How Do I Distinguish Between Normal Postpartum Stress and Distress?
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Kaely Harrod 0:00
As we continue along our journey of postpartum questions and answered, We are joined today by another special guest. Her name is Cindy Kim. She is a psychotherapist and she's here to have a conversation with us about postpartum mental health. The question that we're answering today is how do you distinguish between typical postpartum stress and postpartum distress? Now, as always, there's some overlap and some nuance. So you'll hear that in the conversation. But I do think that you will glean some wonderful tools from this conversation with Cindy. Welcome to Doula Tips and Tits, the podcast where I answer one question about pregnancy postpartum or lactation. This is a space where it's safe to have questions and we're gonna give you real answers. We're not gonna beat around the bush or give you what we want you to know. We're going to answer in an evidence based way. I'm Kaely Harrod and experienced doula, mom of three lactation counselor and a childbirth educator. I started this work in part because of my own lack of answers in my journey of pregnancy and birth. And I'm on a mission for families to be well informed and well supported through this time. This is a space where you will learn about questions that you didn't even know that you should be asking, and have answers to ones that you're already asking. The whole purpose here is for you to feel a bit more educated and informed and competent in this journey that often feels very new, and a little bit disconcerting. If you have not already I would love for you to subscribe to this podcast so that you get updates when there are new episodes. or head to our website Herat doula services.com to subscribe to our email updates so that you get notifications when we have a new episode Episodes Episode out. Thank you for joining us today. Welcome back to Kaely daily. We are still on our postpartum series today. And I am joined by a wonderful colleague of mine, Cindy Kim, and I'm going to hand it over to her to let her kind of give you a rundown of her background and then we're going to dive into our question.
Unknown Speaker 2:16
Okay, hi. It's great to be here. Um, so yeah, so I have been a private practice therapist in the DC area since about 2008 or so. I have started specializing in perinatal mental health that includes infertility trying to get so trying to get pregnant pregnancy postpartum, all of the above. Since about, let's see, 2013 or so 2014. And that very clearly coincides with when I started having children myself, and kind of, you know, experiencing the ups and downs of trying to get pregnant, trying to stay pregnant, having a child going through all the things. And so it really felt like a calling. So I am happy to be here.
Kaely Harrod 3:12
Yeah, amazing. I feel like that is a very common thread in people that work in this space is their own experience around it in some way. So yeah, that's your you're not alone in that.
Unknown Speaker 3:25
Yeah. It's super important to me to kind of take that and take that human experience that I have, as well as centering my client's human experience. So not taking that letting mine overtake theirs, but just kind of being present for everyone's humanity.
Kaely Harrod 3:45
Yeah, yeah. That's super important. Also, why I love your I love your philosophy behind what you do. So today's question that we're gonna dive into is how to distinguish between typical postpartum stress and postpartum distress. And if you've been around for a little bit, you know that these answers are not just super straightforward, though time there is some nuance there. Before we started recording, Sidney and I were both saying that we both very firmly fall on the side of why not have a little bit of extra support in whatever way you feel like you need it. So what we don't want is for this episode to lead you to think, Okay, well, I don't check all of these boxes. And so I am not a person who needs whatever kind of extra layer of support an extra layer of support is not going to be a bad thing. So preventative support is a good idea. But we are going to kind of tease out like, what is the normal amount of stress that postpartum folks feel and kind of how to how to expect that and have a good mindset around like what, what you may experience just because of the postpartum hormones, it's had Tara in that in that timeframe, so Cindy, can you talk to that a little bit? Yeah, sure.
Unknown Speaker 5:04
So, you know very much agree that support is always a good thing, regardless of how, how much you might feel you're well adjusted or adjusting. Having a child can having a baby can throw curveballs at you out of nowhere. And, you know, the whole phrase, I was just talking to somebody, recently, the whole phrase of this too, shall pass is true. And it's also so unhelpful, when you're in the middle of going through a phase that's really hard. So absolutely, getting that kind of support is, is is absolutely recommended. You know, at the same time, there are total, there's so essentially, to begin with postpartum is stressful, regardless, something that you aren't, you absolutely are, for the most part, typically overjoyed by and grateful for. And yet, plenty of times when you just would like a break from it all. Because it's hard. I mean, if you're not getting a lot of sleep, it's hard. But you know, there are ways in which there are times in which this the postpartum stress can kind of tip over from kind of your more typical anxiety will perhaps, you know, a lowercase A ish kind of deal, or a, you know, depressing kind of self identity kind of difference, all those kinds of things over into what we call P. Mads the perinatal mood and anxiety disorders. And there are, there are a few signs, things like, you know, noticing that you're kind of crying out of nowhere, really did not, did not expect that particular expression of emotion, or perhaps that you're actually particularly flat, you know, not necessarily expressing too much emotion. You know, a lot of times we talk and postpartum about the lack of sleep and how much we need the sleep. And then sometimes, you know, one of the signs that can show that something is a little bit off here is when you actually cannot go to sleep, when you can't take a nap, when you can't, you cannot keep your eyes off of your baby. Because what if something happens? anger, rage, these are also really strong signs. There, it's relatively common in kind of postpartum, postpartum world to feel rageful at times that can feel you know, there can be like a stigma, there can be a little bit of shame attached to rage, anger, even excessive anxiety, you know, depression, all the things, anything that makes you feel like, I should be doing something different, you know, I shouldn't be happy, I should be present. Instead, I'm constantly worrying about the next thing. And I'm noticing I'm completely not press, I'm losing, I'm missing all these minutes. So these are some kind of few ways other other things that I might actually say it's just really, the persons that are around you, your support people, your loved ones, may might have a little bit of a better view into what's going on, but feels a little bit. Not quite normal. Because unfortunately, I mean, in many ways, it's just when you're in it, you're in it, it feels normal, it feels real, it feels like this is it. And so it can be really hard to have that objective kind of viewpoint. In particular, when your entire attention being everything is on is your baby. Okay? Just forget about yourself.
Kaely Harrod 8:48
Well, and I think that's especially true when you've never done it before. Because you don't know you don't have anything to compare it to, you know, oh, sometimes I hear people say like, I just assumed it was always this hard. And I'm like, Yeah, well, that's an realistic and understandable assumption to make, you know, and also, it doesn't have to be this hard, you know. And so I think that's part of it, too, that we kind of almost gaslight ourselves in the experience because we don't we're like, Well, gosh, I guess I didn't prepare well enough, you know, and sort of turn it back on my own lack of knowledge or preparation or whatever that is, so
Unknown Speaker 9:26
I write or something about I'm, you know, what's wrong with me that I'm, I can't do this. No, everyone else can do this. Yeah, I can't lie. Yeah. There can also be you know, typically if you are at a OB practice or a midwife practice that follows, you know, I mean, most I think most jurisdictions typically administer the PHQ nine, which is a kind of postpartum depression scale, out about six weeks postpartum. But I don't know it's not a necessarily I mean, it's, to me a postpartum kind of depression assessment is much, much more postpartum anxiety, postpartum, OCD, all the things much more effectively assessed through a conversation than it is through a checklist. So many things can go into that, you know, if I, if I do this, if I check right here that I'm experiencing postpartum rage, you know, I'm afraid of that I'm going to hurt the baby. You know, these are all signs of postpartum anxiety, postpartum OCD. And to be clear, generally speaking, if you are afraid of that, you're going to hurt your baby, that generally means you're not going to Yeah, but then we worry about mom, or birthing person, you know, we were worried about that person's mental health.
Kaely Harrod 10:53
We'll be right back after this message from our sponsor. The birth prep blueprint course, is a guide from pregnancy to postpartum, giving you the confidence to walk through this journey. However it might play out. It is pre recorded on demand content. So you do not have to fit your busy schedule around a class or meeting time, you can go back and revisit the lessons as much as you need to. And you can watch or listen to them on your own time. This curriculum has left many families feeling confident in their decisions, knowing what questions to ask their providers, and knowing when they should be concerned in all of these periods. One of the biggest parts of this work in terms of preparing families and walking through this journey is knowing that you have a guide to rely on. And that's exactly what this class is. Students have told me, they felt like I was walking them along a path to know what to watch for and what to not be worried about. Because you are here, as a listener, you will get the opportunity to have a 10% off discount on this class, that code is podcast, it is in the show notes as well, along with the link to use to check out for the class, I do really recommend that you go give it a look. Because it is going to make you feel more prepared calm and confident for your birthing experience. Now back to your show. Yeah, I remember so clearly as like my kiddos are 1211 and nine now. So it's been a little while since I did that assessment. But I remember at six weeks postpartum being given that checklist and being like, I mean, aren't half of these just like I'm exhausted? Because I'm taking care of a baby like, absolutely sometimes don't want to get out of bed because I only slept for two hours that night. You know, it's like, it's also like contextually really hard to tease out. Yeah, in just that like Check, check, check, check, check. And it's like you didn't get enough points for us to be concerned.
Unknown Speaker 12:57
Right, exactly. I so wish that in that six week postpartum appointment that every person walked away with a list of providers for any of the above issues, whether it's even ads or pelvic floor dysfunction, or whatever it is. So, you know, just easing that barrier.
Kaely Harrod 13:18
Right? Right. Yep. Yeah. So I want to go back to one of the things you said, Because I regularly hear from clients that they are so disconcerted by the random crying in the first days postpartum. So I know that you mentioned that as a possible sign, right? Would you say that there is like a way to kind of tease out the like crying that happens for no reason at two days postpartum? Because your body is going completely bananas and the crying that you would be more concerned about? Or is that the same? I'm like, I mean, again, with the context that both of us are like, by all means, get counseling it two days postpartum if you need that, you know?
Unknown Speaker 14:03
Yeah, yeah. So I mean, so there is a a certainly a phenomenon called baby blues which you know, I'm sure most of your listeners know about already, but something like some absurd number like 80% of postpartum people experienced the baby blues and that can look like kind of bursts outbursts of crying, emotional, you know kind of ups and downs that are just feel totally out of character for yourself. The baby blues though, is something that typically are just always resolves on its own within two weeks postpartum. If it extends beyond two weeks postpartum then we're talking about something different here. And where then it becomes something that it's it's it's a good idea to go get assessed and go get, you know, check to see what what resources there might be available. for you, you know, sometimes the emotional support thing is absolutely. And mental support thing is obviously a therapist I believe in and it's so bias here. And also sometimes we also just need more hands to support and help, you know, and sometimes that looks like postpartum doulas, or, you know, night nurses or, or whatever it might be. So you know, kind of figuring out what that that whole constellation of support can look like afterwards. The other thing I want to note though, also is that perinatal mood side is mood and anxiety disorders do not have to start the moment you are give birth, anytime between birth and up to one year, although to be honest, in my personal opinion, I would go past a year. But yeah, but the general kind of decided upon kind of diagnosis Sybil type thing is between birth and a year. So you could feel like you've been super well adjusted, gotten through all of the everything, and then six months and just kind of get hit by Oh, wow, something's funky here. Yeah. So yeah, I mean, so there is a part that while I said before, you're in it, and it feels real, and it feels normal. There are times when you can notice, this is not, this is not my typical, this is not like this is weird that I'm feeling this way. And if you get a hint of this is weird that it's feel I'm feeling this way, then might as well get assessed.
Kaely Harrod 16:33
Yeah, yeah. I feel like sometimes sometimes it almost feels like there's a layer of gloominess on everything, right? Like it does. I think this, this topic is sometimes tricky, because there are so many different possible ways you could feel it right, or a particular person could feel it. And also, like you said, if one thing is off, and it's persistently off, not ignoring that, and assuming that it's normal, is a really good first step. Because really, you're not doing any harm. Getting getting, like someone else's opinion of if what you're experiencing should have some kind of support, you know,
Unknown Speaker 17:17
yeah, I always think it's really important to kind of turn, you know, our society, I think, or our typical thought is that it's a, it's not quite a sign of weakness, but like, it's a demonstration of deficit and, and something negative about self that you might need to, to access support. But if we could, I was so wish that we could all just turn that and reframe that, that, you know, it is a sign of strength, and self advocacy, and, and really kind of caring for the well being of your child, your relationship yourself, your family, if you go out and seek of kind of support. That is it's not weakness, it is bravery and truth.
Kaely Harrod 18:03
Yeah. 100%. And it's also I mean, you can't slowly wither away, and also take good care of your family and your kiddo, you know, I mean, that's, that's, I think, super unhealthy idea that we have around mothers, especially, but parents in general, you know, yeah, that like you just kind of put yourself to the side, which is not, that's not actually how life is sustained.
Unknown Speaker 18:30
No, exactly. It's your, your being your best self, you will then be able to kind of support and care for and, you know, be the good enough parent that you need to be. And that exactly, it includes that like attention and pain and concern for the quality of the connection between partners. If there is a partnership, or, you know, having a baby, having a child brings up so much, it could also bring up your own stuff with your own parents, you know, and how that then plays into the interactions that exist and everything. So taking care of yourself equals taking care of your baby, taking care of relationship potentially equals taking care of your baby. Yep. It's also important.
Kaely Harrod 19:25
Yeah, no, I wholeheartedly agree. So Cindy, and I could discuss this for a very long time. But I would love for folks listening to hear what some of the best ways are for them to get in touch with you and if you do in person or virtual or kind of what does it look like how you support your patients at this time?
Unknown Speaker 19:47
Sure thing. So I after, I can't remember maybe about 17 years of feeling super great about living in Washington, DC Um, my family and I decided to move out of the area. That being said, I do still maintain my practice in the DC area. So I'm licensed in DC, Maryland and Virginia. And I conduct telehealth appointments, which in many ways, I mean, the pandemic was absolutely, you know, kind of paved the way in a way for this to become very normalized. At the same time, my postpartum and pregnant and, you know, clients, this works, in many ways the best, it's just a lot more easy to access. You don't have to get yourself out of the house, you don't have to take a shower, you know, I don't mind. I don't mind what you're doing. You can be nursing, you can be bottle feeding you can be you can be changing a diaper, it does not matter. We are I'm here for that. So I do telehealth, and my website is www dot Cindy Kim therapy.com. That is my email address, as well Cindy, compare gmail.com. And I have done in the past a pregnancy and Postpartum Support Group, and will likely be re engaging in that and sometime in the near future. But at the moment, I do individual therapy, I do couples therapy, and, and really feel so incredibly honored and fortunate to be able to do the work that I do.
Kaely Harrod 21:33
Yeah, that's amazing. I'll make sure that all of your information is in the show notes so people can connect with you. And I really, really appreciate you taking the time to add to this, I feel like this is one of the topics that I do not have the expertise to speak to on my own. But it's also just like super encouraging to me to have some reassurance of how to support folks, you know, as I'm kind of seeing them in those early days. So,
Unknown Speaker 21:59
yeah, Kaely Do you mind if I add one last thing, of course, go for it. So the one last thing, actually, I just it just came to mind is, I also think it's important to recognize that we are as postpartum individuals, that may not just be the only context that exists. There's also, you know, cultural things there is, you know, there is the statistic that something around, you know, 20%, of postpartum folks experience peanuts. And of those 40% of black mothers experience. Peanuts, you know, and so that's got to speak so much to me about the the environmental context of being a mom, or being a, you know, postpartum person. So, yeah, there's a lot there, it's important to look at everything.
Kaely Harrod 22:58
Yeah. And that's something that we that as a company that Harajuku services we deal with that really head on, because it is a reality that like the layers of racism and oppression that are in the systems that you're working in, are going to have an impact. And that's across every aspect of life, you know, and so there needs to be an acknowledgement of that. And then also layers of support because of that, you know, right. Yeah. Yeah, exactly. Yeah. I appreciate that. You also acknowledge that? Yeah.
Unknown Speaker 23:34
Oh, yeah. Thanks. Thanks, of course.
Kaely Harrod 23:37
Amazing. Well, thank you so much for being with us. Everyone else that's listening. And we will have a couple more postpartum things and also, then we'll be on to some fertility topics. So we'll be into that in 2023. So we'll talk to you soon. This has been Kaylee daily doula Tips and Tips. I'm so glad that you were here joining us today. I am not your medical provider. And so all of this information is intended to be educational and entertainment. Please use it as such. And if you have questions about your own medical health, or need recommendations from your own provider, please do speak to them. This is not intended to replace them in any way. We are so happy that you are here joining us in this walk through pregnancy postpartum and lactation. Please take a second to like and subscribe, leave a positive review. That is how other families get to hear about us and get to learn from all the answers that we have here on this podcast. As always, I would really love to connect with you. I love answering questions. I know that you know that because you are here, but I would love to hear what your questions are. So if I have not yet answered them on the podcast, I would love to add them to the list of questions to be answered. please do reach out to me on Instagram or via email Kaely at Herat, doula services.com so that I can answer whatever question you have and so that I can hear the feedback that you have about the podcast. Until we meet again, I wish you well informed consent filled birth and postpartum experiences
Transcribed by https://otter.ai
When and how do you know if you are struggling with a postpartum mental health disorder? What’s considered postpartum depression vs baby blues? These are common questions people have and questions I hear all the time from clients, so today we are talking all about that.
In order to dive into this more thoroughly we are joined by a special guest: Cindy Kim. Cindy is a psychotherapist who has a private practice here in the DC area and is an advocate for maternal and parental mental health before and after pregnancy and birth. Today she’s answering the question: how can I distinguish between postpartum stress and distress?
KEY TAKEAWAYS:
Baby Blues should only last 2 weeks, so anything beyond on that time is no longer considered Baby Blues
Really, the biggest takeaway is for you to feel the freedom to reach out for support ANY time in the postpartum period.
There’s no need to be “bad enough” to have counseling or support for your mental health!
GUEST SPEAKER:
Cindy Kim:
Cindy Kim MSW, LICSW is a psychotherapist in private practice in the DC area providing individual and couples therapy. While she’s been in practice for over 14 years, she started to specialize in maternal mental health shortly after having her first child. Three children later, Cindy can attest to just how tough it all can be - getting pregnant, staying pregnant, pregnancy, giving birth, and being a good enough parent and partner! She has extensive experience supporting people throughout the various stressful and sometimes traumatic stages of expanding a family.
RESOURCES
CONNECT With Cindy:
FREE Ultimate Postpartum Checklist Bundle
https://www.harroddoulaservices.com/free-guide
Postpartum Preparation Class:
Understand what to expect to feel/experience in the postpartum period or how to deal with it if you’re already there!
This is the real sh*t that happens TO YOU in the postpartum time and works for you whether this is your first or fifth baby!
https://www.harroddoulaservices.com/postpartum-prep-blueprint
CONNECT with Kaely on Instagram
https://www.instagram.com/Harroddoula/
This podcast is hosted by the Birth Prep Blueprint - comprehensive Childbirth Education for expectant parents to feel calm, prepared and confident about labor and birth. Podcast listeners (that’s YOU!) get 10% off! Use the link below and coupon code PODCAST
https://www.harroddoulaservices.com/birth-prep-blueprint
** The Birth Prep Blueprint is offered for only $20 to anyone who qualifies for any kind of social services (meaning that a family has a lower income to the point that they would qualify for WIC or SNAP or Medicaid, etc.). No need to disclose your income, just which service you qualify for and the link can be sent right over. Just email kaely@harroddoulaservices.com to learn more.
If you like this episode, don't forget to share it to your Instagram stories and tag me @harroddoula
Kaely Daily is produced by Kaely Harrod of Harrod Doula Services
It is sponsored by The Birth Prep Blueprint Childbirth Class
Music by Madirfan: Hidden Place on Pixabay
