Patricia Tomasi: Maternal Mental Health is a Women’s Rights Issue

I got pregnant pretty fast. We thought it would take at least six months because that was the norm among our couple friends. But all it took was one quick romp on the couch before dinner on a Tuesday to make it happen. We didn’t even take our clothes off except, for, you know…

We were caught way off guard and ill prepared for what happened next.

A Positive Pregnancy Test

I told my husband we were pregnant in a text on the subway ride home from girl’s night four and a half weeks later. I was a couple of days late and spotting and sure it was the first signs of my period but my bestie insisted we grab a pregnancy test on the way to the bar because wouldn’t it be fun?

So we did and I saw my ex while purchasing it which was really awkward, and I tried to brush off the encounter. I proceeded to the bar to meet up with more friends, drank half a bottle of wine, got pulled into the washroom stall by my friend who didn’t forget about the test, took said test, yelled “HOLY F***!! IT SAYS YES!!”, stopped drinking, and went home completely in shock.

When I opened the door to our tiny apartment, my husband was sitting on the couch, in the very spot where we had made the baby, completely in shock. We were married, in our thirties, had full time jobs, a roof over our heads, supportive families and friends, and had agreed to start trying.

Not that you had to have any of those elements in place to have kids, but with all of that, still, my husband and I were unprepared, mentally, for kids and what was about to go down.

Probably me more so than him.

History of Mental Health Concerns

Not to push his feelings aside or anything, but I’d had a rough go of things lately. With barely a diagnosis of any kind, I had just finished weaning myself off of medication after suffering from debilitating panic attacks that seemed to come out of nowhere. Was it mental? Physical? I had no idea and neither did my doctor it seemed. I did have bouts of anxiety and depression in the past but none of that came up and I was never outright diagnosed by anyone.

My blood tests all came back normal so she put me on an antidepressant. I also took up yoga, changed my diet, and put myself into therapy after getting frustrated on a long wait list. Over the course of a year, I started to feel better and thought that whatever I was dealing with seemed to have been nipped in the butt. Maybe it was just a one off thing and was gone for good.

Girl, was I wrong.

Medication During Pregnancy

I knew one thing for sure though. I definitely didn’t want to be on medication while I was pregnant because that would harm the baby, right? No one had told me any different. I didn’t know I had a greater chance of developing perinatal and postpartum depression because of my history of anxiety and depression and now what seemed like panic disorder. At that point I hardly knew what postpartum depression was and certainly had never heard of perinatal depression.

I was at the point where I wanted to start having kids so I decided to come off the medication and get on with my life.

Two months into the pregnancy, I had a panic attack. “NO!” I declared. “This is not happening to me.” From that point on, I decided to deny any anxiety or panic away. I thought I was the one causing the anxiety because the pregnancy took me by surprise. What I thought I needed to do was pull myself together, grow up and become a normal functioning adult.

Perinatal Mental Illnesses Go Unchecked

What I didn’t know, was that the perinatal anxiety, depression, and panic I was suffering from were biological forces beyond my control that could have been treated. Instead, I suffered my way through pregnancy, never once being asked by my OBGYN if I had any mental illness symptoms because of course, maternal mental health screening didn’t and still doesn’t exist.

I wasn’t flagged due to my previous history of anxiety and depression. No one ever had a conversation with me about perinatal or postpartum depression at any time prior to or during my pregnancy or at any time postpartum. I not only suffered from perinatal anxiety and depression, I went on to suffer from postpartum anxiety and depression complete with panic attacks, OCD, irrational, delusional and intrusive thoughts, uncontrollable sadness and debilitating terror for three years.

Looking back, I really think I suffered from postpartum bipolar disorder which is a serious form of maternal mental illness yet I received no screening, no diagnostic tests, and no treatment. Despite some major upheavals to my life including quitting my job and losing my house, I’m lucky my family and I came out of that situation still intact.

A Second Pregnancy

I only started to feel better once I became pregnant again with my second child. By then, I had educated myself enough about postpartum depression and was determined not to go through it again. I was keen on the yoga and healthy diet and did have an amazing pregnancy despite a few bouts of anxiety. I even took a course in hypnobirthing and delivered naturally! Me! The most anxious person I knew. I felt on top on the world, euphoric actually and the first three months postpartum were blissful.

And then all hell broke loose.

It started with nightmares of driving off a cliff with my baby and progressed into daytime intrusive thoughts. I felt detached from reality and once spent the entire day staring at the television in a zombie-like state with the baby on my lap until my husband came home. Later, I started having panic attacks and became bed ridden. I couldn’t drive or leave the house. We were forced to use my life savings to pay for a full time nanny. Not only was postpartum depression happening again, this time it was worse and entering into some pretty scary territory.

I got myself to the family doctor after it was clear it was only getting worse, not better, and asked for medication right away. She ran me through the Edinburgh Postpartum Depression Scale as a formality, one of the only, outdated diagnostic tools doctors have to diagnose postpartum depression which includes little to no questions about anxiety which happened to be my major symptoms.

Screening Tools Are Often Inadequate

I barely scored to indicate I had postpartum depression, probably because I didn’t have postpartum depression, I had postpartum anxiety and who knows what else? Too bad no one else thought to run me through the EPDS while I was pregnant or after I had the baby. I should have been flagged for having gone through postpartum depression with my first, had I ever been diagnosed. If any kind of screening existed up to a year postpartum, they would have caught my illness in case I wasn’t in any kind of state to catch it myself.

Thankfully, I did catch it and had my wits about me enough to get help, unlike many moms. I was in charge. I took control of my health. But it shouldn’t be that way. I couldn’t do that for myself the first time around. Luckily, this time, I knew enough about postpartum depression because of my own advocacy work as a mental health journalist and writer that I was able to recognize the signs and get myself into treatment right away.

Moms Are the Best Advocates

That’s why I decided to become a Patient Expert Advisor for the Maternal Mental Health Research Collaborative. Though the onus shouldn’t be on moms to fix the system, the reality is, moms are the only ones who can paint a full picture of what postpartum depression and maternal mental illness actually feels and looks like.

Beyond telling our stories, however, I believe strongly along with MMHRC that moms need to be directly involved in setting the priorities for maternal mental health research which is what ultimately will begin to bring about change to a vastly outdated medical system when it comes to the prevention and treatment of maternal mental illness.

This is a patient issue, a health issue, a family issue, a societal issue, and most importantly, a women’s rights issue. We should not have moms suffering and dying in this day and age from the most common pregnancy and postpartum complication that’s existed for thousands of years. It’s time to make maternal mental illnesses in all of its forms, a thing of the past.

Will you join us?

Patricia is one of the Maternal Mental Health Research Collaborative’s Patient Expert Advisors. These moms are a group of kick-ass survivors who use their lived experience to help end stigma, advance research priorities and spread the word about MMHRC.