May 22, 2024 • 46 mins
Navigating Maternal Mental Health: Insights on Postpartum Anxiety and Depression
Welcome to the latest episode of the Heal Your Roots Podcast! In this episode, we dive deep into the complex world of maternal mental health, exploring crucial topics like postpartum anxiety and depression. Our discussion covers a range of vital issues, from the impact of social media on raising awareness to distinguishing between baby blues and more severe mood disorders.
Timestamps:
[00:00] - Introduction: Understanding Maternal Mental Health and Social Media's Role
[03:31] - Differentiating Postpartum Anxiety and Depression from Baby Blues
[07:51] - Recognizing Symptoms, Risk Factors, and Treatment for Postpartum Mood Disorders
[16:10] - Perinatal Mood Disorders in Women of Color: Risk Factors and Relationship Impact
[24:34] - Postpartum Depression and Attachment: Bonding with Your Baby
[29:24] - Navigating Postpartum Depression and Generational Differences
[35:30] - Effective Treatment Options for Postpartum Depression
[40:02] - Coping Strategies for New Mothers: Embracing Self-Compassion
Key Takeaways:
- Maternal Mental Health Awareness: Discover how social media can promote honest discussions about motherhood and mental health.
- Postpartum Challenges: Learn the differences between postpartum anxiety, depression, and baby blues.
- Identifying Symptoms: Understand the key symptoms of postpartum mood disorders and when to seek professional help.
- Cultural Competency: Address the unique challenges faced by women of color and the importance of culturally competent care.
- Attachment and Bonding: Explore strategies to strengthen the bond with your baby, even when facing postpartum depression.
- Generational Insights: Navigate the impact of unsolicited advice and generational differences in parenting.
- Treatment and Support: Review effective treatment options, including therapy, support groups, and medication.
- Coping Mechanisms: Embrace coping strategies to manage stress and anxiety as a new mother.
Join us for an enlightening conversation that aims to provide support, raise awareness, and empower mothers on their journey through postpartum mental health. Don't forget to like, share, and subscribe for more insightful episodes!
Learn more on our website at https://bit.ly/HYRP-Strategies-for-mothers
Disclaimer: This episode is for informational purposes only and is not a substitute for professional therapy.
#MaternalMentalHealth #PostpartumDepression #PostpartumAnxiety #Motherhood #MentalHealthAwareness #HealYourRootsPodcast #CopingStrategies #Parenting #MentalHealthSupport #NewMoms
Check out the rest of the Heal Your Roots Podcast episodes at our website.
Learn more about Heal Your Roots Wellness
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Brianna Bliss (00:00):
postpartum anxiety and depression is pretty
common. Like, I think it's likeone in five or one in sevens,
women something like that span
Dr. Spencer Brown (00:10):
is one in five. I do think social media
has done a really good job ofgiving moms that opportunity to
really talk about the hardshipsthat comes with being a mom,
whereas I feel like oldergenerations made it like, oh,
it's rainbows and sunshine andbutterflies, and it's just the
most beautiful thing. And a lotof ways it is and in a lot of
(00:32):
ways, it's not. And so I feellike our generation is doing a
good job of like, No, this iswhat it is, you know, you're
gonna be tired, you're gonna besleep deprived, is not always
rainbows and butterflies. And soI do think that social media has
given women the opportunity toreally be like, kinda like
brutally honest and give otherwomen a heads up about what this
(00:53):
really looks like.
Dr. Katie Manganello (00:57):
Welcome back to the Heal Your Roots
Podcast. I'm Dr. KatieManganello. And in light of may
being Maternal Mental HealthAwareness Month, I have Dr.
Spencer Brown and Dr. BriannaBliss, who are licensed clinical
psychologists that specialize inmaternal mental health here with
me today. So, welcome. Thankyou. Yeah, yeah, I'm so excited
(01:19):
to have you guys here. They'realso some of my, my friends on
top of my colleagues that wewent to grad school together. So
this is really fun being able toinclude them in on this
conversation, and for them toshare their wealth of knowledge
with us on this. So before weget into it, can you guys both
just tell me a little bit aboutwhat kind of brought you into
(01:42):
the field, not necessarily justthe field of psychology, but
also what kind of inspired youto do this type of work? Sure. I
can start. So I think whatoriginally sort of led me to,
like perinatal mental health wasmy focus on my dissertation.
Dr. Spencer Brown (02:00):
So that's when I really started to look
into women's health, mydissertation focused on female
infertility, stigma, thatcognitive distortions, and
coping responses. And so once Ireally started to get into that,
I was like, hmm, this might be areally good field a really good
(02:20):
niche for me to kind of explore.
So that led me to my internship,which led me to my postdoc,
which then led me to my fulltime job right now. And so
that's kind of like thetrajectory of how I kind of got
into the field was reallyessentially my dissertation
topic. Yeah.
Dr. Katie Manganello (02:38):
And what kind of brought you to choose
that topic again, like was thereanything in particular that kind
of like happened that sparkedthat?
Dr. Spencer Brown (02:45):
Yeah, so it was during the time when The
Handmaid's Tale was on TV, oh,
Dr. Katie Manganello (02:50):
my gosh, yes, I remember this now. So
literally, I
Dr. Spencer Brown (02:54):
was just kind of like laying in bed. And I was
thinking about, like, what do Iwant to do for my dissertation
topic, and I just remembereverybody saying, you don't want
to pick something that's goingto be boring because you'd have
to like sit with it for like ayear or a year and a half. And I
kind of already knew thefoundation was going to be
something related to likewomen's health. I didn't know
what and then I was watching TheHandmaid's Tale and I was like,
(03:17):
infertility. You know, I thinkthat would be like something
that I would want to exploremore and get into more. And so
that's kind of how it kind ofled me to it. And I also read
the book in high school. So Ihad a good foundation for it.
Dr. Brianna Bliss (03:31):
I didn't know that. I didn't either. Awesome.
Dr. Katie Manganello (03:36):
Yeah, actually, I didn't even know
there was a book. I thought itwas just the show.
Dr. Spencer Brown (03:41):
Margaret Atwood is the Arthur.
Dr. Katie Manganello (03:45):
Awesome.
Okay, and what about you Dr.
Bliss? So
Dr. Brianna Bliss (03:50):
I am a pediatric psychologist. And so I
work in primary care with littlekiddos, zero to 21. So I see the
whole the whole pediatriclifespan actually. And I'm in a
pediatricians office and where Iwork now I have over the past
(04:12):
two years or so been starting towork with the younger, you know,
zero to five kids. And obviouslywith that comes parents and
moms. And so I kind of stumbledinto perinatal mental health
through seeing little kids andwhat happens in primary care
(04:38):
sometimes is moms are screenedfor depression or for you know,
any other stressors or familystress. And so, I love to see
like newborns and when the momsyou know, first have the babies
and so I can work with them thenor any of the caregivers really
(04:58):
so I kind of stumbled Toperinatal mental health through
my work in pediatrics, and Ialso do a group, a prenatal
group for pregnant peoplecurrently focused on the fourth
trimester and newborndevelopment. So mostly seeing
(05:21):
kids but have been working withperinatal population through my
work in pediatrics. That's
Dr. Katie Manganello (05:28):
awesome.
Isn't it interesting how we justkind of like stumbled into what
we're doing. It's not just like,This is what I'm gonna do. And
here we are, right. So that'sreally cool. I
Dr. Spencer Brown (05:38):
feel like that's my life. I feel like I
kind of just stumbled intothings. It just kind of happens
that way. So I just, yeah.
Dr. Brianna Bliss (05:47):
Yeah. Never, I never really thought I'd be
going into this kind ofdirection. But especially in
primary care. It's all likepreventative mental health. So
it's like, if you're gonna see atwo year old or a three year
old, then why not just startseeing the mom to like, as early
as possible. So just kind ofhappens that way. Right. And
Dr. Katie Manganello (06:10):
a lot of working with children is working
with parents. So yeah, thatmakes sense. Definitely.
Dr. Brianna Bliss (06:15):
Sure.
Dr. Spencer Brown (06:16):
God bless you, because kids want to work
with the moms.
Dr. Brianna Bliss (06:23):
It's fun.
There's never a dull moment.
They keep you on your toes. Iknow you fellas.
Dr. Katie Manganello (06:33):
Well, so with that being said, and
knowing that you both work withthis, so how would you define
postpartum anxiety anddepression? And how would you
kind of differentiate that fromlike a typical just like baby
blues.
Dr. Spencer Brown (06:49):
So typically, with like the baby blues, just
want to kind of like prefacesthat the baby blues are
extremely common. About 85, upto about 85% of women will
experience the baby blues. Sothis is essentially, you know,
feeling sad, feelingoverwhelmed, feeling anxious,
(07:11):
during the first two to threeweeks postpartum. If those
symptoms do not start todecrease, but rather like
increase or kind of like staythe same, after that three week
mark, then that's when we willbe concerned about postpartum
depression. So I always tell mymoms that when they are
pregnant, and kind of like,brace them for that, because
(07:33):
it's extremely common. And I'malways like, just because you're
crying at the drop of a dime,you're feeling overwhelmed or
anxious. And the first two tothree weeks, that does not mean
you have postpartum depression,you are in the baby blues phase.
So I always kind of give thatsort of like, caveat, in the
beginning, yeah. And
Dr. Brianna Bliss (07:51):
also with that, like, that happens because
of the drop in hormones, right.
So like, right after your, youknow, your body during pregnancy
is developing all these otherdifferent hormones that you
don't typically have, and thenyou deliver, you give birth, and
drastically we see this drop inhormones. And that's why there
are natural consequences or moodchanges within those two to
(08:16):
three weeks. So totally normalto feel that most people do feel
that, and it's for us, but cificreason. But like, you know, Dr.
Brown said, if that continuespast three weeks, then you want
to talk to like your OBGYN oryour doctor or someone, you
know, to get more support. And
Dr. Spencer Brown (08:39):
I will say most OBGYN are screaming at the
six week, checkup postpartum. SoI do I do feel like that is
something that has been reallyhelpful. And and that's how we
kind of get involved, as likeperinatal psychologists, is that
like an OBGYN will, you know,send a referral to us or the
birthing mother will reach outto us? Because maybe she had
(09:03):
like an elevated screening? fordepression?
Dr. Brianna Bliss (09:07):
Yeah. Which is why it's super important to
go to your six week postpartumvisit. Yeah, I know, like,
sometimes moms, it'soverwhelming, and you put
yourself on the back burner. Andyou feel like you have a ton of
pediatric appointments becauseyou're you have a newborn and so
you're going to all your babiesappointments, which is fair, but
(09:29):
also you still you know, need totake care of yourself because
that's the best way to help yourbaby. And so it's really
important to go to six weekcheckup for just a variety of
reasons to make sure like you'redoing okay, health wise and
talking about your labor anddelivery and, but also if there
are emotional concerns, thatcould be a really good time to
(09:51):
get screened and to talk tosomeone and maybe get connected
to mental health treatment andget more support. Yep,
definitely.
Dr. Katie Manganello (10:00):
So as it relates to that timeline, so you
had said that the first like,you know, so many weeks it's
common, it's more baby blues.
Once it hits that point, thenit's considered postpartum. When
is it no longer if it if thesymptoms persist? When is it no
longer considered postpartum?
And it's considered depressionanxiety unrelated? Or is it
(10:23):
something that kind of can lastfor a pretty long time after
birth?
Dr. Spencer Brown (10:27):
It really depends. A lot of people go by
the one year mark. So in termsof one year postpartum is
typically when we kind of saylike, postpartum depression
ends, but really, it really justdepends on the woman and the
symptoms of it. But typically,it's up to a year postpartum, we
(10:47):
will call it postpartumdepression.
Dr. Katie Manganello (10:51):
Okay. And so what are some of the common
symptoms of postpartum anxietyand depression? And you know,
more specifically, how is itdifferent? How does it show up
differently from other types ofanxiety or depression
Dr. Brianna Bliss (11:12):
or you go ahead.
Dr. Spencer Brown (11:14):
So obviously, in terms of like depression, so
it really is kind of verysimilar in terms of the symptoms
of just classic depression andpostpartum depression. So
obviously, feeling really sadfeeling tear for like, we'd be
low motivation, lack ofinterest, not engaging with
other people, but also notwanting to engage with the baby.
(11:37):
That's like a big one. Classic,like, lack of sleep is a really
big common symptom, obviously,because baby may not be
sleeping, you're up at night. Alot of times, it's co occurring
with anxiety, particularly withsleep, because mom may be very
anxious about nighttime, havingto watch baby feeling like she
(12:01):
needs to always have her eyes onthe baby at night because of
different risks that happened atnighttime and sleep. And so
those are some of the commonones. And then, of course,
suicidal thoughts, paths orthoughts to harm yourself. I
tend to see that related to whenthe mom is feeling like
(12:21):
inadequate in some way orfeeling like she's not being a
good mom. And so then havingthose feelings of wanting to
escape, or run away, becauseshe's feeling like she's not
being a good mom or feelsinadequate.
Dr. Katie Manganello (12:37):
So it sounds like they're more I mean,
it's the same kind of symptoms,but more so just focus on the
baby and her mother
Dr. Spencer Brown (12:45):
and a mother.
Yeah. Yeah. Okay.
Dr. Katie Manganello (12:51):
Free. Did you want to add anything to
that? Oh,
Dr. Brianna Bliss (12:53):
no, if you said also like irritability,
feelings of anger, right, thatcould look like you know, both
depression and anxiety. Butyeah, basically, similar
symptoms, loss of interest anddoing things that you wants us
to like to do, right. But moreso because of, you know, this
(13:15):
experience of having a baby andcaring for the baby. And anxiety
tends to be like all about thebaby. Yeah.
Dr. Spencer Brown (13:26):
Like worrying about the baby. Just having
those anxious feelings, feelingoverwhelmed. Sometimes panic
attacks can occur in postpartumperiod because of anxiety. So
yeah.
Dr. Katie Manganello (13:40):
Right. And I think that that it might be
hard for someone to know ifthey're experiencing this or
not, without going to theseappointments or supposed to be
going to because it's normal,like you said, the beginning
like, to an extent to beworrying about your baby, right?
Like, it's now your job to keepyour baby alive and, and to want
(14:01):
to be a good mom and all of thatkind of stuff. So that really
does kind of highlight theimportance of them going to
those kinds of appointments.
Yeah, yeah. Yeah. Okay. So, talkto me a little bit more to about
what you know about riskfactors, or, you know, is there
certain family history that kindof influenced these things? Or
(14:24):
are certain things that happenedduring birth, maybe that could
be risk factors to, to thesethings?
Dr. Brianna Bliss (14:35):
So, I guess first of all, like, postpartum
anxiety and depression is prettycommon. Like, I think it's like
one in five or one in sevenwomen, something like that, then
it's one
Dr. Spencer Brown (14:48):
in five. One in five will experience a
perinatal mood or anxietydisorder of some sort. Yeah,
Dr. Brianna Bliss (14:54):
right.
That's, that's pretty common.
And so like, Other people mightbe wondering, well, how do I
know if I'm going to be one infive? Or you know, what, what
factors? What risk factors, youknow, do I have that would make
me more likely to experiencepostpartum mood disorder? I
(15:16):
think, definitely familyhistory, right. So if you have
anyone in your family that hasexperienced depression or
anxiety, or specifically alsopostpartum depression, or
anxiety, if you yourself hashave ever experienced anxiety or
depression, that makes it morelikely to experience that during
(15:38):
pregnancy. There's a lot of likesocial factors too, right? So if
you have limited social support,or maybe you know, not, you
know, not the social supportthat you would like nearby,
maybe friends or family aredistant, that could be a factor,
(15:59):
financial resources can be areally big factor, lacking
financial resources. What aresome of the other ones? That's
really no,
Dr. Spencer Brown (16:10):
yeah. So in particular, like women of color
are also at a higher rate ofdeveloping perinatal mood and
anxiety disorders. Women ofColor are two to three times
more likely than white women todevelop a PMS disorder, and
three to four times more likelyto die during childbirth. And so
(16:33):
like risk factors are reallyhuge. And so having that
knowledge, and really kind ofadvocating for yourself getting
more information, askingquestions, is something that can
really be helpful duringpregnancy and postpartum
Dr. Katie Manganello (16:48):
as well.
That is alarming. It is
Dr. Spencer Brown (16:51):
we're definitely in a crisis right
now, in terms of this, right?
And
Dr. Katie Manganello (16:57):
what do you do in your roles to advocate
for that, and kind of, like,make changes around that?
Because really, that is scary. Ithink a lot of people don't know
that.
Dr. Spencer Brown (17:06):
So I think one of the biggest things is
talking to like OBGYN and makingsure that they're like
culturally competent, and beingsensitive, and really being
aware of, you know, thisinformation and being really
supportive and an open tolistening to women of color when
they have questions, because alot more women of color are
(17:28):
aware of this. And I do thinkthat that does play a role in
like some of their hesitancybecause even though this risk is
really high, women of color, donot often seek treatment for
this, whether that's because oflike stigma, whether that is
because of like fear of likeproviders. They're just like a
(17:53):
multiple of multiple multitudeof reasons why, and then also,
specifically, like institutionalracism, and things like that,
obviously come up when we talkabout this issue. So it can be a
lot of different reasons.
Dr. Brianna Bliss (18:09):
Yeah, I was gonna say that speaks to like
access of care, you know, like,I work in a predominantly low
income area in New York City,and predominantly, like black
and brown population. And so oneof the things that we try to do
is increase access to care forall those reasons that Spencer
(18:30):
just share. Because of thestigma, because of you know,
there's not where I work verylow financial resources
available to people. So tryingto give people access through
their OBGYN access to mentalhealth services, screening
(18:52):
groups, where they can learnabout perinatal mood disorders
and learn how to like, know, thesigns for postpartum anxiety and
depression know their riskfactors so that they can have
conversations with theirdoctors, if their doctors aren't
asking them. They can bring thatup and say, This is what I'm
(19:13):
feeling like, this is what Ineed to talk about. So I think,
yeah, all of that is reallyimportant to make sure we
address.
Dr. Spencer Brown (19:23):
Yeah, and I also think having like providers
of color, whether that's likeOBGYN or therapist,
psychologist, I think that canalso reduce some hesitancy of
bringing some of these hardconversations up this, if you
can prepare, maybe with yourtherapist before, like, well,
what should I say what questionsyou know, should I be asking,
What should I look out for? Ithink all of that can be helpful
(19:44):
as well.
Dr. Katie Manganello (19:46):
Yeah, absolutely. That makes sense.
Yeah. And so in talking aboutthese risk factors, and a lot of
what you're saying that you dois giving people the education
around the risk factors andblah, blah, blah. would come up?
How do you feel like that helpsfrom a, you know, prevention
lens?
Dr. Brianna Bliss (20:09):
I think people like so knowing the
difference between baby bluesand and Perinatal mood
disorders, sometimes in myexperience, like, the women I've
worked with, they're not,they're not really sure what the
baby blues are, or how you know,if they have these risk factors
to get a mood disorder. So justhave giving them the tools to
(20:33):
know what to look for. And whatthey might be feeling, I think
is super important, because thenthey can advocate for themselves
in a system that like, won'talways help or advocate for
them. So I think that's reallyimportant just to give them the
knowledge and the education toknow like, what I'm feeling and
(20:53):
what I need to ask for. This iswhen I need more help, or this
is okay, this is normal.
Dr. Spencer Brown (21:01):
Yeah, I echo everything Brad just said. And
also just like with anything,the more knowledge you have, the
more information you have, thebetter equipped you are to kind
of face it or overcome barriers,because you kind of can know
what to do and have moreresources at your fingertips.
Dr. Katie Manganello (21:20):
Yeah, so it certainly sounds like it
helps a lot in at least inhealthcare, right. And that also
just kind of is a segue for methinking about how this impacts
so many aspects of a woman'slife or right, like it obviously
impacts them in their health.
But also, can you talk a littlebit about how it impacts their
(21:42):
relationships with people, theirrelationship with their baby,
relationships with partners,family, all of that.
Dr. Spencer Brown (21:53):
I think one of the biggest things that I
have seen come up and I waslike, really not aware of this,
when like just being just like aregular person. But becoming
like a psychologist and workingin this field is how often
people do not talk about likegender roles within their
relationship and like what thatis going to look like when they
(22:15):
have a child. And I think thatis a big source of stress in our
relationship. Like, am I goingto be a stay at home? Mom? Am I
going to be a working mom, ifI'm going to stay at home? Is it
my responsibility to take careof the child 24/7? And then what
is my partner's role in that.
And so I think gender roles is areally big issue and can be a
(22:39):
role sort of like transitionwithin itself becoming
especially for first timeparents, it can be like a really
huge source of stress. Just kindof,
Dr. Katie Manganello (22:53):
like what are some examples of that I'm
really curious about like, howthat shows up. So
Dr. Spencer Brown (22:59):
like, for example, so let's just say the
woman is like a stay at homemom, she may feel a lot of
responsibility to be the one totake care of the baby 24/7
Because she's a stay at homemoms. And typically, let's just
say her husband is the one whogoes to work. And so she may
feel a lot of guilt or shame tohave to get an x her husband to
(23:21):
wake up in the middle of thenight to get the baby because
she's a stay at home mom, andher role is to take care of the
child. And so I think havingthese conversations, you know,
in pregnancy, or before youdecide to have a child can
definitely shed a light on tolike so is this going to be
really truly 5050? Or is thisgoing to be more 6040 8020. And
(23:46):
if you can decide that, youknow, and everybody sort of like
be somewhat okay with that itcan reduce a lot of stress,
because you might go into itthinking like, Oh, we're
partners, and my husband isgoing to be in this 5050. But
really, it may look more like6040. And that's okay, as long
as you can kind of prepare forthat and plan for that kind of
(24:07):
early on versus now we have anewborn and I'm up and I'm
breastfeeding and I have to keepgetting up and my husband is
just sitting there snoring andsleeping. That causes a lot of
resentment, and some anger, youknow, sometimes because you're
constantly the one waking up andquote unquote, responsible for
the child. So that is somethingthat I have seen come up so
(24:29):
much. That's why I kind ofwanted to just throw it out
there.
Dr. Katie Manganello (24:32):
Yeah, no, that's a good example.
Dr. Brianna Bliss (24:34):
Yeah. So everyone you're saying everyone
tried to like, put out therewhat the expectations are? Yeah.
Originally and then.
Dr. Spencer Brown (24:48):
You can't like especially like, you know,
like we're planning to getpregnant. That can definitely be
something to kind of talk aboutlike so. What are your
expectation like? What do youthink this is going to look
like? Ya know, like when thebaby comes, because often it
doesn't look like what both ofthem thought originally. So you
have you both are coming into itwith expectations, regardless if
(25:11):
you talk about it or not. But ifyou talk about it, at least you
can prepare for it.
Dr. Brianna Bliss (25:16):
That's good advice. Thank you. I also, to
answer your question to Katie, Iwanted to talk about
the mom baby relationship, likehow that's impacted with
attachment. Because that is alot of what I talk about in my
(25:37):
role at my job, too. There is aconcept called serve and return.
I don't know if you guys haveheard of this concept. So it's
kind of like a tennis match, youknow, so compare it to that. So
like with attachment and newbornbabies, you think of like, the
(25:57):
babies serving up, like agesture, like a battle or a cry
or something, and then the momreturning that serve. So like in
tennis, you know, you hit itover, you hit it back, right,
serve and return. And so when wetalk about like, moms who are
experiencing postpartumdepression or anxiety, it can
(26:18):
make it really hard to returnthat baby's battle or sort of
bed for like attention or needor cry if mom is kind of
experiencing her own emotions.
So it's super important, becausewhenever we have that serve, and
return interaction between momand baby, or any caregiver and
(26:39):
baby, the, it's like, soimportant for brain development.
So the baby's brain is like,millions of neurons are firing,
right. And it's learning so muchin such a short period of time.
And whenever there's like, youknow, the baby laughs and the
mom serves that back and laughsto that. Neurons are like going
(27:00):
crazy firing. And they're makingthat bond and that connection
together. So if we think aboutmoms who are like, you know,
struggling with depression, andnot able to last with their
baby, or pick their baby up whentheir baby's crying, because
they're going through their ownemotions, that could really
(27:20):
impact the bond, of course, theattachment, but also the baby's,
you know, the way the baby'sbrain is developing to, because
they're really looking for thatattention, and that secure
attachment from the caregiver.
So I think from like, neuronlevel, all the way up to like
(27:43):
attachment. It's so importantwhen we think about when moms
have postpartum anxiety ordepression, because it really
can impact like, the baby'sdevelopment and their secure
attachment.
Dr. Spencer Brown (27:56):
Yeah, just piggybacking off of that really
quick in terms of like the bond,I think there is a huge
misconception that women have interms of feeling like I'm going
to be bonded to my baby, as soonas I see them. Like this is a
huge misconception. And so whenthat bond is not there, it
definitely leaves women to feellike inadequate, or like,
(28:18):
there's something wrong with me,I don't feel bonded to this
child. And so something that Ilike to tell my mom's kind of
when that does happen is like,this is like any other normal
relationship, like when you metyour, your partner or your
husband, you might not have youknow, liked or loved him right
away, it may have took, youknow, some time, a couple of
(28:39):
weeks. And so think of it likeany other normal relationship,
it may take time for that bondto really grow by baby loves you
regardless. But you know, thisis like any other relationship.
And so give yourself that timeto have that bond really, like
flourish. And so likebreastfeeding is a really good
way to increase bonding time andskin to skin is a really good
(29:03):
way to increase bonding andattachment. And specifically
like in those early stages, butit may not happen right away
like a lot of women think.
Dr. Brianna Bliss (29:13):
Yeah, that's such a good point. I feel like
media, social media, it's allportrayed as like, you're just
gonna instantly fall in lovewith your baby, right? Yeah,
that's not always the case.
Dr. Spencer Brown (29:27):
I will say since we brought up social media
that I do think social media hasdone a really good job of giving
moms that opportunity to reallytalk about the hardships that
comes with being a mom like ifjust following different women.
A lot of women out there thatare on social media are really
like doing a good job of liketalking about No, it's hard to
(29:49):
be a mom like
Dr. Katie Manganello (29:51):
that's what I'm saying. Yeah.
Dr. Spencer Brown (29:54):
Yeah, I will say that I feel like Millennials
like us and like Gen Z moms arereally like doing a good job of
telling the harsh truth aboutbeing a mob, whereas I feel like
older generations made it like,oh, it's rainbows and sunshine
and butterflies, and it's justthe most beautiful thing. And a
lot of ways it is, and in a lotof ways, it's not. And so I feel
(30:15):
like our generation is doing agood job of like, No, this is
what it is, you know, you'regoing to be tired, you're going
to be sleep deprived, is notalways rainbows and butterflies.
And so I do think that socialmedia has given women the
opportunity to really be like,kind of like brutally honest and
give other women a heads upabout what this really looks
(30:35):
like.
Dr. Katie Manganello (30:38):
Good points, I, you know, what I also
am really curious about is, youknow, we talk a lot about
partners, and it may be evenlike, parents or the
grandparents of the babies. Andobviously, the relationship with
the, the baby and the mom. ButI'm really curious about how
giving birth to maybe a secondor third or whatever child
(31:00):
impacts a relationship with themom and their other children?
Like, is that something you guysever see? Or talk about with
people? I don't know if that'sreally relevant to your work,
but I'm curious about it.
Dr. Brianna Bliss (31:11):
Oh, yeah, for me in pediatrics, because
sometimes, I'll be seeing like atwo year old and they're jealous
of a newborn baby. And, youknow, parent, the parents can
only do so much, you know, ifthe mom is one person. And so
that does come up a lot. Sosometimes, like, Well, how do I
(31:35):
cope with this adjustment ofhaving a second baby when the
first one is not a fan. So wework, we work through that. And
sometimes that means like,developing like special time
with mom, and then materialslike one on one so that they can
(31:56):
still feel valued, and justother different strategies that
we talked about. But that isvery much a real thing. And it
really just depends on your,your child, if they're going to
have that reaction. Some kidsare perfectly excited and like,
take on a big brother or sisterrole, and it's great. So it
(32:18):
really just depends.
Dr. Spencer Brown (32:21):
Yeah, I would say for me, in terms of like
what I do, a lot of times womenwill have an expectation because
they already have a first childand already had a first
pregnancy and that pregnancywent really well. And then they
get pregnant a second time. Andit's not like that. And then so
(32:41):
there's a lot of likecomparisons of well, this
experience was like this, butthis experience is is not like
that. And so, you know, reallygetting them to stop making
those comparisons and lettingthem know like, you know, each
pregnancy is going to bedifferent and come with it
different challenges. And eachbaby is going to be different
and have different challenges.
And so kind of setting thatfoundation
Dr. Katie Manganello (33:05):
can Yeah, that's a really good point.
That's interesting, actually.
Also, I want to circle back tobecause when I brought up for
the relationships, I was talkingabout, like potentially, like
grandparent relationships andstuff that you kind of giggle
that I want to know what youwere thinking. Yeah.
Dr. Spencer Brown (33:23):
In terms of like grandparents, so if it's
the, let's just say it's themom, and it's her parents a lot
of times, and even even likemother in law's can give
unsolicited advice, right. Andso I think it can be really hard
on the mom, particularly if it'sa first pregnancy, when like,
(33:43):
your mom is like, Oh, I havefive kids, you only have one, it
can be really hard to kind oflike manage that it can feel
very, like undermining in asense of like, Well, what I'm
going through is not hardenough, or I should be kind of
like grateful innocence. So Ithink all again, like older
(34:04):
generations, it can be you know,kind of like grin and bear it,
you know, like, it's not thathard. And so it can really
impact the postpartum periodwhere you kind of feel like
you're being judged orcriticized, because you only
have one child or two or twochildren. And the women, the
older women in your life arelike, Oh, kind of get over it.
(34:25):
Or if they even don't even feellike postpartum depression
exists. You know, you're, you'regonna feel tired, you're gonna
feel, you know, maybe bad, likeit's going to be okay. And so it
again, kind of leaves the womanfeeling like inadequate. So that
can be hard. Yeah.
Dr. Brianna Bliss (34:46):
That's a good point, like, from generation to
generation, right, as we'vegotten more open about mental
health and less stigmatized,although it still is but maybe
grandparents don't They don'tsee postpartum anxiety or
depression or they didn't. Theydidn't have that experience, or
(35:06):
if they did, they weren't goingto talk about or weren't aware
of it. So that's a reallydifferent challenge for
generationally to even, like,meet. Alright, I on that and
understand what's going onthere. Yeah,
Dr. Spencer Brown (35:22):
yeah. And malls and grandparents do come
up a lot, especially mother inlaws. But that's a different
conversation. Yeah, I
Dr. Katie Manganello (35:30):
feel like we can have a podcast on that.
Not even just the mother laws,but just like, parents have the
new parents. Yeah. And like,cultural changes to, you know,
it's not just generationalincense in the sense of like,
well, I'm a millennial in thereor whatever. But also, just
(35:51):
knowing that like, at least inAmerica, this might be a really
interesting dynamic, that'sdifferent. I don't know if it's
different in other countries,but you know, a lot of our
parents or grandparents are, youknow, first generation second
generation and the differencesthat kind of come with that.
That's really, I think, aninteresting thing. But you're
right, that would probably be awhole other podcast, we should
probably table that one.
Dr. Brianna Bliss (36:14):
That'll be next time. I have so many ideas.
Dr. Katie Manganello (36:20):
Send them over, you know, I get very
excited about all the ideas too.
But bringing it back to thisone. So we already talked about
how, like, let's talk about howwe can help the new moms right,
like, what are we going to do?
So you talked a lot aboutpsychoeducation, giving them
information about all of this,the advocacy piece, and being
able to have them advocate forthemselves as well as your work
(36:41):
and advocating? Tell me more alittle bit about like, other
treatment options, once it'sestablished that okay, there is
postpartum happening here, like,what kind of treatments do you
use? What kind of treatmentoptions are there? Like
medication, individual therapy,support groups, maybe couples?
Like those kinds of things?
Dr. Spencer Brown (37:02):
Yeah, so all those things that you name, I
can't answer the question. Moreabout them, though, like, what
does it look like? Kind of likewe said, like, so like, if we
take it all the way back to thebeginning, like screening tools,
so then we get the referral,they meet with us. So obviously,
(37:23):
we do like the intake and all ofthat. So essentially, if I see a
woman for several sessions, andI feel like her symptoms are not
really, you know, getting betteror decreasing, then that's when
I would have the conversation interms of like medication. And so
that will often say, you know,like, some people can do really
(37:43):
well with just therapy alone.
But a lot of people do reallywell with therapy and
medication. And so then I talkto them a little bit about,
like, how do they feel aboutmedication, because one of the
big sort of misconceptions isthat when I'm pregnant, I have
to come on all of my medication.
And that is not accurate. It'simportant for a lot of times for
(38:06):
women to stay on theirmedication, depending on what
the medication is, I'm not apsychiatrist, by any means. But
a lot of times when the womancomes off of all of her
medications, we really see adrop in her mood, and then all
of those symptoms really comeback with a force during
pregnancy. And so then they cometo us, and they're really
distressed. And then we have tothen manage that and kind of
(38:29):
say, Okay, let's get you back onyour medication, because that
was what was helping you duringthis time. And so I think that's
a big piece of it. And then, ifthey've never been on medication
before talking to them about howthey feel about being on
medication, a lot of times womendon't want to start medication
because of breastfeeding. And sothen that's when I would send
(38:52):
them to a perinatal psychologistwho couldn't really ask
psychiatrists, sorry, whocouldn't really talk to them
about what medications arereally saved for breastfeeding.
And I know just offhand a bigone that a lot of perinatal
psychiatrists recommendedZoloft, because it is pretty
safe for breastfeeding.
Dr. Katie Manganello (39:15):
I do think that that is a big pressure that
people feel without knowing thatthey have to go off of
medication when they'repregnant.
Dr. Spencer Brown (39:23):
But obviously talk to your psychiatrist when
you are, you know, pregnantbecause some medications may
have different side effects anddifferent risks, but it's
important to get thatinformation and not just assume
that I have to come off ofeverything, because I am
pregnant in some OBGYN. I don'teven like to prescribe to
pregnant women, which then isanother huge problem. Because
(39:46):
then it's like okay, now, Idon't have access to my
medication because my OBGYNdoesn't want to prescribe to me
because they're, they're afraid,you know, to do it during
pregnancy. But that's why wehave perinatal psychiatrist now
Because it sounds, yeah.
Dr. Brianna Bliss (40:02):
Yeah, that's such a good point, even if your
OBGYN doesn't want to prescribeit, or your primary care
physician doesn't want toprescribe it, yeah, don't give
up hope, that doesn't mean thatyou can't get it, it just means
that they don't want, they don'tsee you often. And so when, when
our providers not seeing you,like weekly or every other week,
(40:24):
they, they can't monitor how themedications are going. So it
just might mean, you see apsychiatrist or, you know, a
therapist who can get youconnected with a psychiatrist to
get the right medication. So ifat first you don't succeed with
the right provider, that doesn'tmean you shouldn't do it, just
(40:45):
to figure out the right, theright person, who's going to be
able to work with you, over timeto make sure that like, once you
start taking these medications,they can look like observe you
and make sure things are goingokay.
Dr. Spencer Brown (41:01):
Okay. And then also in terms of like
couples work. Concerns do comeup during therapy, when just
working with the woman,obviously, we are not couples
counselors. So I do talk to mywomen, we do talk about like the
stressors, and then therelationship dynamics, but I
(41:22):
will often refer to like acouples counselor, because I'm
just working with one half ofthe equation, the partner also
needs to be involved, becausewhat I will often say is that,
when you are in therapy, you aregoing to get better or have a
lot of knowledge, but yourpartner is essentially staying
the same. And so then how isthat going to work if you now
(41:44):
have all of these differenttools, but your partner's
staying the same, it's notreally gonna work that so having
a support person who can seeboth of you and talk to both of
you, and you talk about, likethe communication, I think can
be really helpful.
Dr. Brianna Bliss (41:59):
Make sense?
Yeah. And I think I'm beyondlike, a therapist or
psychiatrist, you know, otherkinds of therapy, a couples
counseling, I think it's alsoreally important to connect to
community resources. So that's abig focus in the group that I
that I run. Like, things,resources, like dual was maybe
(42:23):
like a Healthy Start program,which they have in a lot of,
it's a national program. So theykind of have like, visiting
nurses that can help moms orthey provide you with a doula,
they can give you access toFormula diapers. So there's a
lot of programs out there thatcan be of like, concrete support
(42:48):
that people might need. Ratherthan just like emotional
support, which is reallyobviously very helpful. But
sometimes, if you know you'restruggling with finances, or
like any other social factors,it could be really good to have
a support and like a doula orjust know where to get diapers
(43:10):
or a food pantry, things likethat. So sometimes when you
connect with a therapist, theycan also have access to those
resources for you. So it'simportant.
Dr. Katie Manganello (43:27):
Awesome, do you have any other just kind
of general or practical advicefor it doesn't even have to be
like a mother struggling withpostpartum depression or
anxiety, but any kind of newmothers, do you have any kind of
advice for just how to kind oflike cope with the typical
changes that are happening?
Dr. Spencer Brown (43:48):
I just, you know, I just feel like, this is
such a huge transitional period.
So there's gonna be ebbs andflows that naturally kind of
come along with that. But youare doing a great job, you are a
good mom. And so the fact thatif you, you know, are concerned
that you may not be doing a goodjob, says that you, you know are
a good mom, because if you youdidn't care, then then we would
(44:12):
have pause for concern. But ifyou are questioning that, then
you are definitely being a goodmom.
Dr. Katie Manganello (44:20):
And being gentle and nice to themselves.
Yeah, self compassion.
Dr. Spencer Brown (44:24):
Yes, yes.
100%.
Dr. Brianna Bliss (44:26):
And I would say to add to that, you will
have bad days, and that'snormal. And that's okay. And
that doesn't mean you're a badmom. It just means you're human.
And sometimes, you know, like wetalked about this a little bit
(44:47):
in my group. It's like balancingyour thoughts, right. So if
you're saying to yourself likethis is really difficult, but
maybe you could balance that outwith like, and I'm doing the
best I can right So you can justkind of think about little ways
to balance out your thoughtsbecause sometimes when it weighs
too heavy on one side of thescale, that's when we can start
(45:10):
feeling kind of down. So I thinkit's about balance, knowing
you're gonna have the bad dayshaving the bad days, and
tomorrow will be better. So
Dr. Katie Manganello (45:24):
awesome.
Well, do you have any finalstatements or pieces of advice
or anything that you would wantto leave us with? regarding any
of the things that we had talkedabout today?
Dr. Spencer Brown (45:40):
I feel like that pretty much covers it, but
I will say you know, just lookout for me and Dr. Bliss in the
future. We have some things upour sleeve. So just before
Dr. Brianna Bliss (45:55):
I your maternal and child wellness
needs.
Dr. Katie Manganello (46:05):
Okay, Dr.
Bliss, do you have anything?
Dr. Brianna Bliss (46:09):
That pretty much sums it up?
Dr. Katie Manganello (46:13):
Okay, amazing. Well, this was so fun.
I actually yes, we definitelyhave to do this again. And yeah,
we'll definitely come up withsome more ideas. So thank you
so, so much for joining ustoday. And for everybody out
there listening. Please rememberto like, subscribe and share
this episode wherever you findyour podcasts.
Dr. Brianna Bliss (46:33):
Thanks for having us. Thank you.
Dr. Katie Manganello (46:35):
Bye bye
postpartum anxiety and depression is pretty
common. Like, I think it's likeone in five or one in sevens,
women something like that span
Dr. Spencer Brown (00:10):
is one in five. I do think social media
has done a really good job ofgiving moms that opportunity to
really talk about the hardshipsthat comes with being a mom,
whereas I feel like oldergenerations made it like, oh,
it's rainbows and sunshine andbutterflies, and it's just the
most beautiful thing. And a lotof ways it is and in a lot of
(00:32):
ways, it's not. And so I feellike our generation is doing a
good job of like, No, this iswhat it is, you know, you're
gonna be tired, you're gonna besleep deprived, is not always
rainbows and butterflies. And soI do think that social media has
given women the opportunity toreally be like, kinda like
brutally honest and give otherwomen a heads up about what this
(00:53):
really looks like.
Dr. Katie Manganello (00:57):
Welcome back to the Heal Your Roots
Podcast. I'm Dr. KatieManganello. And in light of may
being Maternal Mental HealthAwareness Month, I have Dr.
Spencer Brown and Dr. BriannaBliss, who are licensed clinical
psychologists that specialize inmaternal mental health here with
me today. So, welcome. Thankyou. Yeah, yeah, I'm so excited
(01:19):
to have you guys here. They'realso some of my, my friends on
top of my colleagues that wewent to grad school together. So
this is really fun being able toinclude them in on this
conversation, and for them toshare their wealth of knowledge
with us on this. So before weget into it, can you guys both
just tell me a little bit aboutwhat kind of brought you into
(01:42):
the field, not necessarily justthe field of psychology, but
also what kind of inspired youto do this type of work? Sure. I
can start. So I think whatoriginally sort of led me to,
like perinatal mental health wasmy focus on my dissertation.
Dr. Spencer Brown (02:00):
So that's when I really started to look
into women's health, mydissertation focused on female
infertility, stigma, thatcognitive distortions, and
coping responses. And so once Ireally started to get into that,
I was like, hmm, this might be areally good field a really good
(02:20):
niche for me to kind of explore.
So that led me to my internship,which led me to my postdoc,
which then led me to my fulltime job right now. And so
that's kind of like thetrajectory of how I kind of got
into the field was reallyessentially my dissertation
topic. Yeah.
Dr. Katie Manganello (02:38):
And what kind of brought you to choose
that topic again, like was thereanything in particular that kind
of like happened that sparkedthat?
Dr. Spencer Brown (02:45):
Yeah, so it was during the time when The
Handmaid's Tale was on TV, oh,
Dr. Katie Manganello (02:50):
my gosh, yes, I remember this now. So
literally, I
Dr. Spencer Brown (02:54):
was just kind of like laying in bed. And I was
thinking about, like, what do Iwant to do for my dissertation
topic, and I just remembereverybody saying, you don't want
to pick something that's goingto be boring because you'd have
to like sit with it for like ayear or a year and a half. And I
kind of already knew thefoundation was going to be
something related to likewomen's health. I didn't know
what and then I was watching TheHandmaid's Tale and I was like,
(03:17):
infertility. You know, I thinkthat would be like something
that I would want to exploremore and get into more. And so
that's kind of how it kind ofled me to it. And I also read
the book in high school. So Ihad a good foundation for it.
Dr. Brianna Bliss (03:31):
I didn't know that. I didn't either. Awesome.
Dr. Katie Manganello (03:36):
Yeah, actually, I didn't even know
there was a book. I thought itwas just the show.
Dr. Spencer Brown (03:41):
Margaret Atwood is the Arthur.
Dr. Katie Manganello (03:45):
Awesome.
Okay, and what about you Dr.
Bliss? So
Dr. Brianna Bliss (03:50):
I am a pediatric psychologist. And so I
work in primary care with littlekiddos, zero to 21. So I see the
whole the whole pediatriclifespan actually. And I'm in a
pediatricians office and where Iwork now I have over the past
(04:12):
two years or so been starting towork with the younger, you know,
zero to five kids. And obviouslywith that comes parents and
moms. And so I kind of stumbledinto perinatal mental health
through seeing little kids andwhat happens in primary care
(04:38):
sometimes is moms are screenedfor depression or for you know,
any other stressors or familystress. And so, I love to see
like newborns and when the momsyou know, first have the babies
and so I can work with them thenor any of the caregivers really
(04:58):
so I kind of stumbled Toperinatal mental health through
my work in pediatrics, and Ialso do a group, a prenatal
group for pregnant peoplecurrently focused on the fourth
trimester and newborndevelopment. So mostly seeing
(05:21):
kids but have been working withperinatal population through my
work in pediatrics. That's
Dr. Katie Manganello (05:28):
awesome.
Isn't it interesting how we justkind of like stumbled into what
we're doing. It's not just like,This is what I'm gonna do. And
here we are, right. So that'sreally cool. I
Dr. Spencer Brown (05:38):
feel like that's my life. I feel like I
kind of just stumbled intothings. It just kind of happens
that way. So I just, yeah.
Dr. Brianna Bliss (05:47):
Yeah. Never, I never really thought I'd be
going into this kind ofdirection. But especially in
primary care. It's all likepreventative mental health. So
it's like, if you're gonna see atwo year old or a three year
old, then why not just startseeing the mom to like, as early
as possible. So just kind ofhappens that way. Right. And
Dr. Katie Manganello (06:10):
a lot of working with children is working
with parents. So yeah, thatmakes sense. Definitely.
Dr. Brianna Bliss (06:15):
Sure.
Dr. Spencer Brown (06:16):
God bless you, because kids want to work
with the moms.
Dr. Brianna Bliss (06:23):
It's fun.
There's never a dull moment.
They keep you on your toes. Iknow you fellas.
Dr. Katie Manganello (06:33):
Well, so with that being said, and
knowing that you both work withthis, so how would you define
postpartum anxiety anddepression? And how would you
kind of differentiate that fromlike a typical just like baby
blues.
Dr. Spencer Brown (06:49):
So typically, with like the baby blues, just
want to kind of like prefacesthat the baby blues are
extremely common. About 85, upto about 85% of women will
experience the baby blues. Sothis is essentially, you know,
feeling sad, feelingoverwhelmed, feeling anxious,
(07:11):
during the first two to threeweeks postpartum. If those
symptoms do not start todecrease, but rather like
increase or kind of like staythe same, after that three week
mark, then that's when we willbe concerned about postpartum
depression. So I always tell mymoms that when they are
pregnant, and kind of like,brace them for that, because
(07:33):
it's extremely common. And I'malways like, just because you're
crying at the drop of a dime,you're feeling overwhelmed or
anxious. And the first two tothree weeks, that does not mean
you have postpartum depression,you are in the baby blues phase.
So I always kind of give thatsort of like, caveat, in the
beginning, yeah. And
Dr. Brianna Bliss (07:51):
also with that, like, that happens because
of the drop in hormones, right.
So like, right after your, youknow, your body during pregnancy
is developing all these otherdifferent hormones that you
don't typically have, and thenyou deliver, you give birth, and
drastically we see this drop inhormones. And that's why there
are natural consequences or moodchanges within those two to
(08:16):
three weeks. So totally normalto feel that most people do feel
that, and it's for us, but cificreason. But like, you know, Dr.
Brown said, if that continuespast three weeks, then you want
to talk to like your OBGYN oryour doctor or someone, you
know, to get more support. And
Dr. Spencer Brown (08:39):
I will say most OBGYN are screaming at the
six week, checkup postpartum. SoI do I do feel like that is
something that has been reallyhelpful. And and that's how we
kind of get involved, as likeperinatal psychologists, is that
like an OBGYN will, you know,send a referral to us or the
birthing mother will reach outto us? Because maybe she had
(09:03):
like an elevated screening? fordepression?
Dr. Brianna Bliss (09:07):
Yeah. Which is why it's super important to
go to your six week postpartumvisit. Yeah, I know, like,
sometimes moms, it'soverwhelming, and you put
yourself on the back burner. Andyou feel like you have a ton of
pediatric appointments becauseyou're you have a newborn and so
you're going to all your babiesappointments, which is fair, but
(09:29):
also you still you know, need totake care of yourself because
that's the best way to help yourbaby. And so it's really
important to go to six weekcheckup for just a variety of
reasons to make sure like you'redoing okay, health wise and
talking about your labor anddelivery and, but also if there
are emotional concerns, thatcould be a really good time to
(09:51):
get screened and to talk tosomeone and maybe get connected
to mental health treatment andget more support. Yep,
definitely.
Dr. Katie Manganello (10:00):
So as it relates to that timeline, so you
had said that the first like,you know, so many weeks it's
common, it's more baby blues.
Once it hits that point, thenit's considered postpartum. When
is it no longer if it if thesymptoms persist? When is it no
longer considered postpartum?
And it's considered depressionanxiety unrelated? Or is it
(10:23):
something that kind of can lastfor a pretty long time after
birth?
Dr. Spencer Brown (10:27):
It really depends. A lot of people go by
the one year mark. So in termsof one year postpartum is
typically when we kind of saylike, postpartum depression
ends, but really, it really justdepends on the woman and the
symptoms of it. But typically,it's up to a year postpartum, we
(10:47):
will call it postpartumdepression.
Dr. Katie Manganello (10:51):
Okay. And so what are some of the common
symptoms of postpartum anxietyand depression? And you know,
more specifically, how is itdifferent? How does it show up
differently from other types ofanxiety or depression
Dr. Brianna Bliss (11:12):
or you go ahead.
Dr. Spencer Brown (11:14):
So obviously, in terms of like depression, so
it really is kind of verysimilar in terms of the symptoms
of just classic depression andpostpartum depression. So
obviously, feeling really sadfeeling tear for like, we'd be
low motivation, lack ofinterest, not engaging with
other people, but also notwanting to engage with the baby.
(11:37):
That's like a big one. Classic,like, lack of sleep is a really
big common symptom, obviously,because baby may not be
sleeping, you're up at night. Alot of times, it's co occurring
with anxiety, particularly withsleep, because mom may be very
anxious about nighttime, havingto watch baby feeling like she
(12:01):
needs to always have her eyes onthe baby at night because of
different risks that happened atnighttime and sleep. And so
those are some of the commonones. And then, of course,
suicidal thoughts, paths orthoughts to harm yourself. I
tend to see that related to whenthe mom is feeling like
(12:21):
inadequate in some way orfeeling like she's not being a
good mom. And so then havingthose feelings of wanting to
escape, or run away, becauseshe's feeling like she's not
being a good mom or feelsinadequate.
Dr. Katie Manganello (12:37):
So it sounds like they're more I mean,
it's the same kind of symptoms,but more so just focus on the
baby and her mother
Dr. Spencer Brown (12:45):
and a mother.
Yeah. Yeah. Okay.
Dr. Katie Manganello (12:51):
Free. Did you want to add anything to
that? Oh,
Dr. Brianna Bliss (12:53):
no, if you said also like irritability,
feelings of anger, right, thatcould look like you know, both
depression and anxiety. Butyeah, basically, similar
symptoms, loss of interest anddoing things that you wants us
to like to do, right. But moreso because of, you know, this
(13:15):
experience of having a baby andcaring for the baby. And anxiety
tends to be like all about thebaby. Yeah.
Dr. Spencer Brown (13:26):
Like worrying about the baby. Just having
those anxious feelings, feelingoverwhelmed. Sometimes panic
attacks can occur in postpartumperiod because of anxiety. So
yeah.
Dr. Katie Manganello (13:40):
Right. And I think that that it might be
hard for someone to know ifthey're experiencing this or
not, without going to theseappointments or supposed to be
going to because it's normal,like you said, the beginning
like, to an extent to beworrying about your baby, right?
Like, it's now your job to keepyour baby alive and, and to want
(14:01):
to be a good mom and all of thatkind of stuff. So that really
does kind of highlight theimportance of them going to
those kinds of appointments.
Yeah, yeah. Yeah. Okay. So, talkto me a little bit more to about
what you know about riskfactors, or, you know, is there
certain family history that kindof influenced these things? Or
(14:24):
are certain things that happenedduring birth, maybe that could
be risk factors to, to thesethings?
Dr. Brianna Bliss (14:35):
So, I guess first of all, like, postpartum
anxiety and depression is prettycommon. Like, I think it's like
one in five or one in sevenwomen, something like that, then
it's one
Dr. Spencer Brown (14:48):
in five. One in five will experience a
perinatal mood or anxietydisorder of some sort. Yeah,
Dr. Brianna Bliss (14:54):
right.
That's, that's pretty common.
And so like, Other people mightbe wondering, well, how do I
know if I'm going to be one infive? Or you know, what, what
factors? What risk factors, youknow, do I have that would make
me more likely to experiencepostpartum mood disorder? I
(15:16):
think, definitely familyhistory, right. So if you have
anyone in your family that hasexperienced depression or
anxiety, or specifically alsopostpartum depression, or
anxiety, if you yourself hashave ever experienced anxiety or
depression, that makes it morelikely to experience that during
(15:38):
pregnancy. There's a lot of likesocial factors too, right? So if
you have limited social support,or maybe you know, not, you
know, not the social supportthat you would like nearby,
maybe friends or family aredistant, that could be a factor,
(15:59):
financial resources can be areally big factor, lacking
financial resources. What aresome of the other ones? That's
really no,
Dr. Spencer Brown (16:10):
yeah. So in particular, like women of color
are also at a higher rate ofdeveloping perinatal mood and
anxiety disorders. Women ofColor are two to three times
more likely than white women todevelop a PMS disorder, and
three to four times more likelyto die during childbirth. And so
(16:33):
like risk factors are reallyhuge. And so having that
knowledge, and really kind ofadvocating for yourself getting
more information, askingquestions, is something that can
really be helpful duringpregnancy and postpartum
Dr. Katie Manganello (16:48):
as well.
That is alarming. It is
Dr. Spencer Brown (16:51):
we're definitely in a crisis right
now, in terms of this, right?
And
Dr. Katie Manganello (16:57):
what do you do in your roles to advocate
for that, and kind of, like,make changes around that?
Because really, that is scary. Ithink a lot of people don't know
that.
Dr. Spencer Brown (17:06):
So I think one of the biggest things is
talking to like OBGYN and makingsure that they're like
culturally competent, and beingsensitive, and really being
aware of, you know, thisinformation and being really
supportive and an open tolistening to women of color when
they have questions, because alot more women of color are
(17:28):
aware of this. And I do thinkthat that does play a role in
like some of their hesitancybecause even though this risk is
really high, women of color, donot often seek treatment for
this, whether that's because oflike stigma, whether that is
because of like fear of likeproviders. They're just like a
(17:53):
multiple of multiple multitudeof reasons why, and then also,
specifically, like institutionalracism, and things like that,
obviously come up when we talkabout this issue. So it can be a
lot of different reasons.
Dr. Brianna Bliss (18:09):
Yeah, I was gonna say that speaks to like
access of care, you know, like,I work in a predominantly low
income area in New York City,and predominantly, like black
and brown population. And so oneof the things that we try to do
is increase access to care forall those reasons that Spencer
(18:30):
just share. Because of thestigma, because of you know,
there's not where I work verylow financial resources
available to people. So tryingto give people access through
their OBGYN access to mentalhealth services, screening
(18:52):
groups, where they can learnabout perinatal mood disorders
and learn how to like, know, thesigns for postpartum anxiety and
depression know their riskfactors so that they can have
conversations with theirdoctors, if their doctors aren't
asking them. They can bring thatup and say, This is what I'm
(19:13):
feeling like, this is what Ineed to talk about. So I think,
yeah, all of that is reallyimportant to make sure we
address.
Dr. Spencer Brown (19:23):
Yeah, and I also think having like providers
of color, whether that's likeOBGYN or therapist,
psychologist, I think that canalso reduce some hesitancy of
bringing some of these hardconversations up this, if you
can prepare, maybe with yourtherapist before, like, well,
what should I say what questionsyou know, should I be asking,
What should I look out for? Ithink all of that can be helpful
(19:44):
as well.
Dr. Katie Manganello (19:46):
Yeah, absolutely. That makes sense.
Yeah. And so in talking aboutthese risk factors, and a lot of
what you're saying that you dois giving people the education
around the risk factors andblah, blah, blah. would come up?
How do you feel like that helpsfrom a, you know, prevention
lens?
Dr. Brianna Bliss (20:09):
I think people like so knowing the
difference between baby bluesand and Perinatal mood
disorders, sometimes in myexperience, like, the women I've
worked with, they're not,they're not really sure what the
baby blues are, or how you know,if they have these risk factors
to get a mood disorder. So justhave giving them the tools to
(20:33):
know what to look for. And whatthey might be feeling, I think
is super important, because thenthey can advocate for themselves
in a system that like, won'talways help or advocate for
them. So I think that's reallyimportant just to give them the
knowledge and the education toknow like, what I'm feeling and
(20:53):
what I need to ask for. This iswhen I need more help, or this
is okay, this is normal.
Dr. Spencer Brown (21:01):
Yeah, I echo everything Brad just said. And
also just like with anything,the more knowledge you have, the
more information you have, thebetter equipped you are to kind
of face it or overcome barriers,because you kind of can know
what to do and have moreresources at your fingertips.
Dr. Katie Manganello (21:20):
Yeah, so it certainly sounds like it
helps a lot in at least inhealthcare, right. And that also
just kind of is a segue for methinking about how this impacts
so many aspects of a woman'slife or right, like it obviously
impacts them in their health.
But also, can you talk a littlebit about how it impacts their
(21:42):
relationships with people, theirrelationship with their baby,
relationships with partners,family, all of that.
Dr. Spencer Brown (21:53):
I think one of the biggest things that I
have seen come up and I waslike, really not aware of this,
when like just being just like aregular person. But becoming
like a psychologist and workingin this field is how often
people do not talk about likegender roles within their
relationship and like what thatis going to look like when they
(22:15):
have a child. And I think thatis a big source of stress in our
relationship. Like, am I goingto be a stay at home? Mom? Am I
going to be a working mom, ifI'm going to stay at home? Is it
my responsibility to take careof the child 24/7? And then what
is my partner's role in that.
And so I think gender roles is areally big issue and can be a
(22:39):
role sort of like transitionwithin itself becoming
especially for first timeparents, it can be like a really
huge source of stress. Just kindof,
Dr. Katie Manganello (22:53):
like what are some examples of that I'm
really curious about like, howthat shows up. So
Dr. Spencer Brown (22:59):
like, for example, so let's just say the
woman is like a stay at homemom, she may feel a lot of
responsibility to be the one totake care of the baby 24/7
Because she's a stay at homemoms. And typically, let's just
say her husband is the one whogoes to work. And so she may
feel a lot of guilt or shame tohave to get an x her husband to
(23:21):
wake up in the middle of thenight to get the baby because
she's a stay at home mom, andher role is to take care of the
child. And so I think havingthese conversations, you know,
in pregnancy, or before youdecide to have a child can
definitely shed a light on tolike so is this going to be
really truly 5050? Or is thisgoing to be more 6040 8020. And
(23:46):
if you can decide that, youknow, and everybody sort of like
be somewhat okay with that itcan reduce a lot of stress,
because you might go into itthinking like, Oh, we're
partners, and my husband isgoing to be in this 5050. But
really, it may look more like6040. And that's okay, as long
as you can kind of prepare forthat and plan for that kind of
(24:07):
early on versus now we have anewborn and I'm up and I'm
breastfeeding and I have to keepgetting up and my husband is
just sitting there snoring andsleeping. That causes a lot of
resentment, and some anger, youknow, sometimes because you're
constantly the one waking up andquote unquote, responsible for
the child. So that is somethingthat I have seen come up so
(24:29):
much. That's why I kind ofwanted to just throw it out
there.
Dr. Katie Manganello (24:32):
Yeah, no, that's a good example.
Dr. Brianna Bliss (24:34):
Yeah. So everyone you're saying everyone
tried to like, put out therewhat the expectations are? Yeah.
Originally and then.
Dr. Spencer Brown (24:48):
You can't like especially like, you know,
like we're planning to getpregnant. That can definitely be
something to kind of talk aboutlike so. What are your
expectation like? What do youthink this is going to look
like? Ya know, like when thebaby comes, because often it
doesn't look like what both ofthem thought originally. So you
have you both are coming into itwith expectations, regardless if
(25:11):
you talk about it or not. But ifyou talk about it, at least you
can prepare for it.
Dr. Brianna Bliss (25:16):
That's good advice. Thank you. I also, to
answer your question to Katie, Iwanted to talk about
the mom baby relationship, likehow that's impacted with
attachment. Because that is alot of what I talk about in my
(25:37):
role at my job, too. There is aconcept called serve and return.
I don't know if you guys haveheard of this concept. So it's
kind of like a tennis match, youknow, so compare it to that. So
like with attachment and newbornbabies, you think of like, the
(25:57):
babies serving up, like agesture, like a battle or a cry
or something, and then the momreturning that serve. So like in
tennis, you know, you hit itover, you hit it back, right,
serve and return. And so when wetalk about like, moms who are
experiencing postpartumdepression or anxiety, it can
(26:18):
make it really hard to returnthat baby's battle or sort of
bed for like attention or needor cry if mom is kind of
experiencing her own emotions.
So it's super important, becausewhenever we have that serve, and
return interaction between momand baby, or any caregiver and
(26:39):
baby, the, it's like, soimportant for brain development.
So the baby's brain is like,millions of neurons are firing,
right. And it's learning so muchin such a short period of time.
And whenever there's like, youknow, the baby laughs and the
mom serves that back and laughsto that. Neurons are like going
(27:00):
crazy firing. And they're makingthat bond and that connection
together. So if we think aboutmoms who are like, you know,
struggling with depression, andnot able to last with their
baby, or pick their baby up whentheir baby's crying, because
they're going through their ownemotions, that could really
(27:20):
impact the bond, of course, theattachment, but also the baby's,
you know, the way the baby'sbrain is developing to, because
they're really looking for thatattention, and that secure
attachment from the caregiver.
So I think from like, neuronlevel, all the way up to like
(27:43):
attachment. It's so importantwhen we think about when moms
have postpartum anxiety ordepression, because it really
can impact like, the baby'sdevelopment and their secure
attachment.
Dr. Spencer Brown (27:56):
Yeah, just piggybacking off of that really
quick in terms of like the bond,I think there is a huge
misconception that women have interms of feeling like I'm going
to be bonded to my baby, as soonas I see them. Like this is a
huge misconception. And so whenthat bond is not there, it
definitely leaves women to feellike inadequate, or like,
(28:18):
there's something wrong with me,I don't feel bonded to this
child. And so something that Ilike to tell my mom's kind of
when that does happen is like,this is like any other normal
relationship, like when you metyour, your partner or your
husband, you might not have youknow, liked or loved him right
away, it may have took, youknow, some time, a couple of
(28:39):
weeks. And so think of it likeany other normal relationship,
it may take time for that bondto really grow by baby loves you
regardless. But you know, thisis like any other relationship.
And so give yourself that timeto have that bond really, like
flourish. And so likebreastfeeding is a really good
way to increase bonding time andskin to skin is a really good
(29:03):
way to increase bonding andattachment. And specifically
like in those early stages, butit may not happen right away
like a lot of women think.
Dr. Brianna Bliss (29:13):
Yeah, that's such a good point. I feel like
media, social media, it's allportrayed as like, you're just
gonna instantly fall in lovewith your baby, right? Yeah,
that's not always the case.
Dr. Spencer Brown (29:27):
I will say since we brought up social media
that I do think social media hasdone a really good job of giving
moms that opportunity to reallytalk about the hardships that
comes with being a mom like ifjust following different women.
A lot of women out there thatare on social media are really
like doing a good job of liketalking about No, it's hard to
(29:49):
be a mom like
Dr. Katie Manganello (29:51):
that's what I'm saying. Yeah.
Dr. Spencer Brown (29:54):
Yeah, I will say that I feel like Millennials
like us and like Gen Z moms arereally like doing a good job of
telling the harsh truth aboutbeing a mob, whereas I feel like
older generations made it like,oh, it's rainbows and sunshine
and butterflies, and it's justthe most beautiful thing. And a
lot of ways it is, and in a lotof ways, it's not. And so I feel
(30:15):
like our generation is doing agood job of like, No, this is
what it is, you know, you'regoing to be tired, you're going
to be sleep deprived, is notalways rainbows and butterflies.
And so I do think that socialmedia has given women the
opportunity to really be like,kind of like brutally honest and
give other women a heads upabout what this really looks
(30:35):
like.
Dr. Katie Manganello (30:38):
Good points, I, you know, what I also
am really curious about is, youknow, we talk a lot about
partners, and it may be evenlike, parents or the
grandparents of the babies. Andobviously, the relationship with
the, the baby and the mom. ButI'm really curious about how
giving birth to maybe a secondor third or whatever child
(31:00):
impacts a relationship with themom and their other children?
Like, is that something you guysever see? Or talk about with
people? I don't know if that'sreally relevant to your work,
but I'm curious about it.
Dr. Brianna Bliss (31:11):
Oh, yeah, for me in pediatrics, because
sometimes, I'll be seeing like atwo year old and they're jealous
of a newborn baby. And, youknow, parent, the parents can
only do so much, you know, ifthe mom is one person. And so
that does come up a lot. Sosometimes, like, Well, how do I
(31:35):
cope with this adjustment ofhaving a second baby when the
first one is not a fan. So wework, we work through that. And
sometimes that means like,developing like special time
with mom, and then materialslike one on one so that they can
(31:56):
still feel valued, and justother different strategies that
we talked about. But that isvery much a real thing. And it
really just depends on your,your child, if they're going to
have that reaction. Some kidsare perfectly excited and like,
take on a big brother or sisterrole, and it's great. So it
(32:18):
really just depends.
Dr. Spencer Brown (32:21):
Yeah, I would say for me, in terms of like
what I do, a lot of times womenwill have an expectation because
they already have a first childand already had a first
pregnancy and that pregnancywent really well. And then they
get pregnant a second time. Andit's not like that. And then so
(32:41):
there's a lot of likecomparisons of well, this
experience was like this, butthis experience is is not like
that. And so, you know, reallygetting them to stop making
those comparisons and lettingthem know like, you know, each
pregnancy is going to bedifferent and come with it
different challenges. And eachbaby is going to be different
and have different challenges.
And so kind of setting thatfoundation
Dr. Katie Manganello (33:05):
can Yeah, that's a really good point.
That's interesting, actually.
Also, I want to circle back tobecause when I brought up for
the relationships, I was talkingabout, like potentially, like
grandparent relationships andstuff that you kind of giggle
that I want to know what youwere thinking. Yeah.
Dr. Spencer Brown (33:23):
In terms of like grandparents, so if it's
the, let's just say it's themom, and it's her parents a lot
of times, and even even likemother in law's can give
unsolicited advice, right. Andso I think it can be really hard
on the mom, particularly if it'sa first pregnancy, when like,
(33:43):
your mom is like, Oh, I havefive kids, you only have one, it
can be really hard to kind oflike manage that it can feel
very, like undermining in asense of like, Well, what I'm
going through is not hardenough, or I should be kind of
like grateful innocence. So Ithink all again, like older
(34:04):
generations, it can be you know,kind of like grin and bear it,
you know, like, it's not thathard. And so it can really
impact the postpartum periodwhere you kind of feel like
you're being judged orcriticized, because you only
have one child or two or twochildren. And the women, the
older women in your life arelike, Oh, kind of get over it.
(34:25):
Or if they even don't even feellike postpartum depression
exists. You know, you're, you'regonna feel tired, you're gonna
feel, you know, maybe bad, likeit's going to be okay. And so it
again, kind of leaves the womanfeeling like inadequate. So that
can be hard. Yeah.
Dr. Brianna Bliss (34:46):
That's a good point, like, from generation to
generation, right, as we'vegotten more open about mental
health and less stigmatized,although it still is but maybe
grandparents don't They don'tsee postpartum anxiety or
depression or they didn't. Theydidn't have that experience, or
(35:06):
if they did, they weren't goingto talk about or weren't aware
of it. So that's a reallydifferent challenge for
generationally to even, like,meet. Alright, I on that and
understand what's going onthere. Yeah,
Dr. Spencer Brown (35:22):
yeah. And malls and grandparents do come
up a lot, especially mother inlaws. But that's a different
conversation. Yeah, I
Dr. Katie Manganello (35:30):
feel like we can have a podcast on that.
Not even just the mother laws,but just like, parents have the
new parents. Yeah. And like,cultural changes to, you know,
it's not just generationalincense in the sense of like,
well, I'm a millennial in thereor whatever. But also, just
(35:51):
knowing that like, at least inAmerica, this might be a really
interesting dynamic, that'sdifferent. I don't know if it's
different in other countries,but you know, a lot of our
parents or grandparents are, youknow, first generation second
generation and the differencesthat kind of come with that.
That's really, I think, aninteresting thing. But you're
right, that would probably be awhole other podcast, we should
probably table that one.
Dr. Brianna Bliss (36:14):
That'll be next time. I have so many ideas.
Dr. Katie Manganello (36:20):
Send them over, you know, I get very
excited about all the ideas too.
But bringing it back to thisone. So we already talked about
how, like, let's talk about howwe can help the new moms right,
like, what are we going to do?
So you talked a lot aboutpsychoeducation, giving them
information about all of this,the advocacy piece, and being
able to have them advocate forthemselves as well as your work
(36:41):
and advocating? Tell me more alittle bit about like, other
treatment options, once it'sestablished that okay, there is
postpartum happening here, like,what kind of treatments do you
use? What kind of treatmentoptions are there? Like
medication, individual therapy,support groups, maybe couples?
Like those kinds of things?
Dr. Spencer Brown (37:02):
Yeah, so all those things that you name, I
can't answer the question. Moreabout them, though, like, what
does it look like? Kind of likewe said, like, so like, if we
take it all the way back to thebeginning, like screening tools,
so then we get the referral,they meet with us. So obviously,
(37:23):
we do like the intake and all ofthat. So essentially, if I see a
woman for several sessions, andI feel like her symptoms are not
really, you know, getting betteror decreasing, then that's when
I would have the conversation interms of like medication. And so
that will often say, you know,like, some people can do really
(37:43):
well with just therapy alone.
But a lot of people do reallywell with therapy and
medication. And so then I talkto them a little bit about,
like, how do they feel aboutmedication, because one of the
big sort of misconceptions isthat when I'm pregnant, I have
to come on all of my medication.
And that is not accurate. It'simportant for a lot of times for
(38:06):
women to stay on theirmedication, depending on what
the medication is, I'm not apsychiatrist, by any means. But
a lot of times when the womancomes off of all of her
medications, we really see adrop in her mood, and then all
of those symptoms really comeback with a force during
pregnancy. And so then they cometo us, and they're really
distressed. And then we have tothen manage that and kind of
(38:29):
say, Okay, let's get you back onyour medication, because that
was what was helping you duringthis time. And so I think that's
a big piece of it. And then, ifthey've never been on medication
before talking to them about howthey feel about being on
medication, a lot of times womendon't want to start medication
because of breastfeeding. And sothen that's when I would send
(38:52):
them to a perinatal psychologistwho couldn't really ask
psychiatrists, sorry, whocouldn't really talk to them
about what medications arereally saved for breastfeeding.
And I know just offhand a bigone that a lot of perinatal
psychiatrists recommendedZoloft, because it is pretty
safe for breastfeeding.
Dr. Katie Manganello (39:15):
I do think that that is a big pressure that
people feel without knowing thatthey have to go off of
medication when they'repregnant.
Dr. Spencer Brown (39:23):
But obviously talk to your psychiatrist when
you are, you know, pregnantbecause some medications may
have different side effects anddifferent risks, but it's
important to get thatinformation and not just assume
that I have to come off ofeverything, because I am
pregnant in some OBGYN. I don'teven like to prescribe to
pregnant women, which then isanother huge problem. Because
(39:46):
then it's like okay, now, Idon't have access to my
medication because my OBGYNdoesn't want to prescribe to me
because they're, they're afraid,you know, to do it during
pregnancy. But that's why wehave perinatal psychiatrist now
Because it sounds, yeah.
Dr. Brianna Bliss (40:02):
Yeah, that's such a good point, even if your
OBGYN doesn't want to prescribeit, or your primary care
physician doesn't want toprescribe it, yeah, don't give
up hope, that doesn't mean thatyou can't get it, it just means
that they don't want, they don'tsee you often. And so when, when
our providers not seeing you,like weekly or every other week,
(40:24):
they, they can't monitor how themedications are going. So it
just might mean, you see apsychiatrist or, you know, a
therapist who can get youconnected with a psychiatrist to
get the right medication. So ifat first you don't succeed with
the right provider, that doesn'tmean you shouldn't do it, just
(40:45):
to figure out the right, theright person, who's going to be
able to work with you, over timeto make sure that like, once you
start taking these medications,they can look like observe you
and make sure things are goingokay.
Dr. Spencer Brown (41:01):
Okay. And then also in terms of like
couples work. Concerns do comeup during therapy, when just
working with the woman,obviously, we are not couples
counselors. So I do talk to mywomen, we do talk about like the
stressors, and then therelationship dynamics, but I
(41:22):
will often refer to like acouples counselor, because I'm
just working with one half ofthe equation, the partner also
needs to be involved, becausewhat I will often say is that,
when you are in therapy, you aregoing to get better or have a
lot of knowledge, but yourpartner is essentially staying
the same. And so then how isthat going to work if you now
(41:44):
have all of these differenttools, but your partner's
staying the same, it's notreally gonna work that so having
a support person who can seeboth of you and talk to both of
you, and you talk about, likethe communication, I think can
be really helpful.
Dr. Brianna Bliss (41:59):
Make sense?
Yeah. And I think I'm beyondlike, a therapist or
psychiatrist, you know, otherkinds of therapy, a couples
counseling, I think it's alsoreally important to connect to
community resources. So that's abig focus in the group that I
that I run. Like, things,resources, like dual was maybe
(42:23):
like a Healthy Start program,which they have in a lot of,
it's a national program. So theykind of have like, visiting
nurses that can help moms orthey provide you with a doula,
they can give you access toFormula diapers. So there's a
lot of programs out there thatcan be of like, concrete support
(42:48):
that people might need. Ratherthan just like emotional
support, which is reallyobviously very helpful. But
sometimes, if you know you'restruggling with finances, or
like any other social factors,it could be really good to have
a support and like a doula orjust know where to get diapers
(43:10):
or a food pantry, things likethat. So sometimes when you
connect with a therapist, theycan also have access to those
resources for you. So it'simportant.
Dr. Katie Manganello (43:27):
Awesome, do you have any other just kind
of general or practical advicefor it doesn't even have to be
like a mother struggling withpostpartum depression or
anxiety, but any kind of newmothers, do you have any kind of
advice for just how to kind oflike cope with the typical
changes that are happening?
Dr. Spencer Brown (43:48):
I just, you know, I just feel like, this is
such a huge transitional period.
So there's gonna be ebbs andflows that naturally kind of
come along with that. But youare doing a great job, you are a
good mom. And so the fact thatif you, you know, are concerned
that you may not be doing a goodjob, says that you, you know are
a good mom, because if you youdidn't care, then then we would
(44:12):
have pause for concern. But ifyou are questioning that, then
you are definitely being a goodmom.
Dr. Katie Manganello (44:20):
And being gentle and nice to themselves.
Yeah, self compassion.
Dr. Spencer Brown (44:24):
Yes, yes.
100%.
Dr. Brianna Bliss (44:26):
And I would say to add to that, you will
have bad days, and that'snormal. And that's okay. And
that doesn't mean you're a badmom. It just means you're human.
And sometimes, you know, like wetalked about this a little bit
(44:47):
in my group. It's like balancingyour thoughts, right. So if
you're saying to yourself likethis is really difficult, but
maybe you could balance that outwith like, and I'm doing the
best I can right So you can justkind of think about little ways
to balance out your thoughtsbecause sometimes when it weighs
too heavy on one side of thescale, that's when we can start
(45:10):
feeling kind of down. So I thinkit's about balance, knowing
you're gonna have the bad dayshaving the bad days, and
tomorrow will be better. So
Dr. Katie Manganello (45:24):
awesome.
Well, do you have any finalstatements or pieces of advice
or anything that you would wantto leave us with? regarding any
of the things that we had talkedabout today?
Dr. Spencer Brown (45:40):
I feel like that pretty much covers it, but
I will say you know, just lookout for me and Dr. Bliss in the
future. We have some things upour sleeve. So just before
Dr. Brianna Bliss (45:55):
I your maternal and child wellness
needs.
Dr. Katie Manganello (46:05):
Okay, Dr.
Bliss, do you have anything?
Dr. Brianna Bliss (46:09):
That pretty much sums it up?
Dr. Katie Manganello (46:13):
Okay, amazing. Well, this was so fun.
I actually yes, we definitelyhave to do this again. And yeah,
we'll definitely come up withsome more ideas. So thank you
so, so much for joining ustoday. And for everybody out
there listening. Please rememberto like, subscribe and share
this episode wherever you findyour podcasts.
Dr. Brianna Bliss (46:33):
Thanks for having us. Thank you.
Dr. Katie Manganello (46:35):
Bye bye
Popular Podcasts
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.