Did you know that May is Maternal Mental Health Awareness Month? We got to know Joni Lybbert, a psychiatric mental health nurse practitioner and host of The Sad Moms Club podcast. Joni brings invaluable insights into the challenges and triumphs of supporting mothers’ mental well-being. Join us as we delve into her expertise and discuss crucial topics surrounding maternal mental health care.
Tell us a bit about what you do as a psychiatric mental health nurse practitioner, and your podcast "The Sad Moms Club".
As a psychiatric mental health nurse practitioner (I’ll refer to it as PMHNP because wow, that’s too many words), I diagnose mental health disorders, prescribe psychiatric medication, provide therapy, and help my clients connect to resources that will aid in their healing.
The Sad Moms Club podcast is a project I started in my doctorate program, and I have continued releasing episodes after graduating because I find so many people are unaware of the resources that exist for perinatal mood and anxiety disorders.
Perinatal mood and anxiety disorders or PMADs is an umbrella term. Perinatal means from conception until one year postpartum. Mood and anxiety disorders include anxiety, depression, OCD, PTSD, bipolar disorder, and psychosis. These mood and anxiety disorders commonly happen before, during, and after pregnancy, i.e. it’s not only POSTPARTUM depression and anxiety, but can be perinatal depression, perinatal anxiety, etc.
Few are aware that there are therapists who are specifically trained to work with those in the perinatal period to help with the major life transition that is motherhood. My hope for the podcast is to validate those who are struggling, educate them on tools they can use, and link them to resources, so they can feel more like themselves sooner.
What inspired you to specialize in psychiatric mental health, particularly focusing on maternal mental health?
I originally became a nurse because I wanted to be there for people in crisis. My brother sustained a traumatic brain injury when he was 17 years old, and I was 19 years old. I remember watching this one ICU nurse support our family in a kind, compassionate, and boundaried way.
When I started in nursing school, I soon realized that I wanted to be there for people emotionally. I wasn’t as interested in placing IVs, managing lines, and putting in rectal tubes. I preferred to hear stories. Luckily, I learned during nursing school that a graduate path for a nurse is to become a PMHNP. I was sold.
I worked as a nurse for several years, and over that time, realized I wanted to work with women. However, it wasn’t until my graduate program that I learned I could specialize in the perinatal period. I interned at Serenity Recovery & Wellness while in school, a group therapy practice in Riverton and Provo, Utah who specializes in maternal mental health, and I loved it.
People often assume I got into this field because of my own experience with children, when in fact, I am actually pregnant with our first after years of infertility. Instead, I chose to work with women because I get a front-row seat to human potential and growth. Many women have been able to function well up until they enter the perinatal space. Suddenly, the coping skills that have sustained them for years are no match against the demands of pregnancy and postpartum. The time they expected to be filled with love and happiness becomes riddled with overwhelm, anxiety, and sadness. It is an honor to support women through this difficult transition, watch them change themselves, and then their part of the world.
As Elastigirl from The Incredibles said, “Girls, come on. Leave the saving of the world to the men? I don't think so."
Could you explain the importance of raising awareness about maternal mental health, especially during Maternal Mental Health Awareness Month?
I WOULD LOVE TO! First, some basic statistics to understand the frequency of these struggles.
One in five women experience a perinatal mood and anxiety disorder (PMAD).
One in ten fathers experience a PMAD even though they do not experience the hormonal component.
As a note, adoptive parents, LGBTQ+ parents, or any primary caregiver of a child can experience a perinatal mood and anxiety disorder even though they did not birth the child.
One in three women report their birth as traumatic.
About 8% of women develop perinatal PTSD, oftentimes related to childbirth.
All parents, yes 100%, endorse intrusive thoughts about accidentally or purposely harming their baby. Thoughts like, “What if my baby stops breathing at night, and dies, and it’s all my fault?” or “What if I don’t put the baby in the car seat properly, and they die in a car accident?” are kinds of intrusive thoughts that parents have and for some, they greatly impact their ability to be parents.
Even if you don’t experience a PMAD, women go through the transition to motherhood called matrescence. Matrescence is a term made popular recently by Dr. Alexandra Sacks and combines the words maternal and adolescence.
Think of your adolescence. What a WILD TIME. Your body was changing, your hormones were changing, your relationships changed, and your identity changed. Well, guess what?
You go through a similar transition as you enter motherhood. Your body changes, hormones change, your relationships change, and your identity changes. Dr. Sacks wrote, “The difference? Everyone understands that adolescence is an awkward phase. But during matrescence, people expect you to be happy while you’re losing control over the way you look and feel.”
I am passionate about awareness because so many parents emotionally flog themselves, call themselves terrible mothers, and feel they aren’t cut out for motherhood. I want women to know that a lot of parents feel like that! They are not alone, they are not to blame, and there is help.
What advice do you have for new mothers who may be experiencing symptoms of maternal mental health disorders but are hesitant to seek help?
First and foremost, know this is really hard. It’s not that you suck at being a mom! Even if you don’t have a diagnosable mental health disorder, motherhood is a challenging transition.
Next, I would reach out to someone safe for help. This may be a friend, partner, parent, neighbor, therapist, or healthcare provider. Tell them about your experience. Shame and suffering thrive in silence, while vulnerability squashes shame and allows for hope.
If you are nervous to reach out or feel you don’t have that kind of safe support, learn about other people’s experiences. One foundation that comes to mind is The Emily Effect, a non-profit organization started by the family of Emily Cook Dyches, a woman who died due to postpartum anxiety. You can watch her story here. You can also learn more about common symptoms of perinatal mood and anxiety disorders from Postpartum Support International under the “Learn More” tab.
Are there any particular challenges or stigmas associated with maternal mental health that you often address in your practice?
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Many women believe in order to be a good mom, they must place their needs on the sacrificial altar, so they can meet everyone else’s needs. One way this shows up in the early postpartum period is lack of sleep. Often our first conversation is discussing ways my client can get 3-5 hours of uninterrupted sleep. This may sound impossible, and certainly, every family and baby is different, so it requires collaborative brainstorming and creativity. I’ll ask questions like, “Can you and your partner take shifts, so you both get 3-5 hours of uninterrupted sleep? Could you skip one feed and allow your partner to feed the baby one time at night? Can you ask someone you trust to come over during the day and watch your baby for 3 hours while you nap?”
This conversation is most beneficial when fleshed out with a perinatal therapist, so you can find a solution for your family. I like to remind my clients that the birthing person arguably requires sleep more than the non-birthing person. Remember, you just GREW a human, then BIRTHED a human, and if you are breastfeeding, you are now FEEDING a human. You need rest!.
- Perfectionism is another common challenge my clients face. Most mothers cognitively understand that there is no such thing as a “perfect” mother, but they still believe that other parents seem to be pretty darn close to perfect, and they are just falling woefully short. Instead of advising them on how to be perfect, we reframe it with a new concept: the Good Enough Mother. The good enough mother meets their child’s needs the majority of the time, but they also fail their child in tolerable ways, so the kiddo can learn to tolerate the real world. This obviously looks different at different ages.
- Many of my clients don’t necessarily feel depressed, but they feel overwhelmed. They feel like they need a break. Some of them wish they could get moderately hurt (like in a car accident that requires a few days in the hospital), so they could get a real break from mothering and their partner would realize the weight of their responsibilities. These mothers are not getting the support they need at home, and oftentimes, they never learned how to ask for it. We go through a skill called DEAR MAN that teaches how to ask for a need to be met. Their needs may include: more sleep, help with domestic tasks, shifting the mental load in the relationship, time away from the baby, time with friends, etc. I remind my clients this is not a one time conversation, because unfortunately, mothers usually carry the mental load. There needs to be frequent recalibration of the relationship. This requires multiple conversations as life shifts and your needs change.
- Because I prescribe medications, I also like to inform people that many psychiatric medications can be taken through pregnancy and breastfeeding. Discussing medication with a provider who can walk you through the risks of taking the medication versus the risks of discontinuing the medication will help you make a more informed decision for your mental health.
What resources do you recommend for further information or support on maternal mental health?
I would first start with Postpartum Support International or PSI. If you go to their website you can learn more about what various mood and anxiety disorders look like. On the main page, you’ll see the PSI number which you can call or text to learn more about resources within your area. If looking for a perinatal-trained therapist feels overwhelming, they can help you navigate the resources.
Also, you can peruse the 35+ support groups (many of which are offered in Spanish) where there are groups for everyone including: those with ADHD, depression, OCD, birth trauma, single parents, adoptive parents, queer and trans parents, infertility, pregnancy after loss, etc.
The PSI Directory is a way to get connected with perinatal-trained providers who take your insurance and work in your area.
You can look for more personalized resources by connecting to your state chapter. If your state chapter is holding a Climb event, I encourage you to attend to connect with local resources! The Climb is typically held in June or October.
As a provider who works in Utah, I like to mention our Utah-specific Directory established by the Utah Department of Health and Human Services. It is called the Maternal Mental Health Referral Network and can help you find a therapist, support group, or other provider who takes your insurance.
If you need someone to talk to ASAP, you can call the National Maternal Mental Health Hotline at 1-833-TLC-MAMA which has interpreters in over 60 languages.
If you are in crisis, you may text the National Crisis Text Line by texting HOME to 741741 or call the National Suicide Prevention Hotline at 988.
What are your favorite products from Copper Pearl?
I am pregnant with my first baby, so I’ll be honest, I haven’t actually used Copper Pearl products yet! However, I am excited to try out the Baby Bandana Bibs for my (likely) drool-prone little one. I also have their Knit Swaddle Blanket, a Sleep Bag, and an adorable Newborn Knotted Gown for newborn pictures. I look forward to using my new Copper Pearl products, but more importantly, I look forward to meeting this human alarm clock after years of infertility.
If you feel like you personally need support, please don’t hesitate to DM me through my Instagram @the.sad.moms.club. I truly love helping mothers find support!