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Breaking the stigma on perinatal mental health issues

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From left, Dr. Ariel Dalfen, Yanekah Jacobs, Arielle Berger, Ira Weisman, Dr. Andrew Howlett and Dr. Molyn Leszcz take part in a panel discussion on mental health issues at Shaarei Shomayim Congregation in Toronto on Feb. 6. (Jodie Shupac photo)

Being depressed is wretched and isolating. Being depressed when someone feels that she should be joyful can result in an even worse feeling of alienation.

This sentiment was emphasized at an event held on Feb. 6 at Shaarei Shomayim Congregation in Toronto, to break the Jewish community’s stigma against mental health issues during and after pregnancy.

The program marked the third in a series on mental illness in the Jewish community and was put on by Sinai Health System, Beth Tzedec Congregation, Shaarei Shomayim, UJA Federation of Greater Toronto, Jewish Family & Child, JACS, Holy Blossom Temple and the Beth Avraham Yoseph of Toronto Congregation.

About 100 people attended, a handful of whom were carrying newborns.

The discussion was moderated by Dr. Molyn Leszcz, a psychiatrist at Mount Sinai Hospital.

Both Rabbi Chaim Strauchler of Shaarei Shomayim and Rabbi Adam Cutler of Beth Tzedec gave opening remarks on the importance of combating the stigma of mental health.

READ: SHORT FILM EXPLORES MENTAL HEALTH ISSUES AND VIOLENCE

The panel included speakers who work in perinatal mental health and individuals who shared their personal experiences of psychological struggles during and post pregnancy.

Dr. Ariel Dalfen, head of the Perinatal Mental Health Program at Mount Sinai, said that between 10 and 20 per cent of pregnant women and new mothers experience some sort of mental health problem. She outlined the distinction between the so-called baby blues and clinical postpartum depression:

Baby blues, which affects between 50 and 90 per cent of new moms, is characterized by feeling overwhelmed and exhausted. It isn’t considered a psychiatric illness and typically lasts a few weeks and dissipates with sleep and social support. If, Dalfen said, those feelings persist, or are accompanied by sadness and crying, then a person may be having a depressive episode. This, as well as if a mother is having intense postpartum anxiety or panicking – including being constantly worried, or even afraid to leave the house with the baby – likely means that she needs to seek psychiatric help.

Therapy – whether individual, group or couples – can be extremely helpful, Dalfen said. She underscored that not only is there a great deal of hope for sufferers of postpartum depression and anxiety, but that having a preexisting mental illness needn’t be a reason not to have kids.

“Most psychiatric medicines are safe to take during pregnancy and breastfeeding, with a lot of data to support their use,” she said.

Yanekah Jacobs gave a personal account of experiencing postpartum depression and of finding solace in Mount Sinai’s Perinatal Mental Health Program.

She stressed that the entire community has a role to play.

“We need to be more vulnerable as a community, more comfortable with being uncomfortable.… When the community is hush-hush about people’s mental health issues … the stigma continues,” she said.

Several panelists stressed that mental illness before, during and after pregnancy is not an issue that exclusively affects women.

Dr. Andrew Howlett, co-founder and head of the Fathers Mental Health Network at Mount Sinai, said the pressure a new or expectant father might feel could put that person at risk of mental health issues.

“This can be one of the most vulnerable periods for men.… About one in 10 dads get depressed at this time of life,” he said, noting that men are generally more reticent to access medical resources or reach out to their support networks when suffering.

Ira Weisman told his personal story of developing anxiety during his wife’s first pregnancy and subsequent miscarriage.

Mount Sinai Hospital in Toronto. (Michael Bonert/CC BY-SA 3.0)

“I felt like I had to be her rock and couldn’t address my own issues … like I couldn’t get it together at work or at home, that things were spinning out of control,” he recounted.

Though initially ashamed to see a psychiatrist, Weisman eventually sought help by going to see Dr. Howlett on a regular basis. The support proved invaluable in the intensely difficult period that followed, in which his wife became pregnant again and he was diagnosed with cancer.

The couple now has a young daughter and Weisman has made a full physical recovery.

Arielle Berger gave a personal perspective on losing a child due to a miscarriage and in finding comfort in Jewish prayer and ritual – some of which she crafted herself.

“Partly what was so hard for me was the lack of (Jewish) ritual around miscarriage. When a child dies before 30 days of life, there’s no burial, no formal prayers to say. I felt like I had this huge pain inside me, but no one knew, cared or knew what to say,” she said.

Following her miscarriage, when it was time to go to the mikveh, she brought along her sister and a friend. They made a makeshift ceremony, wherein Berger read a prayer she had written and a psalm that resonated with the suffering she was then feeling. Then, they all sang a song and she performed her ritual immersion.

“What could have been a moment of such intense loneliness ended up being so warm, loving and powerful,” she said.