resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
June, 2009, Vol. 09, Issue 06
By Elaine Stillerman, LMT
A friend of mine recently admitted that she suffered with postpartum depression (PPD) after the birth of her twins. It wasn't so much her emotional state that took her off guard, she said. But rather that her depression began when they were 5 months old.She was unaware, as are so many new mothers, that the onset of PPD can begin as long as a year after childbirth. All too often health care providers fail to connect a woman's depression with labor and birth after several months have passed since delivery - leaving the mother even more despondent.
It is not at all unusual for most new mothers to experience mood disorders after the birth of their child. The dramatic shift in hormones, the labor and birth, and general fatigue all contribute to fleeting feelings of sadness. As many as two-thirds of new mothers worldwide experience postpartum blues, also known as "baby blues." The onset generally occurs at about day three and the duration of these transient feelings of sadness is about a week or two. The blues are characterized by weeping, insomnia, fatigue, moodiness, and anxiety but is self-limiting. With some rest, support, sunshine, and compassion, these feelings recede without lasting effects.
Since the blues are short-lived, a nurturing massage can be profoundly relaxing and help speed up the emotional healing.
Points of a nuturing massage: Include stimulation to Spleen 3 (Sp 3), under the balls of each foot on the arch, to help balance hormones. Press this point for a count of 6 and repeat a total of 6 times. Sp 6, the uterine tonifier, should also be stimulated. Measure approximately 2 1/2 - 3 cuns (width of a fingertip) from the medial ankle bone posterior to the tibia. The point should be sensitive.
However, for 10 percent to 20 percent of new mothers, the emotional symptoms are more severe and can be debilitating. These women may suffer from postpartum depression, the most common complication of pregnancy, which has a later onset and more exaggerated symptoms. In these instances, massage practitioners should work together with a mental health professional to provide the most supportive environment for the new mother.
Symptoms of PPD
The etiology of PPD is unclear and is varied from woman to woman, but certain factors are suspected to contribute to its development: hormonal fluctuations, any preexisting medical problems, personal or family history of depression, marital dysfunction or general lack of support and social network, immaturity and low self-esteem, negative feelings about the pregnancy, lack of sleep, financial concerns, premature or special needs child, multiple pregnancy, traumatic birth, chronic stress factors, and neurotransmitter deficiencies.
Some important statistics: Teenage mothers are depressed 2.5 times more than older women and African American women suffer from PPD twice as often as white women. Nursing mothers may fare better in avoiding PPD or have less severe symptoms. And for celebrity mothers, PPD is often dismissed or overlooked; it takes a celebrity mother's willingness to discuss her depression before people acknowledge how serious it can be.
The symptoms of PPD almost seem like a typical reaction to childbirth: fatigue, sleep disturbances, and appetite and weight changes. But the red flag should go up when these responses are accompanied by feelings of anxiety, dysphoria, social withdrawal, cognitive disturbances, guilt, hopelessness, helplessness, a sense of worthlessness, or suicidal thoughts.
For women, the symptoms of PPD are similar to major depressive episodes unrelated to childbirth. (New fathers can also experience a form of PPD, as we'll discuss later in this article.) It is also important for the care provider to rule out postpartum metabolic disorders, such as thyroid disease, when assessing PPD because many of the symptoms are similar. Autoimmune thyroid disease can affect up to 10 percent of all women and is often suppressed during pregnancy but is exacerbated during postpartum. Postpartum thyroiditis (PPT) initially presents with a transient hyperthyroid phase 6 weeks to 6 months postpartum. So it appears that the new mother is losing weight in a typical manner. However, this is followed by a hypothyroid phase that can last as long as 1 year. Nearly 6 percent to 9 percent of women develop PPT and manifest symptoms that can readily be construed as depression: fatigue, hair loss, depression, impairment of concentration, inability to lose weight, lethargy, and dry skin.
Both depression and PPT are common reactions to childbirth. As many as 38 percent of women with PPT are also clinically depressed, so it is understandable how difficult it is to determine the cause of the depression. While it is certainly beyond the scope of a massage therapist to make a diagnosis, suggesting that her depression might have hormonal causes that are readily resolved with proper medication may provide support and make her feel less helpless. Regardless of the cause, a client who is depressed should be referred to a doctor or mental health professional who can determine the most appropriate course of treatment.
In the United States, it is estimated that half million women suffer from PPD yearly and that most of them have a history of a mood disorder. The risk of recurrence in a subsequent pregnancy is 25 percent. It is vital that practitioners working with this population recognize the signs and intervene early by referring the client to a mental health professional. One study of PPD found that the depression was less severe for those women whose partners provided them with emotional support. That can extend to include a sensitive massage practitioner. It is interesting to note that in traditional societies where new mothers were celebrated with rites of passage and healing ceremonies, PPD was rare.
Sheila Kitzinger offers several suggestions for new mothers to help them treat PPD. First of all, don't be afraid to ask for help. Make a plan to get out of the house first thing in the morning when symptoms are usually worse; get some exercise, fresh air, and sunshine. Sleep when the baby does and don't try to get everything done all at once. Contact other new mothers and talk with them; seek help if needed.
Although it is not as common or known as women's mood disorders, some new fathers experience their own form of PPD after the birth of their child. These feelings are brought on by fears of becoming a parent, rigid expectations of themselves, feeling ignored by their partner in favor of the baby, and lack of sleep. Manifestations of male (this could also affect the non-birthing female partner) depression might be escaping into work, denying their emotions, outwardly expressing anger at the baby, or complete withdrawal from parenting and relationship responsibilities.
Fathers, often overlooked, also have an adjustment to make to the new member of the household and the better informed they are, the easier this period will be for all concerned. Fathers also need emotional support, for themselves and to be a better support for their partners.
Even more dire but less common is postpartum psychosis (PPP). Affecting 1 percent to 2 percent of the puerperal population, PPP is a clinical emergency requiring immediate intervention because of the heightened risk of infanticide or suicide (especially among young mothers). This psychotic condition has additional symptoms that include sleep disturbances, dissociative behavior, depersonalization, confusion and extreme disorganization, bizarre behaviors, delusions, and unusual visual and/or aural hallucinations. These symptoms can also be an underlying manifestation of bipolar disorder that has a high frequency during postpartum recovery. A woman who suffers from PPP has a 33 percent to 40 percent chance of experiencing it again with subsequent pregnancies. Early intervention dramatically improves the prognosis and prevention of this potentially devastating condition.
Practitioners who massage postpartum women must be on the lookout for any emotional signs that may be troublesome to the new mother. Recognizing these problems early can mean the difference between continued despair or a healthy new lease on life.
Click here for previous articles by Elaine Stillerman, LMT.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.