Interview with authors of "Myself Again" Michelle Wiersgalla MD and Gabrielle Mauren PhD

Doctors Michelle Wiersgalla and Gabrielle Mauren talk about their new book "Myself Again"  The P.A.R.E.N.T.S. Postpartum Survival Guide.  This book uses the crafty PARENTS  mnemonic to describe their approach for new parents.  Practice patience, Activities for yourself, Rest and sleep, Exercise or movement, Nutrition, Time with others and Support network.   

Gabrielle Mauren, PhD, LP, PMH-C is a licensed psychologist and the developer of an award-winning reproductive mental health program, which has a focus on helping parents who are struggling with mental health concerns related to pregnancy, postpartum, fertility issues and pregnancy loss.  Dr. Mauren completed her undergraduate studies, graduate training, and postgraduate fellowship at the University of Iowa, the University of Minnesota, and the University of Pennsylvania, respectively. She has been a featured speaker on topics of perinatal mental health at local, national, and international conferences.  She lives in Minnesota with her husband and daughter. 

Michelle Wiersgalla MD PMH-C  is a perinatal psychiatrist, psychopharmacology consultant to the Park Nicollet Reproductive Mental Health Program.  Major accomplishments: writing our book “Myself Again”, listed as Top Doctor in Minnesota Monthly 7 years in a row, many speaking engagements at local, national, and international conferences. 

Transcript

Speaker 1: 0:09

[inaudible]

Speaker 2: 0:09

Hello listeners and welcome to baby brain PPSs podcast. I'm Samantha, cuculla your host. And with me tonight, I've got two guests, Michelle, where Scala, a reproductive psychiatrist and Gabriel Martin, who is a reproductive psychologist. Thanks for having us. I'm excited for you guys to talk about your project, which I know took hours upon hours of dedication to complete first, could you gave, tell us a little bit about your connection to PPS M or P Mads.

Speaker 3: 0:37

I am originally from Minnesota and did my last little bit of training out in the Philadelphia area. And 10 years ago, I came back to Minnesota to build a reproductive mental health program in our healthcare system. And so for the last 10 years, I've been involved in that and have been a P P S M member for a good amount of that. I'd have to go back and check the dates specifically, but it's been about 10 years that I've been doing this work.

Speaker 4: 1:00

And similarly for me, I moved to Minnesota and started working and had a great mentor at my old job, Dr. Helen Kim, who brought me into the fold of doing perinatal psychiatry. And so I've been doing it since about 2008 and have been a PPSR member. I'm assuming since around 2008, I think I would have joined right away, but it's been such a great organization. And the bigger organization of PSI has been so wonderful.

Speaker 2: 1:26

Your project, a book that you ladies finished recently, is it out for publication?

Speaker 4: 1:33

Not quite yet. It's coming out on November 17th officially, although you can pre-order it right now from Amazon or from our publishers website, the publisher has Preclarus press

Speaker 2: 1:44

The title of the book is myself again. Can you tell us a little bit about how myself again came to be?

Speaker 4: 1:51

Um, Gabe and I used to do a, what are called centering pregnancy groups. So the midwives at our organization run group prenatal classes for their patients, and they would invite us to come in and talk about postpartum life and expectations and that kind of a thing. And we always got great feedback about it from patients and from the midwives. And so eventually about three years ago, or so we looked at each other and said, Hey, we should write this down and we could get it out to a broader audience because it seems to be really useful to people. So we started working on the book and after a few years and many, many hours of writing and rewriting and seeking out a publisher and going through all the sort of administrative stuff with third jobs and lots of, lots of work, we finally had a book put together. We got a publisher about, oh gosh, six months ago or so. And so we've been excited to work on the fun parts of it, like designing the cover and that kind of thing. But the reason it's called myself again is because what we find in our practices is that so many people who are new parents come to us and say, I just don't feel like myself. And they tell us about how they feel so differently. And when they're struggling with depression and anxiety, things just don't feel how they usually do for them. And so the book is titled myself again, because we know that there are so many excellent ways to treat this, where we talk about postpartum, depression and anxiety that we wanted to sort of put a positive spin on it and have it start, you know, with a cover, as you can get back to yourself again and feel well again. And so the book kind of walks through how to do that, and it talks a lot about self care and stress reduction strategies and how to get the support that you need to recover from depression and anxiety.

Speaker 2: 3:42

There's always some unforeseen hurdles when doing a new project. Can you tell a scape what the biggest learning curve, or maybe the most interesting thing that you've taken away from writing the book?

Speaker 3: 3:52

The book itself kind of wrote itself. You know, Michelle and I were really much on the same page. Our writing style is pretty similar, so we could blend our styles together. The actual content creation went really smoothly. And I think the things that we learned were things that neither one of us learned in school, how to get a copyright lawyer and read, copy, read, you know, read contracts from lawyers so that you're having the right agreements and, and all of that. And I think, I think both Michelle and I can speak for like navigating the publishing world. Uh, we were lucky that I have a family member who actually used to work in the publishing world and she was able to give us some very helpful guidance in the beginning because we didn't know what we were doing. We're, you know, we're doctors, we don't know if it, no one taught us that stuff. So I think learning that and because it was so many new things to then have a publisher say, no, we want this. And that was sort of very gratifying. So in the end, kind of all of those learnings and going into really unchartered uncomfortable territory for us, like in the end had this payout where we were like, oh, someone wants their book. Great.

Speaker 2: 4:57

Michelle, what might a new parent glean from reading myself again?

Speaker 4: 5:01

Well, what we hope they gleaned from reading it is that if they have struggles with symptoms of depression or anxiety, or they've had traumatic experiences related to their pregnancy or birth, that recovery is possible and that people can get better and they can feel better. And there are answers out there for them to treat symptoms and to just feel well overall,

Speaker 2: 5:24

Gabe, can you tell me about parents, the method that you created in the book and what it stands for?

Speaker 3: 5:31

Because we know new parents are tired and have very little time. Uh, we created this specific pneumonic to kind of help people structure, um, how they can focus on getting better. And so this parent's acronym that we came up with stands for the first, the P is practice patience activities for yourself is the a R is rest and sleep E stands for exercise or movement, and is nutrition T is time with others and S his support network. And so in each chapter, when we're talking about depression or anxiety or traumatic childbirth, or non-birth parents, they often get ignored. And so we have a whole chapter just for them. We go through each of those elements of the acronym and give suggestions specific for depression, anxiety, et cetera, that are really easy and approachable. And the kind of the whole idea was that if you could just get little nuggets in the five minutes you have in between busy parenting life,

Speaker 2: 6:28

Michelle, will you talk a little bit about why it's important for parents to be new parents, particularly to be mindful of their mental health?

Speaker 4: 6:37

I mean, I always think that some of the big reasons are that first of all, we want people to recognize that they can't get better and they don't have to struggle unnecessarily. And really what I think gave, and I often talk to patients about like, when we've done these centering pregnancy groups in the past is that, you know, there's a lot of joy and delight and pregnancy and childbearing, and there's a lot of joy and delight in having kiddos and raising kids and building a family. And there's also a lot of hard work involved in all of that. And sometimes it can feel so hard that it starts to outweigh the joyful, delightful part. And what we want for people is to have the joy and the delight B most of the time and the hard work and the struggles be a little bit less of the time. And so getting help and getting ways to treat symptoms of depression and anxiety to improve mental health in general, to improve self care just makes family life so much easier, so much more enjoyable, and you get to love parenting and really just have this joy of spending time with your family and your kiddos.

Speaker 2: 7:44

Gabe, what should someone do if they're struggling?

Speaker 3: 7:48

That's a really good question. Um, and we talk like specifically in almost every chapter about kind of when to reach out for help and who to reach out to help for, you know, for most people, it's going to be going first to a trusted person and whether that's a sister or your mother or a best friend, but oftentimes it can also be the trusted medical person, you know, for, for many of our patients that ends up being their midwife or their OB GYN, someone who's known them perhaps for years. One thing that's great about our book is that we actually were able to solicit four of our actual real patients to write about their stories and how they knew they weren't themselves and what they did to reach out for help. And so that, that encouragement comes through in their stories. And so I hope people read those and find that same encouragement.

Speaker 2: 8:34

One of the things I appreciated most about reading the book was that you kind of met the patient or the client or the mom, or where they were, whether that was already wrapped in the arms of a mental health provider in how to take the next step for a higher level of care or somebody maybe that had never experienced anything like that before, and really breaking down what your first step is, Michelle,

Speaker 4: 8:55

What are some of the go-to treatment options? And I know that's a really broad question. So how does somebody maybe get connected to treatment and what are those options that might be available to them? Yeah, there's a lot of good options and that's the good news about all of this. I'm a psychiatrist. So a large part of my work is in treating symptoms of depression, anxiety with medications. And then there's also therapy and gave as a psychologist who does the therapy side of things. So she could talk a little bit more about that, but it's, I think important for people to know that we've got lots of medications that are safe to use in pregnancy and breastfeeding. And so it gives us choices when it comes to deciding what to do. And for some people, medications sound very appealing and that's the route they take. And for others, therapy sounds more appealing and that's the route they take. And for lots of people, they end up doing both. And what the research would tell us is that doing both together is more effective than either one alone, but it just shows that there are lots of options out there. And there's sort of a mix and match kind of individualized approach for everybody because certain things work for certain people, certain things appeal or not to certain people. So we've got lots of good options. And then the other thing, which is the focus of our book is self care in general, and how to reduce stress, how to build your support network, how to find time for yourself and sort of enriching your own life. Um, you asked too about sort of what are the first steps and how to get care. What we usually tell people is start with who, you know, so family practice, doctor obstetrician, midwife, your kiddos pediatrician, a mental health professional, you may have worked with in the past could always return to seeing them or an organization like BPSM of course, which can connect people with clinicians, but you can start anywhere. And the good news is I think that in the last decade or so people in all medical fields have become more tuned into perinatal mental health in general, and the need for treatment of this. And so, you know, if you're approaching your kiddos pediatrician or your primary care provider, they're going to have ideas for next steps for you. And they'll probably have referral resources and folks that they work with to get you connected with mental health clinicians, if that's what you need.

Speaker 3: 11:11

And if I could put in a little pitch for, for psychotherapy, that would be great. Um, Michelle has heard me say this many times that I will say that what you see on TV when it comes to therapy is not what happens in our office. Usually it's some sort of interesting and scandalous thing that happens. Um, but that's not what real therapy looks like. And so I think a lot of people have misunderstandings, which then lead to fear around what therapy might look like. And so in my practice, and I'm sure in lots of other therapists practice who work with, with new parents, it's not lifelong therapy that you're getting into. And so being able to help people understand that in the beginning, it's going to be, you know, maybe once a week, once every other week, but then when we get sort of things re re-establish and sleep better and understanding how to take good care of yourself and your new family, typically I find my therapy sessions or, or, um, episodes are pretty short. And within a couple of months, people are feeling better and sometimes that's all they need. And so I think a lot of people think that, oh, you have to be in therapy forever for it to work. And, and that's just not the case, which is good because otherwise that's really intimidating to think about

Speaker 2: 12:12

Anything else that you would like to share either of you about myself again, or perinatal mental health and access here in the state of Minnesota.

Speaker 4: 12:22

Yeah. I think what I'd like to say, uh, about the book in particular is that we really did design it for, uh, parents who have little free time and are sleep deprived to be read in five minutes chunks. And, you know, it talks about what is postpartum depression. For example, it talks about what are the parents strategies that people can use. It shares these specific patient experiences. And so whatever aspect of that might appeal to a particular reader, there's kind of something in there for everyone. We also tried to cover a lot of the mental health spectrum. So we talk about baby blues. We talk about postpartum depression. We talk about anxiety. We talk about trauma. We talk about escape said, non-birth parents. So dads, same gender partners, adoptive parents. There's a postpartum plan worksheet to help people kind of anticipate what their needs might be postpartum and how their mental health might be affected by some of the things that they can do to take action. Um, you know, based on some of the suggestions and the parents mnemonic, and then as far as kind of mental health access in Minnesota and in particular in the twin cities, I think compared to the rest of the country, we're relatively blessed. We've got lots of great options with lots of clinicians who do this work. So psychiatrists, psychologists, other therapists, nurse practitioners, DMPs, and just lots of folks who are doing this. Plus we've got great systems, reproductive, mental health programs, sort of throughout the twin cities, partial hospital programs, intensive outpatient treatment programs, all these great options that we have access to have been really, I think lucky for us in Minnesota in particular.

Speaker 3: 14:03

So one of the things I would add to what Michelle said is that our grand plan with this book is that it becomes an automatic gift that you give your best girlfriend. When she's pregnant, you buy her a onesy, a bassinet, and you give her this book because it becomes a let's talk about mental health all the time, not just when you're struggling and, and have it be part of like the baby shower gifts. That is, that is our hope. So that parents have this in their hands. They can start using those things from day one and hopefully sort of feel like themselves quicker, or maybe not even struggle with depression, anxiety, so that that's kind of our grand plan with this book and our hope for it.

Speaker 2: 14:38

That leads right into my next question. Do you guys have any idea how somebody is going to be able to lay their hands on it? I know someone, some people like me like to go into a store and touch and feel their books and sit down with them for a bit and make sure that's what I want. How might somebody listening get connected with your book

Speaker 3: 14:55

As of November 17th, it will be on Amazon for easy access. It will be both a hard copy and a downloadable ebook, so you can get it right on your Kindle. You can always purchase it directly from our publisher as well. And then, um, once it's out in the real world, Michelle and I do have some grand plans of getting it into bookstores so that people can go touch it ahead of time. But one of the reasons that we sort of built the book, like we said, was to have kind of quick, I only have five minutes to get through this. And Michelle and I both envisioned this same sort of parent, right? Who is up at 2:00 AM, feeding their child, feeling terrible. And everyone who knows who's ever fed a child at 2:00 AM. You have one hand free. And usually your cell phone is in that hand because you're killing time on Facebook and social media and all sorts of things. And our hope then is that you go on Amazon with your one finger and, and type in postpartum depression, and up comes our book, and then you have that instant download. And so we wanted to make it really accessible for the 2:00 AM. I'm having not feeling myself moments.

Speaker 2: 15:53

Thank you very much for sharing about your book. Again, the title of the book is myself again by Michelle[inaudible] and Gabriel Martin coming out on November 17th. For more information regarding both Michelle and Gabe practice, please see the description of the podcast.

Speaker 1: 16:18

[inaudible].