Rachel Johnston
“I'm a survivor of understanding mental illness, and of conquering mental illness and coming out the other side a stronger person. It's okay to say, I have a mental illness. I take medicine, and myself, and my family and my friends, my community are better for it. I can help my community be stronger with the person that I am today.”
Rachel Johnston is a women’s health advocate and consultant with more than fifteen years of experience in policy, communications, and advocacy. She is a fiercely passionate health professional, working to improve the quality of life for all persons across the State of Virginia and the country. She graduated from Boston University with a BS in Education and from New York University with an MPA in Health Policy and Management. She is currently a Campaign Manager for the Rescue Agency; a health behavior change agency where she works on advocating for tobacco-free outdoor spaces. She serves on the Advocacy and Education Committee for Stop Child Abuse Now of Northern Virginia. Formerly, Rachel served as a Senior Policy Analyst in the Texas State Senate, where she covered Health and Human Services and Veterans Affairs. Rachel has also worked with the National Alliance for Mental Illness training new volunteers and connecting women to essential resources and services. Formerly, Rachel taught preschool children through an Americorps program, Jumpstart, to provide young children with the literacy tools needed to succeed. Rachel lives in Arlington, Virginia with her partner and 2 young children. She is a sister, mother, auntie, partner, and friend to many chosen family members across the US and abroad. She can be contacted via LinkedIn or via email: rachel.kahn.johnston@gmail.com.
This blog is made possible by a sponsorship from Sage Therapeutics. All content on this page has been curated by the Mass. PPD Fund without input from Sage Therapeutics, Inc.
January 2023 | Interviewed and edited by Jessie Colbert, Executive Director, Mass. PPD Fund
We’re grateful to begin another year of Amplifying with Rachel’s story. Rachel was very matter-of-fact in sharing her incredibly challenging journey, which included the loss of both of her parents, suicidal thoughts, and facing a difficult new mental health diagnosis after the arrival of her second child. She has important lessons to share about embracing being a working mother, facing mental health issues, and accepting help and support as a new parent. She also shared multiple examples of “help” that felt critical and anxiety-producing, versus help that was truly supportive and helped her find her way as a new mother.
Did you have expectations about bringing home a new baby? What did you think it would be like?
We were older parents – I was 35. We got pregnant very quickly. And I actually had a very easy pregnancy. I was working full time for a health care consulting company. I was very tired in the first trimester, but I didn't have any significant morning sickness. I think because I had a very easy pregnancy, my expectation was that the postpartum period would be pretty easy as well. I had an expectation like, I'm gonna rock this.
I had kind of read up. I've been told, Okay, it’s best for the baby to breastfeed for 12 months. So, I had an expectation of breastfeeding. I had an expectation for sleep training because I planned to go back to work after four months. In hindsight, I truly believe that my expectation was too high of myself. I think I underestimated how much energy it would take to run a household while having a newborn. My husband only took two weeks off from his company, so he wasn't around much. And we didn't have any family nearby. So by default a lot of it fell on me.
Oftentimes when a baby is born, parents have plenty of support for the baby, but not a lot of support for themselves. Did you feel like you had people looking out for you?
To be quite honest, I kind of glossed over all that. I really didn't think about what I needed at all. I was like, Okay, I'm working full time, I got this! Everyone tells you, Sleep when the baby’s sleeping. And I tried, but as we all know, there’s always laundry and dishes. And my mom had passed away during my first trimester. I didn’t really think of what I might need socially or emotionally. I didn’t really make it a priority to go to the moms’ group at the hospital to meet other people going through similar experiences.
Tell me about your journey with mental health challenges around your new baby. When did you realize something was “not right”?
When [my first baby] Sophia came, one of the biggest challenges for me was breastfeeding. I felt like the nurses were very, very strict that you must breastfeed, and it just gave me a lot of anxiety. I wasn't doing things right, and I wasn't being a good mom. I had some depression with my daughter.
I had more mental health challenges with my second child. He wasn’t gaining weight, and we had to go back to the hospital for weight checks. I felt some anxiety from the nurses, like they felt that I was doing something wrong because he wasn't gaining enough weight soon enough.
My dad got sick about four months after my son was born. And I hadn't been sleeping. I think a lot was based around that. He was also an IVF baby, and I learned that four years after my son was born, I actually went through early menopause. So between the IVF hormones and other hormones that were going through my body, I truly believe that there was probably some chemical reaction that happened that put me in a significant postpartum depression. I had nightmares. I had some severe intruding thoughts.
My father passed away when my son was five and a half months old, and that put me on a downward spiral for a good a good eight to nine months. There were some pretty dark days. I was crying a lot. I did get to see a therapist who I still see today. I would say I was traumatized with the concept of death. I was looking around, thinking about death for myself and my family, and questioning everything in life. It was a catalyst to helping me understand that I needed help, because I realized how precious life is, and how I wanted to be a well-adjusted, intent parent. I remember my therapist would say, Write down five things that bring you joy, you know, whether it's hiking, going to see musicals, spending time with your children, going out to a nice restaurant . . . I did start going to Al Anon meetings. So that did help me in my journey.
I did end up having suicidal thoughts. We were traveling in Portsmouth, New Hampshire, and I had started taking Lexapro. I was in the bathroom, and I was looking in the mirror. I started hearing voices that were telling me to kill myself. We flew home and I called my brother who's a doctor. And he's like, Oh, that's just suicidal ideation.
I just knew something was wrong. I left the baby with [my husband] Frank and I took myself to the Community Services Board [a walk-in psychiatric clinic in Virginia]. I remember sitting in the waiting room and thinking, Why am I here? This is not who I am. The doctor literally said, Keep taking the Lexapro, I'm sure it'll help you. That was around Labor Day weekend, so my son was already eight or nine months.
So then I go see my therapist, and I’m diagnosed as Bipolar II. I had a hard time accepting that diagnosis. I was in complete denial for a while, but I was put on Lamictal, which I take to this day. It took, you know, a couple of months. My psychologist will say, Who knows if you were bipolar before, maybe you're just sort of super high functioning and you never had any other trauma going on in your life. Maybe it’s super mild. I never really had high highs, just kind of low lows. I think if my dad hadn’t died, it could have been a different story, but something would have still been there, you know?
You went through so much. Is there anything about your experience that could have been made any easier by changes in the system?
I never want any woman to get to having suicidal thoughts and hearing voices. So I think part of it is education on the medical side. Before you leave the hospital, I think women need more information presented to them, including at least something about postpartum anxiety.
I think being rushed out of the hospital, feeling alone in the house, [missing] the support network. I would tell other moms, whether it's social media, anything that you can think of to form a social network, so people can provide you with support and encouragement. Your partner can be very helpful, but he or she cannot be everything to you. The whole airplane mask analogy – unless you're helping yourself, it's really hard for you to help others. That’s why the Al Anon meetings were helpful for me.
I feel like we need a cultural shift to dispel the myths about mental illnesses that women go through before, during, and after childbirth. Maybe a doula would have been like, Here's some resources. You're really sad, you need some help. I'll hold your hand and I'll go with you.
Is there any other advice you’d like to give to other new parents?
Know that it will be hard. Have realistic expectations if you can, and when people offer support, then accept it because it will be helpful for you. Just be gentle with yourself and be kind to yourself. My dear friend Carol, who’s been an early childhood educator for many years, would tell me, Just when you get down a routine, something's going to change. And that's okay. Try to accept change. I would tell moms, try not to have the I can do it all philosophy, and have the It takes a village philosophy.
I would also tell other women out there, you have to be very careful and just kind of recognize what you're thinking and feeling. Don't be afraid to vocalize that to any therapist you're seeing because they're there to help. And I think your physician makes a world of difference.
I also want to touch on the working woman-slash-professional conundrum. With my first child I didn't even have a daycare lined up. I had all these preconceived notions of maybe I would love to stay home. And, I realized, no, that's not me! Retrospectively, I would have known I wanted to go back to work. You know, who am I from an identity perspective? I'm a Policy Analyst, I'm a Legislative Director. I'm a healthcare consultant, helping people. But now I have this little person I need to help grow up. I would say to women, Don't try to do too much. Try to do one thing at a time and then move on to the next one, chunk it out and realize it's okay. If the dishes don't get done, it’s okay. If the laundry doesn't get done, there’ll always be another day to do it.
Do you think of yourself as a “survivor”?
Yes. I do feel like I was in a very dark tunnel for a very long time. It was a long journey. And I finally saw the light at the end of the tunnel. I am a survivor of postpartum depression. I'm a survivor of understanding mental illness, and of conquering mental illness and coming out the other side a stronger person. It's okay to say, I have a mental illness. I take medicine, and myself, and my family and my friends, my community are better for it. I can help my community be stronger with the person that I am today.