Episode 15 – Erin Salomon on Postpartum Depression, Maternal Mental Health and the Baby Blues

Episode 15 – Erin Salomon on Postpartum Depression, Maternal Mental Health and the Baby Blues

From reality TV production to social worker, today’s guest Erin Salomon focuses on maternal mental health including postpartum depression in moms & dads, risk factors and how it is different from “the baby blues.”

 

Links and Support:

Call the PSI Warmline at 1-800-944-4773(4PPD)

http://www.postpartum.net/get-help/psi-warmline-english-and-spanish/

The PSI Warmline is a toll-free telephone number anyone can call to get basic information, support, and resources. The Warmline messages are returned every day of the week. You are welcome to leave a confidential message any time, and one of the warmline volunteers will return your call as soon as possible. If you are not able to talk when the volunteer calls you, you can arrange another time to connect. The volunteer will give you information, encouragement, and names of resources near you.

NEW! TEXT THE WARMLINE — 503-894-9453

 

IN AN EMERGENCY:

National Suicide Prevention Hotline and Website

1-800-273-8255

www.suicidepreventionlifeline.org Call for yourself or someone you care about; free and confidential; network of more than 140 crisis centers nationwide; available 24/7

 

CRISIS TEXT LINE:

Text HOME to 741741 from anywhere in the USA, anytime, about any type of crisis.

 

Bio From Erin Salomon, LCSW:

https://www.erinsalomon.com/  

There is nothing that gives me greater satisfaction than helping people discover their strengths and self-worth.  My greatest joy is seeing clients improve their lives and create positive change. As an adolescent, I benefited from counseling which allowed me to navigate my own adjustments, and I’m pleased to now use the skills I learned to help others.  My clients describe me as a great listener who gives honest and direct feedback. I create a safe space for change using deep empathy, warmth, and humor.

I wholeheartedly believe in self-improvement and stay abreast on new developments in the field – regularly attending seminars and workshops. With nearly a decade of experience counseling adolescents and young adults, I have helped countless clients create positive change and develop deeper relationships in their own lives.

I received my Masters in Social work from New York University and obtained my undergraduate degree from The University of Texas.  Before starting my own practice I provided treatment to children, adolescents, adults, and families at the University of Kentucky’s Department of Psychiatry.  While in New York I counseled children who witnessed domestic violence at STEPS to End Family Violence. Prior to my time at STEPS, I served as a case manager at Harlem United, where I connected adults living with HIV/AIDS to mental health and medical care in their communities. I have training in Trauma Focused Cognitive Behavioral Therapy, Cognitive Behavioral Therapy, Family Functional Therapy, and Dialectical Behavioral Therapy.

When I am not at work I enjoy traveling and relaxing with my husband and two daughters, spending time with friends, reading, and walking my dogs.

 

Other Credits

The middle music “Meekness” by Kai Engel is licensed under a creative commons Attribution License

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TRANSCRIPT
Transcripts are created using a combination of speech recognition software and human transcription and may contain errors. Please check the full audio podcast in context before quoting in print.
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Dr. Jones:            Hello and welcome to the Social Work Conversations podcast, produced by the University of Kentucky College of Social Work. My name is Blake Jones. Here we explore the intersection of social work research, practice, and education. Our goal is to showcase the amazing people associated with our college and to give our listeners practical tools that they can use to change the world.

Dr. Jones:            So I’m joined today by Erin Salomon. Erin, thanks for coming on the podcast.

Erin:                       Thank you so much for having me.

Dr. Jones:            It’s good to see you and  just got to know you a month or so ago and really enjoyed  getting to know kinda your background and you are doing a little bit of a foray into private practice and you’ve opened your own private practice. We’ll talk about that in in just a moment, but wonder if you could tell us a little bit about your journey into social work. How, what got you into social work?

Erin:                       I actually used to work in television production before I got into social work and it was really fun and allowed me to be really creative, but wasn’t really fulfilling and I was volunteering a lot on the side and for the reality show I was working with a lot of teenagers and families.

Erin:                       And just found myself gravitating towards that and wanting to work more with teenagers and more with families and was more interested in the volunteering that I was doing rather than the script writing and the editing, things like that- so after doing some soul searching and talking to some friends I decided that social work was the right path for me that I could dedicate my life to serving others. So that’s how I ended up here.

Dr. Jones:            Wow from so you did reality TV?

Erin:                       I did. Yeah I worked for a long time on a show called Made on MTV.  Have you ever heard of that show?

Dr. Jones:            I have not. No.

Erin:                       Not watching a lot of MTV these days probably?

Dr. Jones:            well I’ll have to ask my kids-

Erin:                       (laughter)

Dr. Jones:            … they probably know about it.

Erin:                       So it’s a reality show about kids who wanna be made into something so it might take you know a shy introverted boy who wants to be the star basketball player. And we’ll sort of bring in like a D-list celebrity to help coach them along the way and then they have the try-out so-  it’s an interesting show in that you get to follow somebody’s journey really closely and see what makes them who they are, why they wanna change, and that part I rea- got really into-

Dr. Jones:            Yeah.

Erin:                       … rather than all the other ya know editing and things like that.

Dr. Jones:            Interesting so you got into kinda the social worky part of the show.

Erin:                       … I did. I found myself really connecting with these teenagers and connecting with their families and talking to their schools and I found myself sort of becoming more of a mentor to these kids. They would text me and say what do I do about this- or just found myself wanting to guide them in some way and so I decided that that’s really what I wanted to do was hopefully help support people and guide people.

Dr. Jones:            Hmm interesting. So you’re on their journey with them even back then-

Erin:                       I was.

Dr. Jones:            … with kids.

Erin:                       Yeah.

Dr. Jones:            So you’ve worked with teenagers in in your clinical work?

Erin:                       so I started with teenagers and children and that’s sort of how I got into what I’m doing now because I’ve always worked with children and teenagers and their families. And so working with parents is always been what I’ve, part of what I’ve I’ve done-

Dr. Jones:

Erin:                       … and then after having my own kids and being around my friend group, we all have young kids or most of us have young kids. we’ve talked a lot about the joys and struggles of motherhood and so I’ve started gravitating more towards new parents as oppose- as opposed to working with the parents of the children- that I was working with.

Dr. Jones:            Yeah. Ya know teenagers are a notoriously tough  group to work with in therapy. I think and maybe that’s just me, but I wonder if you found some ways that that helped you connect with teenagers in your practice?   What do you, what do you do to connect with them?

Erin:                       Well I think there’s people who really love working with teenagers- and then I think there’s people who kinda wanna steer clear.

Dr. Jones:            Yeah.

Erin:                       And I’ve always been in the camp of loving them. I just love, I just love the way their brains are working at that stage- and that they’re so open and I just find it really easy to work with them, but I think  also I really remember what it was like to be a teenager very vividly.  And how what seems like small decisions to adults can be everything at that stage. so I really kinda connect to that and allow that to be really big.

Dr. Jones:            Hmm.

Erin:                       Where as I think ya know sometimes I think we dismiss teenagers not meaning to or not out of bad intentions, but sometimes we’ll say oh that’s just ya know-

Dr. Jones:            “That’s just drama.”

Erin:                       … that’s just drama-

Dr. Jones:            Yeah.

Erin:                       … or that’s just young love and ya know when you’re a teenager that’s just everything.

Dr. Jones:            Sure.

Erin:                       So I allow that to be I guess.

Dr. Jones:            Yeah yeah. That’s really good. I have teenage sons and I, I’ve kinda learned that lesson too as a dad to  to just really listen-  ya know not give so much advice, but really listen to what’s going on with them and let and try to enter into their world a little bit.

Dr. Jones:            I think as adults we don’t and as therapists maybe we don’t do that enough.

Erin:                       Yeah.

Dr. Jones:            So you’ve kinda been on this journey and I wanna talk with you really focused today on your area of expertise which is in maternal mental health.  And  wonder if you could talk a little about your journey there? And then we’ll get into ya know maybe advice that you have for new moms that are struggling in this area and new dads as well. But, what drew you to this area of clinical practice?

Erin:                       So while I was working at the Department of Psychiatry at the University of Kentucky, I worked a lot with children and families — and parents. So my passion about helping children and teens with depression, anxiety married by what was happening in my current life, which was becoming a mom-  working with my friends who are moms merging those two together and helping new moms just seemed like a natural fit. Because I really believe that if you can help new parents and new moms that the outcomes for the children will be better.

Dr. Jones:            yeah so you are are a new mom.  You have two young children? How old are your kids?

Erin:                       I do. my oldest one’s almost three and my youngest is seven months.

Dr. Jones:            Wow.

Erin:                       So I’m still in the trenches. (laughter)

Dr. Jones:            (laughter) So you have been while you-

Erin:                       It’s the coffee, a cup of coffee in front of me. (laughter)

Dr. Jones:            Absolutely, I, I’ve found coffee to be my greatest friend as a young dad, yeah.  So as you were doing your therapy and that you were also  becoming a new mom-  what lessons did you learn about yourself when you were becoming a mom?

Erin:                       Oh gosh, so many,  I mean before I had kids I think that one I’m really lucky that I have such a great support system. I have a really supporting loving husband and family and friends and I make self-care a priority which I know you talk a lot about self-care to your students which is really a gift that you’re giving them to make that a priority at this stage in their career.  so I had a lot of support and a lot of self-care in place and I was so excited to be a new parent, felt great when I was pregnant so I was really surprised how difficult it was afterwards and how there’s really not a lot of check-in.  When you’re in that really, really difficult new phase where you’re sleep deprived and you don’t know what you’re doing and you’re wondering am I doing all of this right. women have a six weeks follow up usually- after childbirth, but beyond that there’s not any sort of, hey how’s it going with you?

Dr. Jones:            Right, right.

Erin:                       so I was a little bit surprised about how lonely and isolating it could feel at times — and I’m a go, go, go type of person so just-

Dr. Jones:            Mm.

Erin:                       … being able to kind of sit and be with this newborn and just be, I found really challenging.

Dr. Jones:            Mm. So what did you do?

Erin:                       (laughter)

Dr. Jones:            (laughter)

Erin:                       That’s a good question. really went back to the basics of what I know works.

Dr. Jones:            Mm.

Erin:                       So for me,  self-care, part of my self-care is exercise. Making time for myself- and I had to tap into my support system to do that. asking for help when that’s kinda difficult for some people to do. So I really just had to go back to those basics, working with a therapist- talking about it to my friends and family. Being really open about it helped.

Dr. Jones:            You know I’ve thought a lot about this and and we struggled, both of our sons were born in the dead of winter. January and  three weeks after my second son was born, we had this terrible ice storm in Kentucky and all the power, it went on for days- and all the power off and I remember just sort of sitting with him in front of the fire, , trying to keep him warm. Ya know just-

Erin:                       Wow.

Dr. Jones:            We had gas logs and just just we could not leave our house so we had no electricity and , ya know my wife had just had him and and she was really struggling with some depression and and I was, we had another son too and I was just really, it was just a bad place ya know and he wouldn’t sleep. They had jaundice and just sort of all this stuff and I remember how overwhelming that felt and I was a therapist and  ya know Ph.D. student and this, all these resources around me and it made me think about the people that don’t maybe don’t have the resources that you and I had- when becoming new parents ya know what do they do?

Erin:                       I thought about that a lot in my situation that being a therapist I was so lucky to also know how to navigate the mental health system which-  I think is really overwhelming and confusing for people who, for most people- but so I thought about that a lot how fortunate I am to know how to get myself out of this situation. And that I wouldn’t be feeling this way forever, but  yeah it’s really difficult for people who don’t have resources or are unfamiliar with the mental health system or have never experienced depression before- and don’t know what it is or what to do.  fortunately there are some really good resources out there. I don’t think a lot of people know about them- but one is PostpartSupport International. They have online group support. So you can talk to somebody through video chat or over the phone to be able to get some immediate support.

Erin:                       Which I think is really terrific.

Dr. Jones:            Yeah, yeah that’s great. Postpartum?

Erin:                       Support International.

Dr. Jones:            International. Okay, great.  it feels like maybe society sort of discounts postpartum depression as well. I, I, that might be changing some, but ya know it’s supposed to be a happy time when a baby is born-  and we post pictures on Facebook and ya know where everyone is supposed to be ya know this new th- ya know blessing came into the world. But for women and men, which you’ve educated me about, we’ll talk about that in a moment- but it must feel very lonely to have that that sort of discounted by the larger society.

Erin:                       I think you’re absolutely right that we have this impression that parenthood is just going to be filled with all these moments of joy and happiness-  all the time which there are absolutely moments of joy and happiness and also moments of real struggle.  And I think people are really afraid to talk about that struggle because they’re afraid they’re going to be judged or people will think they’re not a good parent or they don’t wanna be a parent when that’s not really the case. It’s just the reality is sometimes it’s really great and sometimes it’s really hard.  I hope we’re getting better about it, I mean the fact that it’s  in the DSM now is optimistic. I think that there is a lot of room to move forward there. But, I think the more that we talk about it, ya know more people will be educated-  but all pregnant women have to be screened for gestational diabetes-  and that affects a general population of about 7% of pregnant women. Where they’re estimating about 20% of women are experiencing postpartum depression. So the fact that that number is so large and we’re really not doing a good screening or good treatment or talking about it very much to me is really alarming.

Dr. Jones:            yeah so there will be a number of women and men, new moms, new dads who are listening to this podcast and I wonder if we could talk a little bit about, what are the signs, what are the things that new moms and dads should be looking for that should be of concern?

Erin:                       That’s a great question so postpartum depression looks a lot like a depressive episode but is accompanied by severe anxiety often panic attacks. So some people will say well I don’t feel depressed, I just feel really agitated or really worried or really frustrated which is really common. It’s more of an irritable depression. Some things you wanna listen for are when, if if you ask them, are you able to sleep when the baby’s sleeping? And they say no I can’t stop thinking about this, or my mind is racing- That’s a warning sign. That’s a warning flag that they might be struggling. You also wanna listen for any problems with attachments so if they’re not referring to the baby by name- or if they’ve really, really expressing hopelessness, tearfulness,  some moms are experiencing  suicidal thoughts or har- thoughts of harming their children.  The thoughts of harming their children are extremely rare. A lot of times that’s what we see in the news, but that’s very, very rare. That’s like one of 1500 pregnancies  does a person experience any sort of psychosis or delusions- … that’s really rare, but suicidal thoughts is much more common. In fact, the number one cause of death for women postpartum suicide.  So some questions you might want to ask a new parent is, are you having any thoughts that scare you.  That open up the conversation about  maybe thoughts they’re having about wanting to hurt themselves or hurt somebody else or just scary thoughts that they might have that they’re not used to like I keep having these thoughts in my mind about that I’m actually going to drop the baby or- ya know that I’m gonna leave the baby somewhere. Things that make me feel uncomfortable or scared that they might not want to just share openly right away.

Dr. Jones:            Yeah, yeah. Well, Erin I wonder if you could talk a little bit about the risk factors. Ya know a lot of therapists listen to this podcast and  I wanna make sure they know and family members know and and our listeners know, what are some things that put women in particular at risk for postpartum depression?

Erin:                       That’s a great question.  one is a genetic predisposition so a history of mood disorder or if someone in the family’s had postpartum depression-  or any sort of hormone sensitivity. another one is a history of trauma.  one thing that we don’t really talk about a lot in the field is someone who has  experienced sexual abuse.  How triggering that can be-  be examined multiple times during the pregnancy and then also during delivery. So history of trauma is one. Any sort of social stressors, a change of job, financial stress, stress in the relationship- of course sleep deprivation which ya know (laughter)-

Dr. Jones:            (laughter)

Erin:                       … that’s just part of having a newborn.

Dr. Jones:            Right, right.

Erin:                       those are all risk factors to look at.

Dr. Jones:            Tell us a little bit about – the  colloquial term is baby blues that we’ve heard for years. and I think it’s important to distinguish between baby blues maybe kinda what’s normal adjustment to being a new mom a new parent versus postpartum depression. Can you talk a little bit about that and what what’s kind of a typical course if somebody gets some treatment for postpartum depression? What are they, what are they looking at in terms of treatment?

Erin:                       so baby blues most women who have been through childbirth have experienced baby blues. I think it’s up to 85%. And that’s kinda defined as some tearfulness, feeling overwhelmed- and that usually ends around two weeks. So it’s right after pregnancy til about two weeks and then women start to feel a little bit back to themselves. If you’re not feeling back to yourself so if you’re having any sleep issues, maybe ya know trouble falling asleep while the baby’s asleep or feeling hopeless, feeling like you’re a bad mom- that’s often symptoms. I’m just doing this wrong, I’m a terrible mom.  that or you’re having intrusive thoughts about harm that could come to your child or fears of letting other people hold the child. Things like that-  that’s not typical and that’s not baby blues. So that’s something you wanna have  talk to your OB-GYN or talk to a mental health counselor about. And what the treatment looks like is  a lot of times medication is helpful is there’s any sort of- ya know sleep difficulties, suicidal thoughts, anything like that we definitely need to be talking about medication. and then therapy, Cognitive Behavioral Therapy and Interpersonal Therapy are the most evidence based- for postpartum depression. And then other things you wanna look at are self-care and getting more support for from family.

Dr. Jones:            so what would an example of Cognitive Behavioral Therapy look like? What would you be focusing on there with a client?

Erin:                       So examining their worries or examining their  ya know distorted thoughts. “So I’m a bad mom”- what evidence do we have to suggest that worrying about their fears, maybe doing some exposure things about fears that they might have of other people holding their children, things like that.

Dr. Jones:            yeah and I think really related to all of this is anxiety. We’ve talked a lot about depression, but anxiety  is kind of inherent I think in being a new parents- and so we have to, to look out for things like, like severe panic attacks,  agoraphobia-

Erin:                       Hmm.

Dr. Jones:            … ya know staying in the house not going out, right?

Erin:                       Absolutely.

Dr. Jones:            Yeah.

Erin:                       Which makes treatment really difficult.

Dr. Jones:            Yes, yes it does.

Erin:                       You know there’s some real barriers for new moms as far as getting treatment. It’s the time,  the cost a lot of times new moms make their own self-care the the bottom priority. So actually getting them into treatment is difficult.

Dr. Jones:            Yeah, yeah. I know  I’ve talked with a number of new mothers who, ya know especially if they’re breastfeeding is like they, they’ve, they’re just exhausted. Ya know they, they can’t, they can’t sleep, they’ve ya know they’re they feel like the refrigerator, right?

Erin:                       (laughter)

Dr. Jones:            For the, for the baby, and just they’re just always have to be ya know there-

Dr. Jones:            …and I think ya know as men I think it’s hard for us to understand that sometimes just that sort of constant worry about having to be that connected to this other human, right?

Erin:                       Absolutely, absolutely and I think there’s been a big push for for people to breastfeed which- I think everybody should be entitled to make their own- choices.

Dr. Jones:            Mm.

Erin:                       And a lot of times, women who are experiencing postpartum depression are really afraid to be on medication if they’re breastfeeding because they’re afraid how that might impact the child, or even while they’re pregnant.  So that can be, breastfeeding can be a really wonderful experience for some people and really a stressful and difficult experience for other people and I think we should be able to talk about all of those experiences and all those experience  for them to matter.

Dr. Jones:            Talk a little bit about postpartum mood issues in men. If you would, new dads.

Erin:                       Sure, sure so postpartum depression they estimate about one in ten dads experience postpartum depression.  There are some risk factors. If you have a history of mood disorder or if your partner is experiencing postpartum depression those increase your likelihood of being depressed yourself and men don’t, well I’m generalizing here, but I think men have a harder time reaching out. One because maybe they feel like this isn’t about me, this is about the mom or maybe this is just normal thing becoming a dad – so maybe they might have a more difficult time identifying what’s going on or maybe this is just sleep deprivation. So that can be hard to identify. I think a lot of people don’t even know that men can suffer with postpartum depression.

Dr. Jones:            Yeah, I’d never really thought about that before we started, started talking about it. But I, again as kind of a new dad I felt, I felt my role was really to  take care of my wife who was really struggling and and  as a mental health person and and just trying to  help her during that time, but I also ya know was a bit overwhelming to, to see her struggle and then ya know the sleep deprivation and the just everything ya know trying to figure out what it means to be a parent, right? They don’t give you a manual when you drive away from the hospital. (laughter) They just-

Erin:                       Too bad they don’t. That’d be helpful. (laughter)

Dr. Jones:            That would, Wouldn’t that be helpful? For like, if had little robots or something.  Oh I remember looking in the back seat ya know after the nurses had cared for my son and everything and they just waved and said you know good luck and we drove out of the hospital. That’s when it hit me-

Erin:                       I know.

Dr. Jones:            … that this is really real.

Erin:                       Like they’re trusting me to do this?

Dr. Jones:            Right (laughter) right, I don’t know how to do this.

Erin:                       (laughter) What?

Dr. Jones:            I’ll figure it out I guess.

Erin:                       Yeah.

Dr. Jones:            So you’re moving into your own private practice that you’re going to specialize kinda in this area, is that your plan?

Erin:                       It is, it’s hard, I I go back and forth about specializing, I mean this is a passion of mine so- I think that comes through in my work with people.

Dr. Jones:            Right.

Erin:                       But, I also really love teenagers still. I can’t ever give up that love for teens and I also work a lot with women and men with eating disorders.  So I would say those are my specialties. but, I’m really passionate about talking about maternal mental health because I think the more that we can talk about it, educate providers, ya know the better that providers will be because ultimately it’s a family issue.

Dr. Jones:            Yeah and I think that’s where social work is so powerful is that we see the inter-connectedness of families, churches and synagogues, ya know schools, the pediatricians I mean  it seems like they really have to continue to push this issue about assessment right of postpartum depression.

Erin:                       Pediatricians are often on the front lines of identifying this because women follow up with their OB-GYN about six weeks postpart and but the highest onset of symptoms is usually between eight and ten weeks. So even for the women who are getting screened, we’re missing a lot of people. So often times it’s those couple months follow up that the pediatricians are identifying people so it’s really important to stay connected with them and educate them about what postpartum depression looks like and be able to give them resources so they can refer people appropriately.

Dr. Jones:            Well on today’s podcast we have talked about some pretty heavy subjects here and we wanna make sure that our listeners know that there’s help available for them so I I want to give out the the  number for the National Suicide Prevention Hotline and that number is 1-800-273-8255 again that number is 1-800-273-8255 and Erin you have a number that you would like to give out as well.

Erin:                       Postpartum Support International has a warm line and that number is 1-800-944-4773.

Dr. Jones:            Well Erin we always try to talk about self-care on this podcast. You’ve listened to some of our other ones and  doing therapy and working with people that are just in a lot of pain is is very stressful I mean I feel that stress sometimes and  I just kinda wonder what you do to take care of yourself as a new mom, as a therapist, as somebody who’s starting a a new business. What do you do to take care of you?

Erin:                       So my self-care is exercise. It just has to be a priority. Any time that I push it off and then I start to feel it. Ya know? I start to feel myself  being tense or just holding on to stress more so- exercise I just have to make the time for it and even if that’s just walking my dogs and listening to podcasts. Cause we both have our  podcasts we listen to all the time-

Dr. Jones:            Right.

Erin:                       … I know we both share that. so exercise for me is the priority.

Dr. Jones:            Well Erin I really wanna thank you for coming on and I just  appreciate your work so much. Ya know we, we’ve had some  episodes about suicide and and I do research in suicide and several of our faculty members here do and ya know to me that’s the ultimate tragedy.  When that happens and and so I see your work as life-saving, I mean I’m so so grateful for that and and grateful for the moms and dads that you’re gonna help through your life so thank, thanks.

Erin:                       Thank you and thank you so much for being open about your experience and talking about it cause I know that not everybody feels so comfortable. Think gosh this was really hard so I think you being about to talk about your experience and your wife’s experience is really it’s a gift I think that you’re giving your listeners.

Dr. Jones:            Yeah, thanks. Well good luck.

Erin:                       Thank you.

Dr. Jones:            You’ve been listening to the Social Work Conversations podcast. Thanks for joining us and now let’s move this conversation into action.

Narrator:             This production is made possible by the support of the University of Kentucky College of Social Work, Interim Dean Ann Vail, and all the faculty and staff who support researching contemporary social problems and prepare students for the Social Work profession. Hosted by Dr. Blake Jones, produced by Jason Johnston with thanks to our webmaster, Jordan Johnson, music by Billy McLaughlin. To find out more about the UK College of Social Work, and this podcast, visit socialwork.uky.edu/podcast.