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Having a baby can be painful. Life after shouldn't have to be.

A new recommendation urges medical providers to screen new mothers for depression.

"I was like, 'Hey, I'm having postpartum depression.' I went to my OB, and he kind of brushed me off."

Almost immediately, Heidi Koss knew something wasn't right. The psychology major was experiencing some of the symptoms of postpartum depression and sought help. Sadly, it was hard to come by.

She went to her obstetrician/gynecologist only to be told she needed to "get out more" and maybe "buy a nice dress." She wasn't being heard. She wasn't being taken seriously.


"I kind felt like help was unavailable to me," she says.

She loved her baby, but she didn't love motherhood. Heidi recognized the symptoms of postpartum depression right away. Photo by Heidi Koss, used with permission.

Her postpartum depression continued on, untreated, for 17 months.

For those who've never experienced depression, it may be hard to understand what it's like to feel the symptoms compound over time. Heidi had nightmares, she felt scared, and she was irritable. The more time passed, the worse it got.

"And while I bonded to my baby and I loved my baby, I wasn't enjoying motherhood," she said. "It was a nightmare becoming a mother even though I loved my child."

It wasn't an issue of not bonding with her baby. She did. It was the depression, anxiety, hyper-vigilance, and fear that kept her from keeping calm. Photo by Heidi Koss, used with permission.

Her story isn't at all out of the ordinary. Pregnancy-related depression is very common.

According to Postpartum Support International, between 15% and 21% of women experience moderate to severe symptoms of depression or anxiety during pregnancy. Roughly 21% experience depression after birth. In fact, at that rate, mood and anxiety disorders are one of the most common pregnancy-related complications.

"It was a nightmare becoming a mother even though I loved my child."

Various studies have found that untreated depression and anxiety leave potentially lasting negative effects on parents and children.

That nightmare Heidi went through with her first doctor? It should never happen, but now it should happen much, much less.

The U.S. Preventative Services Task Force, an independent review board, in early 2016 issued some new, potentially lifesaving guidelines for depression screening. Here's what that means:

  • All adults should be screened for depression (including pregnant women and new moms).
  • Treatment should be made available for people who test positive.

This may not seem like a big deal, but it is. As Heidi's story illustrates, even when mothers actively sought help, it was sometimes denied. Now, hopefully, screening for depression will become a routine part of pregnancy, and new mothers won't face that same struggle.

"I think it's imperative to do early screening with every single mother every single time," Heidi tells me. Photo by Heidi Koss, used with permission.

Having a treatment plan in place ahead of her second pregnancy made all the difference in the world for Heidi.

Knowing she was at risk — mothers affected by mood and anxiety disorders are more likely to develop them during future pregnancies — she took preemptive measures before and during her second pregnancy, such as receiving therapy and medication to help ease the transition. Shortly after giving birth, symptoms of depression returned. Luckily for her, she had the right people and care providers in place.

"With my first, it took 17 months before I found an appropriate care provider who actually listened and got me into appropriate treatment. ... 17 months is a world of difference."

Not only will new guidelines help prepare doctors, but they'll also reduce stigma that surrounds depression.

In 1996, a National Mental Health Association survey found that the majority of Americans "think of depression as a sign of personal or emotional weakness." Other studies have shown a belief that seeking therapy or medication to treat depression or anxiety is a sign of poor character. Medically, these beliefs are flat-out wrong. Even so, they may deter people from seeking treatment.

If doctors roll depression screening into the battery of tests that accompany pregnancy, they will help normalize and reduce the stigma associated with it.(And, you know, it ensures that they're equipped to help out in these types of situations, as well.) Other tests can be self-administered, such as the Edinburgh Postnatal Depression Scale.

This was a huge step forward in identifying and treating an all-too-common complication.

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Three women, three MS journeys: How multiple sclerosis looks different for everyone

Gina, Nathalie and Helga share their reactions to being diagnosed with MS and how they stay informed and positive in the face of ever-changing symptoms.

Courtesy of Sanofi

Helga, Nathalie and Gina all have MS, and their experiences show how differently the disease can manifest.

True

It’s been 155 years since neurologist Jean-Martin Charcot gave the first lecture on a mysterious progressive illness he called “multiple sclerosis.” Since then, we’ve learned a lot. We know MS causes the immune system to attack healthy tissue, including damaging the brain and spinal cord. Resulting symptoms can be debilitating and include fatigue, blurred vision, memory problems and weakness. Huge advancements in our understanding of MS and its underlying causes, as well as treatment advances, have been made in the past few decades, but MS remains a complex and unpredictable reality for the 2.8 million+ people diagnosed around the world.

Ironically, the only real constant for people living with MS is change. There’s no set pattern or standard progression of the disease, so each person’s experience is unique. Some people with MS have mild symptoms that worsen slowly but sometimes improve, while others can have severe symptoms that drastically alter their daily lives.

All people with MS share some things in common, however, such as the need to stay informed on the ever-evolving research, find various lines of support and try to remain hopeful as they continue living with the disease.

To better understand what navigating life with MS really looks like, three women shared their MS stories with us. Their journeys demonstrate how MS can look different for different people and interestingly, how the language used to talk about the disease can greatly impact how people understand their realities.

woman with horse, woman riding horseGina loves riding her horse, Benita.Courtesy of Sanofi

Gina—Hamburg, Germany (diagnosed with relapsing multiple sclerosis in 2017)

When her youngest son was 4 months old, Gina started having problems with her eye. She’d soon learn she was experiencing optic neuritis—her first symptom of MS.

“Immediately after the diagnosis, I looked up facts on MS because I didn’t know anything about it,” Gina says. “And as soon as I knew what could really happen with this disease, I actually got scared.”

As her family’s primary income provider, she worried about how MS would impact her ability to work as a writer and editor. Her family was afraid she was going to end up in a wheelchair. However, for now, Gina’s MS is managed well enough that she still works full-time and is able to be active.

“When I tell somebody that I have MS, they often don't believe me the first time because I don't fulfill any stereotypes,” she says.

Overwhelmed by negative perspectives on living with MS, Gina sought support in the online MS community, which she found to be much more positive.

“I think it’s important to use as many positive words as you can when talking about MS.” It’s important to be realistic while also conveying hope, she says. “MS is an insidious disease that can cause many bad symptoms…that can be frightening, and you can't gloss over it, either.”

To give back to the online community that helped her so much, Gina started a blog to share her story and help others trying to learn about their diagnosis.

Though she deals with fatigue and cognitive dysfunction sometimes, Gina stays active swimming, biking, riding horses and playing with her sons, who are now 11 and 6.

Cognitive dysfunction is common in MS, with over half of people affected. It can impact memory, attention, planning, and word-finding. As with many aspects of MS, some people experience mild changes, while others face more challenges.

Gina says that while there’s still a lot of education about MS needed, she feels positive about the future of MS because there’s so much research being done.

woman in wheelchair holding medal, woman rowingNathalie is an award-winning rower with multiple international titles.Courtesy of Sanofi

Nathalie — Pennes Mirabeau, France (diagnosed with relapsing-remitting multiple sclerosis in 2002)

Nathalie was a teenager and a competitive athlete when she noticed her first symptoms of MS, but it would take four years of “limbo” before she was diagnosed.

“Ultimately, the diagnosis was more of a relief, than a shock,” she says. “Because when you have signs and you don’t know why, it’s worse than knowing, in the end, what you have.”

However, learning more about the disease—and the realities of disease progression—scared her.

“That glimpse of the future was direct and traumatic,” she says. Her neurologist explained that the disease evolves differently for everyone, and her situation might end up being serious or very mild. So, she decided to stop comparing herself to others with MS.

She said to herself, “We’ll see what happens, and you’ll manage it bit by bit.”

By 2005, Nathalie’s MS had progressed to the point of needing a wheelchair. However, that has not dampened her competitive spirit.

Nathalie began her international rowing career in 2009 and has won multiple world titles, including two Paralympic medals—silver in London and bronze in Tokyo. Now, at 42, she still trains 11 times a week. Fatigue can be a problem, and sometimes hard workouts leave her with muscle stiffness and shaking, but she credits her ongoing sports career for helping her feel in tune with her body’s signals.

“Over the years, I’ve learned to listen to my body, letting my body guide when I need to stop and take breaks,” she says.

Nathalie explains that she used to only look backwards because of the initial shock of her diagnosis. In time, she stopped thinking about what she couldn’t do anymore and focused on her future. She now lives in the following mindset: “Even when doors close, don’t miss out on those that open.” Instead of focusing on what she can’t do, she focuses on the opportunities she still has. Right now, this includes her training for the 2024 Paralympic Games in Paris, where she will compete for another rowing medal.

“I only go forward,” she says. “Well, I try, anyway…It’s easy to say, it’s not always easy to do. But that’s what I try to do.”

woman exiting water after swimming, woman with great daneHelga's Great Dane has become a helpful and beloved companion.Courtesy of Sanofi

Helga—Johannesburg, South Africa (diagnosed with relapsing multiple sclerosis in 2010)

When Helga first started having balance issues and numbness in her feet, she chalked it up to her training as a runner. But when the numbness moved to her face, she knew something was wrong. She never guessed it was MS.

“When I was diagnosed, I felt completely overwhelmed and clueless,” Helga says. “I felt that I had nowhere near enough information. I did not know anything about the disease…I had no idea that it was going to be a process of continually monitoring and adjusting your lifestyle.”

In the beginning, Helga’s symptoms developed slowly, and she didn’t appear ill to others. She was even able to run for a few years after her diagnosis, but she couldn’t do marathons anymore, and she began to fall frequently due to balance issues and right-foot dragging. Then her cognition issues became more problematic, especially in her job as a trainer in a printing company.

“My executive function, decision-making and short-term memory were affected to the point that I was eventually medically unfit for work,” she says. She stopped working in 2017.

However, she didn’t stop living life. Even though she could no longer run, she continued to swim competitively. She got a Great Dane puppy and trained him as a service dog to help her walk. She also serves as vice chair of the patient support organization Multiple Sclerosis South Africa, and she advises others who have been diagnosed to join a patient advocacy group as soon as possible to get reliable information and meet others with MS.

Helga says she is “hopeful” about the future of MS. “I must say that I am so grateful that we have all the new medications available, because my life would not be the same if it wasn't for that,” she adds.

Part of how she manages her MS is by looking at the positives.

“If I could tell the world one thing about MS, it would be that MS is an incurable disease of the nervous system, but it's also the greatest teacher of valuing your health, family, friends, and managing change in your life,” she says. “My life is diversified in a way that I never, ever thought it would, and MS has been honestly the greatest teacher.”

Each MS journey is unique – with each person impacted experiencing different struggles, successes, and feelings as they manage this unpredictable disease. But the common thread is clear – there is a critical need for information, support, and hope. We are proud to participate in World MS Day and share these incredible stories of living life while living with MS. To learn more about MS, go to https://www.sanofi.com/why-words-really-matter-when-it-comes-to-multiple-sclerosis.

MAT-GLB-2301642-v1.0-05/2023

This article was sponsored by Sanofi. Participants were compensated when applicable.

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