No one felt sorry for Andrea Yates, the woman in Texas who, suffering from postpartum psychosis, drowned her five children in the bathtub in 2001. But there was one moment in my life when I did, when I felt an unexpected flicker of empathy for her and for all the other mothers who struggle with mental illness or who have lost control.
Mental illness is in my blood like being Irish is in my blood — it’s just there, part of who I am. Bipolar disorder runs in my family. My sister took her own life last year. Several family members have been institutionalized. As I near age 50, I’ve come to feel there’s no shame in discussing these struggles; better out than in. I have learned there is a generations-deep war with anxiety and depression in our family, and I am not immune to it.
My own mental health issues apparently are relatively mild. My current therapist jokes that I’m “NOS,” or what they call in the Diagnostic and Statistical Manual of Mental Disorders, "Not Otherwise Specified.” I have a psychology degree and spent four years in college trying to diagnose myself (a pre-requisite for psych majors). Adult child of an alcoholic, check. Mildly neurotic, yeah. Garden variety depression and anxiety, sure, but really nothing to write home about. So, up until age 36, I never needed or sought medication for mental illness.
People who are diagnosed at an early age with bipolar or depression are faced with lifelong challenges of managing medication, negotiating their own identity, and coping with the effects of hormonal shifts and situational stressors on their conditions. For me, the mental health scales were tipped by hormone fluctuations over the course of a decade, during which I had seven pregnancies (four children and three miscarriages), leading me up to a moment of crisis when postpartum depression sent me literally running for help.
At 25, I gave birth to my first daughter, Sarah, at 29, my second, Molly. I didn’t experience any feelings of depression whatsoever surrounding their births. I began a successful part-time writing career while I raised my girls. After about two years, I had a miscarriage about 12 weeks into my pregnancy. It was a devastating loss — I’d seen the baby’s heartbeat, everything had progressed normally and suddenly the heartbeat was gone and I had to have surgery to remove the lost baby. Heartbroken, I sought out other women who had experienced miscarriages; they seemed to be the only ones who knew what to say. Others said the wrong things, awful things. Too soon after, another pregnancy came and another miscarriage at around nine weeks. I couldn’t understand why, after two full-term lovely girls, my body seemed to have forgotten how to be pregnant. It was only after this second miscarriage that I learned I had a condition called bicornuate uterus, which meant I’d only ever had a 50/50 chance of carrying a baby to term due to the shape of my uterus.
I felt as though I’d been told my body was some sort of Darwinian abortion factory. Only the fittest children could survive — the luckiest, who landed in exactly the right spot in my womb. How morbid was it, I wondered, how presumptuous, for me to choose to get pregnant again? Was it even fair, expecting a baby to survive in the adverse conditions of my substandard uterus? I felt immensely thankful to have had two full-term, perfectly healthy babies and thought maybe I should just quit while I was ahead. And then I found out I was pregnant, going through yet another miscarriage. I endured three D&C operations (dilation and curettage, aka the carving of your uterus, not unlike a pumpkin), and the worst moment was when an anesthesiologist assumed I was having an abortion and said something along the lines of “It isn’t too late to change your mind.” I just looked at him, bewildered, horrified he’d say that to a woman under any circumstances, and replied, “The baby is already dead.”
I’m sure many other women would have decided to call it quits after five pregnancies. I considered it. But I’d grown up in a large family and wanted one of my own. Although I was scared and my body was tired, I knew I wasn’t finished being a mother yet. It seems cliché to call it “motherly instinct,” but in my heart, despite the odds and the morbid condition and everything I’d been through, I guess I had faith that I would get through it. My third daughter, Faith, was born when I was 34, and her brother Bobby arrived two years later.
My own mother gave birth to seven children, and she always said it was after the third child that things got really tough, because you only have two hands. When you cross a street with three children, one of them is going to be loose.
So for me it turned out that after this seventh and final pregnancy, when my fourth child was born, my world got a little bit out of control.
Maybe the hormonal rollercoaster from seven pregnancies in 10 years took their toll, but I’d never experienced crushing lows or moments of sheer, throat-clenching anxiety, so I didn't recognize them when they struck. The birth of my son had been a joyous occasion (last try for the boy) and I assumed fulfillment would arrive with the completion of my family.
In motherhood, the years are short but the days can be very, very long. I’d never been much of a joiner — playgroups where moms sit around and talk about who’s sitting up or crawling or saying this many words in a sentence were never for me. Writing is an isolated career, too. I was home by myself pretty much all the time. I doubted myself constantly, wondering if I was a good mother, if I was giving my children all they needed, making the best decisions for them and for our family.
I cared about my community and started attending town meetings, concerned about local development in our area. I was elected vice president of the town council while I was pregnant with Bobby. When I went into labor during a town budget meeting, I was jotting down contraction times in the margin of an agenda. It was an overwhelming time for our family, and the evening it happened wasn’t so unusual for us. I hadn’t had three consecutive hours of sleep in weeks. My husband was out of town for work, as he was most weeknights, leaving me alone to care for our four kids and run a small town without really knowing what I was doing.
I felt isolated, didn’t have much of a support network, and was weighed down by exhaustion, anxiety, and an overall feeling of anger and hopelessness I now know was depression.
But despite these feelings I was holding it together, pushing through, getting by, and then one night, I wasn’t.
It started with the Christmas tree. I was getting my middle girls, Molly, 8, and Faith, 2 ½, into the tub when I heard the fully-decorated, 10-foot Christmas tree crash to the ground downstairs. The 1881 Victorian house had plenty of drafts and ghosts; who knew why it happened? I ran downstairs and in a fit of misdirected fury, I screamed at my twelve-year-old as though she could somehow help me fix the tree, which of course she couldn’t. I remember the terror in her eyes — she’d never heard me curse and yell like that. I did my best to upright the tree, but there was broken glass everywhere, shattered and strewn across the floor.
Molly and Faith were still in the clawfoot tub. Beside the tub was my screaming baby in an infant seat; he wanted to be held and nursed all. the. time. Leaving the devastated tree scene, I ran back to the upstairs bathroom.
The girls in the tub were arguing (over something like who gets the blue mermaid or the pink mermaid) and Faith was shrieking as only a child that age can do. Sarah called from downstairs, and I specifically remember a moment where I heard the shrill chorus — the cacophony — of all four of my kids yelling in my direction.
There are these moments in parenthood once in awhile where you just wish you had a remote control (like in the movie "Click") and you could hit the “pause” button on the whole thing, just to stop it for a second so that you can run away — not even far, really, just to the car maybe to put some headphones on for a few minutes, grab a drink or a snack, take a quick walk around the block, just stop time, get your head on straight, think about what to say or do. If we as parents could just have this tiny superpower it would save us so much hurt and pain. We could, for example, take back words we’d never meant to say but spurted out one day to a belligerent teenager — words we know might ring in their heads for years. But we don’t. We don’t have that pause button.
I had to stop all the screaming. I was trying to wash my daughter’s hair and in a moment of true horror that I will never be able to un-live, I dipped her under the water for one brief second just to stop the screaming.
The silence that followed was deafening.
Faith stopped screaming, her blue eyes wide, blinking. Her face, dripping. Molly stopped bickering, gasped, stared. Baby Bobby stopped crying as Sarah ran upstairs and asked what she could do to help. I apologized, dried off, hugged, sorted and tucked each of the girls safely into their beds. And then I laid in my bed, nursing my newborn son, and shook and shook and shook.
Terrified and crying in bed, I didn’t feel fit to be a mother. What kind of monster would do something like that? In recalling the moment that I had dunked my daughter under the water, I thought of the mothers I’d seen in the news — women who’d likely never meant to harm their children but just lost control. I thought of the mother in Texas and, to my own shock, I felt empathy for her. She obviously had been out of her mind to hold each of her children underwater, because no mother in her right mind would harm her child. I thought of Joan Crawford in "Mommy Dearest." This had clearly been my “wire hanger moment."
The next day, I called the doctor. I went to her office, and she (a mom) asked me if I needed "just a little something to help me get by." Yes, I said, perhaps in the interest of my children's health and safety I should take just a little something. Just a Little Something came in the form of a purple and pink pill with an unfamiliar name, the generic for Prozac. Mommy’s little helper. My psych degree came in handy. I wasn’t afraid to join Prozac Nation. The mental health stigma didn’t bother me a bit, not when the health and safety and well-being of my family was at stake. After all, my family had a long history of dealing with these issues, and I wasn’t going to ignore the very obvious danger signs that I needed help.
I took the pink and purple pills for a few years, afraid to stop. They made me feel … well, not happy exactly, but less sad and less anxious. They took away the lows, but also the highs. I didn't cry. Ever. Even for really good moments, like an old movie, when a cry actually makes you feel better. I came up with a term for what I felt like during those years: a mombie.
Too much paperwork, home from schools, that needed filling out? Yeah, fine. Department of public works scandal in the town? Whatever. Kids come home with straight A's? Great. Bully on the bus? Bring it. I have my purple and pink pills, and I am ready to face the world with complete emotionless momchalance.
I didn’t like myself when I was on the medication, though clearly it served a very real and necessary function. For women struggling with postpartum depression, and of course, for anyone struggling with mental health issues, antidepressants are literally a lifesaver. But when I stopped taking the pills after the time I truly needed them, something important happened.
I started writing again. The price of the chill pills, for me, had been creativity. I couldn't write anything longer than a Christmas card during the years I spent taking them. I needed my career back. I missed writing. For me, the medication had been something I needed to help me survive the mental health crisis of motherhood. And apparently, I wasn’t alone. According to the Centers for Disease Control, around 15% of new mothers experience postpartum depression symptoms. PostpartumProgress.org reports that 1 in 7 new moms experiences a perinatal mood or anxiety disorder.
There are such high expectations surrounding that moment when you hold your new baby for the first time. After months and years of hopes and dreams and nursery-decorating Pinterest boards and baby showers, you’re supposed to feel bliss, love and joy. But sometimes you just don’t. Sometimes there are moments when instead of bliss, love and joy, you feel helplessness, rage and terror. And that’s okay. What isn’t okay is that fewer than 15% of the women who suffer with these feelings seek help. This puts not only women at risk, but their children as well. It needs to be okay in our society for moms to not to be okay. In an airplane, the flight attendant tells women, every single time, to administer the oxygen to themselves first before giving it to the child beside them. As hard as we may try, we simply can’t be good moms if we aren’t taking care of ourselves first.
Looking back now (my kids are 22, 18, 12 and 10), I realize my hormones probably stabilized after I finished nursing my son. My three-year term in office ended, and I did not seek re-election. My husband started traveling less. Our marriage would face additional challenges, but I would never again have to deal with the raw depression, agony and emptiness of postpartum depression that had made me feel so alone and scared the night of the crashing Christmas tree. Yet I continue to think about the mother in Texas, sitting in that cell year after year, thinking about her five dead children, and I wonder if there was another way for her and her family, a way it might have been different. I think about all the other moms out there, wading through a depth of anguish they might not have known was possible, and I wonder how close they are to drowning.
Women who are struggling can find out more about Postpartum Mood and Anxiety Disorders at PostpartumProgress.org.
Mary McCarthy is the author of The Scarlet Letter Scandal. She is working on a memoir titled Upper White Trash. Find her on Twitter @marymac.