I’ve been thinking a lot about how to ensure that available mental health resources get into the hands of the women who need them. When and where resources are available, there seems to be a gap between the offering and the accessing. As always, I think back to when I first slid on the shoes of the women now making the postpartum trek.

Women of all socioeconomic, racial, and educational backgrounds share one extremely daunting obstacle when in need of such help: they must articulate their exact problem in order to get the help they need.

In a complex web of medical jargon, insurance restrictions and loopholes, and a frustratingly-absent physical presentation of symptoms (for the most part), it falls upon the sufferer to demand treatment for the condition that, no doubt, impairs the very confidence, decision-making skill set, and strength it takes to do so.

It’s an ironic catch-22. The doctor has the tools to ‘fix’ you, but you must lead her to the workshop. The doctor is the artist, but cannot pick up the paintbrush unless you led her to the canvas. The horse must determine the source of water before the doctor can lead it there.

There is no solution unless the patient gives the doctor information to determine the problem.

When I hinted that I felt like running away a few months postpartum, my midwife recommended I talk to a LISCW. This therapist helped me chip away at the enigma that dragged me down, but it was I who eventually had to request medication from my physician. When that dull cloud still hovered, I made the final call to increase dosage. More recently when I intimated to her that I still felt low sometimes, I apparently wasn’t descriptive enough because I was told the meds shouldn’t make me feel flat; there should be ups and downs.

How well my mental health situation is addressed directly correlates to how accurate I am in describing it. How empowering and crippling at the same time. If I do not share every pertinent detail in clearly descriptive language, I will not feel better. I will not get the meds, therapy, tests, information, etc. that I need to make anything resembling a full recovery.

Regardless of my level of medical literacy, the debilitating effects of depression and anxiety can keep me from adequately representing my plight. Regardless of the quality of care available to me, its benefits will not be afforded to me if I do not say just how much I need it. Nothing will be given to me unless I ask.

How do we on the receiving end of such conversations draw the stories out of the women who need help? How do we teach/speak the language to give them a voice? How do we release the language bubbling beneath their skin? In that wordless abyss is the bridge between therapeutic, wholistic maternal care and the women who need it.