Gold Coast Doulas Registered Trademark

perinatal mood disorders

Mental Health Awareness Month: Podcast Episode #97

 

Dr. Nave now works with queens through her virtual practice Hormonal Balance.  Today she talks to us about hormones and how they affect our mental health, including the baby blues and postpartum depression.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Alyssa:  Hi.  Welcome to Ask the Doulas Podcast.  I am Alyssa Veneklase, co-owner of Gold Coast Doulas, and today, I’m excited to talk to Dr. Gaynel Nave, MD, and she works at Hormonal Balance.  Hi, Dr. Nave.

Dr. Nave:  Hi, Alyssa.  Thanks for having me.

Alyssa:  Yeah.  It’s been a while since we’ve talked, but we were emailing a while ago, and we realized that it’s Mental Health Awareness Month in May, and then this week is Women’s Health Week.  So you wanted to talk about baby blues and postpartum depression.  So before we get into that, why don’t you tell us a little bit more about Hormonal Balance because last time you talked with us, you worked for — you were at a different place.  So tell us what you’re doing now.

Dr. Nave:  Okay.  Awesome.  So as of this year, I’m in my own practice, as you said.  The name of it is Hormonal Balance.  And so I am an Arizona licensed naturopathic physician, and here in Grand Rapids, I operate as a naturopathic educator and consultant to women, with all gender identities, to basically reconnect to their — who they are and directing their own health, hormonal health concerns.  And that’s the reason why I went with Hormonal Balance, because our hormones affect almost every single aspect of our health, including when we wake up, our mood, our sexual health, all of it.  And for us who are women or female-identifying, the medical community sometimes doesn’t listen to our concerns or minimizes our experience, and so I want to be a part of changing that and, you know, helping women be advocates for themselves and learn more about their bodies, basically.

Alyssa:  Yes.  Awesome.  I love it.  And then you can do — so even though you’re here in Grand Rapids, Michigan, you can do virtual visits, so technically, you can work with anybody anywhere?

Dr. Nave:  Yep, yep, yep.

Alyssa:  Cool.  Well, we’ll tell people how to find you at the end, but let’s talk a little bit about the mental health aspect of, you know, bringing some awareness to it this month.  And then, obviously, you know, baby blues and postpartum depression is something that we deal with on a regular with our clients.  So how do you help your patients?

Dr. Nave:  I call them clients.

Alyssa:  Clients?  Oh, you do?

Dr. Nave:  Yeah, because here in Michigan, because my — there is no regulation for naturopathic physicians, even though I have my license.  I function more as a consultant, so I call the people that I work with “clients.”  And so the way in which I assist them is basically gathering information about their concerns as in-depth as possible because I’m not just going to look at you from the perspective of, oh, I’m experiencing this particular symptom, because nothing occurs in a vacuum.  And so looking at you as a whole, how does what you’re experiencing affect you mentally, emotionally, and physically.  And so we do the full assessment, and then a part of that is talking about and educating you on labs that are pertinent to you.  So there are different types of hormonal labs that are available.  There’s salivary.  There’s urine.  There’s blood.  And so, like, making sure that the one that’s best and indicated specifically for you is what we talk about.  It’s very individualized because each person has a different experience, even if we have the same diagnosis.  Does that make sense?

Alyssa:  Right.  So you’re saying if somebody comes in, you do a pretty thorough — kind of like with my sleep clients, I do an intake form.  Right?  There’s no, like — you’re saying there’s no one blood lab for — oh, there goes my dog.  I should have mentioned that we’re recording at home on speakerphone, and — okay.  So what I was saying is with my sleep consults, I do an intake form because there’s no right answer for every family, so if somebody comes in and needs blood work done or — well, like you said, labs.  Blood work might not be the right lab for them?

Dr. Nave:  Yeah, because there’s — let’s talk about female hormones, for example.  So the female sex hormones — and when I say female, I’m using the medical terminology for it, not like — so, like birth sex.  You have ovaries — versus the gender identify.  I’m still working through how to talk about these medical things and still be cognizant and respectful of the different gender identifies, so please forgive me if I say anything that’s offensive.  So the female sex hormones — estrogen and progesterone — but these hormones don’t just occur in women.  They also occur in men.  So all gender identifies have these hormones involved, but specifically for those who can give birth, estrogen is involved in the building up of the uterine lining of the uterus so that implantation of a fertilized egg can happen.  Progesterone is important for maintaining that uterine lining as well as maintaining healthy pregnancy so that you don’t lose the baby.  Obviously, there are a lot more factors involved.  These hormones, based on how the body breaks down balance specifically as it pertains to estrogen — we have three different types of estrogen, so it’s not just one form that’s in the body, and depending on what lab is done, you’re able to verify all three at the same time.  The one that I’m thinking of right now is the urine test called DUTCH test.  I really enjoy that one.  I’m not promoting it right now, but I’m just explaining why I like it.  So that particular type of analysis looks at all three of those types of estrogen in the body as well as how the body breaks them down.  Is it able to get rid of it effectively, which gives information on the metabolic pathways.  So there’s a lot more information that can be gleaned from — depending on what type of lab is utilized and depending on your specific concern and the way in which your symptoms are presenting; a more investigative or information-bent lab analysis might be indicated, and so being able to speak with someone like myself who is well-versed on the different approaches and all the different options can be really beneficial because then you don’t end up having to do multiple tests, you know, all that kind of fun stuff, or having to get blood drawn if you don’t have to.

Alyssa:  Right.  So what hormones are you looking for when somebody comes in and says, gosh, I think I have postpartum depression?  Is it just hormonal, or do I really have — I guess, where do you as a naturopathic doctor, say, “I think I can help you with hormones,” versus, “I think you need to see a therapist”?  Or do you do both?

Dr. Nave:  So I will probably tell them to do both because postpartum depression, as with any mental health condition, is on a spectrum.  So you have mild, moderate, and severe.  Before we go into that, I think it would be important for us to define a couple things.  Baby blues is feeling down or feeling a shift in your mood, like feeling more weepy, more exhausted, after giving birth, and this can last anywhere from a couple days up to two weeks.  If it extends beyond that time or it’s interfering with your ability to function, then it would be classified as postpartum depression, and postpartum depression can occur in that same time frame as the baby blues, like soon after childbirth, within three to five days, up to a year after giving birth.  And I’m going to read a couple of stats, so bear with me.

Alyssa:  Go for it.

Dr. Nave:  Just for a frame of reference.  So postpartum depression affects up to 15% of mothers, and shifting to 85% of moms is that they get the postpartum blues, so that — these statistics may provide some form of comfort that you’re not alone.  Please don’t suffer alone.  If you’re feeling more down and you need more assistance from your family and friends, please reach out.  If you’re a single mom, I’m sure that there are different groups, like single moms groups, or talking to your doctor or your friends who can be there to provide some emotional support for you during that time.  Please, reach out to people.  It’s not anything to be ashamed of.  A lot of women go through it because our hormones, as I said previously, affect a lot of things, including our mood.

Alyssa:  Right.  I feel like mothers are getting a little bit more comfortable talking about how hard it can be and how maybe bad they feel or these thoughts that they’re having.  You know, you talk to the older generations, like our mothers and grandmothers, who said, well, we didn’t talk about those things or we didn’t need help.  And we’re slowly getting to the point where we’re seeing more and more families look for and seek out postpartum support, which is one of my favorite services we offer because they can work day and night.  When a mom is suffering from any sort of perinatal mood disorder, having that in-home support that’s judgment-free can just be crucial to healing.

Dr. Nave:  I totally agree with you.  I’ve seen it in practice and the research back it up.  Just being pregnant, much less giving birth, is hugely taxing on our body and increased your risk for feeling down.  Some of it has to do with the hormonal changes.  I’m going to go really science-heavy because I’m a nerd and I think it’s fun and interesting…

Alyssa:  Do it!  Teach us!

Dr. Nave:  As I said, estrogen is responsible for the building up of the uterine lining, but it also affects things like our serotonin production, which you might know as the neurotransmitter involved in depression.  Like, if you have low serotonin, then you might get depression.  So the thing with estrogen is that it increases the production of serotonin by affecting a particular enzyme called tryptophan hydroxylase that is responsible for processing an amino acid that we get from our food called tryptophan into serotonin.

Alyssa:  Isn’t tryptophan the one that makes us sleepy?

Dr. Nave:  No.

Alyssa:  Tryptophan isn’t the thing that we eat that makes us sleepy?  What am I thinking?  It’s in turkey and stuff?

Dr. Nave:  Tryptophan is in turkey.  Serotonin and melatonin have the same precursor in terms of amino acid but the thing about their bodies is they use similar substrates or building blocks to make stuff, and just because we have the same building blocks doesn’t mean that we’ll get that particular product.  Does that make sense?

Alyssa:  Kind of, I guess.  In my sleep work, I talk about serotonin and melatonin a lot just for, you know, sleep cycles and feeling alert and then feeling sleepy, but I didn’t realize that a lack of serotonin can cause depression.  I’m trying to, in my brain, you know, the science of sleep, then — it makes sense, then, that people who are depressed sleep a lot, right?  Am I going down the right path here?  Because if you don’t have enough serotonin to make those hormones makes you feel awake and alert — sorry, I’m getting you totally off track by asking these questions.  Sorry!

Dr. Nave:  No, no, no.  I don’t think you’re going off track because sleep is very much an important part of the postpartum depression process.  If Mom isn’t sleeping, she’s at a greater risk for experiencing postpartum depression, and we know that the hormonal changes affect our sleep.  Also having a baby, a newborn baby — if the baby’s up crying, and they’re getting their sleep regulated; you’re adjusting to waking up and feeding the baby, feeling exhausted during the day, and your sleep is thrown off in terms of it not going or being matched up to when the sun rises and the sun goes down.  You’re more trying to sync to the baby, and that can lead to fatigue, which then exacerbates your mood, which makes you then more susceptible to feeling more down.  And then it’s like — one of the things that they mentioned is that babies who have a hard time sleeping — there seems to be a relationship between moms who have postpartum depression — so the baby isn’t sleeping; Mom tends to have a higher likelihood of having postpartum depression, but then the opposite is also true.  So if Mom has postpartum depression, it seems that the baby also as a result has a hard time regulating their moods and being more colicky and all these other things.  So taking care of yourself also helps the baby; it’s important to support Mom, which is why I’m so grateful that you guys have the postpartum doulas, and you guys do a lot of work with supporting moms post-baby.  Sometimes people focus so much on the baby that they forget the mother.

Alyssa:  Oh, absolutely.  It’s all about the baby.

Dr. Nave:  Yeah.  Yeah, yeah, yeah.  So the hormonal mood connection is very complex, and it’s not just A + B = C, you know, because, yes, estrogen influences serotonin production, but there are other factors that then influence, you know, the mood.  Does that make sense?  Specifically, when it comes to the mood changes or the hormonal changes in early pregnancy and postpartum – early pregnancy, we see the estrogen or progesterone levels are shifting because you’re now pregnant, so the body doesn’t have to produce as much of those hormones.  And when we have lower estrogen, which is what happens when you get pregnant, and since estrogen is responsible — or, rather, plays an important role in serotonin, which helps you feel calm when it’s at the normal level — if it’s particularly high, it can lead to anxiety-type symptoms.  If it’s really low, depression-type symptoms.  During those times when the estrogen is lower, there’s this lower mood that can also be accompanied by it.  Are you tracking?

Alyssa:  Yeah.

Dr. Nave:  Yeah.  So that’s the estrogen portion.  So estrogen affects serotonin production and also directly affects the neural networks in your brain.  Now, we have progesterone.  So progesterone: I like to think of it as our calm, happy hormone.  And so when you’re just about to have your period, usually it helps you sleep.  It helps you remain calm.  But if it’s really low, that can lead to insomnia, feeling really agitated and grumpy, and those kind of symptoms can also happen postpartum and early pregnancy.  And so that’s how the hormonal fluctuations can then manifest with the depression.  For the reason, at least in the postpartum stage, that these hormones might drop is that you give birth.  There’s a huge change because the body doesn’t have to maintain the hormones to keep the baby inside.  The baby is now outside of you.  And it really drops off really quickly, and that huge shift can then lead to the baby blues.  Then if it prolongs, your body having a hard time regulating, then that’s when we shift from the blues to the depression.  In terms of what I would do, I would assess what exactly is going on for you.  Do you have physical and emotional support?  Do you have a history of depression or any mental health condition prior to being pregnant?  Have you had postpartum depression before?  How is your sleep?  You know, sleep is really important.  If we can get you sleeping, I think that goes a long way.  Good quality sleep.

Alyssa:  You’re preaching to the choir here.  I think it’s one of the most important things!

Dr. Nave:  The other thing that they mention, the American College of Obstetricians and Gynecologists, is that if Mom has any feelings of doubt about pregnancy, that can also influence her feeling depressed because it can get, like, amplified during that time.

Alyssa:  So you’re saying, like, maybe doubting if they wanted to become pregnant?

Dr. Nave:  Maybe, or doubt that she’s capable of being a good mom, because there’s a lot of pressures on moms, you know?  Like, oh, someone will mention, like, oh, my baby’s sleeping through the night, or my baby — you know, they started eating at this time.  So there’s a lot of pressure to meet certain milestones that are from society, and that can amplify feelings of inadequacy that Mom might have had prior to becoming pregnant.  And so addressing that piece with a therapist or someone like myself will be a very important part of supporting her with the postpartum depression and getting her out of the state.  For some women, medication might be what they need to do, and their healthcare provider will be able to assess that.  But it’s not the only thing that’s available.  There’s therapists; there’s hormonal intervention, because if it’s a hormonal issue, if you address imbalance, then women get relief pretty quickly.  There’s having a doula, if that’s something that’s accessible to you, or if you have family members who are close by, asking them to help out some more.  Having people provide meals for you so then you don’t have to cook; having your partner be a part of taking care of the baby and asking them to step up some more to give you additional support.  Basically, asking for what you need is — I know it can be really vulnerable and scary if you’re not used to asking for help, but that can really be important in terms of getting what it is that you need because no one is in your exact position and knows exactly how you need to be supported.  Does that make sense?  Because I can talk about, like, a doula and a therapist and a naturopathic doctor, but you know what you need, and I want you to trust yourself in that knowledge.  You know what you need!  And here are all these different options to provide that.

Alyssa:  So you mentioned something a bit ago, and I don’t know what made me think of this, but how — let’s say a mother came to you pregnant and had postpartum depression before and knew that she — you know, her hormones are all over the place.  How much can you actually do in regard to hormones while pregnant?  Is there any risk to Baby?  You know, risk of miscarriage?  What does that look like for a mom who’s pregnant but knows she needs some help from you?

Dr. Nave:  So in terms of working with me specifically, I wouldn’t want to mess with her hormones during that time.  I would employ other tools, one of which is homeopathy, which basically supports the body’s own ability to heal and regulate itself.  As well as putting a plan in place — basically, working alongside her other healthcare providers to create a plan to support her and make sure that the transition is as smooth as possible.  What does she do if she notices that she’s trending from green and happy, healthy, thriving, into, I’m not doing so hot — what are the resources available to me when I’m at that place?  Who do I reach out to?  Who do I talk to?  What supplemental intervention needs to happen?  Do I need to talk to my doctor about starting me on medication?  There are so many different options, and prevention is always better than cure.  We would talk about what her issues — so she’s coming and she’s had it before — we would talk about what was her previous pregnancy like; when did the symptoms start to occur; what did they look like; what sort of things — what sort of red flags occurred during that time; what was the intervention utilized at that time; what were her hormone levels like?  What else; what were any medications that she was on; what medications is she on presently?  And, basically, maybe even talk about how that pregnancy is different than this pregnancy.  Like, does she feel more supported now?  What were the things that weren’t present in the previous one that she does have presently?  You know?  And basically coming up with a plan.

Alyssa:  Yeah, I like that.  So it’s kind of like what we do, you know, throughout birth.  It’s talking about all those what-if scenarios and what plans do you have in place for if any of these happen.  And then, like you said, once Baby comes home, nobody plans for that.  They’re so worried about the pregnancy and the labor and delivery part that they come home and go, oh, shoot.  What do I do now?  So it sounds like that’s a really healthy way to plan during pregnancy, if you do have any sort of mood disorder, to find a professional like yourself to sit down and say, hey, let’s go over all these things and put a plan in place, and then I’ll be here for you postpartum.  And then we’ll talk about what we can do then.  I like that.

Dr. Nave:  Right, because, as I said, there’s so many different options.  For one woman, maybe hormones, just giving her the hormones, is what she needs, and then I would, you know, work with her other — because I can’t prescribe hormones at the level that would be therapeutic, but I would be able to recommend, okay, that’s what you need.  Let’s talk to your doc.  Hey, Doc.  This is the plan.  If this happens, this is what we’re going to do so that she doesn’t have to suffer.  You know?  Or maybe it’s something else.  Just being able to work with someone who — again, like myself — who is savvy on that in terms of knowing — yeah, it definitely needs a collaborative approach, which is what I’m about.  In my head, in my dream, everyone would have a health team, you know?  People, health professionals, who are all in communication with each other who are just there to support you and help you thrive.  But I think to wrap up, it would be sleep, health, get your hormones evaluated.  If you’re thinking of getting pregnant and you have any mood disorders or any mental emotional concerns, as part of your pregnancy plan, you should be working — ideally, you would be working with a mental health professional as well, just to insure that you have the support that you need and you’re processing stuff effectively, because those concerns, those mental health concerns, can be substantially amplified once you become pregnant, as well as after giving birth.  If you have a mental health condition or if you’ve had postpartum depression before, you are at significant risk for developing it again.  And this applies to — postpartum depression can also occur if you have a loss of a baby, so it’s not just if you’ve given birth, but any form of baby loss can also result in postpartum depression.

Alyssa:  Yeah, I can imagine it would probably be even amplified with that because you still have the hormonal shift, that drastic hormonal shift, and then grief on top of it.  So it probably takes it to a whole new level.  Well, thank you for all of your expertise.  I always love talking to you.  I would love for people to know how to find you at Hormonal Balance, if they want to reach out.

Dr. Nave:  Yeah.  I am on Instagram and on Facebook as @drgaynelnave.  I’m in the process of getting my website up, so I’ll update you on that afterwards, or you can call my clinic at 616-275-0049.  If you have any hormonal or mental health concerns and you want to optimize your health team, you want a second opinion, or you just want some additional support — that’s what I do!

Alyssa:  Thank you!  During this Covid pandemic, can you see people in person, or are you choosing to do virtual only right now?

Dr. Nave:  I’m choosing to do only virtual at this point.  I see clients virtually most of the time Wednesdays through Fridays, actually, from 8:00 to 5:00 p.m., and in person at 1324 Lake Drive Southeast, Suite 7, Grand Rapids, Michigan 49506.

Alyssa:  So once the stay at home order lifts and things get a little bit more back to normal, you’ll be seeing people in person again?

Dr. Nave:  In person, yes.  But for now, we will see each other virtually!

Alyssa:  Thanks for your time!  Hopefully we’ll talk to you again soon!

 

fertility center

A Journey Unlike Any Other

To all of the couples who have had retrievals, transfers, and IVF schedules postponed or affected by the Corona virus outbreak my heart breaks for you. IVF is no small or easy journey; it takes a toll on your mental, emotional, and physical state. It’s beautiful and terrifying all at the same time. It’s expensive and stressful. It’s all the feels at once every single day.

My journey with the Fertility Center of West Michigan began after my son was born. I suffer from secondary infertility. My son was conceived naturally and born in May of 2012. I began doing hormone therapy to conceive again a year after he was born. Unfortunately every pregnancy I had resulted in a miscarriage. We did several months of hormone therapy and endured four miscarriages. Unfortunately we never made it to IVF, instead my then husband and I divorced in 2016. I remarried in 2018 and in January of 2019 my Husband, Matt, and I began working with the Fertility Center again doing the hormone therapy for 6-months, which again resulted in another miscarriage. It was time to step up our game.

After taking a break in April of 2019, Matt and I decided to travel and take some time away from the constant thought of trying to get pregnant. It had become a chore and that can be so hard on a marriage. When December rolled around we decided to get on the IVF list and signed up for March of 2020. During this wait I began doing something for myself, I started taking a close look at my own health and began to prepare my body for pregnancy. Starting IVF at 35 years old made me a senior citizen in this setting. My body had changed immensely since my first pregnancy. So I began working with my coworkers at Grand Rapids Natural Health to address my thyroid and hormone issues as well as my food sensitivities and stress. I began weekly acupuncture sessions that I planned to do all the way through IVF and into pregnancy. I was working out to build my body’s strength to carry a baby and to create healthy habits I could continue into my pregnancy. I also began sharing my journey with the world via Instagram.

Sharing my journey was very important to me. Working in the health industry I notice too often that these sensitive topics are not spoken about enough and I wanted to share my story in hopes that my own vulnerability might help others along their journey. I wanted to empower women to talk about their pain, their loss, and their sadness instead of hiding it from the world. I found once I started to share my journey that there were so many others like me out there. I didn’t feel that I was carrying that burden alone anymore which was incredibly comforting.

When February arrived they started me on birth control. During this time we did our mock transfer and Endosee. I was thankful for the mock transfer because it calmed my nerves and answered a lot of my questions in regards to how the procedure worked. Since I have undiagnosed infertility an Endosee was performed to make sure that my uterus looked healthy and had no underlying problems that may prevent me from getting pregnant. We then met with Dr. Young and our nurse who walked us through every detail of our care during this process. Since my problems weren’t about getting pregnant, but more about keeping a pregnancy, our plan was a little different than what they were use to seeing. They decided, because of my age and history of miscarriages, that they would transfer two embryos. Our chances of twins are now much higher since twins are on both sides of our family, my age, this being my second pregnancy, and because we are transferring two embryos. As scary as that sounded we took our chances and agreed to the two embryo transfer. From there we waited for my period.

During our wait I began getting myself organized, ordering medications, supplements, syringes and needles for injections, and sharps containers, all of which were provided by our pharmacy. I found so many wonderful resources along the way to help me organize and reduce the stress of injections. My favorite was My Vitro. My Vitro is a small business that have created organizational items that help make the process of IVF a bit smoother. I was so thankful for their Caddy and mat. It helped me organize everything I needed everyday in one place. They also offered the gel hot cold pads to use before and after injections to ease the pain of the needle pokes. They were a great resource for support since they were a couple who had also been through the IVF journey and created products they wish they had had when they were going through it.

When February 28th arrived I began my injections. I started with two evening injections. The Follistem and Menopur injections were used to increase the number of follicles and to help with the quality of the eggs. I did these every night between the hours of 6pm and 8pm in the belly, until I was instructed to stop using them on day 10. Alongside these injections I had blood work and Ultrasounds every other day to measure my progress and determine exactly when I would be ready for my trigger shot and retrieval. On day six of my cycle we introduced an injection of Cetrotide, which was also administered in the belly daily in the morning hours between 6am and 10am. Cetrotide inhibits the premature LH surge to prevent ovulation from occurring while the follicles are maturing. By March 6th my ultrasounds and blood work had become a daily routine instead of every other day. By March 7th I was done with my Follistem & Menopur injections, and by March 8th I took my last injection of Cetrotide and was instructed to take my trigger shot. The trigger shots consisted of two injections, hCG (Human Chorionic Gonadatropin) and Lupron, one in the belly and one in the muscle of the upper thigh. These two injections were used to trigger ovulation, help the eggs to mature, and make it easier to retrieve the eggs from the ovaries.

Monday, March 9th I had my last ultrasound and no injections that day which I was so thrilled about because I had a really hard time with the injections making me physically ill, causing migraines and vomiting. Everyone reacts differently to the medications and they all have different side effects. Some women don’t have any trouble with the medication, others do and that was just how my body reacted to them. Our retrieval was scheduled for the morning of March 10th and we were ready to rock. The procedure went beautifully with the successful extraction of nine eggs. Three of the nine were immature; six were mature and ready for fertilization. We did a two-day fertilization process and ICSI (Intracytoplasmic Sperm Injection), a technique for in vitro fertilization in which an individual sperm cell is introduced into an egg cell. We were thrilled to hear they all fertilized beautifully.

Thursday, March 12th was our transfer date and our two little embabies transferred smoothly. After our transfer we would continue injections of Progesterone up to the day of our pregnancy test. If we were not pregnant we would stop taking the progesterone. If we were pregnant we would continue injections for 11-weeks in the muscle of the upper booty. Progesterone is the hormone that is needed to maintain the lining of the uterus and to help support a pregnancy. Now it was time to go home, rest and wait.

After our transfer was complete, our 2-week wait had begun but I had never anticipated what would happen next. That Friday morning, I woke up to the school closings due to the Corona Virus. Our State was gearing up to take action against the spread of this deadly virus that seemed to be doubling in cases overnight. By Monday morning I read with tears in my eyes a message from the Fertility Center of West Michigan that they were suspending initiation of new treatment cycles and strongly recommended patients consider canceling upcoming embryo transfers due to lack of data on the risk if pregnancy complications when COVID-19 is acquired during first or early second trimester of pregnancy. My heart sank. I was terrified for my embabies who just days earlier were tucked into my uterus, and devastated for all the mamas out there that I had met and connected with along my journey. They had supported me every step of the way, they had become sisters and friends throughout this time and now in an instant their worlds, hopes, and dreams came crashing down.

The same day that we were informed that the Fertility Center would be postponing future cycles and transfers, we found out we were pregnant. It was a bittersweet experience at first but I have decided to make it the light that has come out of these dark times. People are dying, losing jobs, and unable to hug loved ones but through it all I was able to finally create life amongst all the turmoil and that is the most beautiful thing in the world. I am taking this time at home and resting, accepting this time as an opportunity to bond with my son before he has to share me with another baby and that is such a gift. I am taking care of my mental, emotional, and physical health and working hard to create a healthy environment to grow a baby in. April 7th is our first ultrasound and my husband will not be allowed to attend it with me to keep down the amount of exposure at the clinic. As disappointing as that is, I am thankful that they are taking these precautions and count my blessings everyday that we have even made it this far because I know so many would love to be in our shoes.

So I ask you to be gentle with yourself, be forgiving, and be kind. Allow yourself to break down and cry, you have earned it. But also be strong, be safe, and be vigilant because your time will come. Take this time if you are able to show yourself some self-care. Eat healthy, exercise, and brain dump into a journal so you can sleep soundly at night. Reach out to me, or a friend along the way, when the days get hard because you are not alone and your story needs to be heard so that others do not feel alone in this time of isolation.

Jen Smits is the Office Manager at Grand Rapids Natural Health.

 

Perinatal Mood Disorders: Podcast Episode #91

Today we talk with Elsa, a therapist at Mindful Counseling in Grand Rapids, Michigan who specializes in perinatal mood disorders.  Learn what postpartum anxiety and depression look like, how they are different, and signs to look out for.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin, and I’m here today with Elsa Lockman from Mindful Counseling.  She’s here to talk to us a bit about postpartum anxiety.  Elsa specializes in the following areas: perinatal mood disorders, which includes postpartum depression, anxiety, OCD, grief and loss, eating disorders, and body image issues.  She also works with clients dealing with relationship problems, coping with medical illness, trauma and abuse, women’s issues and self-esteem, and mood disorders and anxiety.  So obviously, you’re a natural fit working with clients who struggle with everything from eating disorders to anxiety and depression, transitions in their relationships, and expanding their family or having their first child.  So today, Elsa, let’s focus a bit on the difference between postpartum depression and anxiety and what women can do if they’re interested in seeking treatment and getting help.

Elsa:  Yes, postpartum depression and anxiety can go together.  Sometimes women will struggle with anxiety with depression.  Sometimes it is separate.  Postpartum anxiety and depression can look very different.  People classically think of postpartum depression as mothers who don’t connect with their babies, moms who are checked out and can’t get out of bed all day.  That’s actually not always the case.  Often, women with depression are exhausted and often can’t stop crying.  They can’t look, maybe, on the positive side or think rationally.  As far as the anxiety, it can come out more in not feeling necessarily down but feeling like you can’t relax; feeling that something bad is going to happen at any time.  Having thoughts of something happening to your baby; scary thoughts.  Sometimes even flashes of images of very violent things happening or the baby falling, and moms often feel guilty for those, actually, and don’t tell anybody, but they’re actually really important to talk about.

Kristin:  I had a friend who was afraid of driving in her car or anyone driving her baby.  There can be a lot of, like you said, those intrusive thoughts.

Elsa:  Yes, and it’s obsessive sometimes and you can’t get it out of your head.  So rationally, you can say, I’m not going to drop the baby going down the stairs.  I have the baby in my hands.  But it keeps going; it gets hooked, the idea or the image, and then they’ll struggle with almost a loop where it just can’t get out of your head.  Or anxiety can present sometimes in something around sickness.  No germs.  Thinking that my baby is going to get sick; I can’t take her out to the store, and I can’t take her to this house.  And how far that goes; I mean, some of these are common sense, and you want to take care of your child, but then how far does it goes?  Does it prevent you from doing things that you want to do, or do others notice that maybe this is being a little unreasonable?  It seems to be causing you even more anxiety to be thinking some of these things.  Another part is that sometimes anxiety can come out as anger.  Feeling just angry and irritable; feeling tense.  That can come out, obviously, with partners, and they can notice it.  Being different, a marked change from before for women.  Those are some of the symptoms that come that people can notice with anxiety.  Another one would be sleeping; when moms can’t sleep when the baby is actually sleeping.  That’s another sign of postpartum anxiety for people to watch out for.

Kristin:  Sure.  That makes sense.  I know even with postpartum doulas in the house, some women still struggle with fully sleeping even though their child is being care for by someone else. And sleep is so essential.  There are so many studies on how, if you’re not getting enough sleep, it can lead to mood disorders and anxiety and so on.

Elsa:  Yeah, it just leaves women very vulnerable, and now it’s become so normalized that part of the postpartum world is just not getting sleep.  And I think it’s also expected that women are also just supposed to go on with their lives and do all the normal things that they’re supposed to do even when they’re running on little to no sleep, and this goes on for weeks or months.

Kristin:  Yes!  So what resources would you suggest if they’re looking for help?  Obviously, we can talk about how to reach out to you!

Elsa:  For sure!  You can definitely contact Mindful Counseling GR.  You can contact Pine Rest.  They actually have a mother baby unit, so they actually have therapists that have specialized training, like I do, to work with women postpartum.

Kristin:  And now Pine Rest even has the ER when you can —

Elsa:  Oh, the urgent care center?

Kristin:  Yes, the urgent care center.  They can go in at night and not have to go the hospital.

Elsa:  yeah, they can go to the urgent care center and get assessed and get attention or treatment a lot quicker.  OB offices have a list of therapists who are trained and specialize with postpartum or perinatal mood disorders, which includes anxiety and depression in pregnancy and postpartum.  So there’s a list that you can ask for from your OB, as well.

Kristin:  Great!  How do they directly reach out to you?  Are you accepting new patients, Elsa?

Elsa:  Yes, I am!  You can reach out to me by contacting me through our website.

Kristin:  Perfect!  Thank you for coming on today!

 

Postpartum Depression

Supporting a Postpartum Mother: Podcast Episode #79

Elsa Lockman, LMSW of Mindful Counseling talks to us today about how partners, family members, and other caregivers can support a mother during those critical postpartum weeks to ensure she seeks help if needed.  How do you approach a new mother and what are her best options for care?  You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin, and I’m here today with Elsa Lockman.  She’s with Mindful Counseling, and we are talking about how partners and other caregivers and family members can support a woman who has potential signs of postpartum depression or mood disorders.

Elsa:  Yes.  So postpartum is going to be an emotional time, so tears, some anger, sadness, are all part of the experience.  After about two to three weeks out, if spouse or a friend or a mother is noticing maybe a mom is crying more than usual, isn’t really looking forward to things, has these unusual fears that they can’t seem to let go of.  Another sign would be not seeming to eat very much or either sleeping a lot or not being able to sleep when the baby is sleeping.  If they’re noticing those signs, it would maybe be a sign that they could go talk to somebody as far as a therapist or go see their doctor.  Approaching Mom would be in a way to not criticize mom as if she’s doing anything wrong.  She’s not doing anything wrong, so start off with validating, actually.  She’s doing a great job with how hard it is; validate how hard she’s working, and try to tell her that it doesn’t have to be this way.  She doesn’t have to do it alone.

Kristin:  How does the caregiver know if it is baby blues or if it’s something that she needs help for?  Because, of course, there can be that hormonal fluctuation.  They may be teary.

Elsa:  Baby blues usually stops after three weeks postpartum.  So after that would be maybe a sign that there’s more going on.  But I would say, is it getting it the way of functioning?  Is it getting in the way of relationships?  Is it getting in the way of their working in the home or outside of the home, getting those things done?  To a degree, that is expected postpartum; not everything running smoothly, but are relationships being affected?  Those would be signs that it’s more than just baby blues.

Kristin:  How can a spouse, partner, or caregiver be supportive in order to empower her to get help?  Is it best for them to directly reach out for help for her if they’re seeing signs, or what do you recommend?

Elsa:  I recommend the mom reaching out, so that would be encouraging Mom to reach out herself.  And maybe she needs to talk to a friend and have more time with friends or more time to herself; maybe that would help.  See how that works.  If that seems to help and is enough to alleviate whatever stress is going on, then that works, but maybe if it’s not working, then take it to another level, which would be contacting a therapist or your doctor.

Kristin:  And since, obviously, women have multiple doctors — they’re seeing their OB or midwife and family doctor and their pediatrician — does it matter who they’re speaking with about getting help?

Elsa:  No, it wouldn’t matter who you see.  Usually the OB would be the person that they’ve seen most recently, but they can even bring it up to the pediatrician, since moms see the pediatrician very often.

Kristin:  And as far as getting help for our local listeners and clients, they can reach out to you directly?  How do they access you at Mindful Counseling, Elsa?

Elsa:  They can go to the website, and they can contact me through there.  Another resource would be Pine Rest, and through your OB’s office, there also is a list of therapists who specialize in perinatal mood disorders, which includes postpartum depression and anxiety.

Kristin:  That’s so helpful.  And in past conversations, you had mentioned that women can bring their babies to therapy; that you allow that with clients you’re working with, and I know Pine Rest encourages that with their mother-baby program?

Elsa:  Yes, for sure.  Bring your baby to the session; you can feed the baby, breastfeed, anything.  Coming with your baby is welcomed and encouraged, for sure.

Kristin:  Do you have any final thoughts or tips to share?

Elsa:  Just that it doesn’t have to be going through this alone.  It’s very normalized for women to feel that anxiety is just part of the postpartum experience or feeling depressed and stressed is part of it, and while it might be a new phase and there’s a lot going on, it doesn’t have to be that women are just suffering through it.

Kristin:  Great point.  Thanks so much, Elsa, for being on!

 

postpartum doula

Benefits of A Postpartum Doula and Why Should You Hire One?

Author Bio: Roselin Raj is a journalist and a writer. She has been writing extensively on health and wellness related topics for over a decade. Besides her professional interests, she loves a game of basketball or a good hike in her free time to fuel her spirits. “Health is wealth” is one motto of life which she lives by as well as advocates to every reader who comes across her blogs.

In the months leading up to my first delivery, I had many emotions ranging from excitement to fear. The idea of delivering a baby was daunting and had occupied my headspace completely. Though I had a consulting doctor and limitless information on the internet, getting the personal assistance and care from a doula did the trick. 

According to What To Expect, “Doulas, who offer non-medical emotional support, are growing in popularity in the delivery room (or birthing center), but many also do postpartum work, helping new moms navigate the stressful, bleary-eyed early days of parenthood. Here’s why you may want to consider hiring a postpartum doula to help you through the fourth trimester.” With the rising popularity of doulas, let us understand what a postpartum doula is and how they help expectant mothers through and post pregnancy. 

What is a Postpartum Doula?

As mentioned earlier, a doula is a trained professional who guides mothers with information, emotional and physical assistance before, during, and a short while post birth. The guidance and assistance are given to expectant mothers to make the process a healthy and less stressful experience. However, a postpartum doula extends their assistance until the baby has adjusted with the family. 

A postpartum doula is skilled to assist with a variety of needs and requirements according to each family. For instance, once the baby is born, all the attention is directed towards the new bundle of joy. But the physical and mental health recovery of a mother is very important. A postpartum doula can help the mother ease into motherhood, provide necessary information on caring for the baby or help with breastfeeding issues, and much more. But a postpartum doula is not a nanny and helps the mother emotionally to recover after the birth of the baby, bond, offer newborn care, sibling care, and lighten the load of household tasks.

Benefits of a Postpartum Doula

The work of a postpartum doula extends post birth, unlike a birth doula. The postpartum doula’s main purpose is to make the mother comfortable with the baby and support her in doing so. The tasks may vary from mother to mother, and she is equipped to do the best in any situation. Here are a few of the tasks a postpartum doula can provide:

Postpartum Care for the Mother

Once the baby has been delivered, the mother requires a lot of caring and help. The basics involve eating healthy food, drinking water at regular intervals, and most importantly, rest. A postpartum doula will help in cooking, running errands, etc. to allow the new mother to recover. In the case of c-section delivery, she can assist the mother with the newborn, household tasks, offer support and resources, rest and healing, and aid in hassle-free recovery. 

Women are usually emotionally weak post-birth with chances of depression and anxiety. Postpartum doulas can help create a stress-free environment, take care of the baby, and be emotionally available for the new mothers. 

Breastfeeding and Newborn Support

Postpartum doulas are equipped with complete knowledge of handling newborn babies, and they help mothers to ease the process of parenting. The next big challenge after giving birth to a child is often breastfeeding. And as you are probably aware, it can be a challenging experience for both the mother and the baby. 

In such cases, the doula helps with information on newborn behavior, soothes the process of breastfeeding or transitioning to bottle feeding. If further breastfeeding support is needed, she can offer local resources to an IBCLC (Board Certified Lactation Consultant).

Finding the Perfect Doula for You

Doulas can be found through word-of-mouth or going through service providers to find certified doulas as per your needs. The idea is to get a suitable doula who is certified, experienced, and well-synced to you and your family requirements. Before hiring a doula, talk to the agency regarding their qualifications, certifications, insurance, etc. to get a clear idea of who you are hiring. 

Doulas or the agencies usually charge for services by the hour, location, services required, and the experience of the doula. There may be provisions to use your Health Savings Account (HSA) to hire a doula. Clarify with your insurance provider or the doula agency before going ahead with the plan.

Photo credit: The People Picture Company

 

EMDR Therapy

EMDR Therapy: An Overview

We are so excited to share this guest blog by Joshua Nave LLMSW and Paul Krauss MA LPC of Health for Life GR. We get asked frequently about EMDR Therapy, so read below to find out what it is and how it works!

This blog is a discussion of the basics of what Eye Movement Desensitization and Reprocessing Therapy (EMDR) is, its origins, and how it can help people.  Many people have heard about EMDR in one fashion or another, and with over 2 million people reporting healing from its use (Trauma Center, 2007), it’s no wonder that more and more people are asking “Just what is EMDR?”  So let’s begin with trying to answer just that: what is EMDR therapy?

EMDR therapy is a physiological psychotherapy technique that aims at unlocking the body’s natural ability to process information and heal from past trauma and current distress (EMDRIA, 2019).  EMDR therapy seeks to access the process that the human brain uses during the REM (Rapid Eye Movement) cycle of sleep to reduce the disturbance caused by memories, events, and thoughts that have become stuck or intrusively repeated in a person’s mind and/or behavior and personality.  EMDR therapy is an advanced type of empirically-validated therapy that can be utilized by Masters-Level Counselors with specific advanced training (post-graduate school). Hundreds of studies have confirmed that when human beings are enduring great duress or stress, the brain becomes incapable of processing information as it normally does.  While the brain may change its normal processing abilities to protect the person during a stressful situation–there are often negative side effects.  Information that is not processed in a normal manner, due to a stressful or traumatic event can then become “locked” within the mind, and as the brain attempts to process that event, an individual may experience a repetition of the very stress, pain, thoughts, and other body sensations that they experienced during the original event(s).

EMDR therapy works on multiple levels of the brain, both incorporating talk therapy and elements of the rational brain, along with the deeper memory systems as well as the physical memory to allow an individual to access those “locked” stressful/traumatic events in a therapeutic environment– so that the effect on the brain is essentially “reprocessing” the stressful or traumatic event in an adaptive way that allows resolution of suffering. As the brain processes the event, individuals become able to embody with healthy and adaptive beliefs about themselves both from the past and during the current time, which can build long-term resiliency in an individual. In addition, EMDR therapy works to clear the body of disturbing physical sensations associated with the event, or what is sometimes called “the felt sense.”   To this day, scientists and medical professionals have been unable to ascertain the exact mechanism of action that helps to change brain and body’s response to triggers and associated negative stimuli (all of the elements that make EMDR therapy effective), nevertheless study after study demonstrates its tremendous positive effect on people, and often shows improved outcomes over such therapies as CBT and traditional talk therapy. Counselors who utilize EMDR therapy often theorize that it is the use of rapid eye movement or other forms of bilateral stimulation (BLS) during the treatment, combined with the cognitive elements of counseling, which ultimately causes the stress reduction and adaptive processing to occur.

Francine Shapiro originally theorized the foundations of EMDR therapy in 1987 when she discovered that rapid eye movement could have a beneficial effect on reducing the effects of stress and the effects of traumatic memories (EMDR Institutive, 2019).  Dr. Shapiro later went on to perform clinical trials to test her theories, and today, EMDR Therapy is a certified evidence-based approach to recovering from traumatic experiences.  In addition, EMDR Therapy has been reported to be effective with anxiety, depression, panic disorders, addictions, body dysmorphic conditions, phobias, pain disorders, and more (Legg, 2017).  Many people have sought EMDR Therapy as a method of treatment for these conditions instead of the traditional route of medication first.  

Is EMDR Therapy right for you?  If you suffer from repeating intrusive memories, feelings, body sensations, or thoughts of past disturbing events, or in fact, any of the symptoms previously discussed, then EMDR Therapy could assist you in your healing.  If you are interested in receiving a different method of healing where you are in control of having the healthier life you’ve always wanted, then I encourage you to contact a licensed therapist who’s undergone EMDRIA approved training in providing EMDR Therapy services.  

EMDR Therapy is an effective psychotherapy method when its methodology is followed by a licensed counselor. It is important to have the right fit for you, so when investigating, make sure you feel aligned with your therapist and that they are experienced and knowledgeable and have valid EMDR therapy training.  If you’re interested in a free 15-minute consultation to either learn more about EMDR or to set up an appointment, please visit our website at healthforlifegr.com. At Health for Life Grand Rapids, we are now proud to have a counseling wing called The Trauma Informed Counseling Center of Grand Rapids. You can also give us a call at 616-200-4433.

References:

EMDR Institute. (2019). History of EMDR.

EMDRIA. (2019). How does EMDR work?

Legg, T. (2017). EMDR therapy: What you need to know.

Krauss, P. (2019). The trauma informed counseling center of grand rapids.

Trauma Center. (2007). Eye movement desensitization and reprocessing (EMDR).

About the Authors:

Paul Krauss MA LPC is the Clinical Director of Health for Life Grand Rapids, home of The Trauma-Informed Counseling Center of Grand Rapids. Paul is also a Private Practice Psychotherapist, host of the Intentional Clinician podcast, Behavioral Health Consultant, Clinical Trainer, and Counseling Supervisor. Paul is the creator of the National Violence Prevention Hotline (in progress) as well as the Intentional Clinician Training Program for Counselors.

Joshua Nave MA LLMSW 
“I became a social worker and ultimately a therapist to assist in God’s mission to bring healing to the hurt. Through my years of work in the field of trauma, behavioral health, and the broader social work field, I discovered that many of us are held back from reaching true healing by the traumas and lessons imparted on us in our early childhood. It has thus been my passion over the past several years to provide early childhood intervention to families struggling when their young children, as well as assisting adults in overcoming the barriers to healthy living through trauma-informed therapies. I have used my training in Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Play Therapy, and Eye Movement Desensitization and Reprocessing Therapy (EMDR) to assist my clients in achieving a more complete and healthy life. It is my belief that all individuals have not only intrinsic value, but also the natural capacity for healing and change.

As a therapist, I provide my clients with a truly “client-driven experience.” I am skilled at partnering with you to identify the changes that you wish to make in your family’s life, or even your individual life, and developing a plan to achieve success. I look forward to partnering with you on reaching your potential through natural healing!”

EMDR Therapy

 

Pregnancy and Depression

Podcast Episode #60: A Naturopath’s Perspective on Pregnancy and Depression

Doctor Janna Hibler, ND talks to Alyssa and Kristin about how a naturopathic doctor treats pregnant and postpartum women, body and mind.  You can listen to this complete podcast episode on iTunes and SoundCloud.

Alyssa:  Hello, welcome to Ask the Doulas podcast.  I am Alyssa Veneklase, co-owner of Gold Coast Doulas, and I am here with Kristin, my business partner today, and Janna Hibler.  She’s a naturopathic doctor and clinical nutritionist.  Hello, Janna!

Janna:  Hi, how’s it going, guys?

Alyssa:  So Kristin and I met you at a little gathering of the minds at Grand Rapids Natural Health Recently.  We kind of hit it off, and then you and I got coffee, and we hit it off even further.  We got to chatting forever, so we were like, let’s just pause this and record our conversation!  And today, first, I want to know a little bit more about what you do, but when the two of us were talking, we spoke quite a bit about postpartum depression, and I want to talk about what happens leading up to that, even before you get pregnant, but then during pregnancy, too.  What does that look like?  What do depression and anxiety look like?  How do we nip that in the bud?

Janna:  Yeah, definitely!  So it’s really important for all of us mamas and future mamas to know that how we are before we get pregnant and give birth is a good indicator of how our health might look like after we give birth.  Things you mentioned such as anxiety or depression tend to get more severe after we give birth just because of the extreme stress and sleep deprivation that we are under, having a newborn.  I like to emphasize to my patients that this is nothing to feel bad about.  It’s just when you don’t sleep, you don’t release the same neurotransmitters and have the same brain chemistry with certain levels of uppers and feel-good hormones.  So it’s kind of…

Alyssa:  I’m obviously a big proponent of sleep for babies and parents.  So what would you tell a parent who says I’m not even pregnant yet; I’m thinking about getting pregnant.  How does a person even know if they have depression or anxiety?  And what do you do about it?  Let’s say that I’m kind of a depressed person or I get anxious about things at work or with my friends or my family.  What do you recommend?  And then let’s say I came to see you as a naturopathic doctor.

Janna:  So again, I like to really emphasize that you are normal and this is a normal part of being a female.  If we’re talking evolutionarily speaking, we were made to be out in nature, and so when we’re put in the city, even if we’re out half an hour from Grand Rapids downtown, there’s a lot of lights.  There’s a lot of noises.  There’s a lot of things going on that cause an overresponse, and that can lead to anxiety and depression.  So some symptoms might be feeling nervous in certain situations or some OCD tendencies, or a lower mood display and laughing less or getting less excited about certain things in life.  These can be very mild, but if you look at them over the course of the day, if you have a lot of little things, they do add up.  So when you walk into a naturopathic doctor’s office, something I really love and take to heart is that we have our medical concentration, but we also have a lot of education with psychology and knowing how the brain works.  So I would ask you a bunch of questions; the normal medical questions you get, but in addition, we’re going to ask about your sleep cycles, your exercise, your diet regimen.  All these play a part in our mental health, and my end goal is for everybody to feel their best all the time.  In order to find out how people are feeling, I like to run a series of either urinary or blood tests.  This can give us an indication of brain chemistry, hormone levels, cortisol, in addition to the normal things like checking sugar and red blood cells.  I really like to hone in on these specialty tests because by checking our brain chemistry, I can find exactly what neurotransmitters might be high or low, and we can treat appropriately.

Alyssa:  So when you talk about neurotransmitters, what does that mean?  What are you looking at and what does that mean to you?

Janna:  So our neurotransmitters; there’s the common ones we’ve all heard of like dopamine, serotonin, norepinephrine, epinephrine, even histamine.  There is a whole slew of uppers and downers, and basically, we take the brain chemistry analysis tests so we can see if some of them are off.  Some people that have allergies have high histamine levels.  That’s an upper, so when we have allergies, those people actually tend to have anxiety, as well.  And so we can actually nip the anxiety in the bud by treating the allergies and reducing histamine levels.  So it’s really a cool science.

Alyssa:  And the cortisol and serotonin and melatonin, all those things you can actually check with blood and urine?

Janna:  Exactly, yeah.

Kristin:  And a lot of women have issues with their thyroid; is that part of the testing, that you can check thyroid levels?

Janna:  Absolutely.  I like to refer to it as our hormone triangle where we have our thyroid as the king, our sex hormones like estrogen, progesterone, and then we have our cortisol.  All three of those categories play a huge role in our hormone development and picture that we have, so we do a lot of intensive testing to find out where those levels are at.

Alyssa:  And what would you do if I came in and my cortisol levels were sky-high and you noticed something with my thyroid?  What would you tell me to do?

Janna:  So depending on your lab results, the thyroid could be treated in two ways.  One, sometimes we do give conventional medications, and then another way to treat, depending on your levels, is with herbs.  We can give a series of botanical herbs to actually bring your levels back to normal, as well as certain nutrients.  There’s a number of co-factors that actually feed our thyroid hormone to turn from its inactive to active form, and without them, we will not function.  So that’s things like vitamin D and iron and vitamin C; very common nutrients that we take for granted, but they play a vital role in our thyroid health.

Alyssa:  So how long do you test that out before you put them on a drug?

Janna:  Typically, I like to give a patient three to six months to see if we can fix it with nutrients and herbs.  Again, it comes back to what the patient wants.  If a patient wants results this month, then we might take a more aggressive treatment plan.  But if they’re willing to do it completely naturally, then three to six months.

Alyssa:  So let’s say I get it under control; I’m pregnant, and I still notice now that I still have some anxiety or depression.  What do you do during pregnancy?

Janna:  I really like to encourage diet and exercise and sleep.  Those are our biggest best friends to really help out.  Different lifestyle factors can have a huge effect on our mood and behavior.  So let’s start with maybe some foods.  We could eat a diet rich in dopamine, so we could do things like chocolate.  I mean, who doesn’t love chocolate?  We all love it, but do we know it’s high in magnesium and it’s high in zinc?  Those are vital co-factors to run our brain chemistry.  We can also have blueberries or nuts and seeds, which are high in vitamin B6 and 9 and all these B vitamins to help also with our mood.  We could do some grass-fed or fermented foods, which help with our gastrointestinal health, which again, I’m sure you guys have all heard of the gut being the second brain.  And then sulfur; sulfur-rich foods like onions and garlic that actually help with detox, so if we are having some things get backed up, we can help get them out.  So we really try to approach it from a multifactorial view hitting all points.  How’s our diet?  How’s our exercise?  How’s our sleep?  How’s our stress?  And a lot of what I get into with patients, too, is how is your relationship at home?  Do you feel supported?  Do you feel loved?  Do you feel heard by your partner?  By your business partners, your coworkers?  These are all part of our needs that play a role in our mental health when we’re pregnant and when we’re not pregnant.

Alyssa:  I was going to say those are things that should be carried over throughout, right?

Janna:  Yeah, yeah!

Alyssa:  Meanwhile, exercising and getting enough sleep.

Janna:  Totally, and pregnancy just kind of is that opportunity where we find our weaknesses in our body, and it’s actually a great opportunity to increase our health for the rest of our life and find out things we wouldn’t know about it unless we were pregnant.

Alyssa:  Oftentimes, I feel like that is the point in a woman’s brain and body where we finally start to understand and care about what’s happening to our body, and because we’re growing another human, then we’re like, oh, I better start taking care of myself so that I can take care of this baby.

Janna: Yeah, and I think that has a lot to do with what happens after we give birth and why a lot of moms struggle.  I mean, I want to say that loud on this podcast right now that mom life is hard.  It is a struggle, and I know we all try to put on a face that we’re doing well and everything’s perfect at home, but mom life is hard, and that’s maybe another podcast sometime, but that’s a conversation I’d love to get started because it is hard, and to that extent, why we have a hard time after birth is a lot of the time – and I’m sure you guys see this all the time, being in the house with moms – that the moms forget about themselves.  They put all of their energy, all of their love, into their baby, and I was guilty of it, too.  I mean, I have a two-year-old, and I definitely did it.  I’m still guilty of it some days because we love that human so, so much.  But I think it’s really important for our mental health and as mothers to put the energy back into ourselves and remember that we really can’t pour from an empty cup, and we have to be healthy and strong ourselves in order to make strong and healthy babies.

Alyssa:  So what do you recommend to a mom who’s suffering from depression?  You know, maybe they had a beautiful pregnancy, easy labor and delivery, and then they’re like, oh, my God; this is way harder than I thought, and then sink into a depression that they’ve never experienced before.  How do you get them out that?

Janna:  And so many moms do!  There are so, so many out there that come in, and they’re like, not even my husband knows how sad I am; not even my best friend knows how sad I am, and that’s where I really encourage everyone to just start reaching out.  I don’t want you to be ashamed; I don’t want you to feel guilty, because it doesn’t mean you’re a bad mom.  You’re an excellent mom because you care so, so much, and asking for that help and taking that first step, making people aware that this is something I do need help with, and receiving that love.  From a medical standpoint, too, we’ll go in and I’ll help adjust hormones and your brain chemistry with either herbs or conventional treatments or nutrient levels to help your body, but I think so much of it also comes from a mental and emotional spot of feeling supported and loved by your people around you.

Alyssa:  So is naturopathic medicine, in general, more of a functional approach versus the medical approach or kind of a combination?

Janna:  Exactly, yeah, and functional medicine is so great.  That is the bridge between conventional medicine and natural medicine because we all agree on it, you know.  We see a lab level, and it’s important to attend to it when it’s on its lower level.  Traditionally-minded thinking, we only would treat something like vitamin D if it was set low because that’s the level that can cause rickets and true mobility issues, but what about everybody that has low-normal, that they’re in that functional, funky range?  That’s at a stage that can cause depression, that you can get autoimmune diseases.  So as a naturopathic doctor, I really work on treating it then and now so we can prevent getting those diseases because they may not pop up in five or even ten years, but they will happen if they’re not treated.

Kristin:  Even in pregnancy, there’s evidence that preeclampsia with the lack of vitamin D, that can be a factor in developing preeclampsia.

Janna:  Exactly, and that’s how it can be that simple sometimes where moms come in and, hey, they just want to run a nutrient panel just to find out what are their baseline nutrients, and then that way when breastfeeding comes into play, especially for extended breastfeeding – I’ve been breastfeeding for two and a half years, so that’s something I’ve been keeping a constant eye on, what are my nutrient levels, because we don’t want to cause other problems from just being depleted.  So yeah, that’s a great point.

Alyssa:  Depleted is a good word to describe mothers postpartum, I think.  Most of us at some point just feel depleted, whether it’s mentally, physically, whether it’s just breastfeeding.  That alone can make you feel depleted; this baby is literally sucking the life out of me!

Janna:  Because you’re giving everything!

Kristin:  I tandem nursed, so I really felt depleted when I was nursing two!

Alyssa:  It’s like this weird tug of war between “I love doing this” and “I hate doing this so much.”  I remember getting so over it when I was done, and then a month later I missed it.  I was like, oh, my God; I’m not breastfeeding anymore!  But I was so ready to throw those pump accessories in the trash and celebrate, but it’s just a weird…

Janna:  It is!  And every mom is different, so we like to celebrate moms at each level, whether they want to breastfeed for three months or six months or a year.  We all have our breaking point, and we want to prevent us from getting to that point.  Mama matters, too!

Kristin:  For sure!

Alyssa:  Well, thank you so much for joining us, and if people want to find you to come visit you or just ask you questions or follow you on Instagram, where do they find you?

Janna:  Absolutely!  So I’m currently accepting patients at Grand Rapids Natural Health, and I’m also on social media as holisticmommyandmedoc, and you can reach out there anytime.  My name is Janna Hibler on Facebook, and feel free to message me anytime.  I like to get to know my mamas.  Since I just moved from Vermont, I’m looking to build up my network of mamas because we are a tribe and we all need to stick with each other, so whether it’s personally or professionally, I do want to link up with you!

Alyssa:  Thank you so much!

Kristin:  Thanks, Janna!  We appreciate it!

 

Prenatal Stress

Media – Friend or Foe?

In light of recent events, we have a special guest blog by Lindsey Zaskiewicz, LMSW. Lindsey is a licensed social worker currently employed as a clinician on a mental health and substance abuse crisis line. Prior to this role, she has several years of experience working in maternal-infant mental health, as well as direct practice with adolescents and young adults. Beyond her role as a social worker, she is also an expectant mother who is navigating this journey for the first time; this provides a unique opportunity to empathize and appreciate what other moms have experienced themselves.  

In an era when everywhere you turn things are being aired, tweeted, and live-streamed, it’s hard to dodge the media and celebrity updates that inundate our daily lives. Most recently, news and media outlets have covered the deaths of both Kate Spade and Anthony Bourdain, each dying by suicide. And while many people will take the opportunity to grieve those beloved public figures, media coverage of high-profile suicides can also negatively influence those at risk already.

It is important to take inventory of our own responses and internal triggers when confronted with the news of a death by suicide, especially for women who are currently struggling with perinatal mood and anxiety disorders.* You are allowed to give yourself permission to turn off TV reports or not scroll through news feeds in order to maintain a healthy separation. It is also critical to develop and/or use support systems when confronted with worsening depression or anxiety symptoms. Whether you yourself have experienced perinatal mood and anxiety disorders, or you know someone who has (or is at this time), please know that there is help and support available.

We tend to see the side of individuals on social media that they want us to see, and that is not typically an accurate representation of reality. While perinatal mood and anxiety disorders continue to feel somewhat stigmatized in society, there have been several brave women who have come forward to share their stories publicly. When high-profile celebrities can bring attention and shed light on what they have gone through, it can assist women to feel that they are not alone. Some of the most well-known women to speak out regarding their struggles are Brooke Shields, Hayden Panettiere, and JK Rowling.  They each had the following to say about their postpartum experience:

Brooke Shields: “I had gone through numerous attempts to have a baby and when I did finally have this perfect, beautiful, healthy baby it all but destroyed me. I couldn’t hold the baby, I couldn’t do anything for the baby, I couldn’t look at the baby.”

Hayden Panettiere received inpatient treatment after the 2014 birth of her child: “There’s a lot of misunderstanding- there’s a lot of people out there that think that it’s not real, that it’s not true, that it’s something that’s made up in their minds, that ‘oh, it’s hormones.’ They brush it off. It’s something that’s completely uncontrollable. It’s really painful and it’s really scary, and women need a lot of support.”

JK Rowling: “I have never been remotely ashamed of having been depressed. Never. What’s to be ashamed of? I went through a really rough time and I am quite proud that I got out of that.” 

When confronted with perinatal mood and anxiety disorders, or thoughts of suicide, it is crucial to reach out and receive support and/or treatment. You can’t tell that someone is struggling or feeling suicidal just by looking at them. If you are the loved one of a pregnant mom or mom with small children, it’s important to check in with them and ask how they are doing, even if things seem to be going well from the outside.  And if you are someone who is currently experiencing depression, anxiety, or thoughts of suicide, there is help available even if you don’t have an immediate social support network. Listed below are several resources that can be used to provide the essential support and encouragement that you need. Also remember, not all treatment is “one size fits all,” so if you don’t feel connected to a specific therapist or type of treatment, please don’t lose hope. Asking for help takes bravery – there is strength in sharing our story and letting ourselves be seen and heard.

Resources for depression, anxiety, and suicide support:

National Suicide Prevention Lifeline (24 hrs/day) 800-273-8255
Pine Rest Mother Baby Program 616-455-9200
Spectrum Health Postpartum Emotional Support Group (FREE) 616-391-5000

* Any type of mood or anxiety disorder from pregnancy through the child’s third year