Postpartum vs. Peripartum Psychosis: What Every Woman Needs to Know

This is a conversation most people avoid but need to hear.

In this episode, I sit down with nurse practitioner Allyssa Brody to talk about postpartum and peripartum psychosis, something that is often misunderstood, minimized, or completely missed.

We talk about what it actually looks like beyond what people assume, how it’s different from baby blues or postpartum depression, and the warning signs that shouldn’t be ignored. This is not about fear. It’s about awareness.

Because the truth is, not every woman feels like herself after giving birth and sometimes it goes far deeper than we expect.

We also talk about why so many women stay quiet, how partners and families can recognize when something is off, and what real support should look like during this time.

This episode is for women, for partners, for families, and honestly for anyone who wants to better understand the mental health side of motherhood that doesn’t get talked about enough.

If you or someone you know is struggling, you are not alone and there is help.

Listen to Talk2Tamara wherever you get your podcasts.

Transcript

SPEAKER_01 0:00

Hey guys, and welcome back. Today we're talking about something that is still really not discussed openly enough, which is maternal mental health. Pregnancy and postpartum are supposed to be one of the happiest times of women's lives. But for women, they are also some of the most psychologically vulnerable months of their lives. Anxiety, intrusive thoughts, depression, and in more severe cases, postpartum psychosis. Before this touches your family, it can feel like something that happens to someone else. It doesn't feel common, it feels distant. But once you're in it, you realize how common and how misunderstood it really is. That's why we're having this conversation. I'm joined today by Alyssa, a nurse practitioner who specializes in reproductive psychiatry and maternal mental health. She works directly with women during pregnancy and postpartum, treating things like anxiety, depression, and mood disorders, and more severe perinatal psychiatric conditions. I'm so grateful to have her here to help us understand what this really looks like, not just clinically, but also in real life. Alyssa, thank you for being here. Can you share a little bit about your background and what led you into this specialty?

SPEAKER_00 1:18

Sure. I'm actually originally a child and adolescent specialized. When I originally started my career, that's kind of what my goal was. And I treated children for quite a while until I had the opportunity to meet with some adults alongside those kids and found that I was really driven to the perinatal mental health, feeling like I was able to kind of get in on ground zero and talk to moms before they had their children about their experiences in hopes of kind of helping them in their journey to parenthood to motherhood. Um, and that's kind of how I pivoted to the field that I'm in right now. Um, I've really enjoyed it. I've, you know, been in this field for over 10 years and I've I've specifically worked with mothers for over six years exclusively, um, or you know, women in the perinatal period across, you know, that whole life stage.

SPEAKER_01 2:15

Yeah. Wow. That's that's incredible. That sounds really amazing. And I just want to know like there's so much about this topic that we are going to get into. But if there's one thing that you can take from the information that you are going to give, what's something that you really want women to know about this time in their lives?

SPEAKER_00 2:33

I think it's really important to know that you're probably not alone in experiencing distress associated with this stage of life. I think this season of life is really rewarding, but it's also really difficult and really challenging. And that likely if you're experiencing something, someone else has experienced it before and there is help for that.

SPEAKER_01 2:59

Yeah. Yeah. I think, I mean, I just think about my pregnancies, like not so much when I was pregnant, but really after being pregnant, like you're dealing with sleep deprivation, you're dealing with all the things that's happening, your your hormonal um changes, your body's change, like everything has changed for you. And it's it's really hard, like I think for me to notice to understand what the difference is between, you know, kind of having that, those feelings, which is normal for being for being postpartum and even when you're pregnant to have those anxious feelings and depression. But what labels it as something where it's more severe? Like, how do you know that we need to come to somebody like you for, for example?

SPEAKER_00 3:42

Completely. Yeah. No, that's such a good question and one that's often posed at conferences about perinatal psychiatry, right? Because this is so important. So I would say, and I think what most of the um, you know, most of the organizations out there supporting this cause would say is kind of that, you know, if you're feeling emotional, if you're feeling sad if you're crying sometimes, if you're feeling like um really overwhelmed by just being a new mom, or even just being a mom of, you know, a couple of kids but having a new baby, that's that feels normal, right? That feels like uh uh like maybe distressing, but but more common when it starts to feel like your self-esteem is being impacted in a real way. When you start to feel worthless or feel like I'm a terrible mom, or you're crying because you feel like I can't do this. I feel shame or guilt around, you know, all of you know what what I'm doing. You know, I feel I feel guilty about things that I probably shouldn't feel guilty about, right? Like that is when I think it's important to start thinking this this is something that I need to get help with.

SPEAKER_01 4:48

How do you though, as like, as like a first-time mother for sure, and even as like not a first-time mother, differentiate between those feelings? Because I think we all fig we all feel that, like, you know, that we're not, we're not being a good mother, we're not being a good wife, we're not, we're feeling anxious. Like it's it's really hard to know where that where that line is of like, okay, now I really need to get help. And I and I think like I've I've had clients that don't really know that they're even having postpartum depression because they're just like chalking it up to sleep deprivation or they're chalking it up to, and and most family members do that as well, right? They're like, oh, she's fine, she's fine. Um, so you're saying things such as like, oh, if you feel shame, if you feel those types of things, like now I need to get help. But really, how how does a person really have that self-awareness that like this is what's going on for them? They're so overwhelmed.

SPEAKER_00 5:42

Right. So I I mean, if it's if it's interrupting your quality of life, right? Like a mom comes to me and says, like, I feel like I thought this was gonna be so amazing. I thought this was gonna feel so good. I thought it was gonna feel so beautiful. And now I feel so terrible. I feel so depressed. I feel like I'm missing this time with my baby. I mean, I've had moms come to me and say, I feel like I lost this whole stage of life because I can't connect to my baby. I can't connect to the good parts, the joyful parts, because I'm so stuck in kind of feeling this worthlessness or helplessness or shame. You know, I think a level of guilt is normal, right? A level of, I'm not good enough, I'm not a good enough mom, I'm not doing this well enough is is so normal. But when it feels like it's depriving you from experiencing the joy at all in it, um, or when it feels like you're getting down on yourself to the point where you feel completely worthless, like that I think is a really good telltale sign.

SPEAKER_01 6:45

Wow. Wow. That's I guess that I guess that makes sense. Um I just like always wonder, you know, you hear you hear these cases of women who are drowning their baby in a bathtub, you know, and how does it get to that point? How do we, how do we prevent it from getting to that, to that point? When when is a spouse supposed to know, like, okay, they really need help?

SPEAKER_00 7:08

Okay, so I think what you're bringing up is is so important and needs to be spoken about, but I also think there's some misconception around it too, right? Because there's a difference between the different perinatal mood and anxiety disorders, OC perinatal OCD, right, postpartum OCD, um, trauma and then psychosis, right? These are all different areas of perinatal mental health that need to be explored and addressed. Um, but but they're distinct from each other. So I think, you know, empowering, you know, a partner, right, like a spouse to kind of step in and and notice the changes in their in, you know, in their partner, in their birthing partner, right? Like notice how their behaviors are changing so significantly is really important. Um, if they are, you know, like if they're no longer taking care of themselves, for example, if they seem like they're kind of staring out and they have a very blank kind of look on their face, if they're talking to themselves, right? Or like feeling really internally preoccupied, like not paying attention to things going on around them.

SPEAKER_01 8:12

Does that happen? Do they talk to themselves and they just kind of like they act a little bit um odd or strange?

SPEAKER_00 8:18

So with postpartum psychosis, yes. But what I was kind of like wanting to get at also is that that's a very different presentation from postpartum depression that we have to be distinguishing between, right? Someone can be really down and sad and really feel terrible about themselves. And then, you know, someone else can kind of present as, you know, experiencing perinatal psychosis, which looks maybe kind of similar, but is it actually, in fact, very different and is considered, you know, a psychiatric emergency.

SPEAKER_01 8:47

Can you explain the difference for our listeners who may, who may or may not know the difference between postpartum depression and postpartum psychosis? What does it look like? Sure.

SPEAKER_00 8:57

Yeah. So postpartum depression, we're looking at, you know, can present in several different ways. And, you know, some moms postpartum might present as feeling really numb, feeling really detached, not feeling bonded to their baby or attached to their baby, um, wanting to socially isolate, not be around people, or feeling, you know, cry often or possibly not cry at all because they're just feeling so, you know, so numb. Um, again, with kind of like worthlessness, self-doubt, self-guilt, um, you know, and shame around that, and possibly even thinking, you know, I'm a burden on others. I would be better off. You know, others would be better off if I wasn't around. That right is very, that's a very severe case, but that's you know, a symptom of postpartum depression. Postpartum psychosis is different in that, you know, someone might even feel like a bit elated and, you know, might feel even on top of the world and empowered, right? But and and goal-oriented and very driven. But they also start to talk about things like um, I am certain that my baby is, you know, in imminent danger and I need to protect them. I am on a mission. And this is, you know, I with essentially no shadow of a doubt, right? Like I know I'm here for this particular purpose. And that feels a little odd or strange, or they might not make sense. What they're saying might not make sense, doesn't align with reality.

SPEAKER_01 10:21

Wow. Okay. So I guess there's like that big distinction from postpartum depression. Like when you see somebody coming to your office, you would know if they had the difference between a postpartum depression and postpartum psychosis.

SPEAKER_00 10:34

Yeah, most likely. I mean, there are some times where in the very beginning stages it feels unclear. Like maybe um you can rationalize some of what a person's saying and it might feel like it's based in reality. But if if you give it a little time and you poke a little further, you can you can really typically tell as a professional. Yeah.

SPEAKER_01 10:54

And then it's, you know, it's interesting personally for me. Um, I had a family member who had pre-partum, I I I'm not sure what it's called, but something like when when you're pregnant, you have psychosis. So can is that is that actually a thing? Like, do people have that? Or and I I and in the same in the same token, I heard people who, when they're pregnant, have severe anxiety, have severe depression. Um, so how does that play out when you're pregnant and you're dealing with all your pregnancy symptoms, right? So it's not like you can and you can't really go on the medication that's like maybe, may or may not be good for you, or they're scared to go on that medication. In particular with this one, with this one family member, um, you know, she had a lot of anxiety that that was surrounding the psychosis, but because of the anxiety about the psychosis or about everything else that was going on, she did not want to take the medication either because she was nervous that that was going to harm the baby. So it would kind of played hand in hand of, you know, I need to get better, right? And I'm, but um, my pregnancy is causing my my anxiety to be through the roof, right? She was an anxious person to begin with, and then that made it even worse. And then I have psychosis on top of it and I can't take the medication. So, like, what would you um what are I guess like what are your recommendations for people who are suffering it while they're pregnant as opposed to even after?

SPEAKER_00 12:22

Right. So typically, um, psychosis during pregnancy isn't necessarily like one is not necessarily at a higher risk during pregnancy. However, there's so much stress related to pregnancy, and stress is a an enormous trigger for psychosis, psychotic symptoms. Um, anxiety also sometimes is on this spectrum of like hypervigilance to paranoia, right? And I think this is so fascinating because sometimes we're super anxious and anxious, paranoid almost, right? Like where we're like nervous, something bad is happening, or something bad's gonna happen to me, or to my kid, or to my pregnancy, or and it becomes well, where does that become kind of like, you know, paranoia, or how do we distinguish that from paranoia in a delusional kind of frame where we feel like I know something bad. I'm certain that something terrible is gonna happen right now if I don't do X, Y, and Z, or if I don't protect my baby from X, Y, and Z, or if I don't protect my pregnancy. So there's like distinguishing between that is really important. And I think seeking help is really how you distinguish between that and how you like identify what the proper treatment options are. But I can say that having been a prescriber during pregnancy and postpartum, there are medications that are safe to take in pregnancy for psychosis, psychotic symptoms. Yeah. And that's why seeking help is so important. Right.

SPEAKER_01 13:43

So that I knew. Like I know that there are medications that are safe. However, because of her anxiety that was so severe, she was like, I'm not, I'm not gonna take this medication. It's going to her my baby, or she'll tell family members that she's taking the medication and then secretly not because she was so nervous. Like, really, the thought of like having to take that medication in her body gave her so much anxiety that she just was like, she collapsed at the thought of it. So it made things like even worse. So it was, you know, um, that's why I'm also really interested in talking about this topic. Seeing seeing a family member firsthand suffer through it was actually terrifying. You know, it was like you don't even really know what to do and you don't know what the like the right steps are.

SPEAKER_00 14:26

Um yeah, yeah. And I see this all the time. Anxiety is so complicated because it gets in the way of treatment often, right? Like this is something that I have to contend with in practice so often, right? And it's really building that rapport and getting the client on board to kind of see this with you, see it as a physical ailment. If somebody had hypertension in pregnancy, would they not take their antihypertensives? If someone was diagnosed with diabetes in pregnancy and their numbers were really high and they had to take their insulin, would they not do that? The reality is that I think sometimes we consider maternal mental health, like our mom's well-being at odds with the baby's well-being, right? Like it's me versus the baby. And if I take this medication, what does that say about me as a mom? But realistically, mother's best interest is actually the baby's best interest because there are so many studies showing that the psychosis, that the anxiety, that the depression, right, during pregnancy can have profound impacts on that baby, that growing fetus, right? And then for the child's development long term. So we're not talking about a risk versus benefit. We're talking about risk versus the risk of taking the medication.

SPEAKER_01 15:40

So are you saying that if if a mother or if a person who's pregnant suffers from severe anxiety and severe depression during pregnancy, that that will have a long-term effect on the baby's mental health or maternal like, yeah?

SPEAKER_00 15:55

Yeah. I mean, I I think that we, you can, you know, there's a lot available out there in literature as to specifics of how that might happen or what degree of anxiety is necessary to, you know, show prove that we can see, you know, impacts that, but you know, and and babies are pretty well um, you know, protected in you, you know, in the uterus. Like it's it's pretty, they're pretty well protected. But for, you know, there are definitely a lot of bodies of research out there showing this that wow, there are negative impacts.

SPEAKER_01 16:26

I mean, I actually heard this thing and I thought it was like preposterous. Like by my third pregnancy, um, there was a lot going on in in my in my personal life and different things. And I cried a lot in my pregnancy, like all the time. And a person told me, they're like, you know, if you're gonna cry a lot, then your baby's gonna come out crying and your baby's gonna be like all sad and depressed. And I'm like, really? Like, me crying has what to do with the baby being depressed? Like, I don't know. You know, it happens to be that she's like the happy, she was the happiest baby. And like, I don't know if that actually played into it, but you know, it's just it was it was an interesting thing for somebody to tell me. And I didn't think of it that way.

SPEAKER_00 17:05

Yeah, and I don't know that that is a hundred percent right. I don't know that there's any documentation of like a baby, you know. Okay, but I but there are other, there are other um complications that come up with yeah.

SPEAKER_01 17:18

Yeah, yeah, wow. Okay. Um, so and I guess this is like a question that I asked um earlier, but for a person who feels like off during the pregnancy, right? They just don't feel like a hundred percent themselves. How do they differentiate while being pregnant from like the hormones and the different things that are going on for you being pregnant or the fact that like these are red flags and I need to go get help? Is it the same as like postpartum as it as it is when when you're pregnant?

SPEAKER_00 17:49

I mean, I often say, right, like think about distress, think about danger, think about dysfunction and deviance, right? So I know it sounds like a lot, but is it is what you're experiencing dis distressing enough that it is really impairing your ability to function, that your quality of life is really compromised? Is it deviant enough where you feel like you're looking around, you're like, this doesn't feel comparable to the way other people are acting or or you know, feeling around me? Um, and is there any danger element, right? Am I feeling like others would be better off without me? Am I feeling like I'm burdening others and I just want to disappear or I want to um, you know, do something to harm myself? I mean, those are telltale signs that you need help, right?

SPEAKER_01 18:38

Yeah, yeah. Well, I I did have like this family member ask me repeatedly, like, am I crazy? Am I crazy? Just tell me if I'm crazy. Um and you know, my answer to her would always be like, no, you're, you know, you're you're fine, you're you're good, you're just going through a lot. Um, you know, what do you tell people who are on the other side of it to tell people who are going through this type of stuff? What do you answer to that? It's a good question.

SPEAKER_00 19:07

I mean, first of all, um, I would normalize that, you know, that perinatal mental health struggles are common, they're real, they're valid, right? That like, you know, I'm just gonna echo what I said earlier about, you know, comparing it to kind of physical health struggles, yeah, that there your brain is wired in a certain way. And there's, you know, there's the hormone, the kind of the hormonal changes during pregnancy and postpartum, and you know, cortisol changes and and stress, right, can rewire your brain in a way that is really physiologically based. So it's not something to be ashamed of, right? If you are feeling like this, I'm not myself. Something feels really off. Sometimes it feels very validating to know that there's a name to what you're going through. Yes, right. And I'm sure. And people talk about like validate, validate support, tell people that it's normal. But when people come into my office, I can't tell you how many times they feel, they just like, I'm so glad that you were able to validate that this is not normal. Right. Right.

SPEAKER_01 20:12

Right. That I'm not just crazy, right?

SPEAKER_00 20:14

Like yeah, like this is not normal. There's a name for what I'm going through and there's a treatment for it.

SPEAKER_01 20:18

Yeah, yeah. That's that's really true. But it's like getting to that point, right? It's just like getting them into that office and getting them to be seen by somebody is probably like the hardest part, right? Like getting the help is always like the hardest part, right? For sure. Um, and I think like for this family member, like she just wanted to be told like she's not crazy, you know, and like there is something going on for her where everybody around her was just kind of being like, oh, you know, she's crazy. Let's just like stay away from her for a little bit until she has the baby, right? And then she'll go back to being normal. Um, so that was like really hard. But um, so it it it does seem in a way that postpartum and again, I I don't know what the terminology is for when a person is pregnant and has parapardum. Okay. So peripartum, it sounds like really extreme, right? It sounds like this this type this type of thing that can happen to you. That's that's a really extreme possibility um for when you're pregnant or after pregnant. So what is it, um, what does it look like in the beginning parts of it and does it escalate really quickly?

SPEAKER_00 21:24

So I mean it depends on what the person's struggling with, right? But depression specifically, right? Like there are early signs like sleep changes, right? Someone feels like they just want to sleep all the time or they just can't sleep, like they're just up and they can't sleep, and then right, those sleep changes are really important to notice. Um feeling really ambivalent about things, just not caring, not feeling interested in things, socially isolating and withdrawing. I mean, I think those are probably the first indicators or can be, but really any any depression sign, not. Eating, reading too much, right? Like low energy, low motivation, all of that can feel yeah.

SPEAKER_01 22:06

And do the women who come into your office do they usually present the same or it's all different?

SPEAKER_00 22:12

So different, right? I mean, I think that I have, you know, I've seen so many of the same presentations, but then I've seen so many different presentations um, you know, over the course of years, right? Like depression, anxiety, OCD. And um, I think OCD is a really interesting one because I think when you were describing kind of that reassurance seeking, am I crazy? Am I crazy? What speaks to me is that OCD nature of it, right? Like this obsessive notion, you know, this obsessive reassurance seeking that feels very, you know, OCD in quality. And there is a lot of research out there on OCD, postpartum OCD, right? Intrusive.

SPEAKER_01 22:54

Interesting. So does that mean that the person did not have OCD before and then and then after pregnancy has developed it, or they always had the symptoms of it and it just magnified it?

SPEAKER_00 23:06

Some cases are, you know, some cases they've had it before. Maybe they didn't know that they had it before. They like didn't realize it didn't impact them as much. Um, and it's the first time they're coming in and being diagnosed with something like that. Sometimes it just emerges with, you know, in the setting of all these changes. Yeah.

SPEAKER_01 23:23

And are they resistant to that? Are they like, no, I don't have I don't have OCD, right? I don't, I don't have it. Like because they don't want to be labeled as like, oh, I have some disorder.

SPEAKER_00 23:33

Um, I think most are not resistant to it because, like I, you know, like I said, I feel like it's validating to put a name to something that you're experiencing. Especially when, you know, moms come into me and they tell me, um, I'm having these intrusive thoughts, right? Like I I have an intrusive thought of harming my baby, of throwing my baby down the stairs, of dropping my baby over a balcony, of, you know, like I have and I feel like I'm a danger to my baby. I don't think I can care for them anymore. And those kind of obsessive intrusive thoughts are actually based in in usually in OCD, right? And in an anxious kind of pattern. Those thoughts are are usually rooted or we're able to distinguish them as OCD thoughts. And that's so relieving to a parent. Oh my gosh, like, I'm not gonna do these things to my baby, I'm not gonna harm my baby, right? Like, I just it's OCD.

SPEAKER_01 24:25

So, how is that different from OCD like um and depression and anxiety? Like, OCD is really just the intrusive thoughts. Like, can you um explain to our listeners how that presents differently in somebody with postpartum OCD versus regular um OCD that a person would just have?

SPEAKER_00 24:46

So someone with OCD has to kind of essentially in order to be diagnosed with OCD, one has to has have obsessions and also compulsions, right? So obsessions in the way that we typically think about it, right? Can be if I don't wash my hands, right? I'm gonna, you know, there are germs that are gonna, right? If I don't line these things up in a certain order, something bad's gonna happen. If I don't like lock the door three times in a row, right? We that's what we typically think of when we think of OCD. But they can really just be intrusive thoughts, right? Obsessing over, did I, you know, did that email that I just sent my boss have any um, you know, errors in it? Um, I I maybe I made an error. Let me double check that, let me triple check. So the compulsion is the checking, right? Let me check it. I have to check it again, I've checked it again. It might take somebody 30 minutes to just send an email because the obsessions about it, right? So that that's another form of typical OCZ. And then in the postpartum, it presents as is my baby breathing? Let me just check. Let me check again, let me check again, let me check again. Let me buy an owlette because I can attach this device to my baby's ankle and then I can check more repeatedly whether their heart rate and you know, and breathing rate's normal. So that you treat that. So we treat it with therapy. It's very responsive to psychotherapy, um, you know, exposure therapy specifically. Um, we have medications that can help treat it, but it's extremely treatable. It just needs to be identified. Yeah.

SPEAKER_01 26:09

And are they the ones that are like constantly going to the doctor with their baby saying like there's something here, there's something, or is that a form of like hypocontracts? Are they are they OCD?

SPEAKER_00 26:19

Is that um so there is a separate kind of like hypochondriasis, which is now illness-related anxiety. I mean, there's like a whole you know, host of all over. Um, but I'm less concerned with the diagnosis as much as I'm concerned with what are the symptoms, how are they presenting, and is this a thing? You know, like it's a thing, right? Like someone has these particular symptoms that they're coming in with, they're obsessing over the baby and over, you know, and these intrusive thoughts kind of keep coming up and it's distressing and disruptive, they're not sleeping because of it. Like this is a problem. We know we've seen it before, we know how to fix that.

SPEAKER_01 26:53

Right, right. Wow. Um, are there people that are more at risk for peripartum that are more prone to something like to get that, such as like somebody with by with bipolar um genetics, like anything like that? Are there um signs that we can see from beforehand that they they may be more prone to um get something like like this?

SPEAKER_00 27:18

Yeah. So somebody with a preexisting mental health condition or uh, you know, a close family member with a preexisting mental health condition is more prone to you know to experiencing a mental health issue in the pregnancy and postpartum for sure.

SPEAKER_01 27:34

Do you see that in your office a lot? Do you see a lot of people who come in with pre-existing conditions and you know, how do you encourage them, I guess, to go to even get pregnant, right? To even like like have that um, you know, kind of thing where they're where they're where they're not gonna be nervous about falling into this psychosis place or you know, anything like that. Like, do you see that a lot?

SPEAKER_00 27:58

Yeah, yeah. I mean, I think just recognizing that there's treatment, that there's treatment that is um, you know, possible to take during pregnancy and breastfeeding, right? That it's available, that it's a conversation with a provider with a genuine kind of like collaborative approach, right? That's these are options. Treatment exists and it's it's it's accessible. And I think that is so relieving for so many individuals who have struggled with mental health, you know, issues in the past and and feel like they want to have a you know children.

SPEAKER_01 28:32

Yeah. Do you think that IVF or going through any of those types of things play into this um, you know, any type of psychosis or depression or anxiety? Like just, you know, I I just think of the you know, pumping themselves up with these injections beforehand, before they're even pregnant. So they're already anxious to begin with. And then the transfer, the transfer of the um embryo and all of that. Like, do you find that with the rise of IVF being a little bit more that's more common, people are doing it more, people are doing IUI, people are are like it's much it's much more common that you see more of the effects of it after or even during pregnancy?

SPEAKER_00 29:14

So I I've seen so many individuals go through the IUI IBS cycle, and I've watched how mood shifts and anxiety shifts come up during those, you know, initial kind of days with the hormonal changes. And it really differs person to person, also differs cycle to cycle. Like I've been very surprised at, you know, an individual who comes in who has already done a cycle and we think we know what to expect because we saw it before. And then they come in with the second cycle, and you're like, this is a totally different set of symptoms. Um, it's very overwhelming, it's very anxiety provoking. I often describe it as a roller coaster of expectation and disappointment, right? It's a lot of just like the for infertility journey. I mean, whether someone has had a failed IVF or has had failed attempts at conception spontaneously, like that, it's the journey is so taxing and can definitely, you know, kind of impact a person's mental health tremendously. There's no research out there showing that it's going to, you know, contribute to development of psychosis or OCD or like none of that. I think it's just that higher stress levels, you know, can contribute to um, you know, higher anxiety levels and other mental health struggles.

SPEAKER_01 30:32

So you've you've been doing this for about 10 years. You said, Yeah. Do you see a difference in the amount of patients that are coming in with these, with these types of um like symptoms? I mean, we are in a day and age where I think every person and their mother has like anxiety, has some sort of disorder, right? And maybe in the past, like we just didn't label it, we just didn't talk about it. We kind of like just shoved it under the rug, but now anxiety is like everywhere, right? Everybody has anxiety. Yeah. And so do you see like a shift of people um coming into your office with more of this, or is it just like now it's more people are more aware of it and people are just much more interested and they'll come for the help more than in the past?

SPEAKER_00 31:17

I think people are definitely coming in for the help more than in the past. I think that communities that did not support mental health treatment um are now supporting it more. And I think that even if the communities don't necessarily support it, the individuals are coming and breaking those cycles. Like that is, you know, I that's definitely more common than it used to be. Um, as to whether it's more common to experience as, you know, uh an individual going through this perinatal life stage, I think it's always been there. Like I think there's always been, you know, a lot of, you know, kind of covered up depression and anxiety and pregnancy and postpartum. Um that's coming out maybe more because people are seeking treatment.

SPEAKER_01 31:58

Right. It's like I wonder, like back in the day, you know, when when people had like 10, like 10 kids and you know, they just had like a lot of children, a lot of stress, and like nobody really ever spoke about this. Like, I don't remember, you know, my mother or any of any of her friends being like, you know what, let me go seek out help. Let me go, I'm I'm feeling anxious, I'm feeling depressed. You just kind of like push through, right? And I like I wonder if like we are a society that just can't push through or if we actually really do need the help. Like, do you ever see in your office people who just don't actually need to be there and they're just like wanting, I don't know, um, wanting something uh like to seek just to seek out like attention or anything like that. Like, do you ever see that?

SPEAKER_00 32:41

I think that if someone's coming for the help, they need the help. That's what I think. I think that if you know, if someone's seeking something because there's something bothering them so significantly that they're willing to commit to to be, you know, do the treatment necessary, then something's probably there that needs to be contended with, right? Right, right. So that's I guess that's what I would say to that.

SPEAKER_01 33:03

Right. What are some things that you think that people who are going through um postpartum, peripardum, um, and their family members, what are some things that they should not say to people that are going through it?

SPEAKER_00 33:18

So I definitely we know like the more common ones, like don't say calm down, don't say don't say calm down for sure.

SPEAKER_01 33:27

I think they say that people who are anxious, and it's funny because I actually just did this to my sister where she was so nervous about something, and I was like, you need to calm down. And she's like, that is the worst thing that you can say.

SPEAKER_00 33:41

Yeah, right. Like it's not, I mean, they we want to be calm, like right, right, trying to do this. Yeah, right. Like, so there's no, you know, I think that's not the right thing. I also hear, you know, people saying that other people will tell them um that they, you know, well, they made this choice. You chose to have a kid, like you chose to get pregnant, so now you're so stressed out about it, like this was your decision, right? Like I think staying away from like, you know, you kind of brought this on yourself is a really important one. Um, I think giving unsolicited advice, right?

SPEAKER_01 34:17

I that's for sure, right?

SPEAKER_00 34:19

Yeah, yeah. I think the causes more harm than people realize. I I often joke that like I can write a book about the in-law families that gave unsolicited advice because my patients will come in and tell me how distressing it is and how much it throws off their own family dynamic, right? Somebody's trying to create their own, you know, kind of unique family dynamic. And then they have external family members weighing in on everything and anything.

SPEAKER_01 34:44

Um And that's even like how you parent and what like you should be doing and all those things, you know. Um, but I also find I just find it like interesting that people don't really like know what to say. So sometimes when they don't know what to say, they're they're saying the wrong things, right? So it's uh it's like it would be helpful, I guess, if you have like a list of like, don't definitely don't say this, you know, don't ask a person how they're feeling. It's like when a person's in the hospital and like the first thing that that, you know, when someone comes to visit is you say, How are you feeling? And then their answer is, well, I'm here, right? So I'm obviously not feeling great. Like, don't ask that question. Yeah.

SPEAKER_00 35:22

Yeah. Yeah. There are so many things that people say that I feel like are just not helpful. I mean, you want to validate, you don't want to invalidate. So if somebody's telling you that they're upset about something or that they're feeling really down or really sad, you don't want to say, Oh, really? That's strange because I thought this was supposed to be such a nice loving time, or you don't feel connected to your baby. Maybe you should check that out. You know, like there needs to be a more compassionate approach to this. And um, I I found even with partners, right? Like I'll have, I had a woman come to me once and I thought this was such a fascinating kind of description of what she was experiencing in terms of communication. Um, she was really overwhelmed. She felt like she was carrying the load postpartum, right? Like she was doing all the things. She was waking up with the baby. Um, she didn't feel supported enough by her partner. And she, you know, her partner would say to her, you know, her husband would say, you know, maybe you just need to be on higher meds and you would stop losing it. Or maybe you need to like go on different medication and you'd stop losing it. And she came to me, she she came to me and she said to him and she said to me, She's like, Am I gonna ask you to medicate me so I can turn into a stepford wife? And I'm like, that is such an interesting thought, right?

SPEAKER_01 36:37

Yes, yes. Well, that was actually like my next question is like the men who don't obviously they can't understand what like we are going through, right? They are not women, they have not just given birth, they their hormones are not all over the place. Um, and I've actually heard my husband say, I think it's a made-up thing. Like postpartum is not really a thing. Like, okay, so you're tired, like whatever. But like they actually, I think to an extent, unless they really experienced it, don't believe that it's actually a real thing. Um, and so for men also, like, how do you, what do you tell men to make sure that like you are number one, seeing the signs clearly, because that is so such, such a real thing that the men just don't, don't even know what they're looking for. They don't really know what like off means. And if they don't have family members and they don't have friends around or whatever to see it, not everybody lives at a place where they have a support system where they have family members that would see the difference in their in, you know, um, this woman. So, what do you tell men to like do like to realize like, hey, this is actually a real thing?

SPEAKER_00 37:46

Yeah. So I have conversations with spouses all the time. I'll call, I'll be like, give me your husband's number and let me call and explain this because it's such a real thing. And you're right, it's very unrelatable if you're not a woman and you're not going through it. Right. So the, you know, a conversation typically goes where I'll kind of just explain to them, like, hey, this is a medical, I think men can understand medical terminology better. Right. Like, let's compare it to a medical situation, right? Where like these hormones are plummeting at a rate that's so incredibly fast that your entire body and mind are just like going through a huge shift. And it's a real physiological medical shift, right? And it's causing your brain to change in a way that feels so potentially emotionally overwhelming and distressing. And then coupled with sleep deprivation, sleep deprivation is a form of torture, right? It's a form of torture. And then we we do this, we we go into this after post, you know, sometimes surgery if you're doing, you know, having a c-section, and sometimes just post real intense trauma to your body in, you know, in in delivering a baby. And then we go through sleep deprivation and expect to function normally. Yeah. And, you know, let's talk about the signs. Let's talk about how we can support your wife, right?

SPEAKER_01 39:07

Going through all of this. And are they usually responsive or they're like, no, she should just like they'll compare her to like another woman that they see, you know, who has it all together. And and it's just like, well, you know, if she could do it and she has six kids, like why, why can't we do it? And like she we have two.

SPEAKER_00 39:25

Yes. So some and some men will be like, I totally hear you. I get that. Um, tell me what I can do to be helpful, right? And then I'll have some who are kind of like, you don't understand. You don't understand what this is like, like she is losing it, like, you know, and they don't get it. They don't understand how this is an illness, that this is really happening to them, that there's, you know, that the person can put in a lot of work and therapy, but it still feels a little bit out of control. Um, and the comparison is real. I mean, I think the comparison is real for both women and men. Yes.

SPEAKER_01 39:59

I think that, you know, like we're like, how can she have dinner on the table? I can barely take, I can barely take a shower.

SPEAKER_00 40:06

100%. And let me tell you, she doesn't have dinner on the table because she made that dinner. Like, or even if she did, something else is compromised. Sometimes we just see, you know, we we see what we want to see and we don't realize that there's so much going on behind the scenes that we're not really privy to.

SPEAKER_01 40:20

Yeah. Um, okay, so what's one thing? And first of all, um, everything that you said was so valuable and I'm so excited for my listeners to hear this. I think this is this is a conversation that's just really not spoken about a lot. What is one thing from all the information that you've that you've given today that you would want the listeners to know? Like what is something that they can walk that they can walk away with?

SPEAKER_00 40:42

I think that it's important to know that this is valid, that what you're feeling either during pregnancy or postpartum, during this perinatal life stage is valid, that it has a basis and something real, that it's okay to talk about and it's okay to seek help, you know, for. And I think that this is a season of receiving. This isn't a season of giving to everybody else and being a person, you know, support person for everyone in your life. Take the help, take the support, create the support system if you don't have one. At least try, right? Like try to Yeah.

SPEAKER_01 41:14

I think as women, especially as care as caretakers, that's that is probably the hardest part because we are so used to taking care of everybody else and taking care of everything. Like I say, like if like one, you know, if I drop one ball, everything else is going to fall down. Um, so taking that help is really, really hard for women in particular, I think. Yeah. Thank you so much for coming. Um, where can my listeners find resources or anything that would be um great for them to learn more information about what about what you spoke about?

SPEAKER_00 41:47

Sure. So Postpartum Support International is a great resource. They have an app, they have a website. You can go on and access all resources from there related to pregnancy, postpartum, and mental health. I think that's, I would say would be my number one go-to.

SPEAKER_01 42:01

Okay, great. And is there anywhere that you want people to find to find you to reach out to you?

SPEAKER_00 42:07

I mean, I'm I'm at Northwell's Perinatal Center. Um yeah, but you can, you know, look up Northwell and we have a for mom's line. It's 718 4704 mom.