Thursday 20 July 2017

Postpartum psychosis claimed Molly Roth. Her husband hopes to save others

Molly Roth wanted three children, just like her mother had.

Getting to two, however, proved harder than she and her husband, Jamison Roth of Norwalk, had imagined. There would be four years and oneectopic pregnancy between the births of her children, Jaxon and Gracelyn.

But two weeks after Gracelyn arrived Jan. 5, Molly encountered her biggest hurdle. A nurse practitioner called it the “baby blues,” a benign term for a sometimes monumental change that affects about one in five new mothers. Normally a whirlwind of energy, the 32-year-old Molly, who used to make sure everyone else was OK, now had to drag herself through the motions of daily life. She would cry uncontrollably and say she had made a mistake.

About a month in, she was diagnosed with postpartum depression and put on a handful of medicines, Jamison says. By then she was struggling just to bathe: "I had to show her the simple steps of turning on the water and getting a towel." She talked of suicide. What she was suffering from, according to Jamison, was actually a rarer, more dangerous perinatal mood disorder called postpartum psychosis, compounding her existing anxieties.

For Jamison, 35, it was as if a stranger had taken up residence in his wife’s body. The fun-loving mom and wife, the extraordinary organizer, the smartest person he knew, had been replaced by a shell.
Molly Roth with her baby Gracelynn, born Jan. 5 

Molly spent time in Lutheran Hospital’s mental-health unit but came out and overdosed on ibuprofen. She then spent 10 days in Mercy’s mental health wing. Both times her husband says she was with serious substance abusers, though she wasn't one.

Things improved for two weeks. She started a new job. “She was back to her old self, joking around and being happy,” says her husband. Now he thinks it was probably the drugs finally kicking in. It didn't last. The Wednesday after Easter, he came home to find his wife had hanged herself.

Jamison's mother has moved in to help care for the kids, but Jamison says he lost half of himself.  Their 4-year-old son sings a song: “Mom, I miss you. Please come back.” Jamison forces himself to stay upbeat but struggles to understand: How is so little known about postpartum illness when even heart disease has treatments? Hospitals have wings for new babies to rest, but why not for new mothers?

"They should treat them like queens, not mental (cases). They haven’t done anything but have a baby. They did everything they were supposed to,” he said.

Postpartum depression is said to result from some combination of fatigue, hormonal imbalance and depression. Postpartum psychosis, which affects one or two in 1,000 new mothers, may be accompanied by hallucinations and fantasies of dying or killing one's baby.

Many of us learned of it after Heidi Anfinson’s two-week old son vanished in 1998 and turned up under a pile of rocks in Saylorville Lake. Anfinson spent 12 years in prison for killing him before a parole release in 2012. She said she left  him unattended in a bathtub during what she and supporters said was postpartum psychosis.
Jaxon Roth, 4, imitates his mother Molly rubbing her pregnant belly. 

After one hung jury, then a conviction and 50-year sentence, Iowa’s Supreme Court ordered a new trial in 2009 because her attorney had presented no evidence of mental illness.

In the documentary, “When the Bough Breaks,” one women describes “a sheet of glass” separating her from her infant. A psychiatrist says people with a history of depression, obsessive-compulsive disorder or bipolar disorder are most at risk for postpartum problems.

The Roths were each other’s yang and yin, says Jamison: “I was the one who calmed our family down and she was the one who pumped our family up.” But Molly was sensitive and her feelings were hurt easily and there had been disruptions in their lives during her pregnancy.

A few months before Gracelyn was born in January, Molly lost her hotel job in what she believed was pregnancy-related discrimination. In December, Jamison’s job as product manager for a medical supply company was eliminated. They lost health insurance. Friends helped support them through a GoFundMe account, and both found new jobs. His started in late February and hers in early March. She thrived in it those first few weeks, he said.

When her spirits improved, Molly wrote down some advice for others experiencing what she had. “You are not alone,” she wrote. “There IS help and it WILL get better.” She urged getting professional therapy and checking yes to a question on depression on a form given to new mothers in the hospital. It would help them connect with resources later, if necessary, she wrote.

How could she know so much yet be unable to save herself? Hanna Engel-Brower, her general practitioner, says, "She did everything she could and her family did everything they could," but Molly's symptoms were too severe for even the aggressive medications she got.

In Britain, postpartum depression and psychosis are recognized to the extent that women aren't prosecuted for killing their babies in the first year. In the U.S., we've made great strides in demystifying the childbirth process and decreasing reliance on unnecessary medications and C-sections. Yet childbirth and new parenthood can be mentally and physically traumatic and socially isolating. And neither our workplaces, our healthcare system, nor our nuclear family units are always equipped to handle it.

New mothers are out of the hospital in two days and expected back at work in six weeks. They aren't universally screened for depression. Engel-Brower adds to that a severe shortage of mental health care and coverage in Iowa. She recommends all women be told of possible postpartum problems before they ever get pregnant. She thinks stigma and shame prevent many from getting help.

Women have been relied on to perpetuate the human race, yet too little attention has been paid to their emotional well-being in the process. Jamison Roth hopes his family's tragedy can help change that. He is partnering with the National Alliance on Mental Illness to educate people on postpartum depression. They're holding a public celebratory event July 22 from 11 a.m. to 4 p.m. at Fort Des Moines Park, with food, a raffle and information.

(Source: Desmoinesregister)

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