Mothers/Parents and Mental Health

This is a really important article from NPR that I shared on our Facebook page a few days ago. It talks about postpartum psychosis, which is when a new mother has a break from reality. This illness is rare, but not as uncommon as you would think, because most women are too afraid to talk about it. According to the Massachusetts General Hospital’s Center for Women’s Mental Health, only 1 to 20 women per 1,000 will have this disorder. But here’s the thing: women are, consciously or subconsciously, held by society to be mothers. Women who fail at this in one way or another are judged harshly. Women whose mental health suffers and affects their children are dealing not only with the stigma of “bad mothering” but also with that of mental illness.

I am going to say this one time only: mental illness is just another kind of regular illness. The brain is just as much a body part as the pancreas, but one would never judge a mother with diabetes for needing to stop to adjust her insulin, or for needing insulin in the first place (well, at least we tend not to judge those with Type I diabetes – the stigma against fatness is a whole other blog post).

Sometimes our bodies fail us. It is simply a part of being a living creature; we are imperfect.

And I do not deny that mental illness is a challenging thing to deal with. Unlike many other physical ailments, it can affect personality and that is truly a hard thing for those who suffer with it as well as those around them.

But it doesn’t make the stigma any more valid.

Here is a fact for you: Most medications are tested on men. Women have very different bodies and very different neurology, particularly in regards to hormones. Thus, being a woman and needing medication of any kind, you are already at a disadvantage. To add in something as complex as postpartum psychosis which, as we already noted, is dealing with two stigmas, and to try to balance the body and mind with a medication that hasn’t been tested on women, especially postpartum women, is a problem. (Here is a video that talks a little bit about the gender gap in medication testing. The video itself is about pain, but it’s not irrelevant because we do know that the gut and the brain, as well as the immune system and the gut, are connected in ways we do not fully understand.)

And the stigma is built into the mental health system, too. For instance, in trying to find care for my daughter (it is okay with her for me to discuss this publicly), we were met again and again with limited care for mental health. There are clinics here who will only see a patient for 13 visits, with a second set of 13 visits possible if still necessary, but no more. This may be logical for a kid who is simply needing to learn some coping skills or needs help navigating difficult interpersonal connections. But for a kid with a true mental illness, it is simply not enough in any way, shape, or form. You’d never find a medical hospital with a 13-visit limit on any other kind of care. If a child goes through the expected number of chemo sessions and still needs medical help, they will get appropriate medical care. But this isn’t true of mental health care. The stigma is built into the system itself.

If you read that NPR article, you will see the difference between care models here in the US and those in the UK where babies are sometimes allowed to stay with mom. Here in the US, however, infants are not even allowed to visit and breast pumps are not readily available. This is a woman’s problem in that it affects women directly, but it is a social problem when we consider the time off work the woman’s partner will need to take, the childcare involved of the infant and/or older children. Something like this could make or break a family’s survival and here in the US where we don’t offer healthcare to everyone, health problems often do break families, forcing them into poverty and potential homelessness.

I am not over-exaggerating.

I’d also like to quickly note that, yes, police can be involved in mental health cases where it is not safe to transport a person yourself. If you need to call for care (at least here in San Diego – you will want to look up your own local information) you should ask for the PERT team (psychiatric emergency response team). They will handcuff the person while transporting them and, while this is often perceived as treating them like criminals, it is not the intention to do so. It is done for safety and probably policy reasons. Perhaps this is something we need to work towards changing – I’m down with that. But I’m sharing this right now primarily because I think this is important information for the general public to know – it’s certainly not something you want to be surprised by at your lowest moment, and it’s something that can be so easily misunderstood.

So, what do we do about this problem of mental health care, in particular as it pertains to women?

Well, first of all, we share the facts. Women are at a disadvantage when it comes to appropriate medical care. People struggling with mental health issues are at a disadvantage when it comes to appropriate access to services and care. Women struggling with mental health issues are dealing with this from every angle, and women of color or other oppressed groups are oppressed even more. So talk about this. Share the facts with your friends and family even if – especially if – they do not pertain directly to you. A voice outside the community can be a powerful ally.

Second, listen to your friends and family when they speak of their mental health issues. Do not tell them how to fix it, do not offer suggestions. Instead just tell them that you hear them. Offer to help them find services (here in San Diego the Access and Crisis Line is your first stop). Promise that you don’t judge them and that you love them. Remind them that this is just another illness like any other illness and the fact that it is happening in their head doesn’t make them any less worthy of help or love.

If – and only if – you are ready to share your own story of struggling with mental health, share it. The more people admit secrets, the more we find we are not alone – just like with our pictures of our bodies here, we can stand together and be stronger than we are alone. If you want to share your story here, you can do that here.

And if you are a mama or a parent who has struggled with mental health issues of any severity, I am here to tell you that you are not alone and that it does not make you a bad parent. You are worthy of love and life. It is scary sometimes to seek help, and I will admit that sometimes even mental health practitioners are terrible at understanding mental illness, but keep moving forward. Don’t allow yourself to believe anyone – professional or not – that mental health problems are something you should be ashamed of. It’s simply a thing that happened, just like any other challenge people face, no stigma necessary, no judgement at all. You are strong and worthy and beautiful just as you are. I see you and I hear you.

All in due time – There is hope (Joss)

Age: 27
Number of Pregnancies: 3

I had my first child when I was 18. Before her I had a beautiful body, that I was proud of. (Of course most 18 year olds do) After I had her I had NO idea what i was “supposed” to look like or what it was going to do to my body. I wish I had found this site back then. I was so depressed I refused to look at Victoria Secret catalogue’s or associate myself with anyone who could wear a bikini. I was beside myself because of how “messed up” my stomach was. Fast forward a year and I was still so upset about how I looked even though looking back NOW, my stomach looked fine. I swore and knew I was never going to show my stomach to the light of day or public ever again. I had two more children over the last 6 years, and of course my stomach has only gotten worse. (Saggier) I walked around with a heavy weight on my shoulders year after year, and became a single mom. I was depressed for so long. I always felt like no one would ever want me and I wasn’t good enough.

Between a major depression, anxiety, and agoraphobia, I started practicing meditation and exercising (which miraculously pulled me out of that state) I found a happiness with myself again. Which in turn had its affects. I have a much longer story but my main point of this post is to let all the beautiful mommies out there know that it’s ok to be in your skin. It took me 4 years after my last child born to accept my body. A big influence was pole dancing (I’m not saying that’s what you need to do, to feel better about yourself) But it was my outlet and helped me gain my confidence back. I found this site probably 6 years ago and I checked in on it over the years to hear other woman’s stories, to not feel alone. Today was the day I felt like it was appropriate to tell my story , since yesterday I wore a bikini at the pool for the first time in about 10 years. I was scared about the looks I’d get and it felt so uncomfortable, but I f****** did it! I didn’t care what anyone thought. I was a mommy, and I had my three babies with me and we were having fun in the sun. It was a liberating feeling! If people didn’t like it, they didn’t have to look at me.

I actually bought a top that shows my stomach a little bit. I’ll find somewhere to wear it. Lol
I woke up this morning and felt skinny and took a picture. In this picture I’ve had 3 children and my last is 4 years old. The skin on my stomach isn’t pretty or “tight” anymore, but I’m happy with my body, it doesn’t matter what the rest of the world thinks. I wish anyone who reads this, a new found love for their mommy body. I hope to be an advocate for mothers who’s bodies are “different”. Sending positive vibes and love.

062618-joss-1

The Others (Anonymous)

Your Age: 36

Number of pregnancies and births: 3 pregnancies. 1 birth, 2 abortions

The age of your children: Son born September of 2008. Abortion in 1997 at eight weeks and in 2009 at four.

I have always had depression and anxiety, I have no memory of a time when they weren’t present; according to my family I was an anxious infant. I began seeing a psychologist at around age six. After much pleading, and at the recommendation of my psychologist, my parents finally agreed to let me take psychiatric medication at seventeen. It was like the world opened up. Suddenly things that had seemed difficult were attainable. I remember being excited to drive to the house of a friend who lived an hour away. Goddamn, that sounds pathetic.

Post medication I wouldn’t describe myself as being ‘fixed’ but I was certainly far more functional. I could hold down a job and was able to live on my own.

When I was twenty-seven my husband and I decided to have a baby and I went off my medication to do so. I thought I’d be okay.

The only reason I didn’t kill myself when I was pregnant was because I knew I would fuck it up, kill my baby, lose my nerve and then have to live with that the rest of my life. I was very aware of the point in my pregnancy when having an abortion would no longer be legal and up until that point there was always the voice in the back of my mind that if I needed to I could still back out. I wanted a baby very much, I wanted this baby very much, but I was catastrophically depressed. I had vivid dreams where I killed myself and/or my child.

And he was my child. From the very first moment I found out I was pregnant I wanted him, I loved him. I wanted him before he was even conceived.

I thought things would be better after I gave birth, but I was wrong. He was a month early. It’s possible he was early because I was so depressed that I was barely able to eat and he wasn’t getting the proper nutrients. Who knows.

I was hospitalized for the first time when he was eight weeks old. After much deliberation, and many conversations with friends, family and health professionals, I signed myself in voluntarily because I wasn’t able to function. I was unable to sleep, even when my son was sleeping, and at the time that I signed myself in I hadn’t slept for approximately two weeks and was starting to hallucinate.

While I was in the hospital I was able to see my son once daily in a cold, brightly lit conference room that was one floor below the psych ward. I brought a small manual breast pump with me to try to keep up my milk supply and pumped several times a day and throughout the night. Because of the medication I was given I had to throw most of it away.

I was released after a week.

When he was twelve weeks old I was readmitted after taking an overdose of a Ativan. I blacked out in the emergency room as they were placing an IV catheter.

My first memory after passing out is standing naked in front of the mirror in the bathroom off my hospital room and seeing my milk swollen breasts covered in the sticky residue from the EKG leads. I was emaciated because I had been fighting to breastfeed in spite of not being able to eat. To be honest I’m not even sure if that memory is true.

I have been hospitalized since then.

But what I want to talk about, what I feel doesn’t get talked about enough, are the pregnancies I chose not to carry to term.

The first time I got pregnant I was seventeen and about a month away from beginning my senior year. I had just started taking medication for my depression and anxiety. My boyfriend (A) and I had been together for about six months and things were great. We had both had prior sexual relationships but we were each other’s first loves. We were pretty careful over all but there was one night where we got carried away. He didn’t ejaculate inside me. Didn’t even get close. But there was penetration without a condom and apparently that was enough.

When my period was late I took a test. The line was very faint but it was there. A and I looked at it and tried to convince ourselves otherwise but there was no denying it. I told my mother and she took me to the doctor. The nurse congratulated me and calculated my due date as I sobbed.

When I went to A’s house after the doctor his first words to me after I told him the home test had been accurate were, “You’re going to have an abortion, right?”

I was always pro-choice. I always had in my mind that if the situation arose I would have an abortion without a second thought. I would tell every new partner that he had a choice: to know or to not know. A was the one who was pro-life and suddenly he didn’t want to discuss it. I wanted to discuss it. I didn’t think I wanted a baby but I loved A and there was a part of me that imagined the three of us together as a family.

It was 1997, RU-486 wasn’t available, and the clinic told me that I would have to wait until I was eight weeks along to have a surgical abortion.

We did end up talking about it, A and I. We did lots of talking in the four weeks between when I found out I was pregnant and my appointment at the clinic. I had been unsure that I ever wanted to have a child but during that four weeks I realized that I did. Someday.

I had made the appointment for a Friday so that I would have the weekend to recover before going back to school. The clinic was 45 minutes away from where we lived and it was to be an all day affair. We arrived in the morning and were shuffled from room to room. I filled out endless amounts of paperwork, took a pregnancy test, had my blood type checked (they screwed it up*), saw a counselor, and had an ultrasound. Between each step we waited in rooms with other women who were either with a partner or friend. No one talked much or made eye contact.

A was in the room with me for the ultrasound. I asked to see it and the technician seemed a little uncomfortable. She left it up on the screen when she stepped out of the room for a moment. We both looked, A and I. The image was still and grainy.**

After hours of waiting and paperwork and testing and talking and somehow even more waiting they led me away from A and into the secure part of the clinic.

They took my vitals, gave me a key on a plastic bungee to put around my wrist like at a public pool and directed me to a bathroom with lockers. I took off my clothes, stowed them in the locker corresponding with my key, put on a hospital gown from the pile on the shelf and went to meet the nurse.

I was taken to a small room and given a sedative.

The nurse was kind, she stroked my forehead and said it would be okay. The doctor introduced himself but all I remember of him is how the powder from his gloves had collected in the creases of his hands which I noticed when he shook mine. I remember looking up at the ceiling and seeing fall leaves through a skylight, but I don’t think that’s right. I don’t think that’s a true memory because I think the room was in the basement. I don’t know if the doctor is a true memory either.

I do know that I felt a pinch deep inside, and in that split second I thought I could still get up and leave and have it not happen. But I didn’t leave and then there was only the gentle hum of the machine.

When it was over the nurse lead me to a room full of reclining chairs set in a half circle facing a television playing an endless loop of aftercare instructions.

Upstairs everyone had been looking at everyone else out of the corners of their eyes. Down here women were looking at each other directly, telling their stories and asking questions. One woman talked about her young daughter and how she couldn’t possibly support another child.

The first time they had me get up to leave I nearly passed out in the bathroom. I tried to wipe the blood off but it just seemed like there was more where it came from no matter what I did. I started to get dizzy and then went for help soaking the tops of my socks in blood as I shuffled down the hall to the nurse’s station.

The second time I got up I felt much better and was able to get cleaned and dressed quickly. I met with a nurse about aftercare and birth control and then was brought out of the secure area. A was waiting for me on the front steps of the clinic smoking a cigarette. He drove us back to my mom’s house and we watched the movies we’d rented earlier in the week.

A and I were together for a little over a year all told. Approximately six months before and six months after the pregnancy, maybe a little more or less in either direction. He broke up with me and it was all the more painful because I had pictured having a child with him someday. We stayed in touch for a few years, he went into the marines and I went to college, and somewhere we lost touch.

There were times when I thought what if. Absolutely. I would sit in the tiny little one bedroom apartment that I loved in the shitty part of town and wonder for a moment where on earth I’d fit a child into my life. The answer was always no where.

Regret isn’t the word. Ambivalent relief is closer.

Eleven years after my first abortion, while I was pregnant with my son, A got back in touch through a mutual friend. He apologized for ‘making’ me have the abortion and for leaving. He said he thought we could have made it work and that he had made a mistake. We’ve been in touch regularly in the past eight years and our interactions are always positive. He has a four year old son with an ex girlfriend and his current girlfriend has two children. He’s a great guy and I value the relationship that we have.

The third time I found out I was pregnant my son was a year old. I had planned to get an IUD or Essure when he was six weeks old but that had been derailed by my experience with postpartum depression and previously undiagnosed bipolar disorder. I had actually made an appointment with an OBGYN (my son was delivered by a midwife) for birth control but got lost on the way there and then my son began to cry because he was hungry. I had a panic attack and went home. I begged my husband to get a vasectomy but he would just say that I was going to change my mind and want another baby someday.

We used condoms, although clearly not compliantly, and I took Plan B on two occasions when a condom slipped.

I’m not sure when exactly I got pregnant but I took a test two days before my son’s first birthday. I said to my husband, “Fuck, this thing says I’m pregnant.” It was four in the morning when I took the test and as soon as the nearest clinic opened I called to make an appointment.

It was 2009 and RU-486 was available so I was able to make an appointment for the next day instead of having to wait until I was farther along.

My husband refused to go with me to the clinic because he was angry with me. He wanted me to continue the pregnancy in spite of the danger to my health. Our roommate drove me instead.

Even though it happened more recently the second time is less memorable than the first. I know I filled out paperwork, had a physical and blood work, but not much sticks out. This time there wasn’t much to see on the ultrasound, just the amniotic sac, since I was only about four weeks along. I asked for a printout of the ultrasound and it’s in a box along with the things I saved from my son’s first birthday. This time when they offered me RhoGam I declined. I told them that if it were just a case of bad timing I would continue the pregnancy, but it wasn’t just bad timing, I can never have another child.

I met with a counselor and it turned out that she had worked at the clinic I had gone to the first time during the time I had gone there. It was twelve years later and we were halfway across the country from where we’d been but here we were.

I cried as I talked to her and she commented that I seemed really angry. I hadn’t realized that I was until she pointed it out. I was angry at myself for not having been more careful – I still don’t know where we screwed up – and I was very angry at my husband for not listening to me when I told him I didn’t want and couldn’t have any more children.

They gave me the mifepristone to swallow there at the clinic and the misoprostol to take home with me to insert into my vagina the next day. They also gave me a prescription for Vicodan before sending me home.

On my son’s first birthday I inserted the misoprostol tablets, took a Vicodan, and waited. It didn’t hurt much. The bleeding picked up considerably in the middle of the night and when I sat down on the toilet there was so much blood pouring out so quickly that it sounded like I was urinating. I had planned on trying to look for it so that I could see it but I just didn’t have the energy to turn on the lights, let alone fish around in the toilet for a tiny lump of flesh.

The second time was much easier. I knew what it was like to have an abortion and I knew what it was like to have a child. The choice was pretty clear. The pill felt much less invasive as well since I was able to be in my own home. I didn’t experience much discomfort, the Vicodan made me feel relaxed and I mostly slept.

I would say that both of my abortion experiences were pretty positive given the circumstances. I didn’t have much pain either time, nor do I have regrets. I feel bad for A that he ultimately wasn’t happy, I feel bad for my husband, who wanted more children, and for my son who wanted siblings, but for myself I feel thankful that abortion was an option available to me.

I’ve started talking about my abortions more frequently and openly in the hopes that if I put a real live human face on it I might be able to change some minds. I’d found myself getting irritated that there are so many high profile women who are willing to say they’re pro choice and yet so few have come forward with their own stories, but then I realized I was doing a much smaller version of the same thing. Arguing in hypotheticals isn’t as effective as using particulars. If I can sit down with my pro life friends and tell them about my experiences maybe next time they go to vote they’ll think of me, an actual woman they know and like, and vote differently. It’s important that we keep abortion safe, legal, affordable, and accessible because, as we’ve learned over and over, making it illegal doesn’t stop it.

So I’ve started talking, and I hope more women do to.

030617-anon-1