Beyond Postpartum Depression: Meaning Making Amidst Colic, Gestational Diabetes, and Pubis Symphysis Dysfunction

Courtney is a postpartum depression survivor, wife, mom, and a writer who believes firmly that sharing our stories can greatly impact the lives of others. Courtney became a mom in early 2020, and her experiences with postpartum depression, postpartum anxiety, and becoming a parent during the COVID-19 pandemic have transformed her into a passionate advocate for perinatal mental health and making sure that all new parents know they are not alone and they can get better. Courtney is the founder of Beyond Postpartum Depression, which began as a project for sharing her experiences with mental health and parenting, and raising awareness of perinatal mental health disorders. In addition to Beyond Postpartum Depression, Courtney is also a Social Media Specialist for Postpartum Support International (PSI) and serves on the Board of Directors for the Indiana chapter of PSI. She lives in Indiana with her husband, daughter, son, and cat. She can be found on Instagram at @beyondppd and on Facebook at Beyond Postpartum Depression. 

Transcript

Courtney Ginder  0:00  

Because that's how it felt to me, was I'm doing something wrong, like I cannot console my baby, and that is literally my entire job right now, is to feed her, change her, and console her, and I can't do that. So my thought was, there's something wrong with me.

Speaker 2  0:17  

Welcome to perinatal and reproductive perspectives. This is a podcast where we empower birthing individuals, partners and health professionals with evidence based insights, holistic strategies and relatable stories, hosted by a healthcare expert. This podcast fosters understanding equity and growth in perinatal and reproductive health. Here's your host, Becky Morrison gleed,

Rebecca Gleed 0:49  

hello. I am beyond excited to introduce someone extra special today, Courtney Ginder, who is the founder of beyond PPD, welcome Courtney. Hi. How are you? I'm doing well, I'm trying to stay warm. I know. Yeah, and you're coming to us all the way from Indiana. So yes, happy chili there.

Unknown Speaker  1:14  

Oh yes, we're on an extreme cold morning. It's great

Rebecca Gleed  1:18  

in the mid Atlantic, which reminds me so I was so excited to see you in Washington, DC. We had been online friends. Yes, I was sitting at this round table, like, you know, a very large table in, yeah, they spent like 10, like, exactly in Washington, DC. And I said to myself, I think that's Courtney. I got invited for a second, but then I Okay. I need to, you know, muster up my courage and say hello, and here we are. That was so great. Yeah, the conference that was the Postpartum Support international conference, but just, I am so excited for our audience to get to know you a little bit more and to hear your story. I want to open it up to you know, for you, wherever you want to start, share who you are, what's your story? What brought you to the world of perinatal mental health? Yeah.

Courtney Ginder  2:19  

So my story begins back in 2020 my daughter was born the late February of 2020 I'd had a pretty normal pregnancy with her. I don't want to say easy, because nothing about pregnancy is easy, but I had, you know, I was never sick. I only had slight food aversions. Didn't really get uncomfortable until the very end, when you're stretched to your maximum and nothing is comfortable anymore. So just a very smooth pregnancy with her didn't really have any problems. And then she was born late February 2020 and you might have some like little alarm bells going off in your head when you hear late February 2020 because in early spring of 2020 we were in the COVID 19 pandemic. So I had my husband and I had about three weeks of normal parenthood with her, where we were able to, you know, have our my parents stayed with us that first week, his dad would bring over breakfast in the morning on his way to work and stop by and see her. We had friends come over and see her. We had about three weeks of that normalcy, and then everything just went, went sideways. Basically, actually, the hospital I delivered at was the hospital that had the first case of COVID 19 in India. And so people were like, Oh my gosh. Are you okay? Like, that was your hospital. Your hospital. I'm like, Yeah, I've been home for like, three weeks.

Rebecca Gleed  3:47  

Like, what do you remember about that first notification? So

Courtney Ginder  3:52  

I remember we were we didn't think it was going to be that bad. We didn't think it was going to be a big deal. I mean, I was in college for the h1 and one the swine flu pandemic back in 2009 so I was in college for that. I was living in the dorms at the time, and they're done, yeah. And everyone talked about, you know, oh, it's a pandemic. It's the flu. And I was like, we never locked down. We never had any major issues. I was just like, it's going to be like, swine flu again. It's not going to be a big deal. And then my husband, he had gone back to work, and he'd been back maybe a week, and I got a text from him, and he was like that, I'm packing up my cube. They're sending us home, and we don't know when we're coming back. So on the one hand, I was like, yay. I have someone at home with me again. Thanks. Back. I because I have always, I have had, I've always lived with anxiety for as long as I can remember. And actually, after I recovered from PBD, my therapist and I figured out that I actually have OCD as opposed to generalized anxiety. But so i. You like, I might be at risk for some kind of perinatal mental health thing postpartum, but I never really worried about it too much. But bringing her home, I was just so afraid of being alone with her. I was afraid that I couldn't do it, that I didn't have, you know the skills or what I needed to do to be home all day with a brand new baby. And when my husband went back to work, like I I frantically texted my mom, and I was like, Can you please just come over, like, for Monday, just to just I have someone here with me. And she was like, Yeah, I'll come over, but you're gonna do all of it. Like, I'm not doing anything. It's for you. You're going to do all the things to prove to yourself that you can do it. Even just when she was a couple weeks old, I was already having anxiety about being alone with her. Can I do this? Did I, you know, do I have, you know, we all, we all hear about maternal instinct. Do I have that maternal instinct to actually do this? And then what made things worse was, as we're, you know, we're going into this pandemic period. We're having to buy masks. We're having to, you know, the grocery stores are completely empty. Those shelves are empty. My husband's coming home from work all of that. She started crying in the evenings, just inconsolably, crying for hours. Sometimes it was an hour, sometimes it was hours, and it always started at like, five or six at night. I remember one of her first Well, check visits her infant. Well, check this about like, how much crying is too much cry? What level of normal are we talking at here? Because she cries in the evenings and never stops crying until we get her to bed. And her pediatrician was like, Oh, yep, witching hours. That's, that's what that is. It's a witching hour, you know, she'll outgrow it. And I was like, Okay, if, if you say so, she'll outgrow it. Okay,

Unknown Speaker  6:56  

Courtney, to hear that from the pediatrician that felt how,

Courtney Ginder  6:59  

um, at that point, I was like, Okay, maybe, maybe we're not doing something wrong. Like, this is this is normal. This is something babies do. Because that's how it felt to me, was I'm doing something wrong. Like, I cannot console my baby, and that is literally my entire job right now, is to feed her, change her, and console her, and I can't do that. So my thought, was there something wrong with me? Because she's crying all the time, and I can't, I can't help her feel better.

Rebecca Gleed  7:29  

Default. It sounds like for you, the automatic thoughts were negative. They were internalized, yes,

Courtney Ginder  7:35  

yes, that this is, this is something that I'm doing incorrectly. I'm not doing something right, and that's why she cries all the time. And it began it it eventually switched to in the evenings, to just all day long. She cried all the time. And I mean, I, I didn't know I had heard of colic. I had heard, you know, some babies are colicky, but I had never known someone to have a colicky baby. And I remember like, We texted my parents, we texted my in laws, or we talked to them over FaceTime, because obviously we couldn't see anybody. And, you know, we were like, do you remember us crying? Like, asking our parents, like, do you remember us crying this much? Like, did we cry all the time. And they were like, Nope, I don't remember that, you know, because, of course, we, we may have cried all the time, I don't really know, but they, they didn't remember us crying all the time. So, you know, I was like, something is wrong. Something is very clearly wrong, either with her or with me. One of us is broken, and I'm not sure who it is. And we also noticed after she drank the bottles, she would kind of like, arch her back and cry. And so we're like, well, that's That's odd. So we did take her back to the pediatrician for that after one evening where she just she screamed like she was in pain, screaming. And we texted my parents. My parents are pharmacists, and so we texted my parents, and they were like, give her some Tylenol, some like, you know, call the pediatric office, get her in for an appointment tomorrow morning, but in the meantime, like, give her a little bit of Tylenol because something is obviously hurting. So, you know, and you go ahead and give her some. And so my husband goes to the cabinet and gets the Tylenol, and he reaches up for it, and as he's grabbing it, I go, No, stop. And he was like, what? Like, you can't give her that, because what if we give her too much and she overdoses and she dies? And he was like, that's not going to happen, like, even showing me, like, on the syringe, like where it has the little marks where you can't give her more than that.

Rebecca Gleed  9:51  

I want to pause if I can't, because, yeah, I want to make sure that listeners can capture that type of thought. I. I'm guessing and correct me if I'm wrong. Courtney, that felt real to you. Yes, the possibility of your baby dying, yes, felt real. Yes,

Courtney Ginder  10:11  

because she was so tiny. She's only five or six weeks old at this point, so she is still tiny, tiny. And even though, like, logically, I knew, you know, you can't give her, you know, give her more this. And my parents even said, like, if you're not comfortable giving her the full dose for her weight, like, half it, you know, yeah. And I was just like, No, she's so small. What if we give her too much and she overdoses and she dies because she was so, so tiny, and my husband was, he was just like, like, showing me, like, you can't give her too much, we can even give her half of the smallest dose, if that will make you feel better, but like something is wrong with her, she is in pain, and she this will help her feel better, and it will help us sleep. Because it's like, 10 o'clock at night at this point, and we, we have gotten no sleep. And finally, the the unrelenting screaming overwhelmed the anxious thought. And I, you know, we, I was like, Alright, give her the Tylenol. And that did help. It got her to go to sleep. It got us to go to sleep. And at the pediatrician the next morning, we found out that she had silent reflux. So instead of, you know, when you think of typical baby reflux, you think of like exorcism style, regurgitating of bottles, all of that. And she did spit up a lot. But, I mean, we could hear her. She would drink, and we could hear like, like her start to gurgle, like she'd go spit up and then she would swallow it, so she'd get the acid coming up and then going back down, because she wouldn't spit it back up. Or baby, I know it was awful. We got her some little liquid baby Pepcid, and that helped. I mean, that took away the pain after her bottles. That took away the pain after feeding, but it didn't stop the colic. So even though we're getting, you know, we're getting after feedings, she's doing okay. She's doing better, like she is still inconsolably crying a lot, and all of that time, I just kept thinking, like you're a bad mom. You made a mistake. You know, this was, this was a horrible idea. You should have never had a baby, you know, she didn't ask to be brought into this. She didn't ask to be born, and she's clearly so unhappy, and you must be doing something wrong, because she's home with you all day. My husband had never had a remote work policy before the pandemic, so he basically had to pretend he was at his office. He had to heat a time log of this is exactly what I was doing at this time of day, you know, etc, etc, etc. So it was almost like he wasn't home, because I couldn't be like, Hey, take her for a couple hours while. I like, go sit in silence for a while.

Unknown Speaker  13:02  

That's sounds. It's so challenging, exactly.

Courtney Ginder  13:04  

And so I just kept having these thoughts that, like, I was terrible at this. There was something wrong with me, you know, and I never had thoughts of harming myself or my daughter. And that's how I rationalized that it wasn't postpartum depression, because I was like, That's postpartum depression is you're crying all the time and you want to hurt yourself or your baby, and even though I'm crying a lot, and so is she, I don't want to hurt myself. I don't want to hurt my baby. So therefore it is not postpartum depression. That's how I rationalized it in my head.

Rebecca Gleed  13:36  

So for our listeners to translate that you don't necessarily have to have suicidality or homicidality to meet criteria for postpartum depression. I'm hearing a lot of negative thoughts, a lot of negative internalization, self blame, yes, shooting on yourself. Yes. Those can be signs and symptoms, which you so eloquently highlight,

Courtney Ginder  14:00  

yes And so while I never had suicidality, I did have thoughts of I would they would be better off if I was not in this house, like I'm still alive, I'm still part of the picture, but I'm going to go somewhere else. I'm going to go to my parents house. I'm going to go to my sisters I'm going to go to my mother in laws, I'm going to go somewhere else, and they will be better off, because I'm not here to mess things up. Because I'm the reason she cries all day. I'm the reason she's, you know, she's upset. She can't be consoled. It's my fault. My husband's a better parent than I am, so I'm going to go, you know, my brain was like, You need to go stay with your parents. You need to go stay with your in laws somewhere else, because they will be happier if you're not home. And my husband, bless him, he knew something was wrong before I did before I could admit to myself that something was wrong. He knew something was up two days after we got home from the hospital, because I was trying to. Breastfeed, and it was going extremely poorly, and I was feeling guilty about wanting to switch to formula.

Rebecca Gleed  15:06  

Breastfeeding is so hard, hard we do not I could have a whole episode just on that. Oh,

Courtney Ginder  15:13  

it's so hard. And I mean, they checked, they checked her lash the hospital. So many times they were like, she's got a beautiful latch. You're doing great. Everything's perfect. I'm like, Yeah, but it really, really hurts. Yeah. Like, this feels awful. I am not I am not bonding with this. This is awful. But I felt so bad for feeling that way, because everyone tells you, you know it's best to breastfeed your baby, it's best to do all these things. And I was just like, I know this is what's best for her, but I don't like this any at all, and I was feeling guilty for wanting to switch to formula and for not enjoying breastfeeding, because I was under the impression that it was a beautiful bonding experience. And for a lot of moms, it is, you know, I have a lot of friends that breastfed their kids and they had wonderful experiences, but it just what it didn't work out that way for us. And so he was, you know, three days post, you know, three days post hospital. He's like, Can you text your therapist? Like, something, it's not right. Can you please text your therapist? I'm like, I'm fine. It's the hormones, it's the baby blues. They told us about that the hospital. I'm fine. And he's like, No, actually, you're not. But okay,

Unknown Speaker  16:23  

he he knows you well. He was, he knows me very

Courtney Ginder  16:25  

well. We have been, we've been together since we were seniors in high school. So he knows me very, very well better than myself a lot of the time. And throughout this whole whole six week ish period where everything seems to be going wrong. You know, we don't have help. We're stuck inside. We can't go anywhere except the pediatrician's office. I'm having, not only the those negative self thoughts and all of those things, I'm also having massive anxiety, because we're also in the middle of a pandemic with the respiratory virus none of us have seen before, yes, I mean, and a baby and a baby and a brand new baby, but we don't know how it's going to affect this brand new baby with zero immune system. So, I mean, I was he would go grocery shopping. I would make him immediately go upstairs, shower and change clothes before he held our daughter. I would, you know, wipe down all the groceries with, like, disinfecting wipes and things like that. I would follow him around the house and like, you know, disinfect the doorknob, the handrails, the things that he touched, because I was like, we didn't know how it spread at that point. I mean, we didn't know if it was touch based or not at that point. And so I was absolutely terrified that we were going, we were going to get COVID, and then our daughter would get it, and then she would get very, very sick, and have to be taken to like the NICU, the pick you whatever. And because of the visitor restrictions, because pandemic, you know, I wouldn't be able to be with her. I wouldn't be able to be in the hospital with her. And so I had all of this anxiety, this health anxiety, on top of these depressive self, you know, negative self thoughts, you know, I was like, okay, something might not be right, but I can, you know, I can make it to my six week postpartum appointment. And I remember the house we were living at the time. Our laundry room was right next to our loft, where my husband had his desk where he was working. So I had gotten up before my daughter did, and I was like, I will get caught up on laundry. Because even though she doesn't have, like, full blown reflux, like, she still stood up a lot, and we were all going through multiple outfits a day, and so I was like, I'll get caught up on laundry. And as I'm starting some laundry, I heard her start waking up in her bassinet and start crying. And I was just down the hallway for me, so it was like, bedroom, loft, laundry room, so like, straight down the hallway, and I just leaned up against the washing machine and started sobbing. And my husband, like, looks over like, what are you doing? He's like, are you okay? Are you okay? And all I could say was, I can't do this. I can't do this any more. It just felt like something in me had broken. Then he immediately jumped into action. Told his supervisor, like, I'm taking a I'm taking a day off. I'm taking a personal day. You know, he told me, like, I will go get her. I will take care of her. You go lay down. You go sleep. Turn on the sound machines, and you can't hear anything, and just like the

Unknown Speaker  19:29  

alarm bells. And so that's

Courtney Ginder  19:31  

what I did. And when I woke up, he was like, will you please, please, please, call your doctor, text your therapist. I was like, I was like, Yes, I will. I was like, but you know, we're like, a week out for my postpartum appointment, I can make it that week until I get to see my doctor. And then a couple days later, I got a call from my OB GYN office. They were like, Hi. Because of the pandemic, we have made it so that all postpartum. Appointments are now virtual. And I was like, hold up, hold up, hold up, hold up. Because, I mean, at this point, the only time we had been allowed to get out of the house was for pediatrician appointments. So this was, like, the one thing that was just me, just me, and I adore my OB. I wish she was my doctor for everything, because she's amazing and wonderful, and I love okay. And so I was like, I need to see my doctor. And so, like, I tried, I tried all the things. I was like, I was like, What do you mean? You have to see me because I have stitches, and you need to check my stitches. Because I am not checking my stitches. I'm I'm not looking down there. I don't want to know what that looks like. Like, you have to check my stitches. And they were like, No, you know, unless you think there's an infection or something like that. Like, no, we can't. We're You can't come in. And I was like, okay, new plan was like, I want the arm implant birth control. That's, that's the birth control I want. It was like, you have to let me see my doctor, because you can't put that in my arm over the phone like, that just doesn't work. And they were like, Oh well, the health department classified that as an elective procedure, and we're not doing elective procedures right now, so no, you can't come in. And I tried everything. Bless this poor receptionist. I was just crying on the phone like, Please, let me come in and see my doctor, and she just had to keep telling me, No. She was sorry. That's that's not what they're doing right now. It's not, you know, they didn't make this the doctor didn't make this decision. She didn't make this decision. They're just following the rules that had been laid down for what they were doing for the pandemic.

Rebecca Gleed  21:36  

And I want to pop in to just give space and accentuate the pandemic for maternal health as a vulnerable population. Yes, I am so grateful to give voice because I've heard so many stories akin to yours, just in my clinical practice. Of these are real people help, seeking on the phone, crying, asking for help, yes, and being told, I'm sorry, no, yes,

Courtney Ginder  22:13  

because that that appointment, felt like my one tether to the outside world, because it was something that was outside my house. It was something that was just about me. It was not about my baby. It was not about, you know, anything else. It was just focused on me. Because, I mean, you you hear it all the time. We go from seeing our doctors, you know, once a month, twice a month, every week, and then we don't see them at all for six weeks. And then at six weeks, we get one appointment when, I mean, we see our children's pediatrician and all that, but we don't see our doctors. And so I was, you know, that was my one tether to the outside world. And in that moment, it felt like it didn't cut. And I was there was nothing I could do. There was nothing that poor receptionist could do. There was nothing my doctor could do. It sounds

Rebecca Gleed  23:02  

much less, very powerless. I don't know if those feelings resonate, but yes, to me, it's just sounds like such a a helpless position to be in.

Courtney Ginder  23:12  

Yes, and they did turn in. It turned into a phone call appointment. They didn't even have, I don't even think they had video appointments set up yet, because this was still, this was April of 2020, so this was still very early on. I'm not even sure if they had the video telemedicine set up yet. It was all over the phone. But thankfully, I I know myself and I have been in I had been in therapy. I had been doing all these things for my mental health. I had been on medication for my mental health. So I knew myself well enough that when my doctor asked me, even over the phone, like, how are you doing, I was able to be like, I'm not okay, not okay. I'm not okay. I am crying all the time. I am anxious. I'm having these horrible thoughts about how I'm a terrible person, a terrible mother, like I'm not okay. And I mean, I think about that a lot, because this is whenever I tell my story, whether it's been on other podcasts or I've done this, the survivor panels at the psi, two day trainings. I've done those. I always say this is the part where I feel so incredibly lucky, because my Obi immediately is just like, Okay, this sounds like you have postpartum depression. She was like, it's, it's very common, and we're gonna get you feeling better somehow. Yeah, yes, like, this is common. It's not normal, it but it's common, and we're going to get you feeling better. And so she called my primary care physician. They're even in the same building. They're just one floor apart, so they didn't have to transfer records. They didn't have to do anything. She just called her office. They called me, got me into an appointment the next day, another telehealth appointment, but they got me into my primary care doctor. The next day, they didn't do the Edinburgh scale with me. It was another one that combines both anxiety and depression. I can't remember what scale it was or what screener was that what they did with me, but they were like, Yeah, it sounds like you have postpartum depression, postpartum anxiety. We're going to get you on some medication. We're going to get you feeling better. And I mean, even in a pandemic where, like, you're not allowed to go the doctor's office. You're not allowed to go anywhere. I mean, everything I did not fall through the cracks. I got my medication that I'm still on today. I got better. I felt better the next like, a couple days later, I got an email from my therapist, and they had gotten teletherapy set up, and she was able to start seeing me again. So I was like, yes, please put me on your calendar. I would love to see you. I have a lot of things to talk about,

Rebecca Gleed  25:45  

and so any providers listening, what Courtney is really highlighting is the impact that had you remember that even today, of that day and the excellent triage by those providers in the communication and the team oriented approach that made a huge difference. It sounds like that was handled by your OB really well and excluded all of the necessary parties to get the ball rolling.

Courtney Ginder  26:14  

Yes, and I mean, it just makes me think like, how many moms, how many parents slip through the cracks in those days because they weren't being seen in the office? And I mean, we talk, I talk and work all the time. I'm like, I have my customer service voice, like, I can put on I can put on my customer service voice, and I can sound completely normal, completely happy. How many moms did that when their when their appointments got switched to virtual, how many of them were able to skate by and pretend that everything was fine because their doctors weren't seeing weren't looking at them right in their faces, and being able to see like, even though you sound okay,

Rebecca Gleed  26:53  

you don't look okay, you know, like, one too many,

Courtney Ginder  26:57  

exactly. And so that's why I always, always, always say, I feel lucky that I got help and I got treatment and I got better, because I know so many parents, still to this day, so many parents, but especially in early 2020, so many parents that did not get that help and did not get that treatment and did not Get better. And

Rebecca Gleed  27:20  

Courtney, you talked about, at some point you realized, in collaboration with your therapist, that you had some OCD features, as opposed to a generalized anxiety. Can you help listeners understand where it morphs into OCD territory? Yeah, just anxiety.

Courtney Ginder  27:39  

Yeah. So I had, I had anxiety about very specific events. My anxiety, my OCD, tends to revolve around contamination, okay, just difficult as a parent of young children

Unknown Speaker  27:52  

during a pandemic,

Courtney Ginder  27:54  

yes, and during a pandemic, but I would have very, very specific thoughts relating to me getting sick, my children getting sick, my husband getting sick, and then I would have and a lot of also roles around, like safety, like I I have to check the door every night, even though I know I'm the last one who locked it, because I'm the last one who got the Amazon package off the front porch, and no one else touched the door, but I have to go check it, or else I will not be able to go to sleep, because my brain will just check in response to safety. Yes, yes, checking. I also have a lot of rumination. Okay? I tend to ruminate a lot, and I also will do assurance seeking. So, oh, are you? Are you sure you're not running a fever. You sure you're okay? You sure nobody in your school got sick today? Cool, cool,

Rebecca Gleed  28:45  

cool. Yes. And that can be what we call a relational compulsion when it involves our loved ones.

Courtney Ginder  28:52  

Yeah. So that's that's how it more. That's how we figured out it was OCD more than general anxiety. Was that not only was I having very specific things that my brain would just latch onto and not let go of. I was then also performing those convulsions, whether it's physically checking the door, or it's ruminating on it, or it's, you know, checking, like talking to other people, being like, Are you sure you're sure, you're sure you promise you feel okay. Yeah. So that's that has taken some work to work on. It's still a work in progress. It's something that I will be dealing with forever. But

Rebecca Gleed  29:30  

when you I see you bring up another good point, if we can go backward a little bit, that if you have a pre existing, you know, anxiety disorder that does elevate your risk for perinatal mood and anxiety disorders, and oftentimes it's not necessarily getting rid of symptoms. We can allay them through therapy, medication, adjunctive, complementary approaches. But what you're saying is this is going to be a lifelong like this. Symptom Management might be a thing. Right? Yeah. May fluctuate, you know, and persist throughout your life. And I want listeners to understand that sometimes it's a lifelong symptom management.

Courtney Ginder  30:10  

Yes, I had always tended to be more towards the anxious, neurotic side of the scale. I my experience after the birth of my daughter was really my first experience with depression that triggered more the depression side of it. I had never really dealt with that side before. I tended to be more anxious, keyed up, restless, obsessive versus depressive. So that was that, I think, was part of the reason, also why I didn't realize what I what I was going through, was because I, I was used to being anxious. That was, yeah, that was my default state. Was, I'm like, I'm always just a little bit anxious. But I had never experienced those depressive episodes before.

Rebecca Gleed  30:54  

It sounds like it was new territory, that the piece was less familiar. Yes, what can you highlight in terms of your treatment that felt maybe hopeful or felt effective? And then I'd love to hear if you're willing to juxtapose that with your second postpartum experience,

Courtney Ginder  31:14  

yeah. So I take an antidepressant every day. Still do, and I remember my My doctor was just like, I'm going to prescribe you this medication. You know, it takes about two weeks to feel, you know, for you to feel the effects, because it has to build up in your system. And she was like, and, you know, sometimes this, you know, we're going to try this one first, because it's the easiest to go on, it's the easiest to come off, if it doesn't work. And I got lucky in that the first one I tried worked for me. I know that's not always the case. Even my sister, she's one that she took. It took her several tries to find something that worked for her. So again, Lucky. The first one I tried was the first one that worked. And I remember vividly to this day, five years later, my daughter's almost thought that the day that it became that it had built up in my system to where it was therapeutic, because it felt like there was color in my world, like it felt like there had been like, this dark fog, this heavy, dark cloud, and it was just like, all of A sudden it lifted. I was like, oh, it's better. Better. It didn't stop the colic. It didn't stop the crying. She eventually when she was, like, five months or so, but I at least felt capable of handling it, and I wasn't constantly like, Oh, I'm doing something wrong. I'm failing. I'm I'm terrible at this. You know, it stopped all of those really negative thoughts. And then my therapist and I, we did, we actually did some EMDR, a lot of this because it was, it was traumatic

Rebecca Gleed  32:53  

for those who don't know what EMDR, that's eye movement desensitization, reprocessing, or getting those in first, and tell folks a little bit more about that approach.

Courtney Ginder  33:05  

Yeah. So I had done EMDR with her before. I'd had some other traumatic experience before I got pregnant that I needed to work through. And when I saw her in the office, I would have she had like, a headset, and then the little buzzers in your hands, yep. So I would get tones in my ears that would alternate back and forth, and then the buzzers would go back and forth. So I would get that bilateral stimulation through the buzzing and through the tones in my ears. And we would go through these memories that were traumatic, that were giving that were giving me problems. And so with the EMDR in my postpartum period, we did stuff we focused on, you know, the colic and the the never ending crying. We did some EMDR over the pandemic and the anxiety that I felt with not knowing, you know, are we going to get this? Is it going to get into our house? Is it going to make my daughter sick, like all of these very anxious thoughts that because that's how we lived for several months became traumatic, and that was that was very helpful. And if you follow my beyond PPD account, you will know that I really love affirmations, and that's something that I got started in therapy. Was my therapist was like, I want you to write down some affirmations, you know? I i can do hard things. I am not a, you know, I am not a failure. My best is good enough, like all of these things, and she's like, I want them to put you put them on places where you'll see them. Stick some to your computer monitor, sticks under your mirror, stick some, you know, the dashboard in your car, like where you're where you see them. And that way, when you see them, you can have that reminder that, yes, I can do hard things, like I have survived all of my bad days. Your best is always good enough, like all of these things, and so that's that's where those affirmations come from, and that's why I love them so much. It's because that played a part in my recovery

Rebecca Gleed  34:55  

and Courtney that actually drew me to you. I don't know if I actually told you, no, I. Those were so beautiful, not just in the language, but in how your choice of displaying them. I don't know if you if you create them yourself or whatnot. Regardless, I was so drawn to them. They're absolutely beautiful, and we'll highlight you at the end your account. But it is beyond PPD, and they're just beyond the affirmations, I think folks will agree that they're beautiful esthetically. You. Thank you. Yeah, I

Courtney Ginder  35:34  

one of my degree is in professional writing, so I did a lot of like, desktop publishing and that sort of thing in college. So that's yes,

Unknown Speaker  35:42  

I'm like, I need to print these and put them

Courtney Ginder  35:47  

yes. So yeah, actually. And then for a long time, I thought that we were one and done, like a second one, that first one was way too rough. I don't know if I can risk, you know, having colic again, having reflux again, having PPD again, because that is another risk factor, is, if you've had it before, there's a higher risk of it coming back. So for for a while, I thought we might be one and done, but we were going to just have one kid, and that was going to be okay. And then, like, we started, my husband, I started talking a little bit more, and we realized we did want to try again. We wanted to have a second, but I was like, if we're, if we're going to do this, like, I need a plan in place, like right now. So I talked to my OB, I talked to my therapist, and we got, we got these plans in place, and my OB decided that it was better for me to remain on my antidepressant through my pregnancy than to try and go off of it. And she had, actually, she was like I was on the same one for one of my kids pregnancies, and he's just fine. Yeah. So that was something we decided to do, was to the risk, any risks, of being on the antidepressant in my pregnancy, would outweigh what the benefits would outweigh those risks. And it sounds like that was

Rebecca Gleed  37:08  

a conversation with your OB yes that was human and gentle Yes, and could be done in a way that was focused on you and the baby Yes,

Courtney Ginder  37:20  

because she said, the only real issue with the antidepressant that I'm on, I'm on Lexapro, she said, you know, the only real issue with that any withdrawal symptoms that you see in the baby is that they're just a little more fussy those first few days. And I was like, well, we've been through that before. Like, I Yes, we have, like we have been down that road. I you know, I think that's a risk we're willing to take here. And so I did stay on my antidepressant all the way through my pregnancy with my son. And actually, I ended up with prenatal depression with my son, because I ended up with gestational diabetes in my third trimester, and then I also had pubis synthesis dysfunction. I think I'm saying that correctly, or symphysis pubis dysfunction. It's when the joint that holds your pelvis together, it gets real, real loose because of all the relaxing in your system, it loosens up all your joints. It basically goes real hard on that joint, on your pelvis. It makes it very, very loose, to the point where, near the end of my pregnancy with him, I could barely walk because it felt like my weight. The two halves of my pelvis were like working independent of each other. It that's what it felt like. It's very, very painful. So I was in pain. I was uncomfortable. I couldn't eat what I wanted. I had to think about everything that I was putting in my body. Their

Rebecca Gleed  38:44  

trimester is hard enough to add them, yes, factors on top

Courtney Ginder  38:47  

of it, like and I had I, I had more nausea with him. I never actually, like, got sick, but I had more nausea. I had more aversions, like I wanted nothing to do with meat of any kind. When I was pregnant with him, I was purely surviving on carbs. And then they're like, Yeah, you have gestational diabetes. You can't have carbs anymore. You have to have protein. I'm like, protein is disgusting. I don't want protein. So I joke that he could never be allergic to peanut butter because he basically made a peanut butter because that was the only protein I could tolerate when I was pregnant, plant based exactly. So I ended up with prenatal depression with him, because I was in pain and I was dealing with a lot of stuff going on, having to think about every single thing I put in my body, not being able to eat the things I wanted to eat, that sort of thing. And I actually ended up going up a couple milligrams on my antidepressant just because I was able to talk to my OB and be like, Hey, I am, I think I'm feeling depressed. I'm, you know, this is a problem. And she was just like, well, let's go ahead and go up and that's okay, because you know, you're going to deliver here in a couple weeks. And we'll keep you at that elevated level through that immediate postpartum period to make sure that, you know, as a safeguard, basically, from having postpartum depression again. And with him, I did not have postpartum depression again. He and a lot of it, I mean, they talk about, if you've taken psi two day the two day components of care training, they talk about how temperament is also a risk factor for perinatal mental health conditions. Thank you. I can attest to that with both of my children, because my son's temperament is very different than my daughter's like she's, yes, she's a little more high strung, she's a little more excitable. He's much more laid back. He's much more chill. He goes with the flow a lot easier. She needed, you know, a lot more structure her naps needed to be at this time and only this time. Like she needed all of that structure if she didn't nap, or if she had a bad nap, like we were, you know, that was the rest of the day was screwed essentially, because she was just going to be a girl. But he's he's a totally different kid. Um, his temperament is completely different. We like to mention that my daughter is my mini me, and my son is my husband's any me, both in looks and personality. I'm a little more strong, a little more emotional, he's a little more chill, go with the flow, and our kids kind of reflect both of those.

Rebecca Gleed  41:22  

Yeah, something I'm hearing too is asking for help. Like, if you're not feeling well, you have all of these elements in addition to pregnancy and pre existing conditions, and then you add all of this, you called your doctor and you had your medication adjusted, and like not the end of of treatment, but to highlight for anyone who might be listening, who's struggling, don't let it get to that point where you know you're on the floor, or you're in a place of, I can't move, or This is a 911 call you can seek treatment earlier,

Courtney Ginder  42:02  

yes, and not to be ashamed of it, and not to be ashamed because there's, there's no shame in asking for help like that's, that's not a sign of weakness. It. I mentioned it all the time that asking for help has been the bravest thing I ever did for myself and for my family, was asking for help. Ask for help. Yes, it's not. You don't have to be ashamed of it. You don't have to feel bad about it. It's it's a good thing to ask for help.

Rebecca Gleed  42:31  

Yeah, well, tell the audience a little bit more about where you are now. Yeah, I'd love to hear about how your because what stands out with you is somehow you've been able to refocus and repurpose and provide support for so many, not just on social media, but, you know, I saw you at the psi conference. You're on panels, you're doing beautiful work to, you know, melt shame and provide education help our audience know, like the work that you're doing and how you've been able to refocus.

Courtney Ginder  43:08  

So when my therapist and I've talked about how, you know you're familiar with the five stages of grief, you know, anger, bargaining, denial, acceptance, there's one I left out there. I think it was depression, but she talked about how there's other research out there that talks about a sixth stage of grief, and that's meaning making. And I see the work that I'm doing with beyond PPD, with psi, all of that as meaning making. I went through something really, really terrible. I refer to that early postpartum period. Postpartum period with my daughter is one of the darkest times of my life, and there are a lot of things about her early postpartum period that I either do not or cannot remember. Either my brain has blocked it out for me or I just don't want to remember those times. But I take this work as meaning making of making something positive out of that experience, because I went through it, and I know there are a lot of other parents that go through it. The more I started talking about it, the more I had, you know, people my age, but also my mother's age and my grandmother's age, multi generational? Yes, that I went through that too, but I thought that's just how motherhood is. I thought that's just how it is, that it's terrible those first few years, and then eventually you come out of it. And that's not true. It doesn't have to be that way. And so while this is extremely common, it affects one in five moms. It doesn't have to be that way. You can get better. You can feel better. You can, if not, enjoy those early period, those early days. Because, I mean, it's not entirely enjoyable, especially if you two have a more intense. High needs baby, my with my son, I joked. I was like, Oh, I understand why people like the newborn stage, because he actually did just eat sleep and poop. And my daughter was like, eat sleep screen. I remember seeing my OB for my postpartum point with my son. And I was like, did you know that some babies, when you pick them up, they stopped crying, because that was not the case with my daughter. With my son, I pick up. He's like, Oh, okay, we're good now. But I was like, did you know like they stopped crying and giving them up different babies? Yep, it's all I just I want other moms one to know they're not alone. I remember feeling so alone and so isolated when I was experiencing postpartum depression not fit, not even just physically isolated because I couldn't see anybody, but also emotionally isolated because I felt like no one else I knew was going through things like this, like everyone else seemed to, you know, have an easier time with it. Their babies didn't cry all the time. Their babies didn't have reflux, you know? And I assumed that again, that it was my fault. There was something I was doing wrong, because they're all having easy times. I'm not so clearly, I'm the problem. So one that you are not alone, and this is, this isn't your fault. I mean, you can have all the risk factors and never develop postpartum depression or any kind of perinatal mental health disorder, or you can have none of the risk factors and still get one. Like, there's there's nothing you did or didn't do that caused it. It's not your fault, and that you can get better, like you don't have to suffer, you don't have to feel alone. You don't have to have your brain telling you all these horrible things that aren't true. You can get better, either whether that's through medication, whether that's through therapy, whether that's through other other treatment options, like yoga, exercise, or whether it's a combination of all those things,

Unknown Speaker  46:56  

recovery, personal, isn't it? Yes, because everyone's

Courtney Ginder  46:59  

brain is different. So you know what works for me won't work for the next person or the other person? You know it's, you're likely to therapy and medication is what worked for me. It may not work for someone else. That's, it's so personal. It's so unique, because all of our brains are unique. So I feel like because I was the exception, where I got help and I got better, and I got better quickly, where I was the exception and not the rule, that I feel like I need to let more people know that, you know, you can get better, and there's no shame in asking for help and saying, you know, I don't feel like myself. Something doesn't feel right, and you can ask for help when you feel that way. I actually didn't find psi while I was in, while I was experiencing PPD. I actually don't live very far. If you are familiar with birdie Meyer, everyone loves birdie. Yes, he only lives about 40 minutes for me, no kidding. I live on the northeast side of Indianapolis. She lives on the northwest

Unknown Speaker  48:02  

side. And tell our audience who birdie is birdie.

Courtney Ginder  48:05  

She is the head of certification for psi, and at one point she was also the president of the board for psi. So she's very well known in perinatal mental health. She founded, if you're in Indiana, she founded the perinatal mood disorders program at IU Health. So she's kind of a big deal, but when I was experiencing postpartum depression, she's literally 40 minutes down 465, for me, I had no idea she was there. No idea I had no idea that these resources existed. And so I found psi actually, after I was getting better, and I came across a video about the climb, and I was like, Oh, this looks like fun. I can do this. And so I led a climb in Indianapolis for a couple of years. I stepped back when I got pregnant with my

Rebecca Gleed  48:55  

son, because what is it? Climb? For the audience, the

Courtney Ginder  48:58  

climb is psis fundraising and awareness raising initiative. So climb leaders are people who either they work in the perinatal mental health sphere, they've experienced a perinatal mental health disorder, any of those things. They can sign up to lead a client, and they have an event in their city where they usually there's a walk component to it, but a lot of clients have also adopted like resource fairs and that sort of thing, where they can just have parents come together and, you know, find resources in their community, find community among other parents that have been what they've been through, what they've been through, and understand what they've been through. So I led a climb for a couple years, and that led me to join the board of directors for psi Indiana. So if you follow psi Indiana, I do social media for them. And then, because of that, when psi, when social, when our social media manager went on maternity leave in 2022 i believe i. Um, they reached out, and they were like, do you want to cover her maternity leave? Wow, yeah. And so that's how I got on psi staff. And when Caitlin came back, they were like, do you you want to stand I was like, Yes, I want cool though I do. I do social media for psi as well. So yeah. And I mean, we met at the conference, and I remember thinking at that conference like, Oh, my God, if the me from 2020 could see the me now, like, she wouldn't believe that this was possible. Like,

Unknown Speaker  50:32  

what advice would you give her?

Courtney Ginder  50:34  

I would give her Ursula. I would give her a hug.

Rebecca Gleed  50:38  

I would give her a hug too. She would she would. She was very much

Courtney Ginder  50:41  

in need of a hug at that point in her life. I would give her a really good hug, and I would tell her that that there's nothing wrong with her, and she did not do anything wrong. She's not making any mistakes, and that what is happening to her is temporary and it's treatable and she can get better, and that baby that cries all day long will become the most amazing toddler, an amazing preschool, and I have to sign her up for kindergarten here soon. And I don't know how that happened, cashews, but I mean, the the things that made her a very hard baby made her an amazing toddler and preschooler, and now a kindergartener like I I'm convinced this child just didn't like being a baby. She likes to do things herself. And so, like, as she hits those milestones where, like, she could sit up, she could crawl, she could grab she could walk, she could do all these things for herself, her mood got so much better. So I think she just she didn't like being a baby.

Rebecca Gleed  51:40  

Well, Courtney, I think so many your story is going to resonate with so many, and it's going to provide that hope and also guidance and self compassion for all of the women who are either individuals currently going through a tough time or perinatal condition, or maybe they're looking back and saying, oh my goodness, this is so healing. And what can I do now? Yes, I cannot. Thank you enough for coming on. Please tell us again where we can find you.

Courtney Ginder  52:11  

Yeah, so on Instagram, I am at beyond PPD, and I also have a Facebook Facebook page, and that one is just beyond postpartum depression. It's the full

Rebecca Gleed  52:20  

spelled out version, yes. Well, thank you so much for coming on Absolutely. Thank you for having me.

Speaker 2  52:30  

If you would like to learn more about how we can help, visit our website at perinatal reproductive wellness.com, and while you're there, check out the latest edition of our book, employed motherhood. We also invite you to follow us on social media at employed motherhood. Finally, if you enjoyed listening to the show, please subscribe and rate it. Thank you. You.