I don't get why like other moms there they're so tired or this is so hard like I got Lisa felt like she barely needed sleep she had so much energy she was so excited because now I can look back and say that was the warning. I'm Sasha and this week we're devoting our whole show to the story of a woman from Silicon Valley who wanted to be the perfect mom a woman who was ready to be the perfect mom she'd been a successful marketing executive and a successful entrepreneur but success in motherhood seemed lost when the snipers came to take her away the California reports. Has our story. That 1st week after her baby was born the world was nothing but love even when Lisa got time to sleep she still couldn't and I remember thing I'm so tired but I just can't rest when the baby started losing weight the pediatrician said Lisa should start feeding her every 2 hours. Breastfeed and then pump and then feed her the pumped milk and then you know clean the pumping parts which is always something no one thinks about it takes about 20 minutes rest. And basically us through that every 2 hours feedings I cried all the I had 10 minutes of downtime rest. Lisa started to feel like she couldn't keep up she felt overwhelmed and guilty really guilty like it weighed on me is like I failed as a mom I can't feed my child Lisa became even more determined b. I was like needed to feed her that was the most important thing and my wellbeing didn't matter she was barely sleeping even when she could get a release from breastfeeding purgatory she could relax and she got more and more exhausted she started to get. Even as having a conversation with someone like their voices were distorted and it was really hard for me to understand. What what they were saying she decided she go to a spin class something she had done up until the baby was born was. Not a good idea because the noises and the intense volume of the spin class was really alarming to me and it felt like almost like the walls were talking to me. 10 minutes into the class he said it was out of there. I just said to my husband Mike probably a 10200 times a day and I crazy and I crazy and I crazy but then about a month after the birth her clarity came back it was like she woke up from a dream every day for the next week. The day the sun came out she noticed police helicopters circling over the apartment cheered them land on the top of the building you know there stripers on the roof there's by cans in our bedroom everyone watching me cell phone was like giving me their messages we so waited for the police to come in and take her but the next morning she woke up in her own bed the cops had arrested the nanny instead this was wrong the nanny should be punished for her crime Lisa told her husband it wasn't fair she was going to put an end to all this she was going to jump off the Golden Gate Bridge and that's when her husband told her he was going to drive her to the police station himself like oh hey he's taking in s. I'm getting arrested. My mom cooked me eggs and it's like you should eat these before you go on us like this she's like giving me my final meal before I like. That's right I want to work as my life bring my wife to hospital and I've actually checked into an inpatient unit was really really challenging this is David Abramson he explains there was no crime the nanny wasn't arrested and Lisa's destination that day was not jail but rather the general psychiatric ward California Pacific Medical Center though the hospital didn't feel far off from where Lisa believed she was going to have to wait for the door to be unlocked you know buzzer their security and it felt almost like you know brain life had to jelly that she didn't do anything. The other patients were there for drug overdoses or alcohol withdrawal People were screaming one patient thought it was a dog mauling around on all 4 barking it didn't seem like the right place for a new mom that was probably the most heart wrenching thing with having to leave her that night with the hospital staff and you could see in her eyes and her body language she was panicked I was certain that we really were. Probably for the 1st 5 days I just didn't speak to anyone. And I don't know if I didn't speak or I wasn't speaking but I was terrified enough of the environment that I decided like I wasn't going to answer anyone's questions I wasn't going to talk to anyone her husband tried to reassure her he told her the baby was safe at home with his mother he told her she was here to get help but Lisa still thought the people in white coats were all part of some conspiracy because I tried to get out to like leave and I was law in so you can't leave stuff like I am in like a jail but it looks like a hospital or they're saying it's a hospital but it's really a jail Lisa doesn't remember any doctors or nurses telling her why she was there what was going on just thought I was there they did something wrong no one was explaining to me in there is they take these medications you know and they were pissed at me because I wasn't cooperate ing and going to any of the groups or talking to anyone. So it's a no one there told you. No one told me Well my diagnosis was why I was there it wasn't until Lisa had been in the hospital more than a week that she remembers her husband telling her why she was there he wrote her a printout from the Internet on postpartum psychosis that was the 1st time I was like all like he's all my thought I like even though he brought me here like he he made up this disease like just to make me feel better like that was so sweet the paper said it was hormones going wild plus sleep deprivation that can trigger confusion and paranoia Lisa figured it took her husband hours to photoshop all this I really was just like no like I've heard of postpartum depression I've never heard that like there's postpartum crazy of like. Postpartum psychosis is real it's rare but experts believe more women are affected than previously thought and more of them are ending up dead suicide there are a handful of doctors and researchers trying to figure out why. Their doctor detectives really States have never kept good data on this so each suicide is like a mystery and it takes a team of medical investigators to piece it together they start with death certificates and corner reports then work backward they track down hospital records to figure out when the woman gave birth when they study medical charts for clues signs of mental illness that the original doctors didn't catch. California just finished its 1st big study like this it's not published yet it's tied up in state politics at the moment but I got a preview of the data 99 new mums died by suicide over a 10 year period and the doctor detectives determined that of those $99.00 suicides $98.00 were preventable. $98.00 out of $99.00 women might not have died if the health care system in California had done a better job taking care of them. If they had screen better screening diagnose better treat it better. The work that we do here less than 10 percent of what needs to be done psychiatrist normal is one of the doctor detectives she's not the one who told me what was in the report she often treats women in crisis cleaning up what o.b. G.y.n. And missed gaps and she says a lot of docs don't know the early signs of postpartum psychosis waxing and they don't know that the symptoms come and go so a lot of times the patient present very clearly and then at other times her presence and with acute confusion and disorganization like Lisa of sound mind in one moment than believing the walls are talking to her in the next acute confusion and this is a symptom that clinicians are not trained in this field can easily mess because when they see the patient and their office with the family they can think that the patient is normal and you know it's probably suffering from sleep deprivation and distress them home this is how women die in the us mental health problems are one of the leading causes of death among new moms it's number 7 on the list it's actually worse for white women for white moms suicide is number 4 on the list. Dr Dami says even when women do get into care it's often inadequate or inappropriate doctors prescribe the wrong medications insurance companies push patients out of psych units before they're ready. In the psych units themselves in general more psychiatry wards do not have staff that are trained in assessing these illnesses like they really didn't have experience with moms especially moms with you know such young babies coming in to take Lisa Abramson's inpatient experience when Lisa 1st arrived at the psych ward her husband told the resident who admitted her that he thought Lisa had postpartum psychosis the resident said postpartum what he promised he'd study up on it they weren't equipped for me by any means several days after Lisa was checked into the psych hospital her breasts were killing her because I stopped breastfeeding instantly that I mean they just weren't equipped for a new mom and the fact that like of course you have you stopped breastfeeding you're going to have a lot of pain and gorge when no one had thought about that no not at all her husband had to negotiate to bring in Lisa's breast pump from home but she says the only room with an electrical outlet and padded walls and looked like a solitary confinement chamber from a horror movie and that was where like they sent me to go pop you know and under supervision from doctors because they were worried God knows what I would do with the breast pump but. This is a torture device already but the worst thing of all was not being allowed to see her baby inpatient unit had a strict policy no infants on the ward the hospital says this is intended as a safety measure for everybody her family argued with the staff they said you know she needs like she's a new mom and like she needs to see her baby like that keeping this bond going is like really it's important. Yeah those are hard part don't get easier. About 5 days into her time there Lisa's family was able to negotiate short visits with her daughter you know for like you know hours something supervised by a person who kept looking at his watch. Lisa's family it was so unhappy with her care at the hospital her husband practically program out of there they found Dr Dami and asked her to take over Lisa's treatment Dr Dami says separating a mother from her newborn actually makes it harder for the mom to recover a lot of time symptoms of postpartum depression and psychosis and all the mother feeling that she's like a bad mom I feel as if she doesn't provide enough care for her baby I can't feed my child it is a difficult situation for the mother to be in when she has so many negative thoughts and ruminations about herself and her ability to be a good mom and her doctor Danis care Lisa started to reclaim her grip on reality but she didn't know how long it would be before she'd start to feel better she wondered if she'd ever feel like herself again. You're listening to a special edition of the California magazine this week reporter April the bosky is telling us the story of what happens when I have to go to the psych ward they're usually not allowed to breastfeed or see their. Sometimes hospital staff don't even know the best treatments and that way of handling the problem it's pretty unique to the us April again. There's plenty of research dating back to the 1940 s. On the ideal protocols for inpatient treatment of postpartum mental illness the gold standard is to admit the mother and the baby into the hospital together on a specialized mother baby unit they're treated as a pair. Part of the mom's therapy is getting guidance on how to read the baby's cues and how to meet the baby's needs as well as her own at night the baby sleeps in a supervised nursery so mom can get uninterrupted sleep in the u.k. There are 21 of these mother baby units in France there are 15 there in Belgium New Zealand there's one in India in the us there are 0. The closest thing there is to a mother baby unit in the us is 3000 miles from where Lisa lives the hospital at the University of North Carolina in Chapel Hill corner of science Perry Neal you know how many of you this is a psychiatric unit that is reserved exclusively for pregnant women and new moms they accept all kinds of commercial insurance and Medicaid so any woman wealthy or low income can get treated here their mamas I know you're scared and I don't know how to say women 1st arrives nurse and us all away shows them that dear mom book your mama's dear wonderful beautiful mother dear mom's or mom to be this place has saved my life and it will save yours you may think that you're the only crazy girl in the world like this but I promise you you're not a lot I promise you but I promise you you're not alone there Mom you are beyond brave and strong for calm you are strong and your family deserves you you are a wonderful mother almost all of the doctors here are women the psychiatrist who runs the unit is Dr Mary Kemel she wears a denim jacket black suede ankle boots and whenever a patient asks if she's a mom to you she says yes she has 2 kids she has everything here is tailored to the specific needs of me. There is a need for them to see other moms going through what they're going through women get special help with breastfeeding there's a lactation consultant and every room has a hospital grade breast pump we have a refrigerator that's dedicated solely for moms to put milk after they've pumped but the most distinctive feature about the program is the visitor policy most afternoons the unit is bustling with husbands and kids babies can come to the unit and we really encourage that we encourage actually older kids to also come to the unit the staff have tried to make it home here but there are 2 walls of glass separating the day room from the nurse's station so during the sitting hours it's like the toddler scurrying around her in a silent film coloring playing with toys playing with each other. Women cradle their newborns rocking them singing them while a buys the babies are not allowed to stay overnight though there's no nursery here like the units in Europe and the main reason for that is the insurance companies Kamal says no insurer in the us would ever pay for a healthy baby to be admitted to the hospital that baby doesn't have a distinct need to be admitted and so it's not possible to Bill for that baby being at the hospital Dr Kamal says without that the hospital can't afford to run a nursery. The days are very structured with a range of treatments all tailored specifically to pregnant women and new moms there's one on one therapy and lots of group classes parenting and time management lessons for women practice asking their partner for help and a favorite among the moms relaxation class get yourself as comfortable as you can let your body realize recreational therapist Amberg who teaches stress management and coping strategies that you're breathing start to slow. Without forcing your breath she puts on a special light machine that projects a little stars on to the ceiling gives women a place to focus their mind away from the negative thoughts coursing through their heads the now your breath. For Alice the mom's unit at u.n.c. Was the 1st place that gave her hope as a new mom after she had her son she became engulfed by mania she had dealt with depression many times before but never this every minute that I had of so task researching daycares to redo my budget she became an exaggerated version of herself super mom you know of just going to line up 3 bottles I'm going to line up 17 bottles She's a business analyst and loves getting things done she loved how productive she was but then things started to spiral there was a definite snap that I started yelling. About things that didn't make any sense they meant sense to me. If you've ever seen the t.v. Show Homeland It's like when bipolar CIA agent Carrie Mathison sets up a situation room she covers the walls with news articles and photos of the terrorists chasing she crisscrosses the other string in all directions to illustrate the connection she says. It was like that in Alice's mind. To her family though it was just an incoherent rage they called the police and they took Alice to the nearest hospital that had an available bed in this case not the mom's unit at u.n.c. a General psych ward Allison people so drugged they couldn't walk or talk she refused to take any meds and that made her unpopular with the staff I did have a social worker Tamera is going to lose my child if I didn't pull it together. During her 3 weeks day she saw her son once for 20 minutes I was not able to touch him on any level he was and his cars and I reach for him and I was yelled that what was that like to then come back to him after really not seeing him for weeks. I felt like a burden I have from work how my ever going to do this and and I help them and I hate them and you know I did all those things but the connection . I lost time with my son I'm never going to get the time back. Alice was sent home from that hospital even though she wasn't feeling any better she eventually ended up at the mom psych unit at u.n.c. Chapel Hill there everyone finally seemed to understand what she was going through the pressure she was feeling the guilt. Her son regularly helped her start to reestablish her bond changed you know that you have to live my son's life. But even at this seemingly perfect place things go wrong when Alice was discharged her mania cleared but then she slipped into the deepest darkest depression she had ever known that period. Was like This is my life now you know for me not to be manic I have to be this. I checked myself in the last time because I was going to come myself imminently Dr Kemel says with Alice and other patients they're under so much pressure to get Mom's home quickly sometimes they overshoot on the medications some of that pressure comes from the moms themselves who want to be with their kids but it also comes from the insurance companies u n C's mom's unit pays the bills like other hospitals they take insurance to cover the costs of care but the longer a patient stays the more an insurer has to pay and that's not good for their bottom line Kimmel and other doctors say as soon as a patient comes off suicide watch insurers start asking when she can go home are average like this a runs for about one week to 2 weeks in Europe about 40 to 50 days is the average length of stay there that means doctors in the us start patients on new drugs but don't have time to see if they work and that means that patients like Alice can end up hospitalized 4 times before they get better. Alice says mental hospitals in the us are just warehousing people only the moms units. Like a place of healing and despite the limitations of the system it was the only thing that worked for her it's a different kind of place and it's the type frankly the type of mental health care that everyone should have access to this mom. Mental health care in this country and in us right now u.n.c. Is the only hospital in the country that has a designated psych unit just for pregnant women and new moms Hospital in New York has a women's only unit an El Camino hospital in Mountain View where Dr Dolly practices will soon start construction on a women's only psych unit with a special focus on new moms it's slated to open in 2019. Yes. Back in Silicon Valley 2 years after she gave birth Lisa Abramson is playing catch with her daughter Lucy why. Lisa feels like she's back to her normal self she's been thinking a lot about her experience with postpartum psychosis Lisa is pregnant again that was the most courageous moment of my life was like right without knowing anything about how this is going to really work out let's go let's try it again she's terrified though the psy