Dropping the Baby and Other Scary Thoughts: Book Review and Comparison

Dropping the Baby and Other Scary Thoughts

By Karen Kleiman

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Good Moms Have Scary Thoughts: A Healing Guide to the Secret Fears of New Mothers

By Karen Kleiman

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Cognitive Behavioral Therapy for Perinatal Distress

By Amy Wenzel

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As I may have mentioned before, I hate to read. However, it comes with the territory of the work that I do that I need to read and provide quality book recommendations to my clients. I knew that I needed to put books by therapist, author and PMAD pro Karen Kleiman and co-author Amy Wenzel at the top of my list. Based on what I’ve read so far, I can say with confidence that ANYTHING with Karen Kleiman as an author/co-author is going to be a valuable read (Yes I am fangirling here…she’s amazing and I want to be her when I grow up!) A few months ago I did a review on “Good Moms have Scary Thoughts” which you can read HERE, but I wanted to go back to the OG of books on scary thoughts, which is why the subject of this review is “Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood”.

Compared to “Good Moms” this book offers a much more in depth understanding of what exactly scary thoughts are, what causes them, and approaches on how to gain relief. The book is divided in three sections titled “What’s going on”, “Clinical Concerns”, and “Breaking the Cycle of Scary Thoughts”.

Section One differentiates between typical presentations of new mom worry, anxiety, and scary thoughts. It details the different types of scary thoughts that mothers have and includes examples and personal accounts from real women who share their own experiences. The authors do a really good job of normalizing some of these experiences for new parents. They also share some of the “why” behind the scary thoughts, which is very important to many mothers to help with externalizing symptoms and helping ease some of the blame moms place on themselves for having them in the first place. I think it’s important to note that at the end of each chapter they offer a “Take Home Point” for both mothers and clinicians. This was very helpful especially since there is so much good information it’s useful to boil it down to the most valuable information.

Section Two starts with helping mothers recognize when they need additional help/support in addressing their scary anxious thoughts. The different types of Perinatal Mood and Anxiety Disorders (PMADs) are discussed and “really scary thoughts” including suicidal thoughts and psychotic symptoms are also addressed. There is a chapter on barriers to relief and a chapter on screening. I think that these chapters speak a little more to the clinicians reading the book, however are valuable to mothers in order to predict potential obstacles and promote self-advocacy in their treatment.

Finally Section Three really gets at the meat and potatoes of how to get relief. The authors give ideas that are easy to implement and practice in order to begin experience change as well as a whole chapter on Cognitive Behavioral Interventions. This is Amy Wenzel’s chapter to really shine as she’s an expert in utilizing this approach with the perinatal population and co-authored a book with Karen Kleiman on this topic (and HEY I’ve shockingly already read it and it’s awesome! Check it out below!) They continue the section by discussing professional options like therapy and/or medication when self-help just isn’t moving the needle for readers as well as offer a chapter on enlisting help from the supports available to moms.

I would say the best chapter in the book is entitled “Your Personal Treatment Plan” which helps readers create an action plan of how to take all the information presented in the book and implement it. I think this is a great way to put everything in the book together. This is especially helpful for a new mom who is most likely sleep deprived and reading in a disjointed way making it difficult to remember what you read in chapter one by the time you get to chapter 11!

Compared to “Good Moms Have Scary Thoughts” this book is a little more “book-y” in that it’s longer and presented in a typical fashion, whereas “Good Moms” has a more relaxed approach to presenting information. I have a hard time imagining the moms I work with in their most anxious or depressed state sitting down to read this type of book. For that reason I am more likely to recommend “Good Moms” first. I say that while also recognizing that the moms I interact with are typically in significant distress which is why they are coming to me in the first place and a reader dealing with less intensive symptoms may do just fine with this book. I also want to acknowledge that I am also saying that as a non-reader and for someone who reading comes more naturally to, it may bring great comfort to sit and read a book of this nature. This book is a little pricey although I feel the info in it is of great worth. “Good Moms” is much more inexpensive which makes it giftable as a baby shower or new mom present.

To my understanding the book is currently being revised and updated but there was nothing in this book I felt was dated or irrelevant. All in all in my opinion this book is another winner by these authors, and I would highly recommend it to both clinicians and moms.

If you are interested in reading either of these titles click on the following links to purchase through Amazon. And as always, feel free to reach out through my contact page to get more info on this or any other topic relating to reproductive and maternal mental health.

Overcoming the Winter "Blahs"

Winter in Syracuse is still coming at us full force.  Schools have used all their snow days, and everyone seems to be climbing the walls with symptoms of cabin fever.  However, for some the intensity and duration of the winter weather can bring or exacerbate symptoms of depression.  Here is a list of tips for managing

1.        Sleep: The winter months can make us want to hibernate.  The days seem shorter with the dark hours lasting longer than in spring and summer.  Even though it may be difficult to climb out of bed when it’s still dark, it is so important to maintain a regular sleep schedule as part of overall sleep hygiene.  Sleep is such a crucial element to basic self-care and so many of us are significantly deprived.  Try to improve your sleep hygiene by maintaining a regular sleep schedule, keeping weekend sleep-ins or naps to a minimum, keep screens off 30 minutes to an hour before bed, and engaging in a regular pre-bed routine.  Just like we would do for an infant, we need to provide our body cues that it is time to settle in for the night.  Lowering your lights, taking a warm bath or shower, using lavender essential oils, listening to relaxing music or meditations, and/or light stretching or yoga are all different things you can include in your new healthy routine. 

2.        Nutrition: For me, fall and winter months usually mean bringing on the comfort foods.  Unfortunately, these foods usually include rich sauces, soups and gravy, and are carb heavy which can be quite a departure from typical lighter summer fare.  It is important to maintain your nutrition year-round to be operating at your maximum capacity.  That means still incorporating fruits and vegetables in your routine daily and watching the typical increase in in heavier foods.  You don’t have to avoid your cold weather favorites but find ways to lighten them up and be sure to balance it out with nutrient dense and protein rich options as well.  You may also want to check in with your primary care physician (if you don’t have one – get one!!!) and get blood work done if it has been awhile.  Most of us become Vitamin D deficient during the winter months, so it may be beneficial to add vitamin supplements to your diet, as long as it is approved by your doctor. 

3.       Exercise: For many people, exercise is the thing they love to hate but it is a necessary component to your overall well-being.  For those who prefer to engage in outdoor activities, like running or biking it can be really challenging to maintain the same activity levels when the weather changes.  However, we know that winter comes every year, so it is important to make a plan and be intentional about how you are going to maintain your activity levels in the winter.  Join a gym, take a class, buy a treadmill, or break out your old Tae-Bo videos, just do something to move your body.  Research has shown that exercise 3-5 times a week for 30 minutes can have the same impact as a dose of Zoloft and for those already on antidepressants, exercise has been shown to enhance the results you are already getting.  

4.       Light Therapy:  For those who really struggle during winter months, light therapy may also be an option either on its own or in addition to medication management or psychotherapy.  The Mayo Clinic recommends that the lightbox should have an exposure of 10,000 lux of light and emit as little UV light as possible.  It is suggested you use the light within an hour of waking for about 20-30 minutes with about 16-24 inches between you and the light.  The lights are relatively inexpensive and can be found online for around 40-60 dollars.  Before you add a light to your Amazon cart it is important to check with your medical provider to ensure this is a good option for you, especially if you have any eye issues. 

5.       Socialization: Cold temperatures and snowy weather can make it easy to hunker down and stay inside, but when winter weather lasts 4-5 months a year, avoiding social interaction can really have an impact on your mood.  It just as if not more important to maintain social support and connections in the cold months as it is in the summer, even though it’s harder.  However, social support is an important factor in maintaining or elevating moods.  A tip I share with clients is to be very intentional about your social engagements.  When you run into a friend at the grocery store and share the pleasantry “let’s get together soon”, whip out your phone and schedule something then and there.  Life will often distract us from following up on that promise if we don’t do it right away.  Scheduling regular social dates can be helpful too, especially if you are trying to coordinate a group.  Planning to go out to eat every third Thursday means you start prioritizing your social commitments (read: prioritizing YOURSELF) and building your life around them, instead of the other way around.  Finally, if you don’t have many people to connect with a good resource can be www.meetup.com.  You can look up by region and find social groups for just about anything like book clubs, meditation groups, photography groups, dog walking, and more. 

If you know winter can be a difficult time for you, it’s important to try to get ahead of it by implementing these ideas sooner rather than later to beat the winter “blahs”.  If you try these and still find yourself struggling, you may want to reach out to your doctor or a therapist for additional support.  As always, feel free to reach out to me for any additional information or if you have questions. 

Postpartum Depression: NOT Just the Baby Blues

Having a baby is hard. Whether it’s your first or your fifth, the transition after bringing baby home can be challenging at best. And although that transition can come with a lot of emotional fluctuations, frequently referred to as the “baby blues”, Postpartum Depression is a whole other animal.

Frequently, when sitting across from a new mother in my office they share about their efforts to reach out for help. Maybe it’s to a family member, friend or medical provider (OB, Midwife or Primary Care Physician). What boggles my mind is how often they are told that what they are experiencing is “normal”. While unfortunately Perinatal Mood and Anxiety Disorders (PMADs) such as depression, anxiety, OCD, PTSD or bi-polar is very common affecting approximately 20% of mothers (and 10% of fathers and non-gestational parents) it is NOT normal.

I would like to share what differentiates the baby blues from a PMAD so in the event you or someone you care about is affected you will know when it’s time to reach out and get the right kind of help to feel better faster.

Baby Blues:

• Transient mood shifts throughout the day marked by tearfulness or irritability

• First 2 to 3 weeks (at most)

• Influenced significantly by hormonal shifts and sleep deprivation

• Does not significantly affect functioning

• Affects 70-80% of new mothers

• Not a mental health condition

• Resolves itself over time

PMAD (Postpartum Depression or Anxiety):

• Excessive sadness or worry most of the day for most days

• Extends past the first couple of weeks

• Impacts functioning for example, inability to sleep (even when baby sleeps), decreased appetite, unable to concentrate, decreased enjoyment in things

• Scary, vivid and intrusive thoughts about harm coming to baby (both intentional or accidental)

• Disconnection from or excessive clinginess to baby

• Feelings of guilt, shame, inadequacy, worthlessness and/or hopelessness (“Bad mother”)

• Low or no motivation to complete even simple tasks

• Just not feeling like yourself

• Does not get better over time

If you or someone you know are experiencing the symptoms of a PMAD it is imperative you reach out to a medical or mental health provider to get the appropriate help. Prognosis for recovery is much better the quicker the symptoms are recognized and appropriately treated. If your provider tells you it’s “normal”, and just take a walk or get some more sleep and you still feel like something is just not right, keep reaching out until someone listens! A wonderful resource is the Postpartum Support International helpline at 1-800-944-4773. You can speak with someone who can get you connected with providers in your area that can get you the support you need.

If you are local to Syracuse or the Central New York area and think you may be suffering from Postpartum Depression, feel free to reach out to me through my website or call me at 315-552-0180. You are not alone and you can get better with help!