A Strategy to Improve Postpartum Mental Healthcare

It’s no secret that the stigma around mental illness is a significant barrier to people pursuing treatment. During the Postpartum Revolution Road Trip tour, Angelina Spicer stopped in Pittsburgh on her mission to normalize the way we discuss, treat, and even joke about depression. We laughed a lot (she is a comedian, after all!), but we also had some time for serious discussion as she filmed her documentary. I was honored to be included as a panelist to discuss postpartum mental health, and I’d like to share some of that information here so you can better support the people in your world. (Scroll to the bottom for links to resources.)

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Let’s start with some data:

  • Every 12 hours, a person dies from pregnancy-related causes.
  • Mental health conditions are common complications in pregnancy and an underlying cause for approximately 9% of pregnancy-related deaths.  
  • 1 in 8 people report symptoms of depression after giving birth, and over half of pregnant people with depression are not treated. 
  • 1 in 10 experience postpartum anxiety with similar lack of treatment.
  • Black, American Indian, and Alaska Native (AI/AN) women are two to three times more likely to die from pregnancy-related causes than white women.
  • Pregnancy-related deaths for black and AI/AN women older than 30 was four to five times as high as it was for white women. (Even in states with the lowest rates and among women with higher levels of education, significant differences persist.)
  • According to a recent CDC report from 31 states, about 1 in 5 women who participated in the study were not asked about depression during a prenatal visit and 1 in 8 were not asked during a postpartum visit.
  • Sadly, suicide and overdose combined are the leading cause of death for women in the first year following pregnancy.

With so many pregnant people struggling (along with their partners and children), how can we change those statistics for the better?

  • Supporting research to find solutions so every family gets the best possible start. In my life, that means supporting March of Dimes, especially since the research they funded saved my life and the lives of my two sons.
  • Advocating for policies that prioritize the health of moms and babies. Currently, that means supporting The Black Maternal Health Momnibus Act of 2021.
  • Connecting pregnant people and their families to local resources and supporting those organizations.
  • Educating health professionals to improve care for everyone giving birth. In my life, that means screening my pregnant clients and continuing to offer those screenings for the first year postpartum.
  • Making appropriate healthcare accessible for everyone. Pieces of the legislation linked above address that, but we need to tackle the systemic racism and gaps in health insurance coverage that contribute to lack of access.
  • Pressing companies to set goals and implement strategies to help reduce racial disparities in maternal health (like what BCBS is doing).
  • WE NEED TO TALK ABOUT IT! Sharing our stories and educating one another is crucial in supporting people through their perinatal mental health journeys.

So thank you, Angelina Spicer, for bringing your comedy and unfiltered story to Pittsburgh! You’ve created a revolution we can all get behind. Thank you, March of Dimes, Allegheny Health Network, and The Tull Family Theater for bringing this meaningful event to our area. Follow Angelina here to watch for the documentary she filmed along the way to D.C. where she met with legislators to make change happen!

References & Resources:

To inquire about how Jessica can bring these conversations to your organization, please email jessicamgage@gmail.com

Online therapy: A Guide for Clients

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COVID-19 has changed the ways we engage with everyone in our lives, including our counselors. For many clients, that means putting in-office meetings on hold and temporarily replacing them with phone calls and video therapy. Although technology offers options to keep us connected, it’s okay to feel concerned, intimidated, and relieved all at the same time! If you’re feeling unsure, here are some tips to help you navigate this new world of counseling.

First, communicate with your counselor. This is (hopefully) a person you’ve grown to trust, so it’s a wonderful place to process your concerns about confidentiality, quality, and logistics. It might help to have all of your questions and concerns written out ahead of time. Once you’re on the same page about how your sessions will take place, make sure you’ve got any necessary technology lined up prior to your meeting time.

Second, consider the setting. In a counseling office, the space is already set up to be conducive for privacy, comfort, and emotional work. How can you replicate that in your home? Find a comfortable place with the level of privacy you’d like. Wear comfortable clothes for your session, and take a few minutes ahead of time to sit quietly and get centered using techniques from your work together. Leave some buffer time for after your session, too. That space to decompress will help seal the therapeutic time and allow light-bulb moments to set in a bit more. it can also be helpful to have your journal handy or a tablet for note-taking.

Ultimately, keep in mind that your counselor in on your team. If technology fails or video feeds lag, your therapeutic relationship is built to weather whatever storms this odd season throws at you. We’re all in this together!

A Series on Love: 7 Types

Seven Types of Love

You know what I love? Carbs. Chocolate. My dog. Going for a run first thing in the morning… Oh! And sleeping! Definitely sleeping… And those things don’t even compare to my important relationships: my husband, my kids, my dog, my friends, my community…

Isn’t it unfortunate that the English language falls short in differentiating between the different levels of love in our hearts? Think back to my first blog in this series (about intimacy, commitment, and passion) and the second (about the brain chemistry of love). With the complexity of how our minds and bodies respond to deep emotions like love, we need to break it down a bit to differentiate what we’re feeling. When we focus only on romantic love, we miss out on the balance these other types bring to our relationships:

Eros– This is an erotic love, fueled by sexual desire with little to no concept of consequences. It’s passionate, but it’s quick-burning when it stands alone.

Philia– This is a pure-hearted, brotherly love and the foundation of quality friendship. It’s necessary for a fulfilling relationship that lasts.

Ludus– This love is playful, infatuated, and flirtatious. Limerence (a state of infatuation, obsession, and fantasy) also fits in here. It’s fun, but needs mutual effort to grow.

Pragma– This love is longstanding, practical, mature, affectionate, supportive, and respectful. This mature type of love requires individual health and united work over time.

Agape– This is a deep love that hits the soul. It’s altruistic without expectation from the other, offering true empathy and forgiveness without holding grudges.

Philautia– This is the trendiest: a self-love, but not in a narcissistic way.

Storge– This one is similar to the love a person has for a child. It’s about companionship with some of that familial attachment with an instinct to give.

Think about how these play out in your different relationships and the emotional response you have to each type. Talk to your partner about what you enjoy most together and where your growth spots might be.

A Series on Love: Our Brains on Love

Our Brains on Love

Our brains are seriously amazing. Among the coolest are the ways in which different types of attachment affect our brain chemistry. “Love is blind,” is absolutely legit. Hormones flood our brains to turn off critical thinking, self-awareness, and rational behavior. Bye-bye, prefrontal cortex functions! So let’s talk about the three main hurricanes and how to use them in your relationship.

First up, lust and passion. Getting caught up in a moment isn’t simply about a lack of self-control; it’s about brain chemistry. Hormones like testosterone and estrogen rush to our brains, rendering our logical thinking useless. So how can you bring some of those hormones into your sex life? An easy way to boost testosterone is to take a power stance for two minutes before initiating sex. (Watch this TED Talk and you’ll understand how it works.) A more fool-proof way is to talk to your doctor and have your levels tested. There are all kinds of testosterone- and estrogen-based pills and creams for people of any age to bring a little passion back into the bedroom!

Next comes attraction and intimacy. Love high neurotransmitters like dopamine, norepinephrine, and serotonin hit the reward centers in our brains. Yep, the same ones that affect eating and sleeping. These neurotransmitters help our minds learn who we love and why we’re attracted to them. How can you bring more of these brain builders into your relationship? Take care of yourself! Eat well, get regular exercise, take Vitamin D, and invest in a happy light (Verilux is my totally-unsponsored brand of choice).

Finally, and perhaps most importantly, attachment and commitment. These are the hormones that are going to carry your passion and intimacy to the next level. Oxytocin and vasopressin promote bonding, closeness, and loyalty. Looking for more of this in your relationship? Look into each other’s eyes more often and for a longer period of time, especially during times of positive communication. Volunteer together to get those altruistic mirror neurons firing. And do something relaxing together, like a massage or quiet walk in a park, so the stresses of life aren’t a part of the moment.

Our brains are capable of doing many things, so figure out how to make yours work for you in your relationship. Have fun!

A Series on Love: The Triangular Theory

In my counseling practice, it’s typical for half of my cases to be couples and the other half to be individual clients. No matter who is in my office, I find myself often talking about attachment, love, sex, and the ways they affect all our lives. Although we’re still 6 months out from Valentine’s Day (yep… I’ll wait while you check your calendar), love is always a topic on my radar. So I’m launching a blog series on love: summarizing some great theories, starting some practical conversations, and (hopefully) setting you on a path for a really great V-Day in a few months!

Love is complicated. I mean, sometimes it’s pretty simple, but usually only when our brains are experiencing an emotional high. One of my most-used diagrams is of the Triangular Theory of Love. Robert Sternberg looks at loving relationships using three components: intimacy, passion, and commitment.


Intimacy is the closeness, connection, bond, and general friendship in a relationship. When a relationship only contains intimacy, it is referred to as Liking/Friendship. Passion is the arousal state that leads to romance, physical attraction, and sexual tension and consummation in a relationship. When a relationship only contains passion, we call it Infatuated Love. Commitment can be both the choice to love and the decision to maintain that love over time. When a relationship only contains commitment, we call it Empty Love.

If a relationship doesn’t contain any of the three components, it’s Non-Love, and Sternberg developed the term Consummate Love for when all three components are at play. But look at all the combinations! Romantic Love is when a relationship lacks commitment. Fatuous Love is when a relationship lacks intimacy. Companionate or Friendly Love is when a relationship lacks passion.

It’s normal for relationship to go through ebbs and flows, but the levels of each component in a relationship at any given time allows us to assess where we need to grow as individuals within out relationships. Think of a significant relationship in your life. Where are your strengths? Weaknesses? Think about where you can take some initiative, how you can verbalize your emotional needs, and where you need to draw the line in what’s important for your heart.