Dr. Whitney: Our guest today is Dr. Kat Kaeni, an expert in perinatal mental health. Tell us about your background, how you got started, why you’re so passionate about what you do.

Dr. Kaeni: I became an expert in this field because I experienced it. I already was a psychologist and had a planned pregnancy. There were a few bumps through the pregnancy and, looking back, I can see that’s where my anxiety began. I began thinking about really big things. And then after my long labor and delivery, my anxiety really started to be noticeable in my life. My daughter aspirated a little bit of meconium during labor and that triggered the hypervigilance and overwatching, constant worrying. 

At that point, I really didn’t know anything about perinatal mental health. So, for me, a few weeks of heightened anxiety turned into depression and then eventually into OCD with intrusive thoughts (those thoughts that pop into your head randomly that are very disturbing or intense, like “What if I drop the baby?”) and then was doing everything I could to avoid those “what ifs.” I was a prisoner to what was going on internally and this went on for a year.

After I finally came to terms with what was going on, I did a lot of research to help me understand what was happening. And I got angry because I felt like I should have been taught this and I knew nothing. Which means that there were people out there feeling alone too. Since then, I’ve had this passion to make sure that no one suffers alone.

Dr. Whitney: What was the moment that helped you come to grips with everything?

Dr. Kaeni: There was always a part of me that knew that something wasn’t quite right and another part of me that didn’t want there to be anything wrong. And I struggled with that for a long time. It started to impact my functioning more and more. I couldn’t focus and pay attention. My anxiety got so bad that I couldn’t do normal things like walking my daughter in the park in her stroller.

And one day I was doing an intake with a patient where they have to answer these 10 questions to determine if they’re depressed and I decided to take it and be honest with myself. And lo and behold, I was depressed. It really helped to see it clinically in front of me without any of the emotion behind it.

As I started doing research, I was reading about the OCD and intrusive thoughts and it was so validating to know that it wasn’t just me. This was happening to so many other people. So the combination of those two things really helped me move forward.

Dr. Whitney: I’m curious if you ever felt this way, because I certainly did–when you were helping people while you were still having a hard time…did you ever feel like a fraud? Like how can I be helping these people when I can’t even fix myself?

Dr. Kaeni: Oh absolutely. But what I do know about health professionals is after you’ve been trained for so many years and have experience, you can treat people in your office and still do a good job and then when they leave, melt down. Which is so draining. But that’s really what our medical training teaches us to do–to turn our own self off while we’re treating our patients.

Dr. Whitney: When you realized you were having anxiety, you got treatment. What did that look like for you? Or is there anything you wish you did differently during your treatment?

Dr. Kaeni: I started with a therapist that I had seen previously and she basically told me I didn’t have depression. Which just made me shut down and withdraw because all those things like shame and embarrassment then creep in. And I felt like I couldn’t go see a specialist because I was afraid it would be weird when they were my colleagues (which is not true, I absolutely could have gone, but anxiety can make you feel like your choices are limited.)

So I started looking into other options. I saw a naturopath. I did acupuncture. I learned my thyroid was off. I kind of winged it and tried to rely on the training I already had. But once I started getting specialized training in it, it was so validating to see myself in the things I was learning about.

I wish I had tried to continue with therapy and I probably should have gone on an antidepressant, just based on the range of symptoms I was having. I wouldn’t have suffered for as long had I gone that route, for sure.

Dr. Whitney: Now that you’re on the other side, what would you recommend to people so that they can get help early on and not have to suffer for a long period of time?

Dr. Kaeni: I would say, especially if you have a history of mental health issues or even family history, be proactive. Start with a therapist that specializes in this. Even before you have the baby. They can really make sure that you have a plan lined up for after delivery so that you’re as supported as you possibly can be. If you’re starting to feel like something is off, don’t assume it’s in your head. It’s not. Ask for help.

Dr. Whitney: I know that therapy costs a lot and it’s not usually covered by health insurance. I just wish I could show new moms that paying for your mental health and getting your movement in is WAY more important than the fancy crib or stroller.

Dr. Kaeni: Absolutely. Definitely look at your benefits, because a lot of us do take insurance. Or if you have a PPO, you can get reimbursed. And there are great resources out there that can help too. Postpartum Support International is a great organization that has a therapist directory with therapists that are specialists in this field and they offer online support groups for free. They also offer a peer support option so you can be paired with someone who’s in a similar situation as you. If you’re feeling uncomfortable with a group setting, I encourage you to simply check it out. The validation and acceptance you’ll feel knowing that there are so many other women going through the same thing as you is SO helpful.

Dr. Whitney: I get asked how long this “season” of perinatal can last. How long can we pin the way we feel on the fact that we just had a baby?

Dr. Kaeni: Within the profession, we look at a couple of different parameters. We say that postpartum is forever, but there are some factors to qualify that. In terms of when perinatal related mental health issues usually show up, it’s within the first year. And that can be because of the stresses of the new season of life or can be giant hormonal shifts like when you get your period for the first time or stop breastfeeding. It can even be due to trauma during pregnancy and childbirth. And they can show up in anxiety, depression, or OCD like it was for me. Or even, for some, the onset of bipolar symptoms can start here as well.

But if it’s left untreated, symptoms can really peak around the time that child is 4 years old. And when you’re suffering for that long of a time, it really impacts the type of parent that you can be. It’s hard to be affected that way and be the best parent you can be. Which is why it’s so important for you to get the help that you really need, which can come in many forms.

But there is help. And when you know your options, it can help you feel so much more empowered to make a decision.

Dr. Whitney: How can others get in touch with you if they’re resonating with what they’re hearing today?

Dr. Kaeni: My practice is called Well Mind Perinatal and I’m also on instagram at @momandmind and my podcast is on Facebook at momandmindpodcast. We have tons and tons of episodes. They’re sometimes personal stories of people who’ve gone through similar experiences and sometimes we have experts on so they can hear the clinical side of things. On my website, I have a free mini-course: 2 Skills to Manage Anxiety and Worry, plus another self-paced course that’s built for someone who’s having a challenging time with the transition to parenthood with lots of resources and support.

And to reiterate, anyone can go to Postpartum Support International for free resources!