Sunday, July 29, 2007

PP Depression, PP Psychosis, and...

My considered opinion on the Andrea Yates fiasco.
First... I suffered, and I DO mean SUFFERED from Post Partum Depression after the birth of Angel Baby Girl. I was already on anti-depressants when Son was born, so the PPD wasn't so bad after his birth, but it was still there.
In my particular case, my depression started when I was 12 and went untreated until I was 21. I was non-compliant off and on with my meds for a few years. So when I had ABG, I was off medication. My wacky thinking went something along the lines of...”I don't want any of those nasty chemicals passing through the placental barrier...” Besides, I was on a hormonal high all through my pregnancy. And for the first couple of months after she was born, I was OK.
Then the three month colic hit. So I started to get sleep deprived. It just went downhill from there for the next six months. Yes, I said SIX months. It took that long for my husband [that husband, NOT the Dearly Beloved] to notice something was wrong. It wasn't entirely his fault. By that time I'd had 13 years experience hiding my depression from my nearest and dearest. But eventually he noticed that I was breaking a toe at least once a week because I kept running into furniture; I was not eating; I wasn't sleeping.
It finally came to a head one night when he came home from working a 3 – 11 shift [he was an ER Nurse] and I was in tears. When he wanted to know what was wrong, I finally admitted everything I'd been hiding for all those months, the daily crying, the months of sleeplessness,all the accidents, the thoughts of hurting myself and ABG. He held me and let me cry and sat up with me all night.
The next morning, we went to see a husband and wife team. He was a psychiatrist and she was a MSW/Therapist. I had a bunch of medical and psychological tests, got on the right meds, went into therapy with her and stayed on the meds and in therapy. My Mother-in-Law took turns with my Step Mom and Grand Mother coming to help take care of ABG for a month while all this was going on. I also got visits and calls and cards from friends. Without the love and help and support of all the peeps, I wouldn't have made it.
And this was a Post Partum DEPRESSION. A first time, with ONE child.
Now, let's talk about Andrea. She had a Post Partum PSYCHOSIS. The difference between what I suffered and what she suffered is on a magnitude of 10, folks. I was never delusional. I never had voices in my head telling me that my child was going to go to HELL because I was a BAD MOTHER. I was not trapped at home with FOUR little boys and a newborn infant daughter and no car.
The thing that I think is MOST insidious and dangerous about PPD and PPP is that they get WORSE with each occurrence. The only reason my depression was mitigated after Son's birth was that I was already on anti-depressants and seeing a therapist. And when I look back to that period of my life, I say a prayer of thanks.
Poor Andrea, she had been hospitalized, and on medication [Haldol,an anti-psychotic]after the birth of Luke [son number 3]. She had a psychiatrist who seemed to have an understanding of her problem and was not hesitant to hospitalize her to stabilize her on the medication she needed. This same doctor advised Andrea and Rusty [Andrea's now ex-husband] that having any more children would be a danger to Andrea's sanity.
What does Rusty, the loving husband do? Does he go out and have a vasectomy to protect his fragile wife? Does he refrain from sex so as not to impregnate her? NO, he does not! This Rocket Scientist [I am NOT being sarcastic, he works for NASA, that makes him a Rocket Scientist in my book] with his and Andrea's religious convictions to be fruitful and multiply, gives his crazy wife son number FOUR, Paul. Predictably, after Paul's birth, Andrea goes off her meds and has to be hospitalized, AGAIN. She's back on the Haldol and stable, for a while.
Then, along comes their little girl Mary. And Andrea's predictable post partum psychosis. But this time the Doctor who “gets” Andrea has moved to the other side of town. That's an inconvenient drive for Randy, so he finds a Doctor close to home. A Doctor who refuses to prescribe Haldol, even though Haldol has proven effective for Andrea's psychosis in the past. Then when he is called to testify at her first trial, he lies his ASS off. If Randy had cared about Andrea, he'd have changed Doctors the instant this Quack refused to prescribe Haldol. And when he lied on the stand...he'd have sued for malpractice. Andrea still should, IMHO.
Let's spare a few lines here to castigate the insurance company, shall we? Andrea's last two psych hospitalizations were for unconscionably short periods of time. 10 days or 2 weeks is not enough time for a patients to get stabilized and have some meaningful therapy in a hospital setting. 28 days to 6 weeks SHOULD be the norm. And every Dahm gatekeeper knows it! But as long as insurance companies are more concerned with the bottom line than patient outcomes, these sort of stays will be the norm.
Had Andrea been allowed a sufficient time in the hospital after the birth of Mary; had she had a COMPETENT Doctor; had Randy refused to father any more children after Luke; had Randy gotten Andrea psychiatric help sooner; had Randy had live-in childcare/household help for Andrea; if the children had been in Daycare so that Andrea had not had to care for them when she was PSYCHOTIC... MAYBE none of this would have happened.
For it is my everlasting, firm belief that Andrea Yates was Psychotic. She was NOT Guilty by reason of insanity. She had a longstanding history of postpartum psychosis. The fault for the death of those precious, innocent children lies with a profit hungry insurance company; an incompetent physician; and an insensitive Husband. I know that some of my Law Enforcement readers and maybe some of you Medical readers may disagree. That is your right.
I have been down that road. But for the Grace of a Kind and Loving God, I could have been as far down the road Andrea went. No one who has not had PPD, or PPP, can ever know the HELL that it is. If you are a Man, don't even begin to try tell me you KNOW how hard it is. You can sympathize, but you cannot empathize. If you are a woman who managed to escape the postpartum period without a depression or with a Mild case, you are truly Blessed. So, pleased, count yourself as blessed and don't judge Andrea for not having your blessings


Babs RN said...

I have to respectfully, but completely, disagree. Those with intermittent psychoses have periods of lucidity when they know something isn't right.

I work with them. I know.

And they have the capability of seeking appropriate help. And if that doesn't work, they go to someone else.

Sure it was for her husband to be supportive, but the onus was on HER to know that she was in trouble and to resist the urge to murder her children.

It is possible. But too many people like to use their illnesses as an excuse to harm others and to be irresponsible.

I agree that if this was so well known then she should never have had unsupervised contact with the children. Perhaps they should have been placed with a family member or in foster care.

But in the end, she knew something was wrong with her and still she murdered her children. Period.

Babs RN said...

...and I don't see why her husband should have to have the vasectomy since that doesn't stop her from being impregnated by someone else. She should be sterilized - and quickly.

phlegmfatale said...

I think not only was Andrea's husband too stingy with his time to help her stay with a doctor and therapy that worked for her, but he was also too cheap. I'm sure it was music to his ears when the new doc refused to prescribe Haldol. And while I do believe she is responsible for her actions and should be held accountable, I believe her husband is equally guilty.

Same goes for that woman in Tennessee who killed her Church of Christ pastor husband.

Both of these cases are examples of women trapped in abusive domestic partnerships in which a puritanical cult is used as a cudgel to keep the women in line and in a lesser state from the men.

If Andrea Yates had been a friend of mine, I would have scrabbled around and FOUND the money to help her buy birth control and her meds.

What a horrifying scenario, and oh, so unnecessary.

SpeakerTweaker said...

I don't have a lot of room to talk here. I don't have the proper plumbing to know what carrying, birthing, or Post-Partum-ing a baby is like. I also don't have the medical expertise to understand it, either.

What I do know is, SHE knew. She had been hospitalized before for this very issue. She new PRE-PARTUM that there would be issues later. While I deeply pity her (I have experience in the "keeping from those we love" department), I do NOT excuse her for systematically murdering her children.

I also do NOT excuse the other parties involved. I think the "husband" (yes, in quotes. I use that term loosely here) should come on down to my backyard for his vasectomy. I think all health insurance agencies should all fall into Hell simultaneously anyway. And there was a Doctor somewhere who knew something and did nothing.

I think Andrea Yates is the poster child for Capitol Punishment. I guess that's why we have juries.

But, you've also been down that road and I haven't. I praise you for doing the right thing.


lainy said...

I suffered with PPD after my youngest was born, but I knew something was wrong and sought help myself. I didn't depend on anyone else to do it for me.

I think Andrea Yates had times where she KNEW something was wrong and could have picked up a phone, at least. She could have saved those babies, but killed them instead. She deserves what she got.

HollyB said...

Babs, Tweaker and Lainy,
Perhaps, in the initial onset period of the Post Partum PSYCHOSIS, not Depression, Andrea DID have some periods of lucidity. But by the time of the murders [6 months after Mary birth], without effective medication and support, with no effective supervision, She was totally delusional. She HAD asked for help, and what she got was ineffective. How her Doctor and Rusty live with their consciences is beyond me. They abandoned her to her madness.
Did she know PRE-partum that she was at risk? Yeah, but she was under the sway of a nut job fundamentalist preacher. And that, combined with her pre-existing mental illness and her husband's desire for more children, led her to continue have more children. In this case her Religion WAS part of her Pathology and her delusions.
Babs, I've seen psychotics in criminal and clinical settings who have either been un- or undermedicated for less than 6 months who were totally delusional, with NO periods of lucidity. That's why I find it believable that Andrea had no lucid periods during the period immediately preceding the time she killed her kids.
Remember y'all, there is a HUGE, difference between Post partum Depression and Post Partum Pyschosis. Andrea Yates was Psychotic, not just depressed.

Her trial jury was ruled by emotion. The Texas Court of Criminal Appeals looked at the Legal issues with a Reasonable Mindset. That's why she is NOW in a Hospital, instead of Prison. A Hospital is where she belonged all along.

g bro said...

Hey, I had postpartum depression, too! It lasted from the time I was born until I was 17.

I agree; I lay a huge amount of resonsibility at the feet of her husband.

Flo said...

Are women suffering from PPP lucid during periods when they are not psychotic, or are they "merely" depressed? As we know, you can still be suicidal or homicidal if you are depressed. And I know of cases in which religious beliefs have caused harm or death.

People suffering from depression don't always seek help until it's too late for a variety of reasons. Why is it so difficult to imagine a woman with PPP not asking for help?

I have to agree with Holly. Given what we know, Andrea Yates isn't the monster she's been made out to be. And the "lucid" one in the relationship bears a lot of the responsibility.

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