“If mom is not OK, then baby is not OK”

By Maureen Gilmer, IU Health senior writer, mgilmer1@iuhealth.org

Nissa Walker is a nurse by training, but nothing prepared her for the overwhelming anxiety and confusion she felt after the birth of her first child.

She sensed something was not right with her emotional state during pregnancy but figured once her baby was born, all would be bliss.

Instead, she remembers sobbing when she left the Johnson County hospital where she delivered, with a healthy baby but unsure how she would cope in the weeks ahead.

Looking back to that tumultuous time six years ago, Walker can only marvel at how far she has come, thanks to therapy, a supportive family and IU Health’s Perinatal Mood and Anxiety Disorder Program, housed at Riley Hospital for Children but serving women at multiple IUH hospitals.

“I was convinced I was psychotic,” she said. “It was the most terrifying thing I’ve ever experienced.”

“I WAS SCARED”

Walker, now a mother of two, was suffering from postpartum anxiety with some obsessive-compulsive disorder and depression mixed in.

Getting that diagnosis through IU Health was the beginning of her healing. It came about six months after the birth of her oldest son, Mason, now 6. Since that time, she and her husband, Daniel, have welcomed another son, Rylan, who turns 2 in September.

In those early days with Mason, Walker, who still didn’t have a name for what was happening to her, relied heavily on her grandmother to help with the baby while her husband was working.

Walker said she was so desperate that she was showing up in emergency rooms near her Johnson County home in a panic but was sent home because assessments revealed she wasn’t suicidal.

To this day, she still doesn’t understand how no one she saw recognized what was happening to her. True, her symptoms didn’t indicate depression, but she was hyper-vigilant, struggling with intrusive thoughts and unable to rest while her baby slept.

Getting help was vital. But she was scared to reach out, after falling short in her previous attempts.

“YOU ARE GOING TO BE OK”

What she thought was psychosis was more in line with hyper-anxiety, she said. It took a phone call with Birdie Meyer, then coordinator of IU Health’s Perinatal Mood Disorders Program, to see the light.

There would be more phone calls, then an in-person meeting on a Monday morning after her husband drove her there.

Meyer told Walker she was suffering from postpartum anxiety, OCD and depression, but that it was 100 percent treatable.

“You are going to be OK,” Walker remembers her saying.

“I don’t think I am, Birdie,” she replied.

“And she said, ‘I promise you, you’re going to be OK.’

And it was like I could just breathe. I trusted in her. She knew everything I was thinking before I said it, which signaled to me this isn’t just me.”

That was the beginning of the work. But at least Walker felt heard and understood. She began seeing a therapist and going to IU Health support group meetings, where she met other women from all walks of life who were suffering as she was. Some, who were further along in the process, offered hope that things would be OK.

“I was scared to go to group at first,” she said. “A lot of postpartum women think someone is going to take your baby because you’re telling them you’re not mentally sound.”

Instead, she found a community of women who understood her pain and helped her realize she was not alone.

PANDEMIC BABY

Three years later, she and her husband felt the time was right to have a second child. She quickly became pregnant, but three months in, the pandemic hit.

Knowing she was going to need even more support, she reconnected with the IUH postpartum group, now being led by Tracey McInnes, a survivor herself of postpartum depression, anxiety and PTSD.

The two have built a strong relationship; Walker not only returned to group sessions, which continue to be held virtually, she now facilitates meetings. “I attend group religiously,” she said.

“I consider Tracey a mentor, a colleague, a friend. I can lean on her; she can lean on me. We are really in this thing together.”

McInnes describes Walker as “an amazing woman, mother and support to others.”

One in five women are affected by perinatal mood and anxiety disorders, McInnes said. The program she oversees provides screening, education and treatment referrals.

At every IU Health hospital, new moms should receive the Edinburgh Postnatal Depression Screening (EPDS) before discharge. The maximum score is 30. Anytime a mom scores 12 or higher, she is referred to the mood disorder program for follow-up care.

Since the pandemic, the number of referrals has risen exponentially, McInnes said, estimating she receives on average 100 new referrals a month into the program.

“I think the biggest need we have is more resources,” she said. “Some states have partial hospitalization/outpatient programs, specific to perinatal mood and anxiety disorders (PMADs). New York and North Carolina have intensive inpatient programs. In Indiana, it’s a struggle to find a therapist who specializes in PMADs (or even has had training on them). We have our work cut out for us.”

More screening and education would also help. Walker said the only exposure to the topic she can remember was an afterschool special she saw as a child, where women in postpartum crisis were depicted in dark ways.

“It seemed a taboo thing that didn’t happen to regular people,” she said.

Women’s mental health must be prioritized, Walker added.

“I don’t think any woman should leave the hospital without the resources, without the education on perinatal mood and anxiety disorder and someone to call. I think it should be a routine part of maternal health. If mom is not ok, then baby is not ok.”

McInnes reiterates that point.

“It is detectable, and there are treatment options available,” she added. “Left untreated, there can be devastating consequences for the mother, the family and/or the baby.”

CLIMB OUT OF THE DARKNESS

If you or someone you know is struggling with perinatal mood or anxiety disorders, there is help. You are not alone, and you are not to blame, McInnes and Walker both said.

And with the right treatment, you will recover.

“I can’t imagine there is a woman who has a baby who doesn’t go through some of this,” Walker said.

The support group meets virtually at 10 a.m. on Mondays. A couple’s support group that meets on Thursdays is expected to restart in the fall. Call McInnes at 317-948-7308 for information.

Walker will join other women and families at the Climb Out of the Darkness fundraiser from 11 a.m. to 2 p.m. Aug. 20 at the University Green & Gazebo in the Village of WestClay, Hamilton County.

The free event, organized by the Indiana chapter of Postpartum Support International, includes resource tables, vendors, food, chair massages, a mini yoga session and children’s activities.

Walker looks at her two boys today and counts her blessings, even as she notes their personality differences. Mason is more anxious, more in tune with his and others’ emotions, and has a heart of gold, she said, while Rylan is rambunctious, doesn’t know a stranger, and is fearless and strong-willed.

“With Mason, I was scared to reach out … and with Rylan, I had all this new information,” she said.

“It was like night and day, even through the pandemic. When it hit, I thought, ‘Well, I’m not gonna make it.’ And I did.”

Photos submitted and by Courtney Galvan