Netflix Leads the Way In Providing Paid Maternity Benefits

•August 7, 2015 • 1 Comment

Many of us who are concerned with the health of new mothers have long been disturbed at our country’s poor record on paid maternity leave. According to a recent article, the embarrassing news is that we are the only country in the world, aside from Papua New Guinea that doesn’t guarantee paid maternity leave.

But things may be changing. Netflix, the Internet streaming company that led the way we watch old and new television shows, is doing the same by offering its employees unlimited paid maternity and paternity leave for the first year after a child’s birth.

I’m particularly hailing this step because in 2013 researchers from the University of Maryland School of Public Health found that women who had shorter maternity leaves were much more likely to develop depression after their child’s birth. It makes sense that these new mothers are overwhelmed with worries about the health of their baby, spending enough time with their child, and all of the expenses that accompany newborns.

The U.S. Family and Medical Leave Act of 1993 (FMLA) mandates 12 weeks of paid leave for new mothers, but that’s not enough to provide them with sufficient recovery, and crucial emotional bonding time.

Other studies concur with UMSPH and say that new mothers who take extended time off after their child is born are better equipped to fight stress, depression, fatigue, and illness during this major passage in their life.

Researchers found that women who took more than 12 weeks of leave experienced more energy, improved mental and physical health, and a stronger bond with their child — and importantly, their children benefited significantly.

While opponents of paid leave argue that it’s an economic burden, states where experiments with paid leave have been in place for some time found there is no evidence this policy is bad for business.

My personal hope is that other companies will follow Netflix lead, and be proactive in supporting not only new mother’s mental health, but also the health of the entire family.


Health Tap: A Unique Way to have a Virtual Consult or Office Visit

•July 7, 2015 • Leave a Comment

About two or more years ago, I joined HealthTap, an interactive Web site, in which users can gain free medical advice from doctors in various specialized areas of medicine by posing their questions on the site.

The mission of HealthTap is to measurably prolong the life expectancy of humankind and help everyone Feel Good by providing immediate access to top medical experts and their trusted health advice anytime, anywhere.

Over the last few years, I have been responding to questions from all over the country and even all over the world about various mental health issues, such as depression, anxiety, perinatal mood disorders, sexual issues and relationship problems.

According to my most recent perusal of the site, I have helped 273,699 people since I started using some free time to respond to questions regarding mental health. I have created four checklists to provide tips for dealing with anxiety and coping with stress, and I have a following of 254 people, as well as 176 medical colleagues.

All in all, it’s been an wonderful way to share my areas of specialization and I’ve enjoyed this pro bono work and volunteer opportunity.

Most recently, HealthTap has created a new service in which patients can (for a small fee)
gain virtual consults and office visits with medical specialists. I have decided to participate in order to give my own patients the opportunity to do virtual consults in-between sessions or if distance is prohibitive. Additionally, this feature allows me to consult with patients all over the world. (Note: nationally I can only provide virtual consults with Illinois residents due to my state licensure restrictions).

Connect with me on my Virtual Practice on Health Tap.

Visit the Virtual Practice of Dr. Susan Feingold on HealthTap

Antidepressants During Pregnancy: Yes, No or Maybe

•June 5, 2015 • Leave a Comment

I recently read a magazine article in The New York Times written by Andrew Solomon, and titled, “The Secret Sadness of Depression.” Perhaps you read it, too. The story’s subtitle was: “Pregnant women often fear taking the antidepressants they rely on. But not treating their mental illness can be just as dangerous.”

The article covered a topic that frequently arises in my therapeutic sessions with patients. And, because there is no definitive answer of the short or long-term effects of pregnant women taking antidepressants, the question continues to puzzle us.

In my mind, it comes down to a risk-benefit analysis between patient and mental health provider. As with any medication, there are some (yet at times only minimal) risks. However, in some cases, like the one profiled in the article, these types of medications might have been life saving.

If pressed, I’d have to come down on the side of this statement by one of the experts cited, “Untreated depression can take a heavy toll; this isn’t a matter of being depressed for nine months, but of a potential escalation that can result in a lifetime of struggle.”

The tragedy examined in the magazine article involved Mary, a 37-year-old woman who had struggled with depression for much of her life — a fact few of her friends or colleagues knew. Prior to pregnancy, she had dealt with her depression with a combination of therapy and antidepressant and antianxiety medications.

Although Mary was delighted when she learned she was pregnant, she expected the experience to be blissful. And because she had read about the potential danger for a growing fetus with a mother’s use of antidepressants, she opted to discontinue her use of the medication.

Despite being monitored by a psychiatric nurse practitioner, Mary couldn’t shake the idea that something was wrong with the fetus. She spiraled downward, until finally near the end of her fifth month of pregnancy, she resumed taking antidepressants. But, it may have been too late, for at six and a half months pregnant, she jumped to her death.

The question for her medical team was: if Mary had stayed on her medications without a break, or even gone back on them sooner, would she have survived? However, this is an impossible question to answer.

The positive effect of this story is its spotlight on a condition known as antenatal depression, or depression suffered during pregnancy, which affects up to 15 percent of expectant women. The author says, “For more than half of the women who develop postpartum depression, the condition is simply an escalation of pre-existing depression; addressing the antenatal problem would ameliorate the postpartum one.”

He goes on to say, “We have not acknowledged how appropriately anxiety-ridden pregnancy is, how traumatic the change in identity that accompanies prospective motherhood can be.”

Gratefully, studies on the effects of antidepressants on the fetus are numerous and ongoing. Perhaps at some point, there will be definitive evidence to help patients and medical personnel make an informed decision regarding their use during pregnancy.

But currently, I will reiterate my beginning comments: this is a decision to be made between patient and their mental health provider. And to keep in mind, not treating mental illness can be life threatening and a dangerous choice.

Nashville deals with issue of Postpartum Depression

•May 21, 2015 • Leave a Comment

Here’s a recent article that appeared in the Huffington Post about how the TV series, Nashville dealt with the issue of postpartum depression.

Having a Healthy Balance Between Work Life and Motherhood

•May 8, 2015 • Leave a Comment

Here’s a link to an article by Kristin Colella that I was interviewed for, “When Your Maternity Leave Ends: How to Strike a Healthy Balance Between Work Life and Motherhood.”


•May 4, 2015 • 1 Comment

Postpartum Support International (PSI), a group that I am proud to be a part of, has declared May 7 to be International Maternal Mental Health Awareness Day,

The nonprofit organization is calling this year’s campaign, “You Are Not Alone” and to echo that theme, I’m using my social media pages to offer free copies of my book, “Happy Endings, New Beginnings: Navigating Postpartum Disorders,” to the first 10 people to respond to my posts.

I selected this offer because my book includes inspiring stories of women I have treated with postpartum disorders. These true vignettes encourage others to take control of their distressing symptoms, and navigate the challenges to find meaning in their experience, and likewise to make it a positive life-changing event. And by sharing my own personal experience with this syndrome in the book’s pages, I emphasize PSI’s theme of not suffering in silence.

Ann Smith, CNM, and president of PSI, emphasized that “with prompt treatment and support, most women will make a complete recovery within the first year.” This positive statement is mirrored in my patients’ lives. And, that is another reason for my book giveaway. I’m hoping that along with the profiles of new moms, readers will also learn to examine truths and falsehoods about postpartum depression, learn how to deal with unsolicited advice, apply guidelines for spouses, partners, and friends, and find the healing power of hope and spirituality.

Regarding PSI’s goals, I’m particularly interested in the exercise its Board conducted recently. “We asked ourselves, if we had a million dollars, what could we do to help more women?” Smith said. “Three priorities rose to the top. First, provide free or low cost training in perinatal mood disorders for mental health providers in underserved areas where women have almost no access to knowledgeable care. Second, initiate training programs for law enforcement and legal experts to understand symptoms of severe perinatal illness and thus avoid future tragedies. Third, create an endowment to fund research in perinatal mental health.”

It would be wonderful to see all of those priorities implemented and the number of new moms who experience postpartum depression reduced significantly. I’m hoping this May 7 Awareness Day brings the funding needed to accomplish these steps, and that my small contribution to “You Are Not Alone” brings encouragement, relief, and hope to those who receive my book.

Canadian Researcher Aims To Shed Light On Postpartum Depression

•April 26, 2015 • 3 Comments

As a therapist who treats women with perinatal depression, I am an enthusiastic supporter of individuals or institutions that want to help the world understand the illness and to make a contribution to what we already know.

Over the past decade, I have often participated as a dissertation committee member on numerous research projects related to perinatal emotional disorders.

That’s why I was pleased to learn that a Winnipeg researcher is reaching out to mothers “who are depressed, down or overwhelmed” so she can interview them for a study she is undertaking.

This thesis project for Michelle Choch, a PhD candidate at the University of Manitoba, is intended to “empower mothers and their families and healthcare providers.”

Wisely, the Manitoba Health Research Council is funding Choch’s project, which will study the period immediately after the child is born, as well as mothers with older children.

In an interview, Choch referred to the “unique aspects of it [postpartum depression] and what moms experience.” The Canadian Mental Health Association (CMHA) added that the disorder could not only impact women who have previously had children, but also adoptive mothers.

Choch believes that learning and understanding what the experience can be like during the different stages of motherhood will enhance understanding not only for mothers, but also for their families, and the healthcare community.

It appears that prevention is one of the outcomes Choch hopes the study will focus on. She said, “Some of the aspects of the study will also help to… understand the vulnerabilities and the risk factors. So that there can be a better sense of what you can do to prepare and think about and the types of assumptions that we make before we become mothers, to try and prevent some of that maladjustment that occurs.”

I particularly like the phrase, “types of assumptions” that Choch brings up in her comments. For it’s my opinion that our expectations, various myths about motherhood, and what we believe society tells us– what a “good mother” looks like, are all contributors to postpartum depression and anxiety.

If this study, and others like it, can provide realistic views into the experience of women who are considering pregnancy, are pregnant, or have given birth, perhaps the numbers of cases will decline. One can only hope.

New Study Supports Connection Between Our Thoughts and Health

•April 16, 2015 • Leave a Comment

Even though a new study may not be exactly related to postpartum disorders, it reinforces the widely held belief that our thoughts can work for us or against us.

Psychologists find that healthy thoughts lead to greater happiness, less depression and anxiety, positive feelings and behavior.

Cognitive-behavioral therapy, is a short-term model of treatment which provides tools to help us change our distorted negative thoughts which can manifest in depressed and anxious mood.

Now we are able to relate these maladaptive thinking patterns to poor physical health as well as emotional health, reinforcing the power of the mind-body connection.

According to a study at the University of Illinois assessing 5100 adults ages 45 to 84 for affect of cardiovascular health, they found that the most optimistic participants were twice as likely to be in good cardiovascular health. (See Health Behavior and Policy Review, Jan 2015).

Just another reason to work on changing our thinking!

New Study On PPD Peer Treatment Leaves Me Skeptical

•March 24, 2015 • Leave a Comment

As I’ve often said on this blog, any study that focuses a spotlight on Postpartum Depression (PPD) is a welcome sight. And if the research describes new methods of treatment, I’m doubly pleased.

But, at times, some of these reports leave me skeptical about their findings. For example, a new study out of the University of New Brunswick suggested that treating postpartum depression “could be easy and affordable.”

The study, published in a recent edition of the Journal of Advanced Nursing, found “just one call per week from a peer mentor who had overcome PPD dramatically reduced depression in new mothers within about three months.”

Wow! That’s quite a statement. But here’s the catch, the 64 New Brunswick participants were moderately depressed. Note the word “moderately.” So, perhaps it’s not surprising that of this group, at midpoint, only eight per cent showed symptoms of postpartum depression. By the end of the study, nearly 12 per cent were depressed, suggesting some relapse, said one of the authors of the study, Nicole Letourneau, a professor of nursing and medicine at the University of Calgary, who partnered with UNB for the study.

With these results, Letourneau concluded, “peer mentorship is vastly more effective than clinical therapy or medication. Typically, success rates for medication are 25 per cent. We had a 90 per cent success rate with just talking to women on the phone.”

Now I agree that some benefits of the study are that it does not stigmatize the women receiving the phone calls, and that is low cost and convenient. But, this is where I take issue with the report: in my experience, a once a week phone call from another sufferer is a minimal step up from getting no treatment at all. In the moderate-to-severe and severe-populations that I treat, I doubt a weekly phone call would suffice.

In my practice during intake, I always alert patients that they could get better without treatment, but it could take longer or they could also get worse. (A few years ago, Lancet Journal published some statistics that 25% of women who don’t get treatment, don’t get better.)

In my own mind, I suspect the women studied didn’t recover any faster than those who get better on their own.

Identifying New Moms With PPD Is Only The First Step To Getting Them Help

•March 7, 2015 • Leave a Comment

A new report recently submitted at the annual meeting of the American Association for the Advancement of Science claimed that the social media site, Facebook, might be able to identify mothers suffering from postpartum depression.

Munmun De Choudhury of Georgia Tech and her colleagues at Microsoft Research in Redmond, Washington analyzed the Facebook activity of 165 different mothers before and after the birth of their children. The researchers also interviewed the women and provided them with a depression-screening questionnaire.

The investigators learned that the mothers suffering from postpartum depression were not only less active, but also refrained from revealing what they were feeling. On their Facebook pages, they posted content that was “unemotional in nature and designed to elicit advice on how to deal with a matter at hand.”

De Choudhury and her fellow researchers said that a computer program could be created to detect which mothers suffered from postpartum depression. By identifying troubled mothers, someone (hopefully medical professionals) could point them to services where they could get help.

It is that last point that is most important to me. Identifying women who meet criteria for postpartum depression is only the first step. What happens next is the crucial one. Those identified must then be aided into getting timely treatment.

After all, how would you get someone to go for treatment if you identified them as possibly having the illness by their Facebook page? Isn’t this an invasion of their privacy? How likely is it that a woman would go for treatment if they were contacted by direct message, saying we evaluated your content on Facebook and have determined that you may be suffering from perinatal depression.

But I have another idea — why not expand the initiative to screen all women. How about a nationwide effort to provide an assessment to ALL women who deliver their babies at hospitals, with assisted home births or with midwives? Why not encourage obstetricians and midwives to do an assessment? It’s much more likely that the physician or midwife — who has been following the patient for nine months — could be more persuasive in getting the moms into treatment.

As I have often said, although I may differ on various points of PPD articles, I’m always grateful to see more focus on the illness and more research into helping women receive appropriate therapy.

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