May 2014 e-Newsletter- Women's Behavioral Health
Maternal Mental Health in 2014: Perinatal mood disorders
By Linda Huelke-Pfleger, M.S., LCPC
The month of May has again been proclaimed Perinatal Mood Disorders Awareness Month in the state of Illinois. Years ago, healthcare professionals believed that depression affected some women after the delivery of a baby. We now know that along with symptoms of depression, symptoms of anxiety are pervasive in new and expectant mothers.
Approximately 15-20% of pregnant women and new mothers in the first year after giving birth experience a depression or anxiety disorder, making this the most common complication of childbirth. These disorders affect nearly one million women each year in the United States alone but despite their prevalence, perinatal disorders often go undetected. As a result, many women go without treatment and suffer needlessly, negatively impacting their ability to enjoy this special time in their lives.
Symptoms may differ for each woman but typically include excessive worry or fear of the unknown, feelings of sadness, irritability, anger or guilt, changes in sleep or eating patterns, intrusive or scary thoughts, difficulty concentrating or in daily decision making, and in the most serious cases, thoughts of harm to oneself or baby. While new research continues to explore genetic predisposition to these disorders, we are aware that adjusting to a newborn is not easy. Rapid hormonal changes during and after pregnancy along with the stress of our fast paced living plays an important role.
There are factors that can significantly influence the course of treatment and recovery. Many women believe that they cannot safely continue their mental health medications once they find they are pregnant and abruptly discontinue them. Rather than achieving a positive result for mother and baby, this action is the leading cause of relapse in maternal mental health disorders. In the interest of optimal health during pregnancy and the months following delivery, it is important to discuss thoughts regarding medication changes with a physician.
In the onset of a perinatal mood disorder, many women are acutely aware that they are not feeling like themselves and that essentially something is wrong. This is a good reason to discuss one’s feelings and behaviors with a partner, loved one or medical professional. No one needs to suffer in shame or silence with a disorder that, when identified in the early stages, can be quickly and effectively treated.
Additional information regarding perinatal mood disorders and available resources can be found at www.edward.org.
Linda Huelke-Pfleger, M.S., LCPC, Linden Oaks at Edward- Maternal Health Services
Linda is a licensed clinical professional counselor in the state of Illinois and is certified by Postpartum Support International as a postpartum mood disorders specialist. She attended Indiana University in Bloomington Indiana where she received her M.S. in Counseling Psychology. Linda has worked in the field of behavioral health in private practice, community mental health and hospital settings for the past thirty years. She currently works at Linden Oaks and Edward Hospitals in Naperville, IL, coordinating maternal mental health services as well as the integration of behavioral health services to medical patients.
Why Support? The Importance of a Support System in Recovery from Eating Disorders
Joan Mrozek, RN –BC, LCSW
When you see articles about Eating Disorders do you ever wonder how food could become such an enemy for a growing number of individuals? According to statistics published by the National Eating Disorders Organization, 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life, including anorexia nervosa, bulimia nervosa, binge eating disorder or an eating disorder not otherwise specified. The National Association of Anorexia Nervosa and Associated Disorders states that, eating disorders are life-threatening illnesses having the highest mortality rate of all mental illnesses.1
So much of society’s socialization takes place in the context of eating and we have known for years that Eating Disorders are biopsychosocial based illnesses. An article written by Linda Smolak claims that by the age of 6, children, especially girls, may start to express concerns about their own weight or shape.²
At first, I thought that this was a misprint but then I remembered a comment made by my own granddaughter at a birthday party. She was playing party hostess and passing around appetizers. As she approached each guest, she encouraged them to try “just a bite” and reassured each taker that the hors d’oeuvres were all made “with low fat ingredients because we all need to watch our figures.” She was exactly six years old when this happened.
We may think that we are doing more to prevent the development of eating disorders but when I was at a conference last month I was reminded of how much more still needs to be done. One of the keynote speakers talked about how young women are being recruited to modeling right outside of their treatment facilities. When did our society become so predatory? What would you decide to do if you were presented with the opportunity of being paid a great deal of money to keep your disorder or having to pay for treatment?
Every day those of us who are in healthcare develop a discharge plan for our patients – one that begins at the onset of their treatment. However, by the time a patient is transitioned out of our programs, we often send them home to the same support network that they had when they were admitted into our care. This system may have a negative influence on an individual’s resolve to eliminate eating disordered behaviors from their life. Yet staying away from the only support system that they know can lead to social isolation for the person who is seeking recovery. As treatment providers, we desire a positive outcome for our patients, but they may be missing an essential cornerstone of recovery – a healthy support system.
When I was working in a partial hospital setting, I did the after care group for five years. Once a week my former patients would come back to the hospital for an educational/support group. Sometime during the session I would ask the participants: “what or who helped you to stay in recovery this week?” I informally kept track of the responses that I received.
The number one factor in helping someone to stay recovery focused was the support of another person. This is especially true if this person conveys a hopeful message that recovery is obtainable. The reassurance that someone believes in your efforts can be a very powerful antidote to the ambivalence which many of us experience when we are struggling to change our behavior.
At Linden Oaks at Edward, support groups are a primary tool in recovery. At least one support group is held on a daily basis either at the hospital or at the outpatient centers. For adolescents and adults seeking education and assistance with an eating disorder, Linden Oaks hosts a weekly ANAD group. On the first Monday of the month, ANAD holds a Recovery Night where someone from the eating disorder community inspires hope by sharing their recovery story. Attendance on this evening can be a very moving experience and create the needed encouragement for someone in the audience to reclaim their life. Additionally, on the third Thursday of the month an eating disorder friends and family group meets to provide education and a safe environment for the family members and friends of those individuals who have been diagnosed with an eating disorder. This group addresses the needs of those who are expected to be supportive figures in a patient’s recovery.
Being part of a support system is not an easy task. Communicating with a loved one who is struggling with an eating disorder requires patience and understanding. It also necessitates a great deal of awareness of the need for self-care. To weather the highly charged emotional situations that recovery can present, the Family Eating Disorders Manual reminds family members and friends of the need to “keep looking at and looking for that person who is your daughter or your spouse or your brother---and keep believing unconditionally, in the power of that person to recover. Your hope---your patient hope---is a key element in your effective support.”¹
- Hill PhD, L., Dagg MA, D., Levine, PhD, Smolak, PhD, L., Johnson MSW. S., MSW, Stotz, BS, S., Little, MSEd, N. (2012). Family Eating Disorders Manual, 4, 48, 6, 129.
- Smolak, PhD., L., NEDA, (2011), What Are Eating Disorders?, 1.
Joan Mrozek, RN –BC, LCSW, Linden Oaks at Edward- Eating Disorder Outpatient Services Manager
Ms. Mrozek is both a board certified registered nurse and a masters prepared licensed clinical social worker. She joined the team at Linden Oaks in 2007. She is currently the manager for the outpatient eating disorder services. After listening to multiple stories about how painful the dieting experience can be for some individuals, Ms. Mrozek became a licensed facilitator for the program, “Am I Hungry?”. Ms. Morozek is currently collaborating in the exploration of programming design to address mindful eating. She truly believes that binge eaters, over-eaters and restrictive eaters can return to a balanced state with treatment, support and education.
Nursing CEU Seminar
The Specialty and Art Psychiatric Mental Health Nursing
Linden Oaks at Edward is honored to welcome Shirley Smoyak, PhD, RN, FAAN. Dr. Smoyak will be presenting Friday May 9, 2014 on The Specialty and Art of Psychiatric Mental Health Nursing.
Dr. Smoyak is a Psychiatric Nurse, Health Care Sociologist and Professor of Public Health and well known in the psychiatric mental health nursing field. She has played an instrumental role in establishing psychiatric mental health nursing as a specialty practice and has served as a founder and frequent contributor of many professional and community mental health initiatives. She holds numerous honors and awards, and is widely recognized for her expertise, extensive work, and research in the mental health system and service delivery.
Dr. Smoyak is also the Editor of the Journal of Psychosocial Nursing and Mental Health Services. Recently, the American Academy of Nursing awarded her the distinction of Living Legend. Dr. Smoyak is a 50 year veteran and distinguished professor of Rutgers State University in Newark, New Jersey.
Dr. Smoyak’s presentation will be offered twice on Friday May, 9, 2014 in the Linden Oaks at Edward Outpatient Education Center (1335 N. Mill Street., Naperville, IL). The first presentation will be from 9:00-10:15 a.m. and the second presentation will be from 10:45 a.m.-12:00 noon. If you are interested in attending, please contact Kelly Bryant (630-305-5108 or firstname.lastname@example.org) by May 6, 2014.