by Danielle Steer
Suicide is a common postpartum complication.
When I first heard that 1 in 7 women suffer from a maternal mental health complication like pregnancy depression or postpartum depression and that 1 in 1000 will suffer from postpartum psychosis, I was shocked. Why are women in my community not talking about this? Why was maternal mental health not included in my high school sex education or health classes? Why, at 28 and on the verge of starting my own family, am I only now learning that women I have watched on TV, like Andrea Yates and Jeannette Hawes, are not simply monsters and murderers but women in need? These women – sensationalized for killing themselves or their children – were suffering from a relatively common condition.
Fortunately, I am not alone in asking these questions.
Writer and Director Maureen Daniels and fellow postpartum depression survivor, Jennifer Silliman, are releasing online their documentary Dark Side of the Full Moon. Dark Side of the Full Moon delves into the unseen world of maternal mental health in the United States giving a face and voice to the countless women who have suffered in silence. It reveals a failure within the medical community to effectively screen, refer, and treat the 1.3 million mothers affected each year.
Maureen and I both studied public administration and social change at the Monterey Institute of International Studies. I have always looked up to her personally and professionally – she is the type of person whose laughter is beyond contagious and can be heard from a block away. Her husband aptly stated once that if you opened her head you would find lollipops and rainbows.
Yet in 2008, Maureen had her first suicidal thought. An hour later she found out she was pregnant. When she told her gynecologist she was sad and felt depressed, her doctor said, “you should be happy, you’re having a baby.” So Maureen started asking for help elsewhere. Over the next few months, as the suicidal thoughts became homicidal, Maureen sought out the help and diagnosis from 28 different health care professionals, none of whom were able to tell her what was wrong. The 29th professional finally informed her that she was suffering from a severe perinatal mood disorder, a leading complication associated with pregnancy.
Maureen and Jennifer are pissed off and they want you to be too. “Nobody is asking any questions,” Maureen tells me. “Women are dying! Families are suffering! And there still isn’t a comprehensive policy to protect mothers.” Speaking with Maureen and Jennifer, I am struck by their resolve to change the conversation about maternal mental health.
Dark Side of the Full Moon portrays Jennifer Silliman’s terrifying story. After six months of intrusive thoughts – mostly visions of knifes, sharp objects, and stabbing – Jennifer finally told her husband she needed help. Even though she has fully recovered, Jennifer is reminded – and is grateful – daily that she is now able to be in the same room as scissors or a steak knife. When I asked Jennifer why she wants to tell her story, it is simple.
“I was sitting in a support group a few years ago … and I talked about my intrusive thoughts, which is not something that people normally talk about. I noticed the woman next to me started crying and she said to me, ‘I have exactly what you have right now, and I didn’t even know that there was a name for it.’ From that moment on I knew that I have a really powerful tool that I can use to help other people.”
When Maureen first talked to Jennifer about the film, they knew there was a huge need to educate, inform, and create change around maternal mental health. Jennifer tells me, “Things like dropping your baby, sharp knives, or drownings are the three most common intrusive thoughts that mothers have and I know there are other moms out there that are having thoughts like that and they don’t understand that they are not psychotic. They are not Andrea Yates. They are not going to kill or harm their baby because they know what they are thinking isn’t right. They understand that part. That is the difference between psychosis and intrusive thoughts.”
She continues, “This is happening so much more than people think and in so many different ways that are devastating to families. Even for me personally, I will never have another baby. When I think about what I went through there is just no way. I still don’t trust that there is enough help out there to take care of me."
In the film Maureen and Jennifer interview professionals, mothers, and survivors all over the country; and the consensus is the same – we need to do more.
"The vast majority of postpartum women with depression are not identified or treated even though they are at higher risk for psychiatric disorders," lead author Dr. Katherine Wisner, director of Northwestern University's Asher Centre for Research and Treatment of Depression in Chicago, told the Telegraph. "A lot of women do not understand what is happening to them. They think they're just stressed or they believe it is how having a baby is supposed to feel."
When I asked two pediatrician friends if they screen their patients they both said, “Of course. We ask mom how she is doing every time she brings in her child for their check ups. But I have no idea what to do except call Child Protective Services if she says she’s suicidal or that she needs help.”
Maureen and Jennifer found this trend among the many women they spoke with for the film and even experienced it themselves. Maureen says, “I was so thankful that my doctors caught my gestational diabetes. But 29 doctors to diagnose my mental health complication? The specialist was down the street. Down the street! And the OB didn’t know.”
Luckily, there is one state that some might call a positive deviant. Massachusetts has one of the most comprehensive strategies for addressing maternal mental health complications. They have successfully implemented a statewide screening system as well as a network of healthcare professionals that are trained to address and treat maternal mental health complications at every level of care for mothers. But one state is not enough.
While the film focuses on mothers, Jennifer and Maureen both agree that we are also overlooking the impact on children. When mom is sad and distant – or dead – children suffer. In my most recent Skype chat with Maureen, she is living this reality. “I am sitting in a therapist office on Christmas Eve, my 6-year-old son is in a private session on his birthday because he can’t speak in school and has a rare form of social anxiety called selective mutism. Is my health when he was a baby connected to his current anxiety? I think so.”
Jennifer tells me, “As a mom, you want to believe that you’re not the reason why your child’s life will be forever changed. But we can’t really say that.” Maureen adds, “many women we spoke to said their kids have some anxiety issues. Mom’s health is huge for kids. If mom isn’t well the family isn’t well.”
Let’s change the conversation. Let’s help our mothers, our sisters, our daughters, and our future generations. Let’s stand with mothers. We have an opportunity to create real social change for our society and that starts by educating the public. Mothers, fathers, doctors, therapists, and legislators need to be informed about the complications associated with pregnancy and how we can best support mothers in need. Dark Side of the Full Moon gives a profound and startling inside look at maternal mental health. I only hope it will be a catalyst for the change mothers everywhere deserve.
Dark Side of the Full Moon filmmakers invite you to watch and join a global campaign to stand with mothers. Find out more by going to the Dark Side of the Full Moon website. -Ed.
About the author: Hailing from Anchorage, Alaska, Danielle Steer graduated from the Monterey Institute of International Studies with a Master of Public Administration. She received her Bachelor of Arts in Political Science from Lewis & Clark College in Portland, Oregon. After graduating from MIIS, Danielle worked in Peru developing financial strategies for a group of indigenous women in the Sacred Valley. She now serves as the Enrollment Manager for the International Environmental Policy, International Policy, and Public Administration programs at MIIS.