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Deb Wachenheim, who said that her sister, Cindy, appeared easygoing after childbirth and saw a therapist when relatives realized her troubles, in Arlington, Mass., Jan. 17, 2014. Recent findings show that maternal mental illness can emerge later than expected and include a broader range of symptoms. (Gretchen Ertl/The New York Times) ORG XMIT: XNYT64

Gretchen Ertl • New York Times,

secret anguish: Cindy Wachenheim “loved life.” She had no risk factors that would signal a mother likely to become suicidal.

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A new view: Emily Guillermo said she felt “like my body had been invaded” after her second pregnancy. A growing body of research is revealing that maternal mental illness is more complex than previously thought.

Ivan Pierre Aguirre • New York Times,

complex interplay: Jeanne Marie Johnson said she had a happy pregnancy, but had visions after her daughter Pearl, 2, was born. An interplay of genes, stress and hormones causes maternal mental illness, scientists say.

Leah Nash • New York Times,

Jeanne Marie Johnson, right, who dealt with postpartum depression after the birth of her daughter Pearl, 2, cleans off her hands during a visit to the Oregon Zoo in Portland, Ore., Feb. 25, 2014. Studies are revealing a more complex view of maternal mental illness, including that what is known as postpartum depression often begins during pregnancy. (Leah Nash/The New York Times)

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Breaking the silence on their postpartum

  • Article by: PAM BELLUCK
  • New York Times
  • June 21, 2014 - 4:18 PM

 

Cindy Wachenheim was someone people didn’t think they had to worry about. She was a levelheaded lawyer working for the state Supreme Court, a favorite aunt who got down on the floor to play with her nieces and nephews, and, finally, in her 40s, the mother she had long dreamed of becoming.

But when her baby was a few months old, she became obsessed with the idea that she had caused him irrevocable brain damage. Nothing could shake her from that certainty, not even repeated assurances from doctors that he was normal.

“I love him so much, but it’s obviously a terrible kind of love,” she agonized in a 13-page handwritten note. “It’s a love where I can’t bear knowing he is going to suffer physically and mentally/emotionally for much of his life.”

On March 13, 2013, Wachenheim, 44, strapped her 10-month-old son to her chest in a baby carrier and leapt to her death from her Harlem apartment. Her story provides a wrenching case study of one woman’s experience with maternal mental illness in its most extreme and rare form. It also illuminates some of the surprising research findings that are redefining the scientific understanding of such disorders: that they often develop later than expected and include symptoms not just of depression but of psychiatric illnesses.

Now these mood disorders, long hidden in shame and fear, are coming out of the shadows. Advocacy groups are springing up, and some mothers are blogging about their experiences with remarkable candor. A dozen states have passed laws encouraging screening, education and treatment. And celebrities, including Brooke Shields, Gwyneth Paltrow and Courteney Cox, have disclosed their postpartum depression.

Wachenheim’s sister, Deb, is among those breaking the silence.

“We did try to help her, but perhaps if we had been more knowledgeable about postpartum mood disorders, including the fact that postpartum depression is just one of an array of such mood disorders, we could have done something differently that would have maybe saved her life,” she wrote in an e-mail.

Cindy Wachenheim seemed fine until her son was about 4 months old, family and friends said. And as a healthy, active woman, Cindy had no risk factors that would signal a mother likely to become delusional and suicidal. “She loved life,” her sister-in-law, Karen Wachenheim, said.

In fact, Cindy, years earlier, identified postpartum depression in Karen.

Experts say such breaks from reality are likely symptoms of postpartum psychosis, which affects only one or two in 1,000 mothers. About 4 percent of those hurt their children; about 5 percent kill themselves. Flagrant cases usually emerge soon after birth; women may hear voices or feel compelled to inflict harm, like Andrea Yates, who drowned her five children in a bathtub in 2001, or Dena Schlosser, who in 2004 cut off her infant’s arms. Both women were ultimately found not guilty by reason of insanity.

For most other maternal mood disorders, most women know something is wrong, and although they fear they will harm their children, they rarely do.

At Thanksgiving in 2012, Cindy’s family gathered at her brother Ron’s home outside Albany. Cindy told Deb she had thought about suicide, saying “How can you go on knowing that you’ve ruined your baby’s life and it was your fault?” Deb was stunned. She and Cindy’s husband discussed the situation, hopeful that therapy would help.

But on a Wednesday afternoon in March, with her baby snug to her chest, she jumped. “I am so unbearably sorry, which I know does nothing to undo the evil I have done,” her farewell note began. “I wanted to be a mother so badly and I hoped to be a wonderful one, and instead I have become the worst of the worst.”

Searching for anything to blame herself for, she described minor, harmless moments: tucking a light blanket over his face for warmth, letting him suck a leaf, briefly putting a dime in his mouth and immediately removing it. “These things I did were horrible,” she wrote.

She was sure her son would never walk. “I don’t know if there is a hell,” she wrote, “but I hope so.”

She would never know that in her last act, her body cushioned the fall for her son and saved his life. Weeks later, the healthy little boy took his first steps.







 

© 2014 Star Tribune