May 4th – 8th is Maternal Mental Health Week. I will be posting every day regarding maternal mental health. If you missed my story on Monday regarding the darkest point of my PPD/PPA journey, I urge you to read it. If you missed my post on Tuesday regarding what mental illness is and is not, as well as signs and symptoms you can watch out for, I also urge you to read it. Yesterday I discussed risk factors specific to perinatal mental illness, please check them out. All my posts this week are being made public, so please share and help us in easing access to treatment by reducing stigma and shame. This post discusses mental illness, hospitalization, and suicide.
Before Olivia was born, I was told that my life would forever be changed for the better as I felt this bond and incredible love for the tiny human I created. But what happens when you don’t feel that? I had to be a monster! As time went on without feeling any connection to her, I felt more and more that I was undeserving of this beautiful blessing we had prayed for. I felt so alone and fell so deep. And when things became scary, they did so very, very quickly. Unbeknownst to
Gabriel and my family, I had been reaching out for help for over a month. I kept running into brick walls and obstacles that were insurmountable on my own. I couldn’t even get most places to call me back, let alone schedule me. When I told them I was suicidal, I was told I could get scheduled in for an appointment in 8 weeks. I thought in my mind, “a lot of good that will do, I will be dead by then”. I could go to the ER, but Kootenai Health does not have a program for Moms. I would be in a general psychiatric ward and that worried me that it would possibly leave me worse. I called the Crisis Center and was told that I could go there for up to 24 hours and they would give me resources. Again, not helpful in the immediate need. I felt like nobody was willing to help me. And if nobody thought my life was worth saving, then my mind must be correct. Obviously that was a convoluted thought process, but it was very, very real to me at that time.
Now, more than ever, Moms need our support. I can’t imagine enduring the worst of my PPD/PPA while in a national quarantine. If I faced roadblocks in trying to gain access to care, then I know it is only ten-fold right now. Isolation is a dangerous thing for people with mental health disorders. Keep checking on your Mom friends. Be intentional in your questions and actions. Hold their hand on this journey so they know they aren’t alone. Be their legs when they have none to stand on. Make it known that their life is valuable and worth saving, even if they can’t see it in the moment. I am going to again attach all the resources from day one. But I am also going to attach resources for Zulresso.
The Zulresso infusion saved my life. When it looked like I might not be getting the infusion, and this is difficult to admit, I had already decided that I was going to (and had begun to) lie to the medical team and give them responses akin to improvement so I could be released and follow through on my plans. But then, the approval finally came through (at literally the last minute), and the life I had been living rapidly changed.
Within 12 hours, I felt a bit lighter. Within 24 hours, I was sleeping and woke up starving (I had not had an appetite in weeks)! Within 48 hours, the suicidiality disappeared and has not returned. By the end of the infusion, I was experiencing the first inklings of hope since Olivia was born. And it wasn’t just my subjective improvements. Others could tell. The atmosphere was different. Upon seeing me towards the end of the infusion, my husband tearfully proclaimed, “I have my wife back”. I will forever be grateful for the ground-breaking research that led to brexanolone. UNC utilized the Hamilton Depression Rating Scale (HAM-D) to objectively track progress. Directly before beginning the infusion, my score was 34, indicating very severe depression. After 24 hours, my score was 17! It was unbelievable. I was afraid to be hopeful. But as the infusion progressed, it became more difficult to fight that fear. At 48 hours, my score was 8. Could this be real?! I was becoming hopeful. I was excited. I wanted to see Olivia! Prior to the infusion I was rather indifferent toward seeing her, so that was huge! At discharge (60 hours), my score was 6. SIX!!! I had spent every day since Olivia’s birth fervently praying for a path to healing. God answered mine, and many other’s prayers. There aren’t words to describe what it feels like when you are the one receiving the miracle. Zulresso did not cure my PPD, but it started me on a healing journey. It made it all manageable. My SI still has not returned (3 months later), I am still sleeping better, and I am eating. It made me stable and able to actually participate in therapy. It also increased the effects of my antidepressants. Again, there just aren’t words. The photo I am attaching is a screenshot I took while video-calling with Gabe and Olivia in the last hours of the infusion.
I would challenge Kootenai Health to complete their enrollment in the REMS program so women in the Inland Northwest can have access to this life-saving drug! I am happy to work with you and answer any questions.
For Mamas: insurance companies have specific criteria in order for a patient to receive brexanolone. While every company is different, there does seem to be some overlap, which I will list here: documented major depressive depression within the last trimester or first 4 weeks postpartum; moderate to severe postpartum depression on a standardized rating scale that reliably measures depressive symptoms; no active psychosis; the patient is within 6 months postpartum; brexanolone is prescribed in consultation with a psychiatrist; and the patient has stopped breastfeeding, or will not breastfeed during the infusion.
I am attaching some links for anyone interested in receiving the infusion, or for those that know a Mama that you think would benefit.
Sage number: 1-844-4-SAGERX
—This form is the first step toward receiving the infusion. If you do not know where a REMS center is, or don’t have a psychiatric prescriber, ANY provider can fill out Section B and C of the Provider’s page, and then you can mark the box to have Sage Therapeutics work with you to find a REMS certified Healthcare Setting. That facility will then have a psychiatrist prescribe the infusion, should you fit the criteria.
I’m happy to help you with any of this. I did not have a psychiatrist to prescribe. However, my OB filled out the referring provider portion so I could become enrolled, and Sage helped me from there (I filled out the Edinburgh Postnatal Depression Scale and took it with me). And the Sage Central Navigators are just fantastic!! We called them so frequently during the process, and even after, and they were always so kind and helpful. So utilize them!
Suicide Prevention Lifeline
Crisis Text Line: text HOME to 741741
Postpartum Support International:
Edinburgh Postnatal Depression Scale