Joan Phillips remembers being in a really bad spot on a Sunday evening in 2010.
She was doing what she had often done in the months after her son, Jackson, was born: scouring the internet for any shred of hope or help with her postpartum depression and panic disorder. Her days alternated between caring for her newborn and enduring sleepless nights breathing through increasingly debilitating panic attacks. But that evening, she stumbled across a phone number on the Pregnancy and Postpartum Support Minnesota (PPSM) website. She dialed.
“I remember calling and I don’t remember exactly what I was looking for,” Phillips said. “I think I was looking for some kind of connection, like a real live human being to say, ‘That has happened to me. Yes, it sucks and it will get better.’ ”
Phillips is one of 1,200 women in Minnesota who have sought out the help line during or after their pregnancies as they faced anxiety, depression and other mental health problems. People statewide can call the PPSM help line, launched in 2011, for assistance in finding local therapists specializing in perinatal mental health and to access a peer support network. That peer network includes women like Phillips, who used the help line in their time of need.
The help line averages 40 calls per month and has thrived thanks to peer support volunteers — who mail postcards to mothers with PPSM contact information— as well as a growing number of providers attending trainings sponsored by PPSM and an increasingly popular 5k race, said Executive Director Crystal Clancy.
Clancy is also a marriage and family therapist in private practice, who is certified in perinatal mental health at Iris Mental Health Services in Burnsville.
“A lot of people just don’t even know where to start,” Clancy said, referring to the search for maternal mental health resources. A common problem, she said, is that mothers are not being connected to therapists who specialize in perinatal mental health, causing them to walk out of sessions feeling it was unhelpful or made them feel worse. Sometimes, therapists have told moms that it’s just the proverbial “baby blues,” or they wave off the intensity of a mother’s feelings of depression or anxiety as normal after giving birth.
Stories about postpartum depression sometimes focus on the most tragic situations, like mothers who drown their children or drive off the road with their baby. While rare, postpartum psychosis is a severe illness that includes rapid mood swings, paranoia, delusional thinking and irrational judgment.
But most women who experience postpartum psychosis do not harm themselves or anyone else, and cases of suicide and infanticide are rare, according to Postpartum Support International, an organization focused on increasing awareness about the emotional changes during and after pregnancy. Families and friends are often the first to recognize these signs and, if they do, it’s recommended that they seek immediate medical treatment for the mother.
“There’s sort of a stigma of mental health, because a lot of what’s shared in the news is the tragic stories,” Clancy said. That leads some women to feel afraid “to come forward about feeling depressed or having intrusive thoughts,” she said, “because they fear they might be stigmatized, hospitalized or their kids getting taken.”
Cultural differences in communities of color about topics like mental health and motherhood add another layer of difficulty. Language barriers in immigrant communities can also lengthen the time it takes to get help.
Clancy added that her organization also hears that doctors don’t always ask mothers about postpartum depression or suicidal thoughts because they wouldn’t know where to send them for help. That’s why PPSM offers trainings for providers statewide, she said.
“Most women will go to their OB-GYN and even pediatrician and that’s their first visit with someone, and they’re not getting the resources that they need. They’re not getting asked the right questions,” Clancy said.
The help line typically fields calls from people seeking specific mental health support groups, online groups and help finding a therapist in their community. Volunteers connect them with someone from the peer support network, if they’d like. If callers are seeking therapy, volunteers try to help them connect with a therapist who takes their insurance and will see them in less than a week.
The perfectionist problem
Part of the challenge in getting help is that “sometimes new moms are pretty isolated and strive for that perfectionism, which you just can’t do as a new mom,” said Sue Abderholden, executive director of the National Alliance on Mental Illness Minnesota. She said there’s an increased awareness among providers about the importance of asking mothers how they’re feeling. The result: more women are telling their stories about postpartum depression.
While NAMI Minnesota has its own help line, Abderholden pointed out that it only operates during business hours and more often acts as a broad resource for navigating the state’s overall mental health system.
“There’s no way we can address everyone’s needs,” Abderholden said. “I do think there’s a need for this specialized approach, as well. We don’t see this as competitive at all. [PPSM] gives a safe place for moms to call.”
Phillips remembers being one of those moms longing for such safety. Over several months, she felt like “a cellphone on vibrate” all of the time. The panic attacks occurred at home and at work in her city government job, to the point where she sometimes hid in the filing room until they subsided. Her hands shook, her face was always flushed, she rarely slept and she could barely choke down food. All she ate was yogurt or mandarin and peach fruit cups. She lost nearly 70 pounds.
“I do remember being at work and having one of those terrible panic attacks, thinking, ‘I can’t do this another day,’ ” Phillips said. “I feel like one of the things I would tell co-workers and family and friends is [that] my own body feels like it’s killing itself.”
Phillips was put in touch with a peer support volunteer who talked to her for nearly two hours about motherhood, experiences with perinatal mood disorders and what wellness could look like. The volunteer “served as an actual person that could provide that encouragement to keep continuing,” said Phillips. She encouraged Phillips to reach out if she was feeling scared or anxious. The two women would go on to talk often by phone and in person.
Phillips said that having that support bolstered her search for a doctor who would eventually help her find the right medication regimen. In the years since, she has become a peer support volunteer and has donated money to the organization. Throughout her experience, Phillips said she recognizes her privilege, including access to the internet, health insurance, time and money to find providers, and family and friends who supported her. Not all women are that lucky, she said.
“I think that’s probably what my worry is: how do we ensure that those without that privilege are still supported and find that path to wellness?” Phillips said. “I don’t know the answer, but it does weigh heavy on my heart.”
Dr. Katie Thorsness, a perinatal psychiatrist at Hennepin Healthcare, sees the same challenges among her patients, including lack of transportation to the doctor, lack of child care, previous medical trauma and distrust of medical professionals.
Hennepin Healthcare has its own number, called HopeLine, for moms seeking mental health treatment. The help line offers intake within two business days and mother-baby groups. But Thorsness refers moms from outside of the Twin Cities area to the PPSM help line, because she’s not always sure about the availability of providers in their areas.
It’s part of the mission of providers to work together to help moms, however they can, she said.
“One thing I like about the [PPSM] help line is they help connect moms with peer mentoring support, which I think, as a psychiatrist, is not something I’m able to offer in my visit,” Thorness said. “It’s really that peer support and that connection with someone who has been there and can just offer that validation in a way that I cannot.”
Phillips said treating moms with compassion, and not as if they’re broken, and connecting them with the right help is important.
What she would tell other moms is simple: “You’re not alone, you’re not to blame and you will get better.”