Transforming Depression, Increasing Awareness: An Interview with Liz Friedman

Liz Friedman is the Program Director at MotherWoman, Inc. and the Founder of the Postpartum Support Initiative.

What do you remember from your experience of postpartum depression?

Liz:When I became a mother almost 9 years ago I experienced a severe perinatal emotional crisis. My pregnancy was complex, my birth was traumatic, my postpartum period was disastrous. I did everything right and everything went wrong.What I recall most distinctly from that period was the fear that I was losing my mind. I was terrified that I had made a terrible mistake and that I would never be an adequate mother for my beautiful son. I thought I would never recover. The isolation of that time was deeply damaging and my loneliness in the face of that crisis still brings me to tears. Yet step by step I found a path and began to recover with the help of a few excellent resources in my community.

How did that experience influence your work with MotherWoman?

Liz: With every step forward that I took, I became angrier about what no one told me. How could I nothave known there was the possibility of this happening? Why didn't I know that isolation, difficult pregnancy and traumatic birth are some of the key risk factors for perinatal emotional complications? Why didn't I know that there are ways to prevent and prepare for the risks of postpartum depression? Most importantly, why didn't I know that postpartum depression is the leading complication of childbirth? Why didn't I know that 1 in 8 mothers experience perinatal emotional complications?

By the time my baby was 6 months old, I began to gather mothers together to share our experiences of pregnancy, birth and the postpartum period. MotherWoman was born from the same desire to create a place for women to share their REAL stories of motherhood. Annette Cycon, LICSW founded the organization in 1998 and I joined in 2005 with the explicit goal of bringing a focus to perinatal mothers. We founded the Perinatal Support Initiative and developed the MotherWoman Support Group Model to address this issue. We believe in mothers' ability to heal and lead powerful lives as the mothers and women they are meant to be.

Before you had children, what was your awareness of depression and anxiety in pregnancy and postpartum?

Liz: Awareness? What awareness? Not until after having lived through the experience did I gain any real awareness. And it wasn't until I became an advocate and educator that I received a true education. This is the one thing that mothers say again and again as they walk into our perinatal support groups: Why didn't anyone tell me??

I strongly believe it is our responsibility as educators and advocates ensuring that all mothers have accurate information regarding depression/anxiety disorders so they can be informed, and thoughtful about how to best approach the childbearing period of their lives. We need to do this in a way that doesn't frighten them but rather empowers them. If we do not do this as part of our prenatal education we have done mothers a huge disservice.

What would you suggest to childbirth educators and doulas?

Liz: Pregnant women trust you because you are their childbirth educators and doulas. They will listen to you. Have courage and tell them the facts of the postpartum depression and anxiety mood disorders.

Every childbirth educator and doula must make it an essential part of their curriculum to cover the basics regarding PPMAD (perinatal and postpartum mood/anxiety disorders). This means telling mothers and their partners what symptoms, prevalence, and risk factors, and treatment options may be, and referrals in the area. Partners need to know what to look for because often they are the ones who first notice a mother struggling. Childbirth educators and doulas need to insist that pregnant women put attention on what emotional life is like postpartum and prepare for it. Mothers and partners need to be encouraged to create a Postpartum Plans that is evidence-based and addresses some of the most common challenges in the postpartum time. Partners need to be made aware of how much support they will be expected to give and how much physical and emotional support a new mother actually needs for the entire postpartum year!

What questions should pregnant women ask potential doula about depression/anxiety?

Liz:

• Do you have experience supporting mothers who have had depression/anxiety?
• Are you philosophically opposed to your clients using medications to assist with depression/anxiety?
• How can you help me prepare for the possibility of experiencing depression/anxiety?
• What resources do you have to help me if I develop depression/anxiety?

What advice would you offer pregnant women today?

Liz: Many mothers make a birth plan to prepare for their birth. I recommend that every women make a postpartum plan! If mothers had a real idea of what the postpartum period would be like, they would PLAN! In order to make a plan, you need to understand the risk factors, the likelihood of different outcomes and path for prevention that works for you. Could you imagine what our postpartum experiences would have been like if we had real support set up for us after we gave birth to our babies?

What was it like doing TEDtalks?

Liz: I won the TEDWomen's contest in Dec 2010 and it was the first time in the history of TED that a postpartum mother's story was highlighted and given international attention. At TED you have to be bold so I told them the truth. I spoke about the incredible despair and isolation I experienced during my postpartum time. I told them my dream: I will do everything in my power to ensure that no other mother has to go through what I went through; alone, terrified and not knowing if she will ever be ok again. And then I showed them the path: through the MotherWoman Support Group Model we will bring women together to transform our lives and build solid foundations beneath our feet.

Where do you hope to see MotherWoman 10 years from now?

Liz: MotherWoman is going international! Our Support Group Model (SGM) is transforming the way professionals approach the issue of depression and anxiety mood disorders in pregnancy and postpartum. Our Support Group Model is innovative, ground-breaking and provides the missing link in caring for perinatal mothers. Our model not only educates mothers about PPMADs and provides structured safety for perse mothers to share their stories and to heal but it is also an empowerment model which believes in each woman's inherent wisdom and ability to take positive steps that benefit her and her family. Our goal is to have one Support Group for every 2000 births nationally. In communities utilizing our model, awareness about depression and anxiety disorders in pregnancy and postpartum is growing and the number of mothers who are seeking help and care is increasing-- and that means that mothers are recovering and their families are thriving.