Postpartum psychosis

Climbing Out of The Darkness

A few months ago, I wrote a letter to Miriam Carey, the mother who lost her life after a chase with police at our nation's Capitol.  After her death it was revealed that she suffered from some form of mental illness, possibly triggered by postpartum depression or postpartum psychosis. In that letter I made her and her daughter a promise: that I would do better, do everything in my power to make it so that mothers like her, like myself, don't suffer in silence, nor fall through the cracks of the healthcare system in our country. I promised her that I would continue to be a voice crying out for those in our communities to take our mental health seriously and to seek treatment-even if it felt like I was speaking in a silo, into the wind, and no one was listening. I promised I'd do better so her daughter wouldn't be ashamed to seek mental health help if she ever needs it as she grows older.

I've been working very hard since then to live up to that promise, even if it just involves me being completely honest here about where I'm at mentally. I haven't erased my YouTube videos, even though I haven't updated it in months and regret that I haven't seen that project through like I wanted. I do, however have other projects in the works that hopefully I will see through and that will help me carry out my promise to her in tangible, impactful ways.

I WILL be a change agent.

**

When I was thinking of writing this post-what I wanted to say about why I volunteer my time and resources to Postpartum Progress, and why I'm asking for your support, I thought of Miriam, my promise, and then I thought of myself.

I thought back to January 2011. I don't remember the exact date but I remember it was nighttime, and I was sitting in the dark, crying as I sat in front of my laptop typing words into Google search. I had spent the previous hour sitting on my bathroom floor, envisioning my family coming in and finding me bleeding to death in the bathtub. I'd been having suicidal and intrusive thoughts for over a week, and was exhausted from the mental strain and impact of severe shifts and cycles in mood. I remember thinking about the people in my life who had told me that either nothing was wrong with me or that I was suffering because I wasn't "living right." No one could explain why I was feeling insanity dance within me, and no one understood because I could barely articulate what it was that was happening to me.

I remember feeling the exhaustion settling in deep within my bones, overtaking any resolve that remained. So there I was, Googling what I thought were my symptoms. The first link in the search results was Postpartum Progress. I spent the next 3 hours reading everything there: posts, comments, the "Plain Mama English" guides that outlined the symptoms of perinatal mood disorders. I remember crying as I read everything, realizing that I finally had an explanation for what I had been enduring since even before I gave birth to Alex. The rage...the sadness...the anxiety...the compulsions...the intrusive thoughts...the guilt...there it all was, laid out for me in black and white on the screen.

I emailed Katherine Stone, the founder. She emailed me back, encouraging me to seek help and telling me that no, I wasn't crazy, and yes, I would get better, and there as hope for me. She directed me to the Postpartum Stress Center in PA where I eventually started treatment.

Hope and a lifeline. She and Postpartum Progress had given me both.

***

Postpartum depression and related illnesses like postpartum anxiety, ocd, and psychosis, are the most common complications of childbirth, impacting 1 in 7 women, and at a higher rate of 1 in 4 women in minority, lower-income, & impoverished communities every year. Suicide is among the leading causes of death among new mothers every year. (As I mentioned above, it nearly took MY life) With these kinds of grim stats in mind, Postpartum Progress has grown from just a blog, to a non-profit laser focused on improving the maternal mental health of women worldwide through a variety of programs.

For example, in the next 24 months, Postpartum Progress will be updating and expanding the blog including a Spanish language version, creating a video PSA, and starting the development of a mobile app that supports moms through PPD and related illnesses.

These are the kinds of initiatives that Climb Out of the Darkness is designed to help fund. Climb Out of the Darkness is THE first event of its kind: one designed to spread awareness of perinatal mood and anxiety disorders, and help fund Postpartum Progress' efforts to reach every mother, in every community, on every socioeconomic level.

I'm joining mothers all over the world-there are climbs in London, New Zealand, Canada, and South America-to raise money  over the next 48 days that will help Postpartum Progress help every mother and their families have the strong start they deserve.

I did it last year to honor my experience and ascent out of the darkness I found myself in that night in 2011. This year, I'm leading a team of survivors here in Austin, and I'm doing it for Miriam. I'm doing it for the other women who have lost their lives in the last 12 months to suicide. I'm doing it for the mothers in communities that lack access to adequate mental health resources, for the mothers who have no insurance, who are at risk and don't know there's hope and help. For the mothers who are ignorant of the facts and range of their symptoms because their OB doesn't have adequate information in their brochures on PPD. For the mothers who just think that PPD is nothing more than being sad and doesn't understand why she has scary thoughts or full-blown rage she's never in her life experienced up until this time in her life.

Some quick facts on PPD and related illnesses:

  • PPD and related illnesses happen to ONE MILLION WOMEN in the US alone each year.
  • Only 15% of moms with PPD and related illnesses ever get professional help. That means there are more than a half a million mothers (in the US alone) each year who have not gotten any help.

  • The National Research Council reports that untreated PPD is associated with impaired mother-infant bonding and long-term negative effects on the child’s emotional behavior and cognitive skills, lasting into adolescence and adulthood. The Urban Institute says the biggest tragedy of this illness is that it is treatable and thus we could be preventing the damage it has on so many mothers and children.

  • The annual cost of lost income and productivity in the US of not treating mothers with depression is $4-5 billion.

Let's not lose any more mothers to these very treatable illnesses. Let's eradicate the shame associated with these illnesses that keep so many from seeking treatment. Would you consider a $10 or $20 donation this week? Team Austin's goal is to first raise $500, and then stretch to $1k. We're over 60% of the way to $500. Help us get there?

Thank you SO much for your support. Seriously. You're helping us save lives. You're helping us save the other Miriams & A'Driane's out in this world.

To join a climb in your area, click this link: https://www.crowdrise.com/COTD2014

To donate to our team here in Austin, click this link: https://www.crowdrise.com/addyeB-COTD2014/fundraiser/addyeB

To read my latest post over at Postpartum Progress, go here: http://www.postpartumprogress.com/postpartum-anxiety-comes-back

If you or someone you know is struggling with suicidal thoughts, you are not alone. Please call 1-800-273-TALK (8255), and you’ll be connected to a skilled, trained counselor at a crisis center in your area, anytime 24/7.

Universal Mental Health Screening for Pregnant and New Mothers is a MUST

Every mother. Every time.

pregnant mother of three drove her minivan into the ocean at Daytona Beach yesterday. She was reportedly incoherent when questioned by police and is undergoing a mental health evaluation at a local hospital. She is believed to be suffering from psychosis. 

Every mother. Every time.  

A mother in Chicago is being held on $1 million dollar bail today after she tried to kill herself and her 8 month old son by causing head on collisions with other vehicles, not once, but twice. 

Every mother. Every time. 

Out of ignorance I used to judge mothers who committed such acts. But during my second pregnancy, I started experiencing symptoms of antenatal depression and had fleeting thoughts of suicide. After I gave birth, I spent the first year of my son's life crippled with anxiety, despair, and found myself planning suicide 2 months before his first birthday. I wanted to be free of what my mind had fallen prey to. I wanted relief from the intense mood swings, frenzied OCD, and graphic intrusive thoughts that flashed in my mind unwarranted and unwelcomed. (Full disclosure: Driving my car into a body of water or into oncoming traffic? I've had those thoughts. Learn more about intrusive thoughts here)

Thankfully I found hope and help after a google search led me to Postpartum Progress, and I read about the full scope of perinatal mood disorders and their symptoms in "plain mama English." I sought and began treatment;  my diagnosis eventually changed to rapid cycling bipolar 2, OCD, and anxiety, and when it did, I began a medication regiment that included a mood stabilizer instead of just an antidepressant.

I don't judge anymore. Instead I recognize and question if these mothers recieved adequate help and support. I wonder if they felt safe enough to reveal their struggles or if the stigma surrounding mental illness in motherhood choked them into silent suffering. I wonder if  their obstectricians were taking them seriously if they disclosed struggling with the mood swings hormone fluctuations during and after pregnancy trigger. I wonder if their obsetricians and children's pediatricians screened them for depression and anxiety during pregnancy and beyond the 6 week postpartum check up. I wonder if they were told that depression and anxiety during and after pregnancy can manifest as rage, obsessive thought patterns and behaviors, and if they were made aware of the symptoms of postpartum psychosis, and told what to do if they began to hear voices or have delusions. I wonder if anyone told them that having an intrusive thought doesn't make them a bad mother, and doesn't mean they will harm themselves or their child. 

I wonder. 

I wonder what it will take for the medical community and our society to take maternal mental health seriously. I wonder when we'll give just as much care to women's minds as we do their bodies during and after pregnancy. I wonder how many more women and their children have to die because we aren't making a mother's mental health our priority when we care for and treat them.  

Every mother. Every time. 

What will it take for every obsetrician, every pediatrician, every insurance company to screen mother's during pregnancy and their infant's first year? Suicide is THE leading cause of death among women in their first year after childbirth, yet we stop screening for PPD, PPA, and postpartum psychosis after 6 weeks-if we screen at all. At least 50% of the 1 in 7 women who suffer from a PMAD go untreated, whether it's due to lack of screening, or access to support and mental healthcare. 

What will it take to screen and care for every mother, every time? What will it take to offer our mothers and their babies treatment and hope? 

 

There is hope. Women don't have to listen to the siren call of despair. Treatment makes recovery possible. We don't have to leave women to suffer silently on their own, trapped in their minds, unable to free themselves. But too often, we do. Women are being missed and overlooked. 

Every mother. Every time. We must screen. We must be louder than stigma's voice. We must enoucrage our mothers to seek treatment. 

If you believe universal mental health screening for pregnant and new mothers should be mandatory, please consider signing this White House petition. If you or someone you know is currently suffering, please know you are not alone. You are not a bad mother. There is hope and there is help. You can find information and resources at Postpartum Progress, and you can find a community of support on Twitter through the #PPDChat hashtag, and Postpartum Progress' private support forum. 

To read some more about my experience with PPD & Bipolar Disorder during pregnancy, you can type "ppd" in the search box here to find some older posts, and you can read guest posts I've written here and here

 

(addyeB)

To Miriam...

Dear Miriam, My head and heart have been reeling since your death. Upon seeing your picture and hearing details emerge about your struggles mentally and hospitalization, I sat crumpled in my bathroom, sobbing for you, your daughter, and for myself. You see, I saw your face, your brown skin, and I saw a reflection of myself-a mother battling a mental illness. Having lived in the darkness of postpartum depression I know the hopelessness, fear, confusion, and pain that consumes you from the inside out. Although I've never experienced psychosis, I have and do experience the chaos, scattered and fragmented thoughts, paranoia, and such that comes at times with having bipolar disorder. I know that my having such a mood disorder puts me at a much more significant risk of psychosis postpartum, and that terrifies me.  Like you, I've been hospitalized, trapped in my own mind, wandering the halls and monotony of the psych ward, getting help, but also wanting OUT and have some sense of normalcy back...whatever's left of it in your life at least.

I know how triggering and taxing an unplanned pregnancy can be on your psyche, even when you've accepted and embraced the new life growing within you. I know the disconnect you can feel once you're holding that new life in your arms minutes after delivery and long after you've been sent home. I know how difficult those first few months can be, and even that first year. And I know what it's like to need help, be in treatment, but not have anyone you can really talk to about it, no one who "gets" the upheaval your mind and well-being is in. I know what it's like to have to live with mental illness for the rest of your life. I know what it's like to have to make a conscious choice to fight for your life daily, and being too tired to make that choice most days. I know the stigma that comes with being sick, and taking medications. I know side effects and having to rely on meds is exhausting and at times can chip away at your feelings of self-worth, and leave you doubting your capabilities to mother, to accomplish goals and dreams...to LIVE.

I know all of these things and that is why I sat in my bathroom crying for you...for me...for your daughter, and for my unborn son squirming in my belly.

After my tears came questions: were you getting help after your hospitalization? Were your boyfriend, mother, and sisters supportive? Did they encourage you to stick with treatment-were they themselves educated on your meds and illnesses? Did you have a therapist and adequate access to other mental health resources? Did you have anyone, ANYONE to talk to? Were you afraid to talk to anyone? Were you compliant in your treatment? Did you decide to stop treatment because you figured you could do it on your own, or were you pressured to by those around you? Did anyone tell you the dangers of quitting meds cold turkey or talk to you about weaning? Were you given speeches about bootstraps and soldiering on? Did your doctor think you were getting better and miss something? Were you even properly diagnosed and given the right kind of treatment? What led you to DC that day? WHAT HAPPENED?

I know that because you are no longer with us to tell your story, we won't ever really have the answers to these questions-we won't ever know the full truth. My heart aches with this knowledge. My heart breaks that the events that took place unfolded the way that they did and that your life was taken.

Since your death I've seen lots of discussion in the media about the state of your mental health, and lots of misinformation and a lack of distinction between postpartum depression and postpartum psychosis, which is what it appears to be that you might have suffered from, or possibly some other form of mental illness. I've seen anger and outrage over how the police responded to your actions, and calls for an investigation on their use of force policy. I've seen what happened to you become politicized and I've seen people make ugly, disgusting comments about you, a woman they've never met.

I've seen all of this and all I can think about is your precious daughter. When I do anger wells up in me and boils, but not for any of the reasons I see it embodying others. My anger is with our community, with our people. I'm angry that within the black community there is no focus placed on our mental well-being and on mental illness. We fight to quell violence and hardship in our communities but do little to nothing to fight for resources that can help us deal with the mental impact violence, abuse, and hardship has on us. We don't talk to our children about mental illness, other than to point to "Crazy Ray" who lives down the street and further cement stigma about mental illness in their minds. We are misinformed and uneducated. We are ignorant. We think therapy and medications are for whites only. We are held hostage by a code of silence that throughout our history has kept us safe and helped us survived but is now killing us. Our churches tell us to pray more, have more faith, live right, strive for prosperity...but say nothing about the mental illness that is often quietly sitting amongst us in our congregations.

We will fight for Trayvon and for our black boys. We will march against those who believe it's better to close our schools and build more prisons. We will rage at police brutality and systemic racism across the board. But when it comes to our mental health and the facts on mental illness, particularly for the WOMEN'S mental health, we are cold...silent...apathetic...hushed...disbelieving and ignorant of the science and biological roots of mental illness and how vital a role environmental factors play in the manifestation of illnesses like depression, anxiety, bipolar disorder, and schizophrenia.

Our national black leaders and organizations speak little on this issue and make no demands for change. I would go as far as to say it's not even on their radar or list of priorities. Narratives and dialogue on mental health in our communities is driven and dominated mostly by white advocates. Those of us who live with mental illness and choose to face the stigma within our community and society at large often aren't given the same platforms and amplification as white advocates. Our outrage and concern for other issues drown out suicide prevention and mental health awareness. Campaigns and efforts are not targeted at us, in OB offices we don't see our faces on pamphlets on PPD or other perinatal mood disorders, and our doctors rarely screen us effectively for it. Medicaid provisions often keep our single mothers from being able to get adequate treatment and access to resources on the mental health front. (I speak from experience)

All of this...has me angry. Has me raging on the inside, and pushes me to do more with the space I have here. As a woman and mother of color with bipolar disorder who has survived PPD,  I look at you, your daughter, and what happened, and the role mental illness might or might not have played in this, and I rage and I feel a responsibility. To your memory and most importantly to your daughter who witnessed such horrific violence that day, I feel an obligation to do more, say more, fight for better within our community. Others can rage and decry the actions of the police if that's what they feel is most important. Speaking from experience I can say that law enforcement officials are not adequately trained on how to respond to situations when a possibly mentally ill person is involved. But I will rage and decry the lack of education and honest dialogue about mental illness on a national level and within our own community. I will rage and push for you so that your daughter and other women of color get educated and aren't ashamed to get help. I will rage against the "strong black woman" archetype that keeps so many of us from acknowledging we need help and treatment on this front. I will speak up, I will fight, I will advocate for you so that your death will not have been in vain.

I will do this because I know, Miriam, what it's like to be touched by madness and struggle to survive in its death grip. I will do this because your story and your death have shown me that its past time we rise up, get real, and take responsibility for our mental health....and take action. I will step up Miriam. I will continue to speak in the vacuum until our stories and experiences with mental illness are heard and taken seriously instead of dismissed or trivialized.

I'm so sorry we lost you. I'm so sorry you lost yourself. I'm so sorry your daughter will no longer have you. I'm sorry we couldn't do better by you both. But know that now? We will.