April 2017
Peer Support
This month we take a closer look at peer support, which is parents supporting other parents on their journey with perinatal mood or anxiety disorders (PMADs). This can be through formal support groups, telephone warm lines, online forums, Facebook pages, or simply talking to a friend or someone who has recovered from a PMAD. Peer support can play a critical role in recovery, especially in reminding us that we're not alone, in reducing the isolation that can come with being a new parent, and in showing us that recovery is possible.

Peer support does not take the place of other critical elements in a wellness plan: therapy with a professional trained in PMADs; medication management, and self-care such as careful attention to sleep and nutrition. It should be seen as just one part of a complete treatment plan. If you're currently experiencing a PMAD, please do not use peer support as your only treatment tool. 

This month we are pleased to have an interview with a participant in one of our Seattle new parent support groups about what benefits she saw from participating in the group. We hear from a mom who used what she experienced in her postpartum period to provide peer support as a doula and a certified mental health peer counselor. We also have an interview with Julie Dragin, our Warm Line coordinator, about how the Warm Line works and how she ended up involved with it. We have a great parent corner article about how to navigate social media safely when experiencing a PMAD. And we highlight a new research study that shows that indeed, peer support makes a difference in recovery from a PMAD.
In This Issue
Parent Corner
Using Social Media Wisely
There's no denying that social media has changed what it's like to be parent. On one hand it's kind of nice that there is always someone who is "listening," even at 2 am, when we just need to vent. There is always a story to read that makes you feel less "crazy." Or there's a place for you to express yourself and tell your story. Our own moms had to find community the old fashioned way, while we are able to log in and find validation and support within minutes. There are pages and groups full of inspiration, affirmation, and support for parents. Knowing there are moms all over the country or even the world who have struggled with the same or similar feelings as you can make you feel less alone and more normal. It can also give you hope when you hear from people who have been where you are and have come out the other side okay.
Maybe you'd really like to get out and go to an in-person support group (plug for PS-WA support groups here!), but there isn't one near you. Or maybe all you can manage right now is to type on the keyboard. There are now online groups where you can communicate with other moms, read their stories, and not feel so isolated during this vulnerable time. That can be a great thing!
On the other hand, social media should be used with caution, especially when you are feeling vulnerable. With so much information available and so many mama blogs, it can get overwhelming very fast. It can also mean that you are exposed to people at their rawest, lowest moments, which may not be good for you if you yourself are still trying to feel better. It's enough to deal with your own emotions right now! Take a break sometimes if you find yourself getting overwhelmed. You will not miss anything; there are always plenty of stories to read!
Or maybe you're reading about those mamas who seem to have it all together, while you've been wearing the same peed and spit upon, unlaundered pajamas for the last 48 hours because you just can't figure out how to find time or energy to change or do laundry for that matter. Seeing these put-together lives on social media can really make you question yourself and your worth as a person, as a mother. Step away from the computer if you ever feel this way immediately. You're doing the best you can and this is enough. Also, they're lying!!!
And keep in mind you get just as much bad advice online as you do standing in line at the grocery store. Peer support is for support, not therapy. While other moms may mean well with their opinions and advice, it doesn't mean what they say is really going to apply to you and your life situation. We all parent a little differently and that's okay. What is working for someone else may not really apply to you at all. Only listen to what feels right for you. Ignore the rest!
I'm personally glad there are places for parents to turn to in the wee hours or if they're just not feeling up to getting out of the house or if they are really trying to get out of the house, but just not making it (been there!). With access to millions of people's thoughts and lives, we are able to find real community in social media, and it decreases isolation for sure. And as long as you remember the above cautions, it can be a huge help when you're trying to make it through this tough time.
Melissa,  Participant at Adjusting to Parenthood, a New Mom Support Group in Seattle

W hat was your reason for joining the group? 

My PEPS group had ended, and we hadn't kept meeting up. As a result, I had no outlet to talk about the challenges of motherhood, and I started having more dark days than good ones. 
How old was/were your child(ren) when you joined the group?

My daughter was around five months old when we started attending the group.
In what ways did the group support you (e.g. socially, emotionally, practically)? 

The group was a wonderful outlet, both emotionally and socially. As someone who is dealing with depression, it was so incredibly helpful to hear that I wasn't alone in dealing with many of the dark issues that very few openly talk about (e.g., the rage and resentment). I also consider myself incredibly fortunate to have made friends in the group, because I had been feeling incredibly isolated in my relatively new role as a stay-at-home mom.

What was the most beneficial aspect of attending the group?

The most beneficial aspect was that attending the group helped keep the darkness at bay. On weeks when I was unable to attend, I found myself struggling a lot more. I didn't have my usual outlet to vent and hear others' stories and struggles, and so I often felt much more alone and overwhelmed.

What was the biggest challenge in attending the group?

My biggest challenge was the commute: I live in Issaquah, so getting to the group in Seattle was difficult, especially on days when I got even less sleep than normal.
How did the group help in your recovery?

The group helped me realize that what I was feeling was valid, and that many other mothers feel similar things, too. It also helped me realize that I have to talk to other moms about our struggles, and that candor is necessary.

Do you feel that the group impacted your parenting? Your relationship with your partner?

I feel that the group helped me be a bit more forgiving, both in regards to my parenting "failures" and with my husband. It helped me realize that even though he was struggling too, he was still doing a lot to help support me and parent our daughter.

What would you tell other mothers who are contemplating participating in a group?

I would encourage them to attend. We don't often have our mother "village" in our society, and this group and my second PEPS group were vital for me starting to feel like I had one.
Takeallah Rivera , Full Spectrum Doula and Certified Mental Health Peer Counselor

Tell us a little about yourself and your family.

I'm a 27-year-old feminist activist, doula, and mother. I became pregnant with my son at 23 and during that pregnancy, I experienced domestic violence, homelessness, poverty, and maternal depression, which morphed into postpartum depression and anxiety after giving birth. After regaining stability, I was determined to use my experiences to educate and help empower other women who have suffered from similar things that I've suffered, and I trained as a doula (and trained in a million other things because all of these issues intersect with one another!). Currently, I serve my community as a Full Spectrum Doula, Community Health Worker, Certified Peer Counselor, Certified Breastfeeding Peer Counselor, Public School Educator, and Writer.  I am also involved with the 253 Community Food Advocates and the Pierce County Community Voices Council. I am working to build trauma-informed midwifery and therapy practices for low-income women, survivors of gender-based violence, and women that suffer from postpartum mood disorders and other mental illnesses. My family consists of myself, my four-year-old son, Jimi, our four-year-old, yippy Pomeranian, Roxanne, and our cat, Serenity.

What was your journey with postpartum depression like?

My journey with postpartum depression was long, dark, and cold. At the time, I was unemployed, extremely poor living off $142 a month and sleeping on my mother's couch, and suffering from the aftermath of fleeing an abusive relationship while simultaneously enduring the loss of my grandmother and abuse from several family members. I remember locking myself in my bathroom having panic attacks and crying along with my son. I was extremely hopeless, grief stricken, and on the verge of ending my life. I researched and eventually found a local non profit organization where I received medications and therapy to cope with my postpartum mood disorders.  

What were the keys to your recovery?

Medications and meditations!

Could you describe how these experiences influenced your career choice(s)?

When I finally decided to seek therapy, I noticed that there were very limited female therapists, let alone female therapists that specialized in trauma-informed care for women who have suffered from postpartum mood disorders and gender-based violence, despite it being desperately needed within various communities. This inspired me to pursue a career in midwifery and mental health. We desperately need more women with experiences with postpartum mood disorders catering to moms in need of support.

Tell us more about being a peer counselor and doula to expecting women. What kinds of issues do you see come up? How is being a peer counselor different from what a therapist would do? How does your history with postpartum depression play a role in what you do?

Serving women as a Peer Counselor and Doula is similar to being someone's best friend--we are there for the good and to share space with our clients on joyous occasions and victories, but we are also there during the bad when a client calls us at 3am crying her eyes out. Unlike a therapist, a Peer Counselor is openly able to discuss their own personal experiences with issues and share their stories in order to help other women. My history with postpartum depression and anxiety allows me to come from a place of empathy, rather than sympathy, and to also advocate for my clients' needs when they cannot advocate for themselves.

Editor's note: You can find out about what a certified mental health peer counselor does here
In Depth
Julie Dragin, Coordinator of PS-WA's Warm Line

Julie manages the volunteers on our Warm Line, which is our toll-free peer support line--
1-888-404-7763. Our support line offers free telephone support for all parents. The line is staffed by parents who have experienced a perinatal mood and/or anxiety disorder and have recovered fully, or by licensed therapists with specialized training in perinatal mental health. 

How and why did you start your involvement with PS-WA's Warm Line?

After the birth of my first child twelve years ago, I experienced postpartum PTSD. At the time I didn't know I had a PMAD, I just knew that I didn't feel right and that what I was experiencing was more severe than baby blues. When my son was four months old, I called the PS-WA Warm Line (then known as PSI of WA) and for the first time was able to connect with someone who understood what I was going through. Although my road to wellness was a long one, this call was the first and most important step I took in getting there. And that is why I became involved with PS-WA as a warm line volunteer. It was really a full circle moment for me to be involved with helping moms who are struggling, just as I had been helped. 

What's a typical call like? What are most callers seeking? 

We get calls from dads, grandparents, providers (occasionally), but the typical call is from a mom who is reaching out for help. The majority of callers are seeking counselor referrals. Warm Line volunteers listen and ask questions about how a caller is functioning (how are they sleeping, what are they eating, any self care, do they have support?) so that they can collect resources for the caller and help them form a wellness plan. We typically provide callers with counselor referrals, support group information, links to postpartum websites, and a wellness plan. 

How do you help a mom feel like she's not alone when you're on the phone?

I think, for the mom, just connecting with someone who understands what she's going through is HUGE in helping her feel less isolated and alone. I will often share parts of my story if I think it will be beneficial to the caller. And literally saying, "You are not alone," and telling the mom that you are going to help her get the resources she needs to get well. 

What happens when a mom is in acute crisis, perhaps suicidal?

It is very rare to get a call from someone who is suicidal. In the ten years I've been a volunteer on the warm line, I've only had a few calls that I would identify as true crisis calls. The majority of those calls were from a family member expressing concern about the mom in crisis. Since most of the Warm Line volunteers are not medical professionals (and we operate a warm line, not a crisis line), the most important thing for a volunteer to do in this situation is to make sure the mom gets medical attention as soon as possible. This can usually be accomplished by sharing your concern for the mom with her partner or other family member.  

You do follow-up calls after the initial call. What do you typically find when you make that return call? How is it different from the mom's initial call?

When I call back to check in with a mom or family member (2 - 4 weeks after the initial call), they are usually feeling at least somewhat better. About half of the callers who are feeling better, say they a feeling a lot better. If a caller is not feeling any better or wasn't able to connect with a counselor, I offer additional resources and then check back in with them on my next shift. 

How do you see the role of the warm line versus, say, therapy? support groups? talking with a friend?

New moms and dads need lots of support, especially those who are struggling. The Warm Line is a great example of community peer support, which is known to be a highly effective form of support. It is somewhat similar to talking with a friend--but one who knows what you're going through and has great resources to help you on your road to wellness! And then those resources connect the caller with other vital forms of support, such as therapy and support groups. 
Peer Support and Postpartum Depression
A small, qualitative study published this past January in the peer-reviewed journal BMC Pregnancy and Childbirth concluded that peer support has a positive effect on women experiencing postpartum depression. The study included 47 new mothers who were receiving peer support via 10 different programs throughout England.
Researchers used semi-structured interviews to explore the each mother's experience with peer support services, including how she learned about them, why she decided to use them, the nature of the support, and her perceived impact on her well being. All of the mothers interviewed experienced significant social, economic, and emotional stressors during pregnancy and/or after birth.
Using thematic analysis, researchers identified key topics that arose throughout the interviews: emotional distress; stressful circumstances; lack of social support; and unwillingness to be open with professionals. Participants described feelings of inadequacy and shame, loneliness, extreme worry, and fear, particularly of admitting that they were struggling. "I pretend to be happy, I do that with my family as well 'cause I haven't told them [about my depression]... They don't react nicely," said one participant.

From another:  

"[people say,] 'I don't understand how she can be depressed when she's just had a baby, one of the most beautifullest [sic] things in the world' ...That makes you go even more into your shell and feel more embarrassed and ashamed."
When researchers asked how interacting with peer support services impacted participants, new themes emerged from the interviews, including social connection, being heard, building confidence, empowerment, feeling valued, reduced stress, and the value of the peer supporters' own experiences. In the words of one new mother:

"[The peer supporters] were about me...whereas everybody else was about [my baby] first and, well [I] don't really matter... It was always about me and how I felt and what I needed to make me be able to be a better mum ... And something that was nice, "Do you know what? You're doing really well."'
So whether it's one-on-one support, ongoing support groups, or drop-in groups, peer support can make a real difference in the life of a struggling new mother. There is power in shared experience.

When the Bough Breaks screening, April 24. Join us for a screening of When the Bough Breaks, a documentary that follows Lindsay Gerszt, a mom who has been suffering from postpartum depression. Lindsay agrees to let the cameras document her path to recovery. We meet women who have committed infanticide and families who have lost loved ones to suicide. This viewing is for both families and professionals. Please be aware that due to discussion of sensitive subjects, such as self-harm and harm to children, families in recovery may want to watch with caution or postpone their viewing. Monday, April 24th, 2017, 5:30 pm: doors open, networking and light refreshments. 6-8 pm: film and discussion. The 2100 Building, 2100 24th Ave S, Seattle. Click HERE For more information and to register.

GiveBIG is Wednesday, May 10, 2017! Save the date! GiveBIG Seattle is a one-day online giving event to raise funds for nonprofit organizations serving Greater Seattle, and Perinatal Support Washington is registered as one of those nonprofits! Look for emails and Facebook posts near May 10 with details about how you can make your donation go further.

Seattle Mom Prom is May 20, starting at 8pm, at Fremont Abbey Arts Center in Seattle. The Seattle Mom Prom is special night to celebrate and honor moms--a night to let loose on the dance floor, enjoy some drinks and desserts, and ultimately help raise money for perinatal support. Our goal is to celebrate and acknowledge all the hard work moms do, support a great cause, and have tons of fun! It is the ultimate ladies night out!  All profits from the event go to Perinatal Support Washington. For more information, see
Giving to Perinatal Support Washington
Employee Giving
Are you a Microsoft or King County employee or spouse of one?  
Please consider supporting us through your respective workplace giving programs. For King County employees, our code is 9187. Our tax ID is 91-1448669. If you are looking for us, be sure to check our old and new name (Postpartum Support International of Washington) if you don't see us--we are there.

Warm Line: 1-888-404-7763 (PPMD)

Support Education, Referral
(formerly Postpartum Support International of Washington)