 Welcome to Family Affairs. I'm Lisa Kimura. I'm your host here live from the Think Tech Hawaii studios. What's you today with information on from our providers on mental health? I'd like to welcome today Jess Logan and Rachel Ebert to talk about the things that moms are really going through. Welcome. Thank you. Thanks for being here. So I'd like to know please tell me a little bit more about what it's like, what women are really going through after they've given birth. What is it like for them if you get the experience? It can definitely be very overwhelming, especially for first-time moms. It's just kind of no matter how much preparation you do, there are always surprises, always things that are unexpected and can be really challenging. What kinds of challenges do they necessarily have or what kinds of things do people experience that they weren't really expecting? I think it's just it's a combination of things. It's that feeling of almost sometimes moms feel a little bit lost, like they've lost a lot of things. They've lost their their time to themselves. They've lost their previous identity, which may have been as a professional or just as just a wife or you know a lot of different things. Their time with their friends, they've kind of had that loss, but then they also have these mixed feelings of you know maybe anxiety about their baby, maybe they're not doing it right. A lot of moms get this horrible guilt of maybe I don't love my baby enough, maybe I'm not really cut out to be a mom, and a lot of those feelings can just be extremely overwhelming. I think also these days there's so much information out there online and so many different opinions and you hear from all these different people about what you should be doing and where your baby should be at. I think that also can add to some of the stress that, oh well if I'm not doing it the way that my auntie's doing it or that you know this online forum says it should be going then maybe I'm doing something wrong. How did you get involved working with moms? What was what was it that interested you about this field? I really enjoy working with moms. I think that it started for me when I was just practicing therapy in general and I took note of who the clients were that I connected with a little bit more. And so I really enjoyed working with children and also working with their parents and that kind of just developed into maternal mental health for me. And then when I had my own child it was a big eye-opener as far as how challenging it can be and how different it is than what I expected even as someone who kind of had the training in the field. How about you Rachel? Yeah so I have worked with moms in different capacities for a long time. I was a preschool teacher and then prior I worked in early intervention so with moms whose babies were struggling with developmental delays and it wasn't until after I had my child that I was just overwhelmed by how difficult it was and again like just kind of said I thought I had it all together I had so much knowledge I had been focused on early childhood for so long and especially birth to three and then it was just kind of shocking to me how challenging it was for me to go through that and it made me want to help other moms to prepare for that time and then to get through it. Was there any kind of experience that you had yourself that really stuck out that made you maybe change your opinion about the access for moms or the support that moms need or anything like that that was really life-changing for you? I mean I had a several experiences that I thought were you know I was disappointed in the system where you know I had had an experience in before I had my daughter where I had a miscarriage I went to the doctor that whole process was not very like mental health friendly I guess I had checked a boxing that I had been really sad for several days no one ever really asked no one gave me any support and then even postpartum I didn't feel like I don't know if I ever filled out any screenings if I was ever asked you know how are you doing as opposed to how's baby you know how's your body but never really like how are you are doing inside yeah. Yeah I think that I did have some good experiences with mom groups and so I think that that brought me a lot of support at the time and that was one positive that I hadn't really expected I didn't think that having friends with kids or without kids mom friends would make a difference but it actually did really bring me some comfort so that was a big help for me. Yeah I think that the I mean the mom groups are huge and having that support my biggest problem was that my daughter didn't like being in the car I had postpartum anxiety you know a milder form of it and so I didn't you know it was really hard for me to get out of the house so as much as I craved being at mom groups I just struggled to do it to go to them so that was one of the harder parts of that because I knew that I needed more mom friends none of our friends that lived here previously had children so I knew I needed it I just didn't I just struggled to get it I think it took a while. Yeah it's really isolating as a new parent for sure. What are some of the things that you see both work with moms and you both have maternal mental health practices what kinds of things do you see typically with them or what are the common challenges that they have? Guilts is a big one I think a lot of new moms feel guilty that they aren't doing enough they're not not doing enough for themselves not doing enough for the baby not doing enough for their partners if they're going back to work not doing enough at their job so there's always this feeling of kind of lacking somehow or not being as good as they used to or as good as they should be occasionally there are also feelings of shame of feeling like you know this is embarrassing I'm supposed to be so happy and joyous and this is wonderful but I don't really feel that way and there's a lot of embarrassment that comes with that. Yeah I think just you know and then all the other things that we know you know the lack of sleep and the lack of time alone and all of that and I think moms get so caught up in trying to do it all and being the perfect mom and you know I don't have time to take care of me I hear that all the time and I felt that way too like I just don't have time but just you know how important it is that we cannot run on an empty tank like we just we can't we keep trying and I see mom's trying all the time but it just doesn't doesn't really work right and there's that kind of mythical gold standard about work life balance and you know well-rounded perfect mom that is not true and really the attainment of work life balance is kind of I mean if you can try to attain it but it's really really tough yeah what do you can you explain to me a little bit more about kind of the degrees of mental health suffering or depression or what kinds of things you know would moms be able to experience as a range of symptoms after giving birth. So in the first in the beginning certainly people are going to be emotional they're going to be exhausted they're going to be tearful and this you know again none of this is everybody but that does happen pretty common for a lot of women in the first two weeks I would say. It's just from being so overwhelmed having something new happening it can be hormonal it can be a lot of different factors that are contributing to the way that you feel because of those changes in the first two weeks. It can also be something that causes anxiety and stress where you're constantly watching the baby not wanting to leave the baby. If these things continue past the two week mark that's usually around when we would say it might be more than just the baby blues what people talk about as baby blues and that it could be moving more into something like postpartum anxiety postpartum depression or a different kind of adjustment that might need a little assistance. What kinds of things do people experience or how would they know that they're having postpartum depression or anxiety what does that look like? I think I mean it looks different for every mom and that's you know and it's hard to see especially from the outside you know from usually partners can see it a lot of times mom will still come in and say I don't feel like myself and they'll be feeling you know having trouble sleeping even though they're exhausted you know things like just that extreme feelings of anxiety of not wanting to leave the home or not wanting to leave baby with anyone being really nervous about what baby you know of other people are holding baby also can be intrusive thoughts and so intrusive thoughts can be really scary for moms and they can be really hard to tell anyone about because they're so they're frightened of them themselves so those can look like thoughts of like oh I'm gonna you know I can't I'm gonna drop my baby down the stairs and just imagining what how horrible that would be or that you know my baby's gonna stop breathing or you know that as I'm driving I might swerve and something would happen and so these thoughts are like I said usually scary for moms and and that's their way of knowing that that they're you know that there are intrusive thoughts and I think that for a lot of moms like I said they're just scared to share and this with anyone because they do seem so frightened probably fears of getting their babies taken away or things like that you find that people tend to hide their feelings for a while or is it something that I mean stigmatization is really really big for mental health in general right what do you find in particular when it comes to moms how how willing are they to take help or to to suggest that they might need some help yeah I definitely think there is a stigma out there against asking for help because you are supposed to kind of have it all down and be able to manage this and it's supposed to be just come naturally so I do think that that is difficult I think a lot of people do wait a long time before they reach out and one of the things that I try to encourage in in pregnancy is just being open to the idea that even if you're just kind of uncomfortable why suffer you don't have to necessarily diagnose yourself as being clinically depressed to reach out for help sometimes it's just like Rachel said I don't really feel like myself and I want to be you know more comfortable in my day-to-day life and that's just as good a reason to get out then the other thing that unfortunately sometimes happens is people might reach out and not get much response so you know even telling your partner like really I'm not feeling okay you know and they're been saying you know maybe you just need a nap just get some rest and you'll feel better and you know it's I think it's hard for moms to keep reaching out right that they feel like they keep having to try and even with their doctors might say you know just give it a couple weeks maybe you'll feel better but I think we both say encourage moms that get the support and try and make changes start feeling better that's some photos of babies you know and moms in the postpartum period and moms that are meeting with groups of friends or things like that to try to get that support but where would you suggest someone starts or how would they even know that they need to start looking for some extra help so I think how you would know that you want to get extra help is just if you're not happy with the way things are going in your life day to day I would say it's that simple it doesn't need to be much more extreme than that where you can look there are certainly a number of therapists out there who are focused on maternal mental health in the Hawaii area who can be very helpful there's organizations such as postpartum support international that has call lines there is also a local postpartum support international coordinator Diane Ashton who runs a support group in addition there's just mom social group like Pico pals and family Huey and a lot of Facebook groups you know there's really a mom and cakey group for almost anything you can imagine so whatever your interests are if you look out there there's often a place to get at least the social support and then also the mental health support as you need it we'll put up on the screen too as well some of those calls you know how people can reach out and find that support but you know say that after someone's just given birth at what point would someone expect to possibly develop a problem what this even happened during pregnancy yeah it definitely can start during pregnancy some women start to experience some of the anxiety even some of the intrusive thoughts can occur then you know I think that I've been working with pregnant moms a lot more lately and I really enjoy that because a prevention piece right but I find that if women have a history of any mental health issues if they have you know there's there's a whole like list of risk factors that I think will show at some point if you have those risk factors it doesn't hurt to get some support right and to work on planning for postpartum and preparing for it the more you're prepared and the more you're informed then you kind of know what to look out for you know symptoms can start like Jess was saying with baby blues just after you've had baby but then it's kind of figuring out if that goes away and and how to manage it at that point we're gonna talk a little bit more about those symptoms and what to expect right after this break please come back and Lisa Kimura host of family affairs Aloha I'm Yukari Kunisue the host of Konnichiwa Hawaii Japanese talk show on think that kawaii Konnichiwa Hawaii is all Japanese broadcast show and it's streamed live on think deck at 2 p.m. every other Monday thank you so much for watching our show we look forward to seeing you then I'm Yukari Kunisue mahalo hello I'm Dave Stevens host of the cyber underground this is where we discuss everything that relates to computers that's just kind of scare you out of your mind so come join us every week here on think tech Hawaii dot com 1 p.m. on Friday afternoons and then you can go see all our episodes on YouTube just look up the cyber underground on YouTube all our shows will show up and please follow us we're always giving you current relevant information to protect you keep a new safe Aloha welcome back to family affairs I'm Lisa Kimura here with me today Jess Logan and I'm Rachel Ebert experts in maternal mental health and I'm here to talk a little bit more about what to look for when it comes to moms that may figure out that something's not right for them that they don't feel right things are not how they should be they don't feel like themselves you know sometimes people don't really know probably what they're experiencing or what they should be experiencing or what to look for a lot of times the media kind of dictates you know what people's understanding of postpartum depression even is can you talk a little bit about what those symptoms are and really how it differs from what people's expectations are yeah and I think like we had sort of talked about it's looking at that you know that feeling of just not feeling right and that a lot of moms describe when they come in and they say you know I just didn't feel quite like myself and then you know I always like to think about what it might look like from a partner's perspective or an outsider's perspective you know someone that's close to the mom might also be noticing like that she's not sleeping well she's maybe the other thing that happens a lot is anger some of it comes out as anger the lack of sleep that's feelings of guilt all of that can kind of bubble up into looking like anger so the the partner might see some of those things and those different symptoms but you know it's interesting because society might not see it at all mom might look pretty much like she's got it together she might show up at mommy groups with a smile with her lipstick on her hair done looking like she has everything together or she might not but mom sometimes can really hide it well that's part of you know a lot of times moms are good at faking it just to get through the day but you know we never know how long it took her to get the motivation to get out of the house or how many times she canceled before she actually decided to go sometimes it can be changes in your appetite or changes in your weight or changes in your sleep feeling worried all the time feeling kind of hopeless or worthless and you know there are degrees certainly of suffering that women experience what tell me a little bit more about what it looks like for a mom who well okay here's a better question actually what what how often can someone expect to have some sort of postpartum mood disorder it's extremely common to have a postpartum mood and anxiety disorder so they're looking at about 20% of moms so that's one in five moms approximately is having some some of these symptoms we can touch really briefly on the very rare postpartum psychosis which is about one to two and a thousand moms experience that's the one you kind of see a little bit more on the news and that is like I said much more rare it usually happens within the first few days to the first week and it's very different than what we've been discussing it's really when mom has had a psychotic break and she is not aware of what's going on she's not aware of that something's wrong this is usually when the partner might realize that something's not okay but that one is like I said very rare it's much more common for women to experience some of these other symptoms there's a recommendation that moms should be screened during pregnancy and after giving birth but we know that's not routinely happening or it's not happening in the greatest way like you said they may just kind of check the box and move on that something's wrong how would someone really where would you go after that if your doctor maybe doesn't take you seriously or doesn't know to take you seriously how could you how could you find other sources of support I think Jess had touched on it a little bit you can contact postpartum support international they have a lot of resources and through them you could get to the information of Diane who's the local support coordinator she knows where all of us are on the island and kind of what insurance we take and you know where we're located and all that the other option is to call the mother's Caroline that's how you can reach Jess and I mother's Caroline offers other information and services as well information about services for mom so that's a great way to get your questions answered right as far as the treatment goes I mean some people may have a very you know a misperception about what that looks like or that they need to take medication or things like that really what does it look like for a mom who's going through so it depends on what the mom is coming in for but generally I would say there can be therapy alone can be medication involved as well it depends on kind of the severity and what the person is open to so there is sort of thought that medication is not safe for pregnancy or for breast feeding but that's actually not really true in the research anymore there are certainly a lot of medications that are safe and so you would just need to talk with your prescribing provider about what would be okay to take so I certainly wouldn't discourage that but treatment in therapy a lot of it is just kind of someone to be there and support and you know validate what you're going through help to normalize some of the processes that you're experiencing let you know what to look for that would not be normal that you might want to watch out for things that you can do to feel better things that you can do to feel better in the moment things that you can feel do to feel better in the long term you know just little tips and strategies about changes you might make in the way that you're thinking or the things that you're doing that can lead to some better feelings and what would be maybe one of those strategies that someone could incorporate to change those behaviors or patterns yeah I would say definitely reaching out to some sort of social group is a big help so having that that kind of normalizes your experience in a lot of ways seeing what other moms are going through I also really love relaxation techniques so taking some time even just like five minutes of your day to do a breathing exercise or have a guided meditation there's so many apps on phones that people can download these days and I feel like that's a good way to take some time for self-care yeah I talk with my moms a lot about self-care and there's no self-care we have this image of being at a spa or getting our nails done that we that seems so unattainable when we have a newborn and that's not what I'm really talking about obviously that's great if you can fit it in and should be if you can but it's really just carving out those minutes during the day that you can do something so for some moms that something is it just different but you know helping moms to figure out what is that something that can help recharge you in 10 to 15 minutes or 20 minutes and then where in your day can you find that 20 minutes and it can be hard because you you know maybe when your partner is working when they come home you want to have family time or you know it just gets hard to make time but finding that little time in your day to take for yourself to fill you up whatever it is if it's you know doing yoga or meditation or watching a silly show or whatever it is that kind of can help fill that cup for the day how long would someone expect it would take until they feel better or back to themselves again yeah that's a good question and a very common question usually people want to know right away when will this be over and it can be really quick I mean it really can just be a couple of weeks for other people it takes longer it can be more like a couple of months so it does just depend but the sooner that you get help in the more that you do the more likely you are to feel better and it kind of ebbs and flows too I think some moms will be like feeling so much better and now I feel like I'm back into that rut again and it just it does take time I mean it for like you said you know for some moms with milder symptoms it can be pretty quick but for some moms it might take a while and it can be feel frustrating and overwhelming to feel that you know down for so long yeah have you ever had an experience with a patient or a client that you know was did take a long time or was there additional supports that were needed or what would some what would it take for someone who was really persistently having trouble yeah definitely I mean there are some people who really struggle and depending on the level of severity I mean sometimes people will need to see a psychiatrist look into some medication options some people will need to be hospitalized if they're feeling like they're gonna hurt themselves there are higher levels of care out there as needed and maybe for a mom who had had her own history of mental health issues and maybe is very afraid about what's coming up what kind of advice would you give to a mom like that I mean working with moms in pregnancy I think is doing a lot of postpartum planning and getting a lot of supports in place you know it's no one can explain quite how hard it is to have a newborn and to feed yourself and and get keep everything together so just making sure that they have a pretty good support system available to help them during that initial postpartum time to get them through at least that part and then yeah working on different some of those relaxation strategies and a lot of I like to do a lot of psychoeducation so that them and the partners aware of what to expect and what to look out for we just had a list up there on the screen that was talking about things to look for and one of them was just a lack of interest in family or a lack of interest in your baby can you talk about that a little bit yeah I mean that just describes the feeling of you know things that used to bring me happiness are no longer bringing me happiness so I used to love getting out and taking walks and now I can't get off the couch or I used to really enjoy you know dinner with my family and now I don't even want to go so those kinds of things where you feel like lack of motivation low energy and things that used to make you happy don't really make you happy anymore those are also some signs to watch for I think a lot of moms to have this image of like that they're this baby's gonna be born and they're gonna be so in love and it's gonna be perfect and this fairy tale idea and if they don't quite feel of that that intense feeling of love then they feel a lot of guilt because of that because sometimes it does take mom's time to feel that love I mean it's a new person they don't know that it's not this like fairy tale always for moms that baby comes out and especially for moms that have maybe struggled with their in with infertility or maybe had you know a challenging birth experience all those things can factor into a lot of feelings of sadness and guilt I remember with my own first birth that it was very traumatic and very unexpected where everything went wrong and and the bonding didn't happen right away like I thought you know culturally this myth that you know you're just gonna fall in love but everything's perfect how about for yourselves was there anything in your own personal lives that that made you really you know feel like this is something you wanted to help other women with yeah I think for me it was just the shock of not really knowing what I was doing and had you know naively thought that because I had worked in this field that I would have an edge up which you know it's still really overwhelming it's overwhelming for anyone and I think that that was what really stuck out for me yeah and I always go to this idea like I had mentioned it was kind of hard to find mom groups and then I would find mom groups but I wouldn't find like a friend like I really connected with and so I finally did start to find friends at like eight to ten months my daughter was postpartum and it was like we just met when we were pregnant like how much nicer this would have been and how much easier it would have been if we'd connected like then it would have just made the whole process so much easier so it made me really passionate about you know trying to get moms connected during pregnancy or as soon as babies born with programs like people pals and stuff like that absolutely I'm gonna put a number of a website up on the screen right now which will help people if they are looking whether it's looking for support looking for reaching you ladies to get help with their mental health or for anything else hmhb-boya.org is healthy mothers healthy babies organization and the Mothers Carolina is part of that as well but we are just about out of time for today so I want to thank you very much for being here thanks for sharing your knowledge with everyone and hopefully it'll be supportive for other moms that are experiencing this thank you so much for having us. Thanks for tuning in I'm Lisa Kimura host of Family Affairs join us next time at the Think Tech Hawaii Studios aloha