Christine Stewart-Fitzgerald 0:03
We've heard about postpartum depression and maybe we have friends who have confided in us that they were affected by it. But what about twin mamas? If you're carrying multiple babies, are you more prone to experiencing postpartum depression? Today we're here to talk with Dr. Allison Reminick and learn more about how postpartum depression affects women, especially twin moms. This is Twin Talks!

Christine Stewart-Fitzgerald 0:25
Well, welcome to Twin Talks. Twin Talks is your weekly online on the go support group for expecting a new parents of twins. I'm your host, Christine Stewart-Fitzgerald. If you'd like to listen to our show on the go, be sure to download the Parents on Demand app. And it's available on Apple and Android. Not only can you hear our show, but you'll also discover more great podcasts geared towards parents and families. So let's get into it. And let's introduce everyone who is joining our conversation today. So tell us a little bit about yourself and your family. Your experience with today's topic. Let's start with our expert speaker Dr. Reminick. So welcome.

Alison Reminick 1:30
Thank you so much for having me. My name is Alison Reminick, and I am the director of the women's reproductive Mental Health Program at the University of California, San Diego, I work there full time. And I'm also a mom of three little ones. So my youngest right now is 21 months. And I also have a four year old and a five year old. And I've been working with moms who have had mood and anxiety disorders during pregnancy and postpartum for about eight years. So I'm excited to talk to you about what we know.

Christine Stewart-Fitzgerald 2:02
Yay. Well, thank you. And let's see. Let's go to our parents that are joining us. So Maggie, how about tell us about your family?

Maggie Tilley 2:12
Hi, I'm Maggie and and I have four and a half year old twin boys. And I also have an almost two year old boy. And let's see. So what I know about the topic a little bit, I will say that I feel like I suffered a little bit more from depression after my singleton but I did I think with the twins have, I suffered a little bit of postpartum depression, but I just don't think I realized it. And it was more with my second that I kind of recognize the signs more. And I did I did get help for it.

Christine Stewart-Fitzgerald 2:46
Oh, that's great to hear. Awesome. Okay. And Lisa, welcome. Lisa is coming to us from the sunny shores of Hawaii.

Lisa 2:55
Hi, yeah. My name is Lisa. I have three and a half year old boy girl twins. I'm a stay at home mom right now with them. And we had our twins through IVF after many years of trying to get pregnant and failing. And I definitely experienced postpartum depression in the first year. But I really didn't seek help because I was in denial about it until actually they were almost like two and a half years old. I finally realized I needed help. And so I I waited late, but better late than never to get help and treatment for it.

Christine Stewart-Fitzgerald 3:27
Oh, wow. Well, that's we're definitely have to talk about that. The whole timing and diagnosis. That's a really great thing that we'll have to cover. And let's see Sunny, our producer, welcome.

Sunny Gault 3:38
Yeah. Thanks so much. So hi, guys. I'm Sunny. And I have four kids. My oldest two are my Singleton's, I have an eight year old boy and a seven year old boy. And then I have five and a half year old identical twin girls. As far as postpartum depression is concerned, I kind of mirror what Maggie said, I felt like I had it after my first son, my oldest. And then I really didn't get treated for it. I started to I actually went to what do they call intake appointments, I went to an intake appointment. And I just I didn't connect with the person and it was so tough to get to the appointment anyways, it just never really happened. And so I kind of started the process because I could feel myself becoming depressed. And I kind of recognize the symptoms. And I was like, I think I need some help, but then never really got treated for it. And I don't think I really had it with my second son or my twins.

Christine Stewart-Fitzgerald 4:33
And that's so interesting that you would have it with maybe one pregnancy but not the other. And I'm Christine your host. And let's see. So I have identical twin girls who are now nine years old, which I know for a lot of the folks who are listening today, it seems like that's so old. Like wow. And I also have a single ting girl who's six. So we got three girls and I think after having three girls was if you know the chances of having a you know, another kid that would, you know, maybe a boy would be is pretty much nil. And so we're like, I think three girls is good. We're, we're good right there. Yeah. And you know, and I think for me, I wasn't diagnosed with postpartum depression, but I definitely have to say there were times when I probably would would check some of the indicators in the box. So yeah, we'll definitely be talking about that. So thank you and welcome everyone.

Sunny Gault 5:35
Okay, so let's talk about some news headlines. This is our segment that we love to do. And we love to find the crazy headlines out there regarding twins and multiples, and basically look at and go, Wow, can you believe that happened? And this news headline totally falls into that category. So the headline is a month after giving birth, this woman had surprised twins. Now I think everybody that's listening to this episode, you could probably put yourself in that person's position to go Oh, my gosh, how is that possible? I thought I was having one baby. And then, you know, within the period of a month you go home with three babies. So let me give you the background on this. Okay. The woman's name is a Aretha Sultana. She's from Bangladesh. She was 20 years old when she gave birth to this first baby, which was a baby boy. And she had never had an ultrasound. And I don't really know the reason behind that. Maybe it wasn't available, but she never had an ultrasound with her baby boy. She had no idea that she actually had a twin pregnancy in addition to that, but she did end up giving birth to boy girl twins 26 days after she gave birth to singleton now.

Sunny Gault 6:49
Yeah, you guys are wondering how in the world is this possible? So basically, she has what's called and there's a technical term for it. Allison, you may know what it is. But it's a second uterus. So she actually has two. Is it uterine? I don't know what plurals. But so she has two of them. And that happens and one in 2000. Women will have to uteruses and then of that population, only one in 25,000 can have simultaneous pregnancies. Wow. And so she is of a very, very, very select group of women that could actually do this. But yeah, so she had her baby, you know, at home with the baby, everything's great. And she had these severe stomach pains, which are labor pains. And then she went in, the doctors took a look. And obviously, were completely surprised. They performed a C section on her. And yeah, so that mean, that's how the babies were born. The family is very happy. This makes a lot of sense are actually they're worried about finances, they have no idea how they're going to afford these babies. Which I think that went through most of our heads to and someone told us we were going to have to and yeah, the family I guess, their their salary. If you translate it into dollars, they make about $95 per month. And so I think someone needs to set up a GoFundMe account to help this poor family, but they're, they're in good spirits. But oh my gosh, can you imagine like you just gave birth to one. And then 26 days later two!

Lisa 8:26
How did they all fit in there? Or?

Sunny Gault 8:31
Yeah, I mean, it just says there wasn't any complications with their first one. So that leads me to believe that if it wasn't completely full term, it was enough that you know, there wasn't any intervention or you know, anything needed to help the baby.

Christine Stewart-Fitzgerald 8:44
That's just amazing. I mean, yeah, I think you hear about sometimes these the surprise pregnancies where women don't know that they're pregnant. But I mean, you know, even more so if you've already had a baby. That I mean, that's the last thing you'd have on your mind about having no oh there's still more in there I mean, you know, maybe okay, we hear about surprise multiples in the hospitals like oh, yeah, there's there's another one in there but 26 days later,

Lisa 9:12
She's probably thinking oh, you know, you have that you still have that baby bump, you know postpartum and but to her she's, she's like, Oh, well, mine's just extra big are not going away.

Sunny Gault 9:22
Yeah, exactly. Exactly. Now, I would be really curious and there's no follow up on this. But since our topic today is about postpartum depression, man, I wonder you know what kind of depression she or if she was, you know, be at risk of having even greater depression because she had three babies you know, two different you know, two different uteruses. I have no idea what that does to the chemical makeup of your body. And the doctors probably don't even know either, right. But you can only imagine that it has to be intensified.

Lisa 9:50
Wow. Double uterus double the hormones?

Sunny Gault 9:55
Makes sense? Right?

Christine Stewart-Fitzgerald 10:01
We're here today with women's health expert Dr. Alison Reminick of UC San Diego Health. Dr. Reminick oversees the women's reproductive Mental Health Services Program, which is uniquely dedicated to providing mental health care for women in all stages of life. But particularly in the postpartum period. We're here today to talk about twin moms and how they might be especially susceptible to postpartum depression. So Dr. Reminick, I have to say, I'm just so glad that, you know, you have a center that's devoted to women. I mean, I I'm not aware of any other center that puts such an emphasis on women, and particularly postpartum health. And here we are, I think today, we're recording. This is the is it national postpartum health awareness month, I think...

Alison Reminick 10:48
Yeah. Maternal mental health awareness month and Mental Health Awareness Month in general, too.

Christine Stewart-Fitzgerald 10:53
So I'm imagining you've been in great demand recently, just just to raise the flag, and we're all here to learn about it. I think we've heard the term postpartum depression. But I don't know if how many of us really know what that actually means. Can you just give us some, you know, definition of what that means? And how that kind of maybe how it manifests itself?

Alison Reminick 11:16
Sure. So postpartum depression is a depressive episode, but that it can happen late in pregnancy, like in the third trimester, or within the first few months after delivering, and a lot of first time moms really don't realize that they have depression. And I think most of the time, they just think, oh, is this what being a mom is now is this is this how life is going to be. But really, I say the symptoms are mostly just feeling really down, depressed, feeling very tearful all the time, feeling like they have no energy, can feel really irritable, and have really a lot of difficulty sleeping. I think one thing we're trying to move towards too, is trying to title it perinatal mood and anxiety disorders, because a lot of women will say I didn't, I don't have depression and anxiety. And really, we see a lot of anxiety to postpartum, just not having a lot of concern and worry about health of the baby about safety. Having a lot of, like, difficult intrusive thoughts that might seem scary. And you know, at the at the worst, having, you know, suicidal thoughts. And that that point is, you know, it's a medical emergency. But a lot of times two moms might have just a really difficult time caring for the baby during this time, because she can be so sleep deprived. And just dealing with a lot of new changes.

Christine Stewart-Fitzgerald 12:43
Oh, yes, I think we definitely can all relate to that. So I'm just now curious. So how is this different? You know, when you talk about some of these, these symptoms? I mean, how is it different from regular depression? Let's just say that's, that's maybe it's not associated with with post? I mean, is there a difference between postpartum depression and and regular depression?

Alison Reminick 13:05
Yeah, I mean, we think there is just because there's so many biological factors that come into play and genetic factors. So if there's a family history, women are more at risk. If women have had previous histories of depression are specifically postpartum depression, they're more at risk. And then there's just hormones. So estrogen and progesterone go way, way, way up to the highest levels they've ever been when you're pregnant, and the very last day of your pregnancy, and then the day you deliver, they dropped to these extremely low levels. And I like to tell my patients kind of like simply, estrogen is works is kind of an antidepressant, and the progesterone workss and anti anxiety. So you're kind of in this state now where you're a little more depressed, a little more anxious, and then you know, you have to care a baby and you're sleep deprived. And you're trying to learn this whole new role. When your body and your body is really like deficient now and nutrition and vitamins. So it's really like a, it's like the perfect storm for creating a lot of anxiety and mood disorders. So we feel like women are most vulnerable during this time. And it is a bit it seems a bit different than other types of depression to because there seems to be a pretty quick response if we ever used medications, like much quicker than we would see in the general population. And we think it's because of hormones.

Christine Stewart-Fitzgerald 14:30
Wow. I know. I mean, I have to admit, I didn't realize how much hormones have to play in all of this. I knew, you know, hormones manifest themselves in all these very physical ways. But I admit I didn't realize it as far as mental health goes and if any of our panelists how many comments to add,

Lisa 14:50
I mean, I can relate to just immediately after giving birth, just those few days in the hospital and being at home. I just felt just sort of anxious and worried. Really panicky kind of like, oh my gosh, this is really real. But of course I just chalked it up to well, like I just had two babies, you know, it's just overwhelming. And I knew about like how, you know, the hormone drops. I read about that in pregnancy books and things, but yeah, just experiencing it is, it was just Yeah, different than I expected,

Christine Stewart-Fitzgerald 15:19
And how it also is thinking, you know, even taking other medications, you know, I remember, when I had my twins, I was healing from a C section. And I was taking, I think was basically like a, like a Vikatan equivalent. And I just remember, there were a couple instances where I was having these just like, you know, what I would call nightmares. You know, just, it was just like this deep anxiety where, you know, I just remember feeling really just tense and stressed out and worried. And this, you know, as a dream, and you know, I told my doctor about it. And she says, Okay, well, let's just switch you over on your medication. So I just went to like, Tylenol. And she says, Yeah, we don't want to have to put you on additional medication. And I so I did. We tried that. And thankfully, it did help. But I didn't even considered that maybe medications might also be a factor as well.

Alison Reminick 16:16
Yeah. I mean, I think there's a lot of moms Oh, say if it gets a C section that they felt like the anesthesia was potentially precipitated their depressed mood, or if they had any type of narcotic or opiate medication that they felt like that kind of put them in a more vulnerable place to, I would say, like, in terms of the literature that hasn't really been proven, but everybody's makeup, chemical makeup, brain makeup is completely different. So you know, I think there are certain things that make people more susceptible. And certainly, you know, a number of different medications can do that and create kind of a more susceptible environment for postpartum depression and anxiety.

Christine Stewart-Fitzgerald 16:55
Right. So it sounds like there's really, there's there's not any just typical sort of, you know, case study, but we have to really be paying attention to all these little minute things that are happening and these different kinds of influences and be able to report them to our provider. Now we're talking about on the hormone side. Now, with twins, we all know that, at least in the beginning of the pregnancy, with fertility hormones, those when those are just spiking, like way off the chart, and it's like, oh, yeah, you're having twins, right? Is that also the case later in the pregnancy and postpartum? Where do do twin moms have just, you know, higher levels or lower levels of hormones that would make us more susceptible to mood and anxiety disorders?

Alison Reminick 17:43
Yeah, they're there typically is a higher level of hormones. And so that that drop that like, as you deliver is a much steeper one. So I think that puts moms of twins at risk, I think there's a whole other layer of factors that play into moms who have twins or multiples, having, you know, more susceptibility and risk for a mood or anxiety disorder postpartum too.

Christine Stewart-Fitzgerald 18:08
I know those factors. I mean, I think it probably some of that would be just the fact we were getting less sleep, you know, and I can say, in my case, you know, breastfeeding was by far the toughest thing I ever did. Breastfeeding twins. That's a marathon.

Alison Reminick 18:25
It's a full time job. So that's like working two jobs, you know, especially if you throw on pumping, babies not latching or pumping for two and feeding two. You know, I also think that, you know, sometimes babies that are born premature, like twins are often babies are in the NICU. And that also puts moms at more risk for postpartum depression, and worry, you know, just about the health of their baby. And then more likely to have reflux, which can also cause more problems in terms of mood and anxiety and less sleep, and certainly just finding more space and time for yourself. So I know like, a lot of moms have a lot of guilt, like they're not having that one on one time with maybe feel like their attention is constantly divided with with having to and a lot more overwhelmed. And even if you have some help, it never seems like it's enough. Yes.

Christine Stewart-Fitzgerald 19:18
We were all right. Yeah. And you know, now, I was also wondering, twin moms have a higher rate of c-sections than Singleton's um, is that also a contributing factor? I would just think women recovering from surgery and we've got physical pain and we've got you mentally just there's our body's healing in you know, maybe more ways than one and just, you know, carrying two babies for the last nine months. It's just there's more healing and restoration that needs to take place. Right. So I would think that's also a factor.

Alison Reminick 19:51
Yeah, the fiction can put you more at risk and then exactly what you said pain can really be such a difficult thing to deal with. On top of everything else again. So it's like pain and inflammation have also been culprits of things that are proceeding by mood or anxiety disorder during that time, too. So there's, again, there's a whole host of factors that we think kind of come into play,

Christine Stewart-Fitzgerald 20:15
Maggie and Lisa, I mean, did you ever find was there any physical factor or anything that you felt that was either either just a trigger, or just maybe a component that really made you feel like that was part of what would could be either postpartum depression or any anything in your particular situation,

Maggie Tilley 20:34
I did kind of think that something might have triggered a little bit of my depression after and this was after my Singleton, I ended up bleeding really badly after I had him and I had a really fast labor. So I just bled a lot. And then I ended up fainting. And so I was reading more about it afterwards. And I think it might have been a hemorrhage, I don't know for sure. And I did read that it sometimes when you haven't hemorrhage or fast labor, you can be more susceptible to postpartum depression. So I don't know maybe that might have played a part.

Alison Reminick 21:10
That is true to get postpartum hemorrhage definitely sounds like a postpartum hemorrhage, but you had and that could also be another precipitant. We're just layering on.

Lisa 21:19
And for me, I can relate to Christine about the breastfeeding struggle for me that that was also a big thing that just made me feel even more low, just because I struggled with it. And then even when I switched to pumping, it wasn't, it wasn't going well, no matter all the things I tried to like to increase my supply it was it just got me down. And it didn't help them. My husband at the time was also sort of giving me guilt trips about not, I mean, he he was coming from a good place. But he really was he didn't think I tried hard enough, which is like the worst thing you can say to a mom who's trying to breastfeed twins successfully. So yeah, that definitely did not help my mood and just made me feel worse about things.

Christine Stewart-Fitzgerald 22:05
Yeah, I can totally relate to that. I'll just say, yeah, as twin mom, and we're just feeling physically and mentally challenged. And there's always someone says, Well, it could be worse. You're like, really great, thanks for the, you know, the encouragement, right? I mean, I remember, my mother in law was staying with us. And so I am very grateful we had help early on. So she would come and cook for us and, you know, kind of take care of us. But the breastfeeding, it just takes so much time, you know, the, the, the, you know, we do the breastfeeding for, you know, half an hour, and then we do pumping for another, you know, half hour, 40 minutes. And then, you know, joining a tiny job. Yeah, full time job, right. Yeah. And I remember, for me, I really felt like I just there was, there was one time when I mentioned, you know, to my mother in law, and I just said, Oh, my gosh, I just I just feel trapped. I feel like I'm, you know, in jail, you know, and my expression was really around the fact that it's just day after day after day. It's it's the same routine. And I couldn't get out of it. I might have maybe, you know, maybe a 45 minute break in this, but this is just going on, you know, literally 24/7 Right. And her response to that was, well, at least you're in a beautiful prison, meaning you know, our house is nice.

Sunny Gault 23:32
Oh my gosh. Okay. Yeah. How do you respond to that? Thank you?

Christine Stewart-Fitzgerald 23:39
Yeah, yeah. So it's, I think that's probably something we've all heard is just, you know, when we're going through this mess, like, Well, maybe it's well intended, but it's a form of minimizing our, our feelings. Well, you know, we're gonna take a break. And when we come back, we're going to talk about kind of the implications of having postpartum depression and maybe some preventative measures as well. Well, welcome back. Today, we're talking with Dr. Allison Reminick about postpartum depression and twin moms. So I know some of us here have Singleton's in addition to our twins. I think we're learning that sometimes it's it's different. But But I know that I have to ask the question, if a woman has postpartum depression with with one singleton, is she bound to have it with twins? I mean, is there a likelihood that she would have it again,

Alison Reminick 24:35
there still is a likelihood I think, you know, it's put it to be about like, 30% or so but there's, you know, a lot of a lot of times moms who have been through it can then kind of plan to use more like preventative strategies so that they don't get it again. And then I think once they've had postpartum depression been diagnosed and they know what to look for. They know what their triggers are. They know what helped them to get out of it before So I think that a lot of times our patients will, you know, employ preventative strategies so that they don't get it again, having a treatment team or having a therapist or, you know, having just strategies that have worked for you can really come in handy.

Christine Stewart-Fitzgerald 25:14
So So tell me a little bit more about these preventive strategies. No, does do those strategies start during pregnancy? Or do they start afterwards? Or, you know, when when's the best time to start, you know, planning that out.

Alison Reminick 25:26
So you know, how OB is give people birth plans. So in our clinic, we start we have the partner or caregiver, come in with a mom and start doing a postpartum plan, like 32 weeks, you know, talking about what's going to happen with childcare if there's an older sibling meals, like who's gonna be dealing with, you know, who's going to do which shift in terms of sleep? What support can you get in terms of Do you need a postpartum doula or babysitter? So we have people trying to brainstorm those things. And then I also just try to remind people that number one, first and foremost, like the two things we really need moms to do is get four to five hours sleep. I know that doesn't usually happen in the first two weeks, but to really try to get as much uninterrupted sleep as possible, because four hours is what you need for a restorative sleep cycle, which nobody gets, you know, if you're, especially if you're twins, I don't know how you guys do that. But um, so we try to emphasize that and trying to go out for walks every day, like the sunshine is a natural antidepressant and a really like breaks up the day, I think someone says like, it felt like an entirely long day like a, you know, prison. So just getting out and be reminding yourself that you know, their son, and their, you know, the world is beautiful out there to hear twins for a stroll. So there's a lot of different preventative measures. And then if you had a therapist, or someone that you worked with previously, getting hooked up with them, and pregnancy makes a lot of sense. I think I'm an advocate of therapy, obviously. But I think during any big times of transition, having twins would be one of them, I would imagine, we would just want someone to be kind of with a therapist and plotting out potential pitfalls along the way.

Christine Stewart-Fitzgerald 27:07
Wow, that's, that's a great thing. I mean, if maybe even think about Yeah, planning is part of our postpartum care. I know, I'm a huge advocate of really looking at postpartum care on the physical side. And I think that's great. Even start, you know, thinking about it, you know, afterwards. So it's like, yeah, if you don't already have a therapist, you know, lined up, maybe you start looking for, it's part of our self self care plan. So now I'm just wanting to soil and I also love your idea about just getting outside and sun. I mean, here, we're in California, and so we get so many days of son and I know with with twins, it is tough. But that couldn't be a small, just little victory just to you know, bundle, bundle the babies up and put them in the snap and go right and just take a walk. I mean, I will I won't forget, you know, I've got a picture of the first time that I went outside, you know, with my girls postpartum. And it was in my yoga pants and kind of like flip flops, right. But I mean, I took a little stroll around our cul de sac, and it just felt good just to get outside and do something like So Lisa, Maggie, what did you guys do in terms of some self care?

Lisa 28:23
Well, you know, in my case, I didn't, I didn't seek self, or didn't really do any self care until way later, because I was just in denial about my symptoms, or thinking I could just power through it. But when I finally it was when I made an appointment with a therapist, and then I went to see also my, like, primary care doctor and, and to talk about my symptoms and, and then they prescribed me medication, which helped immensely and also just continuing to see a therapist to just to talk about just life stuff, not just my kids are postpartum things, but that really started to to help a lot. Even though I tried to, I did lots of other things before all that to like, I, I was exercising regularly, I was still seeing my friends a lot, you know, I was making I was technically having a lot of knee time. My husband was supportive about that, but it would help for a while but then you know, it just the symptoms would crawl back and I just, you know, something had to give so I knew finally I needed like professional help. But

Christine Stewart-Fitzgerald 29:23
I mean, that's so great that you actually went out to to seek that on your own because I know that's probably not always the case with with a lot of a lot of moms. So do do most moms. I mean, do you know maybe for Dr. Reminick, we do most moms know that there's kind of something wrong or do they need encouragement from family or friends or somebody to kind of nudge them to seek professional help?

Alison Reminick 29:48
I think, you know, most moms, I think in hindsight will say like, Yeah, I knew something was wrong. Or like I said, sometimes they'll just be like is this what is this what being a mom is about and it's new to me, but I think It's always been, you know, loved ones kind of pointing out to them, like, you don't seem like you're the same person, you don't laugh like you used to, you don't have that same sparkle, you don't seem like you're engaged with us in this moment, you're off somewhere else. So I do think it usually takes the encouragement and their knowledge of, of loved ones to really get someone into care. So if you see anyone that's struggling, you know, really say something, or share your story, something that could be supportive for that person to get them into treatment.

Christine Stewart-Fitzgerald 30:28
Wow. So and then I think also, you know, I'm imagining that maybe, you know, some moms might be worried about, you know, getting treatment and, you know, either, you know, taking medication and the effects of the medication, or maybe they're concerned about stigma that you know, from getting a diagnosis. So, what do you what do you say to those, those moms that might be kind of hesitant to, to get treatment?

Alison Reminick 30:54
Yeah, thanks for bringing this up to you. Because I wanted to make a point of us, you know, a lot of moms delay coming in, you know, sometimes I've diagnosed postpartum depression when they're two years postpartum, just because they've been so afraid to come in for so many reasons. You know, I think there's a, there's a huge fear, for some reason that people think they're gonna go into the psychiatry hospital, they go, and they talk to somebody, or that their baby's gonna be taken away. Or, you know, just the stigma, like, this is supposed to be like, the happiest time of my life. And I'm admitting to feeling really depressed,

Christine Stewart-Fitzgerald 31:25
what might be holding women back from coming in to get treatment? And how can we address that? I mean, you know, for ourselves, and because I know sometimes, you know, we go in for the, like, the six week and eight week checkup, and we fill out the paper with our primary obstetrician. And sometimes that's really the only point of official contact we might have with a caregiver, you know, unless we seek it out ourselves. And so I'm just thinking about maybe the moms who are out there, who are identifying with with some of these feelings that we've been talking about, and say, Well, you know, that kind of does sound like me, but, you know, I really don't want people talking about me, oh, and having depression, and worrying about some stigma. And and, you know, will people treat me differently and that sort of thing. And so I'm just thinking, what, what do we tell those moms,

Alison Reminick 32:16
now that this is really normal, I always talk about that, you know, there's one in 10, postpartum depression, when in five, will have postpartum depression or anxiety. So this is, you know, it's it's common and is very treatable. And that these symptoms, we try to normalize symptoms. So moms who have those, you know, maybe they might have scary thoughts, intrusive thoughts, I try to teach them that that's, that is anxiety. And that does not equal, you know, the the scary cases that are unfortunately, the ones that are in the mainstream media of moms, trying to hurt their children. That's a completely different diagnosis. In psychiatry, I think that's one thing, I try to tell my patients that just because they have a thought doesn't mean it's real, or they're going to act on it doesn't mean that they're crazy. I also say that we don't always start with medications, medications can definitely be very beneficial. And there's a lot of medications that are safe with breastfeeding. But you know, we always try to take the steps of try therapy first, and then see how that works for you. And then if there's still so a lot of symptoms, you could benefit from a medication and go to see a psychiatrist too. So some people are more comfortable seeing a therapist first or their OB, and hopefully the OB is talking to them about the skills that they're doing an office and what they're used for and know where to refer.

Christine Stewart-Fitzgerald 33:33
Right? No, I mean, and that's a good point you bring up that the treatment really doesn't have to be all about medication. I mean, there's certainly medications that are really beneficial, and they work but starting out in a therapy, or even support groups. I know. I mean, I'm active in my my local twins group, and we have a support group, they got the twin mamas. And it's run by a member of the group and she's a licensed social worker. And she just, it's just an open place where the moms can talk about what's going on and being real. And I know a lot of people have said that they've really gotten a lot out of that. I don't have either Maggie or or at least if you've been involved with that.

Lisa 34:16
Yeah, I missed that from the club. Now that I moved away that that group was super beneficial for me. I'm so glad I went I think I was only able to go like three or four times before I moved. But yeah, and this was before I sought help on my own. So it was but it was a nice it was it was great just to like talk to other twin moms about real deep stuff that you know, we might not share with other friends or other moms.

Maggie Tilley 34:40
I got a lot out of going to the group too. I went to the support group. And then I also went in and I saw therapist, and I thought between those two things, and then also I started exercising more and just eating a lot healthier and I felt all of those things combined helped me with my depression because I didn't want to go directly to the medication. And I just wanted to try those things out first.

Christine Stewart-Fitzgerald 35:06
Oh, and that's it. That's a good point. You know, we always talk about exercising, and I think so much emphasis is put on, you know, oh, getting your body back. Right. But, but really, that's really a great point to say that you know, the exercise and just getting out and moving is is a good medicine for your, your mental health as well. That's great. Well, I just want to say thank you so much to Dr. Reminick, for joining us today and sharing with us, you know what we need to know about postpartum depression. So hopefully, the moms out there will be more proactive and taking care of themselves. Thanks for having me.

Sunny Gault 35:47
All right, it's time for our second segment. It's called Twin oops. And I love these stories. These are great stories, usually from twin parents about funny things that have happened with their twins where you just kind of have to take a step back and go, whoops, I'll have to learn from that mistake, not do that one again. And I just really appreciate the honesty and all this. So this comes from a mom, her name is Melanie. And here's what she said. When my girls were three, I left a jar of honey in their room, and I think we could probably end the story there. But I will continue. She said she wants to clarify. She said I had given one of the girls some honey for a cough right before naptime. So now we know why the honey was in the room. She says they promptly climbed out of their cribs opened the jar and started eating honey like little poo bears, and then somehow flung honey all over the carpet, their dresser and their crib. And she says cleaning honey out of carpet is less fun than you are imagining. And then she has a side note to it says don't give babies honey, because we do know like there's an age where you can start to give honey so she wants to put that disclaimer out with your babies are too young. Honey is not a good thing. But have you guys ever given your kids something? Or have they ever just made a true mess? Like giant mess out of getting into something?

Maggie Tilley 37:05
Yes, yeah. Yesterday, I left diaper paste somewhere in the room and they were at the stage where they just started climbing onto things that I didn't realize they could climb up and get. So they just grabbed the diaper cream or and they just, you know put all over their hands on the walls just throughout their whole room. So that was a ton of fun claiming that.

Alison Reminick 37:35
Has anyone had the experience where the baby's gotten into their own poop diaper?

Sunny Gault 37:39
I was just gonna say that! It's a poop party!

Alison Reminick 37:45
We called it the poop-nado in our house. Covered in poop.

Sunny Gault 37:52
Oh my gosh, I had to have carpet cleaning people come out and even like they couldn't even like get it all out. I mean, I was using every chemical in the world to the point that like, I mean, it was just it was so it's such a horrible situation was so bad for my carpeting. But it finally got out. But that was the most distribution of see me on my hands and knees scrubbing poop. Everywhere. It was on their furniture and their hair. And I'm like, don't you guys have noses like this is not smelling good. Why? Why are you having so much fun?

Maggie Tilley 38:23
I feel so much better hearing that you guys have had this because I thought it was the only one I really tried to tell. I told my mother in law and she runs a daycare too. So I thought she would know and then from her own kids and she's like I've never heard of that before. Crazy kid.

Christine Stewart-Fitzgerald 38:44
You are not alone.

Alison Reminick 38:46
It happened so much in our household I dreaded to wake up in that state in the morning is the worst things ever.

Sunny Gault 38:52
Oh my goodness. Misery enjoys company. Right?

Christine Stewart-Fitzgerald 38:57
Well, that wraps up our show for today. We appreciate you listening to Twin Talks. Don't forget to check out our sister show Preggie Pals for expecting parents and our show The Boob Group for moms who breastfeed their babies. Parent Savers, your parenting resource on the go, and Newbies for new moms during their first year. This is Twin talks- parenting times two.