Understanding and Supporting Moms' Mental Health
Episode 10 · Laurie Groh, MS LPC SAS with Casey White, Moms Mental Health Initiative (Milwaukee) · 2024-03-14
For this episode I talked with Casey White from Moms Mental Health Initiative, a Milwaukee-area nonprofit that helps moms find the right help for perinatal mood and anxiety disorders. Casey first came to the organization as a mom who used its resources during her own perinatal mental health experience in 2019. Her line, which I love: it takes a village, and it's our job to build it.
Show notes
What Moms Mental Health Initiative does
The organization was started in 2016 by two moms, Sarah and Becky, who had each gone through perinatal mental health struggles and found it too hard to get the right help. Two things sit at the center of the work.
Peer support. A mom looking at you and saying, "I've been there, and it gets better." They run a private, moderated online group called Circle of Hope for birthing people from pregnancy through about two years postpartum in southeastern Wisconsin and the Madison area. They've also been expanding in-person peer support, including perinatal-specific OCD groups.
Resource brokering. This is the most-used part. They act as a bridge to evidence-based treatment, connecting moms to therapists, psychiatrists, or primary care, with someone who takes their insurance.
Most provider directories are pay-to-list or self-submit. Casey said no money changes hands to be on theirs. Every provider has a conversation first, and every provider has to understand intrusive thoughts.
Intrusive thoughts are not the same as intent
Casey was careful to say she's not a clinician, and she put it plainly. Intrusive thoughts are scary thoughts that pop into your head, sometimes about harm to your baby or yourself. They're ego-dystonic: you're aware of them, you hate them, they might terrify you. A true thought of harm is one the person believes and intends to act on. Those are different things.
By Casey's numbers, perinatal mental health conditions affect about one in five moms. Postpartum psychosis affects roughly one in 500 and is a medical emergency: call 911 or a crisis line.
As a mom of four, I know these thoughts. Mine show up at the sweetest moments, when the baby's sleepy and I'm happiest, and then a flash of something terrible. I call it the joy stealer. Everyone has intrusive thoughts. In the perinatal period, with hormone shifts and sleep deprivation, they get louder.
The nightmare, Casey said, is a mom thinking: if I tell a provider what's in my head, will they take my child? That fear keeps people quiet. It's why the organization vets its providers.
Isolation is the real danger
One thing Casey shared stopped me. She said the latest maternal mortality review in Wisconsin found social isolation to be the most significant factor in maternal deaths here. Her words: social isolation is killing moms.
That's why peer support isn't a nice-to-have. Casey said the research they've seen shows moms with peer support are more likely to stick with treatment, whether that's medication or therapy.
Burnout isn't only a work problem, either. Everything that burns people out at work burns out a mother at home.
"This is supposed to be the happiest time"
Society says a new baby is the most joyful time of your life. So when a mom is thinking "this is what I wanted, and it's the hardest thing I've ever done, and I don't feel like myself," there's nowhere to put that.
You can love a moment with your baby and feel postpartum rage an hour later. You can enjoy the smell of a newborn and be so tired you can't see straight. That's not a contradiction. That's just what's happening.
From my side of the room: sleep deprivation can look like severe depression when someone walks in. "Am I a good mom" doesn't even fit what's physically happening to you.
Casey said the clarity she has now about her own postpartum anxiety and OCD came later, with therapy and time. You can be great one day and a hot mess the next, and you're the best mom to your baby on both.
When your doctor isn't listening
Casey hears from moms whose doctor says drink more water, or whose OB took them off a medication that had been working and won't put them back on. She said perinatal mental health isn't taught well in medical training. If you tell a provider how you feel and they don't believe you, it can feel like a betrayal. Her message: you deserve to be heard. Get a second opinion. Their team can help you find a psychiatrist who will listen.
She also pointed to the Periscope Project at the Medical College of Wisconsin, started by perinatal psychiatrist Dr. Christina Wichman. Providers can call for a consult with a perinatal psychiatrist. A mom can ask her OB to check with Periscope about a medication question.
Evidence-based treatment comes first. For some moms that's weekly therapy. For others, medication is what lifts the fog enough to do the work. Self-care comes after you can think again.
Casey's book recommendation: Good Moms Have Scary Thoughts by Karen Kleiman.
Key takeaways
- Intrusive thoughts are common and ego-dystonic. They are not the same as intent to harm.
- Social isolation was the biggest factor in Wisconsin maternal deaths, per the review Casey cited. Peer support is protective.
- You can love your baby and hate this stage in the same hour. Both are allowed.
- If a provider won't listen, you deserve a second opinion.
- Clinical treatment first, then self-care.
If this one hit close to home
If you're pregnant or postpartum and this doesn't feel like baby blues, Shoreside Therapies offers perinatal and maternal mental health therapy in Wisconsin and online in several other states. Our intake coordinator will help you find the right fit, even if it isn't us. Moms Mental Health Initiative is at momsmentalhealthmke.org.
More on this topic: Relationships hub · Matrescence: Becoming Someone New · Becoming a New Woman: Motherhood · Tired All Day, Wired at Night
This episode is for education and entertainment. It is not therapy and does not create a therapeutic relationship. Hosted by Laurie Groh, MS, LPC, SAS.