February 11, 2026 • 45 mins
Reproductive health is often discussed in terms of our physical bodies, but what about our mental and emotional well-being across the reproductive lifespan? In today’s session, I’m joined by Dr. MiMi Sanders, a board-certified psychiatrist specializing in reproductive psychiatry, to help us better understand the unique mental health needs that can show up during menstruation, pregnancy, postpartum, fertility challenges, pregnancy loss, and menopause. We explore what reproductive psychiatry is, why it’s especially important for Black women, how mood and anxiety disorders can show up during major reproductive transitions, and what it looks like to advocate for yourself when navigating mental health care during these seasons. Dr. Sanders also breaks down common myths about medication during pregnancy and postpartum and shares what supportive, culturally responsive care should look like.
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The Therapy for Black Girls Podcast is a weekly conversation with Dr. Joy Harden Bradford, a licensed Psychologist in Atlanta, Georgia, about all things mental health, personal development, and all the small decisions we can make to become the best possible versions of ourselves.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
Welcome to the Therapy for Black Girls Podcast, a weekly
conversation about mental health, personal development, and all the small
decisions we can make to become the best possible versions
of ourselves. I'm your host, doctor Joy hard and Bradford,
a licensed psychologist in Atlanta, Georgia. For more information or
(00:32):
to find a therapist in your area, visit our website
at Therapy for Blackgirls dot com. While I hope you
love listening to and learning from the podcast, it is
not meant to be a substitute for a relationship with
a licensed mental health professional. Hey, y'all, thanks so much
(00:57):
for joining me for session four, p. Fifty of the
Therapy for Black Girls Podcast. We'll get right into our
conversation after a word from our sponsors. Reproductive health is
often discussed in terms of our physical bodies, but what
(01:18):
about our mental and emotional will being across the reproductive
black span. In today's conversation, I'm joined by doctor Mimi Sanders,
a board certified psychiatrist specializing in reproductive psychiatry, to help
us better understand the unique mental health needs that can
show up during menstruation, pregnancy, postpartum fertility challenges, pregnancy laws,
(01:40):
and menopause. We explore what reproductive psychiatry is, why it's
especially important for Black women, how mood and anxiety disorders
can show up during major reproductive transitions, and what it
looks like to advocate for yourself when navigating mental health
care during these seasons. Doctor Sanders also breaks down common
myths about medication during pregnancy and postpartum, and shares what supportive,
(02:04):
culturally responsive care should look like. If something resonates with
you while enjoying our conversation, please share with us on
social media using the hashtag TVG in Session, or join
us over in our Patreon to talk more about the episode.
You can join us at community dot therapy forro Blackgirls
dot com. Here's our conversation. Well, thank you so much
(02:28):
for joining us today, doctor Vivie.
Speaker 2 (02:30):
Oh, thank you for having me. I'm excited.
Speaker 1 (02:33):
Yeah. So, you had such a unique career journey thus
for so tell us about your career as a psychiatrist
and on reality television, And I think this is always
interesting for the sisters in the community who may be
exploring medicine. How did you choose psychiatry as a career path?
Speaker 2 (02:49):
Yes, very unique. I often tell myself, Hey, You never
know what is going to be around the corner, so
just be prepared to pivot. I'm originally from Alabama. I
went to undergrads at Tennessee State University, and at that
time I wanted to be a pharmacist and I was
doing like my chemistry and all the prerecs. But then
(03:10):
I discovered, hey, I you know, I like kind of
medicine as well. What does that look like? And I
entered into like a program after undergrad and it was
for just those who were just wanting to do more
medicine but not necessarily had really fully necessarily committed, but
I want to explore, and so I entered into this
(03:31):
program during the summer after I graduated from Tennessee State
University at Ohio University, and it was my first time
being exposed to what a doctor of osteopathic medicine was,
and it was really focused on general practition and those
of like primary care, and so I kind of fell
in love with really okay, I really like to know
(03:52):
everything about the person, and also behavioral health kind of
fell in that as well. So I entered into Ohio
University for a medical school and stay there, and it
was just different experience. I was coming from a historically
black university and now I am in Appalachia, So I'm like, okay, Lord,
you're giving me all types of experiences in my life.
(04:14):
And then just from there just met really good like
friendships and just really had a really good experience. And
I left there and went to Cleveland Clinic and from
there that did my residency. At that time, I had
decided on psychiatry, And your question was how did I
decide on that? And it was not until maybe one
(04:36):
of my last rotations as a medical student, I'm like, hey,
I don't like surgery. I'm not necessarily a person that
wants to do a true specialty of dermatology. I really
wanted to explore more yes of my primary general practitioner
kind of experience and background. But I found myself in
(04:58):
my clerkship of my rotation in psychiatry on an inpatient ward.
On that ward, I saw a lot of persons of color,
and I didn't see at that time where I was
doing my rotation of a lot of those in those
crisis situations of the majority. So I didn't see a
lot of those who are Caucasian, and I was wondering
(05:18):
why was that. And when I went from an in
patient setting to the outpatient setting, then I saw more
of those who were Caucasian and really exploring those preventative
measures of their mental health and emotional well being. And
that is kind of where I fell in love with psychiatry.
And I'm just like, you know what, I really know
that I can relate to a lot of individuals because
(05:41):
of my background and because of my life experiences, but
I really want to be a representative of that Black
community of a psychiatrist that we necessarily don't have to
see someone in crises. We can have that particular representative
as an outpatient and really work on what is proactive
in my own mental health health. I have someone that
(06:01):
I can relate to, I can talk about these things.
They understand my spirituality and they understand that, hey, I'm
not necessarily having a psychotist if I am talking to
the Lord. And so it was just that particular experience
that in me wanting to fill in that gap or
that void and be truly a representative of this is
(06:22):
what it looks like or what it could look like
for proactive preventative mental health and going to see a psychiatrist.
But funny story. Also, my mom, when I told her
I wanted to be a psychiatrist, her being from the
deep south of Alabama, she was like, so you going
to medical school and you're not going to be a
real doctor. And I said, mom, Mom, And so just
(06:43):
knowing that, and now she's very well educated and she
knows all things about mental health and going to see
someone and medications, and just knowing that that is how
we were. It's gotten much better now, but this is
how we thought about going to see a psychiatrist. So
that is kind of where I fell in love with it.
To be honest, I don't like to get down and
(07:06):
dirty in terms of physical exam Like I really loved
talking to people. I love doing that particular type of examination.
So that's how I landed.
Speaker 1 (07:15):
Yeah, I appreciate you sharing that story because I think
that that can pop up in lots of different ways, right,
Like not just stigma around like medical specialties, but also
I think the stigma related to mental health in some ways, right,
I think that is deep seated for a lot of
our families.
Speaker 2 (07:28):
Absolutely.
Speaker 1 (07:29):
Yeah, yeah, So is the focus on prevention that you
saw what led you to develop your private practice Inner
community Health.
Speaker 2 (07:37):
Yes and no. So my practice inner community health. It
started back in actually in COVID, so it was a
virtual practice. And so I was working while in COVID
as any psychiatrist as well as now self employed doing
my virtual practice. And usually during this time, I had
a lot of women reaching out because we were all
(07:59):
confined and we're like, okay, I can't set these particular
boundaries that I thought I had in terms of work
and life and children and husband and cooking and now
working again. And I had a lot of women reaching
out and say, hey, I need some help. I have
not navigated this before. And I said, well, let me
just open up my schedule and let's just see what
this looks like. And it was again mostly women. And
(08:23):
during that time, also as an employed psychiatrist, I was
working in Cleveland Clinics Women's mental health department and not
necessarily knowing what that was, but I just knew that
I was drawn to women that had these life experiences,
whether it was pregnancy loss, postpartum, postpartum depression as well
(08:46):
as anxiety, and them really wanting to come to the
office and really say, hey, I have a place to go,
I have someone that understands me and also me going
through my own particular journey in motherhood really made me gravitate.
So just disclosure my graduated residency, I was going through
(09:08):
my own particular transition like Okay, I'm attending, now what's next.
Got married during that first year, I lost my grandmother
during that first year out of residency, and I had
a miscarriage, and so going through all those particular life
transitions and not knowing where to turn. So here I
(09:28):
am as a psychiatrist telling my clients or patients these
coping strategies what to do, and I'm really not practicing
what I'm telling them. So I'm not practicing what I'm preaching.
And if I do want to have help or search
out that particular individual, I did not know where to go.
I knew myself because I need to go to someone
(09:49):
that I can receive this information from. I needed to
go to someone that I can feel that I can
relate to. And that is why I think, ultimately, Hey,
where is this place or how could I develop this
space this place where I as a mother, I as
a woman would want to go to and not go
(10:09):
to a particular place where it's not conducive to my
mental health, like my provider perhaps doesn't get me, or
like the physical location is kind of like dim and
not conducive to my mental health. It's not inviting or
giving me aspirations. And so that is what I wanted
to create for my women. I wanted to create a
space that I know that I would want to go to,
(10:32):
that I will feel comfortable and I know that I'm
getting the necessary tools that I know that I needed
at that time of my life.
Speaker 1 (10:39):
Yeah, so you have further specialized in reproductive psychiatry. Can
you say more about that specialty.
Speaker 2 (10:46):
So, reproductive psychiatry is basically a specialty in psychiatry where
we follow the women throughout her reproductive cycle. So that
can be whether it is challenges with infertility, whether it
is miscarriages or even elective or even spontaneous abortions, those
who are pregnant or desiring to get pregnant, those who
(11:08):
have had their child. And now maybe I'm going through
something that is further than the baby blues, maybe I'm
having some postpartum mood or anxiety symptoms or even psychosis.
And then also traveling with that woman when you go
through mental pause or perimental pausal symptoms, So really understanding
that we're very complex and we have hormones, we have
(11:31):
other challenges as relates to all the many things or
people that are pulling on to us, and so just
following her throughout her cycle, her journey just as a woman.
Speaker 1 (11:42):
And have you found that this reproductive kind of spectrum
is where many women actually turn to wanting to have
some mental health support or their particular challenges that you
found that pop up during this period that make somebody
more likely to seek out services.
Speaker 2 (11:56):
I have found that some women or just general population
don't know that we exist. And once they find out
that we exist and we are a place where we
can really relate to each other and hey, yes I'm
not sleeping and I'm forty five or I'm close to
mental pause. Is that something yes, we can really think
about that. Also having some cognitive or brain fog, Yes,
(12:20):
that may be associated with perimental pause. So really educating
others and letting them know that we exist and there
is help. And so I do say, yes, we productive psychiatry,
but it's just in general women's mental health and whatever
that means to you that if we don't have it here,
we can provide resources where it is for therapy met
(12:42):
management groups. So really understanding that we exist and educating
the population that this is a specialty in psychiatry.
Speaker 1 (12:50):
That can mean mean one of the things we talk
about on the podcast, and that I feel like lots
more women are talking about and getting diagnoses for things
like PCOS and endometriosis. We know that there's like the
medical kind of symptom side, Well, what are some of
the mental health challenges that come up with something like
a diagnosis like PCOS.
Speaker 2 (13:07):
Well with PCs, and this is like as we can
just generalize it as some times of ovarian challenge or
ovarian failure, and so there's a lot of symptoms that
may come with that, whether it's physical symptoms of like ecniques,
assive hair growth and fertility or problems conceiving, and so
(13:27):
that can really play a part in someone's mental health journey,
whether it is self esteem, whether that is some type
of guilt or shame and just anxiety. If you are
family planning, what does that look like for me? And
providing that support to that the client as well as
providing that support if you're working with your ovg U
(13:50):
I N I think it's very necessary those patients are
clients that I have with those particular diagnoses. They deal
with the uncertainty and so that uncertain of me wanting
to have a child, the uncertainty of what are these
medications that my obgi in has put me on, whether
it is some type of bird control peel, what type
of pill that is that gon'll cause me to have
(14:11):
some mood swings. So really supporting that patient through this
journey of whatever she chooses. Hey, I'm on this to
regulate any type of physical symptoms that I may be experiencing.
I'm on this medication to make sure that I'm putting
myself in the big chance to conceive or have a
family plan just knowing that, Hey, we see you, we
(14:33):
understand what you may be going through. There's some resources
here and it goes far to you on just medications,
it can just be okay, I'm here to listen. I'm
here to listen to for your concerns and what are
your goals we can have a treatment plan altogether.
Speaker 1 (14:48):
And what is your approach to medication management For somebody
who may be struggling with something like anxiety and depression
if they are also kind of on the fertility journey. Right,
So maybe they are taking fertility medications.
Speaker 2 (14:59):
What's that a So, to be honest, my ladies come
in apprehensive. They come in, Okay, I don't know about
these medications, and I heard about you psychiatrists. You guys
are going to prescribe these medications and I tell them, no,
it's individualize and I'm going to tell you my recommendations.
I'm going to also communicate to you that, hey, this
(15:20):
is what I am hearing from you in terms of
any impairment, whether it is in your sleep, your mood,
your appetite, just in any impairment in your quality of life.
And my job as a psychiatrist is to let you
know your options. And so if you are going on
your fertility journey and I can understand why you are
(15:40):
a little bit hesitant of adding another medication, I can say, hey,
there is limited research and that's just the nature of
it in terms of you're dealing with women of infertility
or pregnant women that we have limited research, but there
is some out there. But there is some reviews saying
that hey, even if you're on the medications like an SRI,
(16:01):
a selective serotonin uptake inhibitor and those different parameters in
terms of your ability to conceive. It has not shown
any particular detrimental effects of you in your inability to
conceive while you're going on this journey. But everything is
individualized to you, so we have to weigh out all
(16:24):
risk and benefits. As a psychiatrist or a medical doctor,
I work closely with the obguy is to make sure
I know all the medications that you're taking. We're doing
drug interactions, making sure my stuff is I'm missing with
her stuff, And it's really having that necessary collaborative care
to make you feel comfortable and let you know your options.
(16:45):
But I'm going to let you know hesis like, we
need to make sure that you are good because when
you do conceive that we are reducing our particular risk
of low birth rate or pre term labor. We're really
looking at the risk and benefits for you as well
as the baby. It's a team effort and understand and
(17:08):
that at the center of the team it's you as
the client and the patient. So I'm gonna tell you
my recommendations, the OBGUI is gonna tell you her recommendations,
and we're gonna all work together and make sure you
feel heard and sing mm hmm.
Speaker 1 (17:20):
You know another place where this often comes up around
do I take medication do I not? Is actually after
somebody has given birth, right and maybe they're breastfeeding, and
so there may be still some like anxiety depression symptoms
that medication actually could be really helpful for. But I
think a lot of new moms are very concerned like, oh,
this is gonna be harmful to the baby. Can you
talk a little bit about some of the considerations of
(17:42):
taking medication, like when you're breastfeeding.
Speaker 2 (17:44):
So if we're dealing with depression or anxiety, my go
to has been searchling and that's just how I have
been trained. They have those parameters you look for. Okay,
it's just safe the lactation.
Speaker 1 (17:55):
Yes it is.
Speaker 2 (17:56):
How does this work with when I'm pregnant? And do
I have to taper off my medications when I get
pregnant again? It depends on how you are doing and
making sure that we're weighing risk and benefits. Have I
had clients that have done great on this medication. Oh
you're pregnant, awesome, How are you feeling? What are your concerns?
(18:17):
And Doctor Sanders or doctor Mimi, I'm good, keep me
on my medication. Okay, I'm going to let you know
that we're going to be seeing each other a little
bit more frequently. I'm going to be monitoring your mood
and sending you all types of screenings to your portal
more frequently. And so I'm your extra set of ears
and eyes, and you tell me how you're feeling, whether
it's once a week, so really having that communication. But
(18:40):
there's research saying that hey, stand on this medication is
good for you and the baby, especially if you have
experienced depression in the past prior to pregnancy. We know
that you're at greater risk, and we want to make
sure that we're making an environment from a pregnancy standpoint,
from a postpartum standpoint that is conduces for you and
the child.
Speaker 1 (18:58):
Yeah. Yeah, more from our conversation after the break. So
in addition to conversations around medicine, we've already talked a
little bit about like unpacking the stigmas that are sometimes
(19:18):
related to things like fertility or just kind of I
think mental health in general in the black community. What
does that look like when you were working with your
clients to help them kind of unpack some of these stigmas.
Speaker 2 (19:28):
So considering that there perhaps would be some type of
going on a fertility journey, and depending on how long
you've been on it, there can be some issues around
your womanhood. And this is what I grew up of
wanting to I'm able to produce. This is how I
grew up people around me, this is what we were
(19:50):
made for in terms of women in order to have
a child. And if I'm having some type of challenges
or barriers, what does that mean for me as a woman?
And so I look at that and we challenge those thoughts.
We challenge those thoughts and say, Okay, what do you
believe in terms of your womanhood and do you know
your particular options when it comes to the different types
(20:11):
of assistant reproductive technology or fertility treatments. So really leading
into those particular thoughts that you have as a woman,
how you define your womanhood, challenging any particular shame, letting
you know that you don't have to go through this alone,
and if you feel yourself having to hide this or
(20:32):
feel is secretive, that here's a place that you can
really be vulnerable and have a deeper dive of what
that looks like for you going through this journey and
as it relates to taking medication, you take a medication
does not mean that you are weak. Does that mean
that you need a little bit extra push. No, it
just means that, hey, this is the right treatment option
for me in this season. And do I have to
(20:55):
be on medication for the rest of my life? No,
But if you want to, I have pages and say,
don't touch anything that I'm doing fine, I am operating,
I'm living the best quality of life. I really love
how I feel. And so it's really looking at that
person or the client making sure that I hear you.
I see you. I'm not devaluing your concerns, but I
(21:16):
want to educate you as much as possible and let
you also challenge any of those false beliefs that you
have had about what womanhood means to you and not
what the expectations have been placed on you.
Speaker 1 (21:31):
So you know what I mean. I feel like we've
had growing conversations around things like postpartum depression, postpartum anxiety.
But what kinds of things do you feel like we
still need to talk more about as it relates to
the postpartum period in a woman's life.
Speaker 2 (21:45):
So when we hear postpartum automatically. I've seen that patients
think postpartum depression, and we really are not leaning into
post part of anxiety, which I see more in my clinic.
Is that post part of anxiety and that separate racial
anxiety that the new mom has with her baby. I
also think that we need to lean more into what
(22:07):
does me returning to work look like? And what does
this new normal look like? And is there options for
me to spend more time to bond with my baby
and what does that look like? And so I have
had many patients come to me and say, I'm just
not ready to return to work. I fear that no
(22:28):
one can take care of that baby like I can.
I feel that I'm going to miss out on some
particular mouthstones when I'm at work. And then we look
at that and said, okay, what else do you need?
And so what was your postpartum plan and have we
deviated from that? If so, how are we in terms
of our pivot? What are our options and what are truths? So, yes,
(22:52):
you are doing a great job as a mom, and
you have those particular safety concerns, but is that postpartum
anxiety leaning more in terms of obsessiveness? And you having
to check that monitor a little bit too often. Now
you can't take care of yourself and you're not sleeping.
We're trying to get the sleep that you can on
when the baby is sleeping. So just leading more into
(23:13):
looking into post part of anxiety and not always thinking
that it's postpartum depression and that post part of anxiety
can lead to secondary depression, but really saying, okay, what
is that anxiety? Is it interfering with me taking care
of myself therefore also interfering with me taking care of
my baby the best way I can. What does that
(23:33):
separation anxiety look like? And what is realistic plans for
me to return to work? And if I'm not ready,
how can I have that conversation with my physicians or
with your psychiatrists so we can have a really good
plan for you and the child.
Speaker 1 (23:48):
So how do you know, doctor Mimi, if something is
just normal kind of especially for first time moms, right, like,
how is it different? How is just regular new mom anxiety? Like,
oh my gosh, what do I do? How do I
take care of this baby? How do you know when
it is crossed the line to be the something that
might meet criteria for anxiety and that you might need
to talk with someone about it.
Speaker 2 (24:06):
So I asked them to give me a time period.
So let's just say, Okay, I'm anxious got your baby's safety.
And so I'm asking you, well, how many times are
you checking that monitor? And when are you checking it?
And some patients will say I'm not even checking the
monitor and I'm sleeping outside the door, or you know,
(24:26):
Or I said, well, have we interview if you do
a daycare, have we interviewed any particular nannies. They have
this idea of the baby can come with them, she
can't leave them and go to target with her mother.
What she knows is a safe person. And so I'm
asking them, okay, how are you maneuvering through life? And
how many hours out the day are you having to
(24:49):
obsess over the safety your concerns for your child. And
I look at that and say, okay, out of the
twenty four hour period you're spending just say this twelve
hours plus really focusing on hey, what if I did
not bathe the baby right? What if they did not
shake up the bottle this many times at that feeding?
(25:12):
So just really looking into those particular thoughts and say Okay,
are they rational? Were you thinking like this prior to pregnancy?
And don't just really having that good interview with the
mom and just debunking those particular myths of no one
can take care of the baby like you can. Granted
you are that child's mom and you have that particular bonding,
(25:34):
but also you know that you have to have some
support and knowing that, hey, I can trust my partner,
I can trust any other family supports around me, so
I can take care of myself. Are you showering? Are
you feeding yourself? Are you really taking care of yourself?
And has those things gone neglected because of you obsessing
or being very anxious about your child? So we really
(25:58):
take a deeper dive of like what does this look like?
And it's this, Okay, it's this rational for you. And
so I will find my lady saying no, I should
be able to not sleep outside the door, or I
should be able to leave my baby with my mom
in order for me to go get me a cup
of soup or something. So it's just really listening to
(26:18):
her and allow herself to listen to her own thoughts
and challenging and facilitating the challenging of those thoughts. So,
but really again leaning into that postpart anxiety, that separation,
that guilt of hey, I'm going to miss every milestone
if I do return to work. No, no, no, you're not.
You are You are engaged in your child's development, and
(26:40):
you will know and you will be able to experience
those things. But we are not devaluing how you're feeling.
We just want to make sure that you're taking care
of yourself. M h.
Speaker 1 (26:49):
You mentioned the baby monitor, and I feel like technology
has evolved so much beyond monitors, right, so now there's
a little sock the baby can wear, there's something you
can put under their mattress. How do you feel about
these tools, Like do you feel like they're actually helping
moms and parents to kind of manage anxiety or do
you feel like in some ways they can kind of
increase the anxiety.
Speaker 2 (27:09):
In some ways, it's increasing it because now you have
different parameters that you're trying to make sure that you're
staying within. It's just a lot of noises and things
and notifications are going out. And so imagine if you're
already anxious and your hormones are already all over the place,
and now you're having all these apps and notifications come
on your phone, and so I would tell them, hey,
(27:31):
let's just turn off too, Let's turn it off, and
then okay, how are we feeling? We feel it? Okay,
was baby girl? Baby boy? Okay? Yes, we can still
watch the monitor and if you're at daycare, yes, zoom
in and let me see what you guys are doing
over there. But we have to make sure that we
are not exaggerating our anxiety with all these developments and technology,
(27:52):
but still understanding that. Yeah, especially as first time moms,
like this is my first baby. I've gone through this
particular journey to have this child, and so I value
that I see that. But we have to make sure again,
how are you mom, because we cannot neglect ourselves because
we have someone else that kind of come into the picture.
We also lean into your support. So instead of those notifications,
(28:17):
if you are fortunate enough to have that family support,
lead into that instead of you know, the technology and notifications.
Speaker 1 (28:24):
So, speaking of support, like what kinds of things would
you say to partners and other family members about how
to support somebody who is kind of in the postpartum
period and maybe how to recognize like when they need
to escalate and talk to somebody else.
Speaker 2 (28:39):
I recently did a recertification in my perinatal mental health class,
and we talked about a postpartum plan and sharing that
plan of course with your supports prior to the birth
of the baby, and during that conversation or during that
(29:00):
eyelock with your support, letting them know and also being
educated as the patient of what this does look like.
If I am having some type of irritability, mood, anxiousness,
and so if I do start to exhibit some of
those particular signs and symptoms, then this is how I
(29:21):
wish for you to communicate to me about what you see.
And I'm very opened for you to communicate that to
me because once I give birth, I know that I'm
going to have some fluctuations in my mood, some fluctuations
due to my hormones, and so I may not be
able to recognize that within myself. So during my postpartum
(29:43):
plan that I'm doing pre baby, I really need you
to let me know how I'm doing. Encourage me to
take care of myself, make sure that I have meals
because my focus will be whether it's breastfeeding or feeding
that baby. So make sure that you're taking care of
me as I'm trying my best to take care of
my new born. So having that conversation pre baby, setting
(30:05):
a postpartum plan with your family members or that loved
one or that partner, I think it will be very
very helpful. And then also, hey, if I get to
a point where I'm unable to receive from you, who's backup,
who's your backup that can that can communicate to me?
And also making sure that you, if it is my partner,
(30:26):
how are you going through this process? And I don't
want you to neglect your needs, partner, so you make
sure that you have your own particular support. So having
a postpartum plan pre baby, I thought it was very
good advice that they were giving us to tell our
clients let's develop it, but also not be so rigid
that we have to stick to it, and so we
know areas where we can pivot. But hey, please let
(30:49):
me know if I am not having the quality of
life that you know that I should have. So making
sure my basics, eating, my social connectivity, my sleeping, so
help me out because we're not going to get the
sleep that we did. But what does this look like
now for me? To make sure as I have gone
through this experience of giving birth, making sure that I
(31:11):
am sleeping good. And then again, well you're not exercising,
but when I can, and if that's something that I
used to like to do, encourage me because that also
has its added benefits.
Speaker 1 (31:22):
Are there any resources in particular that you knew of,
doctor Mimi that are specifically for men to support the
women in their lives around reproductive psychiatry.
Speaker 2 (31:31):
So there's a website and Postpartum Support International and so
on that website. It has different tabs and it's also
they have support groups for partners that you can kind
of put in your zip code figure out where you
could go whether and also if it is virtual for
your partners and they can have male groups and then
(31:52):
also other partner relationship groups. And I believe that was
a really good website. And also on that website directory
for those who are reproductive psychiatrists or how do I
find a provider? And so that is kind of a
website that I give my clients if you're looking for
support groups, if you're looking for other providers, therapists, other psychiatrists,
(32:13):
just other resources when you're going through this perinatal journey.
Speaker 1 (32:17):
Thank you for that. More from our conversation after the break.
So earlier in our conversation you talked a little bit
about you know, we spend a lot of time talking
about like the fertility journey, postpartum kind of pre postpartum,
(32:38):
but also perimenopause and menopause, right, is another part of
this psycho that women go through. You mentioned it like
brain fog and like some cognitive concerns. What are some
of the particular mental health kinds of symptoms that we
see kind of in this perimenopause menopause stage.
Speaker 2 (32:54):
Well, and just self disclosure, like I'm freezing the whole
house out in terms of high insomnia, you know, Okay,
brain fog. So the mental health, it could just be
mood swings because your hormones are literally swinging, they're decreasing,
and so mood swings, irritability, lolabido, and also just physical
(33:16):
symptoms of whether it is vaginal dryness that can also
contribute to your lo levito. So just for perimental pause
or just going through mental pause, look it out for
those symptoms of yes, hot you hear hot and cold flashes,
but also that cognitive of slowing or that brain fog, Hey,
I'm not as quick as I used to get Okay,
just give me some time. But mood swings that irritability
(33:39):
and that snappiness sometimes it can lead to depression. So
again it's different for ladies all ladies. So also you
can I ask, if you have a mom that you're
able to ask, Okay, what time when did you go
through this? How is your experiences because it may be
similar to hers, and so you can be on the
lookouts of those particular symptoms, but moved symptoms of just anxiety, depression, irritability,
(34:02):
just some type of what we call liability in your mood,
not knowing how I'm feeling, and also just I'm not
sleeping as well as I used to. And what are
my particular options? And I do, of course work with
the obgui ns about this, so I leave the hormone
replacement to them if they choose to go that route,
(34:24):
and if not, we still have medications from my standpoint
as relates to depression or anxiety, as well as we
have medications from a psychiatry standpoint for hot flashes. So
there are options and we work together. And if you
are on hormone replacement therapy, your obgui in can do that,
and so you may not need as much as medications
(34:45):
on my end for those hot flashes for that irritability
because now you have that replacement from a hormonal standpoint.
Speaker 1 (34:52):
So I would imagine that all of this is kind
of connected. But how do you distinguish between like anxiety
and depression symptoms that may be really it's a perimenopause
versus something that is just like maybe a generalized anxiety
disorder or major depressive disorder or does it even matter.
Speaker 2 (35:08):
I would say it matters, but then it doesn't doct
enjoy because the way that you would know if it's hormonal, okay,
you're getting your your levels checked and if you want
to elect to go to hormone replacement, okay, But it
doesn't really matter because we're going to treat it the
same way from my standpoint. So if you're having some depression,
(35:28):
you're having some anxiety, you're having some insomnia. If it
was not for your hormones and it was like more
of an I guess organic type of or depression or anxiety,
then I'm still going to give you your treatment recommendations
of Hey, this is what you can use for medications
you can use a villa faccine. We can use a
peroxytine for these symptoms. So it really doesn't matter because
(35:51):
I'm going to treat it the same way. But if
you really want the root, cause, let's get some of
your hormone levels, and if you elect to go this
way in terms of homo replacement therapy, you can. And
if you don't, then we can lean into my medications.
But if you elect to do both, we can do both.
So it kind of doesn't matter. It's all connected. It's biological,
it's psychological, it's got social aspects. So it's like a
(36:13):
biopsychosocial treatment plan that we all just have to agree
on and just know that, hey, we are working on
your team and we want to make sure that you
are living your life the way that you want to
and it's the best quality. Yeah, in all stages.
Speaker 1 (36:27):
You're right. So what would you say to a sister
Docum maybe who might be listening to us, and you know,
maybe she's in our forties or fifties and feels like
her mental health is kind of steadily unraveling. What kinds
of things would you say to her? And where should
she start?
Speaker 2 (36:40):
I would say, go see someone. Okay, if you have
any particular barriers from a mental standpoint, saying hey, I
don't want to go see anybody, I don't want to
tell anybody my business. I don't want to feel like
I need some help in my emotional well being. It
just makes me feel kind of weak. Just try your
best to push through it, because that's the hardest part.
(37:00):
And once you get to that person or you get
to that person that you vibe with, and you can
really kind of say, Okay, this is what I'm going through.
I do feel like I'm unraveling in my mid forties,
my fifties. I know things are off. What do you
got from me? And really educating yourself on your options,
educating yourself on hey, there are resources. I don't have
(37:22):
to be on medication. I just may need someone to
talk to and help me through this particular transition in
my life. We have never been this particular age before,
and so really giving yourself that grace and saying hey,
I may not have needed that help when I was thirty, However,
I have gone through a lot of things. Between thirty
(37:42):
and forty five, I have gone through a lot of
season changes, a lot of transitions, and perhaps my resilience
is not as much as it used to be. And
that's okay, that's not making me weak. It makes me
know that I need to lean into some support that
now I know I have resources.
Speaker 1 (37:59):
Yeah, any tips for advocating yourself with medical professionals.
Speaker 2 (38:04):
It's funny that you asked. I recently told one of
my clients. I said, hey, go back to that obgui
in and let her know that you want some birth control.
And so she was a patient that married, has been
married for several years, but they just wasn't not at
a stage where they wanted to have children, and going
to see her obguy in, she didn't bring up the
(38:28):
fact that she wanted to be on birth control, and
the provider didn't either, because the provider automatically assume you're married,
you were in your career, you have this particular support.
Why wouldn't you want to have children? And so we
really had to work on that conversation in our sessions
and say no, you can really advocate for yourself and
just say hey, no, please tell me more about my
(38:50):
birth control options. Tell me more because right now I
want to do proper family planning for me. And it
wasn't any particular knock for that provider. It was just
maybe it was some implicit bias of like, hey, I
just thought that she wanted to have children. She's married,
and she has this particular setup that I think, you know,
it's beneficial for bringing in a child, But really her
(39:13):
and myself and the patient really having those role playing
type of discussions in session and saying, no, I want
to know my options. Also, I wanted to know if
I want to be on a Monte phase or try
phase a birth control peel. So we're really knowing and
educating ourselves about options and making sure that we are
(39:33):
telling our providers what you desire and advocating and showing
up for yourself and having that voice. And so I'm
just the one in the background, just kind of just pushing, okay,
talk to her. So, yeah, she was my patient, she
got on her birth control. She is fine, she said, Okay,
I feel so I'm so less anxious. I'm so less anxious.
Speaker 1 (39:55):
Yeah, that's a really great suggestion, you know, role playing, right, like,
how can you role play with the tr to the
other person, what kinds of conversations you might neither have
with your primary care doctor? Or your obgyn or whoever. Yes, yeah,
any other resources or affirmations that you find yourself kind
of using in your practice.
Speaker 2 (40:13):
In my practice, so I'm a psychiatrist, but I say
I do a little sprinkle of adult psychotherapy within my
sessions for these of my clients, and so I do
lean in, especially with my very busy ladies, and just
those basic skills of mindfulness is just slowing down and
practicing stillness, and so we really do those mindful exercises
(40:33):
of just hey, you don't have to eat at your
desk at work. You could actually go to the break
room and you could actually eat mindfully in the breakroom
away from your computer. And those mindful are just those
breathing exercises, So just really slowing down because we are
in I think an anxious society because everything is so fast,
(40:55):
it's all at you at once, and so just taking
those moments to do that mindful exercise where it's eating,
whether it is breathing. When we're trying to go to
sleep and we're having some issues, do those progressive muscle relaxations,
So just really slowing down your movement, slowing down your mind,
so you really can practice being in that present moment,
(41:16):
and so I often give out mindful or DVT exercises
to my patients throughout the portal and just challenging those
negative thought patterns and changing our perspectives and again advocating
for yourself in those conversations. Hey, what do you truly desire?
Because we often do a lot of things for other people. Hey,
(41:37):
we are perhaps at an age now where we have
poured out enough and let's steit back and let's be
mindful and let's allow other support in to us, but
also let's teach them how we desire to be poured into.
Speaker 1 (41:51):
Yeah, so where can we stay connected with you? Doctor Mimi?
What is your website as well as any social media
channels you'd like to share?
Speaker 2 (41:58):
Yes, so my practice is community Health, So it's I
n N EER Community Health and that's innercommunity Health dot
com and you can find all information there. Resources. Also,
if you are a healthcare provider and you are looking
for reproductive psychiatrists, nurse practitioners, therapists, we have that in
(42:18):
house at our practice and you can actually click on
referral and we make sure that we can provide those
services for your clients. We see patients or clients in Georgia, Virginia, Maryland,
and Ohio, and of course we see those who are
not in Georgia virtually, but my social media handles are
doctrimimi dot care, so d r m imi dot care
(42:41):
on all social platforms. But yeah, and you can also
just call the practice and get with our concierge or
our office manager. And that's eight hundred sixty two zero
six nine five zero. So we just really want to
be a place where this is, yes for women, but
it is just for that total person to provide that
(43:02):
spectrum of care from whether it's individualized to group therapies,
also to intents of outpatient programming that we are going
to start this coming up late summer, so we're excited
about that and that's going to have a heavy focus
on those that have just reproductive issues. And also, hey,
we're showing active treatment, so if you do need that
(43:24):
particular time off, then hey, this is a place where
I can really get those coping strategies, it's culping skills,
and also be under physician's care. So we're just excited
about how we're scaling and growing and just be in
that place again that I desire during my life transitions.
Speaker 1 (43:42):
Thank you so much for that, Doctor mean we should
include all of that in the show notes. I'm so
happy doctor Sanders is able to join us for today's
episode to learn more about her and her work. We
should have visited the show notes at Therapy for Blackgirls
dot com Session four fifteen, and don't forget to text
this episode to two of your girls right now and
(44:03):
tell them to check it out. Did you know that
you could leave us a voicemail with your questions or
suggestions for the podcast. If you have books you'd like
us to review or movies you'd like to suggest, drop
us a message at Remo dot fm slash Therapy for
Black Girls and let us know what's on your mind.
We just might feature it on the podcast. If you're
looking for a therapist in your area, visit our therapist
(44:24):
directory at Therapy for Blackgirls dot com slash directory. Don't
forget to follow us on Instagram at Therapy for Black Girls,
and make sure to join us in our Patreon community
for exclusive updates, behind the scenes content, and much more.
You can join us at community dot Therapy for Blackgirls
dot com. This episode was produced by Elise Ellis, Indechubu
(44:45):
and Tyrie Rush. Editing was done by Dennison Bradford. Thank
y'all so much for joining me again this week. I
look forward to continuing this conversation with you all real soon.
Take it care what pet foot pen pot fast Woods
Welcome to the Therapy for Black Girls Podcast, a weekly
conversation about mental health, personal development, and all the small
decisions we can make to become the best possible versions
of ourselves. I'm your host, doctor Joy hard and Bradford,
a licensed psychologist in Atlanta, Georgia. For more information or
(00:32):
to find a therapist in your area, visit our website
at Therapy for Blackgirls dot com. While I hope you
love listening to and learning from the podcast, it is
not meant to be a substitute for a relationship with
a licensed mental health professional. Hey, y'all, thanks so much
(00:57):
for joining me for session four, p. Fifty of the
Therapy for Black Girls Podcast. We'll get right into our
conversation after a word from our sponsors. Reproductive health is
often discussed in terms of our physical bodies, but what
(01:18):
about our mental and emotional will being across the reproductive
black span. In today's conversation, I'm joined by doctor Mimi Sanders,
a board certified psychiatrist specializing in reproductive psychiatry, to help
us better understand the unique mental health needs that can
show up during menstruation, pregnancy, postpartum fertility challenges, pregnancy laws,
(01:40):
and menopause. We explore what reproductive psychiatry is, why it's
especially important for Black women, how mood and anxiety disorders
can show up during major reproductive transitions, and what it
looks like to advocate for yourself when navigating mental health
care during these seasons. Doctor Sanders also breaks down common
myths about medication during pregnancy and postpartum, and shares what supportive,
(02:04):
culturally responsive care should look like. If something resonates with
you while enjoying our conversation, please share with us on
social media using the hashtag TVG in Session, or join
us over in our Patreon to talk more about the episode.
You can join us at community dot therapy forro Blackgirls
dot com. Here's our conversation. Well, thank you so much
(02:28):
for joining us today, doctor Vivie.
Speaker 2 (02:30):
Oh, thank you for having me. I'm excited.
Speaker 1 (02:33):
Yeah. So, you had such a unique career journey thus
for so tell us about your career as a psychiatrist
and on reality television, And I think this is always
interesting for the sisters in the community who may be
exploring medicine. How did you choose psychiatry as a career path?
Speaker 2 (02:49):
Yes, very unique. I often tell myself, Hey, You never
know what is going to be around the corner, so
just be prepared to pivot. I'm originally from Alabama. I
went to undergrads at Tennessee State University, and at that
time I wanted to be a pharmacist and I was
doing like my chemistry and all the prerecs. But then
(03:10):
I discovered, hey, I you know, I like kind of
medicine as well. What does that look like? And I
entered into like a program after undergrad and it was
for just those who were just wanting to do more
medicine but not necessarily had really fully necessarily committed, but
I want to explore, and so I entered into this
(03:31):
program during the summer after I graduated from Tennessee State
University at Ohio University, and it was my first time
being exposed to what a doctor of osteopathic medicine was,
and it was really focused on general practition and those
of like primary care, and so I kind of fell
in love with really okay, I really like to know
(03:52):
everything about the person, and also behavioral health kind of
fell in that as well. So I entered into Ohio
University for a medical school and stay there, and it
was just different experience. I was coming from a historically
black university and now I am in Appalachia, So I'm like, okay, Lord,
you're giving me all types of experiences in my life.
(04:14):
And then just from there just met really good like
friendships and just really had a really good experience. And
I left there and went to Cleveland Clinic and from
there that did my residency. At that time, I had
decided on psychiatry, And your question was how did I
decide on that? And it was not until maybe one
(04:36):
of my last rotations as a medical student, I'm like, hey,
I don't like surgery. I'm not necessarily a person that
wants to do a true specialty of dermatology. I really
wanted to explore more yes of my primary general practitioner
kind of experience and background. But I found myself in
(04:58):
my clerkship of my rotation in psychiatry on an inpatient ward.
On that ward, I saw a lot of persons of color,
and I didn't see at that time where I was
doing my rotation of a lot of those in those
crisis situations of the majority. So I didn't see a
lot of those who are Caucasian, and I was wondering
(05:18):
why was that. And when I went from an in
patient setting to the outpatient setting, then I saw more
of those who were Caucasian and really exploring those preventative
measures of their mental health and emotional well being. And
that is kind of where I fell in love with psychiatry.
And I'm just like, you know what, I really know
that I can relate to a lot of individuals because
(05:41):
of my background and because of my life experiences, but
I really want to be a representative of that Black
community of a psychiatrist that we necessarily don't have to
see someone in crises. We can have that particular representative
as an outpatient and really work on what is proactive
in my own mental health health. I have someone that
(06:01):
I can relate to, I can talk about these things.
They understand my spirituality and they understand that, hey, I'm
not necessarily having a psychotist if I am talking to
the Lord. And so it was just that particular experience
that in me wanting to fill in that gap or
that void and be truly a representative of this is
(06:22):
what it looks like or what it could look like
for proactive preventative mental health and going to see a psychiatrist.
But funny story. Also, my mom, when I told her
I wanted to be a psychiatrist, her being from the
deep south of Alabama, she was like, so you going
to medical school and you're not going to be a
real doctor. And I said, mom, Mom, And so just
(06:43):
knowing that, and now she's very well educated and she
knows all things about mental health and going to see
someone and medications, and just knowing that that is how
we were. It's gotten much better now, but this is
how we thought about going to see a psychiatrist. So
that is kind of where I fell in love with it.
To be honest, I don't like to get down and
(07:06):
dirty in terms of physical exam Like I really loved
talking to people. I love doing that particular type of examination.
So that's how I landed.
Speaker 1 (07:15):
Yeah, I appreciate you sharing that story because I think
that that can pop up in lots of different ways, right,
Like not just stigma around like medical specialties, but also
I think the stigma related to mental health in some ways, right,
I think that is deep seated for a lot of
our families.
Speaker 2 (07:28):
Absolutely.
Speaker 1 (07:29):
Yeah, yeah, So is the focus on prevention that you
saw what led you to develop your private practice Inner
community Health.
Speaker 2 (07:37):
Yes and no. So my practice inner community health. It
started back in actually in COVID, so it was a
virtual practice. And so I was working while in COVID
as any psychiatrist as well as now self employed doing
my virtual practice. And usually during this time, I had
a lot of women reaching out because we were all
(07:59):
confined and we're like, okay, I can't set these particular
boundaries that I thought I had in terms of work
and life and children and husband and cooking and now
working again. And I had a lot of women reaching
out and say, hey, I need some help. I have
not navigated this before. And I said, well, let me
just open up my schedule and let's just see what
this looks like. And it was again mostly women. And
(08:23):
during that time, also as an employed psychiatrist, I was
working in Cleveland Clinics Women's mental health department and not
necessarily knowing what that was, but I just knew that
I was drawn to women that had these life experiences,
whether it was pregnancy loss, postpartum, postpartum depression as well
(08:46):
as anxiety, and them really wanting to come to the
office and really say, hey, I have a place to go,
I have someone that understands me and also me going
through my own particular journey in motherhood really made me gravitate.
So just disclosure my graduated residency, I was going through
(09:08):
my own particular transition like Okay, I'm attending, now what's next.
Got married during that first year, I lost my grandmother
during that first year out of residency, and I had
a miscarriage, and so going through all those particular life
transitions and not knowing where to turn. So here I
(09:28):
am as a psychiatrist telling my clients or patients these
coping strategies what to do, and I'm really not practicing
what I'm telling them. So I'm not practicing what I'm preaching.
And if I do want to have help or search
out that particular individual, I did not know where to go.
I knew myself because I need to go to someone
(09:49):
that I can receive this information from. I needed to
go to someone that I can feel that I can
relate to. And that is why I think, ultimately, Hey,
where is this place or how could I develop this
space this place where I as a mother, I as
a woman would want to go to and not go
(10:09):
to a particular place where it's not conducive to my
mental health, like my provider perhaps doesn't get me, or
like the physical location is kind of like dim and
not conducive to my mental health. It's not inviting or
giving me aspirations. And so that is what I wanted
to create for my women. I wanted to create a
space that I know that I would want to go to,
(10:32):
that I will feel comfortable and I know that I'm
getting the necessary tools that I know that I needed
at that time of my life.
Speaker 1 (10:39):
Yeah, so you have further specialized in reproductive psychiatry. Can
you say more about that specialty.
Speaker 2 (10:46):
So, reproductive psychiatry is basically a specialty in psychiatry where
we follow the women throughout her reproductive cycle. So that
can be whether it is challenges with infertility, whether it
is miscarriages or even elective or even spontaneous abortions, those
who are pregnant or desiring to get pregnant, those who
(11:08):
have had their child. And now maybe I'm going through
something that is further than the baby blues, maybe I'm
having some postpartum mood or anxiety symptoms or even psychosis.
And then also traveling with that woman when you go
through mental pause or perimental pausal symptoms, So really understanding
that we're very complex and we have hormones, we have
(11:31):
other challenges as relates to all the many things or
people that are pulling on to us, and so just
following her throughout her cycle, her journey just as a woman.
Speaker 1 (11:42):
And have you found that this reproductive kind of spectrum
is where many women actually turn to wanting to have
some mental health support or their particular challenges that you
found that pop up during this period that make somebody
more likely to seek out services.
Speaker 2 (11:56):
I have found that some women or just general population
don't know that we exist. And once they find out
that we exist and we are a place where we
can really relate to each other and hey, yes I'm
not sleeping and I'm forty five or I'm close to
mental pause. Is that something yes, we can really think
about that. Also having some cognitive or brain fog, Yes,
(12:20):
that may be associated with perimental pause. So really educating
others and letting them know that we exist and there
is help. And so I do say, yes, we productive psychiatry,
but it's just in general women's mental health and whatever
that means to you that if we don't have it here,
we can provide resources where it is for therapy met
(12:42):
management groups. So really understanding that we exist and educating
the population that this is a specialty in psychiatry.
Speaker 1 (12:50):
That can mean mean one of the things we talk
about on the podcast, and that I feel like lots
more women are talking about and getting diagnoses for things
like PCOS and endometriosis. We know that there's like the
medical kind of symptom side, Well, what are some of
the mental health challenges that come up with something like
a diagnosis like PCOS.
Speaker 2 (13:07):
Well with PCs, and this is like as we can
just generalize it as some times of ovarian challenge or
ovarian failure, and so there's a lot of symptoms that
may come with that, whether it's physical symptoms of like ecniques,
assive hair growth and fertility or problems conceiving, and so
(13:27):
that can really play a part in someone's mental health journey,
whether it is self esteem, whether that is some type
of guilt or shame and just anxiety. If you are
family planning, what does that look like for me? And
providing that support to that the client as well as
providing that support if you're working with your ovg U
(13:50):
I N I think it's very necessary those patients are
clients that I have with those particular diagnoses. They deal
with the uncertainty and so that uncertain of me wanting
to have a child, the uncertainty of what are these
medications that my obgi in has put me on, whether
it is some type of bird control peel, what type
of pill that is that gon'll cause me to have
(14:11):
some mood swings. So really supporting that patient through this
journey of whatever she chooses. Hey, I'm on this to
regulate any type of physical symptoms that I may be experiencing.
I'm on this medication to make sure that I'm putting
myself in the big chance to conceive or have a
family plan just knowing that, Hey, we see you, we
(14:33):
understand what you may be going through. There's some resources
here and it goes far to you on just medications,
it can just be okay, I'm here to listen. I'm
here to listen to for your concerns and what are
your goals we can have a treatment plan altogether.
Speaker 1 (14:48):
And what is your approach to medication management For somebody
who may be struggling with something like anxiety and depression
if they are also kind of on the fertility journey. Right,
So maybe they are taking fertility medications.
Speaker 2 (14:59):
What's that a So, to be honest, my ladies come
in apprehensive. They come in, Okay, I don't know about
these medications, and I heard about you psychiatrists. You guys
are going to prescribe these medications and I tell them, no,
it's individualize and I'm going to tell you my recommendations.
I'm going to also communicate to you that, hey, this
(15:20):
is what I am hearing from you in terms of
any impairment, whether it is in your sleep, your mood,
your appetite, just in any impairment in your quality of life.
And my job as a psychiatrist is to let you
know your options. And so if you are going on
your fertility journey and I can understand why you are
(15:40):
a little bit hesitant of adding another medication, I can say, hey,
there is limited research and that's just the nature of
it in terms of you're dealing with women of infertility
or pregnant women that we have limited research, but there
is some out there. But there is some reviews saying
that hey, even if you're on the medications like an SRI,
(16:01):
a selective serotonin uptake inhibitor and those different parameters in
terms of your ability to conceive. It has not shown
any particular detrimental effects of you in your inability to
conceive while you're going on this journey. But everything is
individualized to you, so we have to weigh out all
(16:24):
risk and benefits. As a psychiatrist or a medical doctor,
I work closely with the obguy is to make sure
I know all the medications that you're taking. We're doing
drug interactions, making sure my stuff is I'm missing with
her stuff, And it's really having that necessary collaborative care
to make you feel comfortable and let you know your options.
(16:45):
But I'm going to let you know hesis like, we
need to make sure that you are good because when
you do conceive that we are reducing our particular risk
of low birth rate or pre term labor. We're really
looking at the risk and benefits for you as well
as the baby. It's a team effort and understand and
(17:08):
that at the center of the team it's you as
the client and the patient. So I'm gonna tell you
my recommendations, the OBGUI is gonna tell you her recommendations,
and we're gonna all work together and make sure you
feel heard and sing mm hmm.
Speaker 1 (17:20):
You know another place where this often comes up around
do I take medication do I not? Is actually after
somebody has given birth, right and maybe they're breastfeeding, and
so there may be still some like anxiety depression symptoms
that medication actually could be really helpful for. But I
think a lot of new moms are very concerned like, oh,
this is gonna be harmful to the baby. Can you
talk a little bit about some of the considerations of
(17:42):
taking medication, like when you're breastfeeding.
Speaker 2 (17:44):
So if we're dealing with depression or anxiety, my go
to has been searchling and that's just how I have
been trained. They have those parameters you look for. Okay,
it's just safe the lactation.
Speaker 1 (17:55):
Yes it is.
Speaker 2 (17:56):
How does this work with when I'm pregnant? And do
I have to taper off my medications when I get
pregnant again? It depends on how you are doing and
making sure that we're weighing risk and benefits. Have I
had clients that have done great on this medication. Oh
you're pregnant, awesome, How are you feeling? What are your concerns?
(18:17):
And Doctor Sanders or doctor Mimi, I'm good, keep me
on my medication. Okay, I'm going to let you know
that we're going to be seeing each other a little
bit more frequently. I'm going to be monitoring your mood
and sending you all types of screenings to your portal
more frequently. And so I'm your extra set of ears
and eyes, and you tell me how you're feeling, whether
it's once a week, so really having that communication. But
(18:40):
there's research saying that hey, stand on this medication is
good for you and the baby, especially if you have
experienced depression in the past prior to pregnancy. We know
that you're at greater risk, and we want to make
sure that we're making an environment from a pregnancy standpoint,
from a postpartum standpoint that is conduces for you and
the child.
Speaker 1 (18:58):
Yeah. Yeah, more from our conversation after the break. So
in addition to conversations around medicine, we've already talked a
little bit about like unpacking the stigmas that are sometimes
(19:18):
related to things like fertility or just kind of I
think mental health in general in the black community. What
does that look like when you were working with your
clients to help them kind of unpack some of these stigmas.
Speaker 2 (19:28):
So considering that there perhaps would be some type of
going on a fertility journey, and depending on how long
you've been on it, there can be some issues around
your womanhood. And this is what I grew up of
wanting to I'm able to produce. This is how I
grew up people around me, this is what we were
(19:50):
made for in terms of women in order to have
a child. And if I'm having some type of challenges
or barriers, what does that mean for me as a woman?
And so I look at that and we challenge those thoughts.
We challenge those thoughts and say, Okay, what do you
believe in terms of your womanhood and do you know
your particular options when it comes to the different types
(20:11):
of assistant reproductive technology or fertility treatments. So really leading
into those particular thoughts that you have as a woman,
how you define your womanhood, challenging any particular shame, letting
you know that you don't have to go through this alone,
and if you feel yourself having to hide this or
(20:32):
feel is secretive, that here's a place that you can
really be vulnerable and have a deeper dive of what
that looks like for you going through this journey and
as it relates to taking medication, you take a medication
does not mean that you are weak. Does that mean
that you need a little bit extra push. No, it
just means that, hey, this is the right treatment option
for me in this season. And do I have to
(20:55):
be on medication for the rest of my life? No,
But if you want to, I have pages and say,
don't touch anything that I'm doing fine, I am operating,
I'm living the best quality of life. I really love
how I feel. And so it's really looking at that
person or the client making sure that I hear you.
I see you. I'm not devaluing your concerns, but I
(21:16):
want to educate you as much as possible and let
you also challenge any of those false beliefs that you
have had about what womanhood means to you and not
what the expectations have been placed on you.
Speaker 1 (21:31):
So you know what I mean. I feel like we've
had growing conversations around things like postpartum depression, postpartum anxiety.
But what kinds of things do you feel like we
still need to talk more about as it relates to
the postpartum period in a woman's life.
Speaker 2 (21:45):
So when we hear postpartum automatically. I've seen that patients
think postpartum depression, and we really are not leaning into
post part of anxiety, which I see more in my clinic.
Is that post part of anxiety and that separate racial
anxiety that the new mom has with her baby. I
also think that we need to lean more into what
(22:07):
does me returning to work look like? And what does
this new normal look like? And is there options for
me to spend more time to bond with my baby
and what does that look like? And so I have
had many patients come to me and say, I'm just
not ready to return to work. I fear that no
(22:28):
one can take care of that baby like I can.
I feel that I'm going to miss out on some
particular mouthstones when I'm at work. And then we look
at that and said, okay, what else do you need?
And so what was your postpartum plan and have we
deviated from that? If so, how are we in terms
of our pivot? What are our options and what are truths? So, yes,
(22:52):
you are doing a great job as a mom, and
you have those particular safety concerns, but is that postpartum
anxiety leaning more in terms of obsessiveness? And you having
to check that monitor a little bit too often. Now
you can't take care of yourself and you're not sleeping.
We're trying to get the sleep that you can on
when the baby is sleeping. So just leading more into
(23:13):
looking into post part of anxiety and not always thinking
that it's postpartum depression and that post part of anxiety
can lead to secondary depression, but really saying, okay, what
is that anxiety? Is it interfering with me taking care
of myself therefore also interfering with me taking care of
my baby the best way I can. What does that
(23:33):
separation anxiety look like? And what is realistic plans for
me to return to work? And if I'm not ready,
how can I have that conversation with my physicians or
with your psychiatrists so we can have a really good
plan for you and the child.
Speaker 1 (23:48):
So how do you know, doctor Mimi, if something is
just normal kind of especially for first time moms, right, like,
how is it different? How is just regular new mom anxiety? Like,
oh my gosh, what do I do? How do I
take care of this baby? How do you know when
it is crossed the line to be the something that
might meet criteria for anxiety and that you might need
to talk with someone about it.
Speaker 2 (24:06):
So I asked them to give me a time period.
So let's just say, Okay, I'm anxious got your baby's safety.
And so I'm asking you, well, how many times are
you checking that monitor? And when are you checking it?
And some patients will say I'm not even checking the
monitor and I'm sleeping outside the door, or you know,
(24:26):
Or I said, well, have we interview if you do
a daycare, have we interviewed any particular nannies. They have
this idea of the baby can come with them, she
can't leave them and go to target with her mother.
What she knows is a safe person. And so I'm
asking them, okay, how are you maneuvering through life? And
how many hours out the day are you having to
(24:49):
obsess over the safety your concerns for your child. And
I look at that and say, okay, out of the
twenty four hour period you're spending just say this twelve
hours plus really focusing on hey, what if I did
not bathe the baby right? What if they did not
shake up the bottle this many times at that feeding?
(25:12):
So just really looking into those particular thoughts and say Okay,
are they rational? Were you thinking like this prior to pregnancy?
And don't just really having that good interview with the
mom and just debunking those particular myths of no one
can take care of the baby like you can. Granted
you are that child's mom and you have that particular bonding,
(25:34):
but also you know that you have to have some
support and knowing that, hey, I can trust my partner,
I can trust any other family supports around me, so
I can take care of myself. Are you showering? Are
you feeding yourself? Are you really taking care of yourself?
And has those things gone neglected because of you obsessing
or being very anxious about your child? So we really
(25:58):
take a deeper dive of like what does this look like?
And it's this, Okay, it's this rational for you. And
so I will find my lady saying no, I should
be able to not sleep outside the door, or I
should be able to leave my baby with my mom
in order for me to go get me a cup
of soup or something. So it's just really listening to
(26:18):
her and allow herself to listen to her own thoughts
and challenging and facilitating the challenging of those thoughts. So,
but really again leaning into that postpart anxiety, that separation,
that guilt of hey, I'm going to miss every milestone
if I do return to work. No, no, no, you're not.
You are You are engaged in your child's development, and
(26:40):
you will know and you will be able to experience
those things. But we are not devaluing how you're feeling.
We just want to make sure that you're taking care
of yourself. M h.
Speaker 1 (26:49):
You mentioned the baby monitor, and I feel like technology
has evolved so much beyond monitors, right, so now there's
a little sock the baby can wear, there's something you
can put under their mattress. How do you feel about
these tools, Like do you feel like they're actually helping
moms and parents to kind of manage anxiety or do
you feel like in some ways they can kind of
increase the anxiety.
Speaker 2 (27:09):
In some ways, it's increasing it because now you have
different parameters that you're trying to make sure that you're
staying within. It's just a lot of noises and things
and notifications are going out. And so imagine if you're
already anxious and your hormones are already all over the place,
and now you're having all these apps and notifications come
on your phone, and so I would tell them, hey,
(27:31):
let's just turn off too, Let's turn it off, and
then okay, how are we feeling? We feel it? Okay,
was baby girl? Baby boy? Okay? Yes, we can still
watch the monitor and if you're at daycare, yes, zoom
in and let me see what you guys are doing
over there. But we have to make sure that we
are not exaggerating our anxiety with all these developments and technology,
(27:52):
but still understanding that. Yeah, especially as first time moms,
like this is my first baby. I've gone through this
particular journey to have this child, and so I value
that I see that. But we have to make sure again,
how are you mom, because we cannot neglect ourselves because
we have someone else that kind of come into the picture.
We also lean into your support. So instead of those notifications,
(28:17):
if you are fortunate enough to have that family support,
lead into that instead of you know, the technology and notifications.
Speaker 1 (28:24):
So, speaking of support, like what kinds of things would
you say to partners and other family members about how
to support somebody who is kind of in the postpartum
period and maybe how to recognize like when they need
to escalate and talk to somebody else.
Speaker 2 (28:39):
I recently did a recertification in my perinatal mental health class,
and we talked about a postpartum plan and sharing that
plan of course with your supports prior to the birth
of the baby, and during that conversation or during that
(29:00):
eyelock with your support, letting them know and also being
educated as the patient of what this does look like.
If I am having some type of irritability, mood, anxiousness,
and so if I do start to exhibit some of
those particular signs and symptoms, then this is how I
(29:21):
wish for you to communicate to me about what you see.
And I'm very opened for you to communicate that to
me because once I give birth, I know that I'm
going to have some fluctuations in my mood, some fluctuations
due to my hormones, and so I may not be
able to recognize that within myself. So during my postpartum
(29:43):
plan that I'm doing pre baby, I really need you
to let me know how I'm doing. Encourage me to
take care of myself, make sure that I have meals
because my focus will be whether it's breastfeeding or feeding
that baby. So make sure that you're taking care of
me as I'm trying my best to take care of
my new born. So having that conversation pre baby, setting
(30:05):
a postpartum plan with your family members or that loved
one or that partner, I think it will be very
very helpful. And then also, hey, if I get to
a point where I'm unable to receive from you, who's backup,
who's your backup that can that can communicate to me?
And also making sure that you, if it is my partner,
(30:26):
how are you going through this process? And I don't
want you to neglect your needs, partner, so you make
sure that you have your own particular support. So having
a postpartum plan pre baby, I thought it was very
good advice that they were giving us to tell our
clients let's develop it, but also not be so rigid
that we have to stick to it, and so we
know areas where we can pivot. But hey, please let
(30:49):
me know if I am not having the quality of
life that you know that I should have. So making
sure my basics, eating, my social connectivity, my sleeping, so
help me out because we're not going to get the
sleep that we did. But what does this look like
now for me? To make sure as I have gone
through this experience of giving birth, making sure that I
(31:11):
am sleeping good. And then again, well you're not exercising,
but when I can, and if that's something that I
used to like to do, encourage me because that also
has its added benefits.
Speaker 1 (31:22):
Are there any resources in particular that you knew of,
doctor Mimi that are specifically for men to support the
women in their lives around reproductive psychiatry.
Speaker 2 (31:31):
So there's a website and Postpartum Support International and so
on that website. It has different tabs and it's also
they have support groups for partners that you can kind
of put in your zip code figure out where you
could go whether and also if it is virtual for
your partners and they can have male groups and then
(31:52):
also other partner relationship groups. And I believe that was
a really good website. And also on that website directory
for those who are reproductive psychiatrists or how do I
find a provider? And so that is kind of a
website that I give my clients if you're looking for
support groups, if you're looking for other providers, therapists, other psychiatrists,
(32:13):
just other resources when you're going through this perinatal journey.
Speaker 1 (32:17):
Thank you for that. More from our conversation after the break.
So earlier in our conversation you talked a little bit
about you know, we spend a lot of time talking
about like the fertility journey, postpartum kind of pre postpartum,
(32:38):
but also perimenopause and menopause, right, is another part of
this psycho that women go through. You mentioned it like
brain fog and like some cognitive concerns. What are some
of the particular mental health kinds of symptoms that we
see kind of in this perimenopause menopause stage.
Speaker 2 (32:54):
Well, and just self disclosure, like I'm freezing the whole
house out in terms of high insomnia, you know, Okay,
brain fog. So the mental health, it could just be
mood swings because your hormones are literally swinging, they're decreasing,
and so mood swings, irritability, lolabido, and also just physical
(33:16):
symptoms of whether it is vaginal dryness that can also
contribute to your lo levito. So just for perimental pause
or just going through mental pause, look it out for
those symptoms of yes, hot you hear hot and cold flashes,
but also that cognitive of slowing or that brain fog, Hey,
I'm not as quick as I used to get Okay,
just give me some time. But mood swings that irritability
(33:39):
and that snappiness sometimes it can lead to depression. So
again it's different for ladies all ladies. So also you
can I ask, if you have a mom that you're
able to ask, Okay, what time when did you go
through this? How is your experiences because it may be
similar to hers, and so you can be on the
lookouts of those particular symptoms, but moved symptoms of just anxiety, depression, irritability,
(34:02):
just some type of what we call liability in your mood,
not knowing how I'm feeling, and also just I'm not
sleeping as well as I used to. And what are
my particular options? And I do, of course work with
the obgui ns about this, so I leave the hormone
replacement to them if they choose to go that route,
(34:24):
and if not, we still have medications from my standpoint
as relates to depression or anxiety, as well as we
have medications from a psychiatry standpoint for hot flashes. So
there are options and we work together. And if you
are on hormone replacement therapy, your obgui in can do that,
and so you may not need as much as medications
(34:45):
on my end for those hot flashes for that irritability
because now you have that replacement from a hormonal standpoint.
Speaker 1 (34:52):
So I would imagine that all of this is kind
of connected. But how do you distinguish between like anxiety
and depression symptoms that may be really it's a perimenopause
versus something that is just like maybe a generalized anxiety
disorder or major depressive disorder or does it even matter.
Speaker 2 (35:08):
I would say it matters, but then it doesn't doct
enjoy because the way that you would know if it's hormonal, okay,
you're getting your your levels checked and if you want
to elect to go to hormone replacement, okay, But it
doesn't really matter because we're going to treat it the
same way from my standpoint. So if you're having some depression,
(35:28):
you're having some anxiety, you're having some insomnia. If it
was not for your hormones and it was like more
of an I guess organic type of or depression or anxiety,
then I'm still going to give you your treatment recommendations
of Hey, this is what you can use for medications
you can use a villa faccine. We can use a
peroxytine for these symptoms. So it really doesn't matter because
(35:51):
I'm going to treat it the same way. But if
you really want the root, cause, let's get some of
your hormone levels, and if you elect to go this
way in terms of homo replacement therapy, you can. And
if you don't, then we can lean into my medications.
But if you elect to do both, we can do both.
So it kind of doesn't matter. It's all connected. It's biological,
it's psychological, it's got social aspects. So it's like a
(36:13):
biopsychosocial treatment plan that we all just have to agree
on and just know that, hey, we are working on
your team and we want to make sure that you
are living your life the way that you want to
and it's the best quality. Yeah, in all stages.
Speaker 1 (36:27):
You're right. So what would you say to a sister
Docum maybe who might be listening to us, and you know,
maybe she's in our forties or fifties and feels like
her mental health is kind of steadily unraveling. What kinds
of things would you say to her? And where should
she start?
Speaker 2 (36:40):
I would say, go see someone. Okay, if you have
any particular barriers from a mental standpoint, saying hey, I
don't want to go see anybody, I don't want to
tell anybody my business. I don't want to feel like
I need some help in my emotional well being. It
just makes me feel kind of weak. Just try your
best to push through it, because that's the hardest part.
(37:00):
And once you get to that person or you get
to that person that you vibe with, and you can
really kind of say, Okay, this is what I'm going through.
I do feel like I'm unraveling in my mid forties,
my fifties. I know things are off. What do you
got from me? And really educating yourself on your options,
educating yourself on hey, there are resources. I don't have
(37:22):
to be on medication. I just may need someone to
talk to and help me through this particular transition in
my life. We have never been this particular age before,
and so really giving yourself that grace and saying hey,
I may not have needed that help when I was thirty, However,
I have gone through a lot of things. Between thirty
(37:42):
and forty five, I have gone through a lot of
season changes, a lot of transitions, and perhaps my resilience
is not as much as it used to be. And
that's okay, that's not making me weak. It makes me
know that I need to lean into some support that
now I know I have resources.
Speaker 1 (37:59):
Yeah, any tips for advocating yourself with medical professionals.
Speaker 2 (38:04):
It's funny that you asked. I recently told one of
my clients. I said, hey, go back to that obgui
in and let her know that you want some birth control.
And so she was a patient that married, has been
married for several years, but they just wasn't not at
a stage where they wanted to have children, and going
to see her obguy in, she didn't bring up the
(38:28):
fact that she wanted to be on birth control, and
the provider didn't either, because the provider automatically assume you're married,
you were in your career, you have this particular support.
Why wouldn't you want to have children? And so we
really had to work on that conversation in our sessions
and say no, you can really advocate for yourself and
just say hey, no, please tell me more about my
(38:50):
birth control options. Tell me more because right now I
want to do proper family planning for me. And it
wasn't any particular knock for that provider. It was just
maybe it was some implicit bias of like, hey, I
just thought that she wanted to have children. She's married,
and she has this particular setup that I think, you know,
it's beneficial for bringing in a child, But really her
(39:13):
and myself and the patient really having those role playing
type of discussions in session and saying, no, I want
to know my options. Also, I wanted to know if
I want to be on a Monte phase or try
phase a birth control peel. So we're really knowing and
educating ourselves about options and making sure that we are
(39:33):
telling our providers what you desire and advocating and showing
up for yourself and having that voice. And so I'm
just the one in the background, just kind of just pushing, okay,
talk to her. So, yeah, she was my patient, she
got on her birth control. She is fine, she said, Okay,
I feel so I'm so less anxious. I'm so less anxious.
Speaker 1 (39:55):
Yeah, that's a really great suggestion, you know, role playing, right, like,
how can you role play with the tr to the
other person, what kinds of conversations you might neither have
with your primary care doctor? Or your obgyn or whoever. Yes, yeah,
any other resources or affirmations that you find yourself kind
of using in your practice.
Speaker 2 (40:13):
In my practice, so I'm a psychiatrist, but I say
I do a little sprinkle of adult psychotherapy within my
sessions for these of my clients, and so I do
lean in, especially with my very busy ladies, and just
those basic skills of mindfulness is just slowing down and
practicing stillness, and so we really do those mindful exercises
(40:33):
of just hey, you don't have to eat at your
desk at work. You could actually go to the break
room and you could actually eat mindfully in the breakroom
away from your computer. And those mindful are just those
breathing exercises, So just really slowing down because we are
in I think an anxious society because everything is so fast,
(40:55):
it's all at you at once, and so just taking
those moments to do that mindful exercise where it's eating,
whether it is breathing. When we're trying to go to
sleep and we're having some issues, do those progressive muscle relaxations,
So just really slowing down your movement, slowing down your mind,
so you really can practice being in that present moment,
(41:16):
and so I often give out mindful or DVT exercises
to my patients throughout the portal and just challenging those
negative thought patterns and changing our perspectives and again advocating
for yourself in those conversations. Hey, what do you truly desire?
Because we often do a lot of things for other people. Hey,
(41:37):
we are perhaps at an age now where we have
poured out enough and let's steit back and let's be
mindful and let's allow other support in to us, but
also let's teach them how we desire to be poured into.
Speaker 1 (41:51):
Yeah, so where can we stay connected with you? Doctor Mimi?
What is your website as well as any social media
channels you'd like to share?
Speaker 2 (41:58):
Yes, so my practice is community Health, So it's I
n N EER Community Health and that's innercommunity Health dot
com and you can find all information there. Resources. Also,
if you are a healthcare provider and you are looking
for reproductive psychiatrists, nurse practitioners, therapists, we have that in
(42:18):
house at our practice and you can actually click on
referral and we make sure that we can provide those
services for your clients. We see patients or clients in Georgia, Virginia, Maryland,
and Ohio, and of course we see those who are
not in Georgia virtually, but my social media handles are
doctrimimi dot care, so d r m imi dot care
(42:41):
on all social platforms. But yeah, and you can also
just call the practice and get with our concierge or
our office manager. And that's eight hundred sixty two zero
six nine five zero. So we just really want to
be a place where this is, yes for women, but
it is just for that total person to provide that
(43:02):
spectrum of care from whether it's individualized to group therapies,
also to intents of outpatient programming that we are going
to start this coming up late summer, so we're excited
about that and that's going to have a heavy focus
on those that have just reproductive issues. And also, hey,
we're showing active treatment, so if you do need that
(43:24):
particular time off, then hey, this is a place where
I can really get those coping strategies, it's culping skills,
and also be under physician's care. So we're just excited
about how we're scaling and growing and just be in
that place again that I desire during my life transitions.
Speaker 1 (43:42):
Thank you so much for that, Doctor mean we should
include all of that in the show notes. I'm so
happy doctor Sanders is able to join us for today's
episode to learn more about her and her work. We
should have visited the show notes at Therapy for Blackgirls
dot com Session four fifteen, and don't forget to text
this episode to two of your girls right now and
(44:03):
tell them to check it out. Did you know that
you could leave us a voicemail with your questions or
suggestions for the podcast. If you have books you'd like
us to review or movies you'd like to suggest, drop
us a message at Remo dot fm slash Therapy for
Black Girls and let us know what's on your mind.
We just might feature it on the podcast. If you're
looking for a therapist in your area, visit our therapist
(44:24):
directory at Therapy for Blackgirls dot com slash directory. Don't
forget to follow us on Instagram at Therapy for Black Girls,
and make sure to join us in our Patreon community
for exclusive updates, behind the scenes content, and much more.
You can join us at community dot Therapy for Blackgirls
dot com. This episode was produced by Elise Ellis, Indechubu
(44:45):
and Tyrie Rush. Editing was done by Dennison Bradford. Thank
y'all so much for joining me again this week. I
look forward to continuing this conversation with you all real soon.
Take it care what pet foot pen pot fast Woods
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