“My mental illness may make me feel badly at times, but it will never stop me from loving you.”
Parenting while living with behavioral health challenges
“My mental illness may make me feel badly at times, but it will never stop me from loving you.”
CUMBERLAND – When Marlena Davis became pregnant eight years ago, she decided to write a letter to her unborn child. A single mother who conceived via intrauterine insemination, Davis, now 51, lives with anxiety and depression.
“My beautiful baby to be,” Davis wrote in that letter, “I am going to be your mom, and I am different from a lot of moms around because I live with mental illness: depression, anxiety and post-traumatic stress disorder (PTSD). That means my brain gets sick sometimes and I feel really worried, sad, or scared. So, I may cry a lot. I may feel shaky and nervous. My mind may go back to a time when I got hurt badly.
“I am telling you this because I want you to know your mom will sometimes feel this way due to her brain, but never because of anything you did. Some people who live with these things decide not to be parents; some people feel that those who live with mental illness shouldn’t have children at all, and some people do. It took a lot of thought for me to decide to have you, and although it is scary at times I never regret that decision.”
Her son is now seven and a first-grader in a Cumberland public school. Davis says he knows about and accepts her illness – and he brings unparalleled joy to her and her relatives and friends.
“He’s academically gifted,” Davis told Ocean State Stories in a recent interview. “He has his own struggles with ADHD, but he’s very smart. He loves to read at home, he loves his electronics, and he likes to go on YouTube Kids and play video games. He also loves, loves, to be active! He’s done soccer for a while and right now he’s doing . . . track because Cumberland has a great program. And swimming is his passion. I am super proud of him. He’s had his struggles, but he was student of the month in March for his class, which is huge for him.”
Davis said she cares for herself with therapy, medication, and virtual meetings every Wednesday evening with a handful of friends, most of whom also live with mental illness, in what she described as “a little support group.” Its origins lie in a Butler Hospital support program that closed during the COVID pandemic and was never revived.
For almost seven years now, Davis has worked at Project Friends, a day program operated by the town of Coventry for adults living with developmental and intellectual disabilities. Before that, she was employed for two decades at The Groden Center in Providence.
“I think being a parent with mental illness makes you sometimes more sensitive to things,” Davis said. “I’m just more aware. Sometimes I’ll be really cranky, and what have you, all of the day. And I’ll notice it, and then I’m like, wait a second, ‘it’s not about [my son]. It’s about me.’ He appreciates that.”
Laurie-Marie Pisciotta is the Executive Director of the Mental Health Association of Rhode Island. She does not have children, but she has extensive experience with both parents and children who live with behavioral health issues.
Addressing parents who do, Pisciotta told Ocean State Stories that their health “could make it difficult for them to feel like you are fully engaged and fully present in their child’s life, because depression is exhausting. It really takes it out of you. You’re more tired. You have a tendency to want to isolate. You might not be eating as normal. So perhaps that would affect your children’s meals as well. If you have anxiety about things you can’t control and you’re living with this constant cloud of depression and anxiety, I imagine that it makes it hard to manage stress.”
Pisciotta understands mental health challenges not only from her professional work but also her personal journey.
“I’m definitely an anxious person and yes, I do have a history of clinical depression,” She said. “And at times in my life, it’s been quite severe.
Her awareness began in childhood.
“As a kid, I can remember being moody, miserable, lonely, and isolated and angry. But those are all symptoms of depression in a young person. And then as I got older, I think I made more friends and I was less lonely and maybe more confident but still had this low-grade depression. And then when I was 17, I developed anorexia nervosa. I lost a significant amount of weight. I was disappearing a little each day, and luckily my mom had the right insurance with the right coverage because I got four weeks of residential treatment, four weeks of partial hospitalization, and 15 months of outpatient therapy, and all of those levels of care were needed for me to make a full recovery.
“Since that time, I’ve never relapsed with anorexia, but I do still experience bouts of depression. I do take an antidepressant, and I know that I’m susceptible to more severe depression when I’m overworked, when I’m not sleeping well, when I’m not eating well, when I’m not managing stress well. So it’s not that I see myself as fragile, but I do see myself as having a pre-existing condition that makes me need to be aware and check in with myself more regularly about am I eating well, am I sleeping enough? Am I taking on more than I can handle?”
Payment for services parents need can be another impediment to help, Pisciotta said.
“Having insurance or being in the Medicaid program are essential to managing and/or recovering from mental illness, including substance use disorders. Most of us can’t afford to pay out of pocket for psychiatrists or psychologists or even therapists and certainly not medications as well. So insurance can be a barrier for many Rhode Islanders, whether you have it or you don’t.”
“I see a lot of moms who come in who are very motivated for treatment in motherhood, which is really great because they see and they understand how their health impacts their child’s health,” Dr. Jessica Pineda said in an online interview. Pineda is the Medical Director at Women & Infants Hospital’s Women’s Behavioral Health program and an assistant professor in the departments of Psychiatry & Human Behavior and Family Medicine at Brown University’s Warren Alpert Medical School.
The mothers she and members of her team care for before, during and after pregnancy are given “really great opportunities to learn skills to manage their moods,” Pineda said. “They can meet with a clinician and learn long-lasting coping skills to help deal with feelings of sadness, anxiety, and irritability. And by managing these symptoms, they can enjoy more moments with their children, which helps their children as well. Incorporating these new coping skills into their day-to-day lives can serve as a model to their children for how to handle difficult emotions when they occur. These can be skills to help their own children if they struggle down the road as well.”
Pineda said that another important guidance “that can be more challenging for moms or parents is time to themselves — time to ‘fill their own cup.’ There’s [a societal] expectation that moms are going to do it all, work their 40-hour job, do school pick up, school drop off, prepare meals, arrange playdates, etc. They’re going to be there for all of it. Then they feel guilty when they can’t do it all. And that places a huge burden on a mother, during pregnancy and after birth.”
Pineda said that there have been many studies “looking at moms with postpartum depression and its impact on children’s development. These studies have demonstrated that children have more behavioral challenges, have increased risk of mental health disorders and poorer academic performance than children whose mothers did not struggle with symptoms of postpartum depression. So if we can [positively] impact mothers’ mental health, we would anticipate that we can also improve the trajectory of a child’s health going forward as well.”
David C. Dove, Ph.D. sits on the board of the Mental Health Association of Rhode Island. He shared his thoughts as a clinical psychologist with a practice in Providence.
In an interview, Dove told Ocean State Stories that “the challenges of parenting” for mothers and fathers who do not live with mental illness are considerable. He said they include “time management, organization, all the interpersonal stuff, taking responsibility for this child’s entire experience… All that is required, especially if you don’t have others to help you.”
For a mother or father living with mental illness, he said “the stakes are higher.” An example he cited was “the extra sleep that a depressed person might find themselves getting — that may be inconducive to getting their kid to school on time or picking them up on time. The slowdown in motivation and in movement is inconducive to getting the kids fed and taking advantage of enrichment opportunities and things like that.”
For such parents, Dove said “my most basic advice” is applying the same standards to their mental health as they should their physical health, which include exercise and a close connection to a primary care physician. “That’s a good place to start to really make sure they’re addressing all the aspects of their health holistically. Good sleep, good exercise, and good relationships are such big factors in our mood, in our functioning, in our stress response, and even in our ability to recover from times where we’re not at our best.”
According to Marlena Davis, her son appreciates having her read the letter she wrote to her “beautiful baby to be.”
She told Ocean Stories that “actually, just last night I was telling him about the story. And I read what I had written for him when he was in my belly. We talked about it some. He already knew about my counseling and medication.” Honest communication is important, Davis said.
“After I decided to have you, my (former) psychiatrist took me off all my medication, and I was off medicine for a year and a half,” the letter concluded. “I had a breakdown a few weeks after I got pregnant with you, and although I have been on medication for my issues in the past, it was a really big struggle for me to go back on medication because I was worried how it would affect you.
“But I went to the experts who also warned me that being untreated could affect you too, and I made the decision to go back on medication to keep stable for you. So, I am working closely with a psychiatrist who works with pregnant women, and of course, I am working closely with my therapist to keep me as healthy as I can be for you.
“I also want you to know that although I did not create you to cure me of my mental illness, I already feel stronger because of you. When I had that crisis, I fought harder and stronger because I was now fighting for two but especially fighting for you. The biggest thing I want you to know is that you are so loved and wanted already. My mental illness may make me feel badly at times, but it will never stop me from loving you.”
In an email this week to Ocean State Stories, Davis wrote:
‘I never knew I could love someone so much until my son was born and somehow I love him more every day. When asked how much my son loves me, he replied he loves me 25 times 30 times 60 times 90 times 120 (he loves math too).”
Editor’s note: May is Mental Health Awareness Month. It was started by the national organization Mental Health America.
Anyone in immediate danger should call 911.
Call 988 if you are having thoughts of suicide or are in crisis. 988 is free, available 24/7, and confidential.
Other resources:
● BHLink: For confidential support and to get connected to care, call (401) 414-LINK (5465) or visit the BHLink 24-hour/7-day triage center at 975 Waterman Ave., East Providence. Website: bhlink.org
● The Samaritans of Rhode Island: (401) 272-4044 or (800) 365-4044. Website: samaritansri.org
● The Crisis Text Line: Text HOME to 741741 “from anywhere in the USA, anytime, about any type of crisis.”
● Butler Hospital Behavioral Health Services Call Center: Available 24/7 “to guide individuals seeking advice for themselves or others regarding suicide prevention.” (844) 401-0111
Editor’s note: Miller has covered mental health issues since the 1980s.
