Latest / Wellness, Actually with Emily Oster & Perry Wilson, MD / What's the deal with pregnancy brain? (feat. Allison Williams)

Transcript

What's the deal with pregnancy brain? (feat. Allison Williams) · Wellness, Actually with Emily Oster & Perry Wilson, MD

• 0:00
  Speaker 1: Perry. Have you ever been pregnant?
• 0:04
  Speaker 2: No, not to my knowledge, but my wife has been
• 0:07
  Speaker 2: pregnant several times.
• 0:09
  Speaker 3: Did you know that when you are pregnant, fetal cells
• 0:14
  Speaker 3: get into your bloodstream and they live there forever, So
• 0:17
  Speaker 3: your children's cells are still circulating around your wife's brain
• 0:22
  Speaker 3: as we speak.
• 0:24
  Speaker 2: That is crazy. I mean I believe it pregnancy as
• 0:29
  Speaker 2: I went back to my med school notes for this
• 0:32
  Speaker 2: episode to like remind myself about how incredibly bonkers the
• 0:38
  Speaker 2: physiology is in pregnancy. I mean it is literally like
• 0:43
  Speaker 2: if I didn't know that it served some evolutionary purpose,
• 0:47
  Speaker 2: I would be like, well, this is clearly a terminal disease,
• 0:50
  Speaker 2: like no one can survive this.
• 0:53
  Speaker 1: I totally agree.
• 0:54
  Speaker 3: And that is in fact, how it feels some of
• 0:55
  Speaker 3: the time while you are pregnant, I will tell you.
• 0:58
  Speaker 3: And today we're to talk about pregnancy brain and the
• 1:03
  Speaker 3: ways that pregnancy makes your brain worse or maybe better,
• 1:08
  Speaker 3: or maybe different and both.
• 1:11
  Speaker 1: And we've brought in a special guest, special scientist.
• 1:16
  Speaker 3: We've run a special neuroscientist adjacent guest. Now, Allison would
• 1:21
  Speaker 3: like to introduce yourself and tell us why you're here.
• 1:25
  Speaker 4: I am here by force, I like basically commissioned this
• 1:29
  Speaker 4: episode and forced my way onto the podcast, which I'm
• 1:31
  Speaker 4: an obsessive fan of. I want to thank you for
• 1:34
  Speaker 4: your work. You've accompanied me through many a It's been
• 1:38
  Speaker 4: the equivalent of a panic Google, but much more informed
• 1:41
  Speaker 4: and much better. So thank you for saving me from
• 1:44
  Speaker 4: panic Googling. Although I guess now we panic Claude I
• 1:46
  Speaker 4: ghost mode, panic claud now at dark mode totally anyway, Hi,
• 1:51
  Speaker 4: I'm Allison. I am an actress. I'm also a podcaster.
• 1:55
  Speaker 4: I basically have been wondering for years now whether my
• 2:00
  Speaker 4: brain actually physically changed in a permanent way such that
• 2:04
  Speaker 4: I now have a different amount of or new presentation
• 2:09
  Speaker 4: of ADHD in adulthood, or if I always had it
• 2:14
  Speaker 4: but my ability to mask it was so good that
• 2:16
  Speaker 4: I didn't know, and then once I had a kid
• 2:20
  Speaker 4: there's just so much going on that all those coping
• 2:22
  Speaker 4: mechanisms no longer worked, Or if I don't have it
• 2:28
  Speaker 4: at all, and I just now I am a mom
• 2:31
  Speaker 4: and that means that my whole life feels like an
• 2:33
  Speaker 4: ADHD diagnosis and looks like one, and thus can be
• 2:37
  Speaker 4: treated like one, but isn't actually one. That's kind of
• 2:41
  Speaker 4: where this is coming from. And there was a study
• 2:43
  Speaker 4: which I'm sure you'll talk about with more. I don't
• 2:46
  Speaker 4: know authority and data, but there was a study showing
• 2:50
  Speaker 4: that women's brains changed physically during pregnancy and it was
• 2:53
  Speaker 4: correlated with postpartum depression. And that fascinated me because I
• 3:01
  Speaker 4: also had postpartum depression. And I was like, my brain
• 3:03
  Speaker 4: feels super different, but also my life is unrecognizable. And
• 3:07
  Speaker 4: so it's one of those what is the causation versus
• 3:11
  Speaker 4: correlation questions that I have been asking myself. And then
• 3:14
  Speaker 4: I was like, why am I asking myself this? That's useless.
• 3:17
  Speaker 4: I know what I know, I think, therefore I am therefore,
• 3:21
  Speaker 4: I know nothing extra about this topic, and I need
• 3:23
  Speaker 4: to turn to people who actually will And so I
• 3:26
  Speaker 4: turned to the best people because I weaponized my status,
• 3:30
  Speaker 4: and here I am.
• 3:31
  Speaker 1: We are so pleased that you did well.
• 3:33
  Speaker 4: Thank you. Now I know there's little bits of my son.
• 3:35
  Speaker 4: I can't wait to tell it. He's going to be
• 3:37
  Speaker 4: so proud. He's going to be so excited and proud.
• 3:43
  Speaker 3: I'm Emily ast I'm an economist and a data expert.
• 3:46
  Speaker 2: And I'm Harry Wilson.
• 3:47
  Speaker 4: I'm a medical doctor and I'm Alison Williams, actor and
• 3:50
  Speaker 4: podcaster and a fan of this very podcast.
• 3:53
  Speaker 3: It's Thursday, July sixteenth, twenty twenty six. And this is wellness.
• 3:58
  Speaker 2: Actually, because you're getting a staggering amount of health and
• 4:01
  Speaker 2: wellness information nowadays from every source imaginable, and some of
• 4:05
  Speaker 2: it is awesome and some.
• 4:07
  Speaker 1: Of it is well actually both.
• 4:11
  Speaker 3: Fortunately, we're both people who know how to read studies,
• 4:14
  Speaker 3: how to parse the data, and can tell you what's
• 4:17
  Speaker 3: worth thinking about and what you can safely ignore.
• 4:20
  Speaker 2: But before we dig in, a note that this podcast
• 4:22
  Speaker 2: is for educational purposes and should not be construed as
• 4:25
  Speaker 2: medical advice. We don't know your unique situation, so talk
• 4:28
  Speaker 2: to your doctor for personal health decisions.
• 4:31
  Speaker 3: This week we're asking what's the deal with pregnancy brain?
• 4:34
  Speaker 3: Alison Perry and I will give the official smasher pass,
• 4:37
  Speaker 3: and then we'll get to your question of the week.
• 4:39
  Speaker 1: But first let's do the health news roundup.
• 4:41
  Speaker 5: After the break, we're back.
• 4:56
  Speaker 3: We've set Alison off to go get her coffee so
• 4:59
  Speaker 3: we can cover the health news of the week.
• 5:01
  Speaker 1: Harry.
• 5:02
  Speaker 3: First up, the last American polio survivor in an iron
• 5:06
  Speaker 3: lung dies. I know you know a lot about this,
• 5:09
  Speaker 3: I know it has a personal connection. Tell me more.
• 5:11
  Speaker 2: Yeah. So, some listeners and certainly many of my friends
• 5:15
  Speaker 2: will know that my mom was a polio sufferer. She
• 5:18
  Speaker 2: was in an iron lung when she was a little kid.
• 5:24
  Speaker 2: She ended up only having paralysis of one lower leg,
• 5:29
  Speaker 2: but obviously not everyone was so lucky. Martha and Lillard
• 5:33
  Speaker 2: is the last American polio survivor dependent on an iron lung.
• 5:36
  Speaker 2: She died at the age of seventy eight on the
• 5:38
  Speaker 2: last Friday in June of twenty twenty six. She contracted
• 5:41
  Speaker 2: polio a pretty similar year to my mom, nineteen fifty three.
• 5:45
  Speaker 2: That was her fifth birthday. That was two years before
• 5:49
  Speaker 2: the vaccine became widely available in the US. People don't
• 5:53
  Speaker 2: realize this now, obviously, but that was the reality in
• 5:56
  Speaker 2: the pre vaccine era, is that kids could get and
• 6:00
  Speaker 2: not all of them, but a fraction of them would
• 6:04
  Speaker 2: develop this this paralysis syndrome, which was sometime lifelong. Martha
• 6:11
  Speaker 2: Ann was from Shawnee, Oklahoma. She rescued animals, created art
• 6:15
  Speaker 2: and poetry, and had recently married her second husband in
• 6:18
  Speaker 2: February of twenty twenty six. It's wonderful that she was
• 6:21
  Speaker 2: able to lead such a full life. Not all kids
• 6:25
  Speaker 2: with polio had that opportunity, and I feel like I
• 6:29
  Speaker 2: just need to say that polio only exists in humans.
• 6:34
  Speaker 2: It is therefore a candidate for eradication from the earth
• 6:39
  Speaker 2: like we did with smallpox. It is on the list,
• 6:42
  Speaker 2: but unfortunately, due to recent trends in sort of the
• 6:47
  Speaker 2: anti vaccine movement, the eradication program has had some significant
• 6:52
  Speaker 2: setbacks and there is polio spreading out there, although not
• 6:56
  Speaker 2: in the United States currently.
• 6:58
  Speaker 1: Perry did this woman live her whole life in the
• 7:00
  Speaker 1: iron lung?
• 7:01
  Speaker 2: Is that she apparently for much of her life only
• 7:06
  Speaker 2: had to spend the night times in the iron lung,
• 7:09
  Speaker 2: so she would sleep there. Although I, as far as
• 7:11
  Speaker 2: I understand, she had a couple of bouts of COVID
• 7:14
  Speaker 2: and after that point was more or less confined to
• 7:17
  Speaker 2: the iron lung. Yeah.
• 7:19
  Speaker 3: Amazing, and also, as you say, a reminder that vaccines
• 7:22
  Speaker 3: are really, really life saving and important.
• 7:26
  Speaker 2: Absolutely, Emily. I was fascinated to see an article that
• 7:31
  Speaker 2: writers into Tour de France are using lactate gels. What
• 7:36
  Speaker 2: is up with lactate gel?
• 7:38
  Speaker 3: Okay, so first of all, I want you guys to
• 7:40
  Speaker 3: understand that you're very lucky that I showed up for
• 7:42
  Speaker 3: today's recording because we are in the middle of Tour
• 7:46
  Speaker 3: de France Stage ten.
• 7:47
  Speaker 1: It's an important tour. I could be watching it.
• 7:49
  Speaker 3: Live on peacock right now and I'm instead I'm here
• 7:52
  Speaker 3: at work. Then I have to watch it later. So
• 7:54
  Speaker 3: you're welcome.
• 7:55
  Speaker 2: You're the real hero.
• 7:56
  Speaker 1: Emily totally okay.
• 7:58
  Speaker 3: So there's always every year there's some weird like endurance
• 8:02
  Speaker 3: sports science that comes out in the Tour de France,
• 8:04
  Speaker 3: because these are like the world's most elite athletes, supported
• 8:08
  Speaker 3: by the most amount of money. So like the United
• 8:11
  Speaker 3: Arab Emirates is putting just millions and millions of dollars.
• 8:16
  Speaker 1: Into getting Tadday Pagatcha to like go a little bit
• 8:20
  Speaker 1: faster on his bicycle.
• 8:22
  Speaker 5: Yeah.
• 8:23
  Speaker 1: Their latest thing is.
• 8:25
  Speaker 3: With their gels, which are generally just fructose some combination
• 8:28
  Speaker 3: of glucose and fructose which you eat, you know, while
• 8:30
  Speaker 3: you are biking very very fast.
• 8:32
  Speaker 1: They've added lactate to the gels.
• 8:35
  Speaker 2: Interesting.
• 8:36
  Speaker 3: The idea is that I think twofold one is you
• 8:40
  Speaker 3: can use lactate as a fuel source, and so this
• 8:44
  Speaker 3: gives you yet another fuel source to fuel your cycling.
• 8:48
  Speaker 3: I think there's also an idea that the lactate can
• 8:52
  Speaker 3: make you less tired by eating up the hydrogen ions
• 8:57
  Speaker 3: that are produced with lactic acid, So maybe that works.
• 9:02
  Speaker 2: I mean, so a little nephrology here. The lactate that's
• 9:06
  Speaker 2: going to be in these gels, just a little nephrology
• 9:09
  Speaker 2: is almost certainly not lactic acid. It's probably sodium lactate.
• 9:13
  Speaker 2: So the conjuget base and lactate, as you say, can
• 9:16
  Speaker 2: be used as fuel. That's anaerobic respiration does use lactate,
• 9:20
  Speaker 2: and so maybe that's part of it. The other thing
• 9:23
  Speaker 2: is that your liver metabolizes lactate into bicarbonate. And I
• 9:27
  Speaker 2: know Emily that you're familiar with bicarbonate supplementation during a
• 9:31
  Speaker 2: lot of these endurance sports. So I wonder if a
• 9:33
  Speaker 2: little bit of this is just like bicarbonate with extra steps.
• 9:36
  Speaker 2: But either way, bicarbonate is a good acid scavenger, you know.
• 9:41
  Speaker 2: I teach the medical students this like acidosis, Like being
• 9:44
  Speaker 2: acidemic sounds so bad, But that being said, one of
• 9:49
  Speaker 2: the things that happens when you're acidemic is that hemoglobin
• 9:53
  Speaker 2: and you evolve this way, hemoglobin holds onto oxygen less tightly.
• 9:57
  Speaker 2: In acidic environments because as you might expect, it's like, oh,
• 10:01
  Speaker 2: there's it's getting acidic in here, there's not enough aerobic respiration,
• 10:04
  Speaker 2: like have some more oxygen. And so I always worry
• 10:07
  Speaker 2: even in the hospital about correcting acidosis too aggressively because
• 10:11
  Speaker 2: maybe we don't deliver oxygen as well. So, but I
• 10:13
  Speaker 2: don't know, people study it.
• 10:14
  Speaker 3: Then what I will say about this is it's probably
• 10:17
  Speaker 3: not for you, listener, for two reasons. One, there's actually
• 10:20
  Speaker 3: no evidence that this works. I mean, there's only that
• 10:23
  Speaker 3: they're using. The only evidence is like from the market.
• 10:26
  Speaker 3: You know that the teams are trying to buy all
• 10:28
  Speaker 3: these lack day jails. And also they gels cost nine
• 10:32
  Speaker 3: dollars each, which is a lot since these guys are
• 10:35
  Speaker 3: having like three every hour and that, and there's a
• 10:38
  Speaker 3: lot of people on the team, so they're just really
• 10:41
  Speaker 3: they're wasting they're spending a lot of money on lack
• 10:42
  Speaker 3: day jaels. But it's safer than last year's innovation, which
• 10:45
  Speaker 3: was carbon monoxide rebreathing, where you inhaled carbon monoxide to
• 10:49
  Speaker 3: raise your which is not that sounds like you don't
• 10:52
  Speaker 3: a terrible idea. Don't do that either, Okay, speaking of
• 10:56
  Speaker 3: things that are about optimizing. Brian Johnson fame for his
• 11:01
  Speaker 3: desire to not die, something we all share, but maybe
• 11:04
  Speaker 3: not in the same with the same approach, with the
• 11:07
  Speaker 3: same zeal. He has announced that he has been diagnosed
• 11:11
  Speaker 3: with something called autoimmune guestritis. He described it as my
• 11:16
  Speaker 3: stomach is eating itself. Is that a clinical description, Perry.
• 11:22
  Speaker 2: I mean, it's not bad. It's not bad, okay, but
• 11:26
  Speaker 2: it's not accurate either. It's evocative though. Automun gustritis is
• 11:30
  Speaker 2: as it sounds like an automune condition where your immune system,
• 11:33
  Speaker 2: not your own stomach, attacks the acid producing cells in
• 11:35
  Speaker 2: your stomach and that has the sort of downstream effect
• 11:39
  Speaker 2: of inhibiting iron absorption, and so people can become iron deficient.
• 11:43
  Speaker 2: I think that's how they actually picked this up in
• 11:45
  Speaker 2: Brian Johnson. For those of you who don't know, I mean,
• 11:47
  Speaker 2: I feel like a lot of people know. But Brian
• 11:48
  Speaker 2: Johnson is the millionaire guy who like does literally everything
• 11:53
  Speaker 2: like he's an end of one experiment on every health
• 11:56
  Speaker 2: and wellness thing. From getting his like teenage uns blood transfusions,
• 12:02
  Speaker 2: taking methylene blue and wrap a micin and like a
• 12:06
  Speaker 2: million other things and then gets a zillion lab tests
• 12:08
  Speaker 2: and tries to draw conclusions, which is actually really hard
• 12:11
  Speaker 2: because he's doing one hundred and fifty things at once
• 12:14
  Speaker 2: to optimize.
• 12:14
  Speaker 3: Monitors his erections every night. That's he like has a
• 12:17
  Speaker 3: system to see how good his erections are every night?
• 12:20
  Speaker 2: Does everyone doesn't do that? That's that's uncommon. That's fine,
• 12:24
  Speaker 2: that's fine. So yeah, he's really into the data. And
• 12:28
  Speaker 2: and when you know he came out with this automne gastritis,
• 12:31
  Speaker 2: it's also a little bit like I should say this,
• 12:34
  Speaker 2: this condition can just pop up. Like any autommune condition,
• 12:37
  Speaker 2: you don't always know what the precipitate is. But in
• 12:39
  Speaker 2: someone who's taking you know, a million different supplements and
• 12:42
  Speaker 2: probiotics and methylene blue and rap amcin and all these things,
• 12:45
  Speaker 2: it's like, do you think maybe any of these things
• 12:48
  Speaker 2: could have had this particular adverse effect? And we'll never
• 12:50
  Speaker 2: know because he's doing one hundred and fifty things at once.
• 12:53
  Speaker 3: I will tell you the thing about this story I
• 12:55
  Speaker 3: found most interesting and would love to understand better, which
• 12:59
  Speaker 3: is I think part of how he found this was
• 13:02
  Speaker 3: related to his decision to have a colonoscopy. He's actually
• 13:06
  Speaker 3: forty eight and this was his first colonoscopy. So this
• 13:10
  Speaker 3: is a person who's doing literally everything, it's taking every
• 13:15
  Speaker 3: random supplement, but he actually was three years late on
• 13:20
  Speaker 3: one of the very basic things that we recommend people
• 13:24
  Speaker 3: do to prevent cancer, which is a colonoscopy.
• 13:26
  Speaker 1: So there's something so odd in my head about that.
• 13:29
  Speaker 3: Like, in the order of things I would say health wise,
• 13:32
  Speaker 3: I would put colonoscoby so far above methylene blue, Like
• 13:36
  Speaker 3: you couldn't even see methylene blue from the colonoscopy in
• 13:39
  Speaker 3: my list, Yeah, do the evidence based things first and
• 13:42
  Speaker 3: then you know, play around and then later play play
• 13:45
  Speaker 3: around with your stuff. Is we wish him well?
• 13:48
  Speaker 2: I guess we do wish him well?
• 13:50
  Speaker 1: What is he doing about this?
• 13:51
  Speaker 2: Okay, so his team reportedly is talking about doing car
• 13:56
  Speaker 2: tee therapy for him. This is this is crazy. So
• 14:01
  Speaker 2: there's no actual treatment for an immune gastritis. Like you
• 14:04
  Speaker 2: do iron supplementation, you monitor they have an increased risk
• 14:06
  Speaker 2: of cancers, and so you just do gaster cancer screening
• 14:09
  Speaker 2: when the eddoscopy and stuff. It's just sort of you know,
• 14:12
  Speaker 2: supportive care. Car T cell therapy is like primarily a
• 14:16
  Speaker 2: therapy for cancer where you take people's T cells out
• 14:19
  Speaker 2: of their body and you rev them up so they're hyperactive,
• 14:22
  Speaker 2: and you infuse them back in and you have this
• 14:25
  Speaker 2: massive immune reaction that's supposed to kill tumor cells. In
• 14:29
  Speaker 2: the hospital, the reaction that patients get when you reinfuse
• 14:32
  Speaker 2: car T cells into them, that inflammatory immune reaction is
• 14:36
  Speaker 2: so robust we call it a cartastrophe. They often get
• 14:41
  Speaker 2: into the intensive care unit with an it looks like
• 14:44
  Speaker 2: septic shock, like their pressure is bottoming out and their
• 14:47
  Speaker 2: you know, their fever is spiking, but there's no infectious organized.
• 14:49
  Speaker 2: It's just they have all these rev duvet cells in them.
• 14:52
  Speaker 2: This is a classic example of VIP syndrome, like very
• 14:56
  Speaker 2: important person syndrome, where doctors will well do weird stuff
• 15:02
  Speaker 2: for people that like you wouldn't do for an ordinary person,
• 15:06
  Speaker 2: and actually it probably harms the VVIP. This definitely happens.
• 15:11
  Speaker 1: All right, with that, let's turn back to pregnancy brain.
• 15:20
  Speaker 2: All right, we're back with what's the deal with pregnancy brain?
• 15:24
  Speaker 2: And we're so excited to welcome Alison Williams back to
• 15:27
  Speaker 2: discuss with us.
• 15:28
  Speaker 4: Hi, I'm happy to be back. I'm sure all of
• 15:31
  Speaker 4: that health news was fascinating.
• 15:37
  Speaker 3: Okay, so we're going to talk today about pregnancy brain.
• 15:42
  Speaker 3: We're going to talk about our personal experience with this,
• 15:45
  Speaker 3: but also scientifically about what happens to the brain during pregnancy.
• 15:50
  Speaker 3: And I think the way I would like to structure
• 15:52
  Speaker 3: answering your questions, Allison, are to start by talking about
• 15:57
  Speaker 3: literally what do we know happens to the brain, and
• 16:01
  Speaker 3: then talk about how that connects to some of these
• 16:03
  Speaker 3: things like ADHD or postpartum depression, and how we can
• 16:06
  Speaker 3: separate diagnosis from actual changes from life circumstance changes and
• 16:13
  Speaker 3: hopefully get to the bottom of it. So I want
• 16:16
  Speaker 3: to start with the fact that your brain shrinks during pregnancy.
• 16:21
  Speaker 3: That is my first most interesting fact. And Perry, since
• 16:24
  Speaker 3: you're the doctor here but not have never been pregnant,
• 16:28
  Speaker 3: please tell.
• 16:28
  Speaker 4: Us why did you do this in us?
• 16:30
  Speaker 1: Our brain size is what's wrong with you?
• 16:32
  Speaker 4: Why did you decide to do that to us?
• 16:34
  Speaker 2: I'm going to spin this in the most positive way
• 16:38
  Speaker 2: I can. I mean, if you're listening at the top
• 16:41
  Speaker 2: of the episode, like, pregnancy is a complete physiologic disaster,
• 16:46
  Speaker 2: but let me let me put a number on it.
• 16:48
  Speaker 2: The estrogen level of a premenopausal woman, you know, varies
• 16:53
  Speaker 2: over the course of the month, but like, let's say
• 16:55
  Speaker 2: it's four hundred peekograms per mile leader, so okay, four hundred.
• 17:00
  Speaker 2: In the third trimester of pregnancy, it's thirty thousand. It
• 17:05
  Speaker 2: is absolutely insane, and for the men, because like it's
• 17:11
  Speaker 2: about time someone speaks for the men when it comes
• 17:13
  Speaker 2: to pregnancy.
• 17:13
  Speaker 4: Thank you for doing this every time too.
• 17:15
  Speaker 2: I'm so brief.
• 17:15
  Speaker 4: You got a center the right people.
• 17:17
  Speaker 2: Men. Do you remember the testosterone replacement therapy episode where
• 17:21
  Speaker 2: we pointed out that anabolic steroids like the kind you're
• 17:25
  Speaker 2: juicing with are just synthetic forms of testosterone that are
• 17:29
  Speaker 2: about ten times more potent, and that ten times increase
• 17:33
  Speaker 2: in testosterone level causes muscles to grow. But also, you know,
• 17:37
  Speaker 2: liver disease and heart disease, and roid rage and hair
• 17:39
  Speaker 2: loss and acne and all these hot, horrible things. That's
• 17:42
  Speaker 2: ten times the baseline level of your sort of standard
• 17:47
  Speaker 2: hormone pregnancy is one hundred times higher. It's insane. You
• 17:52
  Speaker 2: asked about brain shrinkage. The positive spin on this is yet,
• 17:56
  Speaker 2: So this is true. This is based on actually several
• 18:00
  Speaker 2: studies that have used MRIs and other techniques, and it
• 18:03
  Speaker 2: finds about a four and a half to five percent
• 18:06
  Speaker 2: decrease in gray matter, which is like the literally the
• 18:10
  Speaker 2: neurons in your brain over the course of pregnancy. The
• 18:15
  Speaker 2: thought is that pregnancy is actually a neuroplasticity event. The
• 18:20
  Speaker 2: brain is cutting a bunch of connections that had existed
• 18:25
  Speaker 2: to essentially make room for a slew of new connections,
• 18:28
  Speaker 2: including the ones that will lead to, like the social
• 18:33
  Speaker 2: interaction with the child, which is going to become such
• 18:35
  Speaker 2: an important thing to the brain once delivery happens. So
• 18:39
  Speaker 2: it might not just be that you're sitting in a
• 18:41
  Speaker 2: toxic stew of hormones for the last three months of pregnancy.
• 18:45
  Speaker 2: It might actually be evolutionary indicated so that your brain
• 18:49
  Speaker 2: is ready to bond better with your child.
• 18:51
  Speaker 3: What do you think, M I feel like this is
• 18:54
  Speaker 3: this is like it's cutting all the parts of the
• 18:55
  Speaker 3: brain that like, you know, knew how to like go
• 18:59
  Speaker 3: out to the club, and then replacing the parts that are.
• 19:06
  Speaker 4: Medical explanation for losing those parts of the brain much earlier,
• 19:10
  Speaker 4: if the parts of the brain that were like you
• 19:13
  Speaker 4: don't need to cry right now. This is really good.
• 19:18
  Speaker 3: But a question that I have wondered about and I
• 19:21
  Speaker 3: think is sort of in here is like you we
• 19:25
  Speaker 3: are not using all of our brain all the time,
• 19:27
  Speaker 3: so we are not using all of them.
• 19:29
  Speaker 1: You know.
• 19:30
  Speaker 3: This is the fact that you're told as a kid
• 19:31
  Speaker 3: is like you only ever use ten percent of your
• 19:33
  Speaker 3: brain and most of it just sits around or whatever.
• 19:35
  Speaker 1: I'm not really sure if that's true, but I don't
• 19:39
  Speaker 1: think it's true.
• 19:40
  Speaker 2: But you're right there, like we're not using all of
• 19:42
  Speaker 2: our brain at every second.
• 19:43
  Speaker 3: Yeah, but when we shrink our brain by five percent,
• 19:46
  Speaker 3: like is that a meaningful number? This gets to some
• 19:48
  Speaker 3: of the broader questions of like is it just like
• 19:50
  Speaker 3: it's shrinking and kind of in ways that are not
• 19:53
  Speaker 3: that important, or is it shrinking in ways that are meaningful? Alison,
• 19:56
  Speaker 3: I'm curious whether you felt during pregnancy. I know we're
• 20:01
  Speaker 3: talking about after, but like, did you feel during pregnancy
• 20:04
  Speaker 3: that your brain was drinking?
• 20:06
  Speaker 4: I started to I didn't feel it for the first
• 20:09
  Speaker 4: two trimesters, but by the end I was like, I'm
• 20:12
  Speaker 4: not in my body, I'm not in my brain. I
• 20:15
  Speaker 4: who's amygdala?
• 20:16
  Speaker 2: Is this?
• 20:17
  Speaker 4: Like everything fell foreign? And also I'm not a hyper
• 20:22
  Speaker 4: emotional person, and Emily, I know you're deeply emotional, so
• 20:25
  Speaker 4: this might be hard to really too. That was a
• 20:28
  Speaker 4: joke because I'm sort of like wishing we had a
• 20:31
  Speaker 4: deeply emotional person here to represent what that's like, because
• 20:35
  Speaker 4: I can't imagine what that would be like. But I
• 20:38
  Speaker 4: just have this one snapshot of me about two weeks
• 20:42
  Speaker 4: shy of delivering. When I made myself pasta and when
• 20:45
  Speaker 4: I took it off the stove, I just dumped it
• 20:47
  Speaker 4: into the sink without a calendar. I don't cook a lot, obviously,
• 20:52
  Speaker 4: and I burst into tears. I was like, this is
• 20:56
  Speaker 4: an unfixable problem, like that time is gone, that pasta's gone.
• 21:01
  Speaker 4: I just was like weeping in the kitchen, sort of
• 21:05
  Speaker 4: like paralyzed with the inability to decide what to do next,
• 21:09
  Speaker 4: like lacking all the skills to handle this situation. I
• 21:11
  Speaker 4: felt like a little kid again. And that is a
• 21:14
  Speaker 4: moment where I felt just like I want all of
• 21:17
  Speaker 4: my old machinery back, and I never got it back,
• 21:21
  Speaker 4: like I got new stuff. I feel like when I
• 21:25
  Speaker 4: lost the five percent, it didn't that same five percent
• 21:28
  Speaker 4: didn't just come back. It was you know, it was different.
• 21:34
  Speaker 2: Yeah, something fundamentally changed.
• 21:36
  Speaker 5: Yeah.
• 21:37
  Speaker 3: Yeah, So I think this connects to the second piece here,
• 21:42
  Speaker 3: which is what happens to measured cognitive function in the data,
• 21:46
  Speaker 3: because it's one thing to sort of say, Okay, the
• 21:48
  Speaker 3: brain shrinks and then it comes back to normal, and
• 21:50
  Speaker 3: it maybe come back to normal in a different with
• 21:52
  Speaker 3: a sort of different set of connections. But there was
• 21:54
  Speaker 3: also a fair amount of research about sort of during
• 21:57
  Speaker 3: pregnancy specific declines and cognitive function in memory and executive function.
• 22:06
  Speaker 3: A lot of this is about kind of processing speed
• 22:10
  Speaker 3: and these sort of measures of like just how how
• 22:12
  Speaker 3: much stuck can you hold in your brain at the
• 22:14
  Speaker 3: same time, and how good is your verbal memory.
• 22:16
  Speaker 1: That's like a common way to measure this.
• 22:19
  Speaker 3: And I think this will this illustrates to me a
• 22:22
  Speaker 3: general problem with all of these discussions, which is that
• 22:26
  Speaker 3: there's there's something we can measure, which is how is
• 22:28
  Speaker 3: your brain actually changing? And then if we measure some change,
• 22:32
  Speaker 3: we then want to say, like why we want toust
• 22:35
  Speaker 3: so story about like either it's because of the hormones
• 22:38
  Speaker 3: all in the brain, or it could be because you're tired,
• 22:42
  Speaker 3: or because because you're paying attention to it, or it
• 22:44
  Speaker 3: could be because like you're thinking about a lot of
• 22:46
  Speaker 3: different things and there's a lot of new stimuli and
• 22:48
  Speaker 3: like you know, when you poured the pasta in the sink.
• 22:51
  Speaker 1: It wasn't because you got stupider.
• 22:52
  Speaker 3: It was because you were also thinking about how you
• 22:54
  Speaker 3: like had to buy a crib and uh, and you.
• 22:58
  Speaker 1: Hadn't gotten enough sleep.
• 22:59
  Speaker 3: So I think the like in all of this stuff,
• 23:01
  Speaker 3: it's going to be incredibly difficult to separate the like
• 23:03
  Speaker 3: life circumstance change from the sort of some kind of
• 23:07
  Speaker 3: true biological parameter.
• 23:10
  Speaker 2: And we've also talked before about how hard it is
• 23:12
  Speaker 2: to measure the something that we all understand conceptually, like
• 23:15
  Speaker 2: brain fog, whatever you want to call it, right, like
• 23:17
  Speaker 2: pregnancy brain, brain fog, you know, baby brain, these subjective
• 23:21
  Speaker 2: states of like I don't feel as smart as I
• 23:24
  Speaker 2: normally do. That's there's no test for that, right, there's
• 23:28
  Speaker 2: not an IQ test that pulls that out. You have
• 23:30
  Speaker 2: to do all this really specific neurocognitive testing, you know,
• 23:34
  Speaker 2: to see if there are problems with like, oh, your
• 23:36
  Speaker 2: verbal memory, which is, you know, can you think of
• 23:39
  Speaker 2: the word for calender? Or your semantic memory, which is
• 23:43
  Speaker 2: like do you know who fought in the War of
• 23:46
  Speaker 2: eighteen twelve? Like, these are actually different things and they
• 23:49
  Speaker 2: get teased out differently. Can I tell my wife's pregnancy
• 23:53
  Speaker 2: brain story because I think it illustrates this really nicely.
• 23:56
  Speaker 2: So my wife is a breast cancer surgeon and she
• 24:00
  Speaker 2: is in the operating room, very pregnant with our second
• 24:04
  Speaker 2: and you've probably seen this on TV, but it's it's
• 24:07
  Speaker 2: literally true. Like if you're the surgeon, you don't want
• 24:09
  Speaker 2: to look away from the field, like you're looking down
• 24:11
  Speaker 2: into the operating field, and so you just stick your
• 24:14
  Speaker 2: hand out without looking and you say the name of
• 24:16
  Speaker 2: the instrument you want, right like you want an adsons retractor,
• 24:20
  Speaker 2: or you want, you know, a debate or whatever it is.
• 24:23
  Speaker 2: They have these names.
• 24:24
  Speaker 4: I was going to say the same thing.
• 24:25
  Speaker 1: Yeah, yeah, the ones. I'm actually holding those right now?
• 24:29
  Speaker 2: How many My destra full of debate's right here? And
• 24:33
  Speaker 2: the scrup text job is they're standing with all the
• 24:35
  Speaker 2: clean instruments, is to hand you the thing that you
• 24:38
  Speaker 2: ask for, or to anticipate the thing that you ask for.
• 24:41
  Speaker 2: And she was having this situation where she's like in there,
• 24:43
  Speaker 2: she's operating, and she holds her hand out and she's
• 24:46
  Speaker 2: like the the thing you know with the one with
• 24:51
  Speaker 2: the teeth, the thing you know, and the scrub tech
• 24:55
  Speaker 2: because scrub techs are amazing, handed her the proper instrument,
• 24:59
  Speaker 2: and you know, they all kind of laughed about it
• 25:01
  Speaker 2: because they'd been pregnant too, and it's one of those situations,
• 25:05
  Speaker 2: but it illustrated to me. So like operationally, the muscle
• 25:08
  Speaker 2: memories there, and all the testing in pregnant women and
• 25:11
  Speaker 2: postpartum women suggest that, like physical memory, muscle memory doesn't
• 25:15
  Speaker 2: really change. If you can swing a golf club, you
• 25:17
  Speaker 2: can still swing a golf club. But so she could
• 25:19
  Speaker 2: do the operation just fine, she just couldn't name the
• 25:21
  Speaker 2: instrument that she needed at that time. And verbal memory
• 25:25
  Speaker 2: is certainly affected during pregnancy and after pregnancy.
• 25:29
  Speaker 4: That is fascinating. Yeah, you're literally a surgeon doing a
• 25:32
  Speaker 4: surgery and yet you're still not spared. You still have
• 25:35
  Speaker 4: a human brain.
• 25:36
  Speaker 2: Yeah yeah, Okay, so there are a million physiologic changes
• 25:40
  Speaker 2: that happen when you're pregnant, and it might be worth
• 25:43
  Speaker 2: just talking about how those things affect your brain. So,
• 25:46
  Speaker 2: for example, you might know that there is a forty
• 25:49
  Speaker 2: to fifty percent increase in blood volume during pregnancy. So okay,
• 25:55
  Speaker 2: that's crazy in and of itself, but what that means
• 25:58
  Speaker 2: that volume expansion paces the production of red blood cells,
• 26:02
  Speaker 2: which gives some anemia. Pregnant women tend to have you know,
• 26:07
  Speaker 2: more anemia, less red blood cell counts, which means not
• 26:10
  Speaker 2: as much oxygen carrying capacity not you know, which can
• 26:13
  Speaker 2: certainly affect if your brain is firing on all cylinders.
• 26:17
  Speaker 2: Let's talk about the cardiovascular changes. So your heart rate
• 26:21
  Speaker 2: is up by about thirty to fifty percent during pregnancy.
• 26:25
  Speaker 2: This is a big energy expenditure. This takes calories and
• 26:30
  Speaker 2: that can contribute to fatigue, reduces cognitive stamina. The respiratory side,
• 26:38
  Speaker 2: tidal volume, how much air you breathe in when you
• 26:41
  Speaker 2: take a breath, increases during until you until you're restricted
• 26:46
  Speaker 2: by belly volume. But for the first few for the
• 26:49
  Speaker 2: first couple trimesters, about a thirty to fifty percent increase
• 26:52
  Speaker 2: in tidal volume leads to slight hyper ventilation, which means
• 26:57
  Speaker 2: your blood carries less carbon dioxide can contribute to feeling
• 27:01
  Speaker 2: light headed or dizzy. And one last thing I've mentioned
• 27:05
  Speaker 2: several times, just the enormous, enormous surge in hormones. We
• 27:09
  Speaker 2: talked a lot about estrogen, but progesterone also goes up
• 27:12
  Speaker 2: by about five hundredfold compared to baseline, and progesterone has
• 27:18
  Speaker 2: some mild sedative effects. So it's almost as if the
• 27:23
  Speaker 2: whole like physiologic state of pregnancy is conspiring to put
• 27:29
  Speaker 2: you in a place where your brain is not working well,
• 27:33
  Speaker 2: where you're tired, and you know your body is just
• 27:37
  Speaker 2: like people sometimes say that the purpose of your body
• 27:41
  Speaker 2: is to get your brain from one place to another, right,
• 27:43
  Speaker 2: like your body is to support your brain. You are
• 27:45
  Speaker 2: your brain. Well, true, except during pregnancy, when the body
• 27:49
  Speaker 2: just decides screw your brain. I'm focusing on the baby.
• 27:53
  Speaker 3: Okay, let's talk about the two good things about brains
• 27:56
  Speaker 3: before we talk about postpartum changes. So why is that
• 28:01
  Speaker 3: while your brain is remapping you get better at recognizing
• 28:06
  Speaker 3: recognition tasks. So if we sort of think about the
• 28:09
  Speaker 3: pieces that you don't that you need to be don't
• 28:12
  Speaker 3: need to be as good at, like going to the
• 28:14
  Speaker 3: club or whatever, then there's a set of things you
• 28:17
  Speaker 3: need to be better at in evolutionary standpoint, which is
• 28:20
  Speaker 3: like recognizing threats. And so we do see some evidence
• 28:23
  Speaker 3: that people get better at sort of differentiating between like
• 28:26
  Speaker 3: known and unknown faces in pregnancy, which may have some
• 28:30
  Speaker 3: beneficial ability to recognize who is you know, an outgroup
• 28:35
  Speaker 3: and in a group member and who do you want
• 28:36
  Speaker 3: to trust more with your baby.
• 28:38
  Speaker 2: That's super fascinating that I always feel like so much
• 28:42
  Speaker 2: of the things we think of as our own thoughts
• 28:44
  Speaker 2: and emotions are just like the monkey inside of us
• 28:47
  Speaker 2: doing monkey things.
• 28:49
  Speaker 3: Yeah, I think that's true, But then I also think
• 28:51
  Speaker 3: it's so easy to write just so stories about evolution.
• 28:54
  Speaker 3: We're just like, well, I guess evolution is why that happened.
• 28:56
  Speaker 3: It often is the Culpridge generally true.
• 28:58
  Speaker 4: But I also feel like when you were saying this
• 29:01
  Speaker 4: is like a medical disaster pregnancy, I've been saying this
• 29:04
  Speaker 4: for a long time, Like I have so many notes
• 29:06
  Speaker 4: for like whoever's in charge for Charles Darwin? I guess
• 29:11
  Speaker 4: because I'm like, why do men have nipples? Why do
• 29:17
  Speaker 4: I have pinky toes?
• 29:18
  Speaker 5: Why?
• 29:19
  Speaker 4: Like why you know all of these things appendices like
• 29:23
  Speaker 4: we don't need? And why are children brought into the
• 29:28
  Speaker 4: earth the way they are? Why is there no new
• 29:32
  Speaker 4: way a velcrow opening perhaps, or a zipper or a
• 29:38
  Speaker 4: magic Wand like as I approach childbirth, I was like,
• 29:41
  Speaker 4: is there honestly no like VIP secret third way to
• 29:46
  Speaker 4: do this? Who do I have to talk to to
• 29:48
  Speaker 4: not go through either of these situations?
• 29:51
  Speaker 2: This is so geeky of me. But I remember watching
• 29:55
  Speaker 2: Star Trek when I was younger, and they would have
• 29:57
  Speaker 2: every once in a while, like someone would be pregnant,
• 29:59
  Speaker 2: and and I was like, why don't they just transport
• 30:02
  Speaker 2: the baby out like we're speming people down to the planet. Why,
• 30:06
  Speaker 2: Like what, how is this not? Is this not the
• 30:09
  Speaker 2: main thing?
• 30:09
  Speaker 4: That's what I want my tax dollars going towards. It's
• 30:12
  Speaker 4: the hovercraft from Back to the Future that we were
• 30:14
  Speaker 4: promised and has not appeared.
• 30:15
  Speaker 1: We're told, where is that we're told?
• 30:18
  Speaker 4: And I want to be able to like disaporate my child,
• 30:21
  Speaker 4: to use Harry Potter verbit from my belly into the world.
• 30:26
  Speaker 4: But I also think about the fact that evolutionarily, also
• 30:30
  Speaker 4: because I have a four and a half year old,
• 30:32
  Speaker 4: we talking about dinosaurs all the time. We've been around
• 30:34
  Speaker 4: for a tiny blip of history, but like a triceratops,
• 30:39
  Speaker 4: by the time they were extinct was like peak. Triceratops
• 30:42
  Speaker 4: had had millions of years to become the best version.
• 30:45
  Speaker 2: Of saying we're not done yet, We've got.
• 30:47
  Speaker 3: And we're gonna still the triceratops was not disaporating the
• 30:51
  Speaker 3: baby out, but.
• 30:53
  Speaker 2: Well, that's right. Wasn't it egg laying? According to Jurassic Park?
• 30:56
  Speaker 2: I know nothing about.
• 30:57
  Speaker 4: Eratops Jurassic Park, Yeah, triceratog.
• 31:00
  Speaker 2: Which also seems like a better way.
• 31:02
  Speaker 4: We're aggling. Yeah, that's right.
• 31:03
  Speaker 2: I mean, if it's small.
• 31:05
  Speaker 3: My worst pregnancy dream was one where the baby did
• 31:09
  Speaker 3: just come out and then but it was like too early,
• 31:13
  Speaker 3: and then I had to like get it back in
• 31:15
  Speaker 3: and like it just but it came out just like
• 31:18
  Speaker 3: like open like a velcro, you know now, like caseful,
• 31:20
  Speaker 3: and just like velcrode itself out, and then I had
• 31:22
  Speaker 3: to be like, no, no, no, it's not time yet, like
• 31:23
  Speaker 3: put it back in.
• 31:26
  Speaker 2: Do you know that humans have babies way earlier than
• 31:29
  Speaker 2: they should according to our body size and level of
• 31:33
  Speaker 2: fetal development, Like we should be pregnant for several more
• 31:36
  Speaker 2: months and and we're not because our brains are so
• 31:40
  Speaker 2: big that they.
• 31:41
  Speaker 4: Have called the cranial it's there's a name for it,
• 31:46
  Speaker 4: a conundrum among because yes, evolutionarily, like our hip size
• 31:51
  Speaker 4: versus our brain size have forced us into a what
• 31:55
  Speaker 4: is it called? Do you remember? I don't want to
• 31:57
  Speaker 4: be born into Homo sapiens now, I want to do
• 32:00
  Speaker 4: it in one hundred million years when we are like
• 32:04
  Speaker 4: peak homosapiens.
• 32:06
  Speaker 1: Okay, anyway, sorry, I got all right.
• 32:11
  Speaker 3: Let us come back to our pregnancy brain because I
• 32:13
  Speaker 3: want to come back to the post pregnancy period because
• 32:18
  Speaker 3: many of these like physiological issues that happen during pregnancy
• 32:22
  Speaker 3: actually do sort of resolve post pregnancy. So your brain
• 32:26
  Speaker 3: grows back differently, but it gets it's five percent back.
• 32:30
  Speaker 3: And there's actually some super interesting research about the like
• 32:35
  Speaker 3: age of your brain as measured by brain age researchers postpartum.
• 32:40
  Speaker 3: So in the period from like like two weeks postpartum
• 32:43
  Speaker 3: to like three months postpartum, your brain actually ages backwards
• 32:46
  Speaker 3: quite quickly. And so whatever sort of aid terrible aging
• 32:49
  Speaker 3: was occurring during pregnancy, you like get some.
• 32:52
  Speaker 1: Of it backs postpartum.
• 32:54
  Speaker 3: And so there's this sort of feeling of like things
• 32:57
  Speaker 3: are kind of returning brain in some way. And yet
• 33:02
  Speaker 3: this is also a period in which we see a
• 33:04
  Speaker 3: lot of we see postpartum depression, we see postpartum anxiety,
• 33:08
  Speaker 3: we see potentially changes in other kinds of diagnoses, And
• 33:12
  Speaker 3: I think that is that's this sort of secondary period,
• 33:16
  Speaker 3: and it's really hard to separate how much of those
• 33:21
  Speaker 3: changes are about actual brain changes and how much of
• 33:25
  Speaker 3: those changes are about like almost a diagnosis window where
• 33:29
  Speaker 3: you're seeing people more.
• 33:31
  Speaker 2: And there's no neuroanatomical correlate of depression, like even putting
• 33:36
  Speaker 2: a side postpartum depression. You can't take people with major
• 33:38
  Speaker 2: depressive disorder and put them in an MRI scanner and
• 33:41
  Speaker 2: see significant differences in brain structure. I mean, there are
• 33:45
  Speaker 2: some experiments that are trying to tease this out, but
• 33:47
  Speaker 2: it really is about the connectivity and the interactions between
• 33:51
  Speaker 2: brain regions that drive these things, which means like a
• 33:54
  Speaker 2: simple test like how big is your brain, how small
• 33:56
  Speaker 2: you know, whatever, is not going to be enough.
• 34:00
  Speaker 3: Yeah, all right, So let's talk about postpartum depression and
• 34:02
  Speaker 3: postpartum anxiety first because these are probably the main primary
• 34:07
  Speaker 3: diagnoses that people get. So, Allison, you said you had
• 34:10
  Speaker 3: postpardon depression. Can you talk about that? Are you open
• 34:13
  Speaker 3: to talking?
• 34:14
  Speaker 4: Yeah? I never, I'm an anxiety girlie. So that's the
• 34:17
  Speaker 4: side of the street I was familiar with. But so
• 34:19
  Speaker 4: I had never, I don't think, been in a depression
• 34:22
  Speaker 4: in my life, so I didn't actually identify it until
• 34:26
  Speaker 4: I was out of it, which is apparently a very
• 34:28
  Speaker 4: common thing. Because you're just getting through it. And also
• 34:34
  Speaker 4: those early months and weeks of motherhood are such a
• 34:37
  Speaker 4: subjective experience that it's one of the few moments in
• 34:42
  Speaker 4: life where you can exchange techniques, data, concrete information. But
• 34:48
  Speaker 4: trading experience stories is not an impulse I had until
• 34:53
  Speaker 4: I was through it, whereas now I get a ton
• 34:57
  Speaker 4: of I don't know, satisfaction from talking about something I'm
• 35:01
  Speaker 4: dealing with in this exact moment as a parent with
• 35:03
  Speaker 4: my friends who are also going through it. There's a reporting,
• 35:06
  Speaker 4: live factor that I was not able to channel in
• 35:09
  Speaker 4: the moment, and I think part of it is a
• 35:12
  Speaker 4: it felt like a valve was switched in my brain
• 35:14
  Speaker 4: that was like, no need to overthink any of this,
• 35:18
  Speaker 4: just get through it. And what was happening was just overwhelming. Emotionally,
• 35:23
  Speaker 4: it was a lot of instances of just real feeling
• 35:29
  Speaker 4: very disconnected from my son, initially, feeling very alone, very isolated,
• 35:36
  Speaker 4: and despite having family nearby, a super supportive, loving husband, therapist,
• 35:43
  Speaker 4: like I had kind of all the resources you can have,
• 35:46
  Speaker 4: we did not have nanny or a night nurse or anything,
• 35:50
  Speaker 4: so I also was dealing with sleep deprivation. But I
• 35:54
  Speaker 4: just it just felt like everything was devasa and I
• 36:00
  Speaker 4: would very often sit on the couch where I was
• 36:05
  Speaker 4: constantly breastfeeding our son, and I have this like very
• 36:08
  Speaker 4: clear example of what it felt like to be in
• 36:10
  Speaker 4: my body. My husband would come like flying through the hallway,
• 36:14
  Speaker 4: like doing his twelfth load of laundry, and he'd be like,
• 36:17
  Speaker 4: do you need me to refill your water? And like
• 36:20
  Speaker 4: time would stop, and then like ten minutes later, I
• 36:24
  Speaker 4: would have done the complicated trigonometry to answer the question,
• 36:29
  Speaker 4: because what my brain was doing was, Okay, yes, my
• 36:32
  Speaker 4: water bottle is empty, but I want to be self sufficient.
• 36:35
  Speaker 4: I want to be the kind of person that can
• 36:37
  Speaker 4: fill my own water bottle, but I'm breastfeeding, so I
• 36:39
  Speaker 4: can't and it'll be a little while and I need
• 36:41
  Speaker 4: water to breastfeed. He's standing right there. Oh my god,
• 36:44
  Speaker 4: he's so impatient. I'm still thinking this through, shouldn't I be?
• 36:47
  Speaker 4: And it was just happening, and I'm a ruminator in general,
• 36:51
  Speaker 4: but it was going on twice as long, twice the
• 36:54
  Speaker 4: self judgment. It was just like everything was magnified, and slowly,
• 37:02
  Speaker 4: after I came out of it, I realized just how
• 37:06
  Speaker 4: dark some of those moments were and how difficult it
• 37:11
  Speaker 4: is to express them while they're happening. And I think
• 37:14
  Speaker 4: that's part of what makes it so gnarly, is that
• 37:17
  Speaker 4: I don't know a ton of women who were able
• 37:20
  Speaker 4: to speak from their postpartum depression while it was happening,
• 37:25
  Speaker 4: rather than about it in retrospect. But it also sucks
• 37:30
  Speaker 4: because you're like, when people ask you how it's going
• 37:33
  Speaker 4: or how's the baby, there's a there's one right vibe
• 37:36
  Speaker 4: to channel after that question.
• 37:38
  Speaker 1: Going great, Yeah, exactly, I love it so much.
• 37:42
  Speaker 4: Yes, he's because that's also true. You're completely obsessed with
• 37:46
  Speaker 4: this little person who you also are so frustrated with
• 37:50
  Speaker 4: sometimes and so exhausted by, and so both things are true,
• 37:54
  Speaker 4: and intuitively you just know that. Just give the surface
• 37:59
  Speaker 4: level answer and case keep it moving. And I wish
• 38:03
  Speaker 4: I had been treated for depression while it was happening.
• 38:07
  Speaker 4: I probably should have begun treatment before I delivered, because
• 38:10
  Speaker 4: I think it kind of started a little bit before then.
• 38:13
  Speaker 4: And yeah, I mean that's sort of what it looked like.
• 38:17
  Speaker 4: It's very hard to describe as you just experienced, because
• 38:19
  Speaker 4: I talked for like five minutes and said nothing, because
• 38:23
  Speaker 4: it's hard to channel that place again. It's hard to
• 38:25
  Speaker 4: go back there, but I can just see moments of
• 38:28
  Speaker 4: just being completely stuck and feeling like I was underneath
• 38:31
  Speaker 4: a wave that I couldn't get up and out of.
• 38:35
  Speaker 3: So about half of because we're saying about half of
• 38:37
  Speaker 3: postpartum depression starts during pregnancy and so, and that is
• 38:44
  Speaker 3: often not screened for.
• 38:46
  Speaker 1: And then when you.
• 38:48
  Speaker 3: Have the babe this the hormonal changes like this estrogen
• 38:52
  Speaker 3: that was like bathing your self for all this last trimester,
• 38:56
  Speaker 3: like totally could just tanks off a cliff. And those
• 39:00
  Speaker 3: changes are very, very difficult, and so almost everybody, I
• 39:06
  Speaker 3: think this is part of the DT the sort of
• 39:08
  Speaker 3: diagnosis issue here. Almost everybody has a period of kind
• 39:11
  Speaker 3: of quite significant mood changes, like immediately afterwards.
• 39:15
  Speaker 4: Yes, my friends were like, beware day three, You're gonna
• 39:18
  Speaker 4: just like burst into tears on day three. And then
• 39:20
  Speaker 4: I was like, I feel fine. And then twenty minutes
• 39:22
  Speaker 4: later I was just bawling and I sent them a
• 39:25
  Speaker 4: picture of myself like just weeping for no reason.
• 39:27
  Speaker 1: I was like, can stay here. I have many memories
• 39:30
  Speaker 1: of that that period.
• 39:31
  Speaker 3: And then then for you know, many people, that sort
• 39:33
  Speaker 3: of for some people that normalizes and sort of what
• 39:37
  Speaker 3: we would really think about as diagnosable. Postpartum depression is
• 39:40
  Speaker 3: sort of can then creep up as late as you know,
• 39:43
  Speaker 3: almost a year after, you can creep up anytime, but
• 39:46
  Speaker 3: sort of can be cidered postpartum depression even up till
• 39:49
  Speaker 3: a relatively long period of time afterwards. And I will
• 39:53
  Speaker 3: say some of it is as Perry said, like the
• 39:56
  Speaker 3: there is no way to put you in an fMRI
• 39:59
  Speaker 3: machine or some kind of like blood test and be like, okay,
• 40:02
  Speaker 3: this is what you have. And so we are left
• 40:04
  Speaker 3: with trying to screen people and give them appropriate treatments.
• 40:09
  Speaker 3: But it really in some ways doesn't matter whether you
• 40:12
  Speaker 3: diagnosed or not, Like, if you have this consolation of symptoms,
• 40:14
  Speaker 3: then you should be getting some treatment.
• 40:16
  Speaker 2: Yeah, and I do think you know what Alison brought
• 40:20
  Speaker 2: up that's really important for people to hear is that,
• 40:22
  Speaker 2: of course you have an alternative explanation than postpartum depression.
• 40:27
  Speaker 2: There's a million other ways that you can justify it
• 40:30
  Speaker 2: to yourself that like, oh, I'm probably okay and I'll
• 40:34
  Speaker 2: just get through this, but don't do that. You know,
• 40:36
  Speaker 2: if these symptoms are significantly different than baby brain and
• 40:41
  Speaker 2: brain fog, you know the things that make postpartum depression
• 40:45
  Speaker 2: postparum depression. If you look at the diagnostic criteria, it's
• 40:49
  Speaker 2: intense dysphoria, right, like, this is real deep sadness, not
• 40:52
  Speaker 2: confusion and stuff like that. Like you might see it's
• 40:56
  Speaker 2: an hodonia, which is that inability to feel pleasure and
• 40:59
  Speaker 2: things you normally take pleasure in, right, like a numbness
• 41:03
  Speaker 2: can be depression. Many, but not all, women with postpartum
• 41:07
  Speaker 2: depression actually have insomnia, which is sort of different than
• 41:10
  Speaker 2: what you see with you know, more typical exhaustion. I'm
• 41:14
  Speaker 2: up all night, like if you can't sleep when the
• 41:16
  Speaker 2: baby is sleeping. Those are signs of postpartum depression. And
• 41:20
  Speaker 2: of course many women make it through this and that's great,
• 41:23
  Speaker 2: but not all of them do. Like, this is a
• 41:26
  Speaker 2: potentially life threatening disease, so it's not something to sleep on.
• 41:31
  Speaker 2: And we're talking a lot about like the funn you know,
• 41:33
  Speaker 2: people like to tell the funny baby brain stories and whatever,
• 41:35
  Speaker 2: like my wife asking for the wrong instrument in the
• 41:37
  Speaker 2: operating room and it's like haha, you know, but postpartum
• 41:40
  Speaker 2: depression is what ten fifteen percent of women, at least
• 41:43
  Speaker 2: as far as we know, probably even higher because it
• 41:46
  Speaker 2: goes undiagnosed and is even potentially life threatening, right, so
• 41:50
  Speaker 2: be careful.
• 41:50
  Speaker 3: Yeah, so we talked about postpartum depression and postpartum anxiety
• 41:55
  Speaker 3: is a different experience but diagnosed in almost exactly the
• 41:59
  Speaker 3: same way. It's actually the same screening tool for anxiety
• 42:02
  Speaker 3: and depression. There's like sort of slightly different ways of
• 42:06
  Speaker 3: scoring it. And I think this gets again at the
• 42:09
  Speaker 3: question of like it's a little hard to separate experience
• 42:13
  Speaker 3: from like that there's some truth generally postpartum anxiety is
• 42:17
  Speaker 3: more anxiety and less depression, but there's a sort of
• 42:20
  Speaker 3: fine line there, and so when we think about diagnosing,
• 42:23
  Speaker 3: it's really about just trying to figure out to think
• 42:26
  Speaker 3: how things are going, and then what is the right
• 42:28
  Speaker 3: next treatment as opposed to like we need to label
• 42:31
  Speaker 3: it a particular way and.
• 42:33
  Speaker 4: They're treated very often with the same medication too exactly,
• 42:36
  Speaker 4: and they.
• 42:37
  Speaker 3: Yeah, okay, I want to talk about then some of
• 42:40
  Speaker 3: these later things, like the ADHD diagnoses, because there is
• 42:46
  Speaker 3: there's like the immediate postparton period when I think people
• 42:50
  Speaker 3: expect maybe there's some you have some postpard depression or
• 42:54
  Speaker 3: postpartum anxiety. You also expect to feel like slower and
• 42:58
  Speaker 3: so on. But then there's a much longer postpartum period
• 43:01
  Speaker 3: in which I think many people with small children kind
• 43:04
  Speaker 3: of feel like I'm still not quite, like like I'm
• 43:08
  Speaker 3: not back, you know, I was hoping to be back,
• 43:10
  Speaker 3: and I'm not back.
• 43:12
  Speaker 1: And this is.
• 43:13
  Speaker 3: Where so I pulled up in thinking about your question,
• 43:17
  Speaker 3: thinking about this episode, what I think is kind of
• 43:20
  Speaker 3: our best data about ADHD in particular. So there is
• 43:26
  Speaker 3: a this actually very recent paper, it's like two months old.
• 43:30
  Speaker 3: The most recent paper we have discussed on this is this.
• 43:33
  Speaker 2: The one from the Danish study.
• 43:35
  Speaker 3: So it's a it's a Danish study which looks at
• 43:39
  Speaker 3: ADHD diagnoses around pregnancy. It's very big because in these
• 43:44
  Speaker 3: European studies you have like everything about everybody.
• 43:47
  Speaker 2: So I'm so jealous of the data sets that total.
• 43:50
  Speaker 1: It's amazing.
• 43:51
  Speaker 3: So they have like three hundred and sixty thousand mothers
• 43:53
  Speaker 3: five hundred and twenty sorry, yeah, three hundred and sixty
• 43:57
  Speaker 3: three thousand.
• 43:59
  Speaker 1: Yes, I'm like, my.
• 44:02
  Speaker 3: Children are fifteen years old and eleven, so I'm still recovering.
• 44:05
  Speaker 1: Oh my god.
• 44:06
  Speaker 3: They have a very large sample size, let's just say that.
• 44:10
  Speaker 3: And they're looking at these ADHD rates and it's quite
• 44:14
  Speaker 3: interesting because they actually decrease during pregnancy and remain low
• 44:18
  Speaker 3: for a couple of years, and then they increase significantly
• 44:21
  Speaker 3: about twenty five percent.
• 44:22
  Speaker 1: Higher diagnoses two to five years postpartum. So we sort
• 44:28
  Speaker 1: of are.
• 44:28
  Speaker 3: Seeing this like uptick in this particular diagnosis in this
• 44:33
  Speaker 3: kind of like one your kids at toddler.
• 44:36
  Speaker 4: And I think that's there.
• 44:38
  Speaker 3: They're in this popular right there, And there's actually like
• 44:41
  Speaker 3: many different ways to interpret that. So one, I now
• 44:43
  Speaker 3: don't think that in this paper we can really tell
• 44:46
  Speaker 3: what's going on. So I think one possibility is that
• 44:49
  Speaker 3: this is like actually brain changes that are driving differences
• 44:54
  Speaker 3: in sort of the way that your brain works postpartum.
• 44:57
  Speaker 3: I guess second option is that the symptoms here are
• 45:01
  Speaker 3: close enough to the symptoms you might have of sort
• 45:04
  Speaker 3: of being overwhelmed and being tired and having a lot
• 45:07
  Speaker 3: of things going on that it would kind of you'd
• 45:10
  Speaker 3: get a diagnosis even though it's maybe almost situational isn't
• 45:14
  Speaker 3: quite the right word, but it's sort of being driven
• 45:16
  Speaker 3: by life experience and other possibilities people had adh this
• 45:19
  Speaker 3: entire time, and it is only because it's a little
• 45:22
  Speaker 3: exacerbated by having kids. And also this is a period
• 45:25
  Speaker 3: of time which maybe people are paying more attention, perhaps
• 45:27
  Speaker 3: maybe because they're noticing some of the symptoms in their
• 45:29
  Speaker 3: own kids that then they're saying, oh, that was me.
• 45:32
  Speaker 3: And this is a thing I hear a lot from parents,
• 45:34
  Speaker 3: which is very interesting, is sort of like my kid
• 45:37
  Speaker 3: was diagnosed with ADHD, and I realized, oh, like I
• 45:40
  Speaker 3: have that too, Like all of these things that I
• 45:44
  Speaker 3: thought were just like the way that I am are
• 45:47
  Speaker 3: actually like I maybe could have been getting some treatment
• 45:50
  Speaker 3: for this. And so I think there's like a bunch
• 45:53
  Speaker 3: of stuff there. I'm not sure we really have any
• 45:55
  Speaker 3: ability to separate those things out.
• 45:57
  Speaker 1: I'm not sure it matters.
• 45:58
  Speaker 4: But yeah, well, I guess what's what intrigues me about?
• 46:02
  Speaker 4: Like why do I want to know? The answer to
• 46:04
  Speaker 4: that is sort of I always find diagnoses of any
• 46:07
  Speaker 4: kind empowering. I think part of that is having anxiety
• 46:11
  Speaker 4: means that before the diagnosis, a huge amount of my
• 46:16
  Speaker 4: operating system is expending energy coming up with theories. Even
• 46:20
  Speaker 4: in the back of my mind, it's just ruminating on
• 46:23
  Speaker 4: what this is, why it is blank? And so someone
• 46:27
  Speaker 4: saying you are experiencing X, Y or Z, I find
• 46:31
  Speaker 4: deeply relaxing, even if what they're telling me I'm experiencing
• 46:34
  Speaker 4: is objectively stressful, because then I'm no longer wondering. I
• 46:37
  Speaker 4: just know and now I can do something about it.
• 46:40
  Speaker 4: And so for me to think of myself as having
• 46:44
  Speaker 4: a new brain rather than waiting to come back, has
• 46:48
  Speaker 4: been a very useful distinction for me, because I found
• 46:52
  Speaker 4: it depressing to think of my brain, which I really liked,
• 46:56
  Speaker 4: which was very high functioning. I was a big fan.
• 46:59
  Speaker 4: I can say that now because I feel like I
• 47:00
  Speaker 4: don't have it anymore, and I'm not like bridening.
• 47:02
  Speaker 1: It feels like it's not anymore. No, it's not.
• 47:05
  Speaker 4: It's like I'm talking about like I don't know what
• 47:07
  Speaker 4: my calves looked like when I was twelve, Like, you know,
• 47:09
  Speaker 4: it's the past part of me that doesn't exist anymore.
• 47:12
  Speaker 4: I loved it, and waiting for it to come back
• 47:15
  Speaker 4: was depressing, It was upsetting, it was frustrating, and it
• 47:19
  Speaker 4: wasn't going to happen. And so for me switching to
• 47:23
  Speaker 4: thinking this experience that I had fundamentally altered me in
• 47:26
  Speaker 4: literally every way. But it altered my like synapses, my
• 47:32
  Speaker 4: you know, everything about my cognition such that I now
• 47:35
  Speaker 4: have a new operating system. I have to learn how
• 47:38
  Speaker 4: it works and learn how to best support it and
• 47:41
  Speaker 4: find out how to use it, Like I learned how
• 47:43
  Speaker 4: to use my old brain and use this one for
• 47:47
  Speaker 4: whatever I need it for now. And I found that
• 47:51
  Speaker 4: to be really useful. And that could just be me,
• 47:53
  Speaker 4: or it could be it could be other people as well.
• 47:56
  Speaker 3: No, I think it's I think it's actually very interesting
• 48:00
  Speaker 3: and valuable frame for people, in part because so many
• 48:04
  Speaker 3: of these things are are really like diagnoses of like
• 48:10
  Speaker 3: experience and how are things working for you? And so
• 48:13
  Speaker 3: to say like, you know, well you didn't have ADHD before,
• 48:16
  Speaker 3: so let's not look for that as a solution may
• 48:19
  Speaker 3: be unhelpful as opposed to being like, right now, we
• 48:21
  Speaker 3: should try to figure out, like what's going on and
• 48:24
  Speaker 3: how can we best support your functioning as a person,
• 48:27
  Speaker 3: whether that's something that was true before or not. And
• 48:31
  Speaker 3: it may be for some people to say the like, well,
• 48:33
  Speaker 3: now you know my brain, the operating system is different
• 48:37
  Speaker 3: and we need.
• 48:37
  Speaker 1: Like a different set of you know, software tools.
• 48:40
  Speaker 4: I also think we live in a time where we're
• 48:42
  Speaker 4: really lucky we don't we don't technically have to white
• 48:46
  Speaker 4: knuckle a lot of the things that we tolerate. So
• 48:49
  Speaker 4: the idea that I can talk to my psychiatrist and say, Okay,
• 48:52
  Speaker 4: we're gonna address my anxiety because that's too much. I'm
• 48:56
  Speaker 4: fed up. I can't live like this. It's exhausting. And
• 48:59
  Speaker 4: then once that's been addressed, there are all these other
• 49:02
  Speaker 4: behaviors and these other executive functioning issues that are revealed
• 49:05
  Speaker 4: not to be part of the anxiety but something else.
• 49:07
  Speaker 4: The fact that I don't have to live with those
• 49:09
  Speaker 4: and tolerate those and spend the energy operating around those
• 49:14
  Speaker 4: is such a privilege of you know, I talk, I
• 49:17
  Speaker 4: talking a lot of shit about being a human in
• 49:19
  Speaker 4: this stage of evolution, but we're very smart because those
• 49:22
  Speaker 4: big brains, and we've developed medication that means I don't
• 49:25
  Speaker 4: have to just figure out how to live with these
• 49:27
  Speaker 4: things if I don't want to. There is help available
• 49:31
  Speaker 4: to me, which is so incredible. And I wish I
• 49:34
  Speaker 4: had availed myself a bit sooner. And I can't, like
• 49:38
  Speaker 4: I don't know, biohack my way through it or just
• 49:41
  Speaker 4: you know, I don't know what and get rid of
• 49:46
  Speaker 4: you tried any time I have injected them into my
• 49:51
  Speaker 4: brain and it didn't work.
• 49:53
  Speaker 1: I'm doing it wrong.
• 49:55
  Speaker 2: As you're talking about you know what changes are long term,
• 49:59
  Speaker 2: and yeah, of course it's really hard to measure, but
• 50:03
  Speaker 2: I will just say, like number one, our brains are
• 50:06
  Speaker 2: changing all the time, right, Like we can learn, we
• 50:09
  Speaker 2: can go to therapy. You know, It's always been sort
• 50:11
  Speaker 2: of an amazing thing to me that talk therapy works,
• 50:14
  Speaker 2: and it's just somehow like if you really make it abstract,
• 50:20
  Speaker 2: like someone is speaking words into your ear and it's
• 50:23
  Speaker 2: reprogramming slowly your brain until it's connected in a slightly
• 50:27
  Speaker 2: different way that makes you feel better. I always think
• 50:29
  Speaker 2: that's amazing. So these changes are always happening. I can't
• 50:34
  Speaker 2: imagine a more significant physiologic event than pregnancy. I think
• 50:37
  Speaker 2: I've said this multiple times right now, you know, I
• 50:40
  Speaker 2: don't think anyone would take a person who like, like
• 50:43
  Speaker 2: went through chemotherapy and came out the other side cancer
• 50:46
  Speaker 2: free and would be like like, okay, and so you're
• 50:49
  Speaker 2: back to normal now, right like everything, you're the same
• 50:51
  Speaker 2: person you were before you did chemo, right, Like that
• 50:53
  Speaker 2: would be almost considered inappropriate, Like how are you not
• 50:57
  Speaker 2: respecting the struggle I just went through? And pregnancy is
• 51:02
  Speaker 2: much like this, Like I definitely think your brain is different,
• 51:06
  Speaker 2: It's different forever. That's not all bad. In fact, you know,
• 51:09
  Speaker 2: Emily pointed out some of the brain aging data that
• 51:12
  Speaker 2: looks at like, you know, whether you when you're sixty,
• 51:15
  Speaker 2: do you have a brain of a sixty one year
• 51:17
  Speaker 2: old or a fifty nine year old or a fifty
• 51:18
  Speaker 2: five year old. And one of the predictors of how
• 51:20
  Speaker 2: young your brain is in older age is how many
• 51:23
  Speaker 2: children you've had with I was going to ask.
• 51:25
  Speaker 4: Is it cumulative these effects over several children or yeah.
• 51:30
  Speaker 2: So the study that I was looking at, there's two here.
• 51:36
  Speaker 2: One is from the UK Biobank, which is which is
• 51:39
  Speaker 2: a big study hundreds of thousands of people over time,
• 51:43
  Speaker 2: which does show that multiparis women, women who had you know,
• 51:48
  Speaker 2: more than one child had younger brains than women who
• 51:53
  Speaker 2: had one child, which had a younger brain than women
• 51:55
  Speaker 2: who never had children. There's also a smaller study out
• 51:58
  Speaker 2: of Rotterdam that basically showed a dose response where the
• 52:01
  Speaker 2: more kids you had, the more great matter volume you
• 52:04
  Speaker 2: had in older age. So yes, so it's the same
• 52:07
  Speaker 2: gray matter that like shrinks during pregnancy, you end up
• 52:10
  Speaker 2: with more in older age. I did dig a little
• 52:13
  Speaker 2: bit deeply and found there there was one study that, look,
• 52:15
  Speaker 2: what's the term, Emily, for women who've had like a
• 52:18
  Speaker 2: lot a lot of babies, Like, uh, super multi paris
• 52:22
  Speaker 2: what's it called?
• 52:23
  Speaker 1: Yes, Like, yes, it's super?
• 52:25
  Speaker 2: Is that what it is?
• 52:25
  Speaker 1: Something like that?
• 52:26
  Speaker 2: Yes, I'm honestly I forget. In any case, there does
• 52:29
  Speaker 2: seem to maybe it falls off like after you know,
• 52:32
  Speaker 2: seven eight kids. But but the question is, I don't
• 52:36
  Speaker 2: think it's the pregnancy that makes your brain better. I
• 52:39
  Speaker 2: think it's the children to some extent, like children represent
• 52:43
  Speaker 2: this whole new source of novelty in your life. Like
• 52:47
  Speaker 2: the thing that counterpoint, I'm about to say something very
• 52:52
  Speaker 2: sweet about my children who may listen to this someday.
• 52:56
  Speaker 2: One of the wonderful things about having children is that
• 53:00
  Speaker 2: the only way you get to experience something you love
• 53:03
  Speaker 2: for the first time again. So like I got to
• 53:07
  Speaker 2: watch The Fellowship of the Ring with my oldest daughter,
• 53:12
  Speaker 2: and I got to go through the whole thing again,
• 53:14
  Speaker 2: even though I'd seen it, you know, thirty thirty times
• 53:17
  Speaker 2: by the time. And I think that's good for your brain.
• 53:20
  Speaker 2: I think it. I think it keeps you. I think
• 53:22
  Speaker 2: they keep you young. All right, Emily, I'm wrong.
• 53:24
  Speaker 3: Why you know, just in rats having babies improves their
• 53:31
  Speaker 3: maze performance and long term spatial learning and memory and work.
• 53:35
  Speaker 3: And I don't think it's because they're parenting at a
• 53:37
  Speaker 3: high level. I mean there's no fellowship. They didnt show
• 53:40
  Speaker 3: them the fellowship with a ring or whatever. They just
• 53:42
  Speaker 3: probably have the babies in a way because it's fucking rats.
• 53:47
  Speaker 4: This way pure anetdata. But I actually do resonate with
• 53:50
  Speaker 4: that idea of spatial Like I think I recognize faces
• 53:56
  Speaker 4: and places better now than I did. Oh that's cir
• 53:59
  Speaker 4: my memory of like have I been to this restaurant before?
• 54:01
  Speaker 4: Have I met this person? Have I stayed at this hotel?
• 54:03
  Speaker 4: It was really bad before and now it's decent. So
• 54:07
  Speaker 4: that's interesting.
• 54:08
  Speaker 2: If it helps recognizing faces. I would love to be pregnant,
• 54:11
  Speaker 2: that is mine.
• 54:12
  Speaker 3: I cannot recognize faces, and I have been pregnant twice
• 54:16
  Speaker 3: and it did not approve.
• 54:18
  Speaker 4: You have like a true face blindness.
• 54:21
  Speaker 3: Not a true face blindness, but I just can't. I like,
• 54:24
  Speaker 3: name face barely to who are you?
• 54:27
  Speaker 4: Who am I? I don't know.
• 54:30
  Speaker 1: It'sciding your name is on the you know podcast thing?
• 54:33
  Speaker 3: Yeah exactly, Okay, I want to before we before we
• 54:37
  Speaker 3: end and get to question I want to talk about.
• 54:42
  Speaker 3: I want to sort of step back one thing, because
• 54:44
  Speaker 3: we talked a lot about like brain changes that are real,
• 54:47
  Speaker 3: and you know the fact that maybe some of this
• 54:49
  Speaker 3: is inevitable and so on, but there actually are some
• 54:52
  Speaker 3: like biological changes during pregnancy that if you are feeling
• 54:58
  Speaker 3: very tired or just very off, it actually is a
• 55:01
  Speaker 3: worthwhile to get some blood work because, for example, a
• 55:06
  Speaker 3: large share of women who have been pregnant women of
• 55:08
  Speaker 3: child bearing age are anemic, and which means your iron
• 55:11
  Speaker 3: is too low, and anemia can cause a lot of
• 55:14
  Speaker 3: the kinds of symptoms we're talking about in particular, like
• 55:17
  Speaker 3: brain fog and fatigue and just like a feeling of
• 55:20
  Speaker 3: being quite exhausted. And so I would sort of balance
• 55:24
  Speaker 3: a little bit as like your brain is new and
• 55:26
  Speaker 3: you got a learn to live with it, and also
• 55:28
  Speaker 3: like go get your thyroid and your anemia checked, because
• 55:32
  Speaker 3: if it turns out that the answer to some of
• 55:34
  Speaker 3: this is like you need to be taking an iron pill,
• 55:38
  Speaker 3: like that would be good too no and too bad
• 55:40
  Speaker 3: to miss.
• 55:41
  Speaker 2: Right, Yeah, go for the easy fis. Yeah, totally. You know,
• 55:44
  Speaker 2: other sort of treatments for we're going to put postpartum
• 55:48
  Speaker 2: depression aside, obviously postpartum depression you want to get your
• 55:51
  Speaker 2: treatments from a doctor and things like that. But for
• 55:54
  Speaker 2: just the regular baby brain fog and stuff like that,
• 55:58
  Speaker 2: obviously sleep is going to come up number one rustrating.
• 56:05
  Speaker 2: Just you should just say more. I don't know why
• 56:08
  Speaker 2: you guys.
• 56:10
  Speaker 4: Why didn't I think of that?
• 56:14
  Speaker 2: So, actually, this is a good question. You both had
• 56:18
  Speaker 2: a partner after the baby was born. How can partners
• 56:22
  Speaker 2: support the new mom during this period so that she
• 56:27
  Speaker 2: can get the much needed rest? Is it bringing cups
• 56:30
  Speaker 2: of water without being.
• 56:32
  Speaker 4: Asked in that doorway as long as I need you
• 56:35
  Speaker 4: to before I can summon the words that I need.
• 56:37
  Speaker 2: I think, then just bring a glass of water.
• 56:39
  Speaker 1: You don't need, don't don't ask, just bring the water.
• 56:43
  Speaker 4: I feel like, honestly, it's having respect for what's happening.
• 56:47
  Speaker 4: It feels like there's just a knowledge gap. I don't
• 56:50
  Speaker 4: think it's just among men. I think most women who
• 56:53
  Speaker 4: go through this process don't understand what's happening to their
• 56:56
  Speaker 4: bodies either. But I think you know that amount of
• 57:00
  Speaker 4: hormonal shift is worthy of respect and awareness and acknowledgment
• 57:07
  Speaker 4: and understanding that for I don't know what the biggest
• 57:12
  Speaker 4: hormonal shift in a man is. I'm guessing it's around arousal,
• 57:16
  Speaker 4: probably somehow, and we just.
• 57:19
  Speaker 2: Don't have anything comparable in any way. But even doing so,
• 57:24
  Speaker 2: the facts and a box spar it's for weightlifting is
• 57:26
  Speaker 2: not the same.
• 57:27
  Speaker 4: Yeah, maybe I mean, but even that, I just feel
• 57:30
  Speaker 4: like understanding that it's both things can be true at
• 57:34
  Speaker 4: the same time. The person you're talking to is your spouse,
• 57:37
  Speaker 4: and you should take what they are saying and experiencing seriously.
• 57:40
  Speaker 4: And if they wrote a document and had it notarized
• 57:45
  Speaker 4: about their opinions and their feelings in a given moment,
• 57:48
  Speaker 4: it may not feel correct anymore a week later, and
• 57:52
  Speaker 4: that is okay, And it doesn't mean you should ignore
• 57:55
  Speaker 4: what they say. You're in a liminal space where it
• 57:58
  Speaker 4: is and it isn't your partner, and what they say
• 58:00
  Speaker 4: is and isn't true, and just deal with it because
• 58:03
  Speaker 4: you're going to deal with it for such a brief
• 58:05
  Speaker 4: period compared to the amount of time they spent in
• 58:07
  Speaker 4: that liminal space themselves. That's kind of what I might say, Emily,
• 58:10
  Speaker 4: what do you what do you think?
• 58:11
  Speaker 1: That's such amazing advice.
• 58:13
  Speaker 3: The main thing my husband did when he's made a
• 58:14
  Speaker 3: spreadsheet that we could keep track of how many minutes
• 58:17
  Speaker 3: my daughter was eating at different times and how many
• 58:20
  Speaker 3: frequency of pooping, which I actually wouldn't.
• 58:22
  Speaker 4: I remember you saying that on the podcast. There was
• 58:25
  Speaker 4: a there's an app for that now called baby Trasher,
• 58:28
  Speaker 4: which I will shock you by telling you. I also
• 58:31
  Speaker 4: use just to feel some control over completely uncontrollable.
• 58:35
  Speaker 2: I feel like spreadsheets are Emily's love language.
• 58:38
  Speaker 1: Totally no, but I just don't think that's for everybody.
• 58:40
  Speaker 1: Not sure that's well I think.
• 58:42
  Speaker 3: But I will say my husband was constantly making sure
• 58:46
  Speaker 3: that I was eating like his main His his love
• 58:49
  Speaker 3: language was like like there is always.
• 58:52
  Speaker 1: Water and like fruit next to the like breastfeeding chair.
• 58:57
  Speaker 4: So nice, it's great, it's so nice.
• 59:00
  Speaker 3: We haven't really discussed endurance sports yet, and so I
• 59:02
  Speaker 3: just wanted to pop in here and say that that
• 59:07
  Speaker 3: your elevated blood volume retains for about a year postpartum,
• 59:11
  Speaker 3: and so there is some people think that that's why
• 59:14
  Speaker 3: some people perform quite well at their sporting events in
• 59:18
  Speaker 3: the first year postpartum, because of the potentially higher bloodvolume.
• 59:22
  Speaker 3: And I represent the group that thanks lol sporting events
• 59:25
  Speaker 3: in the first year post.
• 59:27
  Speaker 1: Yeah, it's not like a Yes, there are some other
• 59:29
  Speaker 1: things that make.
• 59:30
  Speaker 4: You slower, moving not in a walking pace from one
• 59:33
  Speaker 4: room to another.
• 59:36
  Speaker 3: All right, Perry, smash your pass on the pregnancy brain
• 59:40
  Speaker 3: and even know what this means.
• 59:42
  Speaker 2: I think it's important for me to weigh in here though.
• 59:44
  Speaker 1: Yeah, totally.
• 59:45
  Speaker 4: As always, I'm a pass.
• 59:48
  Speaker 2: I you know, let's let's get over. I agree with Alison.
• 59:51
  Speaker 2: I don't know techno Bros. Fixed pregnancy. Emily, how about
• 59:56
  Speaker 2: you smash pass.
• 59:57
  Speaker 3: I'm a smash because I'm my kid's tiny pieces of
• 1:00:00
  Speaker 3: my kids are around in my brain and that's and
• 1:00:02
  Speaker 3: that's so great, Allison.
• 1:00:06
  Speaker 4: I guess I'm I'm a reluctant smash for the same
• 1:00:09
  Speaker 4: reason because now I'd be like passing on my child existing,
• 1:00:13
  Speaker 4: and that feels insane because he's made the world so
• 1:00:15
  Speaker 4: much better. But I have a lot of notes for
• 1:00:19
  Speaker 4: the way it all goes down, and I don't know
• 1:00:21
  Speaker 4: who to talk to about this, but it's we have
• 1:00:24
  Speaker 4: a lot of improve room for improvement.
• 1:00:26
  Speaker 3: I would say that is it for pregnancy brain. Allison's
• 1:00:31
  Speaker 3: Mailbag question of the Week after the Break.
• 1:00:39
  Speaker 4: Emily, I've come to realize that you are not just
• 1:00:42
  Speaker 4: a casual runner. You are. You are runner like ken
• 1:00:48
  Speaker 4: Is Beach. You are runner, and thus I have a
• 1:00:52
  Speaker 4: question for you. I have to start doing cardio because
• 1:00:54
  Speaker 4: I'm doing a movie that's going to require me to
• 1:00:57
  Speaker 4: be cardiovascularly alive in a way that I'm not on
• 1:01:01
  Speaker 4: a day to day basis. I have to pretend to
• 1:01:03
  Speaker 4: be a type of person I'm not, which is my
• 1:01:04
  Speaker 4: whole job. And I don't have extra time though to
• 1:01:09
  Speaker 4: do this cardio. So I am wondering what is the
• 1:01:12
  Speaker 4: best bang for my buck if I don't have a
• 1:01:14
  Speaker 4: lot of time. But I just it's not necessarily about
• 1:01:17
  Speaker 4: weight loss or anything. It's just about getting my ability
• 1:01:20
  Speaker 4: to deliver lines while hyperventilating to be like, what's the
• 1:01:25
  Speaker 4: what did Taylor Swift do before the airstore so she
• 1:01:28
  Speaker 4: could sing and run one hundred miles in a day?
• 1:01:31
  Speaker 4: You know what do I do?
• 1:01:32
  Speaker 1: Okay?
• 1:01:33
  Speaker 3: So, first of all, what Taylor Swift did was she
• 1:01:35
  Speaker 3: ran every day on the treadmill doing the entire set
• 1:01:39
  Speaker 3: for three hours. So she would run like three hours
• 1:01:41
  Speaker 3: a day on the treadmill doing the entire set. It
• 1:01:43
  Speaker 3: sounds to me like you don't have time for that.
• 1:01:45
  Speaker 4: I definitely don't, although I could because I'm such a
• 1:01:48
  Speaker 4: swift ye, I could do the whole set.
• 1:01:52
  Speaker 1: But you don't want to run?
• 1:01:53
  Speaker 4: Is that I can't? My knees are just it's like
• 1:01:56
  Speaker 4: someone read the instructions wrong when they put my knees together.
• 1:01:59
  Speaker 4: They don't, okay, work properly.
• 1:02:01
  Speaker 3: So you're pretty I think this is not a very
• 1:02:04
  Speaker 3: hard question to answer because what you really want to
• 1:02:07
  Speaker 3: be doing is spending some time in like a high
• 1:02:12
  Speaker 3: heart rate zone like zone four five and out of
• 1:02:17
  Speaker 3: what what is that? There's five zones? It doesn't matter.
• 1:02:21
  Speaker 1: You want to be raising your heart rate that's maxed.
• 1:02:23
  Speaker 4: Out like five out of five. I don't know much,
• 1:02:25
  Speaker 4: but that's one hundred percent. It's a hundred Yeah, don't
• 1:02:28
  Speaker 4: get okay, yeah, okay.
• 1:02:29
  Speaker 3: You want to be working hard, like you want to
• 1:02:31
  Speaker 3: think about getting some time in a cardio activity where
• 1:02:35
  Speaker 3: you couldn't talk, or like if somebody came to sort
• 1:02:38
  Speaker 3: of in your husband's game and started chatting, you would
• 1:02:41
  Speaker 3: just like not be able to chat back to him.
• 1:02:44
  Speaker 3: But it can be like intervals of that. You don't
• 1:02:46
  Speaker 3: have to do that for like a long period of time.
• 1:02:48
  Speaker 3: Your best bet is going to be a bike. You
• 1:02:51
  Speaker 3: should get some kind of very fun exercise bike situation.
• 1:02:55
  Speaker 3: You can get these bikes. People, the endurance guys really
• 1:02:59
  Speaker 3: like these swift bikes where you can like race other
• 1:03:04
  Speaker 3: crazy people in like inside a swift race, and it
• 1:03:08
  Speaker 3: like adjusts the thing so you can be like in
• 1:03:10
  Speaker 3: the Tour de France with the other guys, and if
• 1:03:12
  Speaker 3: you win, then you like win extra accessories for your bike,
• 1:03:17
  Speaker 3: your fake swift bike in the in the game, it's
• 1:03:20
  Speaker 3: a it's a video game biking app. But at any rate,
• 1:03:25
  Speaker 3: you want some kind of interval based biking on like
• 1:03:30
  Speaker 3: a stationary bike where you are working quite hard to
• 1:03:33
  Speaker 3: the point where you couldn't talk.
• 1:03:35
  Speaker 4: Can I ask a very ignorant question. It feels like
• 1:03:38
  Speaker 4: there's a lot of types of indoor bikes. There's the
• 1:03:40
  Speaker 4: soul cycle one that I did when everyone was doing
• 1:03:42
  Speaker 4: a soul cycle and I obediently also did it. So
• 1:03:46
  Speaker 4: there's that one where you're like leaning forward. There's one
• 1:03:49
  Speaker 4: that's also in gym's where it seems to be more
• 1:03:52
  Speaker 4: of a an sort of seated upright situation. And then
• 1:03:57
  Speaker 4: there's the third one, which is there's a big fan
• 1:04:00
  Speaker 4: in the front and your arms are part of it,
• 1:04:03
  Speaker 4: which is the bike you picture when you say biking.
• 1:04:07
  Speaker 3: Just any of these is fine. Just a regular bike
• 1:04:10
  Speaker 3: is fine. You just need to go set the resistance
• 1:04:12
  Speaker 3: hard enough that your heart rate goes up.
• 1:04:14
  Speaker 5: That's all.
• 1:04:14
  Speaker 4: Okay, okay, what do.
• 1:04:15
  Speaker 2: You think about swimming?
• 1:04:17
  Speaker 3: M I generally do not think swimming is going to
• 1:04:21
  Speaker 3: raise her heart rate enough.
• 1:04:24
  Speaker 1: And it takes a lot more time because you have to.
• 1:04:27
  Speaker 3: Like go to the gym and you have to put
• 1:04:28
  Speaker 3: your swim soon on, you have to get into the water,
• 1:04:30
  Speaker 3: and the gym pool is not available. The bike is
• 1:04:32
  Speaker 3: like stationary. Bike is like the easiest. You tell me
• 1:04:35
  Speaker 3: you have thirty minutes. You do like five minutes of
• 1:04:38
  Speaker 3: warm up, three minute intervals with a one minute rest
• 1:04:42
  Speaker 3: until you feel like you're going to die, and then
• 1:04:44
  Speaker 3: you get off the bike.
• 1:04:45
  Speaker 4: That sounds yeah, I love it. That sounds like it
• 1:04:47
  Speaker 4: sounds terrible.
• 1:04:48
  Speaker 1: That's what you want. That's what I know.
• 1:04:50
  Speaker 4: I know again, though, if any tech bro can come
• 1:04:52
  Speaker 4: up with a version of this where I don't actually
• 1:04:54
  Speaker 4: have to work very hard and can be physically comfortable
• 1:04:57
  Speaker 4: while something is doing my cardio interested.
• 1:05:02
  Speaker 1: That's what the peptizer for. Thank you for being here
• 1:05:08
  Speaker 1: else and we really appreciate it.
• 1:05:09
  Speaker 4: Thank you for allowing me to be here and acquiescing
• 1:05:13
  Speaker 4: when I refused to take no for an answer.
• 1:05:15
  Speaker 2: You have carte blanche for any future topics.
• 1:05:18
  Speaker 4: Do not say that I've talked so much in this
• 1:05:20
  Speaker 4: episode because I'm so excited. It's embarrassing. But okay, fine,
• 1:05:24
  Speaker 4: I'll come back every week.
• 1:05:26
  Speaker 1: Great.
• 1:05:27
  Speaker 3: Stick with us next week when we'll ask what's the
• 1:05:30
  Speaker 3: deal with alcohol? Wellness Actually is produced in association with iHeartMedia.
• 1:05:41
  Speaker 1: Our senior producer is Tamar Abshi.
• 1:05:44
  Speaker 3: Our executive producer at iHeart is Jennifer Bassett. Our theme
• 1:05:47
  Speaker 3: music is by Eric Deutsch, and our content is for
• 1:05:50
  Speaker 3: educational purposes only.
• 1:05:52
  Speaker 2: If you like the show, help other people find us.
• 1:05:55
  Speaker 2: Leave a rating and review on Apple Podcasts or your
• 1:05:58
  Speaker 2: podcatcher of choice and help let's spread the word about
• 1:06:00
  Speaker 2: the show. You can follow us on Instagram at Wellness
• 1:06:04
  Speaker 2: Actually pod and don't forget We want to hear from you.
• 1:06:07
  Speaker 2: Head over to Wellness Actually do FM and leave us
• 1:06:10
  Speaker 2: a question for our mailbag or suggest a topic for
• 1:06:12
  Speaker 2: a future show.
• 1:06:13
  Speaker 1: We'll let the influencers have the last word.
• 1:06:16
  Speaker 6: You cannot trust your pregnant brain. Last week I went
• 1:06:19
  Speaker 6: to lunch I got there early. I was so proud
• 1:06:20
  Speaker 6: of myself. So I usually run five to ten minutes late,
• 1:06:23
  Speaker 6: but I got there ten minutes early. I wait for
• 1:06:27
  Speaker 6: thirty more minutes am I getting stood up for the
• 1:06:31
  Speaker 6: very first time in my life. A couple hours later,
• 1:06:33
  Speaker 6: I get a text from this person and they're like,
• 1:06:35
  Speaker 6: oh my gosh, we're rating next week.
• 1:06:38
  Speaker 5: But yeah, I was sad.
• 1:06:40
  Speaker 6: I heard my own feelings.