When a Mother Says Something Is Wrong

I’ll be 40 years old in two weeks. Naturally, I’ve been doing a lot of reflecting on my life so far. Among the things that astonish me is the fact that I’ve been married nearly 19 years. My husband has been by my side for almost half of my life.

We got married in September 2007, less than a month after I turned 21. We timed it that way, at least in part, so it would be legal for me to drink wine at my own wedding.

A little over a year later, in January 2009, I found myself standing in a bathroom stall on my lunch break, holding a positive pregnancy test.

I remember the fluorescent light. The dingy bathroom stall. The little white plastic stick in my hand. Watching a brazen blue plus sign appear across it. Back in the finance department where I worked, the phones rang. Someone probably microwaved their lunch. And there I stood, staring at those blue lines while the entire shape of my life changed.

I was married. Technically, I was an adult. But I'd only recently graduated from college. My husband and I had barely begun our marriage. We’d intended to delay becoming parents by at least five years. In fact, we were living in a friend’s basement at the time.

Underneath all of that was a history I didn't yet have the language to understand. My family had suffered a massive trauma when I was 18. By the time I got pregnant, I was estranged from my parents and still reeling. I'd spent much of my childhood surrounded by instability, although at 22 I mostly understood that history as evidence that there was something wrong with me. I didn't know what an ACE score was, or that mine was 8. I didn't understand trauma. I didn't know how much I was carrying.

Getting married had been stabilizing in the way gauze can stop the bleeding. It didn't mean I was healed.

And now I was going to be somebody's mother???

I had barely figured out how to inhabit my own life, and suddenly another life was going to depend upon me.

What I know now, at almost 40 and as a therapist myself, is that none of this history was incidental. I was very young. My pregnancy was unexpected. I had an extensive trauma history, little family support, and a nervous system that had already spent a good portion of my life learning how to survive.

I was vulnerable.

And I shouldn't have had to wait until I was in crisis for someone to notice that.

The care should have started then.

Someone should have asked about my history while I was pregnant. Someone should have talked to me about what that history might mean as I became a mother. I should have been educated about postpartum mental illness before I was experiencing it. My husband and I should have known what warning signs to watch for and what we would do if I stopped sleeping or began to lose my grip. The people caring for me should have been anticipating what I might need rather than waiting for me to become sick enough to ask for it.

Why do we wait until a woman is drowning to teach her what drowning looks like?

I shouldn't have had to become sick before people prepared me, educated me, anticipated what I might need, and surrounded me with care.

But that's not how my story went. The truth is that I did get sick. The latest research suggests that 1 in 5 women in the U.S. develop a postpartum mental health condition, and I was one of them.

I entered a dark period of my life that I can't help but reflect on as we all watch the Lindsay Clancy case unfold.

Something Was Happening to Me

Fable was born in October 2009.

Her birth was stunning in the truest sense of the word. There were bright hospital lights, beeping machines, strangers coming in and out of the room. Then we went home, and the hospital noise was replaced by a newborn crying in the dark.

She woke constantly. My body hurt in ways every new mother knows. I was bleeding and broken, trying to feed a tiny person from a body that had become unrecognizable to me. The love I was supposed to feel for my infant was hard to locate beneath a mounting sense of dread.

And then, about three days after she was born, I stopped sleeping.

When I say that, I worry people will hear the ordinary exhaustion of having a newborn. Of course you weren't sleeping. You had a baby.

No.

I couldn't sleep.

Something in me had tipped sideways. My thoughts were becoming strange. My emotions were enormous. I felt exposed to everything, as though there were no longer any barrier between me and the world.

I could feel myself losing my grip. And I was terrified.

So I did exactly what we tell women to do when something is wrong.

I asked for help.

I Did Not Care How It Sounded

I called my midwife. I called doctors. I told my husband I wanted him to take me back to the hospital. I wasn't hinting. I was telling everyone as clearly as I could that something was wrong with me.

And somehow, I was still the person who had to convince everyone else.

What I remember almost as vividly as the suffering itself is the humiliation of feeling that my desperation was embarrassing.

Around this time, I became convinced that my newborn daughter hated me.

I'm not overstating that. I believed that Fable, who had been alive for a matter of days, hated me. I was also having intrusive thoughts—thoughts that still feel too shameful to name.

Of course a newborn cannot hate her mother. Today, I can see how profoundly unwell I was. But I wasn't standing outside my mind evaluating whether my thoughts were reasonable. I was inside them. They felt true.

Eventually, the doctor who delivered Fable prescribed Ambien, and finally, mercifully, I slept. I'm grateful that he did. But I don't remember feeling that someone finally understood how sick I was. I remember feeling like I'd become distressed and inconvenient enough that someone wanted me to calm down.

I was drowning, and the people standing on shore seemed more troubled by the amount of noise I was making than by the fact that I was underwater.

So I kept yelling.

What would have happened if I hadn't?

Maybe the Problem Was Me

Although I started sleeping a little better, my mood and mind were still foreign to me. So, when Fable was about eight months old, a friend suggested I see his psychiatrist. The psychiatrist gave me an IQ test and several other assessments, but showed remarkably little curiosity about my pregnancy, my birth, the psychiatric symptoms that had begun within days of becoming a mother, or the trauma I'd carried into motherhood.

I left believing something devastating: maybe what had happened wasn't evidence that I'd been sick. Maybe it was evidence that there was something fundamentally wrong with me.

I carried enormous shame from that evaluation.

Thankfully, I eventually found another psychiatrist who understood my symptoms very differently. I was diagnosed with OCD and severe postpartum anxiety. I was prescribed medication, and started therapy.

There were names for what had happened to me. There were treatments for it.

I wasn't bad. I was sick.

Seventeen years later, I'm a therapist, and now I know what somebody should have asked me. How much are you actually sleeping? Are you eating? What thoughts are frightening you? Do they feel like thoughts, or do they feel true? Who is taking care of you?

And when a woman tells me something is wrong, I don't make her prove to me that she deserves my concern.

What More Did She Have to Do?

This is why I've found it almost unbearable to follow the Lindsay Clancy case.

In 2023, Clancy killed her three young children, Cora, Dawson, and Callan, and then attempted to kill herself. Nothing about my anger over her care diminishes the horror of what happened to those children. Their deaths are unspeakably tragic.

The question that haunts me comes earlier.

What more did this woman have to do to get help?

I am not Lindsay Clancy. My illness didn't follow the trajectory hers did. But I recognize the position.

I know what it is to understand that something is going terribly wrong with your mind and discover that the people around you are considerably less alarmed about it than you are. I know what it’s like to receive the wrong diagnosis from a person paying half attention.

I know what it’s like to feel crazy about feeling crazy.

Why is the sickest person in the room responsible for convincing everyone else that she is sick?

We tell women to ask for help. But then what? What happens when she asks again? How coherently does she need to explain her own deterioration? How sick does she have to become before someone else takes responsibility?

What exactly do we think psychiatric illness does?

A woman whose mind is deteriorating may be losing the very capacities she needs to advocate for herself, yet we expect her to recognize what's happening, find appropriate care, withstand dismissal, try again, and somehow continue taking care of children through all of it.

A woman cannot be both the emergency and the emergency-response system.

How Sick Does a Woman Have to Be?

This belongs to a much larger story about women's healthcare.

How much female suffering have we decided is simply normal? How much pain do we explain away because pregnancy hurts, birth hurts, periods hurt, breastfeeding hurts, motherhood is exhausting, hormones are complicated, and women are anxious?

At what point does "this happens to women" become "women are expected to endure this"?

Motherhood may be where this becomes most dangerous because we've romanticized maternal suffering so thoroughly that sometimes we can't recognize illness when it's standing directly in front of us.

But what if she looks you directly in the face and says, "Something is wrong with me. I need help."

No woman should have to fight to be heard while her mental health is deteriorating.

The doors to care should open swiftly. Immediately. And when she walks through them, she should be met with an abundance of care. Not suspicion. Not annoyance. Not someone explaining why what she's experiencing is probably normal. And not a timer counting down how long she's occupied a bed.

The Responsibility Belongs to All of Us

Postpartum mental illness happens inside an individual woman's body and mind, but responsibility for getting her through it cannot belong to her alone.

Sometimes caring for a mother means taking responsibility from her when she no longer has the capacity to carry it.

I think often about the 23-year-old version of myself. She was holding a newborn she loved while believing that newborn hated her. Her body was starving and refusing to sleep. She was dizzy, nauseated, unmoored and terrified. And somewhere inside a mind that was becoming increasingly unreliable, there remained one stubborn signal:

Something is wrong. Get help.

Thank God I listened to it. Thank God I was willing to be embarrassing. Thank God I kept asking.

But I should not have had to.

My survival should not have depended on my willingness to become a pain in the ass.

I needed others around me to become more competent as I became less able to be. I needed someone to understand that my suffering wasn't a referendum on whether I was cut out for motherhood. I needed someone to recognize that something was happening to me.

Seventeen years later, women sit across from me and tell me they're not okay. Sometimes they're ashamed. Sometimes they're afraid of what their thoughts mean about them. Sometimes they've already tried to tell someone and weren't taken seriously.

I can't go back and sit beside that 23-year-old mother. But I know what I can do now.

If a woman tells me she's drowning, I will not ask her to drown more convincingly.

Postpartum anxiety, OCD, depression, and psychosis happen to individual women.

But keeping women and children safe is not an individual responsibility.

The responsibility belongs to all of us.