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1 in 5 women with postpartum mood disorders don’t speak up—here’s how to help

When I was pregnant, I was distinctly aware of the possibility that I may struggle with postpartum depression—especially because I was already prone to depression. I promised myself and my family that I would ask for help at the first inkling of something being wrong. But, initially, I didn’t seem to have any major symptoms.


Then, as the sleepless nights wore on, the familiar feelings of depression came back to me.

I often felt overwhelmed by little things: A tangled car seat strap became an insurmountable struggle and a sign that I should just stay home. Simply thinking about showering during any spare time seemed to zap my energy. I struggled to see myself as anyone outside of “mom.”

In the days before my next scheduled wellness appointment, I thought of what I would say to signal I needed help. But this time our nurse didn’t ask the depression screening questions, and the anxiety that was already constricting me prevented me from bringing up the subject.

Next thing I knew, I was smiling and waving goodbye with one arm, balancing my baby in the other. I walked out of the exam room feeling as burdened as I had going in.

I’m hardly alone. According to a recent study published in the Maternal and Child Health Journal, one in five new moms experiencing postpartum mood disorders doesn’t disclose her symptoms to healthcare providers.

“Our study finds that many women who would benefit from treatment are not receiving it because they don’t tell anyone that they’re dealing with any challenges,” says Betty-Shannon Prevatt, the study’s lead author. According to Prevatt, 10 to 20 percent of mothers experience postpartum mood disorders (PPMD).

The goal of the study was to determine how many of us aren’t disclosing our feelings to our healthcare practitioners—and how we can all work together to improve those outcomes. Prevatt’s team surveyed 211 women who had given birth in the previous three years. The researchers asked the women if they felt PPMD symptoms, and, if so, whether they had disclosed these symptoms to a healthcare provider. The results showed 51 percent of the moms surveyed had symptoms of a PPMD. Yet, 21 percent of those moms didn’t tell their healthcare providers.

“With so many women in our study not disclosing PPMDs to their providers, it strongly suggests that a significant percentage of these women did not disclose their symptoms even when asked,” says the study’s co-author, Sarah Desmarais, an associate professor of psychology at North Carolina State University, who added there are national guidelines intended to help healthcare professionals detect PPMDs among patients.

But as I know from my experience, that may also be because the right questions were asked at the wrong times—and then never again.

What’s more, the research suggests women experiencing the highest levels of stress were the most likely to ask for help while many others (myself included) brush off symptoms that don’t seem “bad enough” to warrant getting help.

We need to help women feel more comfortable discussing mental health during new motherhood—not just in times of crisis.

As for me, I wish I’d spoken up on the day I wasn’t asked. Instead, I plodded along on my own for months before picking up the phone and booking an appointment with a therapist. When I finally did open up about my feelings, the relief was pretty much instant. We worked on some coping techniques I could use when feeling overwhelmed and talked about how a lot of my anxiety was stemming from an unfounded fear of being a bad mom. For other women, the solution for PPMDs may involve medication or other forms of treatment.

If a mom in your life seems depressed but isn’t speaking up for herself, you can help.

Here are a few tips:

  • Acknowledge how hard early parenthood is, without minimizing her experience by comparing it to yours or others. (Remember that the experience of every parent, even those who share a child, is different.)
  • Ask open-ended questions and let her know that you’re there to support her. If she wants help, offer to watch the baby while she goes to the doctor or to therapy.
  • Partners should remember to be patient, too. It takes time to recover from postpartum depression, but with support, she’ll get through it.

Regardless, it all begins with a conversation. You won’t regret it.

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Unstructured play is play without predetermined rules of the game. There are no organized teams, uniforms, coaches or trainers. It is spontaneous, often made-up on the spot, and changeable as the day goes on. It is the kind of play you see when puppies chase each other around a yard in endless circles or a group of kids play for hours in a fort they created out of old packing boxes.

Unstructured play is fun—no question about it—but research also tells us that it is critically important for the development of children's bodies and brains.

One of the best ways to encourage unstructured play in young children is by providing open-ended toys, or toys that can be used multiple ways. People Toy Company knows all about that. Since 1977, they've created toys and products designed to naturally encourage developmental milestones—but to kids, it all just feels like play.

Here are five reasons why unstructured play is crucial for your children—

1. It changes brain structure in important ways

In a recent interview on NPR's Morning Edition, Sergio Pellis, Ph.D., an expert on the neuroscience of play noted that play actually changes the structure of the developing brain in important ways, strengthening the connections of the neurons (nerve cells) in the prefrontal cortex, the area of the brain considered to be the executive control center responsible for solving problems, making plans and regulating emotions.

Because unstructured play involves trying out different strategies without particular goals or serious consequences, children and other animals get to practice different activities during play and see what happens. When Dr. Pellis compared rats who played as pups with rats that did not, he found that although the play-deprived rats could perform the same actions, the play-experienced rats were able to react to their circumstances in a more flexible, fluid and swift fashion.

Their brains seemed more "plastic" and better able to rewire as they encountered new experiences.

Hod Lipson, a computer scientist at Cornell sums it up by saying the gift of play is that it teaches us how to deal with the unexpected—a critically important skill in today's uncertain world.

2. Play activates the entire neocortex

We now know that gene expression (whether a gene is active or not) is affected by many different things in our lives, including our environment and the activities we participate in. Jaak Panksepp, Ph.D., a Professor at the University of Washington studied play in rats earning him the nickname of the "rat tickler."

He found that even a half hour of play affected the activity of many different genes and activated the outer part of the rats' brains known as the neocortex, the area of the brain used in higher functions such as thinking, language and spatial reasoning. We don't know for sure that this happens in humans, but some researchers believe that it probably does.

3. It teaches children to have positive interaction with others

It used to be thought that animal play was simply practice so that they could become more effective hunters. However, Dr. Panksepp's study of play in rats led him to the conclusion that play served an entirely different function: teaching young animals how to interact with others in positive ways. He believed that play helps build pro-social brains.

4. Children who play are often better students

The social skills acquired through play may help children become better students. Research has found that the best predictor of academic performance in the eighth grade was a child's social skills in the third grade. Dr. Pellis notes that "countries where they actually have more recess tend to have higher academic performance than countries where recess is less."

5. Unstructured play gets kids moving

We all worry that our kids are getting too little physical activity as they spend large chunks of their time glued to their electronic devices with only their thumbs getting any exercise. Unstructured play, whether running around in the yard, climbing trees or playing on commercial play structures in schools or public parks, means moving the whole body around.

Physical activity helps children maintain a healthy weight and combats the development of Type 2 diabetes—a condition all too common in American children—by increasing the body's sensitivity to the hormone insulin.

It is tempting in today's busy world for parents and kids to fill every minute of their day with structured activities—ranging from Spanish classes before school to soccer and basketball practice after and a full range of special classes and camps on the weekends and summer vacation. We don't remember to carve out time for unstructured play, time for kids to get together with absolutely nothing planned and no particular goals in mind except having fun.

The growing body of research on the benefits of unstructured play suggests that perhaps we should rethink our priorities.

Not sure where to get started? Here are four People Toy Company products that encourage hours of unstructured play.

1. People Blocks Zoo Animals

These colorful, magnetic building blocks are perfect for encouraging unstructured play in children one year and beyond. The small pieces fit easily in the hands of smaller children, and older children will love creating their own shapes and designs with the magnetic pieces.

People Blocks Zoo Animals 17 Piece Set, People Toy Company, $34.99

BUY


This article was sponsored by People Toy Company. Thank you for supporting the brands that support Motherly and mamas.

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So many parents wish there was a way we could add more hours to the day. Unfortunately, we're stuck with just 24 of them, but we can try to make the most of the time we've got. One way more and more working mamas are maximizing the time we do have is by cutting out the commute and working from home.

It can add an hour or two back to your day, and (depending on your hours and circumstances) it can even make childcare arrangements easier. And with more big companies offering legit remote opportunities, it's easier than ever for parents to find these opportunities. As Motherly recently reported, Amazon is on a bit of a remote hiring spree ahead of the holiday season, and it's not the only one.

Williams-Sonoma is currently seeking Seasonal Customer Service Associates to work from home. It is looking for remote workers in Cincinnati, Cleveland, Phoenix, Reno, Tulsa, and near Raleigh, Columbus, Braselton, and Oklahoma City.

These work-from-home positions are part of Williams-Sonoma's plan to hire about 3,500 associates for its Customer Care Centers. The company says a "significant portion of positions" for the Customer Care Centers will be work-from-home. They're looking for remote workers who live no more than an hour and a half away from one of the Customer Care Centers as "on occasion our Work From Home associates must come to the Care Center for meetings and training with advanced notice," the company notes in the job postings.


The positions are very similar to what Amazon is looking for: Basically customer service reps who can take inbound calls to help shoppers with orders, returns and issues with finding products or deliveries of products. Williams-Sonoma is looking for people who can work 30 - 50 hours per week, and the pay is listed at $12 per hour.

Another perk is a 40% discount on most merchandise, which great because the Williams-Sonoma umbrella includes brands like Pottery Barn and West Elm as well.

Sounds like this could be a great gig for a mama with customer service skills and a high-speed internet connection.

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Plenty of modern motherhood paraphernalia was made to be seen—think breastfeeding pillows that seamlessly blend into living room decor or diaper bags that look like stylish purses. The breast pump though, usually isn't on that list.

It's traditionally been used in the privacy of our homes and hotel rooms in the best case scenarios, and in storage closets and restrooms in the worst circumstances. For a product that is very often used by mothers because they need to be in public spaces (like work and school), the breast pump lives a very private life.

Thankfully, some high profile moms are changing that by posting their pump pics on Instagram. These influential mamas aren't gonna hide while they pump, and may change the way the world (and product designers) see this necessary accessory.

1. Gail Simmons 

Top Chef's Gail Simmons looked amazing on the red carpet at the 2018 Emmys, but a few days after the award show the cookbook author, television host and new mama gave the world a sneak peek into her backstage experience. It wasn't all glam for Gail, who brought her pump and hands-free bra along on the big night.

We're thankful to these women for showing that breast pumps belong in public and in our Instagram feeds.

[Update, September 21, 2018: This post was originally published on May 31, 2018, but has been updated to include a recent Instagram post by Gail Simmons.]

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  2. Behati Prinsloo shamed for 'pumping and dumping' during date with hubby Adam Levine
  3. Nicole Phelps pumping in an evening gown is the ultimate definition of a multi-tasking mama 👏

Dana Dewedoff-Carney has a beautiful family. On paper, she's a mom of three. But in her heart, she has five children. She's had two miscarriages, one last year at five weeks, and another this past summer.

"I lost our son in June. I was 14 weeks pregnant, but he had passed away at 12," she tells Motherly, explaining that she and her husband had already named their boy Benjamin.

He never got a chance to live in this world, but he is changing it. His mama is the force behind Project Benjamin, a photo series that is going viral and changing the way people talk about pregnancy and infant loss.


Dewedoff-Carney started Rise for Women, a New Jersey-based organization dedicated to empowering women and connecting them with the resources they need to thrive. Rise for Women was born out of a painful time for Dewedoff-Carney. She was a single mom of three, and she was struggling, although from the outside she looked fine.

After launching Rise for Women Dewedoff-Carney created the hashtag #StruggleDoesNotHaveALook, which took on a whole new meaning this year after she and her now husband lost their babies. She came up with another hashtag, #TheyMatterToo, to remember them, and invited other moms to join in a photo session.

Each mother had her portrait taken with a chalkboard bearing a phase that someone told her after her miscarriage.

In Dewedoff-Carney's case, a doctor who perhaps meant to be kind told her the baby she lost "was the wrong baby." Other women in the photo series were told they could always adopt, or that they should be happy with the children they already have. Dewedoff-Carney says sometimes people don't realize how much their words cut those suffering a loss.

"I know people are not saying these things to be malicious and hurt us, but if they could just be a support and say, 'I am so sorry for your loss, I'm here for you,' that is so helpful," she explains.

Experts agree. Jessica McCormack is a licensed marriage and family therapist in private practice at The Self Care Path in Burr Ridge, Illinois. She says parents who've suffered a pregnancy loss don't need people to try to offer solutions or minimize their grief, but just to validate it.

"You aren't trying to fix their emotions, you are simply stating, 'I hear you, that was so hard for you, this really sucks right now.' No need to fix, no need to tell someone it will be okay. It's a time to just give a hug and tell them it's okay to feel how they feel. This often creates comfort just by knowing someone is there for you," she tells Motherly, adding that it is totally normal for parents to struggle after a loss.

"It's a completely normal experience to have a bunch of grief, sadness, depression, anxiety, shame, guilt and jealousy of others with healthy successful pregnancies," McCormack explains.


For Dewedoff-Carney, that's exactly what Project Benjamin is all about. She says too often conversations about the feelings one has after a miscarriage or infant death are happening behind closed doors or in private Facebook groups. She hopes her photo series will help people realize they're not alone, and that the woman down the street (or on Instagram) who seems to have it all may be suffering herself.

By having a very public conversation about pregnancy loss, Dewedoff-Carney and her fellow moms are hoping more people will understand what they're going through, and not try to minimize it.

Ashlyn Biedebach is a Registered Nurse and founder of By The Brook Birth Doula. She says "when a woman suffers a loss, at any gestational age, it is truly a loss, not just of a baby, but of hope and an idea of the future."

Biedebach suggests if parents who've suffered a loss encounter loved ones who don't seem to be recognizing their baby, they try to give them some grace, but that doesn't mean you have to pretend it didn't happen.

"Well-meaning family members may intentionally choose to move past painful experiences, even if you are still deep in the grief of the loss of your baby. Bringing up your loss in a gentle way, or having an intentional conversation with those who are moving on can help, but also talking with a counselor, too."

As a therapist, McCormack agrees. "Since it's roughly 1 in 4 women that have a pregnancy that ends in miscarriage, women need support," she tells Motherly, recommending that women who've had a loss talk to their OB-GYN or family physician and ask if there are any support groups in their community.

If your doctor doesn't refer you to a support group you can find a therapist yourself. McCormack suggests women simply search the psychologytoday.com therapist directory by entering their zip code along with the keywords "miscarriage" and "fertility." The therapy doesn't have to be just for mom, either. Sometimes dads need to talk, too.

"I also encourage couples to go to therapy after something like this, as men tend to feel lost and uncertain as to how to process their own feelings while supporting their partner," says McCormack.

Both McCormack and Biedebach agree that talking about this kind of loss, whether in person or over social media, is important. Biedebach says, for some parents, honoring their baby through a social media post is their way of remembering and recognizing their importance. McCormack notes that a social media post can also be a good way to invite a larger quantity of people to support you in your time of need.

"It also reduces the stigma by bringing to light that it is completely normal for women to experience something like this," she explains.

That's Dewedoff-Carney's goal, and while she can't travel the county photographing mothers herself, she's inviting anyone to join the conversation by taking their own photo, sharing their story and using the hashtags #StruggleDoesNotHaveALook and #TheyMatterToo. Since her photos went viral, women have been commenting and sharing their stories publicly, and it's brought Dewedoff-Carney to tears.

"They're naming the children that they lost," she explains. "They're doing that, they're speaking their truth, and they're letting it out."

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