Mum's the Word [12/08/2001] PRODUCER: LAURIE CLARKE REPORTER: MIKE McROBERTS Karen intro: Almost everyone knows someone who's suffered from it. Yet it's hardly ever discussed, often becoming public only when a mother's agony ends in tragedy. And there are many tragedies, most recently an American woman who drowned her five children. She now claims she was delusional, in the grip of psychosis. But post-natal depression is more usually about isolation, fear of speaking out in case you're thought to be a bad mother. Tonight, three New Zealand women brave the stigma to tell their stories to Mike McRoberts. NEWS REPORTS: “It was during one of those visits last Friday that the baby was found smothered.” “They hinted deeper problems, and post natal depression.” “One side of me blames her because she did it, you know.” MIKE (V/O): Mothers who have done the unthinkable. NEWS: “You are charged with capital murder". MIKE (V/O): But there are many others we don't hear about, cases here in New Zealand where women haven't even faced charges. (TO CAM): What is it that drives women to commit such terrible acts, killing or harming their children, or themselves? We hear of post-natal depression, post-partum psychosis, but just how valid are the claims by these women that we didn't know what we were doing, or we weren't capable of controlling our actions? MARY-ANNE: I was always one to say, people get off with the temporary insanity plea, oh right sure, but unless you've gone through it and you realise that what those delusions are, actually real to you, then you... I now believe that people can be classified as temporarily insane. MIKE (TO CAM): Insanity may seem strong but that's how some women describe their post-natal depression. It's an illness that can strike any mother. In New Zealand, one in five will suffer some form of it. But if it's so common, why don't we know more about it? SARA WEEKS: People are often very good at hiding things, particularly depression. People can have the smiling face on, put the act on and yet be feeling absolutely awful inside. MIKE (V/O): Doctor Sara Weeks, a psychiatrist who has seen many women suffering from post-natal depression. SARA WEEKS: Some will get better eventually, some will go on to become chronic low grade depression. Those are the sorts of people that would think, ‘So this is what motherhood is and I wish I’d never done it,’ and some will go on to become worse and possibly end up fatally. NEWS REPORT: “Tears, flowers and stuffed animals for the children allegedly drowned yesterday by 36 year old Andrea Yates.” MIKE (V/O): Texan mother Andrea Yates claimed she had post-partum psychosis, the most severe form of post-natal illness. But it’s important to note she is at the extreme end of the spectrum. Most women will never reach that stage. STEPHANIE: I felt like I was drowning and just keeping my head above water and I just wanted one person to come along and hold my hand and pull me out, but I felt like... I'd sort of say things sometimes and I’d feel like saying, ‘Can't you see me? I'm drowning,’ you know. MIKE (V/O): Stephanie suffered from post-natal depression with each of her four children, but never realised until after she'd had her third. STEPHANIE: I guess I just thought it was just sort of normal and didn't everybody feel like this? MIKE (V/O): Some form of depression is normal after giving birth. The baby blues, or three-day blues is a natural hormonal let down affecting eighty percent of mothers. But post-natal depression is different, lasting longer and with far more severe effects. STEPHANIE: In hindsight now the depression just saps your energy and motivation and I remember saying to a friend of mine, “It takes me almost, it's almost too much energy for me to change the sheets on my child's cot.” I mean, that sounds pathetic. But it was like, you know, you're so tired, exhausted. MIKE (V/O): Because Stephanie’s post-natal depression wasn't picked up after the birth of her first two children, her condition worsened. Throughout the pregnancy of her third child and for a year after he was born, Stephanie was severely depressed. STEPHANIE: I remember with my third child, I used to love it because I’d go into his room and I’d breastfeed him. I used to love that time, putting him to bed and that last feed at night, and I remember thinking, as soon as he's weaned then I’m going to, then I’m going to kill myself, because I just can't go on anymore. They'd all be better off without me. MIKE (V/O): Stephanie would go on thinking these thoughts for many more months until one day she reached a crisis point, unbelievably while waiting for a car wash. STEPHANIE: Usually in a car wash you just drive straight through. Well, this day I had to wait and sit, and I’m a Christian so I was sitting there praying, thinking what I’m going to do, and I thought, ‘No, I don't want anybody else to bring up my children. This is mad.’ It gave me time to just sit there and think about what I was really doing, and I thought ‘I’ve got to get some help.’ MIKE (V/O): Like Stephanie, Sue was trapped inside a post-natal illness and made the decision to get out. (I/V): So at some stage you just said... SUE: Enough. I want me back. And I thought, ‘Yep its all events. It’s all to do with feelings, terror, anger, reliving it.’ MIKE (V/O): Sue’s form of post-natal illness is called post traumatic stress disorder. It stems from the birth of her first child Juliette. Born eight weeks prematurely by emergency caesarian section, Juliette died a day later. SUE: It was the shock of having become parents and then discovering you had a really unwell baby and then the baby having to be taken off life support. And for me I was totally, in my head, totally traumatised but I functioned normally. MIKE (V/O): But the nightmare continued. Less than two weeks after Juliette’s funeral Sue was back in hospital having pieces of placenta removed that had been left in her womb. Grief stricken, Sue could feel herself slipping away. SUE: I was just very, very numb. That would be the most, the basic way of explaining how I was, just numbed, totally out of my brain. SARA WEEKS: It’s a thing that you feel terribly alone with and part of that is because it's a psychiatric, it falls under the spectrum of psychiatric disorder, so there is stigmatisation about it. I think there's just so much stigma around it and so much lack of understanding that it makes it really difficult to ask for help because of fear of how it's going to be accepted. MIKE (V/O): Fifteen months after her first birth Sue was unexpectedly pregnant again. She was fearful and anxious about how her next birth might go, but couldn't talk to anyone about it, says no-one wanted to know. SUE: And they were also now looking at me as someone who was going to get better, because she's going to have baby soon. MIKE: That's all she needed. SUE: Yeah, get me over the loss of the first baby and maybe she'll put this thing behind her, maybe she'll put behind the trying to understand what had happened to her. MIKE: But still at the back of your mind, you had this trauma. SUE: Oh yeah. It was sitting there waiting, waiting to come out, waiting to just be exploded basically. MIKE (V/O): Sue got through the birth of her second child Annabelle without complications. But the trauma remained with her. SUE: Different milestones for Annabelle would trigger off the loss of what had happened before. But I think that's normal for any mother who's lost a baby, when they've got the next one, will be reminded constantly of what they missed out on. And so I didn't think that was unreasonable. It was only as Annabelle got older that the events or the fears and the terror of what had happened before, began to come out. And they just seemed to come out with no say basically. MIKE (V/O): Sue felt she'd lost control, a common theme among sufferers of post-natal illness. And for many that feeling of disempowerment begins with childbirth. SARA WEEKS: It’s the most out of control a lot of women will ever be and I guess the most out of control a lot of partners who are present at the birth, will feel. Being in labour and then being a young mum can be the first experience of really not being in control. MARY-ANNE: I had Cameron two weeks early, which I was totally unprepared for because I’m a very organised person and I knew when Cameron was due and that's when I expected to have him. MIKE: Mary-Anne and husband Christopher. Cameron was their first child, born after 36 hours labour and a caesarian section, an ordeal that would have flattened most mothers. MARY-ANNE: But I was basically up straight away. I was roaming the halls at night. I'd be balancing the chequebook, I’d be on the phone to people in Perth, I’d be on the phone to people at work. If I wasn't doing that, if it was 2 or 3 o'clock in the morning, I was out talking to the nurses in the nurses’ station. I just didn't sleep because I was so happy. CHRISTOPHER: I remember thinking about this, well if this is what goes on with having a baby, wow fantastic, and look at how Mary-Anne's handling everything. MIKE (V/O): In fact the day Mary-Anne got out of hospital she invited friends to stay the weekend. MARY-ANNE: So I looked after them and I looked after Christopher and I looked after the baby and nothing was a problem and I still did not sleep. CHRISTOPHER: One suspicion, and it's based on ignorance, you don't know because you're not trained for it, you don't know anything about it, no-one's ever told you anything about it, and you start to think ‘Well is this normal?’ MARY-ANNE: And then what happened, probably about the eighth or ninth night was that I started to become, I became very religious. I started to sit down and read the Bible and I started to read things into the Bible. CHRISTOPHER: And I had various discussions with our local doctor who was excellent, and said, “I’m a bit concerned about Mary-Anne, is this normal?” “Oh yeah, she'll be right, she'll settle down, not a problem.” MARY-ANNE: The doctor had come, he'd given me an injection to make me got to sleep. Didn't slow me down, still going. You know, they said, “She'll be asleep in half an hour, don't worry, she'll be fine.” No. Still going, raring to go a thousand miles an hour, so that didn't work either. MIKE: So how many nights did you go without sleep? MARY-ANNE: About fourteen. Till it got to crisis point. CHRISTOPHER: Actually I can remember standing at the kitchen sink and looking out the window, looking out at all the trees and thinking, ‘Something's not right here. What’s wrong with my wife and what am I going to do?’ MIKE (V/O): Twelve years ago there was little option. On the advice of Mary-Anne's GP she was committed to Kingseat Psychiatric Hospital. Mary-Anne spent four weeks there, diagnosed with post-partum psychosis, a rare form of post-natal depression occurring in about one in every five hundred mothers. Some mothers suffering from post-partum psychosis have gone on to harm themselves or their children. NEWS REPORT: “Everyone that knows her knows she loves the kids, and that she's a kind, gentle person.” MIKE (V/O): It's what Andrea Yates claims she suffered when she killed her five children. But Sara Weeks says it is treatable. SARA WEEKS: Having a post-partum illness doesn't mean that you have a chronic mental illness or that you're a bad mother or that you're a weak person or don't have any character, or that you shouldn't have been a mother. None of those things are true. It’s one of those things that happens and is a complication of birth, and it needs to be seen as such, rather than something scary that has an awful lot of stigma attached to it. STEPHANIE: It was a great emotional and mental hurdle for me to be resigned to the fact that I needed medication because I guess like most people you kind of think that psychiatric drugs are only for really crazy people. MIKE (V/O): Stephanie was prescribed anti-depressants to treat her recurring post-natal depression. STEPHANIE: Just going to the chemist and handing over that script for psychiatric medicine is a big hurdle. MIKE: Did it make a difference? STEPHANIE: Yup, almost immediately. It was like being let out of a cage you know, that's the way I describe it. Like a bird being set free. SUE: I had spent five years of neglecting myself apart from the nine months of my pregnancy. MIKE (V/O): Medication helped Sue’s depression but it wasn't the answer. She had to deal with her trauma. SUE: Then I decided to actually see if I could get help from somebody who could help me for the trauma, for the scariness, for the feelings, for the anxieties. Somebody who would listen to me, somebody who would believe me and somebody who would say, “That's not unreasonable to fear for your life through what happened to you.” MIKE (V/O): When Mary-Anne had her second child she again suffered from post-partum psychosis. Within days of the birth she was organising a birthday party for husband Christopher. MARY-ANNE: Which was just going to be a few friends and it ended up being seventy people, and it ended up being a ten piece band and instead of having the ice - we've had a few functions here - and instead of having the ice wheelbarrowed in by the guys, you know, put in the spa pool, I had it coming in by helicopter, grandiose things, you know, money wasn't an object. MIKE: You knew what to expect after the first time. Did you not pick up on those signs the second time? MARY-ANNE: What you've got to realise is when you are, when you become unwell, when you start having these delusional thoughts, you don't know what you're thinking is not correct. You actually think it might be other people, it's not actually yourself. So, no, I didn't. MIKE: The second time around, Mary-Anne was treated much sooner because her family recognised the signs. But therein lies the problem for most post-natal depression sufferers. Because it's not talked about, partners, family and friends don't pick up on it until it's too late. SARA WEEKS: You'll get told in your ante-natal classes about what the signs of labour are or what might be warning signs for getting mastitis or an infection or something. I've heard people say that you don't want to tell people what the symptoms of post-natal depression are because you might imagine you've got it. And that is a load of crap. Not that I should say things like that. MIKE: I sense that you feel that not enough is being done. SARA WEEKS: You sense right. SUE: I think a lot of women are suffering out there on their own and they have nowhere to go because the mental health services are only really dealing with women are really seriously ill. Karen Backannounce: Sue, Stephanie and Mary-Anne have all overcome their depression. They hope, by talking openly tonight, they'll encourage others to do the same. In fact Sue has gone one step further. Last month she qualified as an ante-natal tutor.