On the day of our appointment, Dr. Lieberman welcomed me into his office, lined with shelves of books and with windows overlooking the waters of the Hudson River. I sat down on the couch and began to tell Dr. Lieberman as much as I could about my mother, about her childhood in Steubenville, her move to New York. I explained there had been no signs of her illness until after my birth. I brought with me the names of the medications I knew she had taken for her illness after she had moved to the adult home. I explained that she had only been diagnosed as mentally ill much later in life and that throughout my childhood and early adulthood, we had no idea what was wrong with her.
“In order to diagnose mental illness, there isn’t an ironclad test,” Dr. Lieberman told me. “You can’t take a blood test or perform an MRI to determine the nature of someone’s disease. Instead, you have to rely on symptomatic evidence.”
He asked me many questions. Did my mother suffer with insomnia? Did she smoke? Did she have a history of hypochondria? Did she experience any trauma in childhood? Did she have any religious beliefs?
I answered his questions. I explained that by the time my mother received her diagnosis of paranoid schizophrenia, she was in her fifties. She had been taken to the hospital because she seemed to be having some kind of psychotic episode.
“The doctors there would have seen a woman who was delusional, and so they made their diagnosis based on the symptoms she was presenting to them,” Dr. Lieberman said. “But presumably they wouldn’t have had access to her prior history and health records?”
I told him no.
Dr. Lieberman paused, then spoke.
“You mother didn’t have paranoid schizophrenia,” he said. “What you’ve just described to me are the symptoms of postpartum psychosis.”
I was stunned. I had always been told that my mother was schizophrenic, and yet here I was in the presence of the world’s foremost authority on the disease, and he was suggesting a completely different diagnosis.
Dr. Lieberman went on to describe postpartum psychosis, a severe psychiatric condition that can set in during the first month after a mother gives birth to a child, even more serious than the more common postpartum depression.
“Women with postpartum psychosis can experience depression, but also mania, confusion, paranoia, hallucinations, and delusions,” Dr. Lieberman explained. “Some women actually go on to cause physical harm to the infant—even killing the child—but the delusions can take many forms.”
I explained that my mother had never done anything to deliberately harm me; her delusions were only related to my physical health. Dr. Lieberman explained that my mother may have had tendencies toward hypochondriasis and other types of obsessive-compulsive behavior even before my birth, but that the postpartum psychosis would have exacerbated those tendencies, magnifying their effect.
“Today, we consider postpartum psychosis temporary and treatable,” Dr. Lieberman told me. “If left untreated, however, the sufferer only continues to deteriorate, as your mother did.”
At the end of our session, I thanked Dr. Lieberman for his time and insights, then left his offices.
I had spent so many years looking for reasons, trying to figure out why my mother had behaved the way she did, why she was so closed off and disconnected, why she’d kept me home all those years.
Now I knew.
The reason had been me.
CHAPTER 19
That day after leaving Dr. Lieberman’s office, I climbed into my car and pulled away into traffic, but it was hard to focus on the road through tears. As soon as I could, I pulled off and parked the car again. I walked into a store, trying to collect myself enough to continue the drive home. It was a while before I got back in the car.
When I finally arrived at my house, I went to my computer and looked up the symptoms for postpartum psychosis:
Delusions or strange beliefs
Hallucinations (seeing or hearing things that aren’t there)
Feeling irritated
Decreased need for or inability to sleep
Paranoia and suspiciousness
Rapid mood swings
Difficulty communicating
Obsessive concern over the infant
It was as if someone who had met my mother was describing her to me.
In the coming weeks, I spoke with one of the leading experts on postpartum psychosis, Dr. Diana Barnes. I told Dr. Barnes my mother’s story, and she confirmed Dr. Lieberman’s diagnosis. We spoke at length about my mother’s symptoms and about the impact of the surgery she underwent at my birth.
“As a model, your mother’s whole persona was about femininity and beauty, so the hysterectomy would have been particularly hard for her,” Dr. Barnes pointed out. “She would have felt she had lost part of what made her a woman.”
Dr. Barnes explained to me that during the years when my mother first became sick, postpartum psychosis simply wasn’t understood the way it is now; it would have been extremely difficult for anyone to treat my mother with any degree of accuracy. The tragedy of my mother’s story is that the prognosis for her postpartum psychosis would have
