Depression

Depression
Awareness, intervention might have saved mother's five children

June 26, 2001

Andrea Pia Yates systematically drowned four of her children in the bathtub. Then she chased the eldest through the house before she managed to catch him and hold his head under the water until he, too, was dead.

That much we know. We also know that Yates had suffered from postpartum depression after the births of at least two of her children, and she had attempted suicide at least once.

What we don’t know is what to do about cases like Yates’.

We don’t really know, for example, that her depression is what caused her to murder her five small children. Postpartum depression is real — millions of women can attest to that. It manifests itself in many ways, from the "baby blues" through the inability to get out of bed in the morning and care for one’s children and all the way to extreme psychosis. No one familiar with the disorder questions that depression can prompt women to behave as Yates did. Because it’s so difficult to believe that anyone could do what Yates did, it’s very tempting to say, unequivocally, that postpartum depression caused her to kill her children.

Without knowing that, we can’t assess what should have been done to prevent the tragedy. Perhaps her husband, so eerily calm and supportive of his wife when most bereaved fathers would be distraught, should have recognized her distress and sought help for her. Perhaps he should not have left the children alone in her care. Perhaps a kind intervention by friends, neighbors, relatives, her health-care provider, someone — anyone! — could have changed the course of events. That didn’t happen, and it’s useless to wonder "what if."

Now we will engage in debate over the culpability of Andrea Yates, of the Denver-area man who killed his family, of many others whose psychological difficulties have led them to act irrationally and violently. We’ll once again probe the idea that people who cannot control their actions cannot be held responsible for them, never mind that most criminal behavior seems "crazy" to those of us who choose not to engage in it. All too often, that’s a judgment we make after some horrific crime has been committed. (Yes, regardless of Yates’ mental state or motivations, killing one’s children is still a crime.)

A good start at prevention might emphasize three points:

First, parenting is not easy. It’s stressful and it can be extremely isolating; in addition, it’s not politically correct to confess that it’s not always immediately fulfilling. Our society often looks down its collective nose at women who choose to stay home with their small children. A more supportive attitude might have made it possible for Yates to admit that she was having difficulty in handling her role.

Second, sometimes raising a child does take a village. Yates clearly could not handle raising her own, and her husband, for whatever reason, didn’t manage to save them. Intervention by someone else might have made a difference. A kind comment in the supermarket line, a card from a friend, or even a call to a social-service agency might have saved five children. Sometimes we have to stick our noses into situations that are not, strictly speaking, "our business." That’s what bonds individuals into a civilization.

Third, the stigma surrounding mental illness helps no one. Hiding a horrendous problem behind a polite facade does not make it go away. The information that postpartum depression is commonplace might have allowed Yates and her family to be more open about the problems they were experiencing and thus provided more opportunity for her to receive care.

We need to talk about problems such as Yates’. Shaking our heads in horror is an appropriate initial reaction, but we cannot stop with that. Mental-health care, as all other health care, must be made affordable, accessible and socially acceptable. That, not capital punishment, might have saved her five children.