The Death of Miriam Carey: An Unnecessary Cruelty

The Death of Miriam Carey: An Unnecessary Cruelty October 7, 2013

There will be a lot of people who disagree with me. I don’t mind. Disagreement is part of a healthy dialogue. I have said it a gazillion times before and I’ll reiterate it now — I never, ever want to live in the place where everyone thinks the same way.

Disclaimer out of the way, I was not surprised to read the news reports stating that Miriam Carey was being treated for postpartum depression, a year after her daughter’s birth.

As ABC reports,” a 2006 study published in the Journal of Women’s Health found that postpartum psychosis typically occurs in the first one to four weeks after childbirth and is an “overt presentation” of bipolar disorder that coincides with hormonal shifts after delivery.

The patient can develop “frank psychosis, cognitive impairment and grossly disorganized behavior that represent a complete change from previous functioning,” according to the study.

“These perturbations, in combination with lapsed insight into her illness and symptoms, can lead to devastating consequences in which the safety and well-being of the affected mother and her offspring are jeopardized,” wrote study authors Dorothy Sit, Anthony J. Rothschild and Katherine L. Wisner.”

Miriam Carey, you may or may not know, is the name of the woman police wrongly shot to death in Washington, D.C. last week.

She was unarmed, save for the vehicle, which many will claim was a weapon. Listen, if she wanted to kill someone with her car there was ample opportunity to do just that. Yes, she attempted  to crash through a barricade at the Capital building. Had that been a barricade at the Federal Building in Greeneville, Tn. it’s likely that Ms. Carey would still be alive today.

She chose the wrong place, suggested some, as if mental illness leaves a person with choices.

But then that’s part of the problem isn’t it?

Those of us who don’t suffer from mental illness, men in particular who have never dealt with postpartum depression (PPD) — or the more commonly misdiagnosed postpartum psychosis (PPP) – have no idea how paranoia can mess with your ability to reason.

If you have ever borne witness to a loved one struggling with the chemical imbalances caused by pregnancy and the after effects of pregnancy, you know that the shooting death of Miriam Carey was an unnecessary cruelty.

It was an overreaction by well-meaning but frightened law enforcement. What we really had were paranoid people on both sides of the law, but only one side was well-armed. They are the ones who walked away from all this unscathed. While a confused and frightened mother lay dead in front of her daughter’s eyes.

The general public tends to lump all postpartum behavior into one category, most commonly known as the baby blues. This has been the label traditionally assigned to women who are weepy or feeling overwhelmed during childbirth or in the weeks after it.

After the birth of my fourth child, I spent three days in the hospital crying. I didn’t feel overwhelmed. I was overwhelmed. I had four children under the ages of five. Three of them in diapers. I was thousands of miles away from my mother and hundreds of miles away from my sister. I was terrified of failing as a mother. It is an isolating and frightening feeling.

My doctor, who happened to also be a friend, suggested I might need to see someone. I responded to his suggestion by crying more. Eventually, however, I was able to work through the fear and the blues subsided. That’s not because I willed the blues away, it’s simply because I wasn’t struggling with postpartum depression or, as was the case of one of my dearest friends,  postpartum psychosis.

It was my girlfriend’s struggle with postpartum psychosis that inspired me to write MOTHER OF RAIN, the story of Maizee Hurd who can’t silence the voices in her own head.

My girlfriend gave birth twice, ten years apart, and each time she was beset with the symptoms of postpartum psychosis. Perhaps you aren’t aware of them? I certainly wasn’t. I had never heard of PPP until my friend’s second pregnancy and subsequent hospitalization. Here’s how Mental Health Association defines PPP, which affects less than one percent of all pregnant women: 

  • Physical symptoms: Refusal to eat, inability to cease activity, frantic energy.
  • Mental symptoms: Extreme confusion, memory loss, incoherence.
  • Behavioral symptoms: Paranoia, irrational statements, preoccupation with trivial things.

A woman who is diagnosed with PPP should be hospitalized until she is in stable condition. Doctors may prescribe a mood stabilizer, antipsychotic or antidepressant medications to treat postpartum psychosis. Mothers who experience PPP are highly likely to suffer from it again following their next pregnancy.

Do you remember Andrea Yates, the Texas mother who killed her five children? Yates had been diagnosed with PPP and her husband, Rusty, was told that the couple should avoid pregnancy. The worst thing you can do for a woman who suffers from PPP is get pregnant. The second worse thing is to isolate her and deny her the right kind of medical care. The reports I studied on Andrea Yates indicate that Rusty Yates did all of the above. Which, in my book, makes Rusty Yates as much responsible for the death of his children as Andrea. Perhaps even more so, because he was supposedly the rationale one.

I watched in confusion and in prayer as my girlfriend spiraled through her first pregnancy. The PPP did not manifest itself until her third-trimester. By the time her son was six weeks old, my girlfriend was nearly catatonic. She was institutionalized. She was over-medicated. She was wrongly-diagnosed and wrongly-medicated. That is not uncommon for women suffering from PPD and PPP.
That’s one of the reasons I set MOTHER OF RAIN in the 1940s Appalachia. Because it seems to me that when it comes to mental health issues, we often take an archaic approach to treatment. Especially when it’s men doing the treating of issues only women experience, issues like pregnancy. That’s not always the case, of course, but historically, the gender-difference has been problematic when it comes to the care and treatment of pregnant women who suffer from PPD or PPP.

Sometime between the first pregnancy and the second pregnancy, my girlfriend sat down with me and explained the darkness that settled over her when her son was born. She told me about the voices she heard, about the paranoia she felt. She told me about the troubling visions she had and the overwhelming sense of dread. She spoke of her desire to end her life just to escape the torture of her mind.

She spoke rationally of these things. When she explained it, I knew that what she was dealing with was not baby blues, but something far beyond my limited understanding.

I promised  her if she ever got pregnant again, I would be there for her.

When she called me during her third-trimester of her second-pregnancy and begged me to not let her do anything to hurt her babies, I bought a plane ticket. I also called her family and told them that she needed to be under the care of an endocrinologist.

It wasn’t until after a suicide attempt following the birth of her second child that she came under the care of an endocrinologist who has been treating her successfully ever since. Today she is stabilized. Her children have grown into bright and beautiful human beings. Raised by a loving mother who has struggled and fought her way to a level of consciousness beyond PPP.

The difference between my girlfriend and Andrea Yates is that my girlfriend was surrounded by a big loving family intent on getting her the right kind of medical care. Instead of isolating her, the family came together as a community and fought for her. They were persistent and relentless in their care and compassion for her. And they demanded the best of treatment available. Fortunately, she had the health insurance and a husband willing to pay for that care.

But under different circumstances, she could have been the one driving that car.

She could have been Miriam Carey.

She could be dead today, were it not for the intervention of family and loved ones and doctors learned in the manifestations of PPP.

There will be those who shrug their shoulders and walk away from the death of Miriam Carey. They will call it a tragedy. But they will excuse the officers who overreacted and shot and killed a confused and troubled and mentally unstable young mother.

But I won’t be one of them.

Arming people and giving them permission to kill the mentally unstable is not an answer. It’s part of the problem.


Karen Spears Zacharias is author MOTHER OF RAIN (Mercer Univ. Press).




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  • militarymedical

    All of your comments and points are well-taken, Karen, as they apply to the mentally ill – not just women with PPD/PPP, but ALL mentally ill people. Our mental “health” system, such as it is, is a sham and a disgrace.

    That said, exactly HOW were the various police/law enforcement people on scene to know anything at all about Ms. Carey’s mental state? Whether or not she was armed? Whether or not the car was rigged to explode? All these possibilities were very real then and now – and all have happened recently. The bizarre Kabuki theater that passes for “Congress” and “the Administration” these days just adds to that confusion and, yes, fear on the part of LEOs.

    Put yourself in the shoes of just one of those LEOs – either in a car or on foot. A mid-sized car is racing towards you at a high rate of speed and is less than a block away. WHAT DO YOU DO? You box the car in and, on foot, approach the car – which then backs up into surrounding cars AND police and speeds away. WHAT DO YOU DO? Stand there and call 9-1-1 and ask for a psychiatrist to be dispatched to the scene to see if, perhaps, the person driving is a bit disturbed?

    I think it’s a miracle that child wasn’t killed as well. I will not point fingers here because I do not have all the facts. That also means not concluding – without solid evidence and because I know how life-altering decisions must sometimes be made in a split-second – that the police acted “wrongly.”

    • There are proper protocols for such incidences. I’m not suggesting an on-the-spot diagnosis but before LE uses such force, there should be every effort taken to assess the situation. In this case, LE overreacted. A result, I’m sure of the recent Navy yard shooting. Had this happened in the streets of Portland instead of DC there would have been an outcry from the general public of potential police brutality. Instead many are willing to give LE a buy and mark this up to unavoidable.

      • lcham678

        What are the efforts to assess the situation that you mean? We have a person using her car as a weapon. The police boxed the car in and approached on foot and she reversed her car and escaped. A decision has to be made on-the-spot It is easy to 2nd guess later. Cops and the military do not have that luxury.

  • AFRoger

    I concur with most of what militarymedical has said. My wife and I raised a daughter whose wild hormonal swings challenged us to our roots for a decade of life and still, I think, energize her in unique ways more than a decade later. I know personally how deeply the darkness of depression can close in, to the point that light is closed off–psychologically AND physically. Small things in brain chemstry, brain wiring and experience do very, very powerful things.
    A local newspaper story published just days ago tenderly reveals the enormous efforts of a 23-year-old woman to understand and live with her own schizophrenia. How different her life would be (if she would be alive at all, which I doubt), had she not been able to enter ongoing care several years ago.
    Every year when it’s Race for the Cure time, I have the same thought. Cure for cancer is an effort we must wholeheartely pursue. Just as we should a cure for Parkinson’s disease to which I am genetically predisposed on both sides of my ancestry. But how about prevention? Cancer might well be even more preventable than treatable and curable. Likewise, mental illnesses, whose names are indeed Legion. Can we even begin to imagine mental illness prevention?
    If ever I write a nonfiction book based on my own life experience of Christian ministry among folks with high rates of mental illness, I think the theme will be this: the blurred, dissolving, or sometimes non-existent line between whole sectors of religion and mental illness. It is absolutely no accident that the most mentally ill people I have dealt with in greater depth know and fixate on certain themes and images of Judeo-Christian scripture to the near total exclusion of others: dark apocalyptic images of fear, death, destruction and judgment, a sometimes OCD-like focus on rules and rituals and punishment for failure.
    When we who claim to be followers of Christ lament that we are living in a post-Christian or anti-Christian age, as though some piece of legislation or imagined election victory might change that, we would do well to stand before the mirror and re-read the first 18 verses of the Good News according to John. Did Christ bring light? Why was there even a NEED for light to enter the world? Are we indeed bringers or light? Are we motivated by light? Do we even get “iight” in our gut? Lord knows, there is more than enough darkness out there. New mothers may experience it profoundly, teenagers too. Teachers see it daily in their classrooms, our most front-line mental health workshops. The police deal with decades of societal mental health failure on an hourly basis. Darkness walks among the rich and the poor, the housed and unhoused. Among the battered, it is biblically epidemic.
    I’ll never know if my years of volunteer chaplaincy have saved a life, prevented a crime or a suicide, but God does. Not my concern. Our challenge is to live and convey the light in darkness. And to trust the Light to do its job. There is no other calling, no other choice. If I ain’t got grace, what have I got?

    • Roger: So many families struggle with how to help their loved ones who suffer from mental illness in all forms. I had an editor with a mentally disturbed son. I found him with a black eye one day and he told me his son had tried to kill him. He shrugged it off as just one more in a long line of a lifetime of such encounters. The case of PPP and PPD are especially problematic because they are often tied only to a season of a woman’s life — the child-bearing season. But we as a society have cast off the mentally ill as discards. We have shed ourselves of any responsibility towards them. We don’t want them in our schools, in our churches or in our neighborhoods. I am sure you have touched and saved the lives of people too ill to even say thank you.

  • Ima_Squidface

    Thank you so much for this! I posted something very similar on my page last week, and it got some supporters, and a few detractors who reacted with the arguments you laid here. Have known someone who has/is suffering from PPP makes a huge difference in how I see this, I’m sure. Many who commented both ways know the same person I do (small town) and I asked them all to consider whether they would’ve still been okay with LE’s reaction if it had been her. Bam! No more comments.

    • Getting others to think is no small task. It’s the thing we should all strive to do daily. It does make a difference when you know the one hurting.

      • John in PDX

        I tried to think but nothing happened – that’s me – remember our little boat is named 3Stooges.
        Rain was 4 at the time – at what time does it is switch from PP to just plain depression? I have someone close to me that gets depressed and her youngest child is 20.
        I would agree with – yes, I am a guy and their are lots of things I don’t get.

  • CSmith

    I nearly lost a dear friend who suffered from PPD. Hers didn’t show until a little later than typical and was missed completely! She was treated for all kinds of neurological disorders. Some elder from her church told her she must have sin in her life or else she wouldn’t be ill. Such ignorance!
    Thankfully, she was finally correctly diagnosed and treated by a different doctor, and is well today.

  • pastordt

    Powerfully written, Karen. Thank you.