Want to know what kind of treatment Hollywood actress Hayden Panettiere is getting in postpartum depression (PPD) rehab?
I imagine it's not a vacation but a pretty swank treatment centre where Hayden entered for a second time to deal with PPD late last week.
Last Friday, I fantasized about what PPD rehab could look like, having gone through PPD myself twice and getting sub-par treatment.
It was meant to be tongue-in-cheek, and for the most part moms got it, but there were some who took issue with my apparent lack of comedy skills thinking I was shaming Hayden for her privileged access.
Au contraire, mon frère.
While the U.S. entertainment media is respecting Hayden's privacy only saying she's staying at a centre somewhere in Utah, I bet you what's being offered there is a PPD mom's wet dream. And I'm not talking about a leaky diaper.
No, it's probably not a dedicated PPD rehab facility, and no, Ryan Gosling probably doesn't work there, but I bet it's pretty luxurious and probably boasts a sauna, gym, salon, and massage and meditation rooms.
The meals are probably made from scratch by culinary chefs and there's probably all kinds of wonderful things like yoga, horse therapy and art therapy along with your standard cognitive behavioural therapy. I bet it's an ideal place to heal and recover.
We can only dream of a place where professionals wait on us hand and foot, helping us to get through one of the most trying times of our lives while taking care of a baby.
Now, compare that to a psych ward, where moms with the most severe kind of PPD reluctantly end up for treatment. The mental ward is no place for a mom with PPD. All it is is a different wing of your regular, loud, noisy, busy hospital complete with fluorescent lighting, uncomfortable bed, interesting roommates and you know what kind of food.
But what choice do they have?
And what about the rest of us with mild to moderate PPD, which in my case included derealization, terror, panic attacks and intrusive thoughts? We can only dream of a place where professionals wait on us hand and foot, helping us to get through one of the most trying times of our lives while taking care of a baby.
Let me make it abundantly clear. I'm not criticizing Hayden at all. I'm praising her for not only speaking up about her struggles with PPD, but for igniting a larger conversation about PPD treatment whether she intended to or not.
In her words, PPD has "impacted every aspect of her life" and she has "chosen to take time to reflect holistically" on health and life.
She's absolutely right. PPD does impact every aspect of life -- physically, mentally and emotionally, all of which take a toll on the other aspects of life -- relationships, finances and career. I know this all too well.
A five-minute visit with the family doctor and a prescription just doesn't cut it. It's not like you go home, take the pill and you're fine. It takes four to six weeks for the medication to start working and all moms can do in the meantime is wait and continue to suffer at home, sometimes barely making it through the day. If you're lucky enough to get on a short wait list and see a psychiatrist who can provide evidence-based therapy by the time your PPD is over, then you're one of the lucky ones.
Unless you have money, of course.
Which brings us back to PPD rehab.
I can't think of anything better to help moms who are severely suffering than a dedicated facility.
I'm not saying we need helicopter rides, but we damn well need more than we have right now. We need screening, monitoring, therapy, child care and home care.
And why not add PPD rehab to that list? I can't think of anything better to help moms who are severely suffering than a dedicated facility that provides her with the rest, proper nutrition and treatment she needs to recover with baby in tow.
Think I'm nuts for dreaming of such a place and having it fully covered?
St. John's Rehab in Toronto provides patients recovering from life-changing illness or injury with "individually customized inpatient and outpatient rehabilitation services that focus on the whole person -- mind, body and spirit." Their wellness program provides acupuncture, chiropody, chiropractic, massage therapy and aquatic treatment.
As one patient who stayed at St. John's after hip replacement surgery notes in an online review of St. John's: "I feel both privileged and thankful to have been in such good hands."
And another: "It was a great experience and great support program. The nurses took such good care of their patients and they even gave me double portions. I still managed to lose 5 pounds lol."
Now that's what I'm talking about.
A PPD rehab and weight loss clinic.
The point is, PPD rehab isn't a pipe dream. It can happen. All we need are moms willing to stand up and fight for it.
Think about your daughters and granddaughters.
Who's with me?
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The sudden drop of estrogen and progesterone following labour may play a role in the onset of PPD. According to the authors of a 2012 Swedish study, “downregulation of endogenous hormon production in women with PPD history elicits depressive symptoms in more than 60% of cases.” Hypoestrogenism, as it’s called, has also been shown to cause depressive symptoms at other times of a woman’s life. However, there are other studies which challenge this concept and more research is needed.
A number of studies have shown that women with PPD have hypoactivation of the hypothalamic-pituitary-adrenal axis (HPA). The HPA axis controls your reaction to stress and women with PPD have have higher levels of corticotropin-releasing-hormone (CRH), better known as the cortisol, the stress hormone which is released by the HPA axis.
Though it’s not yet known why, research is showing that “failed or discontinued lactation” is associated with the onset of PPD symptoms and that it could have something to do with the feel good hormone, oxytocin, that’s released during milk let-down.
Women with PPD have been found to have lower tryptophan and serotonin levels. Tryptophan is an amino acid and serotonin is a neurotransmitter. Both work together to reduce anxiety and alleviate stress. It’s not known why women with PPD have lower levels of tryptophan and serotonin and researchers are looking into genetics as a possible reason.
Women with PPD reportedly have lower brain-derived neurotrophic factor (BDNF) levels. BDNF works with serotonin, the feel good neurotransmitter, also known to be low in women with PPD. Authors of a 2012 Swedish paper report that “PPD is likely to be the results of an interaction effect between hormonal changes and these brain neurotransmitter systems.”
Our circadian rhythm is our body clock which tells us when it’s time to sleep and when it's time to be awake and alert. Melatonin, the sleepy hormone, is involved in this process. While melatonin levels should be highest in the evening, it’s been shown that women with PPD have significantly higher melatonin levels in the morning suggesting their circadian rhythm is out of whack. Of course this makes sense as new mothers often go hand in hand with a lack of sleep as their care for their babies but researchers note that it’s important to consider that insomnia can also be the consequence as well as a cause of depression.
Many people with depression experience a worsening of their symptoms during the fall and winter months. This is known as Seasonal Affective Disorder (SAD) and is more common among women. Some studies have shown that women who give birth in the fall or winter have an increased rate of PPD than women who give birth in spring or summer. It’s also been reported that there’s a “significantly higher risk” for PPD symptoms to present themselves at six weeks or six months postpartum in women who have given birth in the months from September-December.
Lower vitamin D levels have been found in postpartum women compared with pregnant women and women with mood disorders have been shown to have a vitamin D deficiency. Researchers are wondering whether nutritional habits may play a role.
It’s thought that perhaps some women suffering from PPD are actually suffering from a psycho-neuro-immunological disorder in which their inflammatory response to labour has been exaggerated. Studies show that inflammation can produce anxious and depressive symptoms.
Women with the baby blues have been shown to have higher thyroid-stimulating-hormone (TSH) levels. Women with higher TSH levels tend to have higher depression scores at four weeks postpartum. Women in a study who reported PPD symptoms six months postpartum also had hypothyroidism at the time of delivery.
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