June 11, 2025 ⢠36 mins
đď¸ Postpartum Depression: What New Moms Really Go Through
In this eye-opening episode of the Mothers of Boys Survival Guide podcast, psychologist and mom of five Dr. Kimberly Scipione joins us to break the silence around postpartum depression.
We talk about: âď¸ The difference between baby blues and clinical PPD âď¸ Why social media fuels unrealistic expectations âď¸ When to seek helpâand how partners can support âď¸ Effective therapies and how long recovery really takes
Whether you're a new mom, a partner, or someone who cares about maternal mental health, this episode is for you.
đ Subscribe and listen now to support honest, empowering conversations for mothers everywhere.
đ Listen now on your favorite podcast platform đ Grab the book:Â Mothers of Boys Survival Guide đ Join the community:Â MothersOfBoys.life
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Postpartum Depression (00:00):
A Psychologistâs Insights into Maternal Mental Health
Welcome to the Mothers of Boys Survival Guide podcast. I'm Cheryl Bond and I'm
joined by co-host Suzy Shaw.Hi Cheryl. A new mother of a
baby boy suggested this topic to help her and other moms better understand
(00:22):
the healing process from childbirth, which is a very big life event for sure.
One of the biggest for sure. Last week we spoke with a labor and delivery discharge
nurse about how moms can prepare for life at home with a newborn and she
shared practical tips for healing and sleeping and just overall adjusting.
(00:43):
And this week we're diving into a topic that really doesn't get talked about enough, even
though one in seven mothers are affected by it, which is postpartum depression. Our guest today is
Dr. Kimberly Schipione, a licensed professional counselor with a doctorate in psychology and
education. She has extensive experience working with women and is also the mother of five.
(01:09):
Today she's going to help us better understand what postpartum depression looks like,
how it impacts new moms, and most importantly, how to get help or support for someone going through
it. So welcome Dr. Schipione.Thank you so much.
This is such a huge topic. I get a lot of referrals from OBGYNs and psychiatrists
(01:32):
and PCPs with people that have never been to any type of psychotherapy before and
after childbirth. And there's a variety of things we can discuss as we head there. Yes.
So Dr. Kim, can we just start with the basics? How would you describe postpartum depression
to someone who's never experienced it, and especially men and spouses,
(01:56):
right? And what are the most common symptoms or patterns you see with moms struggling with PPD?
I think the statistic is one in seven, and IÂ think that's probably true to meet the diagnostic
criteria for postpartum depression. However, IÂ would say that every single woman goes through
postpartum depression to some degree. I think to meet diagnostic criteria that you're needing
(02:20):
intensive intervention, that's probably where the one in seven, and I'd like to normalize
that and say that every single woman, you will experience some type of postpartum depression.
Does it meet diagnostic criteria? No. Could it be considered maybe an adjustment disorder
with anxiety and depression? Sure. I anticipate that you're going to have some of this. So some
(02:40):
of the signs and symptoms we're looking for, and I think that's where we have to normalize this.
Social media, it's great for many things, but I think they only show the pictures of
the moms and their cute little babies, like with the big flowery headbands on,
or these cute little boys with like, you know, little newspaper boy,
(03:01):
the old fashioned newspaper boy hats, like looking, I could send you a couple of mine.
So darn cute, and I think that we think that it's all like that all the time.
Instead, we have fluids coming from every orifice of our body that we weren't anticipating, that
we aren't sleeping. Our hormones are an absolute mess, and I also think that we live in a culture
(03:25):
and society where you're supposed to look a certain way, and it takes a very long time for
your body to get back to pre-baby weight. And I think that we're hard on ourselves for that,
and we're embarrassed, and so because we don't look like the other people on social media,
we're not talking to anybody about it.But when we start to look for intensive diagnostic
(03:45):
concerns, we're looking at, you know, depressed most of the day, kind of lying there, not wanting
to eat, obviously sleeping too much, not sleeping at all, change in appetite. Psychomotor is a big
one, too. We have, you know, a slowness, like our body's not moving like it once did, a real lack of
(04:06):
energy and fatigue, feelings of worthlessness, feeling, a lot of times women can often feel
guilt and shame because they're supposed to love and feel connected to this new creature.
And I say, well, if you got a new puppy, would you know when the puppy has to eat
and sleep and use the restroom right away, and they're like, no, I said,
well, it's no different than a baby. And they said, but it's my own, and it's different.
(04:28):
When we start to get really concerned is when we start to have some of the, either the suicidal
thoughts or homicidal thoughts. And that is, and there's psychosis that can sometimes happen
with postpartum, but those are extreme cases.Yeah, it's really something because it, everybody,
you know, you hear, oh, it's supposed to be so joyful. It's, it's the most, you know, which,
(04:51):
which there is a side that obviously is so joyful. But if you have a really difficult delivery and,
you know, you're in a lot of pain and recovery physically is really difficult. I think there
can be a lot of guilt associated with, oh, I'm supposed to be happy because this is supposed
to be the happiest time of my life. And you're, but you're recovering physically, you know, and,
(05:14):
and it's really difficult. So then you're feeling like you should be feeling happier, you know.
Absolutely.
How soon after the birth can signs of postpartum depression appear?
Yeah, that's a, that's a great question, Cheryl. And I think that that's also one
of those misnomers. I think, you know, when I, when I use the word âmanicness,| that is
(05:38):
not meaning you're bipolar and you are, you know, looking like the Hollywood movies,
bipolar disorder. However, mania can kind of come in the first couple of weeks,
if not months of, of after childbirth and then you can hit depression pretty quickly.
Like maybe you're ecstatic, you're over the moon excited,
you're not sleeping. Some people experience that and then they go into a deep depressive state.
(06:02):
It can happen anywhere from like the moment the child is born or it can happen within about,
I think the statistical, the DSM is looking at, you have to present at least
five or more of those symptoms that IÂ listed in the beginning and it can come
anywhere from birth to, I think it's up to three to six months. So it can happen.
(06:26):
And some women don't experience it till six months in, you know, everybody's different.
And I think there's also a denial factor that goes in. And I think if you have other children,
that can be good too, because you're distracted by caring for multiple lives. And then you don't have
a moment to sleep and then you start to sleep and then you realize I'm not doing so well.
(06:47):
Right. Right. I remember my first baby, the emotional roller coaster of having
that baby and being in pain - for me, I had a level three episiotomy. I was
in a lot of pain. I was leaking- itâs what I would call it. So I was crying,
(07:10):
my boobs are leaking, everything's leaking. I wasn't used to leakingâŚ
Every orifice, every orificeâŚSo how long does it take to get
back into normal? And you know, is that six months, two years? What do you think?
(07:31):
Well, okay, I'm going to, I'm coming from the clinical perspective of what I
observe in the clinical setting. Sure. I'm going to, okay, so one of the big things
I think people need to understand is when you started saying that you had
to have the episiotomy and all of these other complications, I think that all contributes.
So I will tell you one thing I do see more than others, women that had a very difficult time
(07:57):
conceiving and went through an IVF process, those women, I see them taking way longer to recover.
And I believe the reason is, has to do with hormones and it, and honestly, Suzy and Cheryl,
I can see it taking two, three years and there's a trauma component to that because we're supposed
(08:18):
to- according to society and biology, we're supposed to just be able to get pregnant.
Then, a lot of these women experience multiple miscarriages. A lot of these
women can have traumatic births. Nobody planned on you having an episiotomy or a
C-section. And there's so many things that go into this. So when you ask the question,
(08:39):
you know, when can you get back to normal? I think it's all relevant to the pregnancy,
what was happening in your life leading up to the pregnancy, what happened during the pregnancy,
and what's happening during delivery and post. And I think all those things are huge factors.
And I guess if you had a second child,
then you're just hitting the reset button within that time period anyway.
(09:03):
Oh, 100%. And so I think that's what, you know, I have a set of Irish twins
and I think that was one of those moments in my life where it was like I didn't,
my body didn't even have time to get back to any type of normalcy and here comes the next one,
right? And that was kid number four. He was quite the surprise.
(09:24):
And so, you know, I, here I am pregnant with kid number four and I've got, you know,
three other humans to care for at the time. And I was working full time and in graduate school.
Oh wow. I know you think everybody has a mom. How difficult can it be? Right.
And it's so difficult. And there can be so many complications. But you, you think,
(09:47):
well, everybody has a mom. So, you know.Well, I think that we're the first generation of
women in our age range that are actually talking about this stuff because I think there was a lot
of shame around it. And even like when you think about menopause, like recently I was contacted to
speak on menopause and I was like, well, I could talk to my experience. But I think
(10:09):
we are coming up on a generation of people that are actually talking about these things.
And I think if our mothers
had the opportunity to be more raw and more real and not, you know, air their dirty laundry,
so to speak, that we would have had a deeper insight to what that's really like.
I agree with you.
I took a class on women's history when I was in college. And this sort
(10:32):
of information historically was in cookbooks. So I mean,
just to double down on nobody was talking about it. It was sort of hidden, right? And slid into
the cookbook. Cookbooks. Which IÂ still remember all these years later.
And, you know, I think as you say that, I think about, you know, with postpartum,
(10:56):
there's this idea that you're supposed to want to engage in intimacy with your partner post
that six weeks when you get the green light. And how that probably wasn't in the cookbook, Suzy?
Oh, no. Yeah, that was, that's a dangerous thought,
right? Yeah, right. Especially after being sewed back up after an episiotomy.
(11:21):
Absolutely.So is there anything else
with the mother's history that could be a risk factor? I know you talked about a few things,
but is, I don't know if there's anything in the mother's history or the family history that might?
Oh, absolutely. I think if you are, if you have a history of depression, a history of anxiety,
it's only going to magnify. I think one of the other things that's really come up is,
(11:44):
especially a lot of the women that had difficulty conceiving,
they were told to get off of all of their SSRIs (Selective Serotonin Reuptake
Inhibitors -a class of antidepressant medications) before they conceived.
And I just- I'm finishing up a fourth master's degree in clinical psychopharmacology. And we
spent an entire weekend talking about medications for women that are wanting to get pregnant,
(12:06):
are pregnant and postpartum. And there was a huge debate in our class, like there are medications
that can cause some birth defects. There are medications that can cause difficulty to the
fetus. However, when you look at the big picture of that, if you have a mother who's actively
depressed and actively suicidal, it is more important for her mood to be stabilized than
(12:31):
it is for the possible side effects of that. And that's where the debate came in. Is it not?
The whole class, and these are all doctorate level people in the class or MDs, discussed
that we felt that obviously it's an ethical, moral discussion to have with your patient.
However, what is more important, however, if you are predisposed, the possibility of being off
(12:58):
of your meds, sleep deprived, hormonal changes, life normalcy changes. It will magnify, we said,
between three and five times. And there's also a lot of research going into women that have already
experienced postpartum or they know they have family history of postpartum. And starting an
(13:22):
SSRI, if they were off of it or have never been on it, it's starting it in the third trimester.
Some of the meds are safe, Zoloft and Prozac, Sirtuline, Floxetine, they are considered to
be safe for pregnant women. However, a lot of women are afraid of taking those things.
(13:44):
Well, it's back to this conversation. The conversation that comes, unless you ask
the question yourself, it's the information doesn't get trickled down to you, I think,
to moms in general during that period.I also think our OB-GYNs, as great as
(14:05):
many of them can be, a lot of people go through healthcare insurance plans where it's literally
like an assembly line. You show up, the nurse will take your vitals and then you meet with the OB-GYN
for three minutes and nobody's spending time having those conversations with you.
(14:26):
Or the women are afraid that if they, because they usually use the PHQ-9 or the GAD-7, those
are typically the scales that they use in doctor's offices. And a lot of women are afraid or fearful
that if they write the truth on those forms that either they're not going to be taken care of or
(14:46):
they're going to be hospitalized or what have you. I think that that's where the education
really needs to start, when you're lucky enough to have access to good healthcare. Not all women do.
I'm hearing more and more situations where the mom is being hospitalized
(15:06):
because of some risk factors before she's having the baby. And I can't imagine how
difficult that would be mentally to be in the hospital or in bed rest for four weeks
before you even deliver. So that has to be a whole other area that would be challenging.
(15:28):
Well, yeah, and Cheryl, I think it's, my husband might hear this, I remember when
I was with my last one, I was put on bed rest for a large percentage of the pregnancy. I was very,
very sick. And he's like, âhon, I think this is great. If I was you, I would get myself a little
cooler here and I'd have cold drinks and I'd just watch shows.â And I'm like, do you know what it's
(15:52):
like to be told that you shouldn't get up longer than going to the bathroom? Right. I mean,
this isn't fun. And not to mention that if I'm taking a day off and it's rainy and I'm just
hanging out in my bed watching TV, that's very different than being told you can't stand up or
you may have your baby delivered early and it might not survive or it'll have birth defects.
(16:14):
Right. Right.
That's a lot of pressure on a woman.
Huge. Huge. So what do you think are the most misunderstood emotions around PPD?
Oh, for sure, the depression and anxiety. And people have to look at,
and that's something I deal with in the mental health field in my office
(16:35):
as well. There's this idea that if it's not like, you know, the way movies portray it,
that you're not experiencing it. And anxiety and depression is on a continuum and anxiety
and depression is personalized. So some people walk through life and they struggle most of
their lives with some feelings of sadness and they're just lower on dopamine or serotonin,
right? That's what we, that's what we say in our field because that's about the best information
(16:59):
we have at this time. We're learning a lot about the brain, neurotransmitters.
However, there's this idea that if I'm not laying there like listless and I'm just thinking of how
I want to die or I don't have enough energy to do the basic things like bathes, that if it doesn't
(17:19):
look like that, that I'm not depressed. And people, I think we really need to take a good
look at themselves and say, you know, based on me and how I present in the world, where am I at?
And I think that's another thing, Suzy and Cheryl, is that a lot of women don't have that,
that meter kind of figured out prior. And so they're, they're not really taking a look at
(17:43):
that. I know I experienced postpartum with a few of the kids, you know, to some degree,
but I remember, you know, my husband and I were, we were in our twenties with our
first child and I was very depressed and he was scared to tell me, because he's like,
he's like, you were so emotional. I was afraid I was going to make it worse. Right.
(18:08):
I think, too, if you if you have other children, possibly you also don't want to admit something's
wrong. You don't want it to impact anybody else. You feel like you have to be really
strong and get through it because you don't want to negatively impact anybody around you. I think
we tend to think that way as mothers and it can be so harmful to ourselves to feel that way.
(18:35):
Well, it's very isolating. And, you know, I think about all the moms that, you know,
during the COVID epidemic, too, like they were so isolated. Right. Like,
like they were they were basically bubble people.
And, you know, I think that's the one thing that in our culture and society that in America
(18:56):
that we really lack that community piece. Right. Like other cultures and societies,
when somebody has a baby, people are showing up for meals. People
are offering to walk their other animals. People are offering to take care of their
children, the extended families moving in and helping out. But in our culture and society,
we don't do those things. And so you have a lot of people just faking it to make it right.
(19:21):
Right. Yep. Absolutely. Absolutely. And it is so overwhelming. I have never been so exhausted
in my entire life as I was after those two boys that I had. And I was working. I was
self-employed. And when you're self-employed and you don't work, we call that debt.
(19:43):
Yes. Yes.You know,
there's just this overwhelming pressure to continue to try to work and make money and
take care of the baby and the little people in your life and your husband, who is, of course, way
down there on the pecking order. So what can moms-Â and I recognize that PPD is much more extreme than
(20:10):
even what I had. I was just a walking zombie. But, you know, what can you recommend to moms
and when should they know when it's time to ask for help? You know, what is that tipping point?
Well, I think that number one is normalizing the fact that this is going to happen. You are going
(20:33):
to have depression. You are going to be sleep deprived. You are going to have all of these
feelings and you're not special to not have them. That this is you're going to have them,
but the continuum and the degree you have them. So I think that's number one.
Number two, I think what would be really fantastic is if the if the OBGYN offices are using those
(20:59):
GAD-7s and the PHQ-9s, that they're actually getting them in the very beginning and taking
them every single week so that we can start to see how are they reporting out and then
they have access to see where they're at. And IÂ think that it also would be really fantastic if
partners had the ability to also, you know, say this is what I'm seeing and this is the changes
(21:25):
I'm seeing and have that type of relationship that that doesn't mean that you're flawed or
you're not going to be a good mom or you aren't currently a good mom, but you are a human with
human experiences and you need support. I think we also need to really start stepping it up.
Women, there's this great book. It's called The Feminine Mistake, not The Feminine Mystique,
(21:45):
The Feminine Mistake. It's a phenomenal book, well researched, and it talks about all the women
who get these advanced degrees and give up their careers to be a stay at home mom, and then they
want to enter back into the workforce. And when they enter back into the workforce, it's the other
moms that are actually the ones that are causing them more distress and treating them poorly.
(22:07):
So with that research, I think we need to step up as women and support our friends,
support our neighbors and support our community. Even when they say they don't need it,
respect boundaries clearly. But giving somebody a Door Dash gift card, that's not invasive here. I
know what it's like to be a mom. I know what it's like to be an aunt. I know what it's like to watch
(22:29):
women have children. Here's a $100 Door Dash. Get yourself a couple of meals that you like. Right.
Well, and that's part of what the MOB, the Mothers of Boys, that is the community exactly that I
really think as a society we need to encourage. And one of the things I hear you saying,
(22:50):
I believe, is that women need to advocate better for ourselves, to communicate better
with our family and friends and to ask for help and recognize when we need help.
Yes. And I want to add that being a good friend, being a good neighbor means saying to somebody,
(23:14):
hey, I notice a change in you and I'm here to support you versus, you know,
why are you acting this way? What's going on with you? Or not even saying
anything. Being able to be kind, not putting the person on the defensive,
though. You don't need to make them feel shame for being a human and having this human experience.
I have found that sometimes you don't even want to say,
(23:39):
how can I help you? Because, again, IÂ think women want to think I can do it
all. Sometimes it's good to just do it. Just drop off the Door Dash, and not sayâŚ
much better help you.
Yeah, that that is what I've found.
Right. Like, yeah, absolutely. Like somebody like, you know, you're somebody passes
away and youâre like, âlet me know if you need anything.â Well, it means a lot more
(24:04):
for somebody to just drop something off. And in the notes, say, let me know if you need any more.
Right. Right.
And I had somebody tell me once that it's really interesting because when you do have a baby,
they are so cute just to hold them and look at them like it's just precious,
right. But what we really need is somebody to come in and clean. We need somebody to come in and do
(24:28):
our laundry. You know, we want to hold our baby.Yeah. So if you aren't bonding with your baby.
Do you have any advice for women that aren't feeling that bond?
Great question. I think that first of all, let's normalize that, too. It's not like
it looks on TV. OK. And most of the times when you see mothers and babies connected and you're
(24:55):
seeing them out in public, those babies are around six months or older. So you're like,
why isn't my baby responding to me? Right. And so knowing that it takes time, it is a process.
I think, you know, we have a pretty big uptake in autism and autism diagnosis. That's all
another beast of a topic. However, I think sometimes when babies aren't connecting with
(25:19):
mom and that attachment isn't present, there may be something going on. And so I think that
that's where the pediatrician should really be consulted with. Like, âhey, I try to coo with
my baby. I try to cuddle my baby. My baby's like not interested and gets and fussier, and that I
think that we need to take a look at that.â I think that that needs to be looked at.
(25:40):
And then I think also, ladies, I'm just as guilty as every one of you out there,
put down the phone, put down the computers, put down the remotes and actually read to this baby,
talk to this baby, connect with this baby. IÂ see so many moms, like even like at a park and
(26:01):
they'll have like an infant with them because the other kids are playing and they're spending the
whole time on their phone versus looking at this little precious little creature. Right.
That's great. Great advice. And what therapeutic treatments have you found effective for PPD?
IFS, Internal Family System, Stich-Schwarz's model is phenomenal because it really talks
(26:24):
to the person about the parts and the different parts and what
they're experiencing within that system as they're trying to attach to the baby.
I think also looking at attachment theories and attachment specialists,
some women themselves have either an anxious attachment style, disorganized attachment style
or an avoidant attachment style. And that definitely can come through with the baby.
(26:50):
I think also when I've worked with women that have had traumatic births, this is also really cool
EMDR (Eye Movement Desensitization and Reprocessing). And I've worked with some
children that they've had really traumatic birth experiences and they have difficulty
attaching to the parent that what we've done is we've taken kids as young as probably my
(27:12):
youngest one was around 20 months, 24 months, and the mom tells the story of the pregnancy,
the pre-pregnancy, the pregnancy, and then the difficult birth. And we're doing EMDR and
tapping on the infant as well as the mother. And that is significantly healing for both of them.
Wow.
(27:33):
Traditional talk therapy, I have to be honest, I think it's great for the validation piece. I
think it's really great for them to just be heard and to have that. But
using those different techniques, I see a bigger neurological shift and a longer lasting impact.
Partner, male, female doesn't really make a difference. How can a partner
(27:57):
support this process of postpartum depression?
I'm going to give you a personal story. So with my first daughter, my milk,
I didn't make a lot of breast milk. And I remember my husband saying that his secretary's daughter,
who was 19, had had a baby at 19. âShe had so much milk. I don't understand why you don't have
(28:24):
a lot of milk.â And I just was like, what? And so I think rule number one, partners, everybody
is different. Everybody is different. Every birth is going to be different. I hear that a lot, too.
I had a couple in here the other day. She's four months pregnant. And the husband's like, well,
you were, you know, this is their fourth child. And, you know, in the last pregnancy, you were
(28:48):
just so different. And I said, that was five years ago. She's 40 now. It makes a huge difference. And
really saying to those partners, every pregnancy is different. Every baby is different. Every
experience is different. You may have a barometer of what it might look like, but it is going to be
different. And I think really saying that every experience is going to be different.
(29:12):
And so saying to that partner point blank, that what you observe and what you experience needs
to be looked at as a new beginning. And it's also a variance of what I normally see? And
how do you communicate? I'm concerned versus why don't you make enough milk?
Why are you so tired this pregnancy? Because that feels really shameful
(29:36):
and it feels really judgmental. And it doesn't feel good when you're hormonal.
Yeah, or comparing your partner to someone else.
Yes, a 19 year old.
Yeah. Or comparing it to a previous pregnancy, like you said.
Yes. And they're all different. And just like all babies are different.
(29:57):
So this is sort of a big question, but if there was one thing you could
change about how we talk about motherhood and mental health, what would that be?
I think the one thing is normalizing that over and over again.
I think that's huge.
(30:20):
And I and I as much as some of these cute TikTok are and as cute as some of these Instagrams are,
stay off of that, please. You know, I tell this funny story that, you know, people are like,
everybody else seems to have it together and IÂ don't. And, you know, client confidentiality,
(30:40):
clearly. However, I will tell you that some of the most chaotic, struggling, mentally
ill families that I've worked with, and then they send me these Christmas cards. And it's like, I
know all the information and these Christmas cards are in no way reflective. They are reflective for
(31:07):
about three minutes of the whole year. And so one of the things is stay off of that.
And if you don't have friendships and a community with people that can be
raw and honest and genuine, find a new one. The people that act like they have it all together,
I am telling you, they are the most chaotic ones you will find.
(31:28):
So, you know, I have I have some friends that they're when they go to the doctor and they're
asked those questions about feeling depressed, they might want to communicate it that they are,
but they're afraid to because they're afraid they're going to have it on the record forever.
(31:49):
I have I've heard that multiple times from many people that I don't want this on my record
forever and that they're going to keep asking me about it. Do you have any advice for that?
Well, I think that there's a lot of truth and validity in that. I think that insurance and
that's one of the main reasons I do not take insurance in my private practice,
(32:10):
because I do some clinical work for a company out of California, I am
telling you, they do get access to those things.So, I think in the perfect world all women should
have to see a therapist postpartum at least three times from birth within the first three months of
(32:34):
the baby's life. I think that would be huge and valuable. And I think that the diagnosis should
be adjustment disorder, which is like having a mental health flu because you are adjusting. It's
not a lie. It's the truth. And if insurance companies see that adjustment disorder, they
usually don't think twice about it. It's a flu. Right. And you can have that for up to six months.
(32:56):
I think the words they use should be what they say. So being specific with the words. So I'm
feeling a loss of energy. I'm feeling a real exhaustion. I'm feeling fatigued. I'm not as peppy
as I used to be. I'm having a difficult time doing the things I once did versus I'm very depressed.
(33:21):
I'm very sad. I don't like this life anymore. So you hear the difference in the wording.
Yeah. Very good advice.
Yeah. And those are the words the women should be using because if
that implies those other words, the first set of words, vocabulary terms,
(33:42):
that implies a hormonal change, not a mental health illness.
Well, also, then we're not self-diagnosing, right?
Correct.
I mean, we're not the expert. The doctor is the expert,
so don't diagnose yourself, right? Let the professionals diagnose you.
Right. Instead of saying, I think I have insomnia,
(34:04):
you say, I find that I don't sleep as well as I used to. OK. Right. You see. And so,
you know, along those lines, looking for words to describe how you're feeling rather than giving it
a label. Does that help?That's great advice.
Yeah. Wonderful advice.
(34:26):
I have colleagues that probably would disagree with me, but I've
seen the other side of things and I'm very raw and open with my patients.
Yes, I would also really love to advocate for those that- postpartum therapy for everyone,
to normalize it. And it's just part of your follow up with your pediatrician or your, you know, your.
(34:53):
Yeah, I mean, like there's EPA services for work. Why can't there be postpartum for all
women that they just have these three sessions and that it be a requirement
that they meet with somebody just for three sessions, just to talk about what they're
experiencing and that the women that do this, that they're you know what they
have to provide to the insurance company is very basic, like completing that PHQ-9,
(35:16):
completing that GAD-7 and saying, yes, they are sleep deprived because they have a newborn baby.
So Dr. Kim, we ask all of our guests to share a mantra or saying that mom can say
to herself as she's experiencing the topic, which today is postpartum depression. So what
(35:37):
is it that you offer to your patients that you counsel on this topic or do you have a mantra?
Well, I think that we're going to stick with this very basic one, âthat everything I'm experiencing
is normal and it's OK.â Everything I'm experiencing is normal and it's OK.
Right. Yeah.
(35:57):
This has been a really important conversation. And I feel like youâve just provided us with
so much insight and knowledge and helpful tips for navigating the postpartum time
in a mother's life. So thank you for this wonderful time together today.
(36:19):
Absolutely. My pleasure.
Yeah, we really appreciate it.
And thank you all for joining us today. Follow the MOB on Facebook, Instagram,
YouTube and your favorite podcast platform. Be kind to yourselves, moms, and have a great week.
A Psychologistâs Insights into Maternal Mental Health
Welcome to the Mothers of Boys Survival Guide podcast. I'm Cheryl Bond and I'm
joined by co-host Suzy Shaw.Hi Cheryl. A new mother of a
baby boy suggested this topic to help her and other moms better understand
(00:22):
the healing process from childbirth, which is a very big life event for sure.
One of the biggest for sure. Last week we spoke with a labor and delivery discharge
nurse about how moms can prepare for life at home with a newborn and she
shared practical tips for healing and sleeping and just overall adjusting.
(00:43):
And this week we're diving into a topic that really doesn't get talked about enough, even
though one in seven mothers are affected by it, which is postpartum depression. Our guest today is
Dr. Kimberly Schipione, a licensed professional counselor with a doctorate in psychology and
education. She has extensive experience working with women and is also the mother of five.
(01:09):
Today she's going to help us better understand what postpartum depression looks like,
how it impacts new moms, and most importantly, how to get help or support for someone going through
it. So welcome Dr. Schipione.Thank you so much.
This is such a huge topic. I get a lot of referrals from OBGYNs and psychiatrists
(01:32):
and PCPs with people that have never been to any type of psychotherapy before and
after childbirth. And there's a variety of things we can discuss as we head there. Yes.
So Dr. Kim, can we just start with the basics? How would you describe postpartum depression
to someone who's never experienced it, and especially men and spouses,
(01:56):
right? And what are the most common symptoms or patterns you see with moms struggling with PPD?
I think the statistic is one in seven, and IÂ think that's probably true to meet the diagnostic
criteria for postpartum depression. However, IÂ would say that every single woman goes through
postpartum depression to some degree. I think to meet diagnostic criteria that you're needing
(02:20):
intensive intervention, that's probably where the one in seven, and I'd like to normalize
that and say that every single woman, you will experience some type of postpartum depression.
Does it meet diagnostic criteria? No. Could it be considered maybe an adjustment disorder
with anxiety and depression? Sure. I anticipate that you're going to have some of this. So some
(02:40):
of the signs and symptoms we're looking for, and I think that's where we have to normalize this.
Social media, it's great for many things, but I think they only show the pictures of
the moms and their cute little babies, like with the big flowery headbands on,
or these cute little boys with like, you know, little newspaper boy,
(03:01):
the old fashioned newspaper boy hats, like looking, I could send you a couple of mine.
So darn cute, and I think that we think that it's all like that all the time.
Instead, we have fluids coming from every orifice of our body that we weren't anticipating, that
we aren't sleeping. Our hormones are an absolute mess, and I also think that we live in a culture
(03:25):
and society where you're supposed to look a certain way, and it takes a very long time for
your body to get back to pre-baby weight. And I think that we're hard on ourselves for that,
and we're embarrassed, and so because we don't look like the other people on social media,
we're not talking to anybody about it.But when we start to look for intensive diagnostic
(03:45):
concerns, we're looking at, you know, depressed most of the day, kind of lying there, not wanting
to eat, obviously sleeping too much, not sleeping at all, change in appetite. Psychomotor is a big
one, too. We have, you know, a slowness, like our body's not moving like it once did, a real lack of
(04:06):
energy and fatigue, feelings of worthlessness, feeling, a lot of times women can often feel
guilt and shame because they're supposed to love and feel connected to this new creature.
And I say, well, if you got a new puppy, would you know when the puppy has to eat
and sleep and use the restroom right away, and they're like, no, I said,
well, it's no different than a baby. And they said, but it's my own, and it's different.
(04:28):
When we start to get really concerned is when we start to have some of the, either the suicidal
thoughts or homicidal thoughts. And that is, and there's psychosis that can sometimes happen
with postpartum, but those are extreme cases.Yeah, it's really something because it, everybody,
you know, you hear, oh, it's supposed to be so joyful. It's, it's the most, you know, which,
(04:51):
which there is a side that obviously is so joyful. But if you have a really difficult delivery and,
you know, you're in a lot of pain and recovery physically is really difficult. I think there
can be a lot of guilt associated with, oh, I'm supposed to be happy because this is supposed
to be the happiest time of my life. And you're, but you're recovering physically, you know, and,
(05:14):
and it's really difficult. So then you're feeling like you should be feeling happier, you know.
Absolutely.
How soon after the birth can signs of postpartum depression appear?
Yeah, that's a, that's a great question, Cheryl. And I think that that's also one
of those misnomers. I think, you know, when I, when I use the word âmanicness,| that is
(05:38):
not meaning you're bipolar and you are, you know, looking like the Hollywood movies,
bipolar disorder. However, mania can kind of come in the first couple of weeks,
if not months of, of after childbirth and then you can hit depression pretty quickly.
Like maybe you're ecstatic, you're over the moon excited,
you're not sleeping. Some people experience that and then they go into a deep depressive state.
(06:02):
It can happen anywhere from like the moment the child is born or it can happen within about,
I think the statistical, the DSM is looking at, you have to present at least
five or more of those symptoms that IÂ listed in the beginning and it can come
anywhere from birth to, I think it's up to three to six months. So it can happen.
(06:26):
And some women don't experience it till six months in, you know, everybody's different.
And I think there's also a denial factor that goes in. And I think if you have other children,
that can be good too, because you're distracted by caring for multiple lives. And then you don't have
a moment to sleep and then you start to sleep and then you realize I'm not doing so well.
(06:47):
Right. Right. I remember my first baby, the emotional roller coaster of having
that baby and being in pain - for me, I had a level three episiotomy. I was
in a lot of pain. I was leaking- itâs what I would call it. So I was crying,
(07:10):
my boobs are leaking, everything's leaking. I wasn't used to leakingâŚ
Every orifice, every orificeâŚSo how long does it take to get
back into normal? And you know, is that six months, two years? What do you think?
(07:31):
Well, okay, I'm going to, I'm coming from the clinical perspective of what I
observe in the clinical setting. Sure. I'm going to, okay, so one of the big things
I think people need to understand is when you started saying that you had
to have the episiotomy and all of these other complications, I think that all contributes.
So I will tell you one thing I do see more than others, women that had a very difficult time
(07:57):
conceiving and went through an IVF process, those women, I see them taking way longer to recover.
And I believe the reason is, has to do with hormones and it, and honestly, Suzy and Cheryl,
I can see it taking two, three years and there's a trauma component to that because we're supposed
(08:18):
to- according to society and biology, we're supposed to just be able to get pregnant.
Then, a lot of these women experience multiple miscarriages. A lot of these
women can have traumatic births. Nobody planned on you having an episiotomy or a
C-section. And there's so many things that go into this. So when you ask the question,
(08:39):
you know, when can you get back to normal? I think it's all relevant to the pregnancy,
what was happening in your life leading up to the pregnancy, what happened during the pregnancy,
and what's happening during delivery and post. And I think all those things are huge factors.
And I guess if you had a second child,
then you're just hitting the reset button within that time period anyway.
(09:03):
Oh, 100%. And so I think that's what, you know, I have a set of Irish twins
and I think that was one of those moments in my life where it was like I didn't,
my body didn't even have time to get back to any type of normalcy and here comes the next one,
right? And that was kid number four. He was quite the surprise.
(09:24):
And so, you know, I, here I am pregnant with kid number four and I've got, you know,
three other humans to care for at the time. And I was working full time and in graduate school.
Oh wow. I know you think everybody has a mom. How difficult can it be? Right.
And it's so difficult. And there can be so many complications. But you, you think,
(09:47):
well, everybody has a mom. So, you know.Well, I think that we're the first generation of
women in our age range that are actually talking about this stuff because I think there was a lot
of shame around it. And even like when you think about menopause, like recently I was contacted to
speak on menopause and I was like, well, I could talk to my experience. But I think
(10:09):
we are coming up on a generation of people that are actually talking about these things.
And I think if our mothers
had the opportunity to be more raw and more real and not, you know, air their dirty laundry,
so to speak, that we would have had a deeper insight to what that's really like.
I agree with you.
I took a class on women's history when I was in college. And this sort
(10:32):
of information historically was in cookbooks. So I mean,
just to double down on nobody was talking about it. It was sort of hidden, right? And slid into
the cookbook. Cookbooks. Which IÂ still remember all these years later.
And, you know, I think as you say that, I think about, you know, with postpartum,
(10:56):
there's this idea that you're supposed to want to engage in intimacy with your partner post
that six weeks when you get the green light. And how that probably wasn't in the cookbook, Suzy?
Oh, no. Yeah, that was, that's a dangerous thought,
right? Yeah, right. Especially after being sewed back up after an episiotomy.
(11:21):
Absolutely.So is there anything else
with the mother's history that could be a risk factor? I know you talked about a few things,
but is, I don't know if there's anything in the mother's history or the family history that might?
Oh, absolutely. I think if you are, if you have a history of depression, a history of anxiety,
it's only going to magnify. I think one of the other things that's really come up is,
(11:44):
especially a lot of the women that had difficulty conceiving,
they were told to get off of all of their SSRIs (Selective Serotonin Reuptake
Inhibitors -a class of antidepressant medications) before they conceived.
And I just- I'm finishing up a fourth master's degree in clinical psychopharmacology. And we
spent an entire weekend talking about medications for women that are wanting to get pregnant,
(12:06):
are pregnant and postpartum. And there was a huge debate in our class, like there are medications
that can cause some birth defects. There are medications that can cause difficulty to the
fetus. However, when you look at the big picture of that, if you have a mother who's actively
depressed and actively suicidal, it is more important for her mood to be stabilized than
(12:31):
it is for the possible side effects of that. And that's where the debate came in. Is it not?
The whole class, and these are all doctorate level people in the class or MDs, discussed
that we felt that obviously it's an ethical, moral discussion to have with your patient.
However, what is more important, however, if you are predisposed, the possibility of being off
(12:58):
of your meds, sleep deprived, hormonal changes, life normalcy changes. It will magnify, we said,
between three and five times. And there's also a lot of research going into women that have already
experienced postpartum or they know they have family history of postpartum. And starting an
(13:22):
SSRI, if they were off of it or have never been on it, it's starting it in the third trimester.
Some of the meds are safe, Zoloft and Prozac, Sirtuline, Floxetine, they are considered to
be safe for pregnant women. However, a lot of women are afraid of taking those things.
(13:44):
Well, it's back to this conversation. The conversation that comes, unless you ask
the question yourself, it's the information doesn't get trickled down to you, I think,
to moms in general during that period.I also think our OB-GYNs, as great as
(14:05):
many of them can be, a lot of people go through healthcare insurance plans where it's literally
like an assembly line. You show up, the nurse will take your vitals and then you meet with the OB-GYN
for three minutes and nobody's spending time having those conversations with you.
(14:26):
Or the women are afraid that if they, because they usually use the PHQ-9 or the GAD-7, those
are typically the scales that they use in doctor's offices. And a lot of women are afraid or fearful
that if they write the truth on those forms that either they're not going to be taken care of or
(14:46):
they're going to be hospitalized or what have you. I think that that's where the education
really needs to start, when you're lucky enough to have access to good healthcare. Not all women do.
I'm hearing more and more situations where the mom is being hospitalized
(15:06):
because of some risk factors before she's having the baby. And I can't imagine how
difficult that would be mentally to be in the hospital or in bed rest for four weeks
before you even deliver. So that has to be a whole other area that would be challenging.
(15:28):
Well, yeah, and Cheryl, I think it's, my husband might hear this, I remember when
I was with my last one, I was put on bed rest for a large percentage of the pregnancy. I was very,
very sick. And he's like, âhon, I think this is great. If I was you, I would get myself a little
cooler here and I'd have cold drinks and I'd just watch shows.â And I'm like, do you know what it's
(15:52):
like to be told that you shouldn't get up longer than going to the bathroom? Right. I mean,
this isn't fun. And not to mention that if I'm taking a day off and it's rainy and I'm just
hanging out in my bed watching TV, that's very different than being told you can't stand up or
you may have your baby delivered early and it might not survive or it'll have birth defects.
(16:14):
Right. Right.
That's a lot of pressure on a woman.
Huge. Huge. So what do you think are the most misunderstood emotions around PPD?
Oh, for sure, the depression and anxiety. And people have to look at,
and that's something I deal with in the mental health field in my office
(16:35):
as well. There's this idea that if it's not like, you know, the way movies portray it,
that you're not experiencing it. And anxiety and depression is on a continuum and anxiety
and depression is personalized. So some people walk through life and they struggle most of
their lives with some feelings of sadness and they're just lower on dopamine or serotonin,
right? That's what we, that's what we say in our field because that's about the best information
(16:59):
we have at this time. We're learning a lot about the brain, neurotransmitters.
However, there's this idea that if I'm not laying there like listless and I'm just thinking of how
I want to die or I don't have enough energy to do the basic things like bathes, that if it doesn't
(17:19):
look like that, that I'm not depressed. And people, I think we really need to take a good
look at themselves and say, you know, based on me and how I present in the world, where am I at?
And I think that's another thing, Suzy and Cheryl, is that a lot of women don't have that,
that meter kind of figured out prior. And so they're, they're not really taking a look at
(17:43):
that. I know I experienced postpartum with a few of the kids, you know, to some degree,
but I remember, you know, my husband and I were, we were in our twenties with our
first child and I was very depressed and he was scared to tell me, because he's like,
he's like, you were so emotional. I was afraid I was going to make it worse. Right.
(18:08):
I think, too, if you if you have other children, possibly you also don't want to admit something's
wrong. You don't want it to impact anybody else. You feel like you have to be really
strong and get through it because you don't want to negatively impact anybody around you. I think
we tend to think that way as mothers and it can be so harmful to ourselves to feel that way.
(18:35):
Well, it's very isolating. And, you know, I think about all the moms that, you know,
during the COVID epidemic, too, like they were so isolated. Right. Like,
like they were they were basically bubble people.
And, you know, I think that's the one thing that in our culture and society that in America
(18:56):
that we really lack that community piece. Right. Like other cultures and societies,
when somebody has a baby, people are showing up for meals. People
are offering to walk their other animals. People are offering to take care of their
children, the extended families moving in and helping out. But in our culture and society,
we don't do those things. And so you have a lot of people just faking it to make it right.
(19:21):
Right. Yep. Absolutely. Absolutely. And it is so overwhelming. I have never been so exhausted
in my entire life as I was after those two boys that I had. And I was working. I was
self-employed. And when you're self-employed and you don't work, we call that debt.
(19:43):
Yes. Yes.You know,
there's just this overwhelming pressure to continue to try to work and make money and
take care of the baby and the little people in your life and your husband, who is, of course, way
down there on the pecking order. So what can moms-Â and I recognize that PPD is much more extreme than
(20:10):
even what I had. I was just a walking zombie. But, you know, what can you recommend to moms
and when should they know when it's time to ask for help? You know, what is that tipping point?
Well, I think that number one is normalizing the fact that this is going to happen. You are going
(20:33):
to have depression. You are going to be sleep deprived. You are going to have all of these
feelings and you're not special to not have them. That this is you're going to have them,
but the continuum and the degree you have them. So I think that's number one.
Number two, I think what would be really fantastic is if the if the OBGYN offices are using those
(20:59):
GAD-7s and the PHQ-9s, that they're actually getting them in the very beginning and taking
them every single week so that we can start to see how are they reporting out and then
they have access to see where they're at. And IÂ think that it also would be really fantastic if
partners had the ability to also, you know, say this is what I'm seeing and this is the changes
(21:25):
I'm seeing and have that type of relationship that that doesn't mean that you're flawed or
you're not going to be a good mom or you aren't currently a good mom, but you are a human with
human experiences and you need support. I think we also need to really start stepping it up.
Women, there's this great book. It's called The Feminine Mistake, not The Feminine Mystique,
(21:45):
The Feminine Mistake. It's a phenomenal book, well researched, and it talks about all the women
who get these advanced degrees and give up their careers to be a stay at home mom, and then they
want to enter back into the workforce. And when they enter back into the workforce, it's the other
moms that are actually the ones that are causing them more distress and treating them poorly.
(22:07):
So with that research, I think we need to step up as women and support our friends,
support our neighbors and support our community. Even when they say they don't need it,
respect boundaries clearly. But giving somebody a Door Dash gift card, that's not invasive here. I
know what it's like to be a mom. I know what it's like to be an aunt. I know what it's like to watch
(22:29):
women have children. Here's a $100 Door Dash. Get yourself a couple of meals that you like. Right.
Well, and that's part of what the MOB, the Mothers of Boys, that is the community exactly that I
really think as a society we need to encourage. And one of the things I hear you saying,
(22:50):
I believe, is that women need to advocate better for ourselves, to communicate better
with our family and friends and to ask for help and recognize when we need help.
Yes. And I want to add that being a good friend, being a good neighbor means saying to somebody,
(23:14):
hey, I notice a change in you and I'm here to support you versus, you know,
why are you acting this way? What's going on with you? Or not even saying
anything. Being able to be kind, not putting the person on the defensive,
though. You don't need to make them feel shame for being a human and having this human experience.
I have found that sometimes you don't even want to say,
(23:39):
how can I help you? Because, again, IÂ think women want to think I can do it
all. Sometimes it's good to just do it. Just drop off the Door Dash, and not sayâŚ
much better help you.
Yeah, that that is what I've found.
Right. Like, yeah, absolutely. Like somebody like, you know, you're somebody passes
away and youâre like, âlet me know if you need anything.â Well, it means a lot more
(24:04):
for somebody to just drop something off. And in the notes, say, let me know if you need any more.
Right. Right.
And I had somebody tell me once that it's really interesting because when you do have a baby,
they are so cute just to hold them and look at them like it's just precious,
right. But what we really need is somebody to come in and clean. We need somebody to come in and do
(24:28):
our laundry. You know, we want to hold our baby.Yeah. So if you aren't bonding with your baby.
Do you have any advice for women that aren't feeling that bond?
Great question. I think that first of all, let's normalize that, too. It's not like
it looks on TV. OK. And most of the times when you see mothers and babies connected and you're
(24:55):
seeing them out in public, those babies are around six months or older. So you're like,
why isn't my baby responding to me? Right. And so knowing that it takes time, it is a process.
I think, you know, we have a pretty big uptake in autism and autism diagnosis. That's all
another beast of a topic. However, I think sometimes when babies aren't connecting with
(25:19):
mom and that attachment isn't present, there may be something going on. And so I think that
that's where the pediatrician should really be consulted with. Like, âhey, I try to coo with
my baby. I try to cuddle my baby. My baby's like not interested and gets and fussier, and that I
think that we need to take a look at that.â I think that that needs to be looked at.
(25:40):
And then I think also, ladies, I'm just as guilty as every one of you out there,
put down the phone, put down the computers, put down the remotes and actually read to this baby,
talk to this baby, connect with this baby. IÂ see so many moms, like even like at a park and
(26:01):
they'll have like an infant with them because the other kids are playing and they're spending the
whole time on their phone versus looking at this little precious little creature. Right.
That's great. Great advice. And what therapeutic treatments have you found effective for PPD?
IFS, Internal Family System, Stich-Schwarz's model is phenomenal because it really talks
(26:24):
to the person about the parts and the different parts and what
they're experiencing within that system as they're trying to attach to the baby.
I think also looking at attachment theories and attachment specialists,
some women themselves have either an anxious attachment style, disorganized attachment style
or an avoidant attachment style. And that definitely can come through with the baby.
(26:50):
I think also when I've worked with women that have had traumatic births, this is also really cool
EMDR (Eye Movement Desensitization and Reprocessing). And I've worked with some
children that they've had really traumatic birth experiences and they have difficulty
attaching to the parent that what we've done is we've taken kids as young as probably my
(27:12):
youngest one was around 20 months, 24 months, and the mom tells the story of the pregnancy,
the pre-pregnancy, the pregnancy, and then the difficult birth. And we're doing EMDR and
tapping on the infant as well as the mother. And that is significantly healing for both of them.
Wow.
(27:33):
Traditional talk therapy, I have to be honest, I think it's great for the validation piece. I
think it's really great for them to just be heard and to have that. But
using those different techniques, I see a bigger neurological shift and a longer lasting impact.
Partner, male, female doesn't really make a difference. How can a partner
(27:57):
support this process of postpartum depression?
I'm going to give you a personal story. So with my first daughter, my milk,
I didn't make a lot of breast milk. And I remember my husband saying that his secretary's daughter,
who was 19, had had a baby at 19. âShe had so much milk. I don't understand why you don't have
(28:24):
a lot of milk.â And I just was like, what? And so I think rule number one, partners, everybody
is different. Everybody is different. Every birth is going to be different. I hear that a lot, too.
I had a couple in here the other day. She's four months pregnant. And the husband's like, well,
you were, you know, this is their fourth child. And, you know, in the last pregnancy, you were
(28:48):
just so different. And I said, that was five years ago. She's 40 now. It makes a huge difference. And
really saying to those partners, every pregnancy is different. Every baby is different. Every
experience is different. You may have a barometer of what it might look like, but it is going to be
different. And I think really saying that every experience is going to be different.
(29:12):
And so saying to that partner point blank, that what you observe and what you experience needs
to be looked at as a new beginning. And it's also a variance of what I normally see? And
how do you communicate? I'm concerned versus why don't you make enough milk?
Why are you so tired this pregnancy? Because that feels really shameful
(29:36):
and it feels really judgmental. And it doesn't feel good when you're hormonal.
Yeah, or comparing your partner to someone else.
Yes, a 19 year old.
Yeah. Or comparing it to a previous pregnancy, like you said.
Yes. And they're all different. And just like all babies are different.
(29:57):
So this is sort of a big question, but if there was one thing you could
change about how we talk about motherhood and mental health, what would that be?
I think the one thing is normalizing that over and over again.
I think that's huge.
(30:20):
And I and I as much as some of these cute TikTok are and as cute as some of these Instagrams are,
stay off of that, please. You know, I tell this funny story that, you know, people are like,
everybody else seems to have it together and IÂ don't. And, you know, client confidentiality,
(30:40):
clearly. However, I will tell you that some of the most chaotic, struggling, mentally
ill families that I've worked with, and then they send me these Christmas cards. And it's like, I
know all the information and these Christmas cards are in no way reflective. They are reflective for
(31:07):
about three minutes of the whole year. And so one of the things is stay off of that.
And if you don't have friendships and a community with people that can be
raw and honest and genuine, find a new one. The people that act like they have it all together,
I am telling you, they are the most chaotic ones you will find.
(31:28):
So, you know, I have I have some friends that they're when they go to the doctor and they're
asked those questions about feeling depressed, they might want to communicate it that they are,
but they're afraid to because they're afraid they're going to have it on the record forever.
(31:49):
I have I've heard that multiple times from many people that I don't want this on my record
forever and that they're going to keep asking me about it. Do you have any advice for that?
Well, I think that there's a lot of truth and validity in that. I think that insurance and
that's one of the main reasons I do not take insurance in my private practice,
(32:10):
because I do some clinical work for a company out of California, I am
telling you, they do get access to those things.So, I think in the perfect world all women should
have to see a therapist postpartum at least three times from birth within the first three months of
(32:34):
the baby's life. I think that would be huge and valuable. And I think that the diagnosis should
be adjustment disorder, which is like having a mental health flu because you are adjusting. It's
not a lie. It's the truth. And if insurance companies see that adjustment disorder, they
usually don't think twice about it. It's a flu. Right. And you can have that for up to six months.
(32:56):
I think the words they use should be what they say. So being specific with the words. So I'm
feeling a loss of energy. I'm feeling a real exhaustion. I'm feeling fatigued. I'm not as peppy
as I used to be. I'm having a difficult time doing the things I once did versus I'm very depressed.
(33:21):
I'm very sad. I don't like this life anymore. So you hear the difference in the wording.
Yeah. Very good advice.
Yeah. And those are the words the women should be using because if
that implies those other words, the first set of words, vocabulary terms,
(33:42):
that implies a hormonal change, not a mental health illness.
Well, also, then we're not self-diagnosing, right?
Correct.
I mean, we're not the expert. The doctor is the expert,
so don't diagnose yourself, right? Let the professionals diagnose you.
Right. Instead of saying, I think I have insomnia,
(34:04):
you say, I find that I don't sleep as well as I used to. OK. Right. You see. And so,
you know, along those lines, looking for words to describe how you're feeling rather than giving it
a label. Does that help?That's great advice.
Yeah. Wonderful advice.
(34:26):
I have colleagues that probably would disagree with me, but I've
seen the other side of things and I'm very raw and open with my patients.
Yes, I would also really love to advocate for those that- postpartum therapy for everyone,
to normalize it. And it's just part of your follow up with your pediatrician or your, you know, your.
(34:53):
Yeah, I mean, like there's EPA services for work. Why can't there be postpartum for all
women that they just have these three sessions and that it be a requirement
that they meet with somebody just for three sessions, just to talk about what they're
experiencing and that the women that do this, that they're you know what they
have to provide to the insurance company is very basic, like completing that PHQ-9,
(35:16):
completing that GAD-7 and saying, yes, they are sleep deprived because they have a newborn baby.
So Dr. Kim, we ask all of our guests to share a mantra or saying that mom can say
to herself as she's experiencing the topic, which today is postpartum depression. So what
(35:37):
is it that you offer to your patients that you counsel on this topic or do you have a mantra?
Well, I think that we're going to stick with this very basic one, âthat everything I'm experiencing
is normal and it's OK.â Everything I'm experiencing is normal and it's OK.
Right. Yeah.
(35:57):
This has been a really important conversation. And I feel like youâve just provided us with
so much insight and knowledge and helpful tips for navigating the postpartum time
in a mother's life. So thank you for this wonderful time together today.
(36:19):
Absolutely. My pleasure.
Yeah, we really appreciate it.
And thank you all for joining us today. Follow the MOB on Facebook, Instagram,
YouTube and your favorite podcast platform. Be kind to yourselves, moms, and have a great week.
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