41 - When Worry Won’t Stop: Postpartum Anxiety & OCD Explained (Guests: Dr. Angie Maxwell, PT, DPT, WCS & Laura Meader, LICSW)

In this episode of Doula Talk: Postpartum, Babies, and the Battle for Sleep, Deb brings back two powerhouse guests, Dr. Angie Maxwell, pelvic floor physical therapist, and Laura Meader, licensed social worker and therapist specializing in perinatal mental health, dig into a topic most parents don’t talk about out loud: postpartum anxiety and OCD.

Too often, new parents are told to “watch out for baby blues or depression,” but anxiety and OCD symptoms get swept under the rug. Deb and her guests break that silence with compassion and clarity, covering everything from what sets postpartum anxiety apart from everyday new-parent worry to how intrusive thoughts in OCD can feel terrifying and isolating. Angie explains how anxiety shows up in the body (yes, even in your pelvic floor), while Laura sheds light on the mental spirals and intrusive thoughts that so many parents hide in shame. Together, they remind listeners that these experiences are common, treatable, and nothing to be ashamed of.

The conversation highlights practical strategies for recognizing red flags, understanding the difference between “normal” worry and a clinical concern, and most importantly, how to get support before you feel like you’re drowning. Deb also shares resources like the Postpartum Progress New Mom Checklist and points listeners toward her free Baby Lounge community gatherings for connection and peer support.

This episode is a must-listen for any expecting or new parent who has ever wondered, “Is this just me, or is something bigger going on?” It’s also invaluable for partners who want to better understand how to support a loved one through the postpartum transition.

Tune in to learn:

• The difference between baby blues, postpartum anxiety, and postpartum OCD
• How anxiety can show up physically and emotionally
• What intrusive thoughts actually mean (and why they don’t make you a bad parent)
• How to create communication systems with your partner that protect your mental health
• Why compassion and community are essential for postpartum recovery

If you’re preparing for postpartum, or living it right now, you’ll walk away from this episode feeling seen, supported, and empowered with tools and resources.

Chapters

• 0:00 Welcome & Guest Introductions
• 4:05 Baby Blues vs. Postpartum Mood Disorders
• 9:33 Screening, Risk Factors & Missed Diagnoses
• 14:01 Warning Signs & Body Clues
• 20:07 Trauma & Dissociation in Postpartum Recovery
• 27:03 Living with Postpartum Anxiety & OCD
• 31:17 Partner Support & Prenatal Planning
• 41:32 Perfectionism, Pressure & Social Media
• 44:02 Healing Isn’t Linear
• 51:44 Breaking Stigma & Finding Support
• 54:05 Final Takeaways
• 57:00 How to Connect with Our Guests
• 58:13 Wrap-Up & Closing Thoughts

Transcript

Deb (00:50)
Hi friends, this is your host Deb and today we're going to dive deep into something that many parents struggle with and that's postpartum anxiety and OCD. Now I know anxiety feels like the buzzword of decade and we all joke about being anxious, but when you're in the thick of postpartum,

There's a huge difference between regular new parent worry And the anxiety that takes over your body hijacks your sleep and leaves you stuck in thought loops that you just can't shake. let's not forget about postpartum OCD. Yes, that's a real thing too. And no, it's not just about being neat and tidy.

So today I am joined by two of my favorite people, Dr. Angie Maxwell, a pelvic floor PT, and

Laura Meader, licensed clinical social worker and therapist who loves working with women who feel anxious, burned out, or just simply want to feel present in the life that they're living.

pulling back the curtain on how postpartum anxiety and OCD actually show up both in your mind and in your body, and why so many parents suffer in silence, and what you can actually do to find relief. So if you've ever wondered, am I just a worried mom or is something more going on?

or if you've been too scare to talk about those intrusive thoughts that make you feel like a bad parent, this episode is for you. So go grab a cup of tea or some coffee, settle in, and let's get into it.

Deb (02:30)
thank you for joining me again, Angie and Laura. Why don't you give a quick introduction of what you do again? We did have a podcast on episode 29, Understanding Postpartum Mood Disorders in May of 2025, which is like the most popular episode we've had. Today we have 108 downloads. It's the most popular one.

Angie And Laura (02:55)
Jesus.

Deb (02:55)
which tells me something that this is like so

important. People want to know more about this, even with all the awareness around depression and anxiety. This is a really important thing that people know the red flags and how it shows up and the treatments and how providers can help. ⁓ So if you wanna just start with what you do and then we'll go from there.

Angie And Laura (03:19)
Well, I'm Dr. Angie Maxwell. I'm a pelvic health physical therapist and I call myself an orthopelvic therapist. ⁓ I own Majorana Physical Therapy in Tacoma. My pronouns are she, her, and we specialize in female at birth bodies at our clinics and we deal mostly with pelvic floor dysfunction.

but a lot of physical therapy issues that female at birth bodies might experience. So I've owned this practice for four years now. I got connected with Laura when she reached out to me as a mental health provider specializing in a very similar area. So that's how we sort of got connected.

It's been quite the love story. Yeah, take that up. ⁓ I do love our like origin story. Yeah, so thank you for that. I'm Laura Meader. ⁓ She, her pronouns and I'm a licensed independent clinical social worker and therapist and also I own a private practice and I work with ⁓

Deb (04:12)
I love it.

Angie And Laura (04:33)
I specifically specialize in working with individuals who

would consider themselves highly anxious folks. That can be anywhere in the postpartum perinatal specialty. I work a lot with individuals who are experiencing perinatal mental health concerns all the way, just if anxiety is something that has been troubling individuals or something that they want to work on, finding more balance in. And then I also work with folks who have challenges around OCD. So those are sort of my

areas of specialization and I serve people virtually and currently in my practice called crescent moon therapy. So that's my area of expertise. And then yeah, right now we're partnering ⁓ integrative way at

So I'm here actually twice a month to work with Angie's clients and also some community folks just making sure that people are getting some mental health needs met. So that's kind of a cool partnership that has been going on. Yeah, and I think in my entire career, like my whole career, always wanted to have a mental

like practicing beside, especially on the physical therapy side. And so this is feel for me because often as a PT, I feel a little bit out of my depth with some of the mental health sequelae. So Laura's here, like I said, to treat current past patients, even.

Deb (05:43)
Mm-hmm.

Mm-hmm.

Angie And Laura (06:00)
community partners, but also to support myself and the other therapists to give us little screening tools and other things if we're noticing some of these red flags we'll talk about later. So it's a dream of mine. Yeah, and started out in coming to fruition.

Deb (06:09)
Mm-hmm.

Aww.

that's amazing. And it sounds like it's just going to be so supportive of your clients that usually they're coming for the physical therapy stuff, but there's always stuff going postpartum. So it's so awesome that they have that resource. ⁓ OK, so today we're going to talk about OCD and anxiety and postpartum. So from what you guys can pick who wants to go first, but I would love to hear what your perspective is on

what the difference would be between just a normal new parent worry and the actual clinical diagnosis of postpartum anxiety. Because I feel like it's quite a buzzword right now. It's like, I have anxiety, So what would be the difference in your perspective?

Angie And Laura (07:07)
and having sort of like anxiety or parent worries and so is situational but it's also like pretty normal. It comes and goes and is proportional to what's happening because there is like sleep deprivation and other things and normally it can be soothed and reassured right and so like you can find support and it can go away and those are things that are just like normal.

parental pieces of like being a new parent. The clinical standpoint from a clinical standpoint about anxiety, that's where it goes over that threshold. It's just persistent. It gets out of proportion. You're not able to control it. It keeps going on and it's really impairing your, you're not doing well and beyond just sort of not, it doesn't come down or there's not a, you know, a feeling of just sort of being able to get a couple

Deb (07:33)
Mm-hmm.

Mmm.

Angie And Laura (07:58)
the days that's leaving you and things feel better. So that's one like over-looking perspective on it. You know, if we break it down sort of like what does that look like from a mental health lens? You know, that kind of show up for people looking like consistently looping thoughts, know, like racing thoughts for people. It can look like making decisions about like avoiding things like what if thinking, you know, fear-based thinking or like what if this is gonna

Deb (08:02)
Okay.

Mm-hmm. ⁓

Angie And Laura (08:28)
I don't that. I don't want the baby do that.

Deb (08:31)
Yeah, like I won't, I don't want to leave the house because I don't

want to worry about the baby getting sick or getting in a car accident

Angie And Laura (08:37)
or I don't want this person to hold them, they don't know, I'm just really anxious about this, this and this, but it becomes so much so that they don't want anybody to come in the house or hold the baby. Feeling so overwhelmed by things like tiny tasks that's becoming difficult to keep up with functional things in your day-to-day life.

Deb (08:45)
Hmm. Hmm.

Mm-hmm.

Angie And Laura (08:58)
that can be a note about that anxiety is tipped over the edge. Not just that a couple of dishes aren't getting washed or something, but that it's becoming so hard to even just pick something up. You're on the floor in a puddle based on it or hyperventilating or becoming so tense.

Deb (09:06)
Right.

Mmm.

Angie And Laura (09:16)
And then the other one that's really interesting I see, I find too, is like the inability to be present. You're there, you're holding baby and you're just not even feeling it. Your mind is somewhere else. It's too much how hard you try to plug into the moment. So those are some mental health. I know there's body based ones too. Yeah. mean, so it's, you know, not to get too sciencey and we've maybe talked a little bit about this, but this idea of like our parasympathetic nervous system.

Deb (09:26)
You're not connected.

Angie And Laura (09:45)
our sympathetic nervous system. And so very simply, right, we have our parasympathetic, which is the more relaxing rest and digest system. And then we have sympathetic, which is our high alert system. And what we look for is just those signs that that person may be stuck in that high alert or sympathetic nervous system. ⁓

Deb (09:55)
Mm-hmm.

Angie And Laura (10:07)
And it can come across, you know, every person is so different, but I mean, think the sleep disturbances are big. So like you can't sleep even when the baby is asleep and everything seems to be fine. The chronic tension, you know, could be your pelvic floor, could be your jaw. Just like this feeling of like tenseness throughout the system.

Deb (10:18)
Right.

Angie And Laura (10:31)
We will see sometimes an overactive bladder. That can be a sign of like something's going on. You you cannot get over this urgency like feeling like you have to pee all the time and then you just peed 15 minutes earlier, right? A lot of digestive issues that don't seem to resolve or change with food or resolve after having had a bowel movement. ⁓ You know.

Deb (10:43)
Mmm.

Mm-hmm.

Angie And Laura (10:59)
this crime need to be sort of like moving and doing something. And sometimes even like the movement you think is somehow going to make you feel better, maybe that goes into the social side, but movement that.

Deb (11:03)
Mmm.

keeping you busy. Yeah.

Angie And Laura (11:18)
Yeah, I mean, it's in a way or is it doesn't have a purpose. So those are some things that we see on the PT body side of things. And so just sort of cross, know, when we partner together or if, you know, your mental health practitioner and your physical like PT, what can be powerful in that is you have relationships with both of these folks. Right. And so I'm observing.

Deb (11:22)
Mmm.

Mm.

Angie And Laura (11:46)
clients

and seeing them week to week and if my client is always presenting sort of like you know I'm also seeing there's stuff happening somatically or going on we're checking in with that and we're trying to work from those perspectives and then you know I can't speak to Angie about how you're checking in with what's going on too. We talk about this a lot with the other therapists too it's just like the screening idea that I mean we're seeing those patients once a week as well sometimes twice a week in that early you know postpartum

Deb (11:52)
Mmm.

Mm-hmm.

Angie And Laura (12:16)
or even pregnancy. But it's sort of like if we notice the looping thoughts or the overwhelm or some of these things that are not what we would call in an expected behavior in those phases, then it sort of alerts us. Something else is going on. Why are they so obsessed with what's happening with the baby's feeding schedule?

Deb (12:31)
Mm-hmm.

Mmm.

Angie And Laura (12:43)
They've been assured the baby's

gaining weight and everything. It's fine. So it's those little things that are more neural that we need to know.

Deb (12:47)
Yeah, it's like the evidence is presenting that everything's fine, but they're just

worried and worried. Yeah, and so when we

in postpartum, we often hear more about the postpartum depression side, and then we're hearing about the anxiety and how sometimes it can go together. But can

it

come just anxiety or does always have to pair with the depression?

Angie And Laura (13:09)
Yeah, it doesn't have to come together, right? know, mean, postpartum anxiety can show up as basically an overwhelmed nervous system like we just talked about. And even if the mood seems okay, right? So someone might feel emotionally fine, ⁓ but in terms of feeling like sad or hopeless, but they're like tired and wired and everything else is going.

Deb (13:11)
Mm-hmm.

Angie And Laura (13:33)
So that doesn't mean that they're always co-morbid or coming together right. And there has been, as we've talked about in the last podcast, as you mentioned here, there's been lot of of really good psychoeducation investment in talking about postpartum depression. Now there is, I think, more attention coming in PMADS to anxiety and other disorders like postpartum OCD, postpartum psychosis. But they don't have to live together. They are standalone.

Deb (14:01)
Yeah.

Angie And Laura (14:02)
diagnoses

Deb (14:03)
Right.

Angie And Laura (14:04)
and they should be treated as such. That being said, they can also show up together and often sometimes people with mood disorders do present with both at times. So it's both and. ⁓

Deb (14:11)
Yeah.

Angie And Laura (14:20)
But just because somebody's mood really is fine and they're not feeling particularly sad or down, as she just talked about and we're acknowledging, some of this is like at the cognitive or like at our insights, our thinking level, like I'm fine. I'm doing everything. I'm actually, my laundry is fine. I'm doing everything I need. I'm going through the list.

Deb (14:38)
Mm-hmm.

Right, it's like check, check, check, check.

Angie And Laura (14:46)
I'm winning! My baby's bottles are so clean! Look at them! Look at them! And then, you know, buddy.

Deb (14:48)
I'm the best. Yeah.

Yeah.

Angie And Laura (14:54)
inside you're not well. You're not feeling well, you're not feeling connected to baby, you're feeling super panicked about things. The fact that you're holding onto that checklist so tight that your fingers are like blistering is an indicative sign of something not being quite right. ⁓ Come on girl, check in on that. So I think that's the part. There's persistent fears, persistent control.

Deb (15:00)
Mm-hmm.

Right?

Yeah. Yeah.

Angie And Laura (15:25)
persistent things happening about seeking reassurance, all of that is going on and feeling on edge oftentimes. Yeah, and I think, I mean you're right, you everyone seems to know like the baby blues and postpartum depression and that is very well known, but it's this other side of it too, and I mean Laura can probably speak to the, I mean the perfectionism or like the pressures that, you know.

Deb (15:38)
Mm-hmm.

Mm-hmm. Mm-hmm.

Angie And Laura (15:52)
maybe we're placing ourselves that aren't even there, and kind of feeding into that anxiety and that state. So I'm just glad there's more awareness happening with postpartum anxiety because I feel like I see that more than the depression side because, you know, family or other health care providers can almost identify the postpartum depression side, but the anxiety, you just look like a super high functioning, you know. ⁓

Deb (15:54)
Right.

Right. It's sleuth. Yeah. And it looks like you're doing so

well. it's the masking is really intense for this period, for sure. Like everything's fine. Look, baby's gaining weight. Look, I'm doing great. But what's the perfect schedule? You know, I get that question a lot of like, what's the perfect schedule that my baby should be on? And the baby's like two weeks. We're like, yeah, the baby's not on a schedule. We're not doing schedules right now.

Angie And Laura (16:21)
Yeah.

Deb (16:42)
right?

Angie And Laura (16:41)
The baby will see with no day and night. ⁓

Deb (16:45)
Yes, And a hyper fixation on doing things the right way is usually a telltale sign for me of like, there's something else happening here.

Angie And Laura (16:54)
Yeah, yeah, that's a big one.

Deb (16:57)
So say someone's resonating with this of like, gosh, maybe my anxiety is a little higher than it should be. are there some strategies that in general that would be helpful to manage, you know, their anxiousness and their nervous system?

Angie And Laura (17:12)
So I can mention some that are, I mean, I always say go to therapy because clearly I'm in that business. But I'm going to sell it. No, but I think there are good ones.

Deb (17:19)
Yes. Yes. Absolutely.

Angie And Laura (17:26)
There are easy ones that I use with clients, but also that are ones you can YouTube and start to get into yourself. And I am a big proponent, even with clients I see, to use resources that are out in the world. So please go for that. But primarily, like when I am working with people, I always use psychoeducation. One, it's fancy words, of course, to just say like, learn about this because it's super validating and it's super normalizing to know that like you're not alone and like in your own house.

Deb (17:55)
You're

Angie And Laura (17:55)
thinking

Deb (17:55)
not crazy.

Angie And Laura (17:56)
this is crazy making.

folks that are listening to this and seeing me touch their face a million times are thinking to themselves either this lady is totally whack and maybe this is normalizing because I'm not alone and that's really important for people to feel. so learning exactly that like this is one you can find help out and through and two there are ways to understand how anxiety works so you can meet it with compassion.

Deb (18:22)
Mm-hmm.

Angie And Laura (18:28)
and not fear. I think compassion is such a curative about this. Yeah, and I mean, I would interject to like, you know, there's self-compassion and those types of things, which I think are good, but it's also, I mean...

You said, it's not just you, right? There's other people experiencing this. so sometimes reaching out to other new parents or groups of friends who are going through something similar and just exploring your experience, right? And it's like, ⁓ my friend Susie, she isn't obsessed with how clean the bottle is. I mean, this is one example. But sometimes that normalize things.

Deb (18:51)
Hmm.

Yeah.

Mm-hmm.

Yeah, right. Yeah.

Angie And Laura (19:14)
We're so in it, right? that we can't, don't even know. So just getting out there, getting that support, right? Through groups or friendships, Because you get kind of mired down in it. I think that's part of it as well. So. Yeah. And hearing the real.

Deb (19:20)
getting other perspectives.

Yeah, well I think that compassion part is huge.

know, like of just understanding, like especially as a first time parent, there's so much anxiety or like just nervousness around like, this is my first baby, I don't know what the heck I'm doing and understanding like, it's okay, it takes time to learn and you'll just get through it and learn as you go.

Angie And Laura (19:49)
And it's interesting because raising a human, it's such a complex task, like most of us, our life's work. And any new task you're learning, adult learning, we talk about five times exposure, right, when you are learning something new. And that would be like a simple task. And then you look at the complexity of parenting.

Deb (20:05)
Mm-hmm.

Mm-hmm.

Angie And Laura (20:13)
and you're learning every day of the time and this idea of fixating on, Am I doing this right? I think sometimes that line of thinking is like, there's no right way, my friends. Yeah. Well, it's a setup. It's a setup. It's a setup. Just so you know. Yeah.

Deb (20:15)
so many things.

Yeah.

Yeah. ⁓ absolutely. For sure. mean, I mean, being

a doula before I had my kids was pretty intense. just had this.

very much black and white thinking of like there's a right and wrong way to do it or a best way to do it. And it felt like so much pressure going into it of like, I'm a doula, I'm supposed to know what I'm doing. And I felt like I was so out of water. And I had to learn everything just like a new parent. And I didn't get to go home and go sleep after my shift with my baby. Yeah, it was intense and it took a really long time to understand like,

Yeah, I'm gonna make mistakes and it's okay. I'm just gonna go through it and do better next time and you know, whatever choice I make right now doesn't have to be permanent.

Angie And Laura (21:19)
The other, so this isn't sort of cut, I think that is really key and you're right about the sense of community and like all of that makes the journey both easier and also like more.

fulfilling like I think with others. Some tactical things, I'll name two, that I like to like give people to put in their toolkit are one, it's like very much, it's pretty straightforward, but it's just thought labeling. So it's coming up, you're hearing yourself go through that loop over and over again. Maybe it's a really negative self-talk loop like, I can't believe I did that. And then like.

Deb (21:56)
Hmm.

Angie And Laura (21:57)
I didn't clean that Passy, now she's using the Passy, catch it and whatever and then you're going to obsess about that or whatever the thing is that comes up constantly for you.

The second you catch yourself noticing that you're in the loop, just name it. I'm in the thought loop. That's it. I'm in it. And just give yourself time for that moment to say, I'm in it. I'm going to just allow myself to step out of this for a moment. I'm to just take a break for a minute.

Deb (22:14)
Mm-hmm.

There it is again.

Angie And Laura (22:26)
And you can, whatever sort of kind thing you can say to yourself to give yourself permission to take a little break. But once you've noticed it, it's okay to not continue to beat yourself up in the thought loop. It takes a minute though when it's so regular, right? So just labeling it and then giving whatever kind way to release that for yourself. So that's one thing. And then the other one would be any sort of grounding tools, any sort of five senses, if you Google that, or ways to sort of ground into your space if you're getting heightened.

Deb (22:38)
rate.

Yes.

Angie And Laura (22:56)
is a nice way for anxiety. It's breathing, breath work, rocking with your baby, doing anything. Do you have things that work for you with your clients? ⁓ I mean, we're definitely all about body scans, noticing where in your body you might be holding tension. Is it being held there often? ⁓

Deb (23:01)
Mm-hmm.

Angie And Laura (23:19)
you're you know being curious about where that tension is, use of breath work right to help you if you can find that tension breathing some lightness into it. I mean there's lots and lots of breath work out there.

One of my favorites is called cyclical sighing. ⁓ And it's really easy to do. It's something you can do anywhere. Changing the baby, whatever. But it's this idea of taking just two kind of short breaths in where you breathe in and then you just sigh all your air out and that's the sighing. And you do it again. Short ones in.

And as you sigh, you want to relax your jaw, relax your lips and just like sigh the air out. The other one that I love because so many people hold their attention in their jaw is to fake yawn. So there's a reason dogs yawn all the time and it's often for us. But we humans are the same way. So if you start yawning, just like fake yawning.

Deb (24:18)
Mm-hmm. And then throw up. Yeah!

You

Angie And Laura (24:33)
which is again kind of an exhale, right? If you fake yawn three or four times, you will then actually yawn. And then your friend right here also yawn because you're... Through the system, right? To just kind of relax, ⁓ like tension that we might be feeling. The other thing I really like is humming or singing.

Deb (24:41)
There you go.

Yeah.

Angie And Laura (25:00)
which those are things we will often like tell new parents that state of overwhelm, maybe the baby's screaming, you're screaming inside. it's like just even if it's like a silly little nursery rhyme you just hum like, I don't know, some Metallica or whatever. her Sandman, but just the hum.

Deb (25:10)
Mm-hmm.

Yeah, whatever does it for you, right?

Angie And Laura (25:24)
that can sort of like downtrain that nervous system. I mean there's lots of little tips and tricks. But the other one that maybe Laura, I'm sure she teaches her clients is just like, is using your senses, right? And doing your sense check in. Like if you're in the moment, you know, what do I see? What do I hear? What do I feel? What do I touch?

taste, smell. And just by kind of grounding yourself back in your body, that can also downtrain that nervous system. So those are some of our favorites. She probably has lots of tricks up her sleeve too. But the other thing I would say, some people don't like breathing and humming. That kind of stresses them more. So other people like movement, right? So just...

Deb (26:12)
Mm-hmm.

Angie And Laura (26:14)
It could be a crazy dance that you do because you changed the diaper perfectly, I don't know. But just releasing tension in your body with big movements, Like throwing your arms up, moving sideways. Something that gets you just moving can also release tension, any tension in your muscles or in your fascia. movement can be a very powerful thing as well.

Deb (26:15)
Mm-hmm.

Yeah.

Yeah, one thing that I really like doing when I'm feeling stressed is like

Angie And Laura (26:42)
fascia. movement can be a very powerful thing as well.

Deb (26:42)
Yeah, one thing that I really like doing when I'm feeling stressed is

moving my hands and feet, like rolling them and like shaking. And sometimes I like the brushing of my skin, of like just kind of making sure that I could feel my body again, you know? And it's surprising when you get so wound up with stress that you really are out of your body and that you're not even in it anymore. just kind of, yeah, I heard that.

Angie And Laura (26:49)
Yeah.

Yeah, and like shake it.

Deb (27:09)
the story of the rabbit that thinks they're gonna get eaten by the fox, and they freeze, and then as soon as the fox leaves, they do this shaking, and it's like that, getting that stress response to just like leave their body. And once I heard that, I was like, you know what? That actually works really well for me. Mm-hmm. Yeah, and the yawning with dogs. Dogs do that all the time when they're super excited, and they're like, I have to calm down.

Angie And Laura (27:24)
love animals too.

I teach that my exercise class. It's like, okay, we'll be a dog shake. And we just shake all of our bodies to get all the ⁓

Deb (27:41)
I love it.

Yeah, that's great. ⁓ So the next question is about collaborating and you guys already kind of talked about how you collaborate.

Because they may be going back for the physical stuff and that's where those red flags are coming up and noticing like, ⁓ maybe there are some something else emotionally going on that I need some more support with. So is there any ideas of what you guys have created or maybe you can go into what you've created and how that works for

supporting your clients.

Angie And Laura (28:10)
Yeah, I mean, I think we talked maybe talked about this in the last podcast, but we do try to screen everyone with either postpartum depression scale, outcome measure or the PPS. It's called the postpartum anxiety scalers. So we do try to do that beginning.

Deb (28:28)
Mm-hmm.

Angie And Laura (28:37)
But we also are looking at, the depression screen. The Edinburgh? Yeah. That's up to eight weeks. Yeah, up to eight weeks. So we're using those measures. that's sort of like, if that score is higher than we expect or what the standard is, that immediately tells us there could be a consult needed with Laura.

sometimes you know patients don't always tell you things. There's a couple of visits and it becomes things that you start to notice and you're seeing some of these behaviors. Yeah and so then that is when I am usually like I think this consult is needed so I chat with the patient and just know Laura's here as a consultant to kind of screen you to see if something is

Deb (29:04)
Yeah.

Mm-hmm, like the patterns.

Angie And Laura (29:29)
is happening or something else we need to address. We see this kind of as taking care of you as a whole, right? The physical and the mental being so tied. And that's how, you know, as PTs we try to talk with patients about it. And it's like, hey, you know, I'm an expert in certain area, Laura's an expert in a certain area. And it takes, you know, both of us to kind of get you to where you need to be. And then we just, we're setting up kind of little half hour screens. And then if she's seeing something more

Deb (29:30)
Mm-hmm.

Yeah.

That's amazing.

Angie And Laura (29:59)
serious, then she may take them on herself or refer on or I mean you can speak more about your process of screening. for us, I just I want to kind of head these issues off before they worsen or become more serious.

Deb (30:15)
Yeah. ⁓

Angie And Laura (30:18)
And sometimes I've been doing these screenings early, early postpartum, right? Because I saw that patient when they were pregnant, and then I'm calling them two weeks after baby's born, and even screening on the phone sometimes, because I'm hearing things in the voice and some panic and things like that. It's like, OK, know, we're all trying to do early intervention, especially in that postpartum period. Which, I mean, we talked a little bit about hormones last time, but there is definitely a lot of hormone activity

Deb (30:39)
Yeah.

Angie And Laura (30:47)
that to me, does make patients more vulnerable to some of those mood disorders because they're not in their normal profile, right? And so they're just kind of up and down and all over. And we want to say, that normal or is it something we need to address further?

Deb (30:55)
Absolutely.

Angie And Laura (31:09)
I'd say also that, and this is with your patient population specifically, because you work with a lot of folks who were pregnant that they saw, and then they come through and they also receive PT services postpartum. So just sort of like through the continuum.

And then of course you do too, you know, it's the doula. But often folks pregnant, like the delivery, I would say most folks delivery doesn't always go exactly as planned. That doesn't mean that there's a traumatic birth by any means. It can, but it doesn't. Now, depending, you know, this is a spectrum. Depending on the delivering parent, that can feel a lot of different ways.

Deb (31:40)
I mean, fair.

Angie And Laura (31:56)
them how that went. And that can be an experience alone, regardless that they may want additional support outside of their partner if they have one or like current support system to process. Some people really wanted to breastfeed originally and that's not and they can get additional supports for that. It should if they want to and that journey may also they want additional supports processing that as well. And so

Deb (32:14)
Mm-hmm.

Right.

Angie And Laura (32:25)
how I conceptualize a lot of this as well is that a therapist, they didn't already have one, or one that specializes in working with postpartum individuals or birthing people, is that there's a unique sense of what happens after birth and welcoming a human. And all of the things that changes both physically, within your familial situation.

And within just all these, just a series, huge amount of changes. there's this extra person that is a support for you in this huge amount of process change.

Deb (32:57)
so many.

Angie And Laura (33:07)
And along that process change, even if things are gone as spiffy as can be, there's a lot of change and change is hard. So I think that's sort of one of the biggest parts that I implore a lot of people to consider that as a support. And then if any one of those pieces or many of those pieces are more of a struggle or you have a pre-existing experience with mental health conditions, anxiety, depression, OCD, issues,

if you've had trauma in the past, if things didn't go as planned. Any of those things can make that journey a little more challenging or make support more worthwhile along the way.

Deb (33:42)
Hmm.

Right.

Yeah.

Yeah, so I mean the way I see it is that everybody should have a therapist in pregnancy and then all the way through postpartum because like you said there's so many transitions that happen and changes that can be unexpected or expected and just it's big changes ⁓ that people just need the support to have that non-judgmental person who's not your mother-in-law or your mom you know or your sister who's judging your choices of feeding you know what I mean that where it's like

Angie And Laura (34:17)
Thank

Deb (34:20)
about you and venting and helping you processing the birth and all of that. It's just so important it's great that you guys are screening so early because I think you're right is that sometimes we don't as parents don't recognize until I don't want to say too late.

but it feels like it's way too big. I have to get help, otherwise I don't know what's gonna happen and it can get pretty scary. Whereas if we had it early and just had somewhere to process all of this physically and emotionally, we wouldn't get to that point and everything would be so much more smooth.

Angie And Laura (35:00)
Yeah, I, you know, we often, our clinic, know, especially early postpartum, you know, I mean the reason I found in my clinic is I just feel like this is an area that the support is lacking, you know, so much support during pregnancy and just not as much in that postpartum period. And then in the postpartum it's like, it's the baby, it's the baby, it's the you know, blah, blah, blah, the baby, the baby, the baby. And then it's sort of like...

Deb (35:14)
Yeah. Don't let the door hit ya.

Mm-hmm. Mm-hmm.

Angie And Laura (35:31)
I think that is needed. The focus needs to be on you sometimes. And I mean, yes, you know, society...

Deb (35:34)
Yeah.

Mm-hmm.

Angie And Laura (35:45)
we have problems with mental health. we, don't know. It's like, you're, you know, you just have this big miracle of birth, blah, blah, blah, and you should be happy, happy, happy, happy. And you know, it's like, we don't explore the mental health side of things, right? And it's like, what if it didn't turn out the way you wanted? And this was not what you expected having a child would be like. And I don't know. I just think we need to do better in general, right, with accepting like mental health and.

Deb (35:49)
Big ones.

Right. Yeah.

Great.

Angie And Laura (36:15)
being

very open about those things and just be like, yeah, it sucks sometimes, right? Or it's great sometimes. I never asked my partner to contribute in this way, or I've never had to stress of that. I've never had to think about this in this, and I don't know how to do that on two hours of sleep or the only time now I feel like I deserve it is an appointment. You know, I hear people who

Deb (36:20)
Yeah. Well, and

Mm-hmm.

Mm-hmm.

Angie And Laura (36:45)
I mean, there's all sorts of things. And so I think there's things that just come up and ways to rethink about therapy like you would anything else as a support. Healthy support. ⁓

Deb (36:47)
Mm-hmm.

Right. Well, it's to help with keeping, yeah,

helping keeping healthy versus like sick care, which is kind of how we treat everything. We wait until it's really bad and then we get the support versus just let's stay supported and we know this is hard. So let's give some extra supports. ⁓ Yeah. So, well,

Angie And Laura (37:13)
Right. Yeah. Wellness. Yeah.

Deb (37:26)
I want to switch gears a little bit to OCD.

Angie And Laura (37:27)
So help is part of

Deb (37:29)
Do you want to just go ahead and define what that is?

Angie And Laura (37:33)
Yes, obsessive compulsive disorder is not anxiety, it's different than anxiety. Postpartum specifically OCD is just the onset is defined that it happens in postpartum, but there's all sorts of different sub variations of OCD, but they're all considered obsessive compulsive disorder.

Deb (37:57)
Okay.

Angie And Laura (37:57)
The

thing that differentiates OCD, generalized anxiety, for example, is that there are what they call intrusive thoughts, that come into your mind that you don't want to be having. are...

technical or clinical terms like ego-distonic. They do not align with your values. You don't want to be feeling that way. They're like often scary or not what you you align with. Yeah, what's an example? So like an intrusive thought? An intrusive thought might be, Especially postpartum might be I am worried what if I touch this knife? I'm going to stab my baby.

Deb (38:31)
Mm-hmm.

Angie And Laura (38:31)
What if I

go and get on the highway? I'm gonna drive off this bridge and I'm gonna hurt the baby. What if I, change the baby? I might accidentally touch the baby sexually.

Deb (38:39)
Mm-hmm.

Angie And Laura (38:47)
really worried about. I don't want to touch the baby. I can't change the diapers. These are things that, and by no means do these intrusive thoughts align with people's values or are they going to do these things. They're terrified of these things and they're very often paired with a lot of shame like really disturbing things and they start to come on, right? And often eight weeks postpartum or beyond. So when people are screening at their six week,

Deb (39:00)
Hmm.

Hmm.

Angie And Laura (39:13)
appointment and or doing the Edinburgh right after, which is really more marked for depression than other screeners specifically for OCD. They're not getting to a lot of these things unless they had OCD prior to, but if the onset is postpartum.

Deb (39:28)
Okay.

Sure.

Angie And Laura (39:29)
Anyways,

then what is happening oftentimes, it's in order to sort of cancel out or like the anxiety will build with these sort of intrusive thoughts and then something known as a compulsion and they can be physical compulsions or they can be internal compulsions and like ruminations will happen to try to cancel out what could happen with this, right? So to prevent the harm or a ritual undo it.

And those unfortunately actually feed this cycle. And so oftentimes anxiety lives alongside OCD pretty significantly. And people's lives can become pretty small because they want to avoid triggers or things that could potentially cause what they don't know will be this intrusive thought.

And there's a lot of like, well, what if this, then it could be this. then all of sudden this is going to happen. you can see a lot of reassurance seeking sometimes, checking some things to try to keep themselves safe and some categories of OCD, especially around postpartum that we like to like are harm based. So I brought up like knives, but it could be anything harm based for a child. This is also true.

true

for general OCD. I brought sort of like things that are sexually intrusive thoughts or things that are sort of in this nature that really are very disturbing for a lot of parents. I can't take them to daycare, this is gonna happen, I can't have any sort of exposure for this. Very disturbing. Also, things around contamination. This is big, we were talking about like...

Deb (40:44)
Mm-hmm.

Mm-hmm.

Hmm.

Mm-hmm.

Angie And Laura (41:10)
germs, bottle washing, people touching things, doing things, not just like I need to clean up, you know, put a Lysol wipe on that. But if this doesn't happen, then what? Right. And then there's also a lot of like scruple-less

Deb (41:17)
Right. Sure.

Angie And Laura (41:26)
religious, there can be like religious split if you know, I'm a bad person if I don't do this, God's eyes, things that happen like this, these could be pretty high level with mothers as well, but these are ones we see a lot. that's a pretty high level overview. But what comes up in when we're assessing or hearing things,

Deb (41:27)
Hmm.

Angie And Laura (41:45)
might be when I'm with a client and I'm hearing repetitive behaviors. So that would be like external compulsions of like very obvious ones might be things like checking, counting, doing this. Less obvious ones are when clients are sometimes seeking a lot of reassurance from me about certain behaviors with the baby and that the underlying fears if they share them.

there's not insight into the OCD are about things that seem outsized or not founded in they're like founded in possibilities but not maybe realities right like I'm worried that I'm going to you know harm the baby with the knife you know and I'll be like okay so that's not

Deb (42:22)
Okay.

Okay.

Angie And Laura (42:34)
Most people aren't going to say, I'm worried I'm going to stab my baby. Clearly, they don't want to stab their baby. That's not coming from a place of what they want. So then we would work through that. Interventions for OCD, specifically targeting therapies for OCD.

Deb (42:39)
Right.

Sure.

Mm-hmm.

So that's That's a lot.

Angie And Laura (42:53)
Yeah,

was thinking back on the patients I've had where maybe as a young therapist and I wasn't as savvy on my mental health or having someone like Laura in my life. But I do recall a patient who, mean, health then, she was like changing the baby like two or three times. And she just had this thing where like the baby had to be.

Deb (43:08)
Yeah.

Angie And Laura (43:22)
or checking the diaper consistently to make sure there wasn't. I have to change the baby now and like any amount of like pee in there or anything you know and it was now that I look at it I'm sure it was more of a...

Deb (43:37)
Hmm.

lot of new parents will do the check, the breathing of the baby and then of like making it when they're sleeping, just, you know, putting their hand on their tummy making sure that they're breathing because they're so quiet in their quiet sleep. ⁓ At what point would that turn into like an OCD thing or would that be one? Like it would be different.

Angie And Laura (44:04)
Well, I think it

would be, so that's not necessarily OCD. I think that, we would be looking more at anxiety.

Deb (44:10)
They were just anxiety.

Angie And Laura (44:14)
I would be looking at that just from what you talked about, unless there was something else going on. Or unless they were up like every five minutes, every day, for months, and they were not getting any sleep, and then I might be more curious in a different way. I would be looking at that more through an anxiety and hypervigilance around that and...

Deb (44:27)
Right.

Okay.

Angie And Laura (44:40)
so the key to know is that, yeah, there are, you have to have sort of, you can call them intrusive thoughts. They're sort of these thoughts or beliefs, these sort of understandings that, ⁓ you know, or doubts like that.

something is gonna happen, it's causing me distress, And something triggers these doubts like what if this happens, you know? And also other people call that an intrusive thought. In that case.

Deb (45:02)
Mm.

Okay.

Angie And Laura (45:16)
of, you know, for SIDS, that's not necessarily, maybe it is an intrusive thought, but the thought is going to often be there's a trigger, like I saw something and that triggered it, but then it's going to be like not...

Deb (45:25)
Sure.

Angie And Laura (45:34)
based maybe totally in, in like, for the example of checking with SIDS, like that is egocentonic, that's in line, like I want to keep my baby alive and then I'm checking that it's like there, there's nothing like with the compulsion there, maybe the frequency wouldn't make sense, but like there would, there has to be sort of a thought. I'd have to have the whole puzzle piece there with that. So there'd have to be some sort of like thing that's coming in from like a

Deb (45:42)
Mmm.

Okay.

Hmm.

Angie And Laura (46:04)
intrusive of thought or like a doubt. they don't even want to this thought. Yeah, they don't want to have it. They don't want to have it. And then the compulsion is like a means of rises and anxiety, like, my gosh, I'm struggling with this. This is right. And this is to relieve that, right? Like if I do this thing internally or externally, that will like resolve this compulsion. It'll go away even though it feeds the cycle. Yeah.

Deb (46:11)
Mmm.

relieving.

Mmm.

Calm it down.

Mmm.

Angie And Laura (46:34)
In playing speak, we hear people throw out all the time, like, oh, that's so OCD and this and that and da da da da. That's not really OCD. We're hearing people like, oh, it's clean and neat and everything is picked up and everything. I think that's, yeah, and there is some forms of, I think that's because there's some confusion about how that language is being used. Just like we throw out like,

Deb (46:41)
Totally.

and neat and tidy.

rate.

Angie And Laura (47:04)
I'm so anxious or so narcissistic. You know, some of these terms are like being misused in our general speaking language. But I think it's a really good question for you. Like, would I be assessing for what would I be looking for here? And should parents be more worried about...

Deb (47:06)
Right.

Alright, buzzed around, yeah. Yeah.

Angie And Laura (47:25)
OCD or anxiety what I want to flag for everybody is like all of all of these conditions or concerns or things people struggle with at times are There's no one that is you know, you're not any worse off or better off, you know, yeah It can be quite distressing though

Deb (47:45)
Right, you're not a bad mom, you're not a bad dad,

Angie And Laura (47:48)
yeah It can be quite distressing though

Deb (47:49)
Right, you're not a bad mom, you're not a bad dad,

Yeah.

Angie And Laura (47:53)
It can be quite dis- if you are suffering from OCD and you don't get the right treatment and you're getting treated for anxiety for example, right? there is a lot of frustration I think for people who have sought therapy and not-

not gotten targeted treatment for OCD and then either haven't gotten relief or it's not been resolved well for them. So I think that's the only thing is, you and because you can imagine there's a lot of sometimes shame or frustration around talking about...

some of these intrusive thoughts, it may be easier to talk about more of the anxiety that sits in between, like, I feel really nervous or I can't sleep or whatever. And those things are the things they talk to the therapist about and not the like, I have this thought that I might throw my baby down the stairs. That feels like scary, right? Why would I tell you that? You might call CPS. Judgment. Yeah, the judgment.

Deb (48:37)
Mm-hmm.

Right, that... you might take my baby away.

Angie And Laura (48:59)
You might call CPS. Judgment. Yeah, the judgment. ⁓

Deb (49:00)
you might take my baby away.

Angie And Laura (49:04)
and that person, if they have OCD, postpartum OCD, is not gonna throw their baby down the stairs. They're terrified. They don't want to. They want help. Like, that's the... Right. So I am super nervous and scared. I don't want to do this, but I also keep getting this thought that I'm gonna do this, and if I don't, you know, go and pray six times over here every time over my baby, then I am making this example up. But, you know, but that's not a... Then like, I don't know. So...

Deb (49:11)
Mm-hmm.

Angie And Laura (49:34)
This is sort of where I think there is a lot of confusion and pain at times and also minimization ⁓ depending on how intrusive thoughts show for people. And the importance of having a clinician who can understand the difference and tease that out, know, that's part of it too.

Deb (49:45)
Mm-hmm.

Mm-hmm.

Yeah. Do you see Angie when people come in for physical therapy, like some of those physical symptoms of OCD and like the counting or doing things, something like that? Do you see any of that?

Angie And Laura (50:07)
Sometimes I think it can be like the repetitive behavior, the lack of focus in some ways. Those are things we see. There's not as many outward bodily signs. There may be tension, there may be... ⁓

Like I said, that checking behavior, that's harder for us to, I think, on the PT side of things. ⁓ I think that anxiety signs are easier, and then I can send them someone like Laura, who, you know, possibly can tease out what's happening, why that tension is there.

Deb (50:34)
Mm-hmm.

Mm-hmm.

Angie And Laura (50:51)
And I think just if you are an allied professional talking about the fact that there is a difference or just knowing that like there's, if you're having scary thoughts that like it's really good to like talk to a therapist that specifically treats OCD and so, and not just anxiety. I think that's what I would say.

Deb (51:10)
Mm-hmm.

Angie And Laura (51:14)
be so that they feel safe to talk about that because they're not going to get like a CPS call letter or something weird that they're not going to feel like they can't share those things. Versus maybe another therapist who's like, I don't know what to do with this. This is a lot.

Deb (51:20)
Yeah.

You're like, they may wonder, is the baby

in danger or even the parents themselves, are they in danger? Without having that extra training of knowing that this is just part of that condition, yeah.

Angie And Laura (51:36)
Right, right, right, when you're not.

Same with other professionals too. Consult with people also before you sort of felt over like, is this a thing? So just folks are not dangerous with OCD or anything else like that. That's not the case.

Deb (51:50)
Right. Right.

Yeah. Well, and I think this is really nice to hear that this is, this is part of sometimes people's postpartum story that they don't want to talk about worrying about harming their baby or their baby's going to do this, or they're going to accidentally do something and their provider is not going to be supportive or they're feeling judged they're going to think I'm going to hurt my baby. And, ⁓ just knowing that this is a thing is really powerful.

Angie And Laura (52:27)
I've heard from a patient once is like, I'm afraid my baby is so cute, someone's going to steal her. And she was like, very like focused on that. You know what mean?

Deb (52:37)
actually scared.

Angie And Laura (52:39)
I mean it could be you know something that is an intrusive thought and it was almost like she didn't want to have it but it was there you know I mean I'm just trying to think of like practical things I've heard from patients that would be like a little interesting. Well this is the other thing right it's like and this is why it's so great to work with.

Deb (52:47)
Mmm.

Mm-hmm.

Angie And Laura (52:59)
people who specialize in everything that's like, you know, don't physically touch people. I tell her all the I physically touch people. She does emotionally touch people. Right. Right. No. And you too. You're just both in physical realm than I am. But if it's like a real birth, like birth, birth question, I'm going to call you down. If it is like a physical, I'm going to call you. If you have something going on and you're like, I don't know what's going on with this.

Deb (53:11)
Yeah. Yeah.

Angie And Laura (53:29)
Can I, call me. ⁓ And I also have like several folks in network who are OCD specialists and postpartum OCD specialists. And so there's people all over the world are great in this network here in Washington too. And then great resources to learn more if you're also an ally professional, you know, who would want to know more. I think it's like, you don't be the expert in this. hey, this is your person.

Deb (53:31)
Yeah, yeah.

Hmm.

Mm-hmm.

Yeah.

You have to know that there's something

Angie And Laura (53:57)
Right. Yeah. And that's the same for what you said, like what we say to like partners or whoever else, right? And I think like to just destigmatize everything is, asking are you scared of? What is going on? What are you holding on to that's hard for you to let go of right now? And that can be a good question in general.

That means what can you let go of like a task? What can you let go of emotionally? What can you let go of not a secret, like that it's weighing on you. Those, that could play at a lot of levels. So if a partner or friend or somebody, if that person is able to share those things, that can be something to sort of come at.

Deb (54:23)
Mm-hmm.

Mm-hmm. Mmm.

Angie And Laura (54:40)
You know, I think that's a place to show your support and also say like, what can I unburden from you and take at any of these levels? So that might be something.

Deb (54:44)
Mm-hmm.

Right. That's a really great thing.

So if family members or partners are noticing that this is happening, what do you think that conversation could look like that felt supportive

Angie And Laura (55:03)
I mean, I would start with that. I would start with like, what can I take? I always start from I statements. I think we've mentioned that before. And asking what people need.

Deb (55:11)
Mm-hmm, like I noticed.

Angie And Laura (55:14)
And ⁓ or if it is pretty extreme, I'm concerned is okay to say I'm concerned, that you might need some more support or I'm concerned that we don't have the right level of support. I'm concerned that this is hard for all of us and that you that we might benefit from another level.

support something along those lines and using some examples If this is hard for me, I can't imagine how hard it is for you being the birthing person So some of those things be useful. You know your partner or your family member best.

Deb (55:37)
Mm-hmm.

Right.

Angie And Laura (55:55)
But really not coming from a place of criticism, but coming from a place of curiosity and trying to open up a conversation of like how would you invite them to sit into welcoming more help and assistance acknowledging that they're doing a great job.

Deb (55:55)
Mm-hmm.

Mm-hmm.

Yeah.

Yeah, and that the partner can only do so much. They're not therapists, right?

Angie And Laura (56:11)
and doing whatever they can as we all are trying to

Deb (56:16)
Yeah, and that the partner can only do so much. They're not therapists, right?

Angie And Laura (56:16)
and doing whatever they can as we all are trying to

Yeah, acknowledging that. So that's all you're trying to get in for, but people have to be willing to do, to want to invite that help in for the time that they are in that recognizing it's not a, it's just a supplement, to helping them better understand what's happening with themselves and, support their journey.

Deb (56:40)
Yeah, and reducing friction to around, getting that help can be really great if the partner's like, hey, we agree that you need more support than what I can give you. So how can I help you get to that appointment? Let me make sure that I'll be home in time for you to go or let's make sure it's a video visit so that no matter what's going on I will have the baby.

everything will be fine, you go take your time and providing that support so that they can actually get the help that they need versus, you know, that's another layer of stress on the parent that is like struggling because they're like, well, I have the baby all the time. What do I do?

Angie And Laura (57:16)
Yeah, and layering those micro supports in where you can is really key, think, seeing what's possible.

Deb (57:23)
Yeah, perfect. Well, that's all my questions. Do you guys want to leave us with some last little nuggets of advice around anxiety, OCD, the postpartum period?

Angie And Laura (57:35)
again, I would just say it's a huge change, right, when we're welcoming a new human. And be kind to yourself, You're learning something new that's highly complex. You know, reach out for the resources you need.

talk to other parents, visit with other parents, join a group. Even if it's just a walking group with your buddies. I think not neglecting some of your own physicality is huge. Again, it could just be a walk by yourself or doing a little yoga flow by yourself or just going out in your garden with your bare feet and having that physical time yourself.

Deb (58:10)
Mm-hmm. ⁓

Angie And Laura (58:13)
It's a challenging aspect of life, which was part of my

to be more accepting of the things they're going through. And reaching out if you feel something isn't right. You're the expert of you, you know? And if something doesn't feel right to you, it's probably isn't right. You know what I mean? So just trust yourself and be curious and kind. And we're also here for you. There's a lot of great support in the birth community here in Tacoma.

Deb (58:23)
Mm-hmm. Yeah.

Mm-hmm.

Angie And Laura (58:50)
reach out if you need it. Yep, and all across Washington too. I mean we're plugged in to folks, you know.

So if you're not specific here to the South Sound, I think we can get you in the right direction. Happy to do that. yeah, I echo everything you say.

Deb (59:10)
Yeah.

Angie And Laura (59:10)
I guess I would say, the one last thing I'd plug is I'm reading a really great book. don't have any promotion or things for this. no rights. No, she's a clinical social worker and I like her a lot. Meg Josephson just came out with a book called Are You Mad At Me? and it's a really great book. ⁓

Deb (59:33)
⁓ that sounds really good.

Angie And Laura (59:37)
Yeah, it's a great book. Thank you for having me. Thank you. ⁓

Deb (59:38)
I know, I wrote it down, I'm gonna read want you guys

to have one more plug of what you have going on,

Angie And Laura (59:47)
yeah, Madrona of physical therapy, um, specializing in physical therapy for female birth bodies and, um, specifically pelvic floor dysfunction. we have Laura here twice a month on the first and third Wednesdays, uh, two 30 to four 30, at least that's what we're doing for now. Um,

And then it's just a matter of getting in touch with me or one of my therapists. This is a free service to our current and past patients and then within our communities, the birth community here in Tacoma. we're super excited to have this partnership and it's something I want to do more of.

so that New Parents know that support.

Deb (1:00:32)
Perfect. So you can reach out for therapy around pregnancy, learning how to, take good care of your pelvic floor around birth and labor, and then also recovery, and if there's any dysfunction, obviously, and then you also have classes though.

Angie And Laura (1:00:49)
Yes. So we do offer a perinatal fitness class on Wednesdays at 1.15. You can bring baby with you to that class. It's pretty fun. Kind of have your own little station and you and the baby work out there together. So that's been going really great for us. And that class is 20 bucks. And if you buy a 10 punch card, you get it for 17.

Deb (1:01:19)
Nice. Perfect. That's it. It always looks so fun when I'm there. Yeah, Laura, what do you have going on? That's OK.

Angie And Laura (1:01:22)
I'm here.

⁓ I see clients. I see clients on Mondays and Thursdays and occasionally I see them on Tuesday and Wednesdays, but I try to keep folks on Mondays and Thursdays. And I'm virtual at the moment. And if you want to learn more,

Deb (1:01:36)
Yeah.

Angie And Laura (1:01:50)
There should be a link in this bottom, but you can email me too or check out my website, which will be...

Deb (1:02:02)
Perfect. Great.

Angie And Laura (1:02:02)
So yeah, see you in

therapy.com. All right. Thanks so much Deb.

Deb (1:02:06)
Yeah, see. Perfect. Well, thank you so much for being on again.

Well, I'd love to have you anytime.

Angie And Laura (1:02:13)
Great. Perfect. All right. Thank you. Thanks.

Deb (1:02:14)
Alright, well have a good day!

Angie And Laura (1:02:16)
Thank you. Thanks.

Deb (1:02:16)
well have a good

Deb (1:02:21)
I'm so glad you made it through this conversation. There was a lot in there, but here are a few gems you to take with you.

There is a difference between normal worry and postpartum anxiety. Worry comes and goes, but clinical anxiety is persistent, overwhelming, and often shows up as racing thoughts, avoidance, or not being able to relax, even when everything's fine.

Number two, your body keeps the score. Anxiety isn't just in your head. It can live in your jaw, your pelvic floor, your bladder, your gut. If you're tense, restless, and can't sleep, even when the baby's sleeping, that's a red flag.

Number three, postpartum OCD is not just being a clean freak. It's intrusive, often scary thoughts paired with compulsions. These are the things that you want to do over and over to try to relieve that anxiety. These thoughts don't match your values and they don't mean you're dangerous. They just mean that you need more support.

Number four, compassion beats perfection. You don't have to do it right all the time.

There is no one right way to do things. Learning to give yourself grace and reaching out for support can make all the difference. And lastly, number five, early support matters. Whether it's a therapist, a pelvic floor PT, or just another parent who gets it, you don't have to wait until you're drowning to ask for support.

So if any of these resonated with you, know this, you are not alone, you are not broken, and you deserve support that actually helps you feel like yourself again. And a big thanks to Angie and Laura for coming back on and sharing their wisdom and for reminding us that the mind and body are always in conversation. I'll drop their links in the so you can connect with them if you need more support. Until next time, remember, you do not

have to white-knuckle your way through postpartum. Take the help, shake off the shame, and keep reminding yourself you're doing better than you think.