Mental Health, Menopause, and ‘Good Enough’ Moms

Would it help you to learn that Christine Crawford, MD—the associate medical director the National Alliance on Mental Illness (NAMI) and a psychiatrist at Boston Medical Center—is also worried she’s not doing the right things when it comes to raising her kids? Her resume is long and prestigious, but like women and mothers everywhere, she can judge herself about snack choices, screen time, and that time she forgot her child’s water shoes on water play day at daycare.

Crawford, as a doctor and educator, has made it her mission to break down barriers around mental health, especially for Black women, and she does it with warmth, humor, and a healthy dose of real talk.

It’s exactly the tone she’s excited for when she joins the luncheon discussion, “A Candid Conversation on Women’s Health: Getting Real About Health, Happiness, and Hot Flashes,” hosted by BMC and presented by AARP this August on Martha’s Vineyard. It’s part of BMC’s third annual panel series during the African American Film Festival—when the island becomes a vibrant epicenter of Black community. BMC plays host to thought leaders, change-makers, and cultural influencers during two days of candid conversations.

This year, in the intimate conversation on women’s health and wellness, Crawford will join Sharon Malone, Tabitha Brown, and Myechia Minter-Jordan, to build community and break through stigma on everything from menopause to parenting and more. The women will create a space where everyone can share what’s really going on—no filters, no judgment. Read more from HealthCity’s sit-down with Dr. Crawford in advance of the event

HealthCity: What makes you excited about this women’s health conversation?

Christine Crawford, MD: I’m really looking forward to having an opportunity to have conversations with women that I know, that I admire that I respect, who have a totally different perspective and experience when

it comes to navigating the world. I think it’s helpful for women to hear from other women what strategies they’re using to deal with some very, very common challenges that that women face, but we don’t really talk about it openly because there’s this expectation—especially when it comes to Black women—that you just power on through.

We’re so used to taking care of other people, we’re so used to being strong and resilient.

We’re so used to just being met with so many different challenges. So, I like the fact that we can have this safe space in which we’re discussing all of those things openly.

There often aren’t times of reflection to sit down and say, “Wow, that was really hard” or “I’m worried about this,” or “I don’t know if I can get through this.” Often, instead, conversations are about what we have to do, how “it is what it is.”

It’s important for the audience hear that other people are struggling, even though on the surface it may look like they’re doing things so easily. At the of the day, we’re all people, and we’re all women, and we’re all faced with the same things behind closed doors.

HC: What do you hope to bring to the conversation from your experience or expertise, either personally or professionally?

CC: It’s okay to not be okay. And it’s okay to say that this is hard.

I think a lot of people don’t feel comfortable acknowledging the difficulties that they’re experiencing when it comes to parenting, when it comes to taking care of their parents, when it comes to health issues that they have, when it comes to taking care of their whole family system.

It’s okay if it’s hard, and it’s okay if you make mistakes—especially when it comes to parenting. We can beat ourselves up about not putting our kids in a certain school, about our kids eating Cheetos, or about our kids having iPads. These are the ongoing worries we have: “Am I doing the right thing?”

What we may not realize is that this is creating a huge mental burden; it poses a significant mental and emotional toll on us, and we’re carrying that burden alongside all the other roles we have to play in our life.

I’ll also touch upon the role of self-care and what that actually look like. Self-care can look like recognizing that you’re a good enough mother if you need to give your kid the iPad for 30 minutes so that you can take a break to watch your favorite Netflix show. To have a babysitter watch your kids so you can go watch a movie with your friends for two hours.

As women, as parents, we often sacrifice ourselves and our free time and, in the process of doing that, we sacrifice our own identity to prioritize our kids. And when you do that, you no longer prioritize yourself. Not only do you suffer, but your kids suffer as well.

HC: Women make the majority of healthcare decisions for themselves and their families. They also spend more time in poor health than men. What do you think of when you think of those statistics?

CC: Part of the expectation of being a woman is that you take care of everyone. And a lot of women enjoy that and feel a sense of purpose through taking care of others.

Picture a water jug pouring water into pots of plants in soil. When you’re prioritizing taking care of others, picture pouring water into your 3-year-old and making sure she is cared for. You’re pouring water in your partner, your parents—nurturing all of these people every day. But who is watering your plant? When you’re dry and empty at the end of the day, who is filling you back up?

We deplete ourselves with the energy that is really needed to be able to take care of ourselves.

You’re not just keeping track of the PTO meetings, the field trip permission slip, whether or not you need to pack the water shoes because it’s water play day at daycare—that literally just came up in my life because I forgot the water shoes—what to make for dinner, to get my spouse an appointment with his PCP to talk about his hypertension. We may minimize the significance of all these things that we’re doing in our head, juggling, keeping track. But the body is keeping track. It’s releasing stress hormones that cause damage to different parts of the body. When we’re constantly releasing these stress hormones it can contribute to chronic medical and psychiatric issues and shortened life expectancy. These micro-stressful things add up. They add up to high blood pressure, they add up to heart attacks in your 40s and 50s. We’re seeing this in Black women especially.

HC: What’s the benefit of having these raw conversations on women’s health—especially something like menopause, that until recently has felt taboo to talk about—in a more public venue?

CC: And for me, it’s really simple. If people are having more conversations about menopause and perimenopause and they are increasing their knowledge base about symptoms and treatment options, then they’re going to be better able to take care of their physical health. And then, in turn, their mental health is going to be better because of it.

If you are aware the symptoms of menopause can include mood swings, sleep changes, sexual function changes, weight gain, then you’re not thinking always to yourself, “Why can’t I lose the weight? Why is my mood all over the place? Why am I no longer enjoying sex? Something must be wrong with me.” All of that can have a significant impact on your mental health.

Right now more people are talking about menopause, with social media a lot more folks are talking about what perimenopause really looks like, the impact that it has on women’s overall well-being and then what transitioning into menopause looks like. And it reminds me about previous conversations around mental health in general.

There was a time when people we’re talking about signs and symptoms of depression, or what generalized anxiety looks like, or the impact of traumatic experience. Now, we’ve normalized conversations around mental health, and by virtue of doing that, we are raising people’s knowledge base. People are talking about it openly, and they’re seeking help and engaging in care more readily now than ever before.

I hope the same thing will be true for menopause.

HC: What are you excited to hear or learn in this discussion?

CC: Yes, especially around parenting. I have a 4- and a 5-year-old. When I have an opportunity to speak to mothers of 17-year-olds, 18-year-olds, or 25-year-old—women who are more advanced in this path of parenting—I think about it how they were able to go through all these different transitions, and moms who have been able to have kids that launch into adulthood. They did something right. What did they do?

Because I’m afraid of not doing the right things to get my kid to where your kid is. Personally, that’s what I’m really looking forward to hearing. Because I know in theory as a clinician, as a psychiatrist, that it’s okay to be a good enough mother, it’s okay not to be perfect. But I also like to be reminded through hearing stories of others.