When she realized her postpartum anxiety and depression went beyond the “baby blues,” one patient turned to the UNC Center for Women’s Mood Disorders to get — and stay — well.
They say having a baby changes everything.
But, after Evelyn Bussell of Raleigh gave birth to her daughter Felicity in June 2011, she experienced changes she’d neither anticipated nor read about in the many books she’d consulted in preparing to be a new mom.
She’d expected the fatigue from sleepless nights with a newborn, but not the crushing anxiety. As a first-time mom, she imagined she might second-guess herself, but not that she would trust herself so little that she was afraid to care for the baby she loved when she was alone.
In the first few months of her daughter’s life, she became abnormally irritable, experienced intrusive thoughts and developed obsessive tendencies. She loved her daughter, but parenthood turned up one insurmountable obstacle after another.
Bussell chalked it up to sleep deprivation.
“We worked out a plan so I could get more sleep, but then I couldn’t sleep,” said Bussell. “My husband couldn’t go to work because I was so anxious that I didn’t feel comfortable being alone with the baby. It was an ugly cycle where my anxiety fed off hers, and the more anxious I was, the more she would cry.”
About seven months after giving birth, Bussell heeded her husband’s suggestion to take a few hours out of the house for herself. She headed to a favorite coffee shop and there, she said, she snapped.
“The shop had run out of decaf coffee, and so I absolutely lost it on a barista. I wish it had been caught on video so I could see what I was like in that moment,” she said. “That’s when I really knew something was wrong.”
Finding the right kind of help
Bussell and her husband first sought help from a walk-in clinic, which prescribed medication. Like many new mothers, Bussell was skeptical and worried how the medication would affect her breast milk. She then turned to a counselor who specialized in depression, but it wasn’t until she joined a peer support group led by Chris Raines, RN, MSN, an obstetrical liaison for the Perinatal Psychiatry Program at UNC’s Center for Women’s Mood Disorders that Bussell felt like anyone understood what she was experiencing.
“It wasn’t just the ‘baby blues,’ it was more, and they understood that.” she said.
Bussell continued to attend the peer support group while her husband prepared to leave for an out-of-state military training. As the date loomed, so did her mounting anxiety, a darkening cloud that worsened each day. The day before her husband’s trip, Bussell went out for a walk, consumed by worries that she’d not be able to care for her daughter alone and that her daughter’s life might be better without her in it.
The next day, Bussell was admitted to the Perinatal Psychiatry Inpatient Unit – part of the Perinatal Psychiatry Program of the UNC Center for Women’s Mood Disorders – at UNC Hospitals.
Those 18 days saved her life, she said. Bussell said the mix of medication, group therapy, art therapy, guided relaxation, biofeedback, yoga and chaplain services allowed her to explore her sickness in different ways, something she said helped her get well and stay well.
“I couldn’t take care of my daughter or myself and it was adversely affecting the relationship I had with my husband,” said Bussell. “That program saved me, saved my life, saved me as a mom, and it saved my family.”
Providers at the center understood how important it was for Bussell to continue pumping breast milk and to be able to see and feed her daughter each day. Breastfeeding was something that had always been easy for Bussell and her baby, and she clung to the idea that, in the middle of a dark time as a parent, nursing her child was an area where she’d always succeeded.
“I was so sick, and I could not believe I was a good mother. No one there tried to change my mind, they just met me where I was,” she said. “They told me every day that they believed I was a good mom, even when I didn’t.”
Raising awareness for maternal mental health
On Friday, May 1, Bussell will be on hand as the UNC Center for Women’s Mood Disorders celebrates Maternal Mental Health Awareness Day, an entire day of events, readings, lectures, food, music and more in the atriums of the NC Women’s Hospital and NC Neurosciences Hospital.
That evening, the Varsity Theatre on Franklin Street will give a free screening of the documentary “Dark Side of the Full Moon,” which explores postpartum depression and other pregnancy and postpartum mood disorders. After the showing, the filmmakers will be on hand for a question-and-answer session. (A five-dollar donation is suggested.)
Samantha Meltzer-Brody, MD, is director of the Perinatal Psychiatry Program and associate professor in UNC’s Department of Psychiatry, which supports the center and its programs. She said she hoped the day’s events would serve as a “call to arms” for improved access and standardized perinatal mental health care across the country.
“This day will allow us to educate the community about not only the prevalence and importance of maternal mental health issues, but also the innovative treatment and research happening at UNC,” said Meltzer-Brody. “We remain the only perinatal psychiatry inpatient unit in the United States and serve as a referral center for women across the country, and we hope to serve as both a national and international model for the provision of maternal mental health.”
The five-bed inpatient unit where Bussell stayed in 2012 is the first of its kind in the United States and, so far, the only one. The unit, which opened in 2011, provides comprehensive and specialized psychiatric assessment and treatment including consultation and collaboration with UNC’s Department of Obstetrics and Gynecology, if needed. The unit also offers gliders and lactation equipment in patient rooms, trained nursing staff and extended visiting hours to maximize positive mother-baby interaction.
In addition to its inpatient services, the center and its programs offer outpatient care, with both clinical and research programs to address the needs of women with reproductive mood disorders, which also includes perimenopause and menstrual-related disorders. In the decade since the Perinatal Psychiatry Program was created, it has grown to include multiple outpatient clinic locations with mental health providers embedded in both high-risk obstetrics and gynecology clinics and within the Department of Pediatrics.
“Perinatal mood disorders are incredibly prevalent, affecting one-in-eight women. They are a cause of significant morbidity and put women at risk for maternal suicide,” said Meltzer-Brody. “The prompt identification and treatment of perinatal mood disorders is critical for the mental health of the mother, her child and family.”
‘Anything I can do to help’
Bussell, now a certified birth doula and a childbirth educator at UNC, encourages her students to plan beyond pregnancy for the changes that are bound to come for most new parents, like sleeplessness, a loss of social life and the stress of raising a child.
She also introduces them to the warning signals of postpartum mood disorders like excessive worry, intense guilt, extended periods of crying or suicidal thoughts. She encourages them, should these problems arise, to seek help at the center like she did.
“When you’re struggling, it can be a huge inconvenience to get out of the house with the baby, but when I talk to mothers, I tell them how important this place is, and that if they can get here, that it’s worth it,” said Bussell. “Anything I can do to help other mothers, I will.”