Maternal Mental Illness - New Moms Never See It Coming

Patient Expert

Warning: Very disturbing content ...

A story in last week's New York Times tells the tragic story of a new mom, Cindy Wachenheim, who last year jumped to her death from an eighth-story window with her ten-month old son strapped to her chest.

In a bizarre twist, her body cushioned the boy's fall. The boy survived and is now taking his first steps.

Cindy's family is now breaking the silence.

According to the article, everything was fine until about four months after the birth. Then Cindy began obsessing over her boy's condition. Somehow, she convinced herself that the boy had brain damage and that she had caused it. She took the baby to one specialist after another. They found nothing wrong.

By now, her family was growing worried. Her sister urged that she get counseling. Cindy agreed. She did receive counseling. She also saw a psychiatrist, who prescribed Zoloft. But she insisted that she did not have maternal mental illness. She thought she was depressed because of the supposed damage she had inflicted on her son.

According the NY Times:

Now these mood disorders, long hidden in shame and fear, are coming out of the shadows. Many women have been afraid to admit to terrifying visions or deadened emotions, believing they should be flush with maternal joy or fearing their babies would be taken from them.

Cindy had her child in her forties. The NY Times reports that she was "a level-headed lawyer" and a "favorite aunt" and that she "loved life."

We tend to identify maternal mental illness with depression, but in Cindy's case a lot more was going on. I first became aware of this several years back when I contacted fellow blogger Katherine Stone, who has put together a tremendous resource, Postpartum Progress.

As well as postpartum depression, her blog lists postpartum anxiety, postpartum OCD, depression during pregnancy, post-adoption depression, postpartum PTSD, depression after miscarriage or perinatal loss, and postpartum psychosis.

From our standpoint, it's useful to know that postpartum depression may be wrapped in one or more of these other conditions, such as anxiety or psychosis.

Another important point: A postpartum condition should not be regarded as confined to the period during the four weeks following delivery. The current DSM-5 now acknowledges this, but offers little insight.

So, in Cindy's case: A lot of stuff was going on, probably centered around postpartum OCD with psychosis and depression thrown in. Moreover, it only started to occur four months after she gave birth. And this leads us to the distressing final point - Cindy had no idea what she was up against.

Yes, she sought help, but for what she thought was an ordinary reactive depression, not for her obsessive delusions. Obviously Cindy suffered an extreme form of maternal mental illness, but no one knew that until she made her fatal leap.

Prior to that, she had to put up with what a lot of new mothers put up with. No one should have to suffer like this. It's time to break the silence ...