“Not a cure-all”

Unique drug to aid postpartum mental health sparks controversy

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“I couldn’t sleep when the baby slept because I felt like they might stop breathing. I didn’t really go anywhere because I felt like I wouldn’t enjoy going anywhere. Everything was just overwhelming and going anywhere felt unsafe.” After the births of her first two children, Nikki Reeves’ personal life took a backseat to the fear and dread of motherhood.

Reeves has experienced postpartum depression (PPD) and postpartum anxiety (PPA), mental health disorders similar to normal cases of depression and anxiety that occur after a woman’s pregnancy. After her first birth, she experienced PPA; after her second birth, she experienced both PPA and PPD.

Nikki Reeves (pictured above) has three sons: Jet (5), Blaze (3) and Striker, her new baby boy.

 

One in seven new mothers are affected by PPD. It can cause an increase in anxiety, sadness, crying, feelings of inadequacy, suicidal thoughts and tendencies or thoughts about harming their baby. Women all around the world experience PPD and PPA in different ways.

Diagnosed PPD is usually treated by therapists through talk therapy. In more severe cases, the therapist may suggest going to a psychiatrist, who may then prescribe antidepressants. Treatments for the conditions differ depending the range of symptoms the mother may experience. Reeves used antidepressants to treat her PPD and PPA.

Jaime Filler is a Marriage and Family Counselor who treats women who have PPD and PPA. As a therapist, Filler talks to her clients and tries to find a way to help them without using medication, unless it is necessary or what the client wants.

“When I see clients, a lot of the work we’re doing is really looking at how they can implement some strategies for some self care, because it is a big thing that contributes to depression,” Filler said. “A lot of new parents aren’t getting a whole lot of sleep, so we look at different things that they can do, what supports they might be able to bring in from their community, resources in their family, their friends and we look at what we can shift and manipulate to get them some more support.”

Filler also stated that one in five women and one in ten men may experience PPA, making it more common than PPD. Despite this, the former isn’t given as much thought to when compared to the latter.  

“Sometimes I think we talk a lot about postpartum depression, but people who are suffering with some really severe postpartum anxiety don’t know that, oh, that’s a thing too, like that’s actually a really common thing,” Filler said.

Despite working out of Decatur, GA,
Jaime Filler (pictured above) graduated
from San Jose State University and the
University of California at Santa Barbara.

On a broader scale, it is common for new moms to experience anxiety. But, if the symptoms are neglected, it could create lasting effects on the relationship between the mother and her child.

“A lot of moms become really worried about their babies, about their own ability to take care of their babies,” she said in regards to PPA. “Sometimes they have what we call intrusive thoughts, which is really common of moms who have anxiety. [They are thoughts] that pop into their head about something bad happening to their baby, maybe something they might accidentally do to their baby.”

Filler elaborates on this idea, elaborating on how the severity of the symptoms may vary as well.

“But, [the number of mothers who experience] these intrusive thoughts or worries, something like ninety-one percent of new moms have said that they have. Maybe not necessarily something that is debilitating, [but] they have had that experience [because] being a new parent can be extremely anxiety provoking,” Filler states.

It is speculated that the development of PPA and PPD originate from a hormone imbalance after pregnancy. Filler contradicts this point by using the example of adoptive parents and, as mentioned earlier, relationship partners.

“[With] adoptive parents there isn’t that hormonal fluctuation, right? It can be partners as well. If a woman is experiencing postpartum depression or anxiety, [there is a] fifty percent [chance that the partner may develop] a mood or anxiety disorder following the birth of a child or bringing a new child into [their] home. I think it’s beyond a hormonal piece. I think that can be part of it, you know. [But] for postpartum depression, there’s a lot more too it,” Filler said.

PPD is similar to ‘baby blues’, a more well-known and less magnified version of the mood disorder.

“Eighty-five percent of women will experience baby blues after the birth of a child. That’s a lot of hormone fluctuation. If symptoms are present more than four weeks after the birth of the baby, then it’s no longer baby blues. Then we start to look at postpartum depression or anxiety,” Filler said.

In March 2019, the FDA approved the first drug approved solely for the purpose of treating PPD. The drug, called Zulresso, was developed by Sage Therapeutics. Parents who are treated with Zulresso are admitted into a hospital for 60 hours and are administered the drug through an intravenous infusion.The drug costs $34,000, not including the cost of hospital stay. The patients must stay in a hospital certified for the treatment in case the patient loses consciousness.

“I think that it is a wonderful first start,” Filler said. “Realistically, there are very few women who are able to be hospitalized for 60 hours to have the drug administered. It’s cost prohibitive [and] it’s expensive.”

Reeves and Filler agree that the affordability of Zulresso is a major issue. Because of its price, most women will not be able to afford it, including those who need its the most. Women who need the treatment, women whose medication isn’t working and women whose symptoms are too severe may not be able to afford the drug even though they desperately need it.

“I think it’s worth it for some people, but financially, for most people, it won’t be an option. People with family support and financial [support] are less likely to experience [PPD and/or PPA] because they have that financial stability and family helping out. So I think, a lot of times, it’s the people with no support at all [like] single moms, and they’re not going to be able to afford it. So, it seems unfair that it can’t be available for the people that need it the most,” Reeves said.

According to Filler, the cost is not the only part preventing women from taking the drug.

“Even just the time to be in the hospital is something that is a barrier for new moms. New moms are so focused on taking care of their babies that a lot of the time, taking care of themselves is way on the bottom of the list. So, telling them that they’re going to go to a hospital for 60 hours to take care of themselves, I think that’s– it’s a big jump,” said Filler.

As someone who has had PPD, Reeves agrees that the time could be an issue for many women.

“I think for some people, it can be really helpful because they need that time to focus on themselves and sleep. But I know for other people with anxiety, being separated is not going to help. So, I think it’s a case-by-case basis,” Reeves said.

Reeves believes that she would not have been able to undergo the treatment during the time she experienced PPD.

“[At the time], I couldn’t be away from my babies; I couldn’t even leave them with my mom. If she were holding them, I would go try to take a nap, but I couldn’t sleep. So, being separated wouldn’t have helped [me],” Reeves said.

Filler and Reeves believe that women who have a more severe form of PPD and are potentially dangerous towards them self or the baby should take Zulresso because of its immediate symptom relief.

Many mothers neglect treatment for their symptoms because they do not understand them and feel that they are the only women who experience PPD or PPA. In order to spread awareness, Reeves created an organization for mothers called “Mom’s Night Out”. During the meetings, they talk about their shared experience and remind each other that they are not the only ones who have to deal with PPA and PPD.

“[Mom’s Night Out] just started out as a private face group where people could feel comfortable sharing their thoughts and not feel judged. That was probably really beneficial in my recovery too, because I felt less alone. I could vent and have people understand, and eventually it turned into an in-person group. I started Mom’s Night Out and we would go do dinner. It was the same thing; it was just comradery and feeling like you’re not crazy, because it’s hard, especially when you’re not sleeping,” said Reeves.

Filler is a part of the Postpartum Support International the Georgia Chapter, an organization focused on helping women who deal with PPD.

“We have an event coming up called Coming Out of the Darkness which is a worldwide fundraiser and event to raise awareness for PPA and PPD. The climb happens on the longest day of the year, summer solstice, to spread  the most light on the topic and all over the world there are climbs,” said Filler. “These climbs are to raise awareness and to fundraise for services.”

Decatur’s Climb Out of the Darkness Event in 2018. This world-wide event occurs on the summer solstice to ‘shed the most
light on’ and raise awareness for PPD and PPA. Filler is seen
holding the banner, kneeling next to two boys.

Filler is the coordinator for Coming out of the Darkness in Decatur. The event will be  held at Masson Mill on June 15th. It is a family friendly event suitable for people of all ages. Last year was Decatur’s first time participating in the worldwide Coming out of the Darkness event.

“Last year in Georgia we raised enough money to create 30 scholarships for providers, so therapists, doctors to get trained. So were doing good things. So I do think getting the word out helping to decrease the stigma is important,” said Filler.

PPD is an illness that many women struggle through alone, without more awareness these mothers will not be able to find the help they need.

“You’re being told [that] good moms do everything for their kids, [but] you have to take care of yourself too,” Reeves said. “Having to learn that when society is telling you these expectations that are just unrealistic. But hiding my feelings didn’t make it better, talking about it.”

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