Sarah Short Circuit

Heal, Nourish, Nurture

Click

I am about to listen to another speaker at the MINDD Forum 2015. A gentleman stands up and starts clicking his pen as he speaks. He continues to click and click and CLICK! I become irritated with all that clicking not being able to fully focus on what he is saying. Why won’t he just stop that infuriating click?

Dr Frank Golick pauses and asks “Who in the room is finding this clicking noise annoying?” Now you have my attention. Dr Golik proceeds with his talk on ‘Pyrroles: Mental Health impacts’ and as I sit there having never heard of pyrolles before it clicks. It is like Dr Golik is describing me and my health issues right back to high school.

Symptoms that I could relate to include:

  • stress intolerance
  • high irritability and mood swings
  • morning nausea which is aggravated by smells and taste (since high school for me)
  • tendency to skip or delay breakfast (I have always tended to do this)
  • difficultly taking supplements in the morning (always make me gag)
  • dry skin
  • little dream recall
  • white spots on nails (this is due to Zinc deficiency not Calcium as we all think)
  • stretch marks (who doesn’t have these especially after becoming a mother)
  • poor wound healing
  • anxiety and inner tension
  • headaches and migraines
  • tendency to stay up late (I have never been a morning person)
  • sensitive to bright lights, loud noises and smells (why I the clicking irritated me!)

There are other symptoms and traits of pyrolles though I have ticked the majority of the boxes. We all produce pyrolles, though some of us have an excess. This excess binds to vitamins B6 and zinc as well as other vitamins including manganese and B3 and leads to over excretion of these nutrients in the urine and a potential nutrient deficiency. This leads me back to my initial thoughts of nutrient deficiency triggering my postpartum psychosis.

Dr Golik continues his talk relating the symptoms and traits of pyrolles to conditions including schizophrenia, bipolar and depression. As he discussing these Pyrolle Disorder Biotypes a name keeps popping up: Dr William Walsh. Dr Walsh has a book Nutrient Power:  Heal Your Biochemistry and Heal Your Brain on the power of nutrients on mental function.

Looking into this further I look up the Walsh Research Institute to find a practitioner to get tested…

Further Information

A Quirky Journey 53: Pyroluria with Jules Galloway ND

The Low Tox Life Podcast #18: Jules Galloway – Is Pyrroles the key to you feeling better?

Functional Nutrition Academy Feb 2017 Intake

Pharmacological Lactation Suppression

Contemporary models of severe psychotic forms of mental illness assume it is triggered by dysregulation of dopamine, i.e. chemical imbalance, arising from adverse interaction of predisposing risk genes and environmental factors. All successful antipsychotic agents have the ability to act as a D2 receptor antagonist (dopamine inhibitor), raising the question as to whether those with have or at risk of psychosis are susceptible to onset or exacerbation of psychosis when prescribed D2 agonists (dopamine activator).

Early postnatal period is a time of high risk for psychosis. The underlying pathophysiological mechanisms of postpartum psychosis are poor understood.

FDA recommends against the practice of prescribing D2 agonists (activator) due to longstanding evidence about cardiovascular disease and neurological risks.

Pharmacological Lactation Suppression with D2 Receptor Agonists and Risk of Postpartum Psychosis – Dr Josephine Power, International Marce Society Conference 2016.

Reference

Snellen et al. 2016. Pharmacological lactation suppression with D2 receptor agonists and risk of postpartum psychosis: A systematic review.

Jammed Up

The start of 2017 has not been the greatest with a few health expressions to slow me down. The first week I endured a 3 day migraine with the second day resulting in a blood shot left eye; not a particularly great look on the first week back to work. Last week I took sometime to slow down and listen to my body with another health expression. I spent time bed napping and resting with body aches, stuffy nose and a smashing headache. Soothed my razor blade throat with Zesty Mumma ginger lemon-aid (I only had oranges). I had my diffusers pumping with Twenty8 Immune Boost, body boosted with this blend as well as added a few drops to my detox Epsom salt bath. Immune Boost blend is a potent combination of Eucalyptus, Lavender, Tea Tree, Cedarwood and Pine is perfect for strengthening the body’s immune system as well as a powerful decongestant with anti-bacterial properties. Took the edge off the headache with Twenty8 peppermint EO.

With all these headaches I was having recently I really was wanting to see my chiro. 12 months ago this notion would not have even crossed my mind. I have started to see a chiropractor in May 2016 after attending the MINDD Forum and ACNEM which really made me think more about how the postural alignment impacts the state of our health. After the first few sessions my fog of fatigue lifted, the clarity of thought was remarkable, and my chiro was able to pin point areas of concern without me saying a word. My chiro noted the sore spots base of head = adrenals, spot just below my right rib cage = food intolerances, stomach = gut issues, all linked via the vagus nerve (more about this another time).

My chiro worked with my body to promote healing, ironing out the kinks, releasing the tension in my neck and shoulders and discovering a lot of tension was located at the very top of my spine, the seat of much emotion for me. With regular chiro sessions, we got my body to a physical point of wellness, and a place to be able to start working through some of the emotion that had been brought to the surface.  I started to stretch the sessions further apart as life became busy. My body soon told me what it thought of this with the return of headaches. Over the Christmas/New Year I let my sessions slip too long and I unravelled into a health expression. I was grateful for my chiro Living Health Care to see me last week and un-jam me. Now to work out what is going on in my neural tree.

Keeping up the fluids and EOs has helped with a quick recovery, as well as booking in a follow up appointment with my chiro. What tips and tricks do you do when you have a health expression?

Transmission of Trauma

Post Traumatic Stress Disorder (PTSD) is the long lasting effects of stress. In the flight/fight response to a threat, the sympathetic nervous system is activated, adrenaline is released to cope with the stress, then cortisol is released to stop the stress response and breaks down when the threat is removed. In PTSD the cortisol levels are lower, which are a reflection of a greater dysregulation of the HPA axis, including circadian rhythm alteration, glucocorticoid receptivity and alterations in cortisol metabolism.

In trauma survivors the stress responsive can be a transformative experience. The offspring of trauma survivors, such as the Holocaust, were also more likely to experience anxiety and depression and have lower levels of cortisol associated with child adversity.

Offspring make their own changes – is this transmission or accommodation? Developmentally programmed changes allow more flexible responding but may be a mismatch for the offspring.

Intergenerational Transmission of Trauma – Epigenetic mechanisms, the in Utero Environment and Early Attachment – Dr Rachel Yehuda, International Marce Society Conference 2016.

Further reading

Yehuda & Le Doux 2007. Response variation following trauma: a translational neuroscience approach to understanding PTSD.

Yehuda & Bierer 2008. Transgenerational transmission of cortisol and PTSD risk.

Shifting the perinatal paradigm

Conference breakfast with Dr Vijay Roach from the Gidget Foundation was sensational! It was so enlightening to listen to a doctor share their personal story of his family experience of perinatal mental illness from both a husbands and a doctors point of view. Dr Vijay reminded me of my own obestrician, who I still can recall visiting me in the mental health ward in his jeans and a tshirt, visiting me to see how I was going even though as doctor his duties were completed. This presentation by Dr Vijay was like an apology speech to me from the health professionals for what I have been through during my pregnancy, my traumatic birth expereince and my episode of postpartum psychosis. In tears, I gave Dr Vijay a huge hug of gratitude as a thank you on behalf of all consumers.


Different people have different perspectives including those in the birth industry. The birth industry is all about the things we ‘must’ do; natural birth, not drink alcohol, breast feed or demand feed and it goes on. Consumers are in the best position to understand what they experience. The Gidget Foundation is run by consumers and the Marce Society should be overrun by consumers (certainly not the case from what I saw at the 2016 conference). Illness works for health professionals, as an authority, understanding big words, knowing what is best for you even though they have never listened to your story, they disempower us with the words they speak.

Doctors will interpret the patient in the first 18 seconds of an appointment. Do women have a choice? Can women decline an exam? Refuse a test? Which woman wants to be the difficult patient? Doctors fail to recognise our feelings, beliefs, values, history, stories. What if the doctors don’t know all the information?

A male gynaecologist is no more disadvantaged, not limited by gender, as they too have the lens to make decisions, to listen actively in planning, pregnancy, trauma, birth to see the world through the woman’s lens. At no point in time did someone ask how we felt. We forget that women are people too, expect to do everything right, the pressure on pregnancy and mothers is huge.

We need to acknowledge what women give to us all. What doctors see as reality as correct is not right. Doctors communicate the fear yet missed the point. What happened to me? I need to understand why? We felt disempowered, no choice, had to do what the doctor said. Doctors hadn’t deliberately tried to harm but by participating in her trauma as health professionals we need to examine ourselves.

Think about the words we use, the posters of motherhood bliss in hospital wards. The gutless implications of the words we use. We do medicalise pregnancy and birth yet no one talks about the wonder of becoming parents and the human inside the womb. We forget the joy of existence. If we miss that, what else is existing? Consumers are people. If we are going to shift the paradigm we don’t need to disempower the consumer, we need their input. The true gift of the health professional is to empower those who seek their help. Its powerful to do no harm and to care; maybe we can make a difference. If we are going to change the paradigm we need to make the shift.

Gidget Breakfast Session – From Illness to Wellness; shifting the paradigm in perinatal mental health care, Dr Vijay Roach, International Marce Society Conference 2016.

Prenatal stress

A mother’s emotional state while pregnant has long lasting effects with cultural, environmental and biological differences. Foetal programming has different sensitive periods and our environment starts in the womb. Sensitive early mothering helps attachment, and can counteract some of what happens in the womb.

It is not just toxic stress that is associated with changes in development and behaviour. Prenatal stress can be pregnancy specific anxiety, maternal mental health and daily hassles. The associated risks in children are that they are more likely to have anxiety and depression, increased aggression, impaired cognitive development, sleep problems, temperament issues. There are risks of physical changes including low birth weight, preterm delivery, decreased telomere length (impacts longevity), decreased immune function and altered microbiome. Some are more affected than others due to the gene-environment interactions, for example, the more depressed, more methylation, more epigenetic changes. 

Just think of the impact globally stress may be having on the next generations. For more info check out http://www.beginbeforebirth.org/

Effects of prenatal anxiety, depression and stress on the child: global implications – Professor Vivette Glover, International Marce Society Conference 2016.

Factors influencing decision making

1 in 5 risk of postpartum psychosis and half are considering pregnancy plans. Research is revealing the large variety of factors influencing decision making for women with bipolar disorder including social support, family history, stigma and fear.

Understanding the importance of stigma, contextual factors such as time pressures and social support from their partner and family, local service provision, fear including the fear of becoming ill and fear of social services, and the centrality of motherhood.

This study also enabled the inclusion of views of women who decided against having a child because of bipolar disorder (26%).

This highlights the problems of getting reliable information and advice to women with bipolar disorder and what women want from services as well as the need for more training for health professionals.

Read the full study here http://bjpo.rcpsych.org/content/2/5/294 (open access).

Factors influencing women with bipolar disorder when making decisions about pregnancy and childbirth: a qualitative study – Clare Dolman, International Marcè Society Conference 2016.

Glow

“In giving birth to our babies, we may find that we give birth to new possibilities within ourselves.” – Myla and Jon Kabat-Zinn

GLOW Perinatal Emotional Health & Wellbeing Clinic – a unique concept on the frontier of perinatal and infant mental health – Dr Araobi Udechuku, International Marcè Society Conference 2016

One third of women deliver in the private system and use some form of complementary medicine. The Glow Clinic in Melbourne, provides a holistic approach to perinatal mental health and has extended the perinatal period from the first 12 months to the first 5 years. This unique service includes not only perinatal psychiatrists and psychologists, paediatrics, midwives, lactation consultants but also early parenting consultants, nutrition, yoga, massage, meditation to support wellness in mind & body for the whole family.

I love Glow’s unique concept and model of care particularly with the lack and fragmentation of health services. I delivered my son in the local private hospital and I was admitted during my episode to the local public hospital with follow up through the public system as well. I have been advised to receive the care I would need if we were to have another baby that I am best to deliver in our public hospital; so what is the point of expensive public health insurance? Any complimentary or holistic services or treatment I were up to me to seek out as I recovered. Follow up appointments with a perinatal psychiatrist were self-initiated only because we were contemplating in having another baby and this was 2 years after my episode. If I see a general health professional or even the local child health clinic, it is up to my own discretion if I mention about my mental health history and how it impacts on my current care needs.

If a service existed like Glow in Sydney I would be still eligible to be receiving care with my son now 4 years old, my whole family would be taken care including my husband who would have the support he needs/needed, I wouldn’t feel conflicted between my wellness and nutrition approach and the advice of health professionals, perhaps I may not have fallen through the medical system cracks and be missed in follow up after my episode, and I would feel more comfortable if we were to have another baby that I would have effective management and support I need in a holistic, integrated, collaborative space.

At risk

131,000 women a year with postpartum psychosis, of which it’s suspected they do not get top care if getting any care at all, with a higher prevalence and worse care in developing countries.
Launch of the Global Alliance for Maternal Mental Health – Dr Alain Gregoire, International Marce Society Conference 2016.

Severe Postpartum Mood Disorders – Who’s Really at High Risk? – Professor Ian Jones, International Marcè Society Conference 2016.

It is important to know more about the risk for postpartum psychosis as an opportunity for intervention and prevention to avoid devastating outcomes. Postpartum psychosis has a rapid onset with the vast majority of cases in the first 3 days to 1 week.

The risk for developing postpartum psychosis is not evenly spread across the perinatal spectrum. Certain groups of women are at a higher risk including  bipolar disorder and those who have previously experienced postpartum psychosis.

The risk for postpartum psychosis is about 50% if the mother has experienced a previous episode. The recurrence rate range is 14-57%, the differences in rates accounted by the differences in methodologies, differences in managements and the differences in the classification of bipolar disorder.

The risk profile for postpartum psychosis is different to bipolar disorder warranting different approaches for treatment. The lifetime pattern of postpartum psychosis has a strong association with bipolar I. A problem with diagnosis of postpartum psychosis occurs as 10% of the population is on the bipolar spectrum, along with with over-diagnosis, perceptions of psychiatrists, pressure from patients to give a label. All this matters because of the overburden of services, worry women unnecessary, combining bipolar disorder with postpartum psychosis underestimates the risk and can include the wrong women in research studies.

Women who have no perinatal episode have a 32% risk of postpartum psychosis. Further variables do not add to the predictive value of having an episode in a first pregnancy. There is a vulnerability of sleep loss in experiencing a manic episode.


There is research into the genetic markers of postpartum psychosis however this is dependent on sample size. Professor Ian Jones is seeking DNA samples from women who have experienced postpartum psychosis.

References

Di Florio et al. 2013. Perinatal episodes across the mood disorder spectrum.

Langan Martin et al. 2016. Admission to psychiatric hospital in the early and late postpartum periods: Scottish national linkage study.

Kendell et al. 1987. Epidemiology of puerperal psychoses.

Robertson et al. 2005.  Risk of puerperal and non-puerperal recurrence of illness following bipolar affective puerperal (post-partum) psychosis.

Bergink et al. 2012. Prevention of postpartum psychosis and mania in women at high risk.

Katie Lewis et al. 2016. Is sleep disruption a trigger for postpartum psychosis?

Jones & Craddock 2007. Searching for the puerperal trigger: molecular genetic studies of bipolar affective puerperal psychosis.

Bergink et al 2013. Immune system dysregulation in first-onset postpartum psychosis.

 

 

Marce Conf books

I indulged at the International Marcè Society Conference for Perinatal Mental Health in getting a few books!

📗Eyes Without Sparkle by Elaine Hanzak – the first book I read about a lived experience of postpartum psychosis.

📘Another Twinkle In The Eye. Contemplating another pregnancy after perinatal mental illness by Elaine Hanzak – haven’t been able to read this yet despite borrowing a few times from the library. May bring me closer to making peace with my decision.

📙 Beyond The Baby Blues by Catherine Knox, Benison O’Reilly & Seana Smith – a must have after hearing Dr Vijay Roach speak at the Gidget Foundation breakfast and chatting with Catherine personally.

📗A Mother’s Climb Out of Darkness. A Story about Overcoming Postpartum Psychosis by Jennifer Hentz Moyer – Jennifer is pioneer spokeswoman for education and support for postpartum psychosis and shares her lived experience in this book. This can be a tricky book to find.

📘The Polyvagal Theory. Neurophysiological Foundations of Emotions Attachment Communication Self-Regulation by Stephen W. Porges – been on my wish list since meeting Holly Bridges at the MINDD forum.

📙Scared Sick. The role of childhood trauma in adult disease by Robin Karr-Morse with Meredith S. Wiley – how our innate fight-or-flight system can unexpectedly become an agent of chronic illness if overworked in the early stages of life. This intrigued me with knowing the SD Protocol.

If you can’t find me you may find me curled up with a book…

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