Latest / Connect Call / EP22 - It’s Not Just Anxiety: What Most Doctors Miss About Hormones, Part 1 | Dr. Carly Snyder

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EP22 - It’s Not Just Anxiety: What Most Doctors Miss About Hormones, Part 1 | Dr. Carly Snyder · Connect Call

0:00
[SPEAKER_01]: Hi, you've reached the voicemail of Hannah Brett with Connect Call, just leave a message, and I'll get back to you soon as I can.
0:06
[SPEAKER_01]: Thanks.
0:07
[SPEAKER_01]: One for more options.
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[SPEAKER_00]: Hey, Hannah.
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[SPEAKER_00]: We had spoken about a year ago about my daughter, who was meeting an adolescent psychiatrist at the time, and I can't thank you enough.
0:18
[SPEAKER_00]: We adore her.
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[SPEAKER_00]: I'm basically my daughter's depression is so much better, but around that time at the months.
0:24
[SPEAKER_00]: Um, she is having these really bad bouts of like darkness and sadness, and, uh, you know, the psychiatrist who sent us to the gynecologists and the gynecologists and the spectacles, the psychiatrist and the psychiatrists and the spectacles, the gynecologists to do further warm-own testing and things are coming back normal, and I just feel like we need somebody like an expert who can connect the dots for us, um, if you can get back to me and let me know what you think that would be great, thank you.
0:52
[SPEAKER_01]: Hi, this is Hannah Bright with another episode of Connect Call, which I often say I do not have a clinical background, but I do have a PhD for picking up the phones for families in crisis.
1:03
[SPEAKER_01]: And I have to say I have been eagerly eagerly awaiting this episode today.
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[SPEAKER_01]: I'm very, very fortunate.
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[SPEAKER_01]: We have Dr. Carly Snyder with us, who is one of
1:16
[SPEAKER_01]: two few of you out there of reproductive psychiatrists in the world.
1:21
[SPEAKER_01]: And I just wanted to introduce Dr. Snyder.
1:25
[SPEAKER_01]: You know, I think my numbers are correct when I say this, which is shocking that I read somewhere that there's about 60,000 registered psychiatrists in this country.
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[SPEAKER_01]: There's about 55,000 gynecologists and there's 500 reproductive psychiatrists worldwide.
1:45
[SPEAKER_01]: Am I right about that?
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[SPEAKER_01]: Or is it just now?
1:47
[SPEAKER_01]: It's about right somewhere in the world, right?
1:48
[SPEAKER_02]: No, no, no, no, no.
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[SPEAKER_01]: I think that's right.
1:52
[SPEAKER_02]: Right.
1:53
[SPEAKER_01]: Yeah.
1:53
[SPEAKER_01]: So why I wanted to have Dr. Snyder on the show.
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[SPEAKER_01]: And let me just let me explain.
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[SPEAKER_01]: Let me just tell you a little bit about Dr. Snyder's.
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[SPEAKER_01]: Dr. Snyder, Carly Snyder specializes in women's mental health across the reproductive life cycle.
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[SPEAKER_01]: and she combines evidence-based psychiatric care with a holistic approach tailored for each of the patients individual needs.
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[SPEAKER_01]: Dr. Snyder earned her medical degree from NYU School of Medicine and completed her psychiatry residence at Mount Sinai Beth Israel Medical Center, not too shabby.
2:26
[SPEAKER_01]: And basically, I'm just, I'm, I'm, the month of September, what I was telling my viewers and listeners before
2:37
[SPEAKER_01]: even men, but not for the right reasons, was just very activated by this previous case with Lindsey Clancy.
2:45
[SPEAKER_01]: And what I've said on previous episodes that I have spoken on a little bit on the case is what was so activating for me personally and professionally it was just
3:00
[SPEAKER_01]: read immediately as this kind of Greek tragedy of this woman, this family, that were begging for help, but not getting the help that they need.
3:09
[SPEAKER_01]: And so, um, and a lot of women out there are not aware that people like you exist.
3:16
[SPEAKER_01]: And so, it was very important that we did this episode, um, this will be a two-part episode where we really get to dive into why
3:25
[SPEAKER_01]: everybody needs to come see you Dr. Snyder.
3:28
[SPEAKER_01]: And I just want to say before we get into the questions, the way I found Dr. Snyder was about, I think it was like eight years ago, working in mental health, I knew how to ask for help.
3:40
[SPEAKER_01]: But, um, there was this thing happening where I was having incredible dips in my depression.
3:46
[SPEAKER_01]: I was in my late 30s.
3:48
[SPEAKER_01]: I think, yeah, no early 40s.
3:51
[SPEAKER_01]: I was having major dips in my depression and all I could describe it because I've also learned over the years with.
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[SPEAKER_01]: changing medications or if I've had any new mental health symptoms, I try to track those days.
4:03
[SPEAKER_01]: And so what I was seeing was for a few days out of the month was this kind of the only way I can visualize it for people is the the girl from the ring, you know, just darkness.
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[SPEAKER_01]: Like a darkness I'd never experienced before where it was dark thoughts.
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[SPEAKER_01]: It felt like a cloak was pulled over me.
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[SPEAKER_01]: And it was really scary, a lot of suicidal ideation, and what ended up happening was, because I know how to ask for help and advocate for myself, but what was going on is I was saying, well, it's happening once a month.
4:35
[SPEAKER_01]: So I was talking to my gynecologist, and they were saying, Hannah, go back to the psychiatrist.
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[SPEAKER_01]: I was going to the psychiatrist, and they said, Hannah, go get your hormones tested with the endocrinologist, which was a very big range.
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[SPEAKER_01]: Anyway, go back to the psychiatrist, then go back to the gynecologist and nobody told me
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[SPEAKER_01]: And what I did one night, although I tell people to stay offline, but I did read some medical journals.
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[SPEAKER_01]: And I was reading, uh, somebody was flirting with the idea that I could be diagnosed with PMDD.
5:07
[SPEAKER_01]: Whether it's Stanford.
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[SPEAKER_01]: Three months short, dysphoric disorder.
5:10
[SPEAKER_01]: There you go.
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[SPEAKER_01]: Thank you, Dr. Snyder.
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[SPEAKER_01]: And I found this medical journal where you had written, they had quoted you and discussed some of your findings and I found you in New York City and I begged for an appointment and the rest is history.
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[SPEAKER_01]: So, thank you for being on Connect Call.
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[SPEAKER_01]: We really, really, really, really, really appreciate it.
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[SPEAKER_01]: I know so many women are going to be jumping at the bit of just the information we're going to be going over.
5:38
[SPEAKER_01]: So just as we start, Dr. Snyder, can you explain to our viewers and listeners, what exactly is a reproductive psychiatrist?
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[SPEAKER_02]: I'm so honored to be here so thank you so what I do reproductive psychiatry is this interesting interplay between classical psychiatry in terms of mood disorders symptoms et cetera and womanhood.
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[SPEAKER_02]: So hormonal shifts related to being a woman.
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[SPEAKER_02]: My practice is entirely made up of women
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[SPEAKER_02]: um 18 to 20 through menopause.
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[SPEAKER_01]: Right.
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[SPEAKER_02]: All this patient is 80 something.
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[SPEAKER_02]: She doesn't really count within the reproductive psychiatrist.
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[SPEAKER_02]: Right.
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[SPEAKER_02]: But basically what I do is I help women who have mood symptoms, emotional symptoms, what have you related to hormonal changes and that could
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[SPEAKER_02]: A lot of women have classic generalizing anxiety disorder, but then they want to have a baby.
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[SPEAKER_02]: And they're like, oh, what do I do about my meds.
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[SPEAKER_02]: That's where I come in is how people also figure out.
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[SPEAKER_02]: what's the most appropriate treatment plan for?
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[SPEAKER_02]: What is a classical psychiatric illness but now in the setting of this new chapter of their lives?
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[SPEAKER_01]: That's a really also important point.
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[SPEAKER_01]: I forgot about that that you can do that.
7:17
[SPEAKER_01]: Ladies out there, you know, for those of you out there that want to get pregnant, right?
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[SPEAKER_01]: And you're on an, an anti-depressant or you're on anti-cyc meds or anything of the sort, you know, you, you, you, I'm, automatically you think I can't be on anything, right?
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[SPEAKER_01]: And you get really scared.
7:32
[SPEAKER_01]: And I think, so this is another reason why everyone should be seeing a reproductive psychiatrist at some point.
7:38
[SPEAKER_02]: But
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[SPEAKER_02]: I'll just give a little plug, I think the other problem is that in medical school and residency, despite the fact that women make up half the population, the amount of education that's provided specifically related to women's health issues psychiatrically is fractional relative to what it should be.
8:05
[SPEAKER_02]: So there are so many psychiatrists who really do want to help women.
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[SPEAKER_02]: in this white, but they are never trained to do so.
8:13
[SPEAKER_01]: And I think that's what was, and thank you for saying that.
8:15
[SPEAKER_01]: I think that's what's so, what was so activating for me, and I think, because I have, and again, mind you.
8:23
[SPEAKER_01]: I had never had postpartum depression.
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[SPEAKER_01]: I was told a little bit that my PMDD, some of those days, could mimic what some women may feel.
8:31
[SPEAKER_01]: How hormones were kind of leveling me, right, with my mental health.
8:36
[SPEAKER_01]: I was really not only offended, I was activated on how
8:42
[SPEAKER_01]: You know, pushed aside, you know, the no one was giving in the medical community, what we were seeing in the Clancy case, especially was the gravity, right, of how these changes and shifts can really affect a woman's mental health, I think.
8:59
[SPEAKER_01]: If we go back in time, there's this stigma, right, where oh, she's emotional, it's that time of month, or it's just traumatic.
9:07
[SPEAKER_01]: history right and so everything's always been played down.
9:10
[SPEAKER_01]: I especially loved this case was around any man out there that's was commenting on hormones.
9:16
[SPEAKER_01]: I mean, I got to tell you and men have their own depleted hormones and that can but and that can affect their mental health and stuff as well and sex drive and all of that, but I wish more men would stay focused on that and not worried about.
9:27
[SPEAKER_02]: the women they're doing so sadly live in a patriarchal society.
9:33
[SPEAKER_02]: Yes, despite everything.
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[SPEAKER_02]: We do.
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[SPEAKER_02]: We can't, you know, avoid that or escape it right now at least.
9:39
[SPEAKER_01]: And so I think that's where, you know, for me, especially even on the mental health tip I was explaining this on another episode that the DSM is like kind of our holy grail.
9:51
[SPEAKER_01]: It's our Bible of, you know, mental health diagnosis.
9:54
[SPEAKER_01]: And I wasn't even aware until this case came about that postpartum
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[SPEAKER_01]: depression wasn't even a major thing, you know, diagnosis of the DSM, which is insane.
10:06
[SPEAKER_02]: But I post-partum psychosis is a adjunct diagnosis, like it's not a standalone diagnosis, which has been a
10:14
[SPEAKER_02]: I'm going source of frustration and just it's very disheartening because for what it's worth, what's most likely coast is is it's own entity, and it's not just a subheading under something else.
10:29
[SPEAKER_01]: No, yes, and it's a real thing and I think I think you know, where I really want all women to hear and this is why I was important to have you on today.
10:42
[SPEAKER_01]: whether you are a young woman at 18 and you were starting to feel some mental health symptoms correlated to your reproductive system or like, I think you would told me like, even when you have fibroids, it can affect your mental health.
10:57
[SPEAKER_01]: And don't be triosis can affect your mental health.
11:00
[SPEAKER_01]: And I think my hope in the future is that more,
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[SPEAKER_01]: training will go to the Catholic colleges and all doctors that are working with women.
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[SPEAKER_01]: So we don't feel like, I mean, it is it is it's sad that, you know, my girlfriends and I can all get together at our age and we're still like.
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[SPEAKER_01]: so uneducated on imbalance of our hormones and everything like that nature.
11:26
[SPEAKER_01]: But I want to ask you, you know, I think when what do you find are like the biggest, I think, because again,
11:37
[SPEAKER_01]: We think of a reproductive psychiatrist and automatically, I think immediately, and we are going to talk about maternal mental health, but I think people are just so focused on that is what is needed or this is when women can their mental health can really take a shift.
11:54
[SPEAKER_01]: Can you kind of, but what I'm we're going to show is that it's all different chapters in a woman's life and.
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[SPEAKER_01]: People like me who never even had a baby, it can really, you know, my own own rock me.
12:05
[SPEAKER_01]: So can you explain a little bit about how.
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[SPEAKER_01]: In layman's terms, little bit about what's happening to a woman on why for some women, it does rock or does affect her anxiety levels and depression and all of that.
12:20
[SPEAKER_02]: Well, so I'm a very big believer that, you know, people should remember reproductive psychiatry isn't pregnancy.
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[SPEAKER_02]: Psychiatry.
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[SPEAKER_01]: Thank you.
12:28
[SPEAKER_01]: Yes.
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[SPEAKER_01]: I do a lot of pregnancy.
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[SPEAKER_02]: Reproductive psychiatry is not pregnancy psychiatry.
12:33
[SPEAKER_02]: Right.
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[SPEAKER_02]: Perry, NATO.
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[SPEAKER_02]: is when I do perinatal work, yes, it's pregnancy related, but there's so much in our lives that don't encompass those, you know, that year plus between pregnancy and then postpartum two years, whatever.
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[SPEAKER_02]: So, you know, the risk of something like anxiety and anxiety disorder.
12:57
[SPEAKER_02]: for some of them higher in women why we don't particularly have a reason but it just is right the thing is there are some women who unfortunately suffer all the time right and that's not hormonal immediate that's just a function of how their brain works they're usually genetics involved but it's not inherently because they're a woman it's just what it is right now then there are women
13:24
[SPEAKER_02]: who find that they may or may not have a mood disorder throughout the month, but anywhere from the point of ovulation until they actually get their period, their mood shifts profoundly.
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[SPEAKER_02]: Now, there are varying degrees to this.
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[SPEAKER_02]: Some women, right?
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[SPEAKER_02]: I think they say 90 percent of women are something I have PMS, right?
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[SPEAKER_02]: Which is like, for a few days, you're a little irritable.
13:48
[SPEAKER_02]: Maybe you're just like, oh, I'm eating a lot and I feel bloated, whatever.
13:51
[SPEAKER_02]: Right.
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[SPEAKER_02]: That's just is, right?
13:55
[SPEAKER_02]: That's just the way our body is responding.
13:57
[SPEAKER_02]: But what happened for, they say, seven percent, I think the number is much higher, but it's underported and underbagnosed, of women is that what are actually very normal hormone shifts.
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[SPEAKER_02]: cause an abnormal response in our brain.
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[SPEAKER_02]: So for example, when you said earlier about getting your hormones checked, I went, because hormone getting your hormones checked means nothing.
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[SPEAKER_01]: Great.
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[SPEAKER_02]: My hormones today are going to be different than my hormones tomorrow versus the next day.
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[SPEAKER_02]: And what's interesting is PMDD as well as all of anything related to what I do.
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[SPEAKER_01]: Right.
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[SPEAKER_02]: It's not that the endocrine aspect is fine.
14:43
[SPEAKER_01]: Right.
14:45
[SPEAKER_02]: Well, that's not okay is the brain response to normal endocrine hormonal shifts.
14:51
[SPEAKER_02]: So what happens is I see women who will say to me, you know, I spend the first two weeks of the month making up for the last two weeks of the month.
15:02
[SPEAKER_01]: So true.
15:04
[SPEAKER_02]: right, they become different people, all of a sudden they're anger becomes very out of control or they're sleeping all the time or they can't sleep or they're eating a lot more than usual, they feel so out of control.
15:16
[SPEAKER_02]: And it's very hard to regulate one's mood and emotions and then that translates typically to the people closest to us.
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[SPEAKER_02]: So that anger comes across and then the next two weeks are like, I'm so sorry.
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[SPEAKER_02]: that wasn't me.
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[SPEAKER_02]: The problem is it's half her life.
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[SPEAKER_01]: I don't think the same cycle.
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[SPEAKER_01]: Like because I would do it.
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[SPEAKER_01]: It's like I would with my wife.
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[SPEAKER_01]: I would literally go down and then have all this anxiety when like the curtain moved over and I was back to Hannah and I was like touching up, catching up, catching up and then I would crash again.
15:51
[SPEAKER_02]: Right.
15:52
[SPEAKER_02]: And, you know, there's
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[SPEAKER_02]: Sure, by all means, eat less salt.
16:02
[SPEAKER_02]: It's just like, again, awesome.
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[SPEAKER_02]: You should.
16:05
[SPEAKER_02]: But when you have really significant mood changes like this, your salt intake is not going to modify what's going on.
16:13
[SPEAKER_02]: And there's,
16:16
[SPEAKER_02]: a misconception.
16:18
[SPEAKER_02]: Yeah.
16:19
[SPEAKER_01]: No, it's going to say it's one of my biggest and so so much respect for influencers out there and those on social media, but I got to tell you because I was just at a podcast recently the individual on this panel who was in charge of the
16:32
[SPEAKER_01]: the nutritional aspect of a woman, right?
16:36
[SPEAKER_01]: And she just got on this pedestal about how a woman's hormones if they just got up and exercised.
16:42
[SPEAKER_01]: If they just had their green juice in the morning and saw the sun.
16:45
[SPEAKER_01]: And to me, I mean, I wanted to yell and go like,
16:49
[SPEAKER_01]: stain your lane one two you know and I feel like as women we're doing a disservice for women by doing this whole like we'll just get up and just have your juice and exercise and get this in magnesium in and all that because I know when I came to see you and mind you what also for me when I did get my hormones actually properly checked it did and
17:15
[SPEAKER_01]: It did, um, my testosterone just happened to be really loud.
17:18
[SPEAKER_01]: Oh, the time.
17:19
[SPEAKER_01]: That's a separate issue.
17:20
[SPEAKER_01]: Yes.
17:20
[SPEAKER_01]: That's a separate issue.
17:21
[SPEAKER_01]: And it did affect my depression.
17:22
[SPEAKER_01]: But what I was saying, I knew something was up with my reproductive system because I was on all my medication for my depression.
17:30
[SPEAKER_01]: Everything was pretty much regular, like regulated except for these days.
17:35
[SPEAKER_01]: And then I was, I remember when I met with you, we were, we were talking about a hysterectomy because, or because like I had already tried
17:43
[SPEAKER_01]: And these days were taking me out.
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[SPEAKER_01]: They were literally leveling me.
17:48
[SPEAKER_02]: And I know what's interesting is that you're, I was just saying, you're not alone in that.
17:51
[SPEAKER_02]: There are a lot of women who have this thing, where they're like, I have depression.
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[SPEAKER_02]: I have anxiety.
17:57
[SPEAKER_02]: Has it right?
17:59
[SPEAKER_02]: But I'm fine.
18:00
[SPEAKER_02]: My meds are great.
18:01
[SPEAKER_02]: Until all of a sudden they're not, right?
18:04
[SPEAKER_02]: And those, and as it turns out, we have a beautiful way to treat it.
18:07
[SPEAKER_02]: It's called Interrupted Dosing.
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[SPEAKER_02]: up the dose of whatever it is that you're on that's working the rest of the month.
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[SPEAKER_02]: And there you go and you're fine.
18:17
[SPEAKER_02]: There are other women for what it's playing that one more time.
18:20
[SPEAKER_01]: So yes, yes, so for someone like me, let's say like so I'm on my let's say well future and right, and I'm at this dose all month.
18:27
[SPEAKER_01]: Okay, not well future and we want.
18:28
[SPEAKER_02]: Now, well, be sure, let's pick an SS, all right.
18:30
[SPEAKER_02]: So interestingly, if the picture is a, yeah, well, future is a dopamine-based medication.
18:35
[SPEAKER_02]: It's excellent for depression, right?
18:37
[SPEAKER_02]: But when we're talking about estrogen-related hormones shifts, et cetera, it doesn't matter.
18:46
[SPEAKER_02]: Zoloft is a great example.
18:47
[SPEAKER_02]: It's a rare to nerd for it, right?
18:49
[SPEAKER_02]: So that's a good example, which is unfortunate because well, be sure to break drug, but it doesn't actually happen to work in this situation.
18:57
[SPEAKER_01]: But what you're seeing is so if you are a woman out there who's on this dose of zooloft, right?
19:02
[SPEAKER_01]: And you're noticing certain times the month or certain aspects of your reproductive system are affecting your mental health for certain days.
19:10
[SPEAKER_01]: You're saying that the dose up during those days.
19:13
[SPEAKER_01]: Yeah.
19:14
[SPEAKER_01]: That's typically under the guidance of a doctor, of course.
19:16
[SPEAKER_02]: Of course, of course, what I call my patients is to
19:19
[SPEAKER_02]: Think of backwards and it's always the same amount of time, right?
19:22
[SPEAKER_02]: They'll say five days, seven days, 10 days, whatever, right?
19:25
[SPEAKER_02]: It's always 14 days or less, right?
19:28
[SPEAKER_02]: So it's the loyal phase after ovulation.
19:32
[SPEAKER_02]: And the way I presented is if you're on Zolaft,
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[SPEAKER_02]: 50, we'll make a number here, take 75 for those days, start the day before you would otherwise be getting symptomatic.
19:44
[SPEAKER_01]: Right.
19:45
[SPEAKER_02]: And, you know, they come back and then stop once you get your period or your symptoms would otherwise go back to being resolved.
19:53
[SPEAKER_02]: Now, it is important to note that there are a lot of women who unfortunately are not well treated, so they're the entire month.
20:02
[SPEAKER_02]: They're not doing great.
20:03
[SPEAKER_02]: There's something called PME, which is pre-menstrual exacerbation, which presents exact same way as PMDD.
20:12
[SPEAKER_02]: The difference is that when you have PME, when you are appropriately and effectively treated on the rest of the month, those worsened symptoms resolve.
20:24
[SPEAKER_02]: So you don't need the interrupted dose and you just need to be on the right dose.
20:29
[SPEAKER_01]: for the rest of the month.
20:30
[SPEAKER_01]: That's a good question.
20:32
[SPEAKER_01]: And so again, I'm trying to think of my viewer and listeners, you know, and immediately I'm thinking of this collar, right?
20:40
[SPEAKER_01]: This is way of a year.
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[SPEAKER_01]: a young woman who's 18.
20:45
[SPEAKER_01]: And so, how, how, as a parent or how is it?
20:48
[SPEAKER_01]: Like, how do we know when to say, okay, well, we've gone to the psychiatrist, she's on anxiety, medication, she's on the answer to present, something's still not, like when do we know to go to a reproductive psychiatrist?
21:03
[SPEAKER_01]: I think that's young up in age, I guess, or during, well, not that you made it.
21:06
[SPEAKER_01]: I don't think it.
21:07
[SPEAKER_02]: I don't even think it.
21:08
[SPEAKER_02]: I think if you have the access, then you should go.
21:11
[SPEAKER_01]: No, of course, but how do you know why I don't need it?
21:14
[SPEAKER_02]: Once your symptoms or her symptoms are so profound that they are negatively impacting her daily life, that, you know, she says, like, I don't feel great today.
21:25
[SPEAKER_02]: You know, I have a 16 year old that happened sometimes not that it's when you see your daughter truly struggling right for those days and despite having, you know, the zooloft and having this psychiatrist and everything else, you're still.
21:40
[SPEAKER_02]: The other thing is really that's really important is that I'm working incredibly closely with obituians because there are a lot of women not ever.
21:50
[SPEAKER_02]: on paper based upon how we conceptualize PMDD.
21:56
[SPEAKER_02]: So being on a birth control.
21:58
[SPEAKER_02]: which is monophasic, meaning the hormone levels don't change throughout the month, right?
22:04
[SPEAKER_02]: That should get rid of all the symptoms because we're saying symptoms are from hormone shifts, normal hormone shifts, and our brain is responding inappropriately to normal shifts.
22:14
[SPEAKER_02]: So at least conceptually, if you are on a monophasic pulse,
22:22
[SPEAKER_02]: you read that, like you should be fine.
22:25
[SPEAKER_02]: Unfortunately, that is only the case from maybe 60% and that may be an overshoot.
22:32
[SPEAKER_02]: A lot of women benefit from the combo approach, where it's both birth control and a SSRI.
22:42
[SPEAKER_02]: not everyone responds well to birth control, though, right?
22:45
[SPEAKER_02]: There are women who, for whatever reason, yeah, I was on a 90 day, I couldn't do.
22:51
[SPEAKER_02]: Oral birth control, like oral hormones can be very destabilizing for some women.
22:57
[SPEAKER_02]: It's this balance you don't know until you try, which is really stressful, obviously, for us, but also looking at an 18 year old, their hormones are all over the place to begin with.
23:10
[SPEAKER_02]: And figuring out what the best approach is really generally takes somewhat, well, first it takes a lot of talk and figuring out, like let's really hammer down what's going on.
23:20
[SPEAKER_02]: And then there's some level of trial and error.
23:24
[SPEAKER_02]: And we see what works, we see what doesn't.
23:28
[SPEAKER_01]: I think, you know, a big reason why I wanted to also do this show Dr. Snyder is I have my life with my mental health is, you know, I've been definitely on the struggle bus.
23:39
[SPEAKER_01]: But with that, I have said the blessing is I have tried every treatment, and I feel like I have advocated for myself.
23:48
[SPEAKER_01]: And I think what, um,
23:52
[SPEAKER_01]: what I guess what I'm going to ask is like what you would recommend for women, like for instance in my situation and kind of like what we saw and I'm going to get into maternal health in a second but with Lindsey Clancy is we just like I did the same thing.
24:07
[SPEAKER_01]: I'd go to a psychiatrist, they'd put me on all these meds,
24:11
[SPEAKER_01]: I feel horrible on certain meds and then there's this urgency to feel better so then you go to the next doctor and the next doctor and you change your meds and you change your meds by the way that's not doctor shopping nobody doctor shops for an antipressant by the way, no, no, no, no, no, no, no, no, no.
24:28
[SPEAKER_01]: because I just heard that a lot too.
24:30
[SPEAKER_01]: So my point is, until I just sat down and read a medical journal, again, I was going to my god in a collegeist, I was going to my psychiatrist, nobody said, hey, let's look into a reproductive psychiatrist.
24:44
[SPEAKER_01]: And I was saying, these were days of the week that, and I was fortunate, because of the work I do, I was seeing the best in the country for mental health, and still nobody was like,
24:57
[SPEAKER_01]: Let's look at this.
24:58
[SPEAKER_01]: You know, so my question is, as a woman, when you have a
25:04
[SPEAKER_01]: I, well, first I would say, I'm sure you're going to recommend with every woman track your moods track.
25:11
[SPEAKER_01]: Do you can you recommend an app?
25:13
[SPEAKER_02]: There's a lot of apps where you can kind of, I, you know, like I period even.
25:17
[SPEAKER_02]: Yes, no matter.
25:20
[SPEAKER_02]: So you're able to track you know, although, you know what someone who has really significant, they know, because it is consistent.
25:28
[SPEAKER_02]: And you know, and then that what happens is people change their lives around that time.
25:33
[SPEAKER_02]: I'm not going to plan a vacation.
25:34
[SPEAKER_02]: I did that coincides with, you know, my loodials face because it's not going to be fun.
25:39
[SPEAKER_02]: And I'm going to be miserable.
25:41
[SPEAKER_02]: And the problem is everyone else's life doesn't work around your hormones shifts.
25:47
[SPEAKER_01]: Right.
25:48
[SPEAKER_02]: So, you know, it's so and so is wedding.
25:51
[SPEAKER_02]: And you want to go.
25:53
[SPEAKER_02]: But you also think, oh my god, I'm going to feel like I'm not going to be able to get out of bed.
25:56
[SPEAKER_02]: How do I say yes?
25:57
[SPEAKER_02]: And then I'm going to write like,
26:00
[SPEAKER_01]: I remember having those conversations with me, where I was like, and even with my therapist, because I wasn't even going, I didn't do this podcast for all these years that I wanted to, because I felt like I wasn't dependable, because I knew unless I was recording on certain days, like this was gonna keep happening.
26:17
[SPEAKER_01]: And since we've last met, I actually have a, his direct name, it has helped dramatically.
26:23
[SPEAKER_01]: But I guess the next part I really just want to kind of get into, which was also just incredibly shocking for me as someone who's never given birth and had a child.
26:40
[SPEAKER_01]: I think what was, you know, when I talked to my mom friends and we start getting into the maternal part during and then the after and and and here's what I am at a loss for is that as a parent you in the hospital, let's say you're having a kid.
26:57
[SPEAKER_01]: and a child.
26:58
[SPEAKER_01]: Then you're bringing this child into the world and the doctors and the nurses and everybody are all about the safety and the health of that mother and that child.
27:08
[SPEAKER_01]: And you're going to have these continuous doctor's appointments to check the height, the weight, and everything of this child.
27:15
[SPEAKER_01]: And at no point is anyone saying, hey,
27:19
[SPEAKER_01]: And we don't even have to get to a situation like what happened unfortunately with Lindsey Clancy.
27:24
[SPEAKER_01]: We can just at least acknowledge your mental health may be rocked a little bit with your hormones.
27:29
[SPEAKER_01]: Like you may have something like I watched my girlfriends literally be scared to leave their kids alone.
27:35
[SPEAKER_01]: be scared that their kids something bad was going to happen, have like some anxiety like very light, but then have more extreme bouts.
27:43
[SPEAKER_01]: I had women from middle school to high school to women from college.
27:47
[SPEAKER_01]: I haven't spoken to the complete strangers right me saying me too.
27:52
[SPEAKER_01]: And it's it's what is shocking is and this goes for
27:56
[SPEAKER_01]: Mom and mom dad and dad and dad's table that the spouse is the fact that parents are leaving a hospital and are not a quit with trust even like the bear or minimum you know and and I know we were talking before a little bit about you know
28:15
[SPEAKER_01]: And people have very strong opinions about what the Clancy family had done to help support Lindsay through this time and it was it enough.
28:22
[SPEAKER_01]: And I have to say as somebody who works with families all the time and you do too, I'm sure as, you know, yes, there could have been so much more done, but with that, there's think about how much there's no education.
28:34
[SPEAKER_01]: So like you can't really and when people do intervene, like I was saying on one of my episodes recently,
28:41
[SPEAKER_01]: You know, I put on my show notes, a list of programs where mothers could go with their babies.
28:47
[SPEAKER_01]: They're all these like five day stays in hospital.
28:50
[SPEAKER_01]: None of it is long-term treatment.
28:52
[SPEAKER_01]: None of it is at least over.
28:54
[SPEAKER_01]: The fact that Mrs. Clancy did not go to treatment for 30 days or more is, you know what I mean?
29:02
[SPEAKER_01]: And so it's these little stints in crisis and then they're sent home, right?
29:08
[SPEAKER_01]: And, and, and, and, and, and more, also more, also, which is even sadder to me is as women, we don't talk about it.
29:14
[SPEAKER_01]: Everybody's got so much shame about this because they've had a baby.
29:18
[SPEAKER_01]: So they have to think this is the happiest time of their life.
29:22
[SPEAKER_01]: And, and God forbid you actually but dark thought about your child, you know, or you're not attaching to the baby.
29:28
[SPEAKER_01]: And so.
29:30
[SPEAKER_01]: Sorry, I'm on a rant about this, but I think can you just talk a little bit about the difference?
29:36
[SPEAKER_01]: Because I think there's also so much misinformation out there between what people call the baby blues to postpartum depression, postpartum anxiety, OCD, psychosis, and what symptoms really should a family get involved and go, okay, we need to do something like now.
29:57
[SPEAKER_02]: It is a great and very huge question.
30:00
[SPEAKER_01]: Yeah, take your time.
30:01
[SPEAKER_01]: We're going to be a little bit.
30:03
[SPEAKER_01]: So I'll be able to do it in parts.
30:05
[SPEAKER_02]: I would say the first thing to realize is the baby blues are not abnormal.
30:12
[SPEAKER_02]: They're not pathologic.
30:14
[SPEAKER_02]: There's no issue.
30:14
[SPEAKER_02]: So baby blues are the first two weeks postpartum is the woman who finds herself crying.
30:22
[SPEAKER_02]: It says, I don't know why the hell I'm crying, but I can't stop.
30:25
[SPEAKER_02]: I always tell people that when I had my first.
30:30
[SPEAKER_02]: who is now 19 in the college, but when he came around, um, Mazelka and home.
30:35
[SPEAKER_02]: Thank you.
30:36
[SPEAKER_02]: If we went home in and we didn't know anything, and we got a convertible car seat.
30:42
[SPEAKER_02]: Here's this little guy where we didn't know what an infant car seat was.
30:45
[SPEAKER_02]: It was just not in our radar.
30:47
[SPEAKER_02]: So I just remember sitting in the back seat and he's a little guy in this huge car seat.
30:53
[SPEAKER_02]: And I briefly felt like a failure.
30:55
[SPEAKER_02]: Start to cry.
30:56
[SPEAKER_02]: My husband's like, who cares?
30:57
[SPEAKER_02]: We'll just buy one tomorrow.
30:58
[SPEAKER_01]: Right.
30:59
[SPEAKER_02]: And I was like, oh, but I could not stop crying.
31:03
[SPEAKER_02]: And I was sitting there going, I don't know what to tell you.
31:06
[SPEAKER_02]: I can't stop crying, but I'm not sad.
31:10
[SPEAKER_02]: I'm not.
31:11
[SPEAKER_02]: I am not crying from a place of depression.
31:15
[SPEAKER_02]: I'm not crying because of the wrong.
31:17
[SPEAKER_01]: Yeah.
31:18
[SPEAKER_02]: I'm just, this is hormones, right?
31:20
[SPEAKER_02]: This was three days after he was born.
31:23
[SPEAKER_02]: My hormones were tanking like, you know, a ton of bricks.
31:26
[SPEAKER_02]: And that was my reaction.
31:28
[SPEAKER_02]: So,
31:29
[SPEAKER_02]: You know, the first two weeks, it's like women who say, oh, I'm really good, but I can't stop this feeling.
31:35
[SPEAKER_02]: That's okay.
31:36
[SPEAKER_01]: That's kind of like what the baby blues are.
31:38
[SPEAKER_02]: Yes, that is.
31:39
[SPEAKER_02]: And if it continues beyond two weeks.
31:42
[SPEAKER_01]: Right.
31:43
[SPEAKER_02]: Or you are not crying for no reason.
31:46
[SPEAKER_02]: You are crying because you are legitimately sad.
31:49
[SPEAKER_02]: You're crying because of the feeling that you don't anticipate.
31:53
[SPEAKER_02]: And I
31:57
[SPEAKER_02]: And with my patients, I'm intentionally very vague.
32:01
[SPEAKER_02]: Anyone person can have any different reaction.
32:04
[SPEAKER_01]: Totally.
32:05
[SPEAKER_02]: They don't feel is right.
32:07
[SPEAKER_02]: And that's what matters, right?
32:09
[SPEAKER_02]: So, yes, we have DSM right gives a whole criteria for what's diagnosable depression and anxiety.
32:15
[SPEAKER_02]: It's at a,
32:17
[SPEAKER_02]: I don't really care.
32:19
[SPEAKER_02]: I care about what she's feeling.
32:22
[SPEAKER_02]: And if she's saying this doesn't feel like what I anticipated, rather than saying to her, you're just being silly.
32:32
[SPEAKER_01]: I want to see the interrupt.
32:34
[SPEAKER_01]: I need things for a second.
32:35
[SPEAKER_01]: This is why I can't stress enough why everyone should be calling Dr. Carly Snyder for an assessment.
32:41
[SPEAKER_01]: In that, I stress in all my episodes, if you, the best providers are those who see the person.
32:49
[SPEAKER_01]: Like, I remember when I
32:54
[SPEAKER_01]: I've said it in another episode, he was like an idol of mine and there's great movie called Patch Adams where it's it's a true story where this this this man was you know he he treated kids with cancer with humor and he was brought to trial because he wasn't a physician.
33:09
[SPEAKER_01]: And in the movie, you know, Robin Williams simply says, you know, something along the lines that if you treat the disease, you're going to lose.
33:17
[SPEAKER_01]: But if you treat the person, you're always going to win, right?
33:20
[SPEAKER_01]: And I remember when I found you, I knew I had the right gynecologist because, and remember Dr. Bill's, we love you.
33:28
[SPEAKER_01]: He said to me, one, he goes, where has she been art in all my life?
33:32
[SPEAKER_01]: We need more of Dr. Snyder.
33:34
[SPEAKER_01]: And, too, he agreed with your mindset of someone's going to say, you know, your levels are good, because this is what it is good in, in, in, for those who are listening, I should quote, but like in the, you know, in the charts of what is normal, but that doesn't matter.
33:51
[SPEAKER_01]: If you don't feel normal, if you don't feel like yourself, that is what we need to treat.
33:57
[SPEAKER_01]: You know what I mean?
33:58
[SPEAKER_01]: And that, those are the people you need to find as providers.
34:01
[SPEAKER_01]: those people.
34:02
[SPEAKER_02]: I think yeah, we are all different.
34:05
[SPEAKER_02]: We all come to, you know, planning a pregnancy pregnancy postpartum, this whole thing.
34:09
[SPEAKER_02]: We all come from different places and different head spaces and everyone's social structures different, right?
34:16
[SPEAKER_02]: What, you know, so to have a criterion that is hard and fast doesn't make sense in my book.
34:23
[SPEAKER_02]: What I do think is important though is, you know, there are certain things that
34:28
[SPEAKER_02]: can't be overlooked, and sometimes are, for example, sleep.
34:32
[SPEAKER_02]: People will say, I can't sleep.
34:37
[SPEAKER_02]: Now, I can't sleep like Lindsay Clancy, which is a different thing.
34:42
[SPEAKER_02]: That is very, for me, as a physician, when someone is given medication to,
34:49
[SPEAKER_02]: sleep, like Benzos, like adivine clomp and wear, and they're not sleeping at all.
34:54
[SPEAKER_02]: That's a huge red flag.
34:56
[SPEAKER_02]: Post-harm psychosis is a form of bipolar disorder, most likely, not always but generally.
35:02
[SPEAKER_02]: That is a huge red flag.
35:03
[SPEAKER_02]: But the women who say, you know, I put the baby to sleep, and I sit there and I stare at this monitor.
35:11
[SPEAKER_02]: And I can't fall asleep because I'm freaking out about the baby breathing.
35:17
[SPEAKER_02]: I fall asleep in the baby wakes up.
35:19
[SPEAKER_02]: I'm going to go get the baby because I don't need to wake anyone else up.
35:23
[SPEAKER_02]: It's okay.
35:24
[SPEAKER_01]: Right.
35:24
[SPEAKER_02]: And then the next day, they're exhausted, which is a really big piece.
35:29
[SPEAKER_02]: They're tired because they're not getting enough sleep.
35:32
[SPEAKER_02]: If you have postpartum psychosis generally or in a manic psychotic state, you're not tired.
35:40
[SPEAKER_02]: So,
35:41
[SPEAKER_02]: very key differential.
35:42
[SPEAKER_02]: But what happens is that with as women, we, this is not just with having a baby.
35:49
[SPEAKER_02]: We say, I got this.
35:51
[SPEAKER_02]: It's okay.
35:51
[SPEAKER_02]: Don't worry.
35:52
[SPEAKER_02]: I'll do it.
35:53
[SPEAKER_01]: So true.
35:54
[SPEAKER_01]: And oh, my God.
35:56
[SPEAKER_02]: Everybody, right?
35:57
[SPEAKER_01]: We all especially on moms because everybody like my mom was like this too It's like she loved telling me to go to therapy take my medication do this But when it was her she white knuckle life.
36:07
[SPEAKER_01]: Oh, yeah, she was like I got this.
36:09
[SPEAKER_01]: I got this.
36:09
[SPEAKER_02]: I got this and I'll wake up I'll do that.
36:11
[SPEAKER_02]: You know, so actually a really big thing that I talked to my patients about before they had babies Is however even a protector sleep
36:20
[SPEAKER_02]: And they look at me like I have three heads.
36:22
[SPEAKER_02]: And I said, yes, I understand new born's wake up very frequently.
36:27
[SPEAKER_02]: You don't have to be the only one waking up with that baby.
36:29
[SPEAKER_02]: Thank you.
36:30
[SPEAKER_02]: Your partner can go.
36:30
[SPEAKER_02]: And if you're exclusive, we breastfeeding God bless.
36:34
[SPEAKER_02]: That's fine.
36:35
[SPEAKER_02]: If you're not, God bless also breastfeeding is not.
36:39
[SPEAKER_02]: The be all end all.
36:40
[SPEAKER_02]: It is not an indicator of you as a mother if you can breastfeed or not.
36:45
[SPEAKER_02]: Please take that out of the equation because it is a huge source of depression.
36:49
[SPEAKER_02]: But anyway, in advance, I say, let's plan out a schedule.
36:54
[SPEAKER_02]: You know, you want to breastfeed it or not, whatever, you're going to wake up from the 11 o'clock.
37:01
[SPEAKER_02]: Your partner is going to wake up for the two o'clock.
37:04
[SPEAKER_02]: And either they're going to give you a bottle or they're going to change a baby, bring you the baby, sit with you while you breastfeed.
37:11
[SPEAKER_02]: Take the baby, put the baby back down.
37:14
[SPEAKER_02]: That saves so much time.
37:16
[SPEAKER_02]: And then you'll do the next shift entirely.
37:19
[SPEAKER_02]: The next night, you flip flop.
37:22
[SPEAKER_01]: What does it feel like that allows who won't do it?
37:26
[SPEAKER_01]: I hate saying it, but they know it happens.
37:28
[SPEAKER_01]: My dad didn't do it.
37:31
[SPEAKER_02]: It was my mom's father, she didn't ask.
37:34
[SPEAKER_02]: Well, that's a big thing.
37:35
[SPEAKER_02]: A.
37:35
[SPEAKER_02]: Ask, be demand when needed.
37:41
[SPEAKER_02]: See, phone a friend and sort of speak.
37:43
[SPEAKER_02]: Right.
37:44
[SPEAKER_02]: You really don't have this support call.
37:46
[SPEAKER_02]: You're, whoever it is, that's close to you.
37:48
[SPEAKER_02]: I'd say listen, I need help.
37:50
[SPEAKER_01]: or D which is my favorite, which I've tried to instill in my girlfriend's years ago, which is instead of having a baby shower, let's just do a go fund me for a night nurse.
38:00
[SPEAKER_02]: I was just like nurses.
38:01
[SPEAKER_00]: Why are people using more night nurses?
38:03
[SPEAKER_01]: We can raise the funding.
38:04
[SPEAKER_01]: I feel like it's in primary expense.
38:06
[SPEAKER_01]: I think I know they're so expensive, but I feel like they are closed.
38:11
[SPEAKER_01]: Get a night nurse.
38:12
[SPEAKER_01]: 100%.
38:13
[SPEAKER_02]: Listen,
38:16
[SPEAKER_02]: There's something better.
38:17
[SPEAKER_01]: I mean, there really do go fun me for a night nurse.
38:21
[SPEAKER_01]: 100% they're very, very helpful.
38:23
[SPEAKER_02]: But it's really, if you think about it, we as a, you know, our army that you wish are.
38:31
[SPEAKER_02]: We use sleep deprivation as a form of torture because if you don't sleep, if anyone doesn't sleep sufficiently, with enough time, you are going to lose it.
38:44
[SPEAKER_02]: That is a given, whether you just had a baby or you didn't.
38:47
[SPEAKER_02]: And there's this really, really, frankly, backwards concept.
38:52
[SPEAKER_02]: Oh, if you're a new mom, you should be fine, though.
38:54
[SPEAKER_02]: It's okay.
38:56
[SPEAKER_02]: It's expected.
38:57
[SPEAKER_02]: You're not going to sleep, get over it.
38:59
[SPEAKER_01]: Right.
39:00
[SPEAKER_02]: And there are people who are okay, right?
39:05
[SPEAKER_02]: But there are a lot of people who aren't.
39:08
[SPEAKER_02]: And they, I mean, I remember with my second daughter
39:14
[SPEAKER_02]: not a great sleeper.
39:15
[SPEAKER_02]: I remember being in the middle of the night and like losing it just being like I can't do this again.
39:21
[SPEAKER_02]: She was waking up by
39:23
[SPEAKER_02]: And the next day, we got a night nurse because I was like, I need it for, we had, and at the time we had no money, we did it for like 10 days, 10 days of my life.
39:33
[SPEAKER_02]: And then by my third, we had, we were a little more comfortable.
39:38
[SPEAKER_02]: Right.
39:39
[SPEAKER_02]: She was also a pre-me and had a bunch of medical things.
39:41
[SPEAKER_02]: We had that night nurse for a while.
39:44
[SPEAKER_02]: Also I saw mom to these two older kids who couldn't function without me and I needed to function.
39:51
[SPEAKER_01]: Talk about night nurses.
39:52
[SPEAKER_02]: I think it's also like a night nurse can be your friend and night nurse can be a family member anybody doesn't matter right, but you need to ask right you need to ask for the help everybody I it's again put the mask on first before your kids you know on the plane well and you can't expect yourself to know everything right like it's obviously every child is different so you have a new experience, but also.
40:16
[SPEAKER_02]: being pregnant doesn't prepare you, sort of speak, for motherhood.
40:22
[SPEAKER_02]: It prepares you, you know, it prepares the baby, but unless you, you know, kind of crowdsource and ask for help and understand, you don't know.
40:33
[SPEAKER_02]: And you're not supposed to know.
40:35
[SPEAKER_02]: And I think there's this really significant misperception that you should.
40:40
[SPEAKER_02]: And unfortunately to your point earlier,
40:46
[SPEAKER_02]: baby friendly hospitals, which means that mom is given the baby unless she asks to sleep.
40:54
[SPEAKER_02]: But because breastfeeding is pushed so heavily, I think of them as mom unfriendly health hospitals because there's no thought about mom and this is actually something just to quickly know when you're pregnant everything's about you.
41:11
[SPEAKER_02]: You're having a baby that everyone thinks they're butterflies floating around your head.
41:15
[SPEAKER_02]: People are touching your belly.
41:16
[SPEAKER_02]: It's quite uncomfortable.
41:17
[SPEAKER_02]: But the focus is still on you're going to the doctor.
41:22
[SPEAKER_02]: You are being monitored.
41:24
[SPEAKER_02]: You're glucose.
41:25
[SPEAKER_02]: All of this stuff.
41:26
[SPEAKER_02]: Then you have a baby.
41:27
[SPEAKER_02]: And you know, your GYN says, Oh, he says, I'll see you in six weeks.
41:33
[SPEAKER_02]: Yeah, that's a really long time.
41:35
[SPEAKER_02]: The pediatrician of good pediatrician, we'll check in on how moms doing, but that's unfortunately, you know, because of our medical system and we insurance works though.
41:46
[SPEAKER_02]: People are generally don't have enough time with any insurance.
41:50
[SPEAKER_02]: Exactly.
41:51
[SPEAKER_01]: And they're just moved.
41:53
[SPEAKER_01]: They're not going to check it out.
41:54
[SPEAKER_01]: Thank you for tuning into this episode of Connect Call.
41:57
[SPEAKER_01]: As we conclude, remember that insights shared are intended for informational and educational purposes only and should not substitute professional medical advice, diagnosis or treatment.
42:08
[SPEAKER_01]: We strongly recommend consulting a qualified medical health professional or health care provider for personalized advice tailored to your unique needs.
42:16
[SPEAKER_01]: Your mental health journey is important and having the right support is essential.
42:20
[SPEAKER_01]: If you're experiencing a mental health crisis or require immediate assistance, please reach out to a mental health provider or emergency services in your area.
42:29
[SPEAKER_01]: We're grateful to have you as part of our community and your well-being remains our priority.
42:34
[SPEAKER_01]: So follow us on social media to stay connected and be sure to catch one of our episodes on our YouTube channel.
42:40
[SPEAKER_01]: We're here to support you every step of the way.