Maternal anxiety is reaching ‘crazy high rates’ in Utah, and experts aren’t sure why

(Leah Hogsten | The Salt Lake Tribune) “I don’t want young moms— new moms— to think this is the norm,” said Evi Figgat, who suffered from maternal anxiety resulting in bouts of insomnia, rage and racing thoughts during her first pregnancy with her son. Before the birth of her daughter, Elinor, 5 months, Figgat was given Zoloft which eased her anxiety.

Editor’s note • This story discusses suicide. If you or people you know are at risk of self-harm, the National Suicide Prevention Lifeline provides 24-hour support at 1-800-273-8255.

The second Evi Figgat heard her son starting to stir from a nap, her body would freeze. “I’d just close my eyes," she said, “tear up with dread, like, ‘OK, here it comes.'”

She’d have to calm herself down before picking him up. “I didn’t know what was happening to me,” said the 28-year-old mother of two.

Figgat, who lives in American Fork, later learned she had postpartum anxiety. She never had heard that term before, but if she had — and if she had gotten help — she doesn’t think it would’ve progressed to her postpartum psychosis and suicidal thoughts.

“Still every now and then, those emotions will come up, and I think back on my son’s first year of life, and I just feel bad,” Figgat said. “... I just kind of felt like postpartum anxiety and depression robbed me of my first year of motherhood in a lot of ways.”

(Photo courtesy of Evi Figgat) Evi Figgat, right, experienced maternal anxiety and insomnia with her son, Oliver, front. When she and her husband, Adam, left, had Elinor, they worked on getting Evi more sleep to help with her mental health.

The state’s maternal anxiety rate “keeps getting higher,” said Brook Dorff, a maternal mental health specialist with the Utah Department of Health. Meanwhile, many moms don’t know they can experience a maternal anxiety disorder, which is described as feeling intrusive, out of proportion anxiety from three months before a woman gets pregnant to after she has given birth, according to Dorff.

“Anxiety and depression before a pregnancy," she said, “are strong predictors of if a woman will have mental health issues during pregnancy and postpartum.”

The Utah Pregnancy Risk Assessment Monitoring System, or PRAMS, screens moms after they’ve had their babies and asks them to self-report any anxiety they may have experienced. In 2017, 17.2% of Utah women experienced depression during pregnancy, while 26% had anxiety, according to PRAMS.

“We don’t currently measure postpartum anxiety,” Dorff said, “but I can only assume it’s higher than depression as well.”

The rate of Utah women ages 20 to 24 who had anxiety before getting pregnant increased from 16.5% in 2014-2015 to 31% in 2016-2017.

In that same time frame, girls under 17 who felt anxiety before getting pregnant jumped from 28.9% to 51.7%, and ages 25 to 29 grew from 13.7% to 25.5%.

“We don’t know why it doubled, and we’re trying to figure that out,” Dorff said. “We’re hoping to send out a survey before the end of the year. But, I mean, it’s crazy high rates.”

(Christopher Cherrington | The Salt Lake Tribune)

The increase may be due to people talking more about mental health and reporting what they’re experiencing. “But it could also be there are more things that are causing anxiety, based on our current climate in the world and in Utah,” Dorff said.

Either way, there are ways moms can learn whether what they’re feeling is considered an anxiety disorder, and get help — from screenings to support to outpatient care.

“If you think that, 'Oh, this is what motherhood is like,’ and that’s how you’re rationalizing it,” Dorff said, then it’s probably time to get help.

Debilitating anxiety

“There is a healthy amount of worry” for parents to have, Dorff said, “and then there’s worry that’s getting in the way of your life." Mothers who have previously experienced anxiety or gone through a major life event, such as a move or a miscarriage, may be more likely to experience maternal anxiety, she said.

Lara Tindall, a mother of two from South Jordan, was overwhelmed with “a constant weight on my chest,” she said. Tindall assumed that what she felt was just what it’s like to become a new mother, to adjust to having multiple children, or have the “baby blues,” yet "it just kept getting worse,” she said.

“I felt like something bad was always going to happen,” the 29-year-old Tindall said. " … I’m sitting here watching TV with my family, but I feel like a frickin’ bear is going to like run through the living room or something. It was miserable."

(Photo courtesy of Lara Tindall) Lara Tindall, right, experienced postpartum anxiety after having her daughter, Avery, second from right, and son, Briggs, second from left. Tindall said her husband, John, left, was supportive when she realized she needed "to talk to somebody" about what she was experiencing.

Ashlyn Whitaker, a 35-year-old mother of four from Orem, developed “extreme OCD with germs.” If someone coughed at church, she panicked. When a family member at a Christmas party recently had strep throat, Whitaker grabbed her baby and left.

“It was so debilitating," Whitaker said, “and, to be honest, that really has not left entirely since then.”

Figgat had insomnia, one of the primary signs of maternal anxiety. After feeding her baby in the night, Figgat “would just stay up because it was a mixture of, ‘Is he going to keep breathing? What if he spits up in his sleep and aspirates? What if?’ I mean, the ‘what ifs’ were just crushing me."

Moms may also get “really irritable” with their baby or partner, not feel like their usual selves, or stop taking care of themselves, Dorff said.

“Anytime I even mentioned it, people would be like, ‘Oh, but you look so put together. You look so good,’” Tindall said. They didn’t see what was happening inside, she said.

For Tindall, “the smallest tasks were so overwhelming for me to the point where I would just start crying and think, ‘Is it always going to be this hard? Is it ever going to get easier?’

“That was when the suicidal ideation came in," Tindall said, “because I just never knew if I was going to get better."

(Photo courtesy of Ashlyn Whitaker) Ashlyn Whitaker, back right, experienced postpartum anxiety and psychosis after having her four children, from left to right, Whitney, Oakley, McKinley and Tycen. Her husband, Shawn, back left, took her to the emergency room twice after having their fourth child.

After Whitaker had her fourth child, she was diagnosed with postpartum psychosis. But since she couldn’t bring her baby along to the mental health floor, she put on a show of feeling well in order to go home. If anything happened, her husband was supposed to take her to the emergency room.

“It was horrible,” she said.

When her husband went back to work, neighbors and relatives accompanied Whitaker as she watched her children, to support her. She said she never felt like she was going to harm her baby; she just wanted to “run away” and “not be on this earth anymore.”

Eventually, Whitaker went to a psychiatrist. “She was like, ‘Oh my goodness, why didn’t you come to me sooner?'” Whitaker said.

If you don’t seek help, “it’s not going to go away on its own,” Dorff said, and it can affect a mother and her child in the long run.

“It’s important to know that you don’t have to live that way," she said, “and you can feel normal, and you can feel joy and happiness again.”

(Leah Hogsten | The Salt Lake Tribune) “I don’t want young moms— new moms— to think this is the norm,” said Evi Figgat, who suffered from maternal anxiety after having her two children.

Getting help

After about her fourth panic attack, Figgat’s husband and mom agreed it was time to go to a therapist.

“I feel like she saved my life,” she said.

Figgat is sharing her story now because she doesn’t want new moms “to think this is the norm” and to know there’s no shame in needing support.

Tindall was initially “scared" to get help. “I was so worried that people were going to think I was a bad mother, like all the things that I had thought before,” she said.

Tindall did four months of an intensive outpatient program at Serenity Recovery and Wellness, going three hours for three days a week. There, she met other mothers and realized she wasn’t alone. She learned skills to manage her mental health.

Serenity, which opened in 2017 and has locations in Riverton and Payson, has a maternal mental wellness program. Lyndsey Proctor, clinical director and owner, said a “good portion” of her clients have anxiety.

There’s a need for more places like this in the state, Proctor said. She estimates it served 300 women the first year, and last year, it was closer to 700.

“Screening is so important,” Proctor said. “... It really should be done during the pregnancy and throughout the postpartum period.” She thinks “it would be amazing if pediatricians did it, because they see the babies and the mothers so often.”

Mothers can go to anyone they trust, such as their OB-GYN or a therapist, to be screened and get medication or find a support group, Dorff said. Free screenings are available over the phone through Help Me Grow Utah at 801-691-5322. Resources are also available through Postpartum Support International Utah at psiutah.org.

“(Moms) deserve help,” Tindall said, and “seeking help is the best thing that they can do for themselves and for their children.”

When she was in the depths of her anxiety, Tindall said, her thoughts “spiraled out of control" to the point she convinced herself that she was “the worst mother on this earth.”

“If I have a bad moment with my kids now," she said, “they pass, and it’s like, ‘No, I’m still a good mom. We just had a bad moment.'"

Becky Jacobs is a Report for America corps member and writes about the status of women in Utah for The Salt Lake Tribune. Your donation to match our RFA grant helps keep her writing stories like this one; please consider making a tax-deductible gift of any amount today.