So you’re at Risk for a PMAD. Now what?

This is part 2 in a 2-part series about risks for developing a Perinatal Mood and Anxiety Disorder. Start with Part 1 to see how many risk factors you or a loved one might have.

Once you’ve identified that you might be at risk for developing a Perinatal Mood and Anxiety disorder such as postpartum depression, anxiety, OCD, or bipolar, it can feel scary to think about what’s next. The good news is that there are effective treatments that exist. We also know that there is great benefit in knowing risk factors ahead of time because the initial effort can be focused on prevention and support. And prevention/early intervention has been shown to reduce severity and duration of PMADs. Knowledge is power!

One of the most beneficial strategies is getting connected with a therapist who is trained and experienced in working with PMADs (more info in a future post about why it’s so important to see a clinician whose focus is PMADs if possible.). In my practice, what this typically looks like is anywhere from a handful of sessions prior to birth to regular weekly sessions leading up to the birthing time. We do educational/informational work, resource-planning, postpartum planning, partner work, as well as regular therapeutic processing work.

Often, if someone has a number of risk factors it can be good to set up a consultation with a psychiatrist (an MD who can prescribe medication if needed), or a psychiatric nurse practitioner to find out about medication options should the need arise. Not everyone who has a PMAD needs medication but often folks find it helpful to know what their options are ahead of time.

Another important preventative factor is to learn about social support in your community. Here in the Minneapolis - St. Paul area where I practice, we are lucky to have lots of opportunities for new parent support. This can include things like La Leche League meetings, new mom support groups, new mom classes, babywearing meetings, breastfeeding support groups, mom + baby yoga classes, and more. Talking to your midwife or doula or OB, or seeing if your local hospital or prenatal yoga studio or community center has any groups or classes can be a great way to make connections. Social support has been shown to be a vitally important healing factor in the perinatal period.

Making a postpartum plan is helpful in early intervention/prevention work as well. Sit down at your computer with your parter and make a postpartum plan the same way you’d think about making a birth plan. What are the things I need to be successful in this time? Who are people I can call on for support? What are the resources I could use in this time? What are the things that I don’t want to be part of my postpartum time? What do I want my postpartum time to look, feel, be like?

Remember, if you know your risk factors ahead of time, you’re ahead of the curve! Being proactive to set up some supports in your life will go a long way toward making sure you have the best postpartum time you can have.

Early Fall Newsletter

Anam Counseling Occasional Newsletter

Early Fall Update

Name Change, New Office Location Scheduling Updates, Telehealth, and More

Jess Helle-Morrissey, MA, MSW, LGSW, PMH-C  Fall 2019

Warm early autumn greetings to you! First, you may have noticed that I’ve slowly rolled out a name-change and new logo over the last year. What was once Metta Therapy is now officially Anam Counseling. I changed the name of my practice in an effort to avoid cultural appropriation. Anam, meaning “soul”, comes from the Gaelic language, and my cultural background is Irish (among a couple other things!) so the name is more authentic to me. Additionally, the work I do in my practice is very soul-centered so Anam felt right on all levels. Going forward, please make sure to use the email address jess@anamcounseling.com to communicate since I’m not checking the old address as much. My phone/text number remains the same. 

In other news, this spring I was approved to sit for the new international certification in Perinatal Mental Health. (Mental health in the period of time covering conception to baby’s first birthday.) I am happy to say that after lots of studying, I passed the exam and am proud to have the letters PMH-C behind my name. Does this change anything in my practice? Nope.  But, it reflects my commitment to the importance of recognizing perinatal mental health as a specific and important specialization that should be treated by folks who are experts and have sought additional training in the field. 

New Minneapolis Monday Office Location

The biggest news is that after six wonderful years renting space from Blooma, I’ll be moving to a new office space with Well + Whole Collective effective Monday, September 30, 2019. This beautiful new space is located just blocks from Blooma and is in a collective space shared by 5 other therapists as well as a reiki practitioner. I’m eternally grateful for my time renting my little room from Blooma. And, I can’t wait for everyone to see the new space! There is ample on-street parking as well as a small parking lot in the back of the building. My Thursday office in St. Paul near the intersection of Snelling and Selby remains the same. Please note this means the only scheduling option going forward is my online self-scheduler. 

4801 1/2 Nicollet Ave

Minneapolis, MN 55419

Scheduling

And speaking of scheduling… Over the last several months, my practice has grown so that I’m filling most of my available sessions each week and sometimes several weeks in advance. So what does that mean for new and existing clients?

• If you’re wishing to be seen on a regular basis, I strongly encourage you to go to my online self-scheduler and schedule multiple sessions in advance. This will ensure that there is room when you want to be seen. Generally if you schedule about three or four at a time, that should account for the increased busy-ness. 

• Remember, if you schedule ahead and something ends up not working, you can always go into the scheduler and cancel the appointment. Just remember that cancellations that are within 24 hours before the appointment are still charged and 48 hour notice is preferred so I can try to get someone else in the open spot.

• If you’re someone who has a regular recurring weekly appointment, then no need to do anything different! If you don’t already do this, consider scheduling a consistent recurring weekly or every-other-weekly appointment. It’s a great idea both logistically and therapeutically. 

• In general, I tend to be slightly less full in my St. Paul office location. So if you are looking for an appointment and can’t find a time on Monday and don’t mind crossing the river, check out my Thursday availability for more options.  If you haven’t been to the St. Paul spot, it’s a lovely, cozy, light-filled room in an old home that is now used for independent therapy offices. It’s on Selby just west of Snelling Ave., conveniently located just south of the Snelling exit off I94.  If you regularly come to Minneapolis, I promise you my St. Paul office isn’t much farther! 

New Telehealth Option

With our record cold and snowy winter, many folks already had the chance to try out my new Telehealth software in February. For those who have not, it’s a new HIPAA-compliant app that lets us have a virtual session from wherever you are. I’m only using this option for existing clients and ideally only when weather or illness keep you (or me!) from coming into the office in person. I still like the old-fashioned, face-to-face therapy best. But it’s a good option in a pinch when life gets in the way of therapy scheduling. 

Brainspotting - A New Treatment for Trauma

This spring I completed training in Level 1 of Brainspotting. This is an evidence-based eye-movement modality that helps the brain move quickly through traumatic or difficult memories. It can be helpful for single-incident trauma such as traumatic birth as well as for longer-term developmental trauma. Additionally, folks use Brainspotting for general issues that feel “stuck” and don’t necessarily rise to the level of trauma. Let’s chat in session if you’re interested in trying it out. 

Small Price Increase on october 1, 2019

Beginning October 1, the ongoing per-session rates will increase by $8 per session from $110 per session to $118 per session. Intakes and joint couples’ sessions will remain $135 since both of those use the full 60 minutes instead of the regular 45-minute session. It has been over two years since my last rate increase, and in that time rents at both my locations have increased, I’ve purchased new Telehealth software, I’ve gained new certifications, and done several additional trainings. And, 2020 will mark my 15-year anniversary as a clinician, which hardly seems possible! 

As a reminder, I am always happy to provide you with a receipt and a diagnostic code for you to submit to your insurance company for potential out-of-network (OON) reimbursement. As a reminder, OON is not guaranteed and is plan-specific based on your individual insurance plan and carrier. Sessions are still paid for up front and your insurance company would give you any potential OON reimbursement directly after you’ve submitted the paperwork. Sessions can also be paid for with an HSA/FSA card. 

EXPLORE THE NEW WEBSITE

Anam Counseling

Practical Counseling with Heart and Soul

Jess Helle-Morrissey, MA, MSW, LGSW, PMH-C

www.anamcounseling.com

Are You at Risk for Developing a PMAD?

Part 1 in a 2-part post about risk factors and prevention for Perinatal Mood and Anxiety Disorders. Part 1 is meant to be a list of risk factors, and in part 2 we’ll talk about what to do if you find yourself with a couple or more of these risk factors.

Early in my career, I was at a conference listening to a panel of survivors of postpartum depression, anxiety, and OCD. One of the survivors said, “If only anyone had told me while I was pregnant that I personally could check off 10 on a list of 15 risk factors for developing postpartum depression, I would have gotten help a lot earlier and maybe all of this could have been prevented.” That was a real lightbulb moment for me and it’s informed how I practice ever since.

If a pregnant person gets told at all about Perinatal Mood and Anxiety Disorders, they’re often only told what to look for after the PMAD has already developed. But because we know that an ounce of prevention is worth a pound of cure, it’s vitally important for all pregnant folks to know about factors that put them in a higher risk category for developing a PMAD. As a Certified Perinatal Mental Health Therapist, my wish would be that every midwife, OB, doula, childbirth educator, lactation specialist, prenatal yoga teacher, or anyone who comes in contact with pregnant people shares this list of risk factors so folks know to be prepared with resources.

So what puts a person in a higher risk category for developing a perinatal mood and anxiety disorder? Here is a list of some things we know increase the chances:

• Any previous history in themselves of depression, anxiety, OCD, bipolar disorder, or any other mental health concern

• A history of having had a PMAD with any previous pregnancy/birth

• If their biological mother had/has depression, anxiety, bipolar, OCD, or any other mental health concern

• If their biological mother had a PMAD with any of her pregnancies/births

• A history of childhood sexual abuse or trauma

• If there is current emotional or physical abuse in their intimate partner relationship

• If they or the people who love them would describe them as any of the following: a “type-A personality”, “perfectionist”, “control freak”, or someone who has very high expectations and standards for themselves

• A history of severe PMS or Premenstrual Dysphoric Disorder or other heightened emotional sensitivity to hormonal changes

• Any sort of recent major life stressors - a move, a new job, a relationship change, financial difficulties, etc.

• If a person lacks social support

• If the pregnancy was unplanned/unwanted

• Teen moms

• Black moms, Indigenous moms, and Women of Color due to systemic oppression and racism

• People with thyroid disorders

• People with Type I Diabetes

• People experiencing lack of financial/employment security, or those experiencing homelessness

• People who experienced fertility struggles or reproductive losses such as miscarriage

And here are some factors that have more to do with the pregnancy/birth/baby:

• If there was a difficult pregnancy such as those with hyperemesis gravidarum

• If there was ever any perceived or real risk to the fetus during pregnancy such as worry about a potential or actual diagnosis

• If the birth is experienced as traumatic

• If there is any NICU/special care nursery stay for baby

• Parents of multiples - twins, triplets, or more

• If the person desires to breastfeed but is unable to or experiences breastfeeding difficulties

• If baby is colicky or otherwise “high needs”

This list is not comprehensive but it represents much of what we know in the perinatal mental health world about who might be at risk. Because PMADs are the most common complication of pregnancy and childbirth, everyone should be aware of these factors. Look for part 2 of this post where I’ discuss what you can do if you’ve identified yourself in any of these risk factors.