I told her I'd never been more miserable in my entire life.
"Aww, you're just pregnant," she smiled.
I could tell she thought I was just another mother overwhelmed by first-trimester afflictions, and she wasn't entirely wrong. For God's sake, I carried around half a lemon in my bag as armor against nausea triggers, which bizarrely, included things like cardboard.
I told her it was beyond pregnancy. It was depression unlike I'd ever known.
She shrugged and said that I was pregnant and there wasn't much they could do.
She told me she would request a mental health provider contact me, but it would be at least six weeks. Nobody ever called.
This was in Detroit, a city with a maternal death rate nearly triple the nation's. And while it's expected that some leg work will be required to find decent care, maternal mental health care is an afterthought at best; lack of it would eventually force me to self-medicate to stay alive.
I went to four different obstetric practices during my pregnancy, trying on different midwives and doctors and driving farther each time to surrounding suburbs when Detroit proper yielded nothing. At every visit some version of "You're just pregnant" was thrown at me like confetti in response to every symptom. In other offices, I took a risk assessment in the waiting rooms. It was ignored even when I ticked off the box about not wanting to exist.
I'm not part of the demographic cited in studies on Detroit's poor maternal care. I am white and educated with a PhD, steady income and a car. All of these resources, and still I felt powerless. I could not even imagine what women without my means experienced. The guilt, it seemed, never abated.
When I whispered that maybe I didn't want to be a mum again, I was told how grateful I should be. I was pregnant, after a miscarriage no less. I could tell with every interaction - the quizzical looks, the uncomfortable silences - that I was committing a societal sin.
"You used to be so strong," my mother lamented on the phone one night just before we hung up.
Unchecked, the depression begot crippling panic attacks. I bordered on the agoraphobic. I was prescribed a low dose of Zoloft (a medication with which I was familiar and which had previously done nothing for me).
I asked about clonazepam, the only medication that has ever quelled my panic attacks. I mentioned a recent JAMA article about its relative safety, but anti-anxiety medication is still as stigmatised as the mothers who seek it. I swallowed the sanctioned blue pill later that evening, knowing that it was like throwing a Tic Tac into the abyss.
On Christmas Eve, my daughter danced around the house; I was a ball on the bed. With normalcy so out of reach, how could I expect to feel festive?
While she and my husband went to a party I palpitated my way through the panic. My thoughts became more recalcitrant; I knew I would not make it to the new year.
Left with no choice, I refilled my old anti-anxiety prescription. After one pill, I felt the phantom grip around my neck loosen, my whirling dervish brain quiet. By the time my husband and daughter returned, I was wrapping presents and thinking about something other than death.
I told my obstetric practice about my decision and was sent to the ER. Strapped to a fetal monitor, scolded for self-medicating, I again rattled off studies touting that the medication was safe. But still, I was strong-armed into checking myself in, so that I could see a psychiatrist "first thing."
I spent the night in a stark room, having to ask for a gown, blanket and basic toiletries. I washed myself in the sink and dried off with paper towels. When I did speak with a psychiatrist, it was not "first thing" nor was it in person, but over the phone (she didn't know she had a patient waiting). She confirmed the medication was fine. Nevertheless, a few days later my obstetrician dumped me as a patient for "withholding information."
My panic ebbed, but I wasn't close to being excited. I still wasn't comparing the baby's size to fruits and vegetables each week, the way I had with my first. I couldn't bring myself to think about the postpartum relentlessness, or even a name. I continued to fold in on myself.
I would scroll through social media comparing myself with other expectant women, beaming and cradling their bellies. I wondered if they ever felt like me, ever seethed with resentment that their body was no longer their own and then felt guilty about it. I wondered if they ever looked through a window and then thought about jumping.
One day, a Facebook mom group yielded a therapist in a nearby suburb. I contacted the practice, and found some relief. I could finally relinquish my thoughts in a safe space. I could rage and sob and still feel validated. Here, I was not just a byproduct of some hormonal stew.
She referred me to midwives (also in a suburb) who would deliver my baby and who could not fathom the prior care I received. I also consulted with a team of psychiatrists nearly 45 minutes away at a major university. Again, I was told that there was minimal risk and I could stay on my medication.
Anxiety over my anxiety medication abated, but still I raged. Why the myriad useless appointments? Why did I have to beg for care? What happens to women who take the doctor's word as sacrosanct and continue to suffer?
It was because I was a "bad patient" and did not listen that I finally received the help I needed. It was only because I was educated enough and angry enough to advocate for myself that I survived my pregnancy. It was only because I fought that I was finally seen - the woman surrounding the womb.
A few days before my due date, my daughter asked how the baby would know how to find her way out of the darkness. She insisted that she be there to hold a flashlight between my legs. She wanted to be like Polaris, a guidepost for this little being burrowing into the world. Her empathy evoked tears from me (admittedly, not that hard to do in those final, hormonal days of pregnancy).
I too, had sought Sherpas across cities and cyberspace to usher me out of my own mental bedlam, but had been brushed off by medical professionals clad in white coats. They only worsened the pain, and the darkness. It had taken nearly the entirety of my pregnancy to finally find the flares.
WHERE TO GET HELP NOW
If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call police immediately on 111.
IF YOU NEED TO TALK TO SOMEONE ELSE
• DEPRESSION HELPLINE: 0800 111 757
• KIDSLINE: 0800 543 754 (available 24/7)
• LIFELINE: 0800 543 354 or 09 5222 999 within Auckland (24/7)
• NEED TO TALK? Free call or text 1737 (24/7)
• OUTLINE: 0800 688 5463
• SAMARITANS – 0800 726 666
• SUICIDE CRISIS HELPLINE: 0508 828 865 (24/7)
• WHATSUP: 0800 942 8787 (1pm to 11pm)
• YOUTHLINE: 0800 376 633, free text 234 or email talk@youthline.co.nz
There are lots of places to get support. For others, click here.
