Ep 44: "You're not alone" with Shannon Weist, Perinatal Mental Health Counselor

In this episode Doula Rachael is talking with Perinatal Mental Health Therapist, Shannon Weist of Maternally Mindful. Shannon Weist is a licensed clinical mental therapist that provides both in person and telehealth services in the state of Georgia. She specializes in infertility, pregnancy and postpartum. Shannon helps to bring awareness and shed light on the importance of creating a therapeutic alliance during infertility, pregnancy, and postpartum. Having a safe, unbiased space to share your most vulnerable thoughts and feelings is vital in effectively and meaningfully supporting birthing people.  In this episode we learn:

• What exactly a Perinatal Mental Health Therapist is and the work they do.
• What led Shannon to do this important work
• What to look for when deciding to hire a Perinatal Mental Health Therapist
• The benefits of seeking mental health therapy during infertility, pregnancy, and postpartum
• Universal screening and who provides this screening and how to make the most of it.
• Warning signs for anxiety, depression, and/or mood disorders during infertility, pregnancy, and postpartum.
• Tips for the partner and loved ones.
• What to expect during your visit.
• Plus Shannon shares her favorite resources

Connect with Shannon:

www.maternallymindful.org (resources tab with tons of books, podcasts and Instagram suggestions)

Instagram: @maternallymindful

Shannon’s Book Recommendations:

The Pregnancy Workbook by Dr. Katayune Kaeni

Good Moms Have Scary Thoughts by Karen Kleiman

Other resources mentioned:

Postpartum Support International 

Edinburgh Postnatal Depression Scale

PHQ-9 Assessment

Follow us on Instagram:

Aligned Birth

Check out our individual websites:

Sunrise Chiropractic and Wellness

North Atlanta Birth Services 

Disclaimer

The information shared, obtained, and discussed in this podcast is not intended as medical advice and should not be relied upon as a substitute for professional consultation with a qualified healthcare provider familiar with your individual medical needs. By listening to this podcast you agree not to use this podcast as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating.  Consult your own physician for any medical issues that you may be having.  This entire disclaimer also applies to any guests or contributors to the podcast.  The podcast hosts take no money from affiliate links provided in the show notes. 

Podcast Editing by: Chris Godfrey of Godfrey Sound

Music: "Freedom” by Roa 

Transcript

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0:06

Hello and welcome to the aligned birth Podcast. Today. I am thrilled to have Shaman wiced on our podcast. She is a clinical therapist with maternally mindful Counseling Center and we are going to talk about all things perinatal mental health. Shannon is a licensed clinical mental therapist that provides both in person and telehealth services in the state of Georgia. She specializes in infertility, pregnancy and postpartum she is a she is certified as a perinatal mental health clinician through Postpartum Support International. She is also a volunteer support coordinator for psi and covers the North Georgia region. So today we are going to talk about what exactly is a perinatal mental health counselor. We're going to learn more about shaman and how she provides services in our community. We're going to talk about how to seek this type of mental health counseling during pregnancy and postpartum and kind of what to look for in that process. And we're also going to talk about the benefits of mental health counseling, universal screening and how mothers can benefit from that and feelings could benefit from that. We're going to talk about, you know what it looks like warning signs for mental health concerns, and how to be proactive in that care. And then some tips for the partner and close loved ones to keep an eye out for regarding mental health concerns. And then we'll learn a little bit more about Shannon her favorite resources that she shares with pregnant and postpartum people and how to get in touch with her. So I'm thrilled to have you on today. Shannon, welcome.

1:37

Thank you so much for having me.

1:39

Yes. Okay. So can you start by telling us what exactly is a perinatal mental health counselor and how did you decide to do this kind of work?

1:48

Absolutely. So apparently, a mental health counselor kind of covers the period. Honestly, preconception all the way through having your baby. So what that looks like is you know, if there is an early loss, you know, maybe when during pregnancy if there's a miscarriage, that's something that someone may seek counseling for, if you're experiencing infertility, and and then also during the pregnancy period, and then one year postpartum. That's kind of what all encompasses that perinatal timeframe. So how I got into this, there's a couple of different things. So first, I have worked with mothers and babies for a very long time. You know, I started out my work doing infant mental health work, which is where you do base visits, and work with the mom and baby and attachment bonding and that was where I first kind of started to develop my love and passion for working with moms and babies. But also, in addition to that, some of my own experiences, which really led me to having a passion for this work. So when I had my first son I remember you know, after giving birth and holding him in my arms and him starting to like fuss for the first time. I felt an immediate rush of anxiety. When you know with those first cries and thinking oh, my gosh, how am I going to handle this? How am I going to calm him? Also not feeling bonded immediately? You know, and I think that that is a misconception in our society is that as soon as you have that baby, that you're going to feel immediately connected and bonded. And while that is true for a lot of women, it's not true for all women. So I would say you know, that was kind of how how some of my perinatal mental health concerns started, I mean, right after delivery, and then My sweet son ended up having colic. And that was a whole new ball of wax that I was not prepared for. And so even with that, you know, I remember days of just going into the bathroom, locking myself in there and sobbing. You know, it's just a feeling of powerlessness. You want to be able to comfort and soothe your baby. And when you've done all the things that then change them, walk them car rides, doctor's appointments, I mean, all the things you can possibly do to help your baby and they still cry for hours on end. is really tough. And so during that time, when I had him that was prior to me being in this field, and so looking back on that now I'm like, Oh my gosh, I wish that I would have talked to someone I wouldn't have had to suffer as long. I could have had someone normalize some of my experiences. Because again, I had I had my son my first son when I was 25, you know, and so still pretty young. And I have been exposed to babies through working in like a daycare and things like that in high school, but I just feel like nothing really prepares you for that. And so again, I think that's what gives me so much passion about this is that I've been through some of those things. I know what can help now, and I just love connecting with mamas in that way.

5:18

Shannon, I love hearing all of that and I appreciate you sharing those intimate details with your early postpartum experiences. And there were so many things you said there that I like kind of want to kind of extract a little bit more from and I think the first thing you mentioned was talking about how mental health counseling during infertility during times of struggling to conceive or miscarriage, and how so many people struggle with that. But you know what I do think more and more people are talking about I do think it's becoming more mainstream, but still it's one of those sort of taboo topics that people feel like they can't talk about, or they don't know that they can seek additional support during that time and how vital support like real, authentic genuine support, not just friends and family, friends and family serve a different kind of true like perinatal health counseling that you provide. During a time when people feel like they probably can't talk to anyone who really understands and can have like tools and resources. So I think that's a really important takeaway to include like people think okay, postpartum I think a lot of people just want it into like postpartum depression or something. Versus Yeah, versus infertility versus struggles during pregnancy versus different, different spectrum. of mood disorders and the type of care you might need. And then the other thing hearing you talk about too, is that I think a lot of people women birthing people struggle with is that immediate, like feeling when your baby's first born, and then the the immediate judgment that comes right away. of yourself or the shame that comes right away to yourself, because you're like, it's not instant love and it's not instant under perfect peace or perfect understanding of the bond. So that there's that bonding kind of therapy to that you can help people work through and is it true that the sooner that type of care is seat that it can kind of reduce or or reduce or shorten the severity of the issue?

7:23

Absolutely, yes, the sooner the better. I do want to say within regards to bonding right after birth, oh, that just the fact that you may not feel bonded immediately, necessarily a reason to seek treatment. Okay, I feel like it can continues, then. Yes. But I guess one thing that I would want people to know is like that's just normalize that experience. You know,

7:47

that's right. That's right. Yes. Good to normalize that there. There may not be an immediate bond. And then if certain things persist, then exactly but then to not have that immediate judgment or shame if you're not if you're not feeling it right away, but the in time though that you're more likely to have a bond.

8:07

You Yeah, and that can be I mean, that can be tough for all mamas, but especially, you know, maybe mothers who are already a little bit anxious, like even prior to pregnancy, mothers who struggle with perfectionism, right? And I would consider myself being one of those people in that camp, which is why it was so hard for me at first because I thought like, Okay, after I have him, everything will be installed and exactly what to do and I will calm him immediately, right, that just doesn't work that way. And so I almost, you know, did myself a disservice and set myself up for lots of guilt and shame, like you said, because I'm like, I should know what to do. Yeah, why is what I'm doing not working? Yeah,

8:55

yeah. And I think that can create a lot of feelings and then that just sort of creates a cycle. That's probably hard to break without some sort of additional support, but I think a lot of that being proactive, probably before conception, being proactive during pregnancy. Yeah, can help people sort of if you are sort of identifying with that perfectionism or kind of aligning expectations, and I think to that, talking about, like normalizing crying for newborns, and then understand the difference in normal crying and colic, right. I think a lot a lot of people say they have a colicky baby but understanding what like true colic is versus normal thing. You know, babies cry but right now, understand the differences. So that that's like setting up the right expectations and then knowing what to do. You know, a lot of this is just understanding resources that and I just don't know, I mean, from my own experiences, the resources there for for this type of support during pregnancy and postpartum. We're not We're not available to me are not part of the mainstream like options right or so I'm so thankful what you're doing. I'm so thankful that you're talking about it, and that there's more awareness surrounding the type of support this can help women and birthing families receive so tell me a little bit. What could someone expect during their first session with you working with you like what does that when or let's back up a little bit, when should someone decide to come see you?

10:23

Yeah, so that's kind of we'll cover that in a couple different parts. So for the you know, there is a loss or speed you know, especially with a loss that is definitely a situation of the sooner the better following bass, and depending on where you're at on your infertility journey. I mean, I guess it would be the case with all the sooner the better. But again, just knowing that that's a possibility, because being able, you know, the therapeutic relationship is really a special one. You know, it's a place where you can go in, talk about things that maybe you wouldn't even talk about with your best friend, you know, you lay it all out on the table in a non judgmental environment. There's a lot to be said for that. You know, and I think especially when people are going through fertility journeys, it is a roller coaster of emotions, you know, there's so many different components to that as far as your egg retrieval and implantation all of the things and depending on the outcome of your embryo transfers, you know, it's you go from happiness to sadness and like such a short period of time. So again, being able to process some of those feelings and emotions with someone who is supportive and understanding, I think does wonders for you know, how a woman feels during that journey.

11:52

Absolutely. And I would love to hear to also so I'm hearing you say like, the sooner the better, right any sort of if you've experienced, especially with loss like that, sort of like an identifiable like okay, this happens I need to probably process with someone and then understanding that family and friends are a very crucial role, but that they're not this type of support. It's so different, how you can be unbiased and, and ask questions in a way and provide options or resources in a way that might be received better than from family or family. All, you know, well intentioned, can sometimes do more harm than good and I know you probably helped provide tools for them to communicate with their support people to help them help each other right. Yeah, and then what would be some warning signs during pregnancy or or when during pregnancy? Should someone seek counseling?

12:56

Yeah, so during pregnancy, you know, if you again know that you have struggled with anxiety or depression in the past, I guess that's kind of a risk factor to be aware of. That that maybe even if you haven't experienced feelings of anxiety and depression and a while, you know, maybe it's been five years or more, but sometimes that can, you know, Spike again during the pregnancy period. And again, there's so much that goes into that. One of the benefits of seeking counseling during pregnancy is for multiple reasons. So preparing for the role transition, right, especially if this is your first child, going from being a person, you know, just being responsible for myself, to then thinking about going into a role of caring for someone else. Thinking about how that might mean am I going to lose myself, you know, is everything that I do are going to be wrapped up in this little one, you know, and again, I think that that is that's kind of a societal standard, almost is that like when you become a mama, your entire life is about your baby. And I'm not saying that there's anything wrong with that, but I think we need to have a balance, right? Like, oh, yeah, you in order for you to be the best mama that you can possibly be. You have to take care of yourself too. So that kind of talking through what that might look like, again, was someone who understands can be really beneficial in prepping for having the baby, but also pregnancy as a time where if you have had previous trauma, or if you had difficulty with your relationship with your parents all of that can kind of start to bubble up to the surface during that pregnancy time. Because you start to think about all the ways in which you want to do things differently. How you want to protect your baby from everything that you went through which again, is is good to think about, you know how you want to do things differently, but what happens frequently get if we're not working with a qualified mental health professional around that, we can start to go down a hole that leads to severe anxiety, panic, all of those things. Because we're so scared about repeating the cycle. And so again, do being able to process that with a counselor is so beneficial and you can find healthy ways to deal with that and create a better life for your little one than what you had.

15:33

And then that kind of leads into the how you probably cope in the postpartum because if they've done this during pregnancy, it's almost like regardless of any sort of current stresses or anxieties or depression, you're experiencing it sort of like it should just be a baseline like talk through this with someone learn about those prior relationships and how those might impact your current situation. And then in the postpartum understanding, you will probably feel very differently than you do now. So it's almost like giving you a framework and a foundation for the postpartum to so it's a little bit more of that proactive care. So they'll kind of know what to look for if they experienced, you know, increased OCD tendencies or increased anxiety or increased Depression during that time and then the loved ones can kind of keep an eye out for it too. So it's definitely like a precursor to that. Postpartum Support to kind of preparing them to do better during that time as well.

16:36

Absolutely. Yeah. I mean, that's certainly what I would advocate for. You know that if Mama's can get into counseling during the pregnancy time, I think you have ideal also because it takes depending on what the woman what her experiences have been. That makes the time as far as like building that therapeutic alliance can take longer, and so you know, it takes a little bit to just feel your therapist out. See if that person is a good fit for you. So if I really feel comfortable and trust that I can tell you my deepest, darkest thoughts and you're not going to judge me, like that takes time to build that relationship. And so if you can start that in pregnancy, then you're you're right, you already have a jumpstart postpartum Yeah, because when postpartum comes, you know, pregnancy, you're kind of preparing for all of the things postpartum, like it's here. It's real. Yeah. Yeah, exactly. And so there's things that come along with that too. I mean, if a woman experiences a perinatal mood or anxiety disorder, it can pop up during pregnancy, but sometimes it might not pop up until postpartum. You know, so we have that we have, again, like the role transition, but then it's really real, and I'm really experiencing it. It can change the relationship with you and your significant other, right? Just because it was just the two of you before and now you have this little munchkin in the mix and trying to figure out like how that all works, how do we make time for the baby? How do we make time for us how do I make time for myself? So Allah

18:15

minutes being exhausted and and probably not taking care of yourself. So it's harder to sort of, I think make decisions in that in that mindset versus being proactive during pregnancy sort of setting that up and that's how we kind of pitch it to our clients, our birth doula clients, like we talked about this. The mental health counseling and similarly like with lactation support, any sort of anything like a pelvic floor therapist, but some of these people who like established care during pregnancy, so that postpartum when you need them, you've already sort of gone through some of that legwork. You've figured out like where they're located. Do they do do they offer telehealth are they you know, do they have space in their, in their schedule for me right now, like, you can kind of work through some of that so that when you need to hit them up postpartum for whatever one of those issues might be, you're ready to go. So we definitely try and advocate and encourage our clients to sort of start initiating those relationships sooner than later, even if there aren't any major warning signs. And I did, I did want to ask about some warning signs. And I know we could sort of like we want to encourage it regardless. But what are some things during pregnancy and postpartum warning sign wise that would be like Bing bing, bing, we definitely want to be seeking the counseling.

19:33

Yeah. So let's talk about postpartum first. So one thing again, to kind of like, normalize and provide education for mamas, you know, we have the first two weeks postpartum where it is completely normal for women to experience what we call the baby blues, you know, and that may look like mood swings, crying, you know, things like that because our hormones are all over the place, right? It was postpartum. But really beyond that two week mark, if we're still seeing lots of crying, we're seeing isolation. Lots of anger, or easily frustrated, you know, that's often a warning sign that gets overlooked that we don't always correlate with postpartum depression is anger, rage, frustration. And again, like all of these things in small doses, again, are normal postpartum because you're you're going through an adjustment period, but if you as a family member or friend, see that that's happening more often than not, right like you're seeing them crying several days a week. In addition to the sadness, anger, anxiety, right, if I share any anxious thoughts with you, I'm worried about something happening to the baby. I'm worried that I'm going to mess my child up because I'm not going to be a good mom. You know, if you notice and hear those thoughts, kind of unrepeated that's a sign that they may be struggling with, you know, some anxiety. So just kind of taking, you know, keeping an eye out for those things. But also, I wanted to because it was something you said earlier that ties to this I wanted to make sure to touch on as a preventative piece as well, trying to as a family member, spouse or whoever, paying attention to the basic needs of mom, because that will do wonders. Because again, I think, you know, baby is born, it's all about baby and mom falls into the background. So as a family member or a significant other, you know, how can I help out to give her longer stretches of sleep? You know, if the family can afford a doula that's an that's an awesome option. You know, to help and come give some relief at night time. Making sure that she's drinking enough water, you know, lack of hydration can lead to symptoms of depression, making sure that she's eating because again, what happens a lot is that Mama's think of themselves last, and so when our basic needs aren't met, then it greatly increases like the risk of us having depression, anxiety, all of these pieces.

22:25

And that is something we drive home hard in our with our clients, even working with them primarily as during pregnancy and birth. But even in the postpartum component, we talk a lot about during pregnancy is who is taking care of you. Like you are you being the birthing person and just had your baby who is taking care of you because you're going to be thinking about everyone else. That's the device. We can't think oh, I can I will definitely be able to take care of myself and the baby and my home as I did before. It's like making a plan now during pregnancy, about who is going to help take care of you. And then I think that term self care people have kind of not misused, but like it's like, oh, that's like a massage or a spa day or go getting a pedicure, or a long workout or a time away. It's almost like basic needs is already and in those early days. That is self care. That is you have to put yourself first and think about those basic needs like the hydration, the nutrition, sleep, oh my gosh, sleep, right, and that everything just assumes I'm not going to sleep but it's like well, no, we just got to create a plan to help you get your sleep so that you can show up and be feeling good and not have extreme symptoms of because like you said, all of those things when they're deficient, contribute to Postpartum Mood disorder like this, maybe the severity of what the symptoms might look like or that might trigger it. So I think yeah, talking a lot about that because that's like doable, right? Like we can we can ask try and ask family members or partners and I always like to say I understand that not everyone has like this, this massive village or support system and that this may not be available for everyone but you know, talking about and this is where like as as postpartum builds, and I'm sure as mental health counselors, you help people with that individualized care. Like if someone comes in and says, I've got a great mother in law, my sister's around, she's willing to help and you're like okay, let's give them some tasks and then you help them at that. But if someone comes in and says, I just moved here, I have no family nearby, I have no friends and my partner is checked out. Like, right, you then say, Okay, we're going to look at that differently and help you get some tools to ensure you you can also be taken care of. So it's understanding that there are all kinds of different scenarios and that just because you don't have that huge network doesn't mean that that was fine more reason to seek counseling, right. So you can help them with that lately. Such good stuff. So when what would you say are the main benefits of this type of mental health counseling for people during infertility, pregnancy postpartum? And that's like three different categories. But overall, like what do you like the main benefits like what's the purpose or reason that people should want to do this?

25:29

I think first and foremost, knowing that you're not alone. I mean, that just that in and of itself and being able to talk with someone who understands is huge. I think in addition, the amount of time that you struggle can be decreased. You know, if you are with a qualified mental health counselor, so I think that's another huge benefit. But again, just even some of the psychoeducation that comes along with counseling, you know, like we were just talking earlier about, you know, how how I felt like I should have bonded with my baby immediately. No one ever told me anything different, you know, and I don't fault anyone or blame anybody for that. It's just that like, that just wasn't a conversation that we had. And I think that there's so many rich conversations that can happen, again with that therapeutic alliance, that make Mama's better prepared during pregnancy and postpartum

26:25

and I think that is that is the the gift there and that is I think the one of the main benefits is that ripple effect. So you help one person and now she has that different she's probably now even they will say like a you know it could be a partner or a family as now who has experienced this type of mental health counseling during any of those phases, but they're not going to be wired slightly differently and be able to have those conversations differently with loved ones and friends and within themselves, so then therefore, or even their children, right. So that therefore that cycle is, is hopefully better with each generation. And then they talk to a friend and they're like, Well, this is my experience, and this really helped me and, and even if they're talking to a girlfriend or a family member who just had a baby and even just saying things like it's normal to not bond right away, like just simply because they learn that through this education with you or or because it's become more of a conversation and our overall health care for people who are experiencing, you know, during pregnancy and postpartum. So, I think that is, is that sort of like that shift in conversation? To like, the ripple effect the downline benefit. Is, is huge. So I love that.

27:42

I think Can I add something to that? Oh, please. So um, as far as like having conversations with maybe other friends who have just had babies too you know, it also depends on what the safety and security looks like in those friendships, right? And how, if you feel like you're able able to be vulnerable enough to say some of those things because true, I think back to again, you know, the time that that I was having those thoughts about like oh, my gosh, why am I not bonding with him? All of these things? I told no one. I hope no one that I was feeling that way and again, that is that is no knock to my family, friends, anybody it was just that that was within me. You know, I had so much guilt and shame around that. I didn't feel comfortable telling anyone that I was having those thoughts. You know,

28:35

I don't think you're alone in that though. I think that's probably feels like in my experience a majority is we want were either told that it's it's gonna feel natural or it's gonna be it happens right away, you know, and you're just gonna love your baby from the moment you set eyes on um, there's like these phrases in there well intended, I think, but it's wrong, or it sets it sets people up for or maybe what we see in movies or reading books or whatever the however our perception is being informed creates that mentality that you had, and then there's shame around feeling because you're like, I must be the only one who has ever felt this way. And I can't share that with people because then they'll judge me and shame me and your newly your newly postpartum too, so you're not you know, there's a whole mix of feelings. So like, I guess, normalizing that conversation or creating safe spaces for people to be able to talk openly. And, and I think that's, that is best done inside of therapy.

29:34

Yeah. And now what do you think about you can walk in that room, right? Like if I'm walking into the therapy room for the first time and I had an opportunity, like, I typically do a 15 minute like free consult before we actually set people up for sessions. So if I've had an opportunity to talk to the therapist, maybe I've read their website, and it speaks to some of those things right about scary thoughts or whatever. The thing is, it's so different walking, then into that therapy room knowing like, this person gets it. I don't have to put on a mask. I don't have to pretend that I'm not going through these things. You know, it's kind of like Nick and depending on their experiences, it still might take time. To build that trust, but at least you know, walking in the door. This is someone who understands and is not going to judge me.

0:02

consultation. So again, that's that at no cost, and it's a phone call. And it's an opportunity for me to ask questions about what it is that they're experiencing. But it's also a time for them to ask questions of me, Phil, whoever you're going to select as your therapist, like I said, it's such a close relationship. You want to make sure that it's the right fit. And so it's kind of like a preview to what's to come. You know, in that conversation, you might not know 100% If you're going to connect with that person, but you'll get the initial feeling you know, like, okay, yeah, I think this is someone who I could trust and someone that I could work with. So but I think it also takes a little bit of the stress off of the first official session. Yeah, because I've already had an opportunity to talk with you and kind of get to learn what you're all about. And that's, that's a risk free right? Like that's it. Yeah, dad is like a free Oh, man.

0:57

That's wonderful. That's super smart.

0:59

Yeah, and so if for whatever reason, you know, cuz I'm not the therapist for everyone, right. And so, and kind of being a good therapist is being aware of that. And so if we kind of talk and the person's like, I don't know if we'd be a good fit together, like no harm, no foul, that's totally fine. And so you know, how we'll leave it is that they'll say, you know, oh, maybe I'll get back with you and schedule an appointment like there's no pressure. Yet in the same token if someone wants to go ahead and schedule a session after that 15 minute consultation, then we can do that too. And so then after we do that, I send them a link with all of their paperwork to fill out. And then that first session is really me getting to know them, getting to know more about like their presenting problems, getting to know more about their history, and just asking follow up clarification questions from their paperwork. Because, again, like think of like the paperwork, kind of like in medical offices, right, there's often a lot to fill out. And so sometimes you just put like, enough to kind of answer the question. And so when we meet in that first session, I'll dig a little bit deeper, you know, like, tell me a little bit more about this. Just so because the more that I know, then the better equipped I am to be able to help and support.

2:18

That's wonderful. We have a similar process for our doula clients too. As far as like there's a questionnaire and then our first meeting is to dive deeper into that information and, and I love that that's a good get to know you, you know, process. Yeah.

2:35

And then I also so kind of beyond that first session, because again, the first session is really just like information collecting, you know, but in our in our subsequent sessions, it looks a little bit different for every, every mama, you know, depending on what their presenting issues are, and what I always try to tell my clients up front is, this is your journey. Like I am not here to say, you know, like if you if you were my client, I wouldn't say Rachel, you need to do this, this and this and you will be healed. Right? Everyone's journey looks different. And also what I like to explain to people is that you might come in for concerns around infertility, you might come in for postpartum depression, but there's often many other aspects of our life that are feeding some of those feelings. And so, like if anxiety and depression are at the core kind of floating all around, that is our relationship with our significant other, our relationship with our families, boundary issues, postpartum, our work environment, there's all of these things that like play into our life, that we also would be remiss to not address and try to like work through because it's gonna impact your overall mental health as well. So you might come in the door for one thing, but then we ended up talking about all sorts of things. And so that's why I like to let Mama's know that because I think especially if you've never been in therapy before, sometimes people see it as very prescriptive. And like, okay, session one, we're gonna do this to address my anxiety Session Two is this. And what I say is, we might have a game plan for session two, but if you come in the door that day, and you're like, oh my gosh, I had a horrible argument with a co worker, or my mom or whoever. I'll go wherever you want to go. This is again, this is your journey. And so I just really like people to know and understand that upfront, because if they've never been in counseling, like I said, I think sometimes there's a misunderstanding of what that looks like.

4:46

I appreciate you explaining it that way because I feel like even for me that made more sense than maybe how I would have expected it to be and that's, it makes perfect sense. Yeah, um, and envisioning an onion or some sort of like, there's some layers and it's not always it's not always a like, linear process, right? It's kind of Yes. It's depends on where they're at and so many factors, right, that can influence and sometimes I imagine you end up getting to sort of some core things that might be stemming or creating the the anxiety or depression and maybe it wasn't anything they even expected or maybe it was further back in their life that is coming up because they're now pregnant or postpartum. I know for me, things I learned from my birth and from from my birth, my own birth and my childhood, and then becoming a parent brought up all kinds of things. That I didn't anticipate the created, I mean, good feelings and also resistant feelings and like, anxiety inducing feelings. And so that's, I can imagine that that conversation being evolving and ever it's not like it's not firm. It's not like okay, this is what we're going to do. So I like how you explain that and I think that is definitely a gift of counseling. And the benefit for sure. Is and then I mean, I imagine if you're working through it in that way, then they're going to maybe improve in those areas, but those relationships, those different people, like it's not just helping during it's not just helping the pregnancy or helping the postpartum. It's like maybe improving the relationship with the partner or the family member or the work relationship. So I imagine the benefits expand far beyond and last a long time and then you give them tools to I'm sure for beyond right because you got to hire them and then you've got a toddler or you then become pregnant again or you know, teenage years or you know, all kinds of seasons that I think it could be beneficial. I just love it. Um, so if someone is seeking a perinatal mental health counselor what during pregnancy and postpartum infertility, what are some certain credentials they should look for? Like what says okay, this is who can help me just on like surface level, because obviously, we want them to connect on a deeper level. But if they're just sort of beginning that search, what's a basic thing they should look for?

7:05

Yeah, so one of the primary things is looking for p m h fee. And that is a credential that Postpartum Support International offers. So you know, typically when you're looking at counselors, you'll see different letters after their name. Yes. And so basically what that means is that that particular counselor has had additional and extensive training in perinatal mental health. They also had to take an examination to prove that they they have acquired this knowledge. And again, that's not to say that a counselor who doesn't have that couldn't support because they they absolutely could. But if you want to find someone with that specialization, you know, that's one of the credentials that you'd want to look for. In addition to that, I m H E is another one, which is infant mental health endorsed. And I think that there is there's a lot of connection with maternal mental health and infant mental health endorsement and the infant mental health work, again, really focuses a lot on that attachment and bonding. So that's an important piece to kind of have as well. And also for infertility. You know, any anyone who has advanced training through ASRM that is about reproductive medicine and focuses more on like the infertility side of things. That's kind of another thing to look for as well.

8:38

Okay, those are really helpful because I won. One of my questions was going to also be that kind of helped me understand some of the credentialing like you know, you have lots of letters after your name y'all Shannon has all the things so if you need any of this, like she's got it all, and I know that takes a lot of work and time and commitment and dedication to learn and acquire those certifications. So just kudos to you because that is good work, friend. Good work. Thanks. Thanks that I also know something that's really important to you and to in to us as well, as doulas is universal screening. Can you help us learn more about what that is? How it works and the benefits of that?

9:20

Yeah, absolutely. So universal screening, hopefully is done, you know, at your OB GYN office and then postpartum at your pediatricians office. And so that is typically a questionnaire that is given to you the ask if you have had feelings of depression, anxiety, all of these things, but the reason that this is so, so passionate about this is one not every doctor's office screams for this and Perinatal mood and anxiety disorders are the number one complication during child like birth time, so pregnancy and postpartum. So if you think about when you go to the doctor and they screen you for preeclampsia, right, they are constantly checking your blood pressure, they check your blood sugar to see if you have gestational diabetes. And the reality is that perinatal mood and anxiety disorders occur far more than either of those things. And it's so normalized

As to check for blood sugar and blood pressure, but it's not as normalized to chatter most mood and anxiety disorders. And there's I think, I think the statistic is 400,000 I think it's 400,000 babies are born a year to mothers who experience a perinatal mood or anxiety disorder, and only about six to 8% of those actually get treatment.

0:28

Wow. Yeah, why that screening is so critical. I mean, we still the routine is to go see your doctor or max six weeks postpartum. And that's it. And this is like, or we're missing so many opportunities to help people and normalize these Yeah, very common complications.

0:54

Wow, those numbers are very staggering to hear even that's like, I know it's an issue that's so can people do universal screening themselves?

1:05

They could. They could, but if you look up the Edinburg scale online, anyone can access it. And sort of the cutoff score is 10 or more is where we would consider you might want to seek out some additional support.

1:23

But even in addition to you know, because again, there also are lots of physicians who do screen but kind of what I want to go aware of with that as well which I think Rachel you and I have talked about before some of the ways that the questions are worded. Yeah. And I'm gonna I'm gonna totally butcher this because it's not right in front of me but the question would say something like you know, I have experienced feelings of anxiety over the last such and such days for no good reason. And nor no good.

1:56

Yeah, that for no good reason qualifier, I think causes a lot of women to under report because again, like I can speak on that from personal experience, too, like when I scored that because my doctor was someone who did screening, but when I scored that, I didn't read it as an area of concern because I'm like, Well, of course I have good reason my baby screams 24/7. You know, but not knowing that, you know, I could still be experiencing depression and anxiety because of my child's colic, but just because of the way that question was worded and no one kind of explained that to me or talk through that with me. Then I underreported and I think kind of another piece of that is that women will often under report because of the stigma, the fear, all of those things. You know, I have heard women say to me before, well, if I was honest about that, they would take my baby away.

2:59

You know, which is is heartbreaking. You know, what that screening is meant to do is to identify women who need additional support. You know, it's not about you know, how can I take your child away, but I mean that I understand the fear right. I understand the fear behind that, because sometimes, if we feel like we have really dark thoughts, we're scared to share those with other people. And so again, I think that just speaks to the need to have a conversation and not just say, here's the piece of paper fill this out. Right because so, so much goes unnoticed. You need someone to sort of walk through with you help you understand the intention of the question help you understand that, you know, it's to help get you care if needed, not necessarily take your baby away, right like they didn't walk through that. But the people administering the screenings for the most part, though, are people who are busy doing other profession demos like I would rather I'd rather the OB or midwife or pediatrician, provide a number to call to do that 15 minute phone call or live or some someone who can walk them through and maybe it doesn't, I feel this feels like something that could be done virtually or over a phone call, instead of like, oh, I don't have to go to another doctor's appointment or I have to pay extra. It's like it's almost like can we build this in in a way that's more meaningful and effective? Because I just know OBS for my first I had an OB midwife practice. I did not get the screening. And I didn't get it to our pediatrician.

4:36

And it's just like, I didn't get it at all. And I think I was asked, How are you feeling? Are you having any thoughts? Like some beta questions very surface, and thankfully, I didn't struggle severely with with anything that needed additional care, but it's like that could have been a missed opportunity. And if it's happening to me, it's happening to lots of other people.

5:00

And, and so I feel like you know, obviously there's there's room in there for so maybe reconfiguration of how the cares even given is just like, here's a, here's a survey. Here's the thing, fill it out. It's like, when I'm hearing these days, it's like you need some extra, like if you're going to do this, especially if you're going to do it without the care of a professional, helping you through and then to be considerate and like think about those questions and and take what you're saying into consideration for how they're doing the screaming. Yeah, just trying to problem solve around like how those conversations can be had. Now don't get me wrong if the way that their practice is set up that they're you know, it's not time to sit and have those conversations. Some screening is better than no screening. So I wouldn't say if you can't have the follow up conversations, don't do it. But in order to do it well and to make sure that we capture, you know, all of the women who need support that's really considered best practice. Okay. Okay. And are there any other ways to do screenings or evaluate evaluations of outside of your OB pediatrician and outside of hiring you directly?

6:12

And do or, you know, there's the end of our scale? Is there another? Are there other options? For people to figure out if they're, what they're struggling with? Or if they're struggling? Yeah. So there's another assessment that pH Q nine. That's another assessment that that people can take a look at. But well, my hope is, is that you know, other birth professionals will start using screening as an option to you know, so that it doesn't all fall on obese pediatricians I mean, even though they should be doing that you just shared examples of, you know, your experience where that didn't happen. But maybe if you had a doula who screened you you know, I think I think there's so many opportunities kind of within the birth professional realm, to be screening our mamas that we can make sure that we catch them, too. Yeah, and I'm glad you brought up the doula screening because Hannah and I after meeting with you have incorporated and Hannah as my co doula partner, but we've incorporated it into because we provide services 12 weeks like if you hire us as your birth, doulas from the time you hire us all the way through 12 weeks postpartum. We're still your doula. It doesn't end at the birth. And we are in constant contact, like we are checking in regularly having phone conversations.

7:35

And so we are incorporating we have began incorporating the end of our scale and doing it in a way that is we're having conversations around and not just like oh, here's this thing, fill it out, but trying to trying to do better and spread that word and and let doulas know that they you don't have to be scared to do it because I've talked to some other birth professionals who are hesitant because they're worried about doing it wrong or worried about it being out of scope. But after talking to you and learning that it's not out of scope so long as you you know, this is there are some some tips to kind of learn about the screening process, but that we can do it. So yeah, I think for I think a lot of work professionals listen to our podcast and so I want them to hear that. And if they've got questions, they can reach out to you or learn more, you know, we'll include some links and resources and stuff, but to begin incorporating it that in their practices too because we again and I think like chiropractors have a lot of influence they typically see birthing people a lot if they're if you're under chiropractic care, but seeing them during pregnancy and postpartum like it's yours and you might see them before you do before you see your OB or midwife. So there's a lot of different professionals who could begin to incorporate I think this the screening. Well, I think too, you know, if if people are considering doing that and decide to you know, take it on, the biggest thing is to make sure that you have people to refer your class to shore has I know that I've heard even from you know, obs and pediatricians that a lot of times, you know, one of the barriers why they don't screen is because they say well, if I screen and I find these concerns, who am I? Who am I going to send this person to, you know, yeah.

9:20

So I know that that can be a barrier sometimes to especially now you know, since the pandemic, which is, I think, a blessing and a curse, right that all most mental health professionals, I mean, we stay pretty full, you know, if there's been more awareness, more acceptance around mental health concerns, which is amazing. Yeah, right. But also can impact you know, timeliness of care. And so I do that, that would be my one thing is that if people decide to undertake screening, they just want to make sure that they have a really good referral list of multiple providers. Yes. So that if I call so and so and they're full, well, then I'll go on to the next one, so that I make sure that I get this person connected to someone. Yes. And that's exactly what we do. And I encourage other people to do it as well. That's certainly a good tip. And it's also just also kind of surprising to me that said like a, an OB practice would have that as a barrier. I mean, there are people doing this work. So all it takes is a little bit of effort to say okay, I want to put together a list of of Merryman perinatal mental health counselors for our patients who might need that care and that just feels like that feels doable to me and it's hurting a little bit to hear that that's a barrier but everyone has their thing and the more we talk about it, hopefully we can get more people trying to take steps to make that list of referrals and do the screening with every extra.

10:51

Yeah, sorry. Go ahead. No, just with every extra person doing it like we will hopefully make that number much bigger than six or 7% of 400,000. Yeah, I think it depends too on access. Right? So especially if you're talking about certified perinatal mental health counselors.

11:11

They're I mean, we have we have a decent number in Georgia. I don't know, off the top of my head, but I mean, it's not enough to meet the need. Maybe we're actually

11:25

screening and getting keeping that that's part of it, you know, is that we need to bring awareness that this is such an area of me that we need more professionals to kind of take advanced training and step into these roles as well. Yes, absolutely. Access is huge. And then I mean, I'm sure that gets into insurance and how people can actually access it who can't afford paying out of pocket and and then more more actual professionals doing it. I'm sure it's it that is a deep conversation for maybe another day, but definitely something to consider and bring awareness to because access is huge. And not not everyone does access and that's also part of the problem. So definitely bringing awareness to that is what we're doing here.

12:11

So would you can you share with us some tips for a partner or close love a loved one to keep an eye out for or how they can help if someone is struggling that they know is is going through infertility, pregnancy or postpartum?

12:26

Yeah, so I think the first the first tip I would say is just to be have heightened awareness. You know, like any of those periods, you know, there's stress that's associated with that, because what's going to happen most times is that someone is not going to come right out and say, I'm depressed. I'm anxious. Right. And so paying attention to, you know, some of the things that I said earlier, do you notice that she seems to be more withdrawn and isolating herself? Does she seem more quick to anger than usual? Just kind of being aware of those things and asking the question, you know, Are you Are you feeling okay? Is there anything that I can do to help support you? And there's going to be some times right because that mom that will not mom guilt, mom, guilt postpartum, but just like, guilt and shame in general during infertility and pregnancy. Sometimes they might tell, you know, when you ask for the first time, right, you might say, are you okay? And it's like, no, I'm good. You know, everything's okay. When really that's not how they're feeling. Yeah. And so just kind of not just accepting that and rolling with it. But keeping keeping your awareness level up. And if you notice things, ask again. And in addition to that, like even if you say, how can I support you, how can I help you? Especially if you're dealing with a perfectionistic type personality? They're gonna say nothing like Office. So sometimes it's just about like, stepping in and seeing where you can help. You know, let's say, postpartum you know, I'm I'm over in the living room on the couch feeding the baby. I just made a comment. I gotta feed the baby and then I gotta start dinner and then I got to do the dishes. You know, that's a cue to say, Okay, what, what can I take off of that load? Yeah, to kind of help with that.

14:18

So just just listening. You know, actively listening and being attentive. To those things, I think goes a long way.

14:27

That's great. That's great. I love that we often share with our clients too, like.

14:33

Obviously, this has to be done in a gentle and compassionate way. But even doing some research if you're a partner in the house or a loved one like really close friend or family, you can kind of do some research. Like if you're hearing this and you're like, Okay, Shannon Weist or you know, something, you know, you can do some of your own gathering of professional than doing some research and maybe, maybe even maybe even having that 15 minute phone consultation. Okay, my I've got this close loved one or partner who's struggling or what this is what I'm seeing, and I'm just like teeing it up a little bit to be and then coming to them and saying, Hey, I've done some research. I love you. I want to help like, lets you know we're in this together, just finding a compassionate way. To help beyond asking, how are you? Right, like paying attention to that? Yeah. But do you think it's beneficial to for the other person to maybe do some of that legwork for them to help them or do you think that ends up being counterproductive?

15:33

I think it depends on the person. Yeah. Right. And that's really knowing knowing your partner, knowing your family member, you'll know if they would receive that or if they would be offended by it, you know, because I would imagine there would be some women to like, oh, you you think I need to go see a counselor you know, and it would be an immediate so it's just about knowing the person but I could certainly see the benefits though to what you just suggested in some situations, because what happens if we are dealing with depression as an example, sometimes taking even the smallest step towards getting help even though we know that we made it can feel like too much? You know, it's kind of like, I don't even know where to start. I don't know who to look for, like.

16:20

So in those situations, and if you think that person would be receptive, you know, I certainly think that that would be an amazing gift. You know, hey, I've done the research for you. Here you go. Yeah. Here are a couple you can call and get a free conversation with or something. Yeah. And even if even if someone is resistant, you know, maybe you don't give them the resources, but maybe you offer to do that and give it's like you're giving the power back to them to make that decision. Like, Hey, I've noticed, you know, I've noticed that you've been staying in the bedroom for multiple days. I've noticed that you've been crying a lot. I'm really concerned about you. Would you ever consider going to talk to someone because if you would, I'd be happy to look up some of those resources for you. You know, again, it's about knowing that person and how to frame it to where you can still get the same end result, but you're just approaching it a little bit different based on how you think they might respond. Yeah, but just sort of finding that kind of thinking of it that way. And like how can I really help this person versus just asking, how are you doing? I mean, we are default, everyone. Good, I'm fine. Great. And then underneath, there's some stuff but that might break that sort of down a little bit. I don't know just some other ways to think about how to meaningfully and effectively help people if you're the partner or a close family friend or loved one.

17:49

So that's really helpful. We I feel like you've shared some of your resources with us, but what are some of your favorite resources and we'll be sharing, link those in the notes but any sort of resources that you want to mention for people to kind of go check out?

18:03

Yeah, so first, on my webpage maternally mindful bath org, I have a Resources tab, and it's broken down by infertility, pregnancy and postpartum Yes. Yeah. Awesome. Podcast, Instagram, like all different kinds of recommendations for each of those areas.

18:25

But I'll just talk about two of my two of my favorites that I like to share with a lot of my clients. One is a book by Dr. Cat Kenai. It's called the pregnancy workbook. And it gives you all kinds of activities to kind of work through with respect to anxiety and depression during that period. There are a lot of mindfulness activities in that book. That is, for any of the pregnant women that I work with, I highly encourage them to check that out. Just because it you know, we do a lot of work again in the therapy room, but that gives them some things to work through outside of the therapy room as well. So that's one of my favorites. Another one is a book called Good moms have scary thoughts.

19:09

That's another one that that a lot of the women that I work with really enjoy kind of diving into as well and there's some activities and stories around that as well. So that's another great one. I love it and I am going to check those out myself and I love that you have the resources tab and broken down by each sort of area that can help people I think that's super, super helpful. So we'll be sure to include all that in the notes and the books as well. I just think you've shared so much with us. So where can people connect with you do do social media or anything like that?

19:46

Yeah, so I actually just got started an Instagram probably like early January, so trying to get that up and running. My Instagram handle is at maternally mindful.

19:59

My website, which is that org that has all of our contact information.

20:05

There are spots on the website that you that will shoot an email to me, you know, if you want to try to connect our telephone number as well, you can call it or you can text it that's 678-310-9216 Because a lot of times too especially when mothers, you know or in the infertility period or pregnancy. When you have a lot on your mind. It's just a little less threatening, I guess to shoot a text sometimes and so possibility as well. Absolutely. Yes, I can relate to that for sure. Well, that's good to know. So we'll include the phone number too. And let people know they can text that way. We'll include all the resources you've mentioned. And I will also note, Shannon is located in Canton, Georgia, which is about 30 miles north of Atlanta. That's we're real close to each other.

20:57

And so but you also offer so local can, people are I'm sure surrounding areas that you also offer telehealth services. So that isn't throughout for the anyone in the state of Georgia. So just wanted to note that for people if they're looking locally and then also if they're not super local that they could still reach out to you within the state of Georgia.

21:19

We have gone over a lot of stuff today Shannon I am I've learned so much you have been incredibly gracious with your knowledge and your wisdom and and helping us think critically and compassionately about mental health for the perinatal period of time for for birthing people. So just thank you so much for your time. It's an honor to have you on here and I look forward to many more conversations. You're so sweet. Thank you so much for having me. All right, guys. If you liked what you hear, please be searcher and subscribe and we would love if you left us a review. Have a great day. Bye

Transcribed by https://otter.ai