Danny

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Photo Credit: Susan Spaulding

I stood before the shed where they found my friend, Danny.

We used to hang out every day, daydreaming about how we were going to change the world.  He wanted to be a lawyer for the poor and disadvantaged while I dreamed of being a social worker.

Danny was more than a friend to me.  He was the older brother I wish I had.  I am the youngest of three girls.  My sisters didn’t have much time for me.  They were too busy with their friends and social engagements but, I didn’t mind because I had Danny.

He and I were thick as thieves.  We were inseparable.  That’s why his sudden change in behavior was a shock for me.  The sweet, easygoing guy I loved so dearly had become a stranger to me.  He had mood swings, was hyperactive and seemed to have trouble concentrating or staying on topic.  He became withdrawn and spent most of his time in this shed.  I learned later, that he was taking Crystal Meth.  It claimed his life and his dreams.

This morning, I wanted to stop by on my way to the Centre where I run a Crystal Meth Addiction Treatment Program.

199 Words.

This story was inspired by a program I watched last night on CNN about a mothers addicted to Crystal Meth.  The story that really touched me was that of a young man whose mother was taking it.  On the wall of their home hung framed photos of him as a boy and as a promising football player.  All those dreams of a bright future were dashed when he became addicted to Meth and if convicted of selling it, he faces life imprisonment.  What a waste of a young life.

This was written for Sunday Photo Fiction hosted by Susan Spaulding. For more details, visit Here.  To read other stories based on this week’s prompt, visit Here.

Source:  Serenity Acres

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Women and Postpartum Depression

For 1 in 8 women, new motherhood is anything but joyous – Health.com

Mother In Nursery Suffering From Post Natal Depression

Postpartum depression is a very real and very serious problem for many mothers. It can happen to a first time mom or a veteran mother. It can occur a few days… or a few months after childbirth – Richard J. Codey

Recently on the news I saw that Drew Barrymore admitted that she suffered from postpartum depression after she had her second daughter.  It was a short-lived experience.  It lasted about six months. She was grateful for the experience because it was a constant reminder to stay present in the moment.  Her motto was, “one thing at a time.”

I have heard quite a bit about postpartum depression but this time I wanted to educate myself about it and my heart was touched by the experiences women go through.  First of all, I want to point out that it’s a real and serious condition.   I was appalled at how women with postpartum depression were treated.  Stigma, disbelief and lack of support from others prevent them from getting the treatment they desperately need.  So, they suffer in silence.  How terrible it is for a woman who has images of her child drowning in the bathtub or being smothered on his burp cloth, fearing for her sanity but is afraid to say anything so she keeps it from her husband for as long as she could. And how sad it is that a woman should feel judged for taking antidepressants for postpartum depression because of the mistaken belief that depressed mothers are self-centered and weak.

Women who have postpartum depression feel a triple whammy of the stigma reserved for people with mental illnesses.  Not only are they brought down by what many expect to be the happiest even in a woman’s life–the birth of a child–but also total honesty about their emotional state could invite scorn or even a visit from social services (Health.com).  

“We’re suffering from an illness that cannot be seen.  We don’t have a fever, swelling, vomiting, or diarrhea.  No open wounds that will not heal–at least not the kind you can see with the naked eyes.  So, many wonder if we’re really sick at all – Katherine Stone

Psychologist Shoshana Bennett, founder and director of Postpartum Assistance for Mothers endured two life-threatening postpartum depressions in the mid-1980s, at the time when help for women in her condition was hard to find.  “I was quite suicidal.  My doctor told me to go and get my nails done,” Bennett recalls.  Can you imagine going to your doctor because you are feeling suicidal and being told to go and get your nails done?  It didn’t help that she had an unsympathetic mother-in-law who, believe it or not, had been a postpartum nurse for years.  The mother-in-law had given birth to five children and had not suffered from baby blues with any of them.  When Bennett’s husband asked his mother what was wrong with his wife, her response was, “She’s spoiled.  It’s not just about her anymore.”

Bennett’s husband was angry, confused and upset with her.  Bennett hated herself and things got worse after her first child was born.   She was 40 pounds overweight and very depressed.  She went to her ob-gyn for help.  When she told him, “If life’s gonna be like this, I don’t wanna be here.”  His response?  He laughed and said that all women go through this.  So, there was Bennett, suffering from postpartum depression, with no support or help.  It was her own experience that motivated her to become a licensed therapist, specializing in postpartum depression so that she could counsel women who are going through what she did.

Sometimes women are given medications with terrible side effects.  Katherine Stone experienced this when the first psychiatrist she went to treated her with four or five medications.  She had to find a practitioner who specialized in the treatment of postpartum mental disorders.  She discovered the hard way that no all psychiatrists are experts in treating postpartum depression. “So many psychiatrists don’t understand the condition, don’t have the tools to treat this, and aren’t trained in varying ways in which women with this disorder need to be cared for,” she says.

It is recommended that you ask your ob-gyn, nurses and social workers if the hospital in which you delivered offers postpartum depression services or sponsors support groups for new moms. Ruta Nonacs, MD, Associate Director of the Center for Women’s Health at Massachusetts General Hospital in Boston, recommends, “Call Postpartum Support International (800-944-4773) to find a support group near you.  I also recommend seeing your family doctor.  They’re treating people with depression all the time and can also help with referral to a therapist.”

How can you tell that you have postpartum depression?  There are three postpartum conditions – baby blues, depression and psychosis.  Here are the symptoms outlined by Mayo Clinic:

Postpartum baby blues symptoms

Signs and symptoms of baby blues — which last only a few days to a week or two after your baby is born — may include:

  • Mood swings
  • Anxiety
  • Sadness
  • Irritability
  • Feeling overwhelmed
  • Crying
  • Reduced concentration
  • Appetite problems
  • Trouble sleeping

Postpartum depression symptoms

Postpartum depression may be mistaken for baby blues at first — but the signs and symptoms are more intense and last longer, eventually interfering with your ability to care for your baby and handle other daily tasks. Symptoms usually develop within the first few weeks after giving birth, but may begin later — up to six months after birth.

Postpartum depression symptoms may include:

  • Depressed mood or severe mood swings
  • Excessive crying
  • Difficulty bonding with your baby
  • Withdrawing from family and friends
  • Loss of appetite or eating much more than usual
  • Inability to sleep (insomnia) or sleeping too much
  • Overwhelming fatigue or loss of energy
  • Reduced interest and pleasure in activities you used to enjoy
  • Intense irritability and anger
  • Fear that you’re not a good mother
  • Feelings of worthlessness, shame, guilt or inadequacy
  • Diminished ability to think clearly, concentrate or make decisions
  • Severe anxiety and panic attacks
  • Thoughts of harming yourself or your baby
  • Recurrent thoughts of death or suicide

Untreated, postpartum depression may last for many months or longer.

Postpartum psychosis

With postpartum psychosis — a rare condition that typically develops within the first week after delivery — the signs and symptoms are even more severe. Signs and symptoms may include:

  • Confusion and disorientation
  • Obsessive thoughts about your baby
  • Hallucinations and delusions
  • Sleep disturbances
  • Paranoia
  • Attempts to harm yourself or your baby

Postpartum psychosis may lead to life-threatening thoughts or behaviors and requires immediate treatment.

For more information such as when to see a doctor, what your options are or how you can help a friend or a loved one, click on this link.

Why do some women suffer from postpartum depression while others don’t?  According to Marcie Ramirez, Middle Tennessee coordinator for Postpartum Support International, “People with a history of mental illness have a high risk, as do people on either end of the age spectrum–young mothers or older mothers.  If you have a history of minor depression, panic attacks, or OCD (Obsessive Compulsive Disorder), you are at a higher risk for postpartum depression.  A mother who experiences a traumatic birth is more likely to develop postpartum depression, as are new mothers who have a history of sexual abuse.  Bipolar disorder is a big indicator for postpartum psychosis, a very serious form of postpartum depression that affects about 1 to 2 out of every 1,000 new moms.”

Other predictors of postpartum depression are:

  • marital difficulties
  • stressful life events such as financial problems or loss of a job
  • childcare stress
  • inadequate social support
  • having to are for a child with a difficult temperament
  • low self-esteem
  • unplanned or unwanted pregnancy
  • being single
  • lower socioeconomic status
  • postpartum blues (Babycenter.com)

An article in the Daily Mail says that a woman’s risk of post-natal depression increases if she has a Caesarean section.  According to researchers, women were 48 per cent more likely to experience depression if they had a planned procedure rather than an emergency one.  Some women choose to have a Caesarean because they are afraid to give birth naturally, have had a previous childbirth trauma or want the convenience of a scheduled delivery.

Postpartum depression should be taken seriously.  Women are so overcome with fear and anxiety that they are afraid to be in the same room with their babies.  This affects them being able to bond with their babies which is vital to their development.  Women need to talk about their feelings, no matter how painful they are.  They need the support of their husbands and families.  “A functioning, healthy mom is vital to the family unit, and getting mothers with postpartum depression professional help can ensure that they avoid years of needless depression,” says Ramirez.

Advice for mothers who are experiencing depression is, “do what’s best for yourself so you can do what’s best for your baby” (Health.com).    Ann Dunnwold, PHD, a Dallas-based psychologist who specializes in postpartum depression, says, “The key is to have it on your own terms.  Sometimes the mother-in-law will come over to be with the baby, but what the new mom needs is for her to do the laundry.  To help, everyone needs to ask themselves what the mom really wants.”

There is hope for women suffering from postpartum depression.  The key is finding a health professional who specializes in treating it and who won’t brush you off or make light of it.  There are medications and treatments that can relieve or even reverse postpartum mood disorders. Don’t wait to get help.  Don’t suffer in silence.  Speak up.

If you know a woman who is going through postpartum depression or are married to one, please help out as much as you can.  Make sure that she gets enough sleep and encourage her to speak with her healthcare provider.  Encourage her to get some kind of support.

If you are suffering from postpartum depression, here is a list of postpartum depression support groups.  Perhaps reading stories of mothers going through what you are going may help. You’re not alone.   Help and hope are available for you.

Mature woman gives solace to crying adult daughter

Mature woman gives solace to crying adult daughter

Sources:   http://celebritybabies.people.com/2015/10/21/drew-barrymore-postpartum-depression-people-cover/?xid=rss-topheadlinesMayo Clinic; Baby Center; Postpartum Depression Progress; Health.com; Daily Mail; Brainy Quotes; Healthscope

Women and Bipolar Disorder

The first time I was aware of bipolar disorder was years ago in New York.  It was there that I learned that my sister was manic depressive.  She had suffered from a nervous breakdown.  I never knew that she was manic depressive.   It was not evident to me.  She seemed fine to me.

While living in New York, she only had one episode where she had to stay in the hospital overnight but after that she was fine.  She had a good doctor who was diligent in her care.  I have other relatives who suffer from bipolar disorder.  And a co-worker of mine is no longer working because she had a relapse.  The last time I saw her I couldn’t believe it was the same person.  She called me on the phone and she was saying things that didn’t make sense and using language I never expected to hear coming out of her mouth.  I realize that when a person has bipolar disorder, he or she is different.  The illness changes the person.  Things from the past are dredged up, there are resentments and the belief that there is a conspiracy against him or her.

It’s hard to see someone you love suffering from a mental illness.  It’s harder when the person comes off of the medication and winds up back in hospital.  Each time he or she comes off the medication, it becomes harder to get back on track.  And the scary thing is they get into debt or in some cases trouble.  It’s hard for family members to know just how to cope, especially if during these episodes harsh and hurtful things are said.  It’s so disappointing when the person is doing well for a long time and then there is a relapse.  Each time he or she gets better, you are wary, wondering how long it would last.  Each time he or she promises not to come of the medication and vows to stay out of the hospital but something happens and there is an episode.

Even though I am aware of bipolar disorder, I still don’t know much about it.  I thought that I would search the web and gather all the information I could find just to get a better understanding of the illness.

What is Bipolar Disorder?
Bipolar disorder, formerly known as manic-depressive illness, is a brain and behavior disorder characterized by severe shifts in a person’s mood and energy, making it difficult for the person to function. More than 5.7 million American adults or 2.6 percent of the population age 18 or older in any given year have bipolar disorder. The condition typically starts in late adolescence or early adulthood, although it can show up in children and in older adults. People often live with the disorder without having it properly diagnosed and treated.

What are the symptoms of Bipolar Disorder?
Bipolar disorder causes repeated mood swings, or episodes, that can make someone feel very high (mania) or very low (depressive). The cyclic episodes are punctuated by normal moods.

Mania Episode Signs and Symptoms:

  • Increased energy, activity, restlessness
  • Euphoric mood
  • Extreme irritability
  • Poor concentration
  • Racing thoughts, fast talking, jumping between ideas
  • Sleeplessness
  • Heightened sense of self-importance
  • Spending sprees
  • Increased sexual behavior
  • Abuse of drugs, such as cocaine, alcohol and sleeping medications
  • Provocative, intrusive or aggressive behavior
  • Denial that anything is wrong

Depressive Episode Signs:

  • Sad, anxious or empty-feeling mood
  • Feelings of hopelessness and pessimism
  • Feelings of guilt, worthlessness and helplessness
  • Loss of interest or pleasure in activities once enjoyed, including sex
  • Decreased energy, fatigue
  • Difficulty concentrating, remembering or making decisions
  • Restlessness and irritability
  • Sleeplessness or sleeping too much
  • Change in appetite, unintended weight loss or gain
  • Bodily symptoms not caused by physical illness or injury
  • Thoughts of death or suicide

Apparently there are several types of bipolar disorder but the two main ones are bipolar I and II.  Bipolar type I disorder is the “classic” form, and patients often experience at least one full or mixed episodes with major depressive episodes. Bipolar type II disorder is where patients have at least one milder form of mania and one major depressive episode.  However, they never get a full manic or mixed episode.  Bipolar II is harder to diagnose because some symptoms of hypomania may not be as apparent. Hypomania is described as a milder form of mania with less severe symptoms.  I believe that my sister displays more symptoms of mania.

All the people I know who have bipolar disorder are women.  Although it is prevalent among men as well, it seems that it is approximately three times more common in women than in men.  For women it is rapid cycling.  Rapid cycling describes incidences where a bipolar patient experiences four or more episodes of mania, hypomania, or depression within a time period of a year (Leibenluft, 1997).

The article explains why rapid cycling bipolar disorder more common in women than in men. Three potential hypotheses to explain the higher prevalence of rapid cycling in women are hypothyroidism incidence, specific gonadal steroid effects, and the use of anti-depressant medications. First, more women encounter hypothyroidism than men do; however, there is not a general consensus on it being a primary cause of increased rapid cycling. Second, gonadal steroids, such as estrogen and progesterone, fluctuate throughout the menstrual cycle. Sixty-six percent of bipolar type I women had regular mood changes during either their menstrual or premenstrual phase of their cycle. They were more irritable and had increased anger outbursts (Blehar et al., 1998). These may set up women to frequent mood changes (especially prior to the menstrual cycle, as noted in the term “premenstrual syndrome”). Increased estrogen may cause women to develop hypercortisolism, which may increase the risk of depression. Stress levels are associated with cortisol level, so this may possibly be the reason for increased risk for depression.

There are risks involved in pregnant women who suffer from bipolar disorder.  Manic episodes and cycling seemed to occur exclusively during pregnancy.  For reasons still unclear, apparent pregnancy poses a question of relapse, which has an important effect on women and the fetus that they are carrying. The fetus can be at risk due to lack of attention to prenatal care, if the woman is not treated for the psychiatric illness. Precipitated episodes in the absence of treatment may be very detrimental to both parties involved. Secondly, the woman would be at risk because with each successive episode, the length of time to following episodes gets smaller. That is, the woman could have manic and depressive episodes more often. This would neither be beneficial to the woman or her child. The effect on the fetus due to many mood episodes is unclear (Viguera et al., 1998). “During pregnancy, a woman’s glomerular filtration rate increases” (Llewellyn et al., 1998). This means that any medication that she takes, such as lithium (discussed below), will be excreted more rapidly. This is very dangerous because if she does not have enough medication in her system, she can fall into relapse.

A dilemma arises in that if she increases her medication amount, she may be exposing her fetus to grave side effects and even danger (discussed below). Moreover, during labor, it is important that women remain fully hydrated. Since the period of time for delivery varies with each individual, a pregnant woman can become very dehydrated. When a woman gets dehydrated, the serum medication concentrations will increase (Llewellyn et al., 1998). This is the opposite effect of the increase in glomerulus filtration. Nonetheless, both situations are dangerous and can be very toxic to the woman and indirectly to the fetus.  As varying as the symptoms of bipolar disorder, per individual, so are the treatments. It is very important that bipolar pregnant women get the appropriate care and treatment that they need, in order to properly care for themselves as well as for the child that they are carrying.

It is disturbing to know that women with bipolar disorder are more susceptible to misdiagnosis.   recent study estimated that the odds that a woman with bipolar disorder will fail to be correctly diagnosed are roughly three times the odds for a man. This disparity may be explained in part by the fact that bipolar disorder tends to look different in women than it does in men—in the same way that physicians sometimes fail to catch heart disease in women because they are effectively looking for the male version of the disease, mental health professionals may not always be aware of the distinctive signs of bipolar disorder in women.  According to Vivien Burt, MD, PhD, director of the Women’s Life Center at UCLA’s Resnick Neuropsychiatric Hospital, “Women are more demonstrative—they have more of what’s known as ‘affective loading’—so it’s not surprising that bipolar disorder might be underdiagnosed in women compared to men.”

Another article stated that a woman is likely to have more symptoms of depression than mania.  And female hormones and reproductive factors may influence the condition and its treatment.  Research suggests that in women, hormones may play a role in the development and severity of bipolar disorder. One study suggests that late-onset bipolar disorder may be associated with menopause. Among women who have the disorder, almost one in five reported severe emotional disturbances during the transition into menopause.  Studies have looked at the association between bipolar disorder and premenstrual symptoms. These studies suggest that women with mood disorders, including bipolar disorder, experience more severe symptoms of premenstrual syndrome (PMS).

My sister had the disorder since she was in her thirties.  She is unmarried and doesn’t have any children.  If she had children would they be at risk?  Bipolar disorder is more likely to affect the children of parents who have the disorder. When one parent has bipolar disorder, the risk to each child is estimated to be 15-30%.  Bipolar symptoms may appear in a variety of behaviors. According to the American Academy of Child and Adolescent Psychiatry, up to one-third of the 3.4 million children with depression in the United States may actually be experiencing the early onset of bipolar disorder.

If you notice mood swings in yourself or someone else, don’t write them off as hormonal changes.  Seek medical help.  And if you are diagnosed with bipolar disorder, consult a psychiatrist or a general practitioner with experience in treating this illness.

My sister is currently on disability.  A bipolar diagnosis can have a great effect on your job and career.  In a survey of people with depression and bipolar disorder conducted by the Depression and Bipolar Support Alliance, 88% said their condition affected their ability to work.  Don’t be discouraged, though.  Being diagnosed with bipolar disorder doesn’t necessarily mean that you can’t keep your job. Plenty of people with bipolar disorder work and live normal lives.  If you are currently unemployed and are seeking employment, find a job that is a good fit for you–one that is not stressful and has a flexible schedule.  If you are currently in a job that is not working for you–is affecting your health, not letting you get enough sleep, maybe it’s time to make some changes.  Here are some things you should consider:

  • Decide what you really need from your job. Do you need to reduce your responsibilities? Do you need extra breaks during the day to reduce stress? Would you rather work independently or in a group? Do you need to work shorter hours or take time off? Or do you need a different job altogether?
  • Make decisions carefully. People with bipolar disorder are prone to acting impulsively. Think through the effects of quitting your job — both for yourself and possibly for your family. Talk over your feelings with your family, therapist, or health care provider.
  • Look into financial assistance. If you do need to take time off because of your bipolar disorder, see if your employer has disability insurance, or look into Social Security Disability Insurance, which will provide some income while you recover. You can also look into the Family and Medical Leave Act. Ask your doctor or therapist for advice.
  • Go slowly. Returning to work after you’ve taken time off can be stressful. Think about starting in a part-time position, at least until you’re confident that your bipolar disorder has stabilized. Some people find that volunteer work is a good way to get back into the swing of things.

Unfortunately you may encounter stigma at work.  Some people might treat you unfairly because of your disorder.  If you feel that you are being passed over for promotion or are being treated unfairly, there are things you can do.  Find out what policies are in place at your company that will protect you from this kind of discrimination which is illegal.    The Americans with Disabilities Act can protect some people who are discriminated against because of a health condition.  Before you do anything, research the law and talk things over with family, friends and therapist.  Mitzi Waltz, author of “Adult Bipolar Disorders,” advises bipolar employees to call a counselor or local support group to help them with workplace problems.

Bipolar disorder is tough on families and spouses.  They have to cope with behavioral problems.  Family members often experience feelings of extreme guilt after the individual is diagnosed. They are concerned about having had angry or hateful thoughts, and many wonder whether they somehow caused the illness by being un-supportive or short-tempered, although this is not the case.  There are times when I feel guilty because I didn’t touch base with my sister as often as I should have.  There are times when I am frustrated with her for coming off her medication because she is aware of what happens when she does.  I feel that she should take more responsibility for keeping the disease under control by taking her medication.  I see how her relapses affect my mother who has Parkinson’s.

I realize that although it is difficult to cope, families of patients with bipolar disorder need to be more supportive.  It is in the best interest of the person to be hospitalized for his or her own protection and for much needed treatment if he or she is in the middle of a severe episode.  And it is important for the patient to  to understand that bipolar disorder will not go away, and that continued treatment is needed to keep the disease under control. It is important that they understand that proper therapy will enable them to have a good quality of life and enable them to have a productive life.

The following tips are for families who want to help their loved ones to cope with the illness:

  1. Educate Yourself
  2. Learn How–and When–to Talk
  3. Make Some Rules
  4. Plan Even More
  5. Listen
  6. Go Gentle
  7. Laugh Together
  8. Support Yourself

I encourage families of people with bipolar disorder to educate themselves and then see how they can help their loved ones to cope.

Sources:  http://bbrfoundation.org/frequently-asked-questions-about-bipolar-disorderhttp://psychcentral.com/lib/2007/women-and-bipolar-disorder/all/1/http://www.health.com/health/condition-article/0,,20274376,00.htmlhttp://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-womenhttp://www.bphope.com/BipolarIndepth.aspxhttp://www.ehow.com/about_5032842_signs-bipolar-disorder-women.htmlhttp://www.webmd.com/bipolar-disorder/going-to-work-bipolarhttp://www.livestrong.com/article/23014-good-career-those-bipolar-disorder/http://www.psychiatry24x7.com/bgdisplay.jhtml?itemname=bipolar_familyhttp://www.beliefnet.com/Health/Emotional-Health/Bipolar/8-Ways-to-Help-Your-Bipolar-Loved-One-Cope.aspx