Sarah Baroud, LICSW
“I would love if we all got annual mental health exams and screening. Just like we check on our physical health, we have lots of normal tests for that. And perinatal mental health care should be standard.”
Sarah Baroud (she/her) is a Caucasian, cis married mom of two, clinical social worker and private practice owner. She has been working with children and families in community mental health since 2010 when she earned her Masters in Social Work from Simmons University. Sarah currently works with individuals and couples on their prenatal and postpartum journeys, which may also include loss and new paths. Sarah is very passionate about maternal mental health education both on the micro and macro levels. She facilitates a postpartum support group at UMASS Memorial Health - Milford Regional Medical Center.
This blog is made possible by a sponsorship from Sage Therapeutics, Inc. and Biogen Inc. All content on this page has been curated by the Mass. PPD Fund without input from Sage Therapeutics, Inc. or Biogen Inc.
December 2024 | Interviewed and edited by Jessie Colbert, Executive Director, Mass. PPD Fund
To wrap up the year, we’re happy to share this interview with perinatal Social Worker Sarah Baroud. The Mass. PPD Fund was grateful to partner with Sarah earlier this fall as a presenter for our Expanding the Circle of Support in the Perinatal Period training series, where she offered a valuable overview of talk therapy treatment for Perinatal Mood and Anxiety Disorders (PMADs).
Sarah is also a survivor of Perinatal Mood and Anxiety Disorders (PMADs), an advocate with Chamber of Mothers, and an active member of PSI-MA (the Massachusetts Chapter of Postpartum Support International). In this interview, she shares her personal and career journey, a fascinating story from her family’s past, thoughts on why moms shouldn’t be so hard on themselves, and how we can all normalize caring for our mental health.
Let’s start with your career. What brought you to social work, and to a focus on the perinatal period specifically?
I've always loved volunteering and helping people. My dad passed away recently, so I’m going through the house and finding a lot of my old journals and letters. And it's reinforcing the idea that this has always been me – keeping a journal, being self-reflective, wanting to do more for people.
I went to Merrimack College undergrad. It’s an Augustinian college, and I did the Augustinian volunteer program after college through AmeriCorps. I was placed in Philadelphia for a year at a homeless shelter for teenagers and their children, and then I worked there for another year. I really loved it, and I also felt that I needed more education around it. My roommate said, You know, you can go to grad school for social work. That's kind of what pushed me on this path. I went to Simmons, graduated in 2010, and I've worked in community mental health since then, mostly with children and families.
Then through the pandemic in 2021 I wanted to make a shift, like many people and many moms needed to or wanted to, and I started my own private practice. I had my own struggles after both my children were born, [but I] never really sought help other than some support groups, never got diagnosed or had my own therapy. I know that there's a gap out there, and the level of assessment is really not great. I felt a pull to make perinatal mental health my focus.
Can you share more about your own perinatal mental health experience that inspired this new focus for your work?
My oldest is six-and-a-half, and if I had sought therapy after he was born, I think I would have been diagnosed with postpartum depression. It was a lot of crying on my part (and his part!), a lot of feeling alone, feeling isolated, really wondering what I had just done. It took me a while to regroup and find myself again. Whenever I would go to a pediatrician appointment, she would say, You're doing a great job, you can do it! I know she was trying to cheer me on, but it really felt almost invalidating, because I was crying right in front of her. I was like, This doesn't feel great to me!
And having two children really threw me for a loop. They're very close in age, about 21 months apart, and after having my second my biggest symptom was hypervigilance. Always being on guard, on alert; someone needs something, someone's spilling something, someone's falling, someone's crying. . . I really think it was driven by anxiety, and not taking care of myself at all. I lost a lot of weight unintentionally, I certainly wasn't sleeping as well as I should have – again, kind of a loss of myself. It took about two years after my second was born to really come out of that fog.
The support I did seek and receive was through support groups. I went to the hospital that I delivered at, and they had some wonderful support groups for breastfeeding moms and for new moms. That was huge, that was a lifeline. But I did not get my own therapy, which I really should have.
I’m sorry it was so hard. Was there eventually an “aha” moment where you understood your challenges were perinatal mental health issues and got more help?
With my second, I did reach out around the two-year mark. It came through a moment that felt really hard. I would describe it as postpartum rage. I found myself screaming, because I was overstimulated or mad at something, and my two kids started crying. My husband saw it, and it wasn't the only time it happened, but it felt very embarrassing, very out of control. I thought, something has to change. I started with my primary care provider. She was wonderful, and she said, Yes, I think you're very much struggling, and you can certainly start some medication for anxiety, and you should find a therapist. That validation was huge, that I didn't have to just keep going through this.
Another interesting thing that happened recently when my dad passed away, was that a woman came to his wake who had known my parents even before I was born. She told me that when I was a few weeks old, my mom called her and said, I cannot do this anymore. Sarah is in the closet and she's crying, and I can't stand this anymore. I need help. I never knew this story. My mom passed away 14 years ago, and I never thought to ask about motherhood before I had kids. This was remarkable!
This friend came and picked me up – she lived a couple miles away – and I stayed at her house for three or four weeks! And my dad would go over and visit me every day for a couple hours. She had two toddlers at her house, but this was who she was. I asked her, What did my mom do? And she said, I think she knew there was no treatment, no one talked about it. I think she just rested. She kind of got herself back together.
I said to the woman, Well, let me tell you what I do for a living now. She was blown away. I'm still processing the whole story, but I'm thinking about how brave my mom was to ask for help. There was no conversation about this 40 years ago. And the importance of knowing that PMADs are genetic, too – it's very informative to me that my mom struggled so significantly.
Wow, that’s an amazing story. One thing that I appreciate about your work is that you seem to be continually learning. Can you share more about how your clinical approach has evolved over the years?
Being a lifelong learner feels very true for me. I think being a mom has amplified that, because you are always learning; every day you have to adjust! But professionally, I look back when I finished grad school for social work in 2010, we learned a lot about being a blank slate, just being this completely neutral person for your clients to bring all of their stuff to. I've wrestled with that idea a lot over the years. I don't think that's 100% necessary, I think there's a lot of nuances. I think being genuine and being a human and bringing parts of yourself to the therapy experience is really important. And actually, I get a lot of feedback from clients that they appreciate when the therapist is human themselves. It’s not a hierarchy.
I think the conversation around privilege is a huge part of that. If we are this blank slate, then we're ignoring everything culturally, too. We're ignoring the fact that I'm white and I'm a female and I've had two healthy children, and I'm married and live in a suburb. All of that comes into the therapy space, and I don't believe that we can or should ignore that. It doesn't mean I'm introducing myself in all those ways when I meet a new client, but I think it's very important to be aware of all this and bring it in when it feels necessary.
You’ve been involved with Chamber of Mothers and PSI-MA (Postpartum Support International’s Massachusetts Chapter), which is awesome. How does your activism tie in to your clinical work?
I feel like it's super connected, because no one person exists in a vacuum. When I'm meeting with someone individually, I'm well aware that as soon as we end our session, they're back into their family system, back into their community, their town, whatever other systems [they live in] – you know, racism, gender issues. I believe that we as professionals need to be advocating for changes for the populations and the people that we care about and that we work with on a daily basis.
The Chamber of Mothers has three pillars that they advocate for: affordable childcare, paid family leave, and improved maternal health outcomes. I'm a firm believer that all those are huge and impact not only my individual clients, and me as a person, but also our community, our systems, economics, the bigger world. And then Postpartum Support International is a remarkable organization advocating for perinatal mental health. I appreciate them tremendously.
One great initiative that I've been fortunate to work with the Chamber of Mothers on is this educational acronym that I created: HEAL MAMAS. We have it on posters and magnets, and every letter stands for something different that folks in this prenatal or postpartum realm could be looking out for. So, if this was on someone's refrigerator, their partner could look at it and say, Oh, interesting. I'm noticing that it's talking about Apathy. My wife is feeling pretty apathetic, she's not herself. Or, Medication, I wonder if she's still taking her medication that she was taking prenatally? Things like that. It’s using evidence-based information and putting it all into one concise tool. We don't have to wait for a doctor's appointment – this puts this in the hands of anybody to help their loved one.
That’s great! What do you wish were different in terms of how we as a society support perinatal moms and families? And how can we do better at supporting perinatal mental health, and mental health generally?
I would love if we all got annual mental health exams and screening. Just like we check on our physical health, we have lots of normal tests for that. But we don’t do anything to check on our mental health.
And perinatal mental health care should be standard. [In the current system, you have to have] insurance, you have to meet certain criteria clinically, or wait till you’re feeling horrible and literally can't get out of bed before you qualify for mental health treatment. Prenatal and postpartum mental health care should just be baked in: every insurance, every hospital, every birthing center. We know what a difference it can make when we catch folks before they hit their worst, so that would be huge.
And there's still so much stigma around mental health, so I try to talk about it as much as I can. Making it analogous to physical health can also be helpful. People are very comfortable talking about, you know, I broke my leg, or Diabetes runs in my family. Why don't we talk about mental health that way? It would be a lot more commonplace, and it would reduce the stigma. We can just acknowledge, Depression runs in my family, so I'm on the lookout for it. It's not your fault, it's not a big deal. We have ways to treat it. We might not be able to make it go away, but we can certainly improve your life.
What’s your favorite part about being a perinatal-focused therapist? What would people be surprised to learn about the work from your perspective?
I love this question! What I like best is when I can help relieve a client's pain, or their shame or their guilt. Sometimes that can take years, and sometimes you see the moment that it happens in a session, and it's truly remarkable. That person is struggling so much, or they're feeling so much shame about something, either as a parent or something from their childhood, and the ability to help them relieve even a little percentage of that is . . . there's nothing like it.
And the most surprising thing is: how hard moms still are on themselves. Moms are, like, drowning in guilt. There's so much pressure on moms right now as a society. From the pandemic, and social media, the pressure to keep up with the Joneses and do this perfect holiday or have a perfect birthday, or whatever school your kid gets into. We put up this façade that it’s easy-breezy, like out at the playground or at school pickup or drop-off, but there's so much guilt and feeling like we're not doing enough.
Every time I hear that I'm like, Oh my gosh! Because I'm also hearing how much the person is doing. I'm like, You're doing incredibly! You might be struggling with depression right now, and you're still showing up for your family every single day. There’s still so much guilt and shame and feeling of not doing a good job, and that surprises me every single time I hear it. There’s no reason for that. We’re all doing more than enough.