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 —
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.
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!
Many of our clients and listeners don’t fully understand what overnight doula support looks like. Kristin and Alyssa, both Certified Postpartum Doulas, discuss the kinds of support their clients look for and how their team of doulas support families in their homes. You can listen to this complete podcast on iTunes or SoundCloud. You can also learn more here about overnight postpartum doula support.
Kristin: Welcome to Ask the Doulas with Gold Coast Doulas. I’m Kristin.
Alyssa: And I’m Alyssa.
Kristin: And we’re here to chat about what an overnight postpartum doula does, as that is a question that we get asked often by our clients and our podcast listeners. So, Alyssa, my first question to you is, as a postpartum doula and sleep specialist, what do you see as the key benefits to a family in hiring overnight postpartum doula support?
Alyssa: Whether they hire for sleep or not, it helps the parents get sleep. So let’s say they’re not even hiring me for a sleep consult. Parents don’t understand what sleep deprivation means until their in the midst of it, probably at least three weeks in. Like, our bodies are designed to survive a couple weeks of this, sometimes even three or four, but after that, our systems start to shut down. So if you think about overnight support being this trusted person who sleeps in your home to take over all those overnight responsibilities so that you can get a good night’s rest. Even a six-hour stretch or sometimes even a four-hour stretch makes you feel like a whole new person the next day when you’re used to only sleeping maybe one- or two-hour chunks. A four-hour stretch seems amazing in that moment, whereas right now if you told me I could only have four hours of sleep tonight, I would cry. I would be miserable the next day. And you, Kristin, as a birth doula, you know that feeling. If you’ve had one night of no sleep, you’re just wrecked. So you’re running on adrenaline. You’re sleep deprived. So having a doula come in and take over all that responsibility at night — obviously, she can’t breastfeed your baby, but you have a couple different choices if you’re a breastfeeding mom. If you’re a bottle-feeding with formula mom, you can literally go to sleep at 10:00 PM and wake up whenever you want because the doula can just feed that baby every three hours.
Kristin: Exactly, and clean the bottles and change the diapers and burp the baby, all of it.
Alyssa: Yeah. So if your partner is feeding in the middle of the night, you’re certainly not going to wake up to clean bottles and parts in the morning. The doula does do that. But for a breastfeeding mom, you can choose to pump instead of breastfeeding because it’s usually a lot quicker. So you pump and you set those bottles out for the doula. The doula wakes up when the baby wakes up; feeds the baby; burps the baby; changes the baby; gets the baby back to sleep — and Mom’s sleeping this whole time. Or, if Mom chooses to breastfeed, the doula can bring Baby to Mom so Mom doesn’t even have to get out of bed. I was just talking to Kelly Emory, our lactation consultant friend, and she was saying that when she was nursing, she would just side lie and her husband would bring the baby to her. She would lie on her side, so she didn’t have to get up. She didn’t even have to open her eyes if she didn’t want to. She was still kind of in this half-sleep state, and then when Baby was done on that side, her husband would take the baby and she’d roll over and she would feed on the other side, and then the husband would take the baby away, change the baby, burp the baby, and do all that stuff. So she said it was amazing. She took over one shift of the night, and he took over the next, so she would get a six-hour chunk of sleep and would feel amazing in the morning. So you’re able to tackle all those everyday tasks during the day because you didn’t have to also worry about those at night.
Kristin: Yes! And I’ve also had overnight clients who prefer to come into the nursery and sit in a rocker and feed their baby rather than have me come in and disrupt their husband’s sleep.
Alyssa: Sometimes they’re sleeping in separate rooms, too, because they’ve become used to that. So oftentimes, my goal as an overnight doula is to have both parents sleeping in bed together again, or wherever you were before this baby arrived.
Kristin: Right, no more partner on the couch or in the guest bedroom.
Alyssa: Right.
Kristin: So as far as other tasks of an overnight postpartum doula, sleep is one. So we can get Baby back to sleep and if they’re working with a certified sleep consultant, like you, then they can implement that.
Alyssa: Yeah, I guess I didn’t answer that initial question. So if they do work with me as a sleep consultant, you can hire an overnight doula in conjunction with. So I offer this customized sleep plan for your family, and then our doula knows that plan, understands that plan, and implements that plan overnight.
Kristin: That’s amazing.
Alyssa: So you wake up again refreshed because you’ve slept, and then you have the energy to implement the sleep plan during the day. And then the doula comes in at night and implements that plan overnight. So it’s consistency because that’s always the key with any sort of sleep consult is that you have to be consistent. You can’t just do it during the day and then give up at night because you’re tired. Your plan will fail.
Kristin: And so who hires a postpartum overnight doula, and how often do they use the doula support?
Alyssa: Who hires them? Tired families hire them! You get to the point of exhaustion. I don’t think when you’re pregnant you’re thinking about an overnight doula because you truly don’t understand what you’re in for. But newborn babies sleep all the time, so they could sleep up to 22 out of 24 hours a day, so you’re thinking, well, of course, like, newborn babies sleep all the time. I’m going to sleep when the baby sleeps. They’re going to be feeding every two to three hours!
Kristin: They get up a lot!
Alyssa: Which means all day and all night, you will be up feeding every two to three hours, at least. So your sleep becomes these little tiny chunks. Because if you think if you have a newborn baby that’s eating every two hours, and it takes you an hour to breastfeed, and then after the breastfeeding session, you have to burp; you have to change the diaper; you have to get the baby back to sleep. You’ve maybe got 30 to 45 minutes, if you’re lucky, to sleep before the baby needs to feed again.
Kristin: And some clients hire us for one overnight to get a good night of sleep and catch up; other clients hire us every night, and we bring in a team, in and out, or have one doula consistently. And some of our clientele have a partner who travels a lot, or I’ve even supported a family where the mother was going back to work from maternity leave and was traveling for her job, so as an overnight doula, I supported the husband as he cared for the toddler that was waking; I was caring for the baby. And so there are a lot of unique situations, but a lot of our moms who have partners who travel a lot want that extra support, whether they have a new baby or other kids in the household that need support, as well.
Alyssa: I think it depends on resources. So if someone is sleep deprived and they’re like, I just need one night of reprieve, and that’s all we can afford and that’s what we’re going to do, then that’s what they do.
Kristin: Exactly.
Alyssa: Even if they don’t have the resources, oftentimes during pregnancy, if parents have the foresight to ask for postpartum support as a baby shower gift, they can have several overnights gifted to them by friends and family.
Kristin: Which is better than all the toys and clothes they’ll outgrow.
Alyssa: I always tell them, you’re going to get mounds of plastic junk that you’ll literally look at and say that’s hundreds of dollars’ worth of stuff I’m never going to use, and you could have had an overnight doula in your home so you could sleep.
Kristin: Easily!
Alyssa: So I think it’s just based on resources because, like you said, we’ve had people hire us for, you know, two overnights and we’ve had two months straight. So I think it just depends. I mean, I don’t know that it’s a type of client. I think that’s just kind of based on resources available.
Kristin: And we certainly support families who are struggling with postpartum mood disorders and anxiety, but that is not all that we serve as far as clientele. But for moms who are being treated in therapy, then we certainly are able to give them much-needed support and rest as we care for their baby, and we do have a package where we are able to lower our hourly rate for clients who are in the Pine Rest mother-baby program or are seeking therapy.
Alyssa: Yeah, sleep deprivation is considered to be the number one cause of perinatal mood disorders, so all these moms with anxiety, depression, up to postpartum psychosis — when you’re sleep deprived, you’re literally torturing your brain and your body, and it’s really hard to function. So sleep is such an imperative thing, and for your baby, too. If you’re not sleeping and your baby’s not sleeping, physiologically, that baby needs sleep in order to grow, for their brain to develop, for their immune system to function properly. It’s so critical for both parents and children.
Kristin: Agreed. So, really, anyone can benefit from it. Our shortest shift would be coming in at 10:00 PM and leaving at 6:00 AM, but a lot of clients extend that time.
Alyssa: I’ve found that a lot of people like you to come a little bit earlier, especially if they have older children. So if there’s older siblings, let’s say 6:00 comes around and you’re trying to get dinner on the table. You have a two-year-old, a five-year-old, and a newborn.
Kristin: That’s a lot!
Alyssa: That overnight shift tends to, when parents say, yeah, yeah, come at 8:00 or 9:00 when I’m going to go to bed — that very quickly changes to 5:00 or 6:00. So either that shift moves up, or it just lengthens. So the doula can come from, a lot of times, 6:00 PM to 6:00 AM, and they do a lot of 12-hour shifts because they’re there for the hustle and bustle of getting dinner, wrangling toddlers, helping with the newborn, and then helping with bedtime routines for two or three children and then taking that infant newborn and helping them get to sleep. Usually, it’s in that order. Like, the doula will take the baby and put them to sleep, and then the parents get to spend some quality time with this toddler who is usually lashing out because they are used to being the only child, if there’s only one, and are really, really seeking that one-on-one attention that they’re not getting anymore.
Kristin: Yeah, that’s the perfect time to bond, and they can read them a bedtime story and sing songs; whatever their nighttime routines were before Baby arrived.
Alyssa: Yeah, and that’s one thing I stress, too, with my sleep consults is just having a really good bedtime routine, and even if I’m doing a consult for one child and there’s others in the household, I usually ask about them, too, because if you’ve got three kids who all have a different bedtime, and each bedtime routine is taking an hour, certainly whoever’s last on that list is going to bed at 9:00 or something, which is way too late for these little kids. So trying to consolidate and have a system in place and just get a schedule that works for the family, for everyone in the family, is a really big goal.
Kristin: Awesome advice.
Alyssa: So you mentioned earlier that a doula sleeps when the baby sleeps, and sometimes parents wonder, well, what do you mean? What does that look like? Depending on the house, we’ve had doulas sleeping on sofas in the living room.
Kristin: Yes, that’s what I’ve done.
Alyssa: We’ve had doulas sleeping in a spare room. We’ve had doulas sleeping in a spare room on the same floor, in a spare room on a different floor, and you can make anything work.
Kristin: With monitors and technology now, you know the second a baby stirs.
Alyssa: So parents are always like, oh, shoot, I don’t know how this is going to work. How am I going to do that? We’ve had blow-up mattresses in the nursery. Ideally, you want the doula to be as close to the nursey as possible, so they’re the one, when they hear that baby, they’re up; they’re there.
Kristin: No one else gets woken up in the household.
Alyssa: Yeah, you want the parents to be as far away. So sometimes I even tell them if you have a spare bedroom in the basement, go sleep there, because even with one of my most recent sleep clients, the first night we did the sleep consult, the doula was there overnight, and I contacted them the next day: how did you sleep? And they were like, oh, I wanted to so bad, but I kept hearing this phantom crying. Even when the babies weren’t crying, they hear it, anyway. So it does take, as parents, who are used to not sleeping for week after week after week — it takes time for your body and brain to adjust back to, oh, I’m able to sleep again. So it’s not instant. It usually takes at least a couple nights to get your brain to say, I can sleep. It’s okay to sleep through the night. I don’t have any responsibilities tonight. This doula is taking care of it. And it’s just a matter of them getting sleep in two-hour chunks instead of the parents getting sleep in two-hour chunks. So a doula can usually do two or three in a row before they’re too exhausted.
Kristin: Just like a birth doula. We can do a couple nights with a client in the hospital without sleep, and then we’re done.
Alyssa: Yeah. So for those clients of ours who we’ve had for two weeks straight or two months straight, it’s several doulas taking turns. Otherwise, they’re just too exhausted.
Kristin: Right, and that’s where we sometimes will bring in a team if it is continuous care.
Alyssa: But I think ideally, with sleep training, I would love to see every parent have a sleep plan and then a doula for five nights. That would just be — I don’t know; I think the mental well-being of these parents would increase drastically if they were able to do both.
Kristin: I would have loved an overnight doula with my kids being 21 months apart; having a toddler and a newborn. It would have been amazing.
Alyssa: Well, and some people, too, think it’s weird to have somebody sleeping in your home. I mean, always, when they meet the doula, they’re totally fine with it, but it is a weird thought to have this stranger come into your home who’s going to care for your babies. That’s why I think we’re so adamant about talking about our training and our certification process, and we’ve done background checks for people who want us to.
Kristin: Yeah, and we’ve shown immunization records and CPR certifications and so on and liability insurance. We have all of that.
Alyssa: Yeah, because especially with a mom with anxiety who needs to sleep and knows she needs this help, but now she has anxiety because a stranger is going to be sleeping in her home — we need to do whatever you have to, to make that mom feel comfortable to be able to sleep.
Kristin: Yes, and we’re there to do just that. So feel free to reach out to us if you have any questions about overnight doulas. We’d love to work with your family! Remember, these moments are golden.
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!
After our recent event at the Wealthy Street Theatre where we screened ‘When the Bough Breaks – A Documentary about Postpartum Depression’ we realized that there are many great resources available to our community, but people may not know how to find them.
We at Gold Coast, with the help of Cristina Stauffer, have compiled a comprehensive list of resources for Postpartum Depression, Anxiety, and Psychosis.
