I wrote this piece (cross-posted) for Melodie at Breastfeeding Moms Unite! She’s running a series on mental health and breastfeeding, and asked several bloggers for stories on their experiences with the mental health field while nursing. While I haven’t had any contact with mental health practitioners in the 2.5 years the Boychick has been breastfed, I immediately recalled an incident with a psychiatrist from years before, when I was on medication and was first contemplating the idea of someday procreating. Although this incident was almost a decade ago, I still recall it strongly. And although I am a strong advocate for alternative therapies in mental health, I am also a strong advocate for rationality and options in pharmaceutical treatment of lactating women. This is part of why.
I Never Went Back
I don’t know how to tell this story. On the surface, it doesn’t seem so bad — just another case of an ignorant douchebag doctor being an ignorant douchebag; no especial reason for me to have wound up sitting on the floor of my mother’s office, sobbing into her skirts. No real reason I should still be carrying around this pain, which clenches around my heart when I think about it. Certainly to an outsider, it must seem like “not a big deal”. And yes, my reaction was extreme, a symptom of my instability at the time. And yet, that’s the point, isn’t it? If it isn’t safe to be crazy around a psychiatrist, then who can we be vulnerable around? Psych workers should be held to higher standards, and they need to understand how seemingly “small” remarks can have a large, lasting impact on those they work with. This is why my story — my small, seemingly insignificant story — is worth sharing.
I had been seeing this psychiatrist friend of my mom for a couple years, since I first sought help for my bipolar disorder. As a fellow physician, he offered her the “professional courtesy” of seeing me without out of pocket costs, even when I had no insurance. He’d even given me several months’ worth of “samples” of my medication, which would have cost hundreds if not thousands of dollars full-price at a pharmacy. I liked him well enough, and trusted him well enough — even if he didn’t get the full truth, because some things I could only say out loud very recently. I had no more defenses against him than I did against myself (which is to say, some, but none I would admit to at that point). I had no reason to expect anything but professionalism. I had excepted to be respected. I had expected to be safe.
Which is why, when I talked to him about my oh-so-tentative plans for pregnancy and breastfeeding and attempted to discuss options for medication management through that time, I wasn’t expecting to be told “Oh, I wouldn’t have you breastfeeding on anything. Formula is fine, and we don’t know what these drugs do to developing brains.” I wasn’t expecting the fight-or-flight adrenaline spike sitting there in that quiet room; I wasn’t expecting the panic attack as I realized I was in a room with an enemy, not an ally. I wasn’t expecting to know more than the supposedly-educated man sitting across from me; I wasn’t expecting to have my knowledge so blithely, casually dismissed. I was expecting a rational discussion of what my options might be, of how best to balance my medication needs and the potential risks to my maybe-baby; I wasn’t expecting that.
I still don’t remember how I got out of there. I don’t remember what I said; I’m fairly sure I did not say what was going through my head, because I didn’t start yelling and raving until later. I must have gone into fully walled-off protection mode, and probably smiled, and nodded, and mouthed whatever I thought he wanted to hear. Somehow, I walked out, trust and sanity in tatters, dignity and pride tied around me, holding me together. Somehow, I walked out; I never returned. I rode the elevator down the single flight to my mother’s group office; I found her talking with her colleagues; I went back to her office and waited for her. There, just ten feet below where I had been ambushed, attacked so unknowingly, the ropes unraveled and I fell apart. I cried — great gulping sobs, fluid falling everywhere, halting, hiccup-interrupted explanations bawled into my concerned mother’s lap.
I was so angry. Hurt, yes; shocked, shaky, unstable, yes; but angry. I was angry at his ignorance — in fact, we know formula causes harm to developing brains, and immune systems, and so much else, and we don’t know if most mood-stabilizers do anything but give babies saner mothers. I was angry that I was so easily dismissed, that he didn’t question his own assumptions, that he was so arrogant he couldn’t consider I might have a point, that I might know things he didn’t. I was angry that instead of being treated with respect as an equal, a person, I was just being treated, like a patient — like a thing.
I never went back. For the next many months, I went without med management of any kind. My dosage wasn’t great, but it was — almost — good enough. I might have done better on another dose, or another drug altogether, but I didn’t know, and had no one to tell me. I might have gone into liver failure, because I wasn’t getting my levels checked, and had no one to order the lab tests for me.
I eventually got stable — mostly through my own hard work — and found someone to oversee my weaning off the medications. In the end, I was able to go through pregnancy and breastfeeding without any of the drugs the doctor who had betrayed me said he would deny me. But if I had needed pharmaceutical assistance — or, to be more honest, if I had admitted I needed more help than I had — I had no one to turn to. I would have had to start anew, and overcome the aversion I learned on that day years before, try to learn to trust again while struggling with postpartum neurology and new life with a neonate. And all because of an off-hand assertion by a psychiatrist ignorant of normal physiology and human development, of the risks of formula and the damage of denying a woman’s right to breastfeed.
I’ve been med-free for almost five years, and breastfeeding for just over half that. I have been lucky that I have been able to avoid the psychomedical complex almost entirely since that day, but I am still angry that one physician’s ignorance and arrogance has alienated me for so long — and I’m angry at myself, no matter how nonsensical it is, for not standing up to him that day. I always wonder: how many other women and babies has he harmed with his ignorance on lactation and medication? How many other women didn’t know as much as I, and didn’t walk out, and didn’t breastfeed their babies? How many other women did walk out, and were alienated, left alone, but weren’t as lucky as I? How many needed medication they were unable to acquire for risk of being bullied into weaning?
How many of us need to speak out before there is change?