In this episode of The Pulling Curls Podcast: Pregnancy & Parenting Untangled, hosts Hilary Erickson, RN, and Kara Kushnir, LCSW, delve deep into the topic of postpartum anxiety. They discuss personal experiences, signs and symptoms, distinctions between anxiety and other mental health conditions, and practical tools for managing anxiety at home. They also emphasize the importance of seeking help and provide resources like Postpartum Support International’s helpline for those who need professional support.
Find it here on Apple or Spotify Podcasts
Big thanks to our sponsor The Online Prenatal Class for Couples — we have a whole section on postpartum as well as recognizing danger signs that can help ALL of you manage your entry into life with a new baby better.
Today’s guest is Kara Kushnir, psychotherapist and founder of A Work of Heart Counseling, author and current Chair of the Board for Postpartum Support International New Jersey. Kara specializes in supporting new parents and children navigating pregnancy, postpartum, anxiety, trauma and hard life transitions. Her new book, “Mama’s Thoughts” (a children’s book for parents in disguise) helps affirm new parents by considering how their baby views them despite the ups and downs many new moms experience. Through sharing her own lived experience and professional training in perinatal mental health, Kara aims to stop the stigma that keeps new moms suffering by training providers and helping new moms reclaim their confidence and trust in themselves.
- Her book: Mama’s Thoughts
- Find her on Instagram: https://www.instagram.com/aworkofheart_counseling/
- Her Website: https://www.aworkofheartcounseling.com/
Links for you:
PSI Helpline: https://www.postpartum.net/get-help/psi-helpline/
- Call 1-800-944-4773 (4PPD) #1 En Español or #2 English
- Text “Help” to 800-944-4773 (English)
- Text en Español 971-203-7773
- Contact HelpLine
Timestamps:
00:00 “Pregnancy & Parenting Insights”
05:49 Postpartum Anxiety Concerns
06:37 Postpartum Anxiety and Self-Doubt
10:18 Leaving NICU: Overcoming New Parent Anxiety
15:31 Embrace Presence in Parenting
16:40 Prioritizing Self-Care in Parenthood
20:22 Pregnancy Mental Health Support Tips
23:25 Distinguishing Postpartum OCD from Psychosis
26:41 Perinatal Mental Health Awareness
Keypoints:
- The episode covers postpartum anxiety in-depth, aiming to demystify it and provide practical advice for new parents.
- Hosts Hilary Erickson, RN, and guest Kara Kushnir, LCSW, discuss common symptoms of postpartum anxiety, such as feeling like “jumping out of your skin” and uncontrollable worries.
- Kara highlights the difference between normal anxiety and clinical anxiety, providing signs that indicate it’s time to seek professional help.
- The episode stresses the importance of addressing perinatal mental health even during pregnancy to prevent postpartum complications.
- Differentiate between postpartum OCD and postpartum psychosis, and the seriousness of thoughts that cause distress versus those that align with the person’s beliefs.
- Kara offers practical tools for managing anxiety at home, including the ACE technique (Acknowledge, Come back into your body, Engage).
- The significance of a strong support system and the dangers of facing motherhood alone are emphasized.
- The episode encourages engaging with trained perinatal mental health professionals and promotes resources like Postpartum Support International (PSI).
- They share the PSI hotline and text line, assuring listeners that seeking help is a sign of good parenting, not failure.
- The discussion aims to reduce stigma and normalize the experience of postpartum anxiety, offering empathy and understanding for struggling parents.
Producer: Drew Erickson
Transcript
[00:00:00.000] – Hilary Erickson
Hey, guys. Welcome back to the Pulling Curls Podcast. Today, we are talking about postpartum anxiety, so let’s untangle it.
[00:00:07.980] – Hilary Erickson
Hi, I’m Hilary, a serial overcomplicator. I’m also a nurse, mom to three, and the curly head behind Pulling Curls and the Pregnancy Nurse. This podcast aims to help us stop overcomplicating things and remember how much easier it is to keep things simple. Let’s smooth out those snarls with Pregnancy and Parenting Untangled, the Pulling Curls Podcast.
[00:00:30.220] – Hilary Erickson
Today’s episode of the Pulling Curls Podcast is sponsored by the Online Prenatal Class for Couples. If you want to get prepared for everything from your third trimester all the way till when baby’s home, come join me in the online prenatal class for couples where we discuss things, including postpartum anxiety. So come join us.
[00:00:52.090] – Hilary Erickson
Today’s guest is a psychotherapist and founder of A Work of Heart Counseling. She actually has a children’s book called Mama’s Thoughts that affirm new parents by considering how their baby views them despite the ups and downs of many new mom’s experiences. She is also the Chair of the Board for Postpartum Support International. I want to introduce today’s guest, Kara Kushnir. Hey, Kara. Welcome to the Pulling Curls Podcast.
[00:01:14.780] – Kara Kushnir
Thanks for having me. I’m excited to be here with you today.
[00:01:17.120] – Hilary Erickson
Yeah, excited to talk about anxiety. Those are two antithesis.
[00:01:21.420] – Kara Kushnir
Well, listen, I get it. It’s a weird thing to say, although excitement and anxiety can feel very similar in your body, so fair enough. But it’s so important, so I’m excited to be able to talk about it and demystify it, hopefully a little bit.
[00:01:33.200] – Hilary Erickson
Yeah, that is 100% what I tell myself on planes. I’m like, I’m just excited to be there. It’s fine. Yeah.
[00:01:39.500] – Hilary Erickson
Okay, so I had postpartum anxiety on my first baby. I remember I had a fourth degree tear. And I was up trying to do aerobics because I felt so anxious inside. Probably wasn’t a great thing for my old perineum at that point in time.
[00:01:56.110] – Hilary Erickson
Had no idea. I was like, Oh, it’s not depression. I just feel like I want to jump out of my skin and scream 95% of the day, including when I was asleep. I would have horrible dreams about losing receipts, those little weird things that would make you anxious, like receipts flying around, and I had to grab them.
[00:02:13.890] – Hilary Erickson
So I’m so excited that you’re coming on because I hear so often people don’t know that anxiety can be an issue, and then they find themselves having the anxiety, and they don’t know what to do because they’re not suicidal, but they also cannot get comfortable in any way, shape, or form.
[00:02:29.200] – Hilary Erickson
By the way, I totally talk about this in my birth class because I think postpartum is just left behind like a sad little sister to labor.
[00:02:37.200] – Kara Kushnir
100%. Yeah, I always say when you’re getting ready to have a baby, it’s like when you get ready to get married, you’re planning for the wedding and you forget about the marriage. It’s the same thing. Everybody is all about the birth plan, all about the nursery, all about the prep. We forget that actually this is the rest of your life. ‘You’re postpartum for life’ is something we like to say in our world. But yeah, the real meat and potatoes of what it is we really need to be planning for, actually. Yeah.
[00:03:03.750] – Hilary Erickson
So what do people… How do they describe it? So I said I wanted to jump out of my skin. I couldn’t be comfortable in any way. There were a lot of worries in my mind. A lot of like, don’t drop the baby. Constantly like, don’t drop the baby. When I had worked for a pediatrician, I had been a nurse, I had never dropped a baby before.
[00:03:22.150] – Kara Kushnir
Yeah. First of all, I still like to say to commonize it, over 90 % of new moms have scary or intrusive thoughts. It is just par for the course. It doesn’t necessarily mean you have postpartum anxiety. Certainly, there is, I would argue anecdotally, and I think the research is going to catch up, far more individuals who have postpartum anxiety than we realize because people do often default and assume it’s postpartum depression, and that’s what we talk about. That’s what the media talks about. But I think it’s just as if not more potentially rampant in our society than postpartum depression.
[00:03:53.500] – Kara Kushnir
Anxiety is something that we can all feel. It doesn’t mean it’s clinical. But what new moms will say is to your point of, I feel like I’m jumping out of my skin, they also say things like, I just don’t feel like myself. I can’t stop thinking about this. Or they don’t say anything because these are the thoughts they have in their head that they’re afraid to say out loud. If you’re having thoughts of, What if I do this? What if this happens? A lot of the what if, the maybe, this could, things like that.
[00:04:20.320] – Kara Kushnir
You either don’t want to tell somebody because you think they’re going to think I’m crazy or they’re going to be, What do you mean? It’s fine. That can be a potential sign, but I think if it’s coupled with, you can’t stop thinking about it, that rumination, it’s over and over, or it’s coupled with, I can’t sleep because of it. It’s affecting how I function in my day to day. I’m really starting to feel like not only, yes, my life turned upside down because I have this new person to take care of, but it’s beyond that. It’s “I feel so out of sorts and just so lost and scared”. That’s often a sign to me something’s going on.
[00:04:54.960] – Kara Kushnir
Most of the people that end up in my office or that I speak with will say that anxiety looks like that intense, constant or repetitive presence of those kinds of thoughts. They can vary in shape or form. It’s interesting, too, is it’s not just postpartum anxiety. That can also be postpartum OCD, which is a type of anxiety disorder. There’s a lot of overlap and nuance to this for sure.
[00:05:18.920] – Hilary Erickson
Yes. Okay. I agree that I think a lot of people have anxiety, mostly about doing something wrong with this baby, right? Or themselves. Some people are concerned they’re going to not catch a problem with themselves, and they could have a bigger deal. Thankfully, so many people have just ignored themselves for so long. So I’m glad that we’re actually thinking about ourselves after we have a baby. But what are some signs that this has progressed past normal anxiety for a new mom, because there is a certain threshold that is pretty normal. Yeah.
[00:05:49.360] – Kara Kushnir
So it’s very common and normal, to your point, to be anxious in those first few weeks. Just like we think about baby blues in the first two weeks and having that significant drop in hormones and shift in your life, you’re going to experience a change in mood and anxiety level.
[00:06:02.540] – Kara Kushnir
I would expect that, especially if you’re a first-time parent. It doesn’t just have to be for a first-time parent, but certainly, if it’s continuing on now for beyond that first few weeks or month, and it’s pretty present for that duration of time, we start to realize, Okay, this is more than just I’m adjusting and having a tough time and I’m nervous. This is something more.
[00:06:22.020] – Kara Kushnir
Again, going back to functioning, the sleep piece, being able to eat, and also a lot of avoidance. So you will see a lot of new moms with anxiety avoid anything from, I’m afraid to give the baby a bath because what if something happens? And you have to be home with me to do it. To, I can’t take them out because what if this happens? Or what if they get sick? And so a lot of fear of doing typical day-to-day things, getting out there, meeting other people.
[00:06:46.570] – Kara Kushnir
So they’ll cocoon. But there’s also a lot of mistrust of self. So a lot of self-doubt talk that persists beyond that first few weeks. And I think also, really, we know that postpartum anxiety can present any time in that first year after having a baby. So just because you were okay for the first few months and you were anxious, but you were navigating it, and then you start to feel a spike in intensity, maybe at the three or the six month mark, it doesn’t mean it’s not postpartum anxiety.
[00:07:12.110] – Kara Kushnir
There’s so much nuance to how the entry into motherhood could look, whether you had a pleasant birth experience to a traumatic birth experience to life circumstances, that it might catch up with you later. If you’re noticing that you feel this way for a longer period of time within that first year, it’s a sign that it’s time to go and ask somebody about it. I think often people will go to their OB as a first line, which is a great resource, but it’s okay to even bypass them and go straight to somebody who’s trained in paredatal mental health and say, Hey, I want to meet with you and see what’s going on here if you’re concerned.
[00:07:44.120] – Kara Kushnir
Certainly, if you’re having such anxious thoughts that you’re not sleeping at all or you’re avoiding taking care of your baby, we’re talking about a real intense need to be addressed as soon as possible.
[00:07:53.450] – Hilary Erickson
As you were talking, I was thinking about two things that happened to me, especially… Well, this first one on my first baby, I could not get our car seat to click in. So I would haul him down from our third apartment landing, and there was one day I could not get it to click. I was not well-versed in car seats. You got to remember this was back in the three-point harness days, and I felt really good that we had a five-point harness day.
[00:08:13.480] – Hilary Erickson
And after that, I was so anxious to even try and put him in the car because he started crying. I thought people would make fun of me in the parking lot. All these anxiety thoughts came back to me. And I think a lot of times we don’t think about those simple things, but the car seat started to revolve a lot of anxiety for me.
[00:08:29.330] – Hilary Erickson
The second one is, every single time my husband goes back to work, I cry. Even if I am mostly pretty much handling everything at home at that point, I burst into tears. I hear that so much in my groups. People are like, My husband’s going, or my mom’s leaving, or whatever, and I’m going to have to do this on my own.
[00:08:47.190] – Hilary Erickson
I know that I can do it on my own, but I’m so nervous about it. Those are things that people might be feeling, but I agree when it just continues and continues. Or if it’s getting worse, would you say? Because that’s always my thing. When you go home, your bleeding should be getting better. You’ll probably have a ramp up of anxiety when you get home because all of a sudden the nurse isn’t there, you feel alone. Maybe you go to your pediatrician and you find out there were a couple of things you weren’t doing at a level. I think it’s normal to have your anxiety go up, unlike bleeding. Anxiety is probably going to go up a little bit when you go home.
[00:09:21.770] – Hilary Erickson
But I would say that if it keeps going up or it’s not going down, that’s a time to seek help. I agree, OB’s are not super helpful on this.
[00:09:29.940] – Kara Kushnir
Yeah. Unfortunately, by and large, what I hear is people go to their OB, they offer them some medication, and then they sell them on their way. That’s just such a bandage to the issue, and it’s so problematic. To your point of those triggers of somebody’s going back to work, another transition, another level of responsibility that comes up that’s a trigger for that anxiety to possibly intensify.
[00:09:50.260] – Kara Kushnir
I think that that points to something that’s really critical, which is that we were never supposed to do this alone, and yet we live in a world that really puts that pressure on us to to be it all, do it all, and for moms to feel so capable of, Oh, yeah, I know what I’m doing, and I’m just going to navigate this, and it’s all going to be fine. It actually makes a lot of sense sociologically for people to be nervous and anxious when they start to do things on their own. I see this, especially in parents where… I work with NICU parents. It’s terrifying when you leave the NICU. It’s terrifying to leave the hospital, period. But then you have to take care of a baby who might have extra needs or did have extra needs at that time.
[00:10:27.080] – Kara Kushnir
You doubt your ability to do it. There is comfort despite the fear of the tubes, the wires, the nurses, the being checked at 4: 00 AM, it feels like somebody’s there to catch you. I think that that shift into doing it on your own or having just a partner or just a family member who’s there for a short while, it sets us up to then have to go through it again, that same transition in another way. And that can really start to ramp up those feelings of self-doubt that underpins a lot of that anxiety. Yes.
[00:10:56.430] – Hilary Erickson
And oddly enough, when I went back to work, so I went back to work at six weeks with all of my kids, that actually decreased my anxiety because all of a sudden, I was at work, which I knew how to handle. Nothing had changed at work. People were still having babies the same way.
[00:11:09.850] – Hilary Erickson
I was like, this is so much easier than dealing with a newborn and two other kids at home. So not every transition. Sometimes I feel like that was a part where all of a sudden it started to drain away. I was like, You’re capable. Get over it. I don’t know. It’s tricky, but I get a lot of parents who are like, I’m freaking out about work. I was like, You just never know how the situation going to hit you, you have to take it a little bit because that was really surprising to me that work. I was like, I’m popping it in one spot.
[00:11:37.930] – Kara Kushnir
Yeah, but you faced that fear of taking the leap. Once you’re in it, you usually start to realize the idea of it might have been actually much more worse than the reality of it. And that’s massive for people with anxiety, right? It’s the idea. It’s the fear that keeps you stuck, not the reality. The reality, by and large, is usually, Oh, I can do this, or, Oh, I do know how to do this. So when I go back to work, I’ve got this.
[00:11:59.450] – Kara Kushnir
I felt the same way when I went back to work and I got to have an adult conversation or work with a client, I was like, wow, this is actually really easy. I know how to do this. All the other stuff, I feel like a fish out of water. Absolutely, that can definitely be the case for people. And I think that it’s funny because by and large, I see that probably more often than I see people go back to work and they say, oh, my gosh, I feel like I’m miserable. There’s sometimes a lot more guilt that can come up with that of, Oh, my gosh, I am doing so great here.
[00:12:26.020] – Kara Kushnir
What does that mean about me? And then we start to question ourselves and the anxiety could take form somewhere else. But I think that’s the trickiness. It’s like whack-a-mole sometimes with anxiety. It’s like it pops up in different places. And getting to the root of what is it you doubt in yourself or about this experience can be a really critical part of alleviating it for a lot of people.
[00:12:44.620] – Hilary Erickson
Yeah. Okay, So you have your basic anxiety. What are some tools people can use just at home to manage the… Everybody’s worried that baby’s in their crib and they’re going to die during the middle of the night. I want to say that’s a worry for everyone. And honestly, that worry is never going to leave because you send them to school. You’re playing outside. You don’t know if they could fall.
[00:13:02.530] – Hilary Erickson
The worry is… You teach them how to drive, which we’re doing again at my house. The worry is always going to be something because everyone’s like, Oh, once they get past six months, I won’t have that worry about Sids anymore. I’m like, Yeah, but that worry is constant. So you have to make friends with it and just realize that that’s a part of being a mom for me.
[00:13:20.290] – Kara Kushnir
Yeah. So one of my favorite lines I tell people is the more you resist, the more it persists, meaning that the more you’re like, No, no, no, don’t think about it. It’s not true. You try to argue with anxiety. It can often get louder. Usually, the technique of acknowledging what you’re feeling, and I’m having the thought that this could happen. It’s bothering me. Putting it out there, I’m acknowledging it. It’s real. And I’m going to come back into my body and I’m going to realize I’m here, what’s actually in this present moment, what I can control, and then I’m going to keep doing whatever I need to do is the way through.
[00:13:52.250] – Kara Kushnir
A really helpful technique is ACE, right? That’s an acronym. I acknowledge the feeling, I come back into my body, and then I continue to engage in whatever it is that I am doing in that moment. If I should be sleeping, I’m going to notice my body in the bed. I’m going to notice how I feel. I’m going to pay attention to my breathing and just slow it down. Maybe I’ll do something else to help my brain settle. For some people, they need something to be a little bit more distracting.
[00:14:17.520] – Kara Kushnir
A really great technique for that could be some mental gymnastics technique around, okay, I’m going to pick, think of a word. It starts with the letter R. I’m going to come up with a bunch of other words that start with the letter R. So starting to let your brain take a break and deviate from what it was you were focusing on. Not resisting it, not outwardly saying, I can’t think about it, but choosing purposely, I’m allowed to and can think about other things. And then to that point, focusing on what you can control when you can.
[00:14:45.480] – Kara Kushnir
So going back to sleep, for example, I set up a safe sleep environment. I have the monitor. I’ve done everything I can do. Now I need to trust myself because the hard reality is that we face uncertainty all day, every day. We don’t know if we’re going to walk outside and we’re going to get struck by lightning, or if we’re going to win the lottery. We have no idea. And we do it anyway because it’s worth it. So actually learning how to face that with a baby is setting you up for success in parenthood, because as you go through, uncertainty continues to unfold in so many different ways, including all the way through to teaching your kid how to drive.
[00:15:17.190] – Kara Kushnir
That’s a whole level of uncertainty and anxiety that can emerge for folks. It’s just a nice way to remind yourself, I have faced every other hard thing I’ve had to up until this point. I’m still here. I want to enjoy as much as I can what is and be present in that.
[00:15:31.710] – Kara Kushnir
Another good way to think about the coming back into your body being present is when you are feeding baby, changing baby, you’re touching them, you’re seeing how soft their skin is, you’re really soaking them in, you’re talking to them, you’re just really allowing yourself to be present with your baby, it’s a really great way to slow it down and say, This is my life right now. I’m going to try to be present as much as I can in that, not so much getting sucked into the future or to the past and getting being immersed in this idea, this story of what could be.
[00:16:03.530] – Kara Kushnir
Because it is just a story. It’s not actually what your reality is. If you did have an adverse experience, there’s ways to address that therapeutically to alleviate the pressure that puts on you. But it doesn’t serve you to live anywhere else but the here and now.
[00:16:18.810] – Kara Kushnir
I think that way of trying to come back is really critical. I also will say, encouraging people to prioritize the things that do help them access that. If you are struggling with sleep because of anxiety, finding somebody who you do trust to be able to help you get that sleep is so critical.
[00:16:35.580] – Kara Kushnir
Protecting sleep is massive for protecting your mental health, and it’s not often sleep with a baby sleeps. It’s, I have my mom come over to be here, so if a baby wakes up, I get to have a 4: 00 to 5: 00 hour chunk of time uninterrupted to sleep. It might be hiring a doula or a night nurse.
[00:16:50.340] – Kara Kushnir
It might be, I’m noticing that I really am not eating so great. I need to prioritize that, especially for individuals who are having troubles with feeding. That’s a source of anxiety. How do I have access to lactation consultant and support? It’s really noticing, those are the places to put your energy to actually take care of you.
[00:17:08.260] – Kara Kushnir
When you are doing better, you can be in a better mental state to respond to the anxiety and also to be the best version of yourself in parenthood. It is coming back to what do I need right now, not what could happen. That’s a massive shift for people to try to make, though, and it takes practice.
[00:17:24.870] – Hilary Erickson
It’s funny when you were talking, you’re like, you could get hit by lightning or you could win the lottery. I’m like, oh, I never think about winning the lottery. And maybe that’s one of the things that you could think about to get your mind off of the negative things is how amazing this baby could end up being, right? Yes.
[00:17:39.190] – Kara Kushnir
I love that. And to that point, another technique that I will often ask people is to shift what if this happens to, I wonder what will happen. So what if something happens to my baby? I wonder what they’re going to be like when they’re three. I wonder who they’re going to be when they grow up.
[00:17:52.660] – Kara Kushnir
Giving yourself permission to wonder rather than worry is a really big shift. And it’s a gift, and it takes practice, but it’s allowing yourself, I’m allowed to feel good about this. And I think what’s really exciting about that, too, is that it gives you permission to see through your child’s eyes. That’s massive to me. I actually wrote a children’s book about motherhood for moms because of all the scary and mean thoughts we tell ourselves.
[00:18:17.150] – Kara Kushnir
And I wrote it intentionally reframing things through baby’s eyes because I wanted us to consider… Your child never looks at you and doubts you and thinks the scary things you think. They look at you and you are the sun, moon, and stars. So if you consider that you’re allowed to also take a little bit of that glimmer and that shift into the wonder that they have, that also can help you leave some of those anxious thoughts behind.
[00:18:40.790] – Hilary Erickson
Yes. What is it going to be like that first time when they’re three and they see the Christmas tree light up or they see Santa and they’re just like… There are so many magical parts of parenting that never crossed my mind with a newborn. It was like, what if we’re at the park and I can’t get the car seating the car and we literally have to live at the park and I need to find a tent?
[00:18:58.600] – Kara Kushnir
Yeah. Yeah, then you stop and you’re like, wow, what did I just say out loud? Yeah, that’s not realistic, but we buy it. We buy that story every time, even though if we took a step back to say, what do my five senses tell me right now that I can touch and see with my eyeballs? What is it that is actually realistic and possible? What does common sense say?
[00:19:19.050] – Kara Kushnir
You’re like, wait a second, hold on. This could actually be really good. It’s going to be okay. That is a really empowering place to shift to. I love that.
[00:19:26.660] – Hilary Erickson
Okay, so if people are there like, I’m not able to fix this on my own, and especially pregnant individuals, if you’re already noticing a lot of anxiety around something specific, like putting baby in their bed, maybe you have a niece or nephew or a previous loss of your own, there is absolutely no reason not to address that while you’re pregnant because it is going to be so much easier to get to your appointment while the baby is inside of you.
[00:19:49.250] – Hilary Erickson
What can people look for? I mean, I would hope OBs have someone to refer people out to, but I know that there just are not a lot of trains. So what can people look for? Who could they call? I know there’s a hotline for postpartum individuals.
[00:20:01.230] – Kara Kushnir
Yeah. So I love that you asked this. I think it’s so important. I wish I had learned about this well many, many years ago. I now actually am very involved with Postpartum Support International. And if you go to postpartum.net, there is a provider directory that you can filter and search for your state. You can filter by your insurance. You can look for specialization. And it’s a great resource to getting support.
[00:20:22.170] – Kara Kushnir
I 100 % recommend, to your point, if you’re already unsure, you have a history of anxiety, or you have a history of depression, or you’ve experienced something that was really adverse earlier in your life that you’re starting to notice might be creeping up in pregnancy. Being connected to a provider during pregnancy, we know, will by and large yield a positive and better result for you in postpartum because you already have access to a team.
[00:20:45.720] – Kara Kushnir
But more importantly, we can actually prevent some of what you might have experienced because you’ll have the tools earlier and you’ll feel more confident and safe in that transition to parenthood. It’s something that I think we wish more people would do. Some local OBs do have great connections to providers locally, and I do encourage folks to ask.
[00:21:03.640] – Kara Kushnir
I think the more we ask our providers and we put that responsibility on them to consider the need to have those connections, the better the outcomes will be, too.
[00:21:10.690] – Kara Kushnir
But certainly, for folks listening and for people who are unsure where to start, PSI at that website has a great list of resources, and there’s free virtual support groups, including one for pregnant individuals for peer support, because that’s also just as important as individual psychotherapy, medication, things that people need sometimes, whether they’re pregnant or postpartum.
[00:21:31.250] – Hilary Erickson
I remember just thinking I was completely alone. No one else felt this anxiety. Everyone else looked like they were handling parenthood like a dream. It was just Hilary in her own mind. I think understanding that other people, especially people love that because my kids are adults, well, some of them are adults now, they’re like, Oh, she made it through.
[00:21:49.680] – Hilary Erickson
Even though she had these crazy, anxious dreams, it’s really nice to know that somebody made it through that and their kids are functioning adults, right? Because you’re like, I’m a mess. I’m going to make this kid a mess if I don’t kill them, these are my two options.
[00:22:02.620] – Kara Kushnir
Yeah, no, totally. I think that’s so true. The lived experience piece is so vital. I even see it in my office. I have a preschool-age kid, and they’re like, Okay, you got through the thick of it. All right, you might know something.
[00:22:14.400] – Kara Kushnir
I think that that piece is really helpful for people to see that, yes, this too shall pass. You will get through this. You’re not alone. That’s so important. It’s destigmatizing. That’s a massive piece of this, too. We talk about speaking the secret. If more people talked about this, The reality is we probably would have far better outcomes and far greater access to care.
[00:22:35.450] – Kara Kushnir
I encourage people to find the folks who really are trained in this because it’s not just about seeing any therapist or talking to any mom. It’s like being in a community of people who intentionally choose to be there, as well as finding a provider who’s trained in perinatal mental health so that they really understand not just what this can look like, but how to get you access to the best resources and supports you might need and the most effective techniques and tools to get you where you want to be.
[00:23:01.240] – Hilary Erickson
Yeah, because I think as our going out note, we should say that this can be really scary. As I look at the moms who ended up really hurting their kids or having real serious issues, everyone’s like, Oh, it’s postpartum depression. But when you hear what they’re thinking in their mind, it’s really postpartum anxiety, right? Yeah, or psychosis. There are demons coming to attack my kids. That also sounds very anxious to me rather than I’m so sad.
[00:23:25.460] – Kara Kushnir
That’s so important. I’m really glad you brought that up. It’s so critical because sometimes people will have really scary intrusive thoughts like that, and that’s where it can be a border into the difference between postpartum OCD and postpartum psychosis. Psychosis, it’s egosyntonic thoughts. It’s I agree with my thoughts. If I think my child is a demon, I believe it, I truly believe it, and I want to hurt them, that’s usually somebody’s having a psychotic episode.
[00:23:49.350] – Kara Kushnir
Whereas postpartum anxiety or OCD, I have this thought, but it’s so distressing to me. I don’t agree with it. Why am I thinking this? What’s happening to me? And sometimes untreated, Sure. Sometimes untreated, it can lead to psychosis, and that’s really challenging for folks. It’s so important the earlier you get care, the better we can prevent these tragic outcomes from happening. It’s sad that it happens at all. I do think it reflects that people don’t know what to look for.
[00:24:17.860] – Hilary Erickson
Especially support people. I love that because if you’re… In my head, I was like, at some point, you’ll get the car seat to click in, you’re not going to live in a tent. But if you’re like, I’m going to live at the park, and a homeless man is going to come and kill both of us, and my husband’s hearing me say that, I agree with this, it’s just going to escalate, then they need to think, Okay, maybe this is time to get some help. She doesn’t even realize that she’s insane at this point, would be what we think.
[00:24:42.330] – Kara Kushnir
Yeah, when you’re in that episode, I think that’s so important because usually at that point, people don’t realize that it’s a crisis, and that’s a time in emergency psychiatric support. It’s unfortunate. It happens roughly in 1-3% of cases. It’s not super, super common, but it does happen enough that we need to acknowledge it.
[00:25:00.910] – Kara Kushnir
And I think that being able to recognize and also not demonize yourself, I see this a lot with my clients with OCD. Yes. So for example, I have a lot of new moms who will talk to me about harm thoughts. Why do I keep thinking about, I’m chopping vegetables. Oh, I could stab my baby. Oh, my gosh, why are you thinking that? I don’t want to do that. Because you don’t want to do that. It’s an intrusive thought. That’s an egodystonic thought.
[00:25:22.040] – Kara Kushnir
I don’t agree with it versus, Oh, yeah, I could do that. Yeah, because my child is a demon, I should hurt them. That is different. That is an emergency, and that’s something that we need to get that parent help. We need to make sure that child is safe. People hearing that and knowing to look for that is really important because it also helps to demystify anxiety, OCD, because they can overlap a lot.
[00:25:42.860] – Kara Kushnir
It doesn’t make you a bad person. And psychosis doesn’t make that person necessarily bad. It means they’re so sick. They need so much help. We have to do something about that before they do something that they regret and can’t take back. And it’s really, I think understanding that nuance helps people to actually come forward and say, I am having these really scary intrusive thoughts. I’m so anxious. I don’t want to do this. Please help me. So that they know that it’s okay to say that because people do fear if they speak up, something terrible is going to happen, their child is going to be taken away. And that should not be the case at all. Yeah.
[00:26:14.960] – Hilary Erickson
And I think a lot of people think of it as like, I am a failure. And you should look at it the same way as, I have a headache that won’t go away. I think I need to go to the ER. My bleeding has increased. I need to go to the ER. I have a red tender spot on my calf. I need to go to the ER. We have these problem signs. It’s just a problem sign. It’s not like you are a failure. If you look at the graphs of hormones after delivery, it’s insane. It’s amazing any of us make it out alive.
[00:26:40.630] – Kara Kushnir
You’re so right. I think that’s so important is the mental and physical health component being on that equal playing field for folks. Listen, perinatal mental health or postpartum mental health conditions are the number one complication of childbirth, which means that you’re more likely to experience this than you are a pulmonary embolism or hemorrhage or anything else, this is something that more people face.
[00:27:02.010] – Kara Kushnir
If you are aware of it, you can prepare for it. You can know what to do so you can get the help immediately, and in some cases, you can prevent it. I think that is a huge thing for people to take away and realize that you don’t have to feel like this. If you do, we can do something about it. So say something. That’s a huge thing I think that people need to really embrace more of.
[00:27:23.100] – Hilary Erickson
Do you know the PSA hotline number so we can give that to people right now?
[00:27:26.150] – Kara Kushnir
Yeah, it’s 1-800-944-4773, and you can speak to someone in English or Spanish. There’s also a text line. You can text “help” to 800-944-4773, as well to get connected to someone at the PSI Helpline to get support close to you as soon as you can.
[00:27:46.620] – Hilary Erickson
Yeah. And those people are amazing, so compassionate, really also passionate about helping people postpartum because they understand how important it is. So don’t be afraid to text them. They are not going to call social services on you. I know that’s the biggest concern that they are going to come take away your baby. That is not the same thing.
[00:28:03.620] – Kara Kushnir
Yeah, 100 %. I think that’s so critical is that asking for help from them and asking for help for yourself actually says what a good mom you are. Amen. It’s the opposite.
[00:28:12.250] – Hilary Erickson
Kara, thank you for coming on. I think I’m actually going to be a better teaching my kid how to drive. I’ll be like, imagine how much fun she’s having at prom rather than envisioning her with the sirens and everything in the ambulance.
[00:28:24.920] – Kara Kushnir
Yeah. No, it’s tough. Yeah. Give yourself permission. One day I won’t be a taxi driver. That’s the wonder.
[00:28:30.700] – Hilary Erickson
Amen. All right. Thanks, Kara.
[00:28:32.320] – Kara Kushnir
Thank you. Take care.
[00:28:33.530] – Hilary Erickson
Thank you guys so much for joining me on this episode. It’s not one that you’re like, Yay, let’s talk about anxiety, but it is so important. Important to know when to get help. That’s one of the key things I wanted to talk to her about, how to get help. And if you are feeling anxiety during your pregnancy, I cannot recommend any more finding someone to talk to, even just one appointment before baby’s born to give you a few tools in your toolbox.
[00:28:55.200] – Hilary Erickson
And then you already have somebody that you can reengage with after baby’s born if you’re having issues. Maybe you won’t. Hopefully, you won’t because you’ve already got those tools in the toolbox. I will say that I hear so many people saying, I can’t have a cervical exam or I can’t have an IV because I’m afraid of needles. If those kinds of fears are keeping you from enjoying your pregnancy or life, go have a chat with a therapist. I think it can only pay off a ton.
[00:29:18.710] – Hilary Erickson
Thanks for joining us on the Pulling Curls Podcast today. If you liked today’s episode, please consider reviewing, sharing, subscribing. It really helps our podcast grow. Thank you.
Keywords:
postpartum anxiety, postpartum advice, new mom anxiety, postpartum depression, perinatal mental health, mental health support, new parent fears, anxiety symptoms, birth plan, postpartum blues, psychotherapist, A Work of Heart Counseling, online prenatal class, intrusive thoughts, psychosis symptoms, postpartum OCD, sleep deprivation, postpartum support, parenting anxiety, Postpartum Support International, pregnancy nurse, childbirth complications, anxiety in motherhood, managing anxiety, infant safety, seeking therapy, support for new mothers, acceptance of anxiety, acknowledging anxiety, mental exercises for anxiety.
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