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Mary Jo Codey

By Kelly Burgess

Each month, iParenting.com spotlights a mother who inspires and moves us, who embodies the qualities that we all admire in a person, a woman and a mother. Above all, the Mom of the Month is dedicated to her children. Rich or poor, famous or not, she shines as an example of what mothering is all about.

It's estimated that eight in 10 women suffer from postpartum depression (PPD) to some extent. Mary Jo Codey, former first lady of New Jersey, is one of those statistics.

When Codey was hospitalized for severe PPD after the birth of her first child, she didn't even realize that what was happening to her was related to her pregnancy. She just thought she was a bad mother.

Now she's working to make sure no other woman goes through PPD alone by becoming a spokesperson for Speak Up When You're Down, a campaign to recognize and treat postpartum depression (www.nj.gov/health/fhs/postpartumdepression/index.shtml). Thanks to her efforts, New Jersey is also the first state to require postpartum depression screening for all new moms. Codey is determined to bring this common ailment out into the open, so that no other mother has to suffer as she and her family did.

After three years of infertility treatments, Mary Jo Codey and her husband, Richard, were thrilled when she became pregnant with their first child. But secretly, Cody harbored deep fears for her child.

"It was such a struggle for me to get pregnant that I worried throughout my pregnancy that something would happen and I'd lose the baby," says Codey. "At first, I thought it was all that stress that led to my postpartum depression."

After the baby was born, a boy, Codey didn't understand why she felt so terribly wrong, why she didn't feel the joy she saw in her husband's face. "I never heard anything about how a new mother could be so depressed," says Codey. "I even looked it up in my pregnancy books and couldn't find anything about it. I am very religious and I took it very hard. I thought it was a very shameful thing to have."

A great deal of Codey's shame stemmed from the fact that it wasn't just sadness – she actually had thoughts of harming her infant son. She later learned that those are called "intrusive thoughts," but at the time they just scared her. Finally, when her son, Kevin, was 6 weeks old, she left him with her husband and checked herself into a mental institution, still not aware of what was wrong with her.

"I had a bout with depression when I was 24 years old that had been treated with antidepressants, and I found out later that made me more susceptible to PPD, but at the time, I didn't realize the connection between pregnancy and such a severe return of my depression," says Codey.

Antidepressants helped to stabilize her mood, but she was deeply ashamed and kept her problem a secret from family and friends.

Although Codey has some trepidation about having another child, because of the emotional problems she suffered after the birth of her first, she also dearly wanted more children. She knew it wasn't a good idea to try to conceive while she was on antidepressants, so she consulted with a psychiatrist who encouraged her to go off her medications, telling her that PPD may not occur with her second child. It wasn't bad advice, but the problem was that Codey got pregnant much more quickly than she had anticipated.

"The doctor told me I could start trying [to get pregnant] two months after I went off the antidepressants," says Codey. "I figured it had taken me so long to get pregnant the first time that it would take me at least a year this time and that would give my body plenty of time to stabilize and get used to being off the medications. Of course, I got pregnant right away and I wasn't prepared; I hadn't had time to figure out how I would deal with another bout of depression."

This time the depression wasn't postpartum. It started while she was actually pregnant. She couldn't take antidepressants, so in her 8th month, her doctor recommended electroshock therapy. The therapy worked, leaving her drained and unhappy, but not clinically depressed.

"I still didn't understand where the depression was coming from and I thought I was a terrible person," says Codey. "Here I was with this wonderful gift of another pregnancy and I was undergoing shock therapy. I was deeply ashamed."

After Christopher was born, Codey went back on antidepressants, which saved her from the PPD she had suffered after the birth of her first child. She felt, she says, like a normal mother.

That was not the end of Codey's struggle with depression. Reactions to her medications have caused a worsening of her depressions, hospitalizations and a near death experience, and have been an issue her entire adult life. It's also been complicated by a bout with breast cancer, resulting in a double mastectomy and chemotherapy. But, for Codey, her experience as a cancer patient resulted in an epiphany for her.

Try Mary Jo Codey's recipe for Lobster Salad Sliders!

"People were so concerned and caring when I had cancer, but I didn't feel that warm, accepting, caring feeling with my depression, which I had no more control [over] or responsibility for than I did with my cancer," says Codey.

She formed a PPD support group at her local hospital – the first of its kind – and was shocked at how many women were afflicted with the same condition she had struggled with alone. Thus, it was a no-brainer a couple of years later when her husband became governor of New Jersey and they had to pick a cause to represent.

"It took us about three minutes to decide on a PPD campaign," says Codey. "By that time we knew that it was a disease and we weren't at fault and we didn't deserve what happened. We knew we needed to spread the word."

Thanks in part to her efforts, in 2004 New Jersey became the first state to mandate screening all new mothers for PPD. Codey sees it as being as important a postpartum follow up as any physical.

"I don't know if I would ever have fallen into the depressive cycle if I hadn't developed postpartum depression; my doctor doesn't know if that was some kind of trigger," says Codey. "What's important is that it can be managed, and it doesn't mean you're unworthy or bad. It means you need medical care, and the more people who understand that, the better chances we have of helping every woman who needs it."

The Edinburgh Postnatal Depression Scale New Jersey uses the Edinburgh Postnatal Depression Scale (EPDS) to screen new mothers. The user is asked to underline the response that comes closest to how she has been feeling in the previous seven days. The questions are scored 0, 1, 2 and 3 according to increased severity of the symptom, except for questions 3, 5, 6, 7, 8, 9, 10, which are reverse scored (i.e., 3, 2, 1, 0). A score of 12+ indicates the likelihood of depression, but not its severity. The EPDS score is designed to assist, not replace, clinical judgment. The questions are as follows: 1. I have been able to laugh and see the funny side of things. As much as I always could. Not quite so much now. Definitely not so much now. Not at all. 2. I have looked forward with enjoyment to things. As much as I ever did. Rather less than I used to Definitely less than I used to. Hardly at all. 3. I have blamed myself unnecessarily when things went wrong. Yes, most of the time. Yes, some of the time. Not very often. No, never. 4. I have been anxious or worried for no good reason. No, not at all. Hardly ever. Yes, sometimes. Yes, very often. 5. I have felt scared or panicky for no very good reason. Yes, quite a lot. Yes, sometimes. No, not much. No, not at all. 6. Things have been getting on top of me. Yes, most of the time I haven't been able to cope at all. Yes, sometimes I haven't been coping as well as usual. No, most of the time I have coped quite well. No, I have been coping as well as ever. 7. I have been so unhappy that I have had difficulty sleeping. Yes, most of the time. Yes, sometimes. Not very often. No, not at all. 8. I have felt sad or miserable. Yes, most of the time. Yes, quite often. Not very often. No, not at all. 9. I have been so unhappy that I have been crying. Yes, most of the time. Yes, quite often. Only occasionally. No, never. 10. The thought of harming myself has occurred to me. Yes, quite often. Sometimes. Hardly ever. Never.