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After I wrote this post yesterday called “Motherhood is Not a Medical Disorder” about the Mother’s Act, which advocates for widespread screening of moms for post-partum depression (PPD), something I don’t think is a good idea because it medicalizes a normal stage of life, increases the chances that people will be but on antidepressant medications that they may not need and that may have side effects, and represents yet another intrusion into privacy, I got this response from John Grohol at psychcentral (“False Claims by Bremner”).
First he grumbles about my pointing out that the psychiatrist quoted in the Time article, Katherine Wisner, MD (you can follow the link to the Time article in yesterday’s post), was on the speakers bureau for Pfizer and Lilly (something not noted in the article but which I found on my own), makers of Zoloft and Prozac, respectively, which as a commenter pointed out are promoted as the two safest antidepressants for pregnant and lactating women. Being on a speaker’s bureau these days means giving “promotional talks”, which translates into working for the drug company to advertise to other doctors, and is relevant. In addition, the psychcentral website has paid ads, most of them for treatment (which includes medications), while this site has no ads. And don’t say I am trying to profit off my book, which now goes for a nickel on amazon.
Grohol further takes issue with my statement that women without a prior history of anxiety or depression are not at risk for PPD and therefore would not benefit from widespread screening. However in support of that he cites Ross et al 2009, claiming that history of abuse and alcohol or substance abuse are risk factors for PPD as well. However a perusal of Ross et al shows that a history of childhood abuse is not in fact a factor, rather only abuse during pregnancy. In addition, it is alcohol and substance abuse during pregnancy that is a risk factor, on the order of a pregnant woman drinking a six pack a day or actively abusing cocaine. That kind of substance abuse is a risk to the fetus, and needs to be stopped.
If you have a man beating his pregnant wife, or a woman snorting cocaine while pregnant, that it is a situation much more serious than PPD, and should be stopped. These extreme circumstances hardly justify mass screening for PPD.
I still say NO to the MOTHER’S ACT.
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is it open book, or do we wing it?
Glad you are back and operating. Lots of chatter at Psych Central. Hope you can join in and clarify?
Hooray! It’s working.
Eh, this whole thing is so tiring.
I really don’t care whether or not someone chooses to take meds for a psychiatric or any other condition. That’s their business. Of course, they’re busy labeling us as mentally ill (and therefore, our opinions don’t count), scientologists (and therefore, our opinions don’t count) or anti-psychiatry (and therefore… yeah, get it?)
In between, they’re sharing their stories of how they would have died and/or killed their babies without anti-depressants (gee, how did the human race survive without Zoloft?) and then in the next breath, that our stories don’t count, because we lack insight. It’s just getting very boring.
Dr. Grohol did not like it very much when I posted in response to Katherine Stone the amount of money going to her and other MOTHERS Act supporters from the pharmaceutical industry which was between 13+ and 15+ million dollars in recent years. He called it a logical fallacy. Now apparently he has put comments on moderation. I say we bring our comments here instead, his blog has a seriously bad vibe going. I also have an urge to be a Bremner-lolcopycat and break out my Photoshop.
“Bremner claims, with no evidence, that all mental health screenings are simply pharmaceutical sales tactics to help increase prescriptions. That’s ridiculous. When I worked in community mental health, we ran annual mental health screenings in the clinic — with no funding from any pharmaceutical company — because it reduces stigma, decreases misinformation and increases education about mental health issues in the general population.”
I assume by this statement Grohol is alluding to your original article where you wrote about the fact that Wisner was quoted in TIME, without the public being told by TIME that she has conflicts of interest. I assume this is what you meant above when you said he grumbles about the pharma money. Grumbling is what he seems to do best.
It’s like when people post “Where does it say in the bill that moms are going to be force fed drugs and locked up against their will.”
Duh… I could be a total moron, but I can’t imagine that a legislator would ever write that into a bill. Can you imagine “To ensure that new mothers are locked up, drugged and deprived of the right to informed consent.”
I don’t think Grohol’s arguments are all that convincing, I mean, so he says hey wait a minute there are more risk factors for PPD than you said. So he just laid himself a trap in which he suddenly looks for an even wider spectrum of mothers to be labeled mentally ill.
Does John Grohol realize he just made a very good argument for your side, when you said that if a woman is experiencing abuse that is a case far more serious than PPD?
I agree with the original TIME magazine article that giving birth does not automatically qualify you as at risk of PPD. I think that John Grohol listed 13 factors, none of which was giving birth.
I should clarify and say having the baby does not mean you are more likely to get depressed. Because PPD comes after giving birth, obviously. Unless you’re last year’s bill, and then it also is defined as starting in pregnancy.
“prenatal depression, self-esteem, childcare stress, prenatal anxiety, life stress, social support, marital relationships, depression history, infant temperament, maternity blues, marital status, SES, and unplanned/unwanted pregnancy.”
http://uniteforlife.wordpress.com/2009/07/15/faction-of-pill-pushers-embarks-on-anti-information-frenzy/
Last year’s bill defined PPD as starting in pregnancy:
http://www.uniteforlife.org/content/view/24/27/
“SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Postpartum depression is a devastating mood disorder which strikes many women during and after pregnancy.”
I should think prenatal depression qualifies as previous history of depression, and marital status is listed twice, and all of those other factors are simply things that might make anyone else depressed. Regardless of whether you are giving birth. What is maternity blues? Is that baby blues? Again, not a reason to label a mother with PPD.
Dr. Bremner,.. Is postpartum PTSD real? Never heard of it before. Since you are a PTSD expert I thought id ask.
Never heard of it either… it will be interesting to see what Dr. Bremner has to say about it.
On Dr. Grohol’s blog, someone said that “making a false dichotomy” should be diagnostic criteria for a mental illness. In other words, if you disagree with our dogma, we’ll label you with something! Holy crap, I thought that was stuff straight out of CCHR-type paranoia and exaggeration. Never dreamed I’d actually see it being used in a debate.
While I am not anti-psychiatry (hey man, let people drug themselves as much as they want), I definitely DO suffer from Post-Traumatic Psychiatry Disorder. My horrible experiences with psychiatry have led to a general mistrust of and disregard for ALL in the medical profession. Also, when I complained of toe pain, and my podiatrist showed me an x-ray confirming a worsening of my 4th digit joint, I was shocked. “What? An ACTUAL DIAGNOSTIC TEST? I don’t have to take your word for something and you’re not diagnosing me and treating me based on my symptoms alone?” I mean, I was literally shocked. That’s when you know you have spent too much time with your psychiatrist.
Aw, Evelyn Pringle wrote this awesome comment but now I can’t get to the comment page to paste it here. I replied but I have no idea if my comment will be posted.
[...] on the comments under John Grohol’s psychcentral post on my original post and followup on Motherhood is not a Medical Illness (I know I am paranoid but having my website hacked into and comments disabled right after I made [...]
There is another issue here, to my mind, which is: Even assuming that we do want to screen for PPD, do we need a law to do it?
I think not, for a couple of reasons. OK, for several reasons.
#1. Laws based on single-case incidents rather than on data(in other words, laws passed in the heat of emotion rather than via a reasoned process)tend to be bad laws.
#2. There are thousands of combinations of potential acts any physician treating a pregnant woman should perform. Are we going to legislate them all?
And what happens to a law on the books when best practices change? Suppose we had legislated a decade or so ago that all men over 45 needed to be screened for prostate cancer annually? Because heaven forbid we should miss a case. The recommendation now has changed. A physician following the new treatment protocols would be in violation of the law. A physician following the law could conceivably be committing malpractice.
#3. I forgot what #3 was. I’m going to bed.
As for post partum PTSD I don’t know. My medical understanding is that at birth there is a release of hormones that help us forget what a bitch it was so we can bond to our babies.
See my most recent post about how I was censored from the Grohol blog. Who is this guy? Capitalizing on the ‘hornets nest’ (his words) from his attack on my post to get a lot of people reading his blog and then CENSORING ME? Who the hell does he think he is? I mean god forbid you should get moms to start asking questions about their own health issues. Geez!
There is an article in WSJ from last summer by a Rachel something or other, about PTSD from Childbirth. The article quoted me, and a bunch of PSI people, and it said I was against The MOTHERS Act because I had “an adverse reaction” to Zoloft. It also attacks Tom Coburn who has been the Senator on the HELP Committee with objections to the bill.
The article talks about how people should get put on drugs before their pregnancies are over, to prevent a traumatic birth, so that whatever happens during the birth apparently won’t affect them. I mean, seriously? Why not just go back to twilight birth instead of drugging the fetus throughout the pregnancy, if you’re really that scared of birth. (That’s sarcastic in case you couldn’t tell.)
I heard they were looking into Ketamine (an anesthetic?) as a potential antidepressant because it’s faster acting in its effect than SSRIs. WT Heck?
[...] Motherhood Still Not a Mental Illness – Bremner responds to Grohol Jump to Comments **UPDATE – Not long after one of Dr. Bremner’s blogs was posted, the site started “malfunctioning” disabling both the archive and the comments. The site was later back up and running and this is a functioning link to the entry: http://www.beforeyoutakethatpill.com/index.php/2009/07/15/test-2/ [...]
Yep, the ketamine thing is true. I did a lot of ketamine when I was younger for my 10 orthopedic surgeries between the ages of 5 and 8. Honestly, if they’re going to start adding “treatments” like ketamine (which causes shizophrenic-like symptoms in some people), why stop there? Why not low doses of PCP?
Also strange how the Grohol followers are just adding the word postpartum to every disorder. Apparently there is also postpartum OCD.
There is some seriously scary crap going on over there, and Grohol keeps reiterating that our opposition is somehow stigmatizing people with mental illness, yet he never says a word about his followers accusing others directly of mental illness as a way to detract from their credibility. And EVERY other comment he posts is using anecdotal evidence, yet whenever someone else uses their own anecdotal evidence against the MOTHERS Act, he cautions against it. The logic is dizzying, I tell you.
Postpartum PTSD is absolutely real. A study done my Childbirth Connection shows that 9% of postpartum women meet all the driteria of PTSD… and those are only the reported cases. It is a little known postpartum issue that needs to be addressed. If I had been screened before I left the hospital, somebody would have found the signs of it in me. Which is why I’m hopeful the mother’s act passes. Maybe other moms won’t have to go through the torture I went through. Please check out my website. It’s full of information about ptsd after childbirth.
A webpage put up by Katherine Stone on Postpartum Progress, to provides answers to the question: “What are Perinatal Mood and Anxiety Disorders?” shows how easy it will be to pin a money-making diagnosis of postpartum PSTD on vulnerable and naive young new mothers.
For “Postpartum Post-Traumatic Stress Disorder,” she writes: “All you have to do to be at risk for getting postpartum PTSD is to have the perception of a traumatic childbirth — in other words, even if your doctors and nurses feel that everything went fairly normally, if it was upsetting and scary and unexpected to you that’s what counts.”
A March 2009, “Practice Guideline for the Treatment of Patients With Acute Stress Disorder and Posttraumatic Stress Disorder,” by David Benedek, MD, Matthew Friedman, MD, PhD, Douglas Zatzick, MD, and Robert Ursano, MD, reports that, “SSRIs are recommended as first-line medication treatment for PTSD.”
“Benzodiazepines may be useful in reducing anxiety and improving sleep,” the authors state.
“In addition to being indicated in patients with comorbid psychotic disorders, second-generation antipsychotic medications … may be helpful in individual patients with PTSD,” it says.
“Anticonvulsant medications …, α2-adrenergic agonists, and β-adrenergic blockers may also be helpful in treating specific symptom clusters in individual patients,” the guidelines note.
Get out your check books young mothers with postpartum PSTD, because you’re gonna need it.
Evelyn Pringle
Evelyn,
It’s funny that you memtion nothing of counseling or different forms of therapy in your equation. EMDR therapy is especially effective in trauma cases. Drugs are not the only answer.
Also, what about the thousands of soldiers, abuse victims and rape victims diagnosed with PTSD every year? Is their plight more important than a young mother’s who feels violated by her OBGYN during childbirth? Or the mother who is rushed into the OR for an emergency c-section who feels as if she is going to die? Is she not good enough to have legislation passed that will help her???
So what if I have to get out my checkbook to pay for something that will help me make it through a difficult period of my life. People do it all the time in many different circumstances. Some women eat, or shop, or go to therapy. It all costs money… So what’s your point?
Well being that PTSD remains the only diagnosis in the DSM that I don’t have issues with, that actually doesn’t bother me too much. I have PTSD from my Postpartum Psychosis hospitalization and “treatment”, that’s for sure.
Kimbriel,
I had PTSD from my childbirth experience. EMDR therapy is the only thing that worked for me. I have links on my website. Just click on my name.
you know what? I DID check it out… I have plenty of trauma, so maybe EMDR will work for me… I’m willing to give any (non-medication) option a try. I tried crazy meds for over a year and THEY made me crazy.
PS- I actually did a lot of the research you suggest when I was preparing for the birth of my baby. I had a great birth but ended up going psychotic due to the fact they freaking wake you up every 2 hours for your tests, the baby’s tests, and visitors. After a certain point I just was not able to go back to sleep for 14 days straight and went completely psycho (then they sedated me).
Your births sound really traumatizing; I’m sorry you had to go through all that. Your recommendations for preparing for birth are all really good ones- I hope first time moms-to-be read them.
Jodie wrote:
“Also, what about the thousands of soldiers, abuse victims and rape victims diagnosed with PTSD every year? Is their plight more important than a young mother’s who feels violated by her OBGYN during childbirth? Or the mother who is rushed into the OR for an emergency c-section who feels as if she is going to die? Is she not good enough to have legislation passed that will help her???”
Great try at switching and also a perfect example of disease mongering.
Soldiers who have experienced the horrors of death and injury in war should not be placed in the same category as women who are experiencing the type of problems that women have coped with for centuries without drugs.
Yes, their plight is more important than women going through the “natural” process of childbirth.
Nor should rape victims or abuse victims be grouped or compared with women giving birth.
I can’t help but notice that the description of postpartum PSTD that I provided from Postpartum Progress was not addressed.
Jodie also said: “So what if I have to get out my checkbook to pay for something that will help me make it through a difficult period of my life. People do it all the time in many different circumstances. Some women eat, or shop, or go to therapy. It all costs money… So what’s your point?”
My point is that some of the drugs (listed in the guideline above) cost over a grand a month. Add that to the cost of any “therapy” the women receives, and the prescribing doctors fees, and a bill of $20,000 a year can easily accumulate for women conned into thinking they have PSTD under Katherine’s Stone’s advice on the “most widely read blog” in the US on postpartum conditions.
Maybe Jodie’s check book is bulging, but in the majority of cases, the bills will be sent to public health care programs, meaning I will be paying for this health care fraud.
In which case, I object to being forced to participate in a blatant off-label drug marketing scheme against my will.
Again, this is disease mongering at its worst because nursing infants will be forcibly drugged without any say-so in the matter.
Evelyn:
“Soldiers who have experienced the horrors of death and injury in war should not be placed in the same category as women who are experiencing the type of problems that women have coped with for centuries without drugs.
Yes, their plight is more important than women going through the “natural” process of childbirth.”
Childbirth in an american hospital is anything but natural. There are too many medical interventions for it to be natural. When you see blood spurting out of you, your baby’s heart rate is falling, and you go into respiratory failure on the way to an emergency c-section while being fully conscious of the situation, then we can chat… and my experience is not unique! But that’s a topic for another day…
Men went off to war for thousands of years and no one helped them until someone realized that they were troubled when they came back. It’s time that someone realizes that SOME, not all, women are troubled after childbirth and need help. The issue is not the drugs, the issue is the thousands of women every year that need help and support.
Simple screening and referral to support may prevent costly medical bills down the road. It may prevent long term hospitalizations, and most of all it may prevent infanticide caused by pospartum psychosis.
“I can’t help but notice that the description of postpartum PSTD that I provided from Postpartum Progress was not addressed.”
Katherine is very capable of speaking for herself, and she often does. I just can’t believe that you stooped so low as to use her blog against her, when she is one of the foremost spokespeople for the Mother’s act.
“Maybe Jodie’s check book is bulging, but in the majority of cases, the bills will be sent to public health care programs, meaning I will be paying for this health care fraud.”
Believe me, my checkbook is far from bulging, but how many things do we already pay for in our tax dollars that we may not agree with?
“Again, this is disease mongering at its worst because nursing infants will be forcibly drugged without any say-so in the matter.”
DRUGS ARE NOT THE ONLY TREATMENT OPTION! And any doctor that instantly prescribes drugs without doing a full assessment of a new mother’s situation is a disgrace to the medical profession. That’s why doctors, especially OBGYN’s, need to be educated about alternative therapies, instead of just writing out scripts. This way nursing infants will not be drugged (even though many drugs are as safe for breastfeeding as Tylenol) But every baby is entitled to a healthy mother, physically AND mentally/emotionally.
Postpartum PTSD is real. It is, of course, the mothers perception of trauma that creates the condition – not your perception or the providers perception. Trauma is an injury that occurs when a person perceives that they, or a loved one, are in immediate danger. It is not a label given to people after they undergo some experience that others feel is traumatic. Just like many soldiers don’t get PTSD, many mothers don’t either. There are 9 criteria that need to be met to qualify for PTSD, and many women who find their births to be traumatic do not qualify for all 9 of them, and therefore can not be diagnosed even though they are significantly affected by trauma. Most women with postpartum PTSD have to fight for the diagnosis and are often misdiagnosed with PPD. Most can not find a mental health provider who is familiar with it or has ever treated it before. It is definitely not something that is overdiagnosed or medicated. Medication is actually not always even recommended due to it’s ineffectiveness at treating trauma. Trauma often needs to be worked through and treated differently, though some women benefit from medication or supplements.
Some women are at higher risk for developing postpartum PTSD due to past trauma, others are treated brutally during their birth experiences. Many here seem to be advocates of informed consent when the treatment is medication, but what about in childbirth? What if a woman does not want that IV of narcotics, or that episiotomy, or that vaginal exam, or that induction, or that c-section? What if she is forced to have those things against her will? PTSD can result if she feels her life is in danger, or her baby’s life is in danger, or if she doesn’t feel she is in control of what is happening to her body and her choices about her medical care are taken away from her. Informed consent is simply not practiced in American obstetrics. Things are done to the woman and then her baby from the moment they enter the door of the hospital. Women are manipulated, coerced, forced against their will, or simply have procedures done to them without even knowing that they are about to happen. Rarely are these things life or death emergencies. And even if they are, women still should have the legal right to refuse care. To force care is illegal and causes emotional harm. The result of all this can be PTSD.
As for the Mothers Act and PTSD, I fail to see how the mothers act will pick up PTSD, and no one has yet to answer this for me. The mothers act will be using the current screening tool for PPD, and this tool is specifically looking for PPD, not PTSD or any of the other many postpartum mood disorders. Women with postpartum PTSD will either not show up as having PPD on the screening tool and will be missed altogether, or they will show up as having PPD (because depression can be one of the many symptoms of PTSD). If a woman with PTSD shows up as having PPD, she will likely be given the same course of treatment that a woman with PPD would be given. This is not appropriate for PTSD, as trauma is a very different thing then depression and will need to be treated differently. Medication may or may not have a place in the treatment of PTSD, but it will rarely benefit women with PTSD when it is the only course of treatment provided (as is often the case with PPD).
Jodi, you say that if you had been screened in the hospital your PTSD would have been picked up. I agree, and mine would have as well. However, some women are not immediately affected. Also, where in the mothers act does it say that PTSD will be screened for in the hospital? The way I read it, only PPD will be screened for and not in the hospital. Am I missing something here? No one can seem to answer this for me.
Whoa Jennifer, you just contradicted yourself about 3 times.
As I said before, WSJ covered PP PTSD last summer in an article by Rachel Zimmerman, on The MOTHERS Act. This article is nothing more than a piece of fluff about women who had PTSD and one who took Zoloft while pregnant to “prevent” PTSD during childbirth.
None of us on here are for informed consent with birth? Um ok. I have an entire website on this at babywhys.org. I have kept it separate from the most part from UNITE because I don’t have time to work on it. I think it’s sad that someone who claims to be for informed consent or natural birth though would also be for this bill.
First you said you don’t think The MOTHERS Act would catch PTSD, and at the end you said if you had been screened you would have had yours picked up. While I agree with you that modern childbirth interventions can be traumatic and even abusive, I disagree with your comments as a whole because you contradict yourself and seem to want to distract from the issues of medication / oversight. The MOTHERS Act does not pertain to reforming childbirth interventions so I’m not sure your argument can be taken seriously.
I’ve covered this topic on my blog in the past. Take a look at uniteforlife.wordpress.com
P.S. When I was in the hospital and being told that I could not be suffering from Zoloft side effects because I had only been taking it for three days (despite the fact that this is one of the times that the FDA warns to watch out for the worst side effects – any time you start, stop, or switch doses) – I asked the psychiatrist if I might have PTSD from watching Isaac almost die. The response I got was “Your baby didn’t almost die.” Yes – I made the whole thing up! And apparently Children’s Hospital went along with the idea. Amazing.
I am all for alternatives, I am not for targeting and labeling women in a mass screening program. If women want to choose to enter the mental health system on their own, so be it. But leave the rest of us alone.
It’s so obvious that the commentators here have not checked out any information on the past disease mongering screening campaigns using the pretense of “helping” to identify mental illness in other patient populations.
They seem to believe that this Mothers Act campaign is some kind of new revolutionary undertaking.
The same exact drug marketing schemes have been used for years to reel in teenagers, and now even infants and toddlers.
Why don’t you people do a few google searches with words like “TeenScreen,” so you can understand what the hell is going on.
More money is now spent on treating mental disorders in children, aged 0 to 17, than for any other medical conditions.
Check out how much tax payers are already paying for psych drugs. The Medicaid budgets in every state are going broke.
There is no epidemic of mental disorders in this country and public health care programs cannot afford to pay for the victims of another blatant disease mongering campaign aimed at reeling in all women of child bearing years with specialties like “Reproductive Psychiatry” and “Reproductive Mental Health.”
Amy,
“Whoa Jennifer, you just contradicted yourself about 3 times.
As I said before, WSJ covered PP PTSD last summer in an article by Rachel Zimmerman, on The MOTHERS Act. This article is nothing more than a piece of fluff about women who had PTSD and one who took Zoloft while pregnant to “prevent” PTSD during childbirth.”
I don’t think I contradicted myself, can you point our where? I am not familiar with this article, can you link to it? As for taking Zoloft to prevent PTSD, that would simply not work. Do you mean perhaps that she took Zoloft after experiencing PTSD once before having another child? I could at least see the reasoning in that, not that I would agree with it.
“None of us on here are for informed consent with birth? Um ok.”
I never said you were. I said that it seems that you are all advocates of informed consent for medication. I was responding to some of the comments on here about Postpartum PTSD. I was trying to explain that it is real, that it happens, and why it happens. But, I find this to be a strange statement. How do you know what the feelings of all your commentors are on this issue? Do you mean you are all against women having informed consent in childbirth? What would the justification for that be? Not having informed consent leads to trauma, which leads to more (inaccurate) diagnoses of PPD, which leads to more women being given meds (that may not help if they have trauma and not depression). And informed consent in health care is one thing, you can’t separate it out and say you are for informed consent with medication, but against informed consent in childbirth practices. It isn’t broken down into different categories, there is one definition of informed consent: to be offered the risks, benefits and alternatives and to have the right to choose or refuse care. All people should have this legal right when it comes to health care. Why would you be for it for one purpose and against it for another?
“I have an entire website on this at babywhys.org. I have kept it separate from the most part from UNITE because I don’t have time to work on it. I think it’s sad that someone who claims to be for informed consent or natural birth though would also be for this bill.”
Who said I was for this bill? I am neither for nor against this bill. I have several questions about it, and I have concerns about how it would affect women with Postpartum PTSD. I am commenting here to respond to the comments that said that Postpartum PTSD was not real, or that they did not understand how it occurs. I was also responding to Jodi’s comments that the Mothers Act includes screening for PTSD while women are still in the hospital. I have not read that anywhere in the act and I am curious to find a source on that information.
“First you said you don’t think The MOTHERS Act would catch PTSD, and at the end you said if you had been screened you would have had yours picked up.”
Exactly. The screening tool that is currently being used will not catch PTSD because the current screening tools only screen for PPD. You can’t catch something that you are not screening for. A woman with PTSD will either not be picked up as having anything, or will be labeled with PPD. Had I been screened in the hospital for PTSD using a screening tool that would pick up such a thing, then yes, it may have been picked up in my case at that point. However, I do not know of any screening tool for PTSD at this time, nor any plans to screen women for it in the hospital. This is why I asked Jodi about this. I did not test as having PPD until about 4 months postpartum, but three days after the birth I already had symptoms on PTSD which were very severe in the first few months. It would have been really helpful for me to have been offered psychological services at that time where several techniques could have been implemented to help me overcome the PTSD (the same type of things they currently use with soldiers coming back from war).
“While I agree with you that modern childbirth interventions can be traumatic and even abusive, I disagree with your comments as a whole because you contradict yourself and seem to want to distract from the issues of medication / oversight.”
I don’t believe I contradict myself. I am not distracting from any issues, I am simply offering a differing viewpoint and answering the accusations in the comments that Postpartum PTSD is not a real disorder. Also, why would you disregard everything I have said (even things you may agree with) simply because you don’t agree with every single point?
“The MOTHERS Act does not pertain to reforming childbirth interventions so I’m not sure your argument can be taken seriously.”
Huh? I don’t have an argument about the mothers act. At this point I am neither for, nor against it, I need more information on it. As it appears right now, it will either be irrelevant to women with Postpartum PTSD, or it will lead to them being misdiagnosed and possibly medicated for a completely different disorder then what they have.
“I’ve covered this topic on my blog in the past. Take a look at uniteforlife.wordpress.com”
I’m not familiar with your blog, I found this particular entry because postpartum PTSD was being discussed. But I will take a look at the sites you have provided.
“P.S. When I was in the hospital and being told that I could not be suffering from Zoloft side effects because I had only been taking it for three days (despite the fact that this is one of the times that the FDA warns to watch out for the worst side effects – any time you start, stop, or switch doses) – I asked the psychiatrist if I might have PTSD from watching Isaac almost die. The response I got was “Your baby didn’t almost die.” Yes – I made the whole thing up! And apparently Children’s Hospital went along with the idea. Amazing.”
Wow, that is horrible. I am sorry about what happened to you with the Zoloft and with the your son. It is very frustrating that mental health professionals have so little understanding of postpartum PTSD, it’s risk factors, and it’s rate of occurrence. I feel that many cases of PPD could actually be PTSD that is misdiagnosed, which is why I am leery of the mothers act if it means that this will occur even more frequently.
“I am all for alternatives, I am not for targeting and labeling women in a mass screening program. If women want to choose to enter the mental health system on their own, so be it. But leave the rest of us alone.”
If the Mother’s Act is carried out the way it reads, women would be screened and then offered a referral to a mental health provider where ideally they would be given an accurate diagnosis. It doesn’t say that they will be diagnosed and labeled with anything. However, I am not confident that it would be carried out the way it is written, and I think that it is a valid concern that women with any postpartum mood disorder may be diagnosed with PPD and written a prescription for meds by her doctor without ever being referred. I wish there was something more to protect against this from occurring written within the mothers act. I also wish the screening tools currently being used were not specific to PPD. If those two things were taken care of, I would likely support this act.
Any time people are screened, it results in an uptick in diagnoses and “treatment”. This has been shown.
Melanie Blocker-Stokes was in treatment when she killed herself. How would a screening test have helped her? So she could get on the drugs that she killed herself on even sooner?
Once psychiatry is more than “evidenced-based medicine” (pig latin for “crock of sh*t”) I will support its greater involvment in our lives through smokescreens like the MOTHERS Act. As it is, the ONLY diagnostic tool available is the DSM, and then they throw drug after drug after drug at you to see if something “works”. If you feel great, well, it’s obvious the meds are working. If you feel lousy, well, that’s the underlying illness peeking through. If you feel like killing yourself or your kid, well that can’t possibly be the MEDS THAT JUST ALTERED YOUR BRAIN CHEMISTRY, you are obviously mentally ill!
Meds can’t lose.
This debate demonstrates how absurd the labeling of human emotions and resulting behaviors has become.
As a young mother, Amy had a perfectly normal reaction to observing the near death of her first-born infant.
But it’s blown up and turned into a mental illness with debates over whether it was a “panic attack” or “PSTD,” or some other label.
All she needed was for a competent therapist, who knew what he/she was doing, to sit down and listen to her for a few hours and validate that her feelings of terror, fear and dread were real, predictable, and understandable, so she could release those thoughts from her mind.
After that, she could have been helped to understand that the event was over, that the baby would be fine and the choking incident was not likely to re-occur.
Any therapist who needs to charge a client for more 3 appointments to accomplish these goals, is either totally incompetent or rip-off artist.
Amy’s human reaction was not PPD, a panic attack, or obsessive-compulsive disorder and major depressive disorder, the last two labels now listed in Amy’s medical records for all time.
She was not mentally ill before she took Zoloft, and the horrifying mental state she experienced after she took the drug was not a mental illness, it was the side effects of Zoloft, period.
Proven by the fact that none of the above disorders exist in Amy today.
Evelyn, I can’t find your latest comment, but I really think that people don’t get THIS:
“Amy’s human reaction was not PPD, a panic attack, or obsessive-compulsive disorder and major depressive disorder, the last two labels now listed in Amy’s medical records for all time.”
Do people realize that once you are labeled mentally ill your LIFE (forget health insurance) insurance rates go through the frigging roof, if you’re even insurable at all? Do people realize that once you are labeled mentally ill, you are legally allowed to be discriminated against in any profession where it is deemed that “personal judgment” is an essential function of the job? Do people realize that once you are labeled mentally ill, you lose all credibility in internet debates? (LOL) I mean, really, this is serious stuff. Is this all going to be disclosed to mothers before they agree to be screened? “Warning: Even consenting to this screening test, you are risking being diagnosed with an unverifiable mental illness, which will nonetheless adversely affect you in legal, social, and financial ways”
If you notice, kimbriel, nowhere to be found are reports on any kind of therapy provided to Melanie other than drugs and ECT.
Considering the amount of time she was receiving “professional” services there should be at least some reports of attempts to provide some type of cognitive or behavioral therapy.
I have found none.
You’re absolutely right, kimbriel, people don’t get it.
The labels in Amy’s medical records will follow her forever.
For people who question my concern over the inability to prove that the diagnosis of a mental disorder is real, I challenge them to find Amy a “professional” who is willing to document that one never existed.
I’m sorry forgive me if I just woke up from a nice dream only to land in opposite day. I am thoroughly taken aback by Jennifer’s two posts and don’t consider addressing her 10 or so self-contradictory statements to be a good use of time.
Jennifer, please re-read what you originally wrote, and then read my response at least once or twice more. You misunderstood what I said. Your follow up comment is not only thoroughly contradictory, but also irrelevant until you understand that you misinterpreted what I said.
I’m not very convinced here by the little game that is taking place.
But just to clarify, when I said “No one here is for informed consent for childbirth? Um ok” – that was a rhetorical question- followed by another comment with proof of the fact that I personally do advocate for better maternity care when I referred you to an old website I put up called babywhys.org.
But that this has nothing to do with The MOTHERS Act is still the case.
So in case you were planning to write a blog entry or a press release for some organization claiming that I said nobody here is for informed consent for childbirth interventions, don’t bother.
(Re: “Do you mean you are all against women having informed consent in childbirth? What would the justification for that be? Not having informed consent leads to trauma,…”)
Amy,
Sorry if I misunderstood that one line. Without seeing the website, it was not too clear.
This is the second time you have accused me of contradicting myself multiple times, but you don’t provide examples. I guess I don’t see it. If you don’t want to discuss it with me, fine. But please don’t accuse me of contradicting myself when I am not. I have been very clear and have answered each of your original accusations of contradiction in order to show you that I was not contradicting myself – but that only gets me accused of contradicting myself, so whatever. I guess you only want the very extreme views on the mothers act to be discussed here and are not interested in the views of someone who is not sure one way or the other about it. I am glad though that my comments are here for anyone who may find this later who is wondering about Postpartum PTSD.
Like I said I don’t intend to play this game. I suggest people click on your name and see your website if they want more information about PTSD since you are apparently an authority. However I have a hard time believing you when you say that you don’t already have an opinion on The MOTHERS Act, based on your comments, and because you link to PSI on your page I assume you have actually clicked on that link to check out their site.
The original point I tried to make is that we are for informed consent in other areas too, which you were questioning.
I am going to go watch Brokeback Mountain now with my husband. Unlike the characters in the film I do know how to quit things. Have a great day.
Amy,
That site is a non-profit organization I volunteer with, not my site. They neither support, nor oppose, the mothers act – just as I have represented here in my comments. They link to other useful sites, one of which supports the mothers act, none of the other linked orgs do to my knowledge, some are even opposed I believe. Their views on the mothers act were not taken into account when they were linked to, only the support and information they could offer women with postpartum PTSD. I find it interesting that you feel I support it from my comments. I doubt very much that a true supporter would feel the same about what I have said here.
Just so you know, I am not playing games with you or trying to argue with you. I simply posted a comment in response to things being said here in the comments section, and you responded to me by calling into question what I had said and claiming I contradicted myself. In trying to explain myself and clear things up, you again stated that I contradicted myself (but failed to provide any ways in which I did so). If you do not wish to have a discussion with me, simply don’t. I will not continue this on my own. However, if you continue to call what I say into question, imply that I am contradicting myself and not making sense, then I feel I have an obligation to the other readers here to clear up any confusion there may be about my comments – either due to myself not being clear, or to you misrepresenting what I have said, or broadly accusing my views of not making sense.
Well Evelyn, the only reason I continue to see my psychiatrist is because he DID say that if I went 5 years without an episode, he would remove the diagnosis. I honestly don’t know what good that will do, or if he’s even serious about it. (Not to mention- I DO have some level of attachment for the guy- yeah, I’m screwed up… in ways that have NOTHING to do with Bipolar)
I will tell you that as a financial advisor, one of my tasks is to sell insurance. I became curious about my insurability so I called the underwriter and asked them about a “hypothetical client” with bipolar I disorder who is only taking a small dose of Klonopin and no history of drug abuse. She said that my “client’s” BEST case scenario was a TABLE F rating… There’s standard, below that is rated A, B, C, D, E, F… each letter represents a 25% INCREASE in premiums…
Not to mention, people like Gina Pera can instantly discredit me by pointing out my anosognosia which is “just a fact”, and many people will believe her.
These doctors have no freaking clue what they are doing to our lives when they toss this label around. Unfortunately I DO exhibit the symptomology of classic Bipolar so I can’t be all that pissed on my own behalf (I have not, as yet, had a clinical depression- but note that a Bipolar I dx doesn’t even REQUIRE a depression. Only a mania.) but there are MANY others who are just sort of unhappy people who sometimes get irritable who are getting slapped with the label. Pretty much anyone who displays emotion in front of an MD in psychiatry runs the risk of at least a Bipolar II dx these days.
I’m sorry Jennifer that I assumed you were from that website/organization that I got to by clicking on your name. Please don’t continue to accuse me of being against informed consent for maternity services. Hopefully we have cleared that up. I still think you contradicted yourself but perhaps the comments make sense to others. I don’t feel like wasting my time on that, what’s the point? You maintain that you don’t know how you feel so perhaps you did not come here to play games and are just a little new to the debate. Forgive me for misunderstanding, I could use a bit more sleep I suppose.
Here’s a link to a blog posting on the UNITE blog about preventing and treating PPD and other emotional / physical problems safely. http://bit.ly/8vaMH This is based on our Feb. 3, 2008 open letter to Congress against The MOTHERS Act in which I included an appendix that mentions some of the things you discuss, such as improving childbirth for women so that they won’t have a difficult time after birth recovering and things will go more smoothly. http://bit.ly/ZkdCl This is a link to an archive with all of our initial press releases during last year’s fight.
Of note, working to improve maternity care would be a great way to help moms without screening / labeling / diagnosing and drugging them. Letting moms choose their own path and support groups rather than assuming they need a nanny state to come target them when they are at their most vulnerable and add to their problems would be a great way to go. This is one of the problems with The MOTHERS Act. Here is my story if you have not read it or watched the video: story written out – http://bit.ly/2lvM4W and video – http://bit.ly/bLCfl
As you can see we are on the same page when it comes to improving maternity care. However I am not sure if you know about the effects of psychotropic drugs for babies. They include seizures, PPHN, heart defects, SIDS, coma, stillbirth, etc. And this is not going to improve or reduce PTSD. You would be well advised to consider that. Check out http://bit.ly/BjrZv and http://bit.ly/Heefl
Hopefully those links work and do not cause my message to be stuck in the SPAM filter.
Thanks and have a great day.
Here are some articles on my blog pertaining to PTSD, the WSJ article (Birth Trauma: Stress Disorder Afflicts Moms) and childbirth as they have been used as a guise to promote The MOTHERS Act. PTSD is the next big thing that big pharma is promoting, so it’s no surprise to see a PTSD-related debate going on over here. I quite frankly think it’s ironic that the alleged cure for PTSD induced by bad obstetrics and fear mongering to mothers while they are in labor is going to a psychiatrist or therapist who may further frighten mothers and tell them that their next childbirth may be more upsetting and this will make women rethink having babies again. I had a great second birth at home with a CNM so I know that birth does not have to be scary even though things did not go so well the first time.
http://bit.ly/HoSw2 (MOTHERS Act – forced treatment, PTSD, Lusskin, PSI, etc.)
http://bit.ly/1I3nwQ (Julie Edgington responds to Rachel Zimmerman’s WSJ article)
Excerpt:
Which brings us to the infamous “non-profit” group, Postpartum “Support” International, who claims to be the lead sponsor of The MOTHERS Act, while also maintaining that they have no interest in seeing pharmaceutical companies do well. This group has put countless women in danger by pushing drugs with absolutely no remorse and no mention of the risks, and it has dishonored Melanie Stokes by doing so much of this in her name. PSI also pushes government agencies and the private sector to advertise depression in print and on TV so that women will “admit” their depression and seek “help.” The group espouses the idea that the universal mental screening proposed by The MOTHERS Act is justifiable because too many women apparently do not realize they are depressed and need a screening to tell them so.
Despite being a “non-profit,” the organization consists of numerous mental health professionals who directly benefit from increased diagnosis and drugging of mothers. They also will be eligible to receive grants to carry out enforcement of the nationwide detection of women considered at risk of mental illness, should The MOTHERS Act pass, and they even have these enforcers ready and waiting to start their surveillance as soon as the bill becomes law (or as they hope it will).
So we’re supposed to trade our freedom and our lives for this bill, and accept that women who do not feel depressed can trust a quiz to tell them that they are so depressed that they can’t live without “treatment?”
(Mental Illnesses: The Only ‘Diseases’ Spread Through Pop Quizzes)
Shari Lusskin M.D., who is a long-time member of the advisory board of Postpartum Support International (PSI) and a professor of “reproductive” psychiatry at NYU, discussed PTSD in new mothers for a recent Wall Street Journal article written by Rachel Zimmerman. The article promoted diagnoses of mental illness for women who go through traumatic childbirth, as well as prevention of “PTSD” via the use of drugs like Zoloft during pregnancy. With this new push to redefine aftershock from trauma as a disease, any woman having an emergency c-section, or any woman whose baby has a life-threatening complication, or any woman whose baby’s heart rate drops during labor, or any woman giving birth to a dead baby could be classified as mentally ill rather than deemed to be reacting normally to an emergency surgery or the death or threat of death to her own baby.
In this Wall Street Journal PTSD article Lusskin said that mothers who experience traumatic births should not jump to the conclusion that they will get PTSD. This statement is highly ironic considering her employment as a speaker for Wyeth, AstraZeneca, Pfizer, and GlaxoSmithKline. In a separate presentation made to mental health “professionals” Lusskin promoted a range of psychotropic medications and even electroshock for use by pregnant and nursing mothers.
In the same article, Susan Stone, the immediate past president of PSI, discussed The MOTHERS Act, stating that “the law’s intent is to provide ‘effective’ care, whether it’s talk therapy, medications or some combination, to suffering mothers.”
I find this article absurd considering that with the push to prevent depression and PTSD by drugging women before they give birth, more babies will die or be born with life-threatening complications. More babies will suffer drops in heart rate as the drugs given to their mothers for labor interact with those given to them for depression or prevention of PTSD, causing more traumatic emergency c-sections and stillbirths. And more women who lose their babies as a result of preemptive drugging will become severely depressed and doctors will try to drug away their grief. So much for treating or preventing PTSD.
Considering the fact that PSI recently sponsored an event to push drugs on anxious women called “Beyond The Blues,” cosponsored by AstraZeneca, it is more apparent why The MOTHERS Act mentions medications and biological agents and not simply antidepressants. Because we wouldn’t want to rule out the government-sponsored drugging of women with drugs given for anxiety and panic attacks.
Zimmerman’s timing in publishing this PTSD promo article is impeccable. The PTSD marketing all ties in quite neatly with the next big epidemic. Perhaps if antidepressants cannot be shown to help depression, drug companies can resort to marketing them for numbing the effects of PTSD, as the patients taking them become psychotic and no longer show any remorse, regret, or fear. In fact, the Pentagon just launched a $300 million project to study PTSD in the military. I can think of many ways that money could be better spent for our military than by administering drugs and waiting to see their effects. Yet many people want to do the same thing for all the nation’s mothers.
Julie Edgington, whose son Manie was born with Paxil-caused Transposition of the Great Arteries, wrote to Rachel Zimmerman of the Wall Street Journal in protest of the “perinatal PTSD” article. “My mission has become very difficult especially when reporters want to demean what has happened to my son by singing the praises of antidepressant use to help with postpartum depression. The MOTHERS Act is set up to screen women even during pregnancy for depression and the only listed treatment is biochemical. What does this mean? It means this world better get ready for many many more babies to be born like my son if this act is passed. Paxil is now a Class D drug yet GSK continues to tell women to take the drug if the benefits outweigh the risk. When the risk is serious and deadly birth defects why would they tell women to take this drug? The same reason they want to pass the MOTHERS Act. The same reason why they said nothing when they knew years before I became pregnant with my son that their drug caused heart defects. They are not scared to get away with murder.”
Keep in mind that this press release posted above is from last year and the bill and PR strategies of those pushing for its passage have changed slightly since then in terms of screening and enforcement. Check out: http://uniteforlife.wordpress.com/2009/05/15/new-fax-campaign/ because this pertains to the current language of the bill.
Kimbriel said:
“Well Evelyn, the only reason I continue to see my psychiatrist is because he DID say that if I went 5 years without an episode, he would remove the diagnosis.”
This would be impossible to do.
First it would require a change, or the erasure, of the diagnosis in years of medical records from the doctor’s office to the pharmacy to any other treatment provider involved.
It would be kind of like a doctor saying, well I had a hunch this patient had diabetes so I had her take diabetes meds and insulin for umpteen years and I billed for office calls all that time, but now I think I was wrong.
Her behaviors and ways of expressing herself led me to believe she had diabetes, but she really doesn’t.
Tell all the billing departments and pharmacies to remove that diagnosis from her medical records so her health insurance rates will be lower.
This will never happen.
Advocates of this bill who act like drugs won’t be forced on you are living in another world. I guess you aren’t familiar with the fact that many states have strengthened their mental health commitment laws to the point that if you utter dark feelings even though you would never act on them, that is grounds for an involuntary commitment.
In my state, even mental health “consumers” who are not anti meds, feared these laws.
As far as insurance, even though I am tapering off of psych meds and am down to 1 final one at the outrageous dose of 3.2mg, I can’t get health insurance.
I have also suffered many adverse side effects from these meds including a hearing loss. Can’t be the drug I was told and I am sure it was all attributed to my “label”.
Regarding screenings helping people, actually, it is out of control in all areas. People are are being diagnosed with the “infamous” pre diabetes and pre high cholesterol states when nothing is wrong with them other than the fact they need to lose weight and change their diets. But that isn’t profitable to the pharmaceutical companies is it?
Finally, after Dr. Bremner was ridiculed for saying that cancer screenings don’t work on psych central, lo and behold, an article comes on out in the NY Times supporting his position.
I thank Dr. Bremner and Evelyn Pringle for being a voice for people like us who have suffered greatly from these psych meds .
Finally, to people who disagree with me, don’t misconstrue my views as stigmatizing mental illness or not having compassion for mothers who suffer PPD. I have great compassion for anyone who suffers so don’t even play those games with me.
AA said:
“Advocates of this bill who act like drugs won’t be forced on you are living in another world.”
Advocates of this bill will not acknowledge that there is no way to get around the fact that the fetus and nursing infants will be subjected to forced drugging, without their consent, and in addition to birth defects, will be put at risk for all the adverse events occurring in adults.
I remain appalled that the priority placed on the health and safety of helpless infants, by mothers and doctors for centuries, has now fallen to the bottom of the list.
I dunno, Evelyn… I had a friend whose psychiatrist took her dx of Bipolar I off, and she was able to get cheapo individual health insurance, though I’m not sure HOW… as she’s been on psych drugs since she was NINE (she is 24 now).
And being that dx’es change all the time from provider to provider… I presume there is at least SOME recognition that mental disorder dx’es are not exactly analogous to diabetes. Then again, these are actuaries we’re talking about, so they probably lump all the dx’es together and go with rating according to the one with the worst prognosis, just to be on the safe side.
In any case, it’s not so much the insurance I’m worried about… for various reasons, I don’t exactly have to worry about health insurance coverage… and luckily I bought LIFE insurance before the whole mess so I got tons of coverage for cheap. It’s somehow a matter of personal vindication for me.