Join us for drinks, snacks, desserts, fun, laughter, and more! Bring your tribe and party with us at the Monmouth Beach Bath and Tennis Club in Monmouth, NJ!
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For many women, having a baby is all they ever wanted. Pregnancy, and the promise of motherhood, will make you the happiest woman on earth. However, the reality for 1 in 5 women is a far cry from the what they always dreamed of. Postpartum depression, anxiety, OCD, and other perinatal mood and anxiety disorders become the new reality, and for these women options are scarce. Women suffer in silence. Mom guilt descends, screening is spotty, providers are untrained, treatment is sparse, and it’s one of the greatest causes of maternal mortality. So on March 19th when the FDA approved Zulresso, the first drug ever for postpartum depression, the game changed. But, initial reports of lengthy hospital stays and costs over 30K created a huge backlash from skeptics and hopefuls alike.
Lisa Tremayne is the Director Center of the Perinatal Mood and Anxiety Disorders in Long Branch, NJ. This center is one of only a handful across that country that is hospital based and provides support and treatment for women suffering from PMADs. Lisa has also been part of Sage Therapeutic’s (maker of Zulresso) advisory council and returns to the Bloom Foundation (she is also President) after meeting with the Sage team and other leaders in the PMAD field in Washington DC to discuss the next steps for Zulresso with COO, Shannon Hayes.
Shannon Hayes: When the announcement came that the FDA approved Zulresso, we were thrilled here at Bloom. I don’t think our phones stopped ringing for days. It was exciting, but then we started to see a backlash.
Lisa Tremayne: Yes, the pushback came pretty quickly.
SH: Because you are on the front lines, you see and treat women suffering from PMADs every day which is an unusual situation due to the limited number of resources around the country, you have a unique perspective on this issue. There are very few people like you and your team. You know what works and what doesn’t work…
LT: …and we see the collateral damages of waiting to get help. That is my number 1 frustration. So, here we have a breakthrough drug, the first drug ever for PPD and I wonder why anyone would feel anything other than – WOOHOO! Why, without the full answers, would one be against something so groundbreaking. I also assume this approval will open up a full new class of drugs. Every time there is a new allergy drug it is like, yay this is the best one! Why wouldn’t this be received the same way.
SH: I think you said it when you said “without full answers.” So let’s address that because we don’t have all the answers but let’s talk about what we do know. It has been reported that the treatment doesn’t come cheap—the average cost per patient is $34,000. Do you know anything more about that, how is that going to be addressed?
LT: The FDA approved this drug on March 19th, and now the process begins. The manufacturing, release, and launch looks to be about June. Again, I am not an FDA person, I am just telling you what I heard. Once the FDA approved it, Sage went to their insurance board and said – here is what we have, here is what it treats and what will be the reimbursement for this or what information do you need from this. As of day 8 from FDA approval, they have had no negative feedback from insurance companies. There is an out of pocket and deductible expense, as there is with any hospital treatment. Everyone reacted to the wholesale price that was reported, but that is not the price that will be passed on to the consumer.
SH: Another pushback that has garnered lots of discussion relates to the 60 hours of IV infusion needed. One of the first texts I received after the announcement was “What mom who has just had a baby is going to take the time away from their newborn to spend 60 hours in a hospital hooked up to an IV?”Do you feel this a valid push back?
LH: I feel this is an uneducated response. Zulresso is a tool in the breadth of drugs available, if needed, for a woman and for a family unit that is suffering the impacts of perinatal mood disorders. Say a mom scores off the charts for PMADs, hypothetically a 10 out of 10. Medication will work, but it will be 4-6 weeks before any real effects are seen, and that is if the correct med and dosage is given the first time. Can we help her with that now; absolutely? But, If you told me I could feel better from my allergies tomorrow instead of June, I choose tomorrow. Zulresso is the tomorrow choice. A woman who is going to be considered for this drug, or more likely will be suggested to receive this 3 day treatment after evaluation, is despondent. She is not intact in her family. She is not showering. She is probably not breastfeeding.
SH: Breastfeeding is another question that has been raised.
LT: If breastfeeding is a way mom is feeling attached to her baby, then she can pump and dump for 3 days. We do this when babies go into NICU, we do this if a mom gets into an accident and needs general anesthesia. This is not a bizarre request.
SH: So this is for the woman that is suffering so much that 3 days won’t matter because she is not engaged, she is not involved, because mom is sick.
LT: Exactly, mom is sick. I also did hear some questioning about the single mom. This is a valid question, and I think this is a wonderful opportunity for nonprofits and advocacy groups to step in and offer help. Help with child care, or financing so dad can take time off or for a nearby hotel for the family to stay… there are may ways to address this.
SH: Who exactly is this drug for?
LT: This is for the mom who is experiencing moderate to severe PMADs. A valid screening tool has been used and a team has made an evaluation and assessment of the mom. This is not a one size fits all. This is not a treat and street situation. This is not, okay you had your IV now off you go! There is a responsibility to say- Hey, we think this IV treatment is your best option right now and when mom is discharged, here is her follow up treatment plan. She can’t go home and start thinking – I can’t believe I left for 3 days, I stopped breastfeeding, what mother does that? So she has to be in a PMAD specific treatment plan.
Remember, they are coming in for treatment at a time when they feel despondent, lost, are experiencing intrusive thoughts, are not connected. Wouldn’t it be great to take that time mom is hooked up to IV and get her started on some nice self care as well. Have a therapist visit and maybe a survivor who can let her know she is not alone, how about a little aromatherapy and lots of sleep. The goal is to get the mom back to feeling like a human being, not a monster, not a failure, not disconnected.
SH: A lot of blog posts and comments addressed sleep. Many suggested that any new mom who got 60 hours of sleep and rest would feel better no matter what.
LT: Of course, if you put any mom with estrogen and progesterone anywhere for 3 days with protected sleep they would feel better just to get the mental load taken off their hands. My questions is would be how would they feel 3 days or a week later.
SH: So with this drug they still feel better 3 days later? A week? A month?
LT: Yes, but it is not 100%, it is around 70%. 70 works for me. I would a take 70% chance. If it doesn’t work, there are still other options such as medications and therapy.
SH: So hospitals that will be given the opportunity to provide this drug will also need to have in place a comprehensive PMAD therapy plan. Do you know if there are any physical side effects.
LT: The only one I know of is somnolence, which means sleepy. I think this is a really good side effect.
SH: I was going to wrap it up by asking what your feelings were on this drug, but I think that it is pretty apparent.
LT: I think it is amazing in my lifetime to see a first drug for something, that part of it blows me away. I can’t remember a first drug for anything.
SH: Viagra?
LT: Viagra was a very good invention….for some people. Maybe not women, hahaha just kidding.
SH: LOL, and Viagra is covered by insurance.
LT: So if erectile dysfunction pills are covered… this better be covered.
The bottom line is that postpartum depression and anxiety and OCD and psychosis and rage and all PMADs affect the health and welfare of the mom, their children, the family and society as a whole; and suicide is one of the leading causes of women after their first year postpartum. Our nationwide resources are abysmal and while there is no magic pill, Zulresso is one step closer to saving lives and THAT is worth celebrating.
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What do you do when you have done everything and it still isn’t enough?
We talk about suicide a lot here at Bloom.
We talk about recognizing the signs, where to get help, we share quotes and infographics and stories. We hope we help… and I think sometimes we do, but what happens when it isn’t enough?
This week it wasn’t enough.
Meet Brandon.
Some time on Wednesday, December 5th Brandon Tremayne got into his Black Nissan SUV and started a journey he had been planning for a while.
It was cold in New Jersey that day. Maybe if it had been snowing Brandon would have postponed his trip and everything would be different.
But it wasn’t snowing.
So on Wednesday, December 5th Brandon left his home, got in his car and started his journey… and so everything is not different.
It was a long drive, but Brandon didn’t notice. He stopped to get gas twice, but he didn’t talk to anyone. His cell phone rang a few times, but he didn’t answer it.
It was late when Brandon arrived at his destination. He knew people fished there – he used to love to fish with his dad when he was little – but he hadn’t cared about fishing for years. He knew people rafted and camped and celebrated life there, but he didn’t care about those things anymore. He also knew people died there, and that is why he was there.
If you have ever been to the New River Gorge in West Virginia you know about the bridge. It soars high above the gorge and from below gives the impression of touching the clouds.
It was cold and dark when Brandon pulled his car over, he was halfway across the bridge. He knew he had very little time before someone showed up, because this is where people came to die. Brandon climbed out of the SUV, leaving the doors and windows open and his cell phone and wallet on the driver’s seat, and in the early morning hours of December 6th Brandon jumped off the New River Bridge.
We don’t know when Brandon began planning his journey. Perhaps it was 2 days earlier when he said goodbye to his virtual video gaming friends and told them he was quitting forever. Perhaps it was 2 months earlier when he quit his job and told no-one. Or maybe it was when he started canceling his therapist appointments, refusing to take medication, or stopped attending family get togethers or answering his phone. But, it is more likely his journey began years earlier when a happy, loving 14 year old boy experienced depression for the first time.
Brandon battled depression and OCD until his journey ended on December 6th when he was just 22 years old. Brandon did not suffer silently or alone. His family knew he was in pain. They did everything they could to ease his pain, but it wasn’t enough. Because sometimes, no matter what you do, it isn’t enough.
Brandon Tremayne was part of the Bloom Family. He was the son of Carter Tremayne. He was the step-son of Lisa Tremayne.
Brandon is gone. He was not lazy or crazy or stupid or selfish. He was a smart, handsome man who had a family who loved him.
Every day we work hard to help moms who are suffering from mental disorders. We talk about getting help, erasing the stigma, creating resources, and stress that it will get better – and yet, we lost one of our family.
There isn’t a good ending to this story. I have struggled with a way to wrap it up neatly to make everything better. I can’t find a way so I will leave you with this:
Brandon’s pain didn’t disappear when he died, it was transferred – to his family. 1 in 4 suffer from mental disorders, but we are all affected… and this is why we will continue to fight here at Bloom. Get help, accept help, ask for help, give help because sometimes what you do IS enough.
If you are suffering or know or suspect someone is suffering please visit The Suicide Hotline or call 1800-273-8255.
[vc_row 0=””][vc_column][vc_column_text 0=””]David Zinell, writes in his science fiction novel, The Broken God, “Before, you are wise; after, you are wise. In between you are otherwise.”
We have all been there, been in the thick of it. We struggle to stay afloat in the proverbial swamp and only later when we emerge and dry ourselves off do we see the paths we could have taken to avoid the swamp completely; and while hindsight can be frustrating the power it provides is immeasurable. The power to help others.
A couple of blocks east of Downtown Scottsdale in a newly renovated 3 bedroom townhouse that would make Joanna Gaines proud, Lisa and I sat at a kitchen table that had become our impromptu office space and talked lived experience, hindsight, PPD, and the triangle of power they form. We talked about moms in the swamp, when they are “otherwise”, and wondered how to get their husbands, their partners, their families –their people– to notice them. To see their PPD. We talked about how PPD manifests itself differently in its’ sufferers, and as the Arizona sun shone through the windows and the kitchen table grew heavy with empty coffee cups and discarded post it notes, we realized we needed help from those with the power.
100+ moms who have been swam in the PPD swamp told us how to help people see. They told us what they wished “their people” had noticed. This is their hindsight.
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[vc_row 0=””][vc_column][vc_column_text 0=””]***TRIGGER WARNING***
“Missouri mom believed to have killed husband, baby, herself; postpartum depression eyed” This headline and accompanying article filled my news feed this week, and it probably did yours as well. Or perhaps you saw the articles that replaced the word “depression” with “psychosis.” I saw those as well.
When I saw this story, I quickly reached out to the women of the Bloom Foundation. These are the women in the thick of it, deep in the trenches. They are clinicians and support group leaders, they are survivors and advocates, and they are the women who everyday work with new moms struggling with postpartum anxiety and depression. I needed to hear what they had to say.
“This is heartbreaking on every level. My prayers are with the family and friends of the Trokey’s. I am saddened, but I am also frustrated. There is such an enormous amount of power in the words we use every day and a responsibility that comes with the terms we attach to illnesses. Depression and psychosis are very different conditions, and the tendency to use them interchangeably when pairing them with “postpartum” frustrates and scares me. We wage a daily battle to erase the stigma associated with postpartum mood and anxiety disorders so women no longer have to suffer in silence. When terms are misused or used ignorantly, in order to sensationalize a story, I fear the effects. I fear for every new mom suffering from postpartum anxiety who today will decide to not speak up, to not seek help. I fear for every mom next week who Googles postpartum depression and is presented with Jessica Porten’s story and what she encountered when she did speak up. I fear for every mom next month who will find the strength to make that first call finally asking for help, and then the second, and third, and then finding nowhere to go. These are not bad moms. They have a real illness, and it is treatable and with help they will get better. Yes, there are moms who experience psychosis, and yes, tragedies happen. I feel it is the biggest part of our job to be the voice of the women silenced by the stigma, the shame, and the secrecy. To educate the public, the providers, the families about the realities of postpartum anxiety and depression. It is treatable, it is temporary, and it affects 1 in 5 new moms. We must erase the shame.”
“As soon as I heard there had been another maternal mental health tragedy, my heart sank as my tears welled up. These stories shake me to my core. But this time, for the most brief of moments, I realized with satisfaction that the article I saw labeled what happened as a potential case of postpartum psychosis. Bravo to the St. Louis Post Dispatch, I thought fleetingly. Because when the media reports that this tragedy happens because of a battle with postpartum depression, and not the more accurate psychosis, they spread misinformation that keeps women who DO suffer from postpartum depression and anxiety from coming forward to seek treatment. They suffer in silence because they think, “we’ll, I’m not that bad.” “I don’t want anyone to think I’d do THAT.” What people need to know is, there is a spectrum to perinatal mood and anxiety disorders (PMADs) such as postpartum depression, postpartum anxiety and postpartum OCD. The symptoms and severities can appear differently in each person, but all are temporary and treatable, if we know what to look for, are open and honest about our feelings, and seek the help that we need to get better. Yes, postpartum psychosis is on the far end of that spectrum. But it is not postpartum depression.”
We don’t know Mary Jo Trokey’s suffering. We do know that postpartum psychosis only affects 1 to 2 in 1000 out of every 1,000 deliveries, or approximately .1-.2% of births and .00005% suicides and/or infanticides. We have a responsibility to use our words wisely, with thought, compassion, and a real understanding of their impact and meaning on others.
The Bloom Foundation sends its deepest condolences to the extended Trokey family. Our hearts ache for their loss, one that we feel so acutely. We are committed to doing the work and informing and educating pregnant women and new mothers about the signs, symptoms and risk factors for PMADs. We are committed to reducing the shame and stigma associated with these illnesses, the most common complication of childbirth.
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[vc_row 0=””][vc_column 0=””][vc_column_text 0=””]It started with a simple request. A simple request from a formidable woman. Claire Zlobin, founder of Life With A Baby asked for some stories. A little blurb or two about why maternal mental health is important.
This simple request took a circuitous route. I considered writing about the road it traveled… the conversations about the origins of lying and Patricia Meyer’s TED Talk, the bravery of the #metoo campaign, the strength that comes from vulnerability, or even my own personal struggles of surviving the grief of my mother’s passing… all stops on the road that led to The Mask I Wore. While each stop was necessary in the journey, the women below are the destination.
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The image of a woman sitting alone in a dark corner, usually on the floor, shoeless, head down, hair a mess.
It is the picture we attach to postpartum depression. We use this picture – I’ve done it – and then add a quote to it or include it in a blog post as a visual representation – an offering of understanding.
She is the face of postpartum depression… and she is lying to you.
I understand this woman is only here to help. She is a placeholder, a conduit, a way to connect and say “you are not alone,” and perhaps calling her a liar is a bit harsh, but in her desire to help she may be hurting as well.
Postpartum mood and anxiety disorders are real…and this nameless, sitting in the corner, shoeless woman represents the depression many new moms experience after the birth of a child. Depression is this woman, the face of PPD, but depression rarely arrives alone.
Postpartum Anxiety is a strong companion and usually much more formidable.
Recently, in one of our closed PPD/A online support groups a member asked this question…
“What does your PPD look like?”
As you read how members responded you can see that while depression peppers the conversation, the face of anxiety is a constant and powerful force… and this is what I mean when I say the woman in the picture may be a problem. She connects, but she also alienates, because PPD has another face and it is NOT staring at the floor or out the window or hiding under the bed covers.
[su_pullquote]Mine was white hot rage. Obsession over sleep schedules-mostly naps. Insotmnia which fueled racing, intrusive thoughts. Hopelessness. But for months I spent my energy making it look good for anyone and everyone around me. Only my husband knew something wasn’t Pinterest perfect. And I felt like I was a monster for months before seeking help.[/su_pullquote]
[su_pullquote]So much rage, insomnia, intrusive and racing thoughts, feelings of failure and hopelessness. So much anger followed by deep sadness.[/su_pullquote]
[su_pullquote]Mine was mania with a side of OCD. Doing it all like a baby hadn’t changed me. Putting on a good face. Obsessed with order both in my home and for my kids. Rigid schedules. I’d crack behind closed doors.[/su_pullquote]
[su_pullquote]My PPA is like a musical crescendo. Slowly building up and my heart is racing and sometimes a cannot catch my breath. It causes me to snap at my kids. Then I feel awful.[/su_pullquote]
[su_pullquote]Feeling completely overwhelmed, intrusive thoughts, feeling like a failure, crying uncontrollably for no reason, rageful moments[/su_pullquote]
[su_pullquote]Panicking awake in my sleep every half hour until I started medication-Terror at the idea that my colicky baby was going to wake up any second and cry-The obsessive thought I should give him up for adoption because I clearly wasn’t meant to be a mom.[/su_pullquote]
[su_pullquote]Insomnia, racing thoughts, failure for everything I did or didn’t do, crying uncontrollably for no reason, feeling completely overwhelmed, and being scared of my baby at times.[/su_pullquote]
[su_pullquote]Feeling like a failure, feeling like I had made a huge mistake having kids because I obviously was no good at it, constantly feeling overwhelmed by the simplest of tasks. Severe anxiety around the safety of my kids.[/su_pullquote]
[su_pullquote]I learned recently that rage is a big indicator of depression. So I’m going through both PPD &PPA. I can’t sleep. I don’t want to do anything. Intrusive thoughts. Crying comes and goes. Not wanting to get out of bed or where ever I’m sleeping. But force myself. I work on putting a show for my 3 year old. [/su_pullquote]
[su_pullquote]Overthinking schedules, being extra type A, obsessing over how many oz Jake was drinking, pretending I was fine all the time.[/su_pullquote]
[su_pullquote]Can’t nap and turn my brain off when baby is sleeping. Anxiety. Nauseous [/su_pullquote]
[su_pullquote]Rage! So much rage. And just obsessing over every little thing, especially things I can’t control. Not living in the moment, depressed about the past- worried about the future.[/su_pullquote]
[su_pullquote]Crying uncontrollably and not being able to explain why, nausea, not eating, racing thoughts, feeling the need to lay still in bed, guilt[/su_pullquote].
[su_pullquote]Feeling “good” one minute and than what feels like a wave of heaviness taken over by instant tears. Insomnia. No appetite. Lack of interest in things that used to bring great joy. Inability to move past the trauma of my labor/delivery.[/su_pullquote]
[su_pullquote]Because I was so hyper, people kept complimenting how I “had it altogether” and I was a “super mom.” I fed off of it and thought I was just destined to be miserable all the time.[/su_pullquote]
[su_pullquote]Intrusive thoughts (so scary) paralyzed by my anxiety. I would hear my baby cry and not be able to move. Not eating, throwing up, constant crying[/su_pullquote]
[su_pullquote]Panic and racing thoughts. Then it was feeling like a failure and complete withdrawal. I remember nothing from the first few months of his life. My second wasn’t as bad but I had rage and anger. I enjoyed her newborn stage but I resented my older children because I felt like i couldn’t split myself into enough pieces.[/su_pullquote]
[su_pullquote]Rage; hopelessness; racing thoughts; sense of impending doom; cognitive impairment; insomnia; inability to make decisions; complete overwhelm and inability to begin or finish tasks; need to escape/flee. My eating disorder returned[/su_pullquote]
[su_pullquote]Extreme rage and extreme sadness. So overwhelmed with extremely simple tasks, like getting new contact solution from the linen closet because mine was empty. I just couldn’t do it. Crying for no reason at all. Some days not being able to get out of bed.[/su_pullquote]
[su_pullquote]Feeling overwhelmed, rage, hopelessness, insomnia, obsessive thoughts , crying over everything, wanting to just be home, extreme guilt, panic attacks , feeling like I’m going to “jump out of my skin “[/su_pullquote]
[su_pullquote]Paralyzed by every minor decision, obsessed over each detail, nervous, to leave the house, anxious, worried, couldn’t sit still, overwhelmed, hopeless, afraid people would know I was losing my mind, no appetite, uncontrollable crying, I wanted to run away & disappear – very intrusive thoughts of driving my car off of bridges…. felt so alone.[/su_pullquote]
[su_pullquote]I also had intrusive thoughts about driving my car off bridges. It was terrible. I couldn’t go near my windows for awhile bc I had thoughts of throwing my son out them when I couldn’t get him to stop crying n it had been hours of non stop crying.[/su_pullquote]
[su_pullquote]I first started with Being almost “manic.” I was like super mom… i was getting everything done, taking care of the house family etc.. i did it only on a couple hours of sleep.. i felt like i was just in go motion.[/su_pullquote]
[su_pullquote]My PPD/PPA is contradicting. Feeling trapped but no motivation to get up. Constant worry but lack of ways to console those worries. Lack of communication but no desire to communicate. Lack of intimacy but anxiety x1000 about my body image and sex in general. In a nutshell my PPD/PPA is a clusterfuck of emotions. Anger, sadness, helplessness, no control..[/su_pullquote]
[su_pullquote]Rage. Anxiety. No desire to eat.[/su_pullquote]
[su_pullquote]Lately I have a fear of leaving the house to do anything. I have paralyzing anxiety. I want to get back to my normal self. I am not happy. I do leave the house, but it isn’t easy.[/su_pullquote]
Studies from the Center for Disease Control and Prevention say 1 in 7 new mothers suffer from maternal depression.
WBGO’s Ang Santos takes us to the Monmouth Medical Center on the Jersey Shore, where a team of experts are operating the state’s first treatment facility for perinatal mood and anxiety disorders.
Check out the article here!
The Bloom Foundation
716 Newman Springs Road, #117
Lincroft, NJ 07738
