In 1972, while pregnant with me, my mother experienced extreme feelings of sadness and apathy. I was her third child and she had never experienced such unshakeable emotional indifference. A trained nurse, she began to wonder if she was suffering some kind of medical or mental issue. She asked her OB-GYN if he had ever treated pregnant women for depression. “Only when they’re pre-psychotic,” was his oh-so-sensitive response.
Unable to shake her concerns, she decided to approach our family priest. “Stop watching soap operas,” was his invaluable input.
My mother never watched soap operas.
When she reached out to my father for support, his own ignorance and fears rendered him disabled. He couldn’t help.
So, my mother struggled, fighting not only depression, but also a whopping case of obsessive-compulsive disorder. Determined, she “pulled herself up by her bootstraps,” as we are fond of saying in New England, and reached out for help through a local mental health facility, finding a therapist who helped guide her out of the dark with a combination of talk-therapy and medication.
Of course, the mindset on “problems of the head” were not highly evolved in the backwoods of New Hampshire back in the early ’70s, so she kept her treatment quiet. Even in the privacy of our home, my mother referred to medication as her “pills” and her therapist as her “special friend.” (A term, I later told her in my teens, which made it sound like she had a secret lesbian lover, and wasn’t it better to just go ahead and say “therapist?”)
While we’ve come a long way with the identification and treatment of mental health disorders since then, we have miles to go as a society. There is still a stigma, a feeling of shame and embarrassment that accompanies the admission of such issues, as if anything related to the brain must be locked away in the attic like Rochester’s lunatic wife. But how is what happens in our brain different than any other “socially acceptable” health problem, like a thyroid imbalance or diabetes, which can be discussed openly? This philosophy of embarrassment is not only misguided, it’s also dangerous.
Had my mother not reached out and simply surrendered, sinking into the quicksand of depression, where would I be today? If my mother had not sought treatment, would I even be here?
A recent study conducted by the University of Texas Southwestern, funded by the National Institute of Mental Health (NIMH), compared the effects maternal depression had on children from mothers who were treated for antenatal depression versus those who went untreated. The study, called STAR*D (Sequenced Treatment Alternatives to Relieve Depression), followed moms struggling with depression and their children over a four-year period, starting in 1999. (STAR*D is the nation’s largest multi-site clinical trial on treatments for depression and was recently published in The American Journal of Psychiatry.)
In the conclusion of the STAR*D study, Dr. Trivedi, professor of psychiatry at UT Southwestern and the study’s co-author, reported that “The faster we can get mothers better, the greater impact on their children:In the long term, children will have a better outcome than if you take more time to get their mothers better.”
I’m sympathetic to all depressed mothers’ plights, not simply because of how it affected me in my childhood development, but because I too, have struggled with a mood disorder that surfaced during pregnancy.
Somewhere in between discovering I was “in the family way” and the time I shared the news with my own family, I had a bad day. I was cranky, moody, difficult. Then came another bad day. I cried for no reason; I let the answering machine pick up calls from well-wishers – calls I never felt like returning. I stopped going out with friends, only leaving the house when it was totally necessary and then not at all. One bad week turned into two, then three. I didn’t feel like watching TV or reading or cooking or even taking a shower. I slept. Yes, sleeping was my new hobby. “Get all the sleep you can now,” people said to me, “because when the baby comes you won’t get any!” I told myself I was just tired because it was my first trimester. But I was lying.
Even though I was conscious that the human body makes certain biological and hormonal accommodations for pregnancy that can seriously tweak brain chemistry – and knowing what my mother went through – I was reluctant to admit to myself, or to my husband, that I was trapped in the rising waters of depression and anxiety, unable to pull myself to shore. I needed help.
But how to seek help when you’re supposed to be a rosy-cheeked Earth mother basking in the joy and magic of your “with child-ness”? Who do you call when you’re stuck in a bottomless sadness, torturing yourself with the million-dollar question: “Does this make me a bad mother?”
In this modern world of immediate connectivity and infinite information, many sufferers of maternal depression will reach out online in search of scientific answers or a sisterhood of support. Of course, many of the ante-partum depression “facts” you will find have not been vetted, tested or proven, which sadly doesn’t keep them from appearing and reappearing on various “medical” sites, creating more misconceptions and narrow-minded fears about mental health, further boosting your fears that you’re a social pariah.
And as for the supportive sisterhood? I’m not saying it doesn’t exist, but one certainly shouldn’t expect to roll right from their Google search to the entry of the Red Tent. You laugh but, before I got pregnant, in my incredibly fertile imagination, I had woven a lovely fantasy of Motherhood. I imagined that news of my fertility would reach the high priestesses and I would be led to the Tent. One of the elders, gorgeous and wise, wrists stacked with bangles, would fold back the entryway flap and offer me a cup of homeopathic herbal tea as she guided me into the mystical teepee of maternal wonder to share the secrets of those who birthed before me. But you know what I found when I Googled “pregnancy, depression, treatment with antidepressants”? An angry posse of she-witches, winding up to stone any depressed, drug-addled, baby-poisoning, interloper who wandered into the Province of All-Knowing Supermomdom.
After my depressing trip around the World Wide Web, I came clean with my husband and my doctor. Together we decided that the one-two punch of talk therapy and Prozac would be the best way to knock my depression out. And it was the right call. Within weeks it was like I had been pulled out of the dark and the future seemed bright once again.
Even though I was hopeful and feeling better, I was reticent to share the secret of my chemical savior. I feared the judgment, even from friends, that would follow my admission. After all, I know several mothers who won’t let their kids eat sugar or wheat. Some even pump and dump after a gargle of Listerine, just in case! And here I was deliberately introducing Prozac into the placenta. And, as I had learned online, everyone has an opinion about expecting mothers taking antidepressants and how “selfish” it is to willingly endanger their children.
Those who judge so harshly and force the conversation to be about “mother’s health vs. baby’s health” have never been depressed, I’d wager. They lack the understanding that depressed mothers who go untreated can endanger their unborn children in entirely different ways: not getting to regular appointments, neglecting self-care, eating poorly, sometimes even drinking or smoking during pregnancy, in some cases suicide.
And therefore the myth of guaranteed maternal magic is detrimental. When a newly pregnant woman finds herself in the crosshairs of her desire to be the brimming icon of beauty and fertility seen on magazine covers and the reality of the consuming, terrifying, pounding storm of antenatal depression, she must believe that that she can safely reach out for assistance without fear of rejection or admonishment.
Being depressed did not make my mother “pre-pyschotic” or a “bad mother.” It made her an exceptional mother, a brave mother, a mother who fought through extraordinary pain so that she would be able to fully love, nurture and protect her children. And is that not the very definition of “mother?”
Today I am good – better than good. I am the mother of a happy, hilarious, intelligent, extroverted three-year-old. When I remember the darkness, the struggle, I pull my son onto my lap and breathe in his delicious smell. I make monkey noises that send him into peals of laughter, and soon I am laughing too.
Depression and I may be destined to meet again, but now I know my enemy and if I must return to battle, I am ready and I am well-armed.