I gave birth to my oldest baby on April 23, 2009 at Wilford Hall Medical Center at Lackland AFB in San Antonio, TX. 3 months after giving birth, I was back at Wilford Hall, this time at the ER, terrified that I might act on the terrible thoughts and images that were in my head although I didn’t want them there. For 3 long months I had ignored the symptoms and tried to pretend that nothing was wrong, tried to hide my agony from the world, from my friends and family.
Why did I hide it? Why didn’t I ask for help sooner?
My husband is in the military and on top of the typical stigma and myths faced in general by those with Postpartum Mood and Anxiety Disorders, there’s another set of challenges and stigma and myths that I was fighting, even though I didn’t recognize it. These are issues that I have heard from other families dealing with or who have survived PPMD.
One issue is, as I stated, the stigma, fear, and myth. It’s so easy to think “If I am having problems, they might take away my spouse’s security clearance/job/weapons qualification & access/kick them out of the military. As a general rule, this is not the case. The military is not going to pull your spouse’s security clearance because you spend some time in therapy or admitted to the hospital with Postpartum Depression. Actually, the military wants you to get the help you need, and many command teams will try their best to work with your spouse on adjusting their schedule. If you are struggling and you need to seek help, help them find some educational material to take with them to go speak with the Commander, 1SG, whoever. If it helps, speak with the chaplain first. They may have suggestions on how you/your spousecan approach this with the command team to achieve the best results for both your family and your spouse’s unit. But they can and should work things out and help your spouse get things squared away… all without giving them UCMJ action.
One of the other issues that faced me, and also faces many other women needing to seek help for PPMD, is with TriCare and/or the doctor(s)/clinic(s). Not only can it be a huge run around and pain in the butt to find a provider you can see, get your referral approved, and then actually get an appointment, it can be daunting and slightly terrifying, not to mention confusing. You may or may not be seen by military health providers, and you may or may not have to deal with paperwork for referrals, etc. I’d like to offer some suggestions on how to deal with the TriCare etc. side of PPMD as a military spouse (please note that this is info specific to dependents, servicemembers should of course follow their protocols).
- Know your coverage. TriCare is not a one-size-fits-all insurance. Your benefits may vary depending on, for example, whether you’re with TriCare Prime or TriCare Standard. You will first need to know which type of TriCare you have (don’t laugh, I have known dependents who didn’t know this information). Once you know that, I would recommend trying to learn generally speaking what TriCare covers and how they work when it comes to mental health care. I suggest starting at this link (http://www.tricare.mil/mentalhealth) ; it has a lot of really good information as well as contact info for the 24/7 TriCare Nurse Advice Line and a crisis hotline.
- If you are having an emergency, CALL 911 or GO STRAIGHT TO THE EMERGENCY ROOM. You do NOT have to call TriCare or your PCM, get a referral//authorization ahead of time, etc. If you are admitted, as per the TriCare website on getting mental health care (http://www.tricare.mil/CoveredServices/Mental/GettingMHCare.aspx), you will need to call your regional contractor within 24 hours or the next business day, and admissions must be reported within 72 hours. Please note that it does not have to be you doing the calling, so please don’t stress about that. Let your spouse or another trusted family member or friend have all the information they need and take care of the paperwork. You focus on getting better.
- Again, get to know your coverage. In many cases, you might not need a referral/authorization before starting outpatient care. And once you do, your provider can take care of that paperwork for you.
- Another fantastic resource is Postpartum Support International. They have resources specifically for military families, including support coordinators for the different branches of the military. You can access this website at http://www.postpartum.net/get-help/psi-support-for-military-families/.
As military spouses, it’s easy to get caught up in the culture of being brave and strong and carrying on, of supporting our spouse and not taking care of ourselves. It’s easy to buy into the fears and misinformation such as “Will Family Advocacy come investigate me and try to take my baby? Will the MPs get involved? Will my spouse get in trouble? Will my spouse lose their clearance?”. But these are all things that should not keep you from seeking the help that you need. If you are worried, talk to a military chaplain. I started with the on-call chaplain for my husband’s battalion. He talked to me and met me at the ER, and stayed as long as I wanted/needed. It doesn’t matter whether you’re religious or not, or if you’re the same denomination as the chaplain. They are there to support you and your family, without judgment. You can talk to them without fear of reprisal, they are confidential. I went to an Army chaplain with some concerns about a friend of mine, and the chaplain assured me that he is not a mandated reporter. A chaplain is about as safe a person as you can go to to seek help in figuring out what steps to take.
Take care of yourself. You don’t have to be brave and strong. It’s okay to be whatever you need to be, to feel whatever you are feeling. If you feel alone, there are other spouses who are there or have been there, who are willing to walk with you through this dark valley. Let us help you.