So yesterday was "End the Stigma Day" and I shared my story in my I am the Face of Mental Illness blog post because I have no shame in having had Postpartum Mood Disorder. I did, feel ashamed at the time though, so I can relate to why women don't seek the help that they need. Guess what? I shared my story and the sky didn't fall in! It's freeing in fact. And if it helps one woman feel less alone then it was worthwhile. And here's the thing, I don't know if it changes anyone's view of me and I DON'T CARE, if it does they aren't someone I want in my life anyway.
The medical community doesn't recognize hormone imbalances as disorders
I had Postpartum Mood Disorder more than once and didn't go to the doctor for it until the 3rd time. It felt different each time and it got worse with each of my pregnancies. In some cases it escalated when I was weaning my babies from breastfeeding. (I rarely hear this talked about and we need to discuss this. But that's for another day!)
Interestingly, of all the women I know, I didn't know anyone who suffered from it - how can that be possible? With prevalence rates being estimated at 1 in 7 women having Postpartum Mood Disorder. Too many women suffer in silence. The more of us that speak up the better.
Mental Illness? Endocrine Disorder? or Reproductive Disorder?
Here's the thing about my story - my Postpartum Mood Disorder was easily treated by my OB/GYN by balancing my hormones - so was it a Mental Illness or an Endocrine Disorder or a Reproductive Disorder? The thing is the medical community doesn't recognize hormone imbalances as disorders, so therefore, it falls under the category of a mood disorder in the Diagnostic and Statistical Manual of Mental Disorders, (DSM-5). Herein lies the problem - my OB/GYN has had success for many years prescribing hormone therapy to women who have postpartum mood disorder, yet this still isn't first-line treatment provided or recommended in the guidelines mostly due to lack of enough studies.
Some might call what my doctor does, Experience Based Medicine, but I believe he's actually an expert in what is actually Evidence Based Practice (EBP) described by Engebretson, Mahoney, & Carlson, 2008 as involving three parts:
- best research evidence
- the provider's clinical expertise,
- and the patient's values and circumstances.
I didn't stumble upon this doctor - I sought him out which is due to my strong belief in advocating for myself in my healthcare. It's the same approach to prevent my miscarriages - progesterone wasn't in the guidelines and probably still isn't. So it is a lucky or proactive woman who finds herself with this kind of doctor.
Mood disorders fall under Psychiatry, Hormone problems fall under Endocrinology and Reproduction falls under Obstetrics!
So who's talking to whom?
I've wondered if women thought they might have an Endocrine Disorder or thought of it as a Reproductive Disorder would they seek the help they need? I believe they would. Would they get the help they need? I think the chance is higher. Do I think it will happen? I have hope in the way of Integrative Medicine - an approach which is on the rise and I believe is growing rapidly.
Although my dream has yet to be realized en-mass I'm not alone in my vision and hope for the future. Back in 2006, Katon and Unutzer, were speaking about the "interdisciplinary practice of medicine", such as co-location of Gynecology-Psychiatry clinics which would increase the usage of hormonal treatments for mood disorders and benefit the mental health of postpartum women. And while they call it the interdisciplinary collaboration - I really think is the integrative approach to medicine.
To find out more about my vision for women's health you can check out Open Source Health.
To read my other Blog Posts related to Postpartum Mood Disorder:
The Happy Mask of Postpartum Mood Disorder
Could a Blood Test Have Predicted My Postpartum Mood Disorder?
The Cruel Joke of Postpartum Mood Disorder
Love Letter to My Pharmacist - Bioidentical Hormones for Postpartum Mood Disorder
Postpartum Anxiety - I Thought I was Dying - Part One
Postpartum Anxiety - I Thought I was Dying - Part Two
40% of Women Cannot Identify the Full Spectrum of Perinatal Mood Disorders
Eat FAT and Other Tips for the Best Postpartum Mental Health
Postpartum Thyroid Disorder
Is Half a Postpartum Plan Better Than No Plan At All?
Are Women's Health Issues Being Painted with a Mental Health Brush?
My Postpartum OCD
Maternal Mental Health - Make it Your Business