My PMAD (Perinatal Mood & Anxiety Disorder) Gets No Respect! Part One

Rodney-Dangerfield-no-respect

 

Happy Thursday, my friends!

In the wake of the recent Marianne Williamson “just pray and meditate and love postpartum depression away” sh*tstorm, I’d like to share this post with you again. When I published it seven months ago, I tagged it incorrectly and it didn’t reach many people.

I want this information out there…more now than ever before. Yesterday I was rebuffed by a Very Important Bipolar Advocate who doesn’t think my (arguably) least-known form of bipolar disorder and least-known perinatal mood and anxiety disorder matters.

It matters. 

If you reblog this, you’ll get paid! (in good karma! 😉

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Since 2013 I’ve abstained from writing this post because I worried it wouldn’t apply or appeal to most of you, even if you have bipolar disorder.

I finally decided to spill the beans.

Why?

Because it feels good, it’s free, and most importantly, there’s the chance this information may be relevant to a reader, maybe even you!

Postpartum bipolar disorder is often ignored or misunderstood by the postpartum and bipolar communities. It helps to know what postpartum bipolar disorder is, exactly, as different definitions are floating around the world.

So here goes – PPBD 101, if you will! 😉

My mood disorder postpartum bipolar disorder (PPBD) is also sometimes referred to as bipolar, peripartum onset in the DSM-5. (Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association and widely used by psychiatrists to classify mental disorders.) While I’m currently seeking a more recent statistic, in 2008 it was found in the United States that 29 out of 1000 women were affected by postpartum bipolar disorder.*

Here’s what PPBD is not:

PPBD is NOT postpartum depression (PPD or PND) or antenatal (during pregnancy) depression.

PPBD is NOT postpartum obsessive compulsive disorder. 

PPBD is NOT postpartum anxiety, postpartum panic, or postpartum post-traumatic stress disorder/PTSD. 

PPBD is NOT postpartum psychosis (PPP).  

It’s important to note that postpartum psychosis and postpartum bipolar disorder often manifest together, but postpartum bipolar disorder is NOT always accompanied by postpartum psychosis. 

To reiterate, the two severe mental illnesses PPP and PPBD are NOT always one and the same!

 

Unfortunately medical professionals, websites, and articles are misinforming the public about the correct definitions of PPP and PPBD.  

Most of the time PPBD is omitted from lists of perinatal mood and anxiety disorders (PMAD’s).

This bums me out, especially when these omissions occur on high-traffic websites, which I’ll discuss in Part Two as there’s a twist involved.

Here’s an example of the kinds of errors I encounter:

In order for me to be notified of the latest perinatal mental health research, I created a Google alert for the phrase “postpartum bipolar”. Once in a blue moon I’m alerted about women with PPBD who are profiled in the media, such as this article that popped up last month about an awesome mom named Sarah Hutchison. 

Sarah Hutchinson is someone who fits the PPBD diagnosis bill, and it turns out I know her from my Facebook days.

As cool as journalist Karen Longwell’s “Sarah Hutchison Finds a New Path” article is, the piece contains subtle-yet-erroneous information. Sarah was diagnosed with postpartum bipolar disorder in 2008. Longwell states, “On Mother’s Day, 2010, she was hospitalized and doctors determined she had bipolar disorder, but it was no longer a postpartum illness.”  

Gong!  

Longwell was off the mark. Once a mother is diagnosed with postpartum bipolar disorder, she has bipolar disorder. The “postpartum” qualifier simply explains when the bipolar disorder was triggered.  

A 2013 CTVNews article that got PPBD right was titled “Baby Pinks? Postpartum Euphoria Can Be As Dangerous as Baby Blues“. It contains an interview with a Toronto-based psychotherapist specializing in postpartum mental health named Maya Hammer.

Regarding postpartum hypomania and mania Hammer remarked, “In many women, the condition eventually clears up. But for others, it’s the beginning of a long battle with postpartum bipolar disorder.” 

“Long battle” is an excellent way to put it. 

I’ve suffered with PPBD since 2007 and until there’s a cure, my battle shall continue. I was so glad to find this article, and I wish there were more mainstream articles published with such accurate information.

I was faced with a more significant error a few weeks ago.

I spoke with a local psychiatrist who told me that he considered postpartum bipolar disorder and postpartum psychosis to be the same.  While postpartum psychosis often presents with manic symptoms, which is what makes this all confusing, it’s not always associated with postpartum bipolar.

In other words, I had postpartum mania, but I wasn’t psychotic. The stack of my hospital records delineating my diagnostic codes and symptoms and behaviors backs that up.

Make any sense? I know it’s confusing.

Despite my nine years of PPBD research, after my exchange with the physician, I grew paranoid about my knowledge, so I consulted a doctor and nurse who have studied perinatal mood and anxiety disorders in depth. I couldn’t believe my luck – within just an hour of my contacting these brilliant, busy women, they emailed me substantive, definitive research material supporting that PPP and PPBD can most definitely be two separate conditions.  

In the DSM-5 there is a peripartum onset specifier with bipolar disorder (pp. 152-153 DSM 5). I was emailed a scan of the DSM-5 pages so I could see it for myself. There is no mention of psychosis in the section which includes peripartum onset of bipolar disorder

After my friends came to my rescue, I felt confident enough to email the doctor. I haven’t received a reply yet.

The fact that even perinatal psychiatrists experts aren’t clear about what postpartum bipolar disorder entails is a major reason why I’m writing my book. Part Two of this blog post will further examine about why any of this really matters.

I’ll explain the Postpartum Progress conundrum and throw in an ode to my high school English teacher – it’s all connected. 

Part Two will be published next Thursday – thanks for reading!!

Have an awesome 4th of July!

take care,

Dyane

 

Thanks to my mentor Dr. Walker Karraa and the extraordinary mental health advocate/mom Ann Preston Roselle of Bipolar and Me  for medical research assistance. 

Dyane’s memoir Birth of a New Brain – Healing from Postpartum Bipolar Disorder with a foreword by Dr. Walker Karraa (author of  Transformed by Postpartum Depression: Women’s Stories of Trauma and Growthwill be published by Post Hill Press in Fall, 2016. 

*Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS

Stable, Manic & Depressed Letters to the Editor – My Greatest Hits!

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Suellene Petersen, Editor-in-Chief of the Press Banner

Suellene joined the Press Banner staff last year and I’ve become a fan. One obvious reason is because Suellene liked my recent Letter to the Editor I sent her last week. (My letter appears at the end of this post.) I also love seeing a woman in this job because female newspaper editors are rare.

I’m excited that Suellene will help me promote our mountain community’s only free support group for women with mood disorders. She’ll feature an article about the “Women with Mood Disorders” support group sometime during May, Mental Health Month. 

And now, on to the nitty gritty:

Over the years when I’ve become particularly defrosted about an issue, I’ve taken the opportunity to write a Letter to the Editor to a local paper. I don’t usually write these missives when I’m placid. (The exception is when I’m writing a thank-you letter; those are always fun and easy to write.)

My modus operandi is to write when I’m seething. My blood pressure soars as I pound away at my innocent keyboard, but writing serves as a beautiful catharsis. I always feel better after I’m done.

So is writing a Letter to the Editor free therapy?

Yes!

I’m sharing some of my favorite letters with you.  

One time when I was very peeved I wrote to the acclaimed editor-in-chief/author Greg Archer. Ironically, my hissy fit led to a fantastic friendship and writing mentorship that thrives to this day!

I encourage you to write your own Letter to the Editor. Who knows what might happen? If your letter gets published, I’ll share it in a future blog post!

I’ll start with a shiny, happy letter that was written when I was depressed:

Good Times, February 2011, “Nice ‘Peer’”

Thank you, Gretchen Wegrich, for your excellent articlePeer to Peerabout Mental Health Client Action Network’s incredible array of community services for those suffering with mood disorders (GT 2/11). At age 37, I was diagnosed with bipolar disorder. Last year I founded the Santa Cruz County Chapter of the DBSA (Depression and Bipolar Alliance) which offers free, confidential peer support groups for those living with bipolar disorder and/or depression. The way I see it, the more high-quality, safe peer support groups, the better! For more information about DBSA Santa Cruz please visit DBSA’s website, http://www.dbsalliance.org.
Dyane Leshin-Harwood, Santa Cruz

There’s the “I’m Trying to Gain Points with My Husband By Promoting His Book” category:

Good Times, June 2013, “Good Flight”

Thank you so much for writing this fine piece on Craig Harwood’s book Quest for Flight: John J. Montgomery and the Dawn of Aviation in the West.  It’s cool to know that we had an aviation pioneer in our very own neck of the woods.

Dyane Leshin-Harwood | Santa Cruz

Backstory is needed for the next letter, which was written in 2013:

In 2013, I was in the process of tapering off my bipolar meds. I landed a book deal about living without medication, with a foreword by Dr. Liz Miller. This brilliant woman was featured in Stephen Fry’s documentary The Secret Life of the Manic Depressive and she was the first female neurosurgeon in the U.K. Dr. Miller had bipolar disorder, and she lived an entire decade without medications, remaining stable. She was working as a general physician when I connected with her, and doing well. My book deal was with a different publisher than my current one. When I relapsed, I had to back out of my contract with the publisher, and I was hospitalized three times within two months.  

There were only two positives to that experience. 1) I fully accepted medication into my life and stopped demonizing it, and 2) This letter led to my finding a kindred spirit friend.

The following letter was written during a fit of manic pique.

Good Times, February 2013,  There Are ‘Silver Linings’

For years I have enjoyed Greg Archer’s articles; moreover, I loved his book Shut Up, Skinny Bitches! but I respectfully disagree with his movie review of  Silver Linings Playbook. I was diagnosed with bipolar in 2007 just six weeks postpartum. I almost lost my life to this mental illness numerous times, but I am now in remission. (I’ll be explaining how I became well holistically in my book to be published in 2014.) My L.A. Philharmonic violinist father was diagnosed with bipolar disorder, so I witnessed firsthand how bipolar could destroy a family.

Mr. Archer states that actor Bradley Cooper “lacks believability” and is “grating on the nerves.” I felt that Bradley Cooper’s portrayal of a man with bipolar disorder was accurate and heartfelt. I loved this movie; and it made me become a Robert DeNiro fan as well. I hope it wins Best Picture at the Academy Awards! To cope with this stigmatizing mood disorder, I founded the DBSA (Depression and Bipolar Support Alliance) of Santa Cruz County, which offers free, peer-run support groups for those suffering from bipolar and/or depression and DBSA also serves as a resource to family members and friends. For information email dyane@baymoon.com
Dyane Leshin-Harwood, Ben Lomond

Then there’s the Bermuda Triangle region of my brain that doesn’t remember reading the Malibu Times, nor writing a letter to them that follows the Malibu Times article excerpt below! 

“Fit to serve, Peak says,” by  Knowles Adkisson , Associate Editor of the Malibu Times, July 26, 2012

Last week, Malibu City Councilmember Skylar Peak confirmed that he was diagnosed with bipolar disorder by a doctor at UCLA in early May. Peak attributed the diagnosis to stress caused by personal issues involving his family. Peak said he is currently taking lithium, a common medication used to treat bipolar disorder. Peak said he has no plans to step down or take a leave of absence from the City Council. 

When asked if he is currently mentally fit to serve on the City Council, Peak responded, “My answer is absolutely, 100 percent, there’s no question.”Currently, Peak said he is taking 1200 milligrams of lithium per day. Peak said he had never taken prescription medications before he was diagnosed with bipolar disorder in early May. Since his diagnosis, he said he has had two separate voluntary one-week stays as part of his treatment at a treatment center in Sedona, Arizona, called the Alternative to Meds Center. In late May, Peak left for a two-week surfing trip to Indonesia, which caused him to miss the May 29 meeting of the City Council.

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Malibu Times Editor’s note: The following is a comment from malibutimes.com in response to the article “Fit to serve, Peak says,” July 26, 2012

Malibu Times, August 2012, “Stop the Stigma”

Bravo to Skylar Peak! I commend you so much for being “out” about having bipolar disorder and for asserting that you are mentally fit to serve on the council.

I grew up in Pacific Palisades, the daughter of a manic depressive first violinist who was lauded by Leonard Bernstein for his musical genius. Many people in my father’s orchestra have mood disorders as well as in all branches of the entertainment industry. This is a well-documented fact –  – see Dr. Kay Redfield Jamison’s book Touched With Fire.

I, too, have bipolar disorder. I am a University of California college graduate, and I’ve been married for over a decade with two remarkable little girls. I founded the DBSA (Depression and Bipolar Support Alliance) Chapter of Santa Cruz County, which offers free, peer-run support groups to those with mood disorders.

I’m sure a good part of the Los Angeles population has bipolar disorder and they don’t have the ability to be open about their disorder for many compelling reasons, sadly, mainly due to the social stigma. Many people with bipolar are known to be unusually talented but they are shunned.

Like Skylar, I take lithium. I take 900 mg a day, and I fall within the therapeutic range as far as blood levels go (I used to take 1200). I just wanted to take a little less as long as my blood levels were safe.

If you have bipolar disorder or know someone who does, and you need support, please contact NAMI (National Alliance on Mental Illness) and/or DBSA (Depression and Bipolar Support Alliance).

Be proud of who you are. People with bipolar disorder are no different than those with cancer or diabetes. Stop the stigma!

Dyane Leshin-Harwood, Santa Cruz

And continuing with the anti-stigma campaign in my hometown:

This Letter to the Editor addressed the use of the word “crazy” in response to another resident’s Letter to the Editor. I was very gung-ho when I wrote my two cents; I’ve softened my stance since then, but I stand by what I wrote:

Press Banner, May 10, 2012Avoid stigmatizing mental illness”

EDITOR,

I agreed with every word of Claudio Sebastian Nobile’s letter to the editor (“Reading stunt sets bad example,” Letters, May 4) until the last sentence, in which Nobile stated “…be more like an adult, not like a crazy person.” I take issue with the word “crazy,” as it perpetuates the stigma of mental illness. A better way to express himself might have been “not like a person with poor judgment.” As the mother of two young girls, I’m teaching them that it is not OK to use the word “crazy,” as it is derogatory. I hope Mr. Nobile, a fellow parent, will act as a good role model to his girls when it comes to using appropriate language and helping our world break the stigma of mood disorders.

Dyane Leshin-Harwood, Ben Lomond

I was happy that the Press Banner chose to publish my letter.  I received two comments on their website in response to my letter. One comment was positive, and the other one, submitted by “Crazy Guy” was ignorant and rude.  He wrote:

“So now were not supposed to use the word “crazy” too? Add that to the list of forbidden words along with midget, colored, negro, fat,..and all the rest.  I’m telling you, the politically correct need to publish a book on the correct words to use every year and which ones we’re not supposed to use.”

“Crazy Guy” indicated a lack of empathy (ya think???) and I felt he demonstrated that he was passive/aggressive by selecting his name to be “Crazy Guy” in the first place.  I wrote one final response:

“I know we can’t micromanage all our words – that would be ridiculous. But once mental illness affects you or your family, your life is different. Your viewpoints change. If you have kids – that makes a difference too.  I understand where you are coming from, but your anger ruins the effectiveness of your message.”

“Crazy Guy” never responded to me.  Quelle surprise!

I realize that the word “crazy” is deeply embedded in our vernacular, and each of us has only so much energy to devote to changing our language habits as well as others’ speech.  But if we all chip away a little bit here, and a little there, a sea change can occur.

I’ve taught my daughters that it’s not acceptable for them to use the word “crazy”.  I know I’m many things in this life, but crazy is not one of them.  It’s just the name of a catchy Seal song (and the classic Patsy Cline song) nothing more, nothing less.

Finally, here’s the slow-the-bleep-down-when-you drive section:

San Lorenzo Valley/Scotts Valley Press Banner, October, 2011 

Dyane Harwood, Ben Lomond
 
And last but not least, to be published this Friday:
 
Press Banner, January 29, 2016 “Highway 9 Is Not A Freeway”
I’ll admit it. I’ve sinned. I’ve driven faster than the 35 MPH speed limit on Highway 9’s curves. Once my two daughters were old enough to read the speed limit signs, they’ve acted as my personal California Highway Patrol officers, often saying, “Mommy, slow down!” When my kids aren’t in the car, I’m tempted to drive faster than what’s posted on the speed limit signs. In particular I feel pressure from aggressive tailgaters to speed up. We all know there are few places to pull aside safely on Highway 9.
This “rush-at-all-expenses, even your life mentality” is something I’m familiar with. I learned how to drive on Los Angeles freeways, the land of the ultimate unsafe driving. But San Lorenzo Valley is not Los Angeles, and trust me, we don’t want Highway 9 to become more like Los Angeles’ Harbor Freeway.  During Tuesday’s downpour I couldn’t believe how many drivers raced too quickly on Highway 9 given the puddles, small landslides, and challenge of trying to see through torrents on windshields. I realize that if you’re reading this letter, you’re most likely a safe driver. But if you were crossing the line of safety that day (or any other) please think twice the next time you want to speed in any kind of weather. As your fellow community member, I vow to also slow down when that temptation strikes. Please share this message with your loved ones and friends.
 
Dyane Leshin-Harwood, Ben Lomond
If you made it this far, you’ll get a brand-new blogging award:
“The Marathoner Award”. I’ll ask blahpolar to create a meme for it. Please notify me in the comments if I shall to bestow you with this illustrious award! 😉
Thanks for reading. Think about writing a Letter to the Editor…and see you next week!
love, Dyane

I’m now on Instagram! You can follow me here: birthofanewbrain

Dyane’s memoir Birth of a New Brain – Healing from Postpartum Bipolar Disorder, with a foreword by Dr. Walker Karraa (Transformed by Postpartum Depression: Women’s Stories of Trauma and Growth)will be published by Post Hill Press in Fall, 2017.

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