about how I was feeling, he immediately was like,
00:31:02
Speaker
Well, I think you'd feel better if you got up and got dressed and put on makeup for the day and like feel good about yourself. I'm like, yeah, dude, I probably would. But like, yeah, like if I do that right now. Right. Like if I could do that, I would. So it's very much like, thank you, Captain Obvious. Like, yeah. Like, yeah. And they're like, well, have you have you worked out? And it's like, I mean, no, but yeah.
00:31:31
Speaker
I would have. It's really, it's like smart to disarm that from the beginning. I actually saw a TikTok once that was like, do you need like to just before you have any serious talk with your partner to go ahead and state whether you need, whether you need comfort or whether you need like help or there was different words there, but, and it's something I need to do better is be like, I don't need fixes right now. I just need comfort.
00:31:59
Speaker
And like, I don't need you to tell me what to do. I just need a hug. And for you to be like, I see that you're having a hard time. And like, I'm here for you if you need me. Like, then just, I think, default to the fix. Yeah. And I remember a postpartum, like my one compliment I wanted all the time was like,
00:32:21
Speaker
You're such a great mom. Like that made me feel amazing because my whole world and focus was on great in those first nine months that I had them at home. And if someone said that to me, it immediately made me cry because I was like, Oh my God, you're recognizing all the work I'm putting into like my, my favorite thing in the world. So it's just like, yeah, just tell me that. And I'll, it'll make me feel better already, you know, something like that. So yeah.
00:32:50
Speaker
Yeah, absolutely. And sometimes I have, well, every time I'm working with someone who's pregnant, we go through a postpartum plan while we're working together. And we might include on there things that I need for my partner to feel supported or to feel validated. And it might be that we're writing on there, Hey, I need you to tell me when you see me do something that's really great. Um, or I know in general, you appreciate everything I'm doing, but I need you to tell me that.
00:33:19
Speaker
And that can really change a moment if we're feeling stressed and overwhelmed and somebody says, Hey, I see what you're doing and I really appreciate it. It can disarm us in those moments. Since we all, well, Mallory, since you already have two and Candace and Whitney and I are all about to have our second.
00:33:41
Speaker
I would, I'm just curious if you guys have been feeling this, like I'm a little more, I'm less anxious about just the pregnancy in general and like the labor and delivery process. Cause I've been through it, but now I have a child already and I feel like we have our family unit and we've spent.
00:33:59
Speaker
it'll be two years like nailing that and like readjusting to that and like finally feeling like you're in a flow again. And I'm having a lot of anxiety about TJ my son and like
00:34:13
Speaker
how he's going to respond to this and just like his experience of me bringing home a new child. And then also like having Andrew will have to play a greater role. It's almost like the birth I'm not nervous for, but I'm a little bit even more nervous for the postpartum like first few months. Yeah. Yeah.
00:34:37
Speaker
There's more at stake now because you already have a child. So there's somebody else to take care of too. And it might mean that your partner is not there to support you as much because they're taking care of this other little person while you're taking care of the baby. And that's hard. Yeah. I feel like we need to have some like real conversations around
00:35:05
Speaker
what it's going to look like, what the responsibilities will be. And I hadn't even really considered what you just said, that he's not going to be able to take care of me as much. Like I really just realized that for the first time just now.
00:35:20
Speaker
I think it'd be really helpful to even talk about like what we just said or what you just said Mallory about like those things you need to hear or like here are some ways I would love for us to connect whenever we do have a second to like I know things are gonna be wild when we have a toddler and a newborn but like maybe one night when the babies are sleeping like this is a way we could connect or you know making a plan to like reconnect as a couple because I think that's what I'm really scared about is like
00:35:49
Speaker
I feel like we already have no time. How is that going to fit in when we have a newborn again? It's going to be really hard. It is. It absolutely is. That first year is hard. We know that having a newborn is threatening to marriages. It's one of the
00:36:14
Speaker
biggest threats to a relationship and having your expectations set can sometimes be helpful for some people that, you know, I'm not going to be able to give you as much attention. I know even just personally, not professionally after with our first baby, my husband felt like he didn't get
00:36:38
Speaker
much of my attention. And he was really sad about that. And going into it the second time he was able to say, I realize that your attention is going to be on the baby. That's going to be hard for me. Now I know it doesn't mean that you love me any less or that you want to be with the baby more than you want to be with me. I just understand that that's the way this has to be. And there's something to having that expectation. Then we kind of revisit that.
00:37:04
Speaker
every now and then too, because we're still in it. We must four-year-old and a four-month-old, we are very much in it right now. And so we're in this business, I'd say. Absolutely. Figuratively and literally, we are absolutely in it. And we revisit that every now and then that with the older one, it did get better over time. We did find time to be together again, but it took a while.
Mallory's Journey and Advocacy Work
00:37:31
Speaker
And so we're in that again.
00:37:33
Speaker
can feel like you're just roommates or your coworkers, you're passing off responsibility. You're just seeing each other to pass one kid and then go do something else, but acknowledging that every now and then that like, hey, we're going to get back to it. This is just where we are right now for a season. This is not forever.
00:37:53
Speaker
I feel like the seasonality piece and like we're trying to remember that is so key. I wanted to know how you got into perinatal counseling and if you had any personal experience with it that brought you there. I wanted to be a therapist in the first place because I went to therapy when I was 18 and found it such a transformative experience and also was just saying it for real that I had never seen before. I didn't even know I existed growing up in rural Alabama.
00:38:23
Speaker
no exposure to anything related to mental health. And then as I went through having my first baby, I developed the interest in perinatal mental health. I had a need to access care for myself. I experienced mental health challenges while I was pregnant with my first, and there was not a whole lot of access to providers.
00:38:53
Speaker
started getting trained and got certified and have gradually kind of increased my involvement in this field and in advocacy and education. So it's been evolving, but I think you're fine with a lot of perinatal mental health providers that they have personal experience. And so they're not treating you based on their personal experience, but it's that experience that creates
00:39:21
Speaker
the desire to help quite often. Would you say since you experienced this with your first, which she's almost four, right? Have you seen an increase in discussion around perinatal mental health and an increase in resources? Do you feel as though it's gotten more, like there's more awareness around it in the past three or four years?
00:39:50
Speaker
at least locally, yes. So I can't speak to nationally, but when I attended that training, there were very few providers in the national area that were trained in perinatal mental health. And that training, you know, brought information to, I want to say 150 providers, probably many of them local. And then there tends to be a ripple effect from there. So as
00:40:17
Speaker
Those people get trained and they take it back perhaps to their organizations, their supervisees, and there's a ripple effect. And so now there are many professionals trained in the greater national area and perinatal mental health. I think nationally, there's still so much room for growth. Locally, there's so much room for growth.
00:40:38
Speaker
especially for people who don't have the same privilege and resources that, quite frankly, I do and many of the clients that I serve do. So for people of color, people who are LGBTQ, people who are lower income, who are in areas where there's not significant access to resources, then there's so much room for growth in all of those areas.
00:41:07
Speaker
In your advocacy work, I'm just curious, who do you try and partner with the most and who do you find is the most responsive in partnering with? Yeah, I had this really wonderful opportunity to be part of a task force through Postpartum Support International and the International Obsessive Compulsive Disorder Foundation to bridge this gap in OCD treatment in the perinatal period because there were providers trained in OCD treatment.
00:41:31
Speaker
And there were providers trained in perinatal mental health and they were not really crossing over and sometimes recommending treatments that were contraindicated for the other. Sorry, contraindicated meaning? No, so contraindicated just meaning, you know, there were people perhaps in the perinatal mental health sector saying, evidence-based treatment for OCD will make perinatal mental health concerns worse.
00:42:00
Speaker
or vice versa. And what the research team found was that that was not true. And so that evidence-based practices were beneficial for perinatal individuals as well. And so then the work of the task force was to disseminate that information to individuals, to treatment providers, so that people experiencing perhaps OCD and the perinatal period could get access to the help that they needed.
00:42:30
Speaker
Yeah, it's so awesome though. Interesting. I'm so grateful for what you do and bringing awareness locally and, you know, I'm hoping that this podcast brings some awareness to perinatal mental health and postpartum mental health. I know that many conversations we'll have.
00:42:49
Speaker
over the next, you know, forever, probably. I do have one question. Is it possible to have perinatal mental health issues in one pregnancy and not another? Absolutely. I mean, you're more at risk if you experience, say, depression in one pregnancy or the next, but you also are more informed.
00:43:11
Speaker
So if you know, this was a really hard time for me, then you can start planning. So you can go ahead and have your treatment team. You can have a therapist. You can have a psychiatrist.
Exploring Treatment Options
00:43:22
Speaker
You can let your OB know, Hey, I experienced depression my previous pregnancy so that they can kind of check in with you and watch more frequently than they did in that first pregnancy. And then you can also set up your social support.
00:43:36
Speaker
You know, this is what I need from family. This is the kind of help that I need. This is the kind of help that I need from my partner. Personally, these are the sorts of things that I need to do to help me.
00:43:49
Speaker
that can actually help you in subsequent pregnancies, perhaps get through it without experiencing depression or maybe it will be less severe or for a shorter duration if we've got those things in place. So just because you did it in one pregnancy does not mean that you automatically will in subsequent pregnancies with this sort of period. You are more at risk, but that also gives you more opportunity to intervene with the information that you have from previous experiences.
00:44:19
Speaker
Good to know. I know I'm worried about that postpartum. I feel like a lot of it had to do with me not knowing what I was doing. And I'm hoping now that I'm such a bomb mom that I'll be better at it this time. But we'll see. Yeah, you are. And you are a wonderful mom. And that has nothing to do with why we experience depression. And so many times people think, well, I'm not a good mom if I'm depressed or anxious.
00:44:48
Speaker
And that's just not true. Like most of the time, you know, really, really wonderful moms who love their kids more than anything in the entire world. And they also need to work too. It's, you know, kind of all about the baby, but it needs to be about mom too. Yeah. Is medicine the only treatment? No, medicine is a treatment and it can be wonderful. And there are a lot of medications that are safe and pregnancy and safe as part of them. And so seeing a prescriber who
00:45:17
Speaker
has that information is really important if that's something that's helpful for you, but it's certainly not the only option. Some people improve with just self-care and supported care from their network. Others need the assistance of a therapist or want the assistance of a therapist.
00:45:40
Speaker
And a lot of times if I'm working with someone and they say, you know, I want to address this just in therapy and maybe we're not making the progress that they want to make or their symptoms are increasing in severity, then I might refer for a medication consultation. But for many people, they never end up taking medication because they implement what they're learning in therapy, increase their support. And sometimes that can bring your symptoms down to a more manageable
00:46:07
Speaker
level. So it is an option, but it's not the only option. There are also a lot of support groups available. And we talked about how isolating this can be. And so for some people connecting with other people who can empathize, even if it's not the same experience, that can be really powerful as well. That's been the most powerful for me is just talking about it and hearing from other moms and making me feel less alone. Like
00:46:32
Speaker
I feel so much better in the past week after talking about it for the first time and to like, obviously I have seen my therapist, so that is definitely part of it. But I mean, I cannot tell you how many messages we got from other moms after me speaking about it on our Instagram stories of them feeling the same way. It helped me so much to talk about it and to hear from other people so I can totally see how groups would be a really, really powerful thing.
00:47:02
Speaker
Yeah, I feel like it's kind of like letting go of the guilt and shame around it if you just acknowledge it and have it be acknowledged. Yeah.
00:47:11
Speaker
And I liked what you said Mallory about getting acknowledgement from the people at home as kind of like a first step maybe, or who knows where you go to first, wherever you feel most comfortable. But I think getting that acknowledgement at home is really important because that's who you're with every day. And then that probably emboldens you to advocate for yourself outside the home and talk to your doctor.
00:47:37
Speaker
Um, which kind of led me to a question which would be practically, it sounds like the best way to advocate for yourself. Let's say someone thinks they might be struggling with this. What is like the first step they should do? They should take. That's up to them. And so might vary depending on the person. It might just be acknowledging it to themselves. It might be calling your mom or talking to their partner or their sister or their best friend. It might be.
00:48:07
Speaker
that I don't really want anybody in my support system to know about it. And I'd rather just talk to my doctor and that's okay. Or I would rather talk to a therapist and that's absolutely fine. And so like you said, it's starting wherever you're most comfortable and knowing that all of those options are okay. There's nothing wrong with any of them. You know, if you are experiencing severe symptoms,
00:48:34
Speaker
where, you know, say maybe you're not able to continue working, taking care of yourself, your family. Certainly if you're experiencing suicidal thoughts, something like that, then talking to a professional can definitely be a wonderful place to get started. And it doesn't have to be the first place to start for everybody. For some people, they may find talking with their spouse or partner being met with support, encouragement, love and acceptance rather than judgment.
00:49:03
Speaker
can relieve so much of the weight because part of what is so unbearable is that guilt. I should be happy. Something's wrong with me for feeling this way. I must be a terrible mom and not being met with the judgment from other people that you expect can take a lot of that weight off sometimes.
00:49:26
Speaker
I think you mentioned there's like a list you have of potential providers.
Conclusion and Gratitude
00:49:31
Speaker
Um, I think we should definitely share that in our episode because if somebody is just like wanting to reach out to a doctor, but they're not currently in therapy, I feel like they're probably like, okay, well, where do I even find somebody to talk to?
00:49:46
Speaker
Of course, and thankfully, this work has kind of been done for us now that there is a directory for the postpartum support international where you can look for providers in your state because at this point, licensure is state specific. So, you know, you can't in most circumstances, say be in Tennessee and have a therapist in in Florida or vice versa, but
00:50:10
Speaker
There is a directory where you can look in your state, who are the providers, you know, whether they be OBs or psychiatrists or therapists or support groups, what resources are available to me. How do I get in touch with them? Do they offer sliding scale or low fee? Do they accept insurance? Do they do telehealth because I can't leave the house. I've got children. You know, there you can filter so that you can find who might be a good fit for you.
00:50:36
Speaker
That's amazing. I feel like all of this has been so enlightening just because I never had really heard about it until I connected the dots of Mallory Yu talking about it. And then Candice saying she feels like she has it. And I was like, oh my gosh, this is all coming together. But hopefully through this podcast, the biggest thing being advocacy, hopefully us spreading the word to our millions of listeners out here.
00:51:05
Speaker
Just that this is such a big deal. And I mean, me being pregnant two years ago, I never heard of it to now. It's just good to know that it is growing in awareness. So I really appreciate you being on with us today. Yes. Thank you all for giving me the opportunity and Candice, thank you for sharing your experience too. I know that that's a really vulnerable thing to do and that it's coming from the place that I'm wanting to
00:51:33
Speaker
for other people so that they feel comfortable doing the same. Thank you for sharing your experience. Thank you. It's been a good week and I'm happy that I'm happy to share and I'm so happy for all of our listeners who have shared their experience with me. I've gotten so many amazing messages. I just appreciate you being here, Mallory. Honestly, I learned so much today about
00:51:59
Speaker
how to move forward as I like continue. I mean, I still have a long time in this pregnancy, unfortunately. So, you know, I want to take care of myself the best way possible moving forward. And I would love for our listeners to do the same. So I appreciate all of the information and resources and everything you brought to the conversation.
00:52:21
Speaker
I love it. Check in on your pregnant friends. That's something else that I feel like was a good takeaway, like how to, you know, reminding me to just be there for people who are struggling and check in and not try and problem solve right away. Great chat. Thank you so much, Mallory.
00:52:40
Speaker
Thank you so much for being a part of our mom group chat. New episodes drop every Tuesday. And don't forget the group chat is blowing up on our Instagram page. So make sure you're following along over there. All right, gotta go. My toddler just put something in her mouth.