A Long Road for Massip : Postpartum Psychosis: Recovery Is Torturous

Her third pregnancy was an accident. And the tingle of excitement that Angela Thompson of Sacramento felt upon hearing the news in the fall of 1986 was quickly overshadowed by a dark sense of dread.

“How do I tell my husband I’m pregnant again? What’s society going to think of me?”

The questions were obvious, for this was a woman who--just 3 years earlier--was charged with murdering her infant son by drowning him in a bathtub. Thompson claimed in court that she was the victim of postpartum psychosis at the time of the killing, believing her husband to be Christ and her son the devil. She was acquitted.

The unexpected pregnancy crystallized for Thompson only the most dramatic of a host of uncertainties and anxieties that experts say are shared by thousands of women nationwide who are trying to recover from postpartum depression or, in its more severe form, psychosis.

Massip in Court

The same anxieties now await 24-year-old Sheryl Lynn Massip of Anaheim as she returns to court today after being acquitted by a judge Dec. 23 on charges of murdering her son.

After failing to kill the 6-week-old infant by throwing him into oncoming traffic, Massip hit him over the head with a blunt instrument, then ran over him with the family Volvo. Massip became the first woman in Southern California to test the postpartum psychosis defense and, like Thompson, was found not guilty by reason of insanity.

Under ordinary circumstances, such a ruling would require a defendant to submit to an extensive state mental examination that could keep her in an institution for up to 6 months.

But the frail demeanor of this unlikely murder defendant, the brutality of her crime, the rarity of her defense and the judge’s extraordinary decision to acquit her make Massip’s case far from ordinary.

Today, Superior Court Judge Robert R. Fitzgerald will begin confronting a question that no other local judge has had to face: Under what circumstances should such a woman, found temporarily insane, be allowed to return to society?

In her own answer to that question in a recent interview, Massip said: “I’m willing to do whatever the court feels is right. . . . It makes no difference, because no matter where I go, I’m doing time. I have to live with the death of my son for the rest of my life.”

Massip could in theory face up to 11 years in a state mental institution because of Fitzgerald’s decision to throw out the jury’s verdict and find her criminally insane.

But even the prosecutor who tried to convict her doubts that will happen. Those close to the case say the former hairdresser and housewife--still suffering from depression but apparently sane--will more likely go free under supervised probation by state medical personnel and the court.

Indeed, defense attorney Milton C. Grimes is so confident that Massip is sane that he may ask the judge to forgo altogether the standard state-administered mental exam.

Instead, Grimes said, he wants the judge to allow Massip to voluntarily enter a program that would treat her bouts with depression.

‘Not a Criminal’

“She is not a criminal. She is not psychotic now. And she does not need to be locked up (in a state mental hospital) for any period of time,” Grimes asserted.

Deputy Dist. Atty. Tom Borris said he would fight such a move.

“I have some thoughts on what she needs,” the prosecutor said. “She needs to go to state prison. But that’s not one of the options right now, unfortunately.” Given the judge’s ruling, Borris said he “would like to see some independent people with no ties to either side evaluate her at a state hospital.”

Complicating Massip’s future further is the fact that the state mental health system is not accustomed to dealing with cases such as hers. The rarity of postpartum psychosis and its temporary nature make her an anomaly in the system, officials say.

“It’s a disorder that doesn’t fit any of the standard psychological classifications, and we don’t really understand it all that well yet,” said Dr. Carl Hanssen, chief of psychiatry at Metropolitan State Hospital in Los Angeles.

“It’s such a bizarre kind of thing, such a minuscule problem (in numbers of victims) that we rarely have to deal with it,” Hanssen said.

‘Baby Blues’

A severe form of the more common “baby blues,” postpartum psychosis is thought to cause intense anxiety, psychotic delusions and even violence in about one to three of every 1,000 new mothers. Often, the women--like Massip--have no history of mental illness or violence, leading some researchers to suggest that the temporary disorder is rooted in the hormonal changes that women undergo after giving birth.

By some estimates, as many as 24 California women each year suffer the extreme form of the psychosis and are driven to kill their babies. But most of those deaths are likely to be misattributed to willful child abuse or natural causes, researchers say.

Doctors say the biological changes that women such as Massip have undergone as an apparent victim of postpartum psychosis can be easily treated with hormones such as progesterone and estrogen, making physical recovery well within reach.

Psychological Issue

But tougher to address are the emotional and psychological questions that loom--as well as the social stigma that goes along with them.

Dr. Susan Hickman, a San Diego psychologist who runs a postpartum depression clinic and has treated several hundred women who have had post-pregnancy problems, says the disorder’s aftereffects can be devastating.

“I’ve seen the whole range--marriages breaking up, problems with alcohol, self-doubts and fears, depression. It can be an incredibly trying period,” Hickman said.

Massip, served with divorce papers as she sat in jail 2 years ago awaiting trial, said in several recent interviews that her plans are uncertain.

Buoyed by family members who attended every day of her 2-month trial, Massip wants to rebuild her life, come to terms with her own guilt and help “other women like me.”

“I have a lot of years of healing left. I still have scars, and I just want to get better,” she said, her voice trailing off.

Thompson’s Case

Massip faces troubling prospects that Angela Thompson knows well.

A registered nurse, Thompson said she and her doctors missed the budding signs of postpartum psychosis after the birth of her first child 9 years ago.

Left untreated, she said, her psychotic delusions, hallucinations, obsession with the devil and other signs of the illness reappeared with deadly force after the birth of her second child, Michael. She drowned the 9-month-old boy in a bathtub in her home near Sacramento in August, 1983.

Although acquitted of her crime, Thompson faced a road to emotional recovery that at times seemed unbearably steep.

There were biting remarks from unsympathetic outsiders who seemed skeptical or disdainful of any medical explanation for the killing of a child.

There were--and still are--intense pangs of guilt and bouts with depression that at times have forced Thompson’s hospitalization.

Having Children Again

Perhaps most potent of all were Thompson’s own vexing questions about her prospects for leading a normal life and someday having children again.

One of the main anxieties that face women trying to recover from the disorder is the thought of having more children, specialists in the field say.

Hickman, who runs a clinic for postpartum sufferers in San Diego, said some women find having more children to be “a healing experience that is therapeutic for them and their families.” Others, she said, purge themselves of any such thoughts out of intense fear.

Said Dr. James A. Hamilton, a retired Stanford University psychiatrist who is recognized as a world leader in the study of postpartum depression: “With proper attention, there’s no reason these women cannot go on to lead normal, productive lives. . . . Without the right care, however, the danger for them--and any other children they may have--is high.”

Odds of Recurrence High

Although postpartum psychosis is extremely rare, the odds of it recurring in a mother who has already experienced the disorder soar astronomically: She stands anywhere from a 30% to 84% chance of facing the same problems should she get pregnant again and not receive proper treatment, some medical experts estimate.

With proper hormonal and psychiatric treatment, the risk is “virtually zero,” Hamilton said.

Despite such scientific evidence, the psychiatrist said that “prejudice and gut instincts” make him personally wary about such women having children again for fear of pressing the odds too far.

Massip says she has no intention of having more children. Neither did Thompson.

Yet when Thompson found out she was pregnant in fall, 1986, she said she was convinced that with proper treatment she could avoid endangering the child or herself.

“If I had thought there was the possibility of my killing my baby again, I think I would hang myself first.”

Signs of Depression

The months after the birth were not trouble free. There were some recurring signs of postpartum problems--sleeplessness, trouble concentrating, forgetfulness.

But court-appointed health professionals, friends and family helped monitor her around the clock for the first 12 weeks of the child’s life as a “safety net,” Thompson said. After some initial problems, Thompson entered a halfway house at the insistence of state health workers.

Today, Thompson considers herself and her 22-month-old son to be out of danger. And she has no regrets about her decision to have the child.

“I remember people used to see Allyson (her 9-year-old daughter) and say: ‘Oh, is she an only child?’ It really tore me up; I would just cringe inside,” Thompson said. “Now Allyson has a brother again, and he has brought happiness back to us in a way that only a baby could.”

It is a happiness that Sheryl Massip fears may elude her. But Thompson offers the Anaheim woman this advice: “She has to understand this postpartum psychosis and learn to live with herself for what happened. That’s the toughest part.

“She has to know that it was the illness that killed the child, much like cancer kills a child--separate from the mother. She just happened to have the illness. It’s not an excuse for the tragedy; it’s an explanation.”