Editor’s Note: This is the first in a series of stories on postpartum mood disorders. Tomorrow: Residents share their personal experiences.
Aaron Polson kissed his wife good night, and she said, “That’s the last kiss.”
He asked why she said that.
“Well, we are going to be in prison tomorrow,” she replied.
Her comment was surprising but familiar.
His wife, 40-year-old Aimee Ziegler, a Free State High School guidance counselor, had struggled with postpartum psychosis and depression for eight years. She was first hospitalized for the illness after the birth of the couple’s first son, Owen, in 2003, and she had her first psychotic episode after the birth of their second son, Max, in 2006.
At the end of last March, the symptoms of her illness had returned. He knew the signs well: dilated eyes and icy cold fingers. She would rub her fingers together and play with the back of her hair. She feared people were out to get her and that she would lose her job and go to jail.
Four months earlier, Ziegler had given birth to their third son, Elliot. She loved being a mom and longed for more children despite her illness.
“She never accepted her diagnosis. She would call it postpartum stuff or issues or trouble. I don’t think she ever knew how bad it was,” Polson said.
After kissing his wife, he slept in the bedroom with his older sons, who were feeling restless. The boys’ bedroom was underneath the couple’s bedroom where Ziegler was sleeping.
“I woke up so many times that night just listening like, ‘Is she awake?’ I had checked on her before I went to bed, and she was asleep,” he said. “She had taken a sleeping pill that was prescribed for her.”
Then, he woke up to the sound of someone pounding on the front door of their home. It was the police. Ziegler had died about 2:20 a.m. She drove her car around some crossing gates and onto the railroad tracks, where she was hit by a train in North Lawrence.
Postpartum psychosis is a rare illness compared with occurrences of postpartum depression or anxiety. Postpartum psychosis is diagnosed in about 1 to 2 of every 1,000 deliveries, and of those only 4 percent go on to commit infanticide or suicide.
“Aimee is a rare statistic,” said Meeka Centimano, a therapist who is a founder of the Pregnancy and Postpartum Resource Center in Kansas City.
Among symptoms of psychosis are delusions or strange beliefs, hallucination, hyperactivity, paranoia and rapid mood swings. Women who suffer a psychotic episode are experiencing a break from reality. In their psychotic episode, the delusions make sense to them and seem meaningful.
“Psychosis can be tricky. There can be times when mom seems really connected, and then there are periods where she becomes very disoriented and isn’t making sense. It can be really hard to know what you are looking at,” Centimano said.
She said psychosis and depression are different illnesses.
“A woman doesn’t become depressed and then becomes so severely depressed that she becomes psychotic. They are two parallel paths, and they are very different. It’s different mechanisms in their brains.”
During an interview in his Lawrence home, Polson talked frankly about his relationship with his wife, her illness and how he’s coping with her death.
“I cried a lot, especially early on,” Polson said. “I yelled a lot — not around the kids. I would have grandma watch the kids, and then I would get in the car and go out to the lake and just yell.”
Polson, 37, said he met Ziegler through a mutual friend, and he had to pursue her because she was working full time and coaching several sports.
“It was the old-fashioned I had to chase her down,” he said. “Aimee was a very driven person. She was go, go, go, all of the time.”
She was from St. Louis and had earned a degree from the University of Missouri and then earned a master’s degree in social work at Kansas University. During her last year at KU, she was an intern at Bert Nash Community Mental Health Center where she helped write a grant to start a WRAP program. WRAP, which stands for Working to Recognize Alternative Possibilities, focuses on bringing mental health services to schools.
Polson grew up in Clay Center, a small, central Kansas town, and earned a bachelor’s degree from Kansas State University, and then moved to Lawrence where he first worked at Hastings as a department manager.
After dating a couple of years, they married on June 16, 2001. By then, Polson was an English teacher at McLouth High School, and Ziegler was a WRAP counselor at Free State High School. They enjoyed their work, traveling and spending time with family. Then, they decided to start one of their own.
Their first son, Owen, was born Aug. 8, 2003.
Ziegler’s close friend Heather Coates recalled meeting her for lunch while she was on maternity leave.
“She was so happy and so excited to be a mother,” she said. “Aimee was always a good storyteller, and there was lots of laughter.”
But her mood gradually changed. Coates noticed she wasn’t smiling as much, and she would be at a loss for words. It became hard for her to take care of Owen.
“It was like she couldn’t respond to all of his needs,” Coates said.
Six months after Owen was born, Polson noticed that his wife was anxious and had trouble sleeping and focusing. That May, he graduated from KU with a master’s degree, and that’s when he noticed a significant difference.
“I remember walking down the hill, but she really wasn’t there. It was surreal because it was suppose to be a celebration, but it wasn’t,” he said.
The symptoms escalated from there, Polson said. She told him that a co-worker was out to get her and the person was going to get her fired and make her lose her license. She shared suicidal thoughts.
“This is tough because this is what happened,” he said. “But she talked about going out and watching the trains and thinking about driving out and just letting the train hit her.”
Polson started following her to work to make sure she got there safely. Meanwhile, his mother temporarily moved to Lawrence to help care for Owen.
They were able to convince Ziegler to seek help in June — nine months after Owen was born — at Stormont-Vail HealthCare in Topeka.
“My wife was a very stubborn person,” he said. “She didn’t take time off for a headache, so she wasn’t going to do anything. She didn’t want to go to the hospital. She didn’t want to do any of that, but it was good.”
She was there for about a week, and they prescribed medication. She also began attending a postpartum support group in Kansas City.
Polson said she recovered “pretty well” but wasn’t the same.
Their second son, Max, was born in April 2006, and Polson said he had a lot of trepidation.
“The summer was great. I was thinking, ‘Maybe we are going to be OK,’” he said.
Ziegler was scheduled to return to work Aug. 1, but she didn’t make it. She had been up the night before pacing and called her parents around 5 a.m. and told them, “We’re free.” Then, she went into the bedroom and shook Polson to wake him up. She said, “We’re free Aaron. We’re free.”
It was her first psychotic episode.
“She was just gone. She was out of touch with reality,” he said.
He called Coates, and she came over to watch the children while he took Ziegler to Lawrence Memorial Hospital’s emergency room. Coates described it as scary: “I had never seen anyone like that before. She was talking and walking but wasn’t at all herself. She wasn’t making any sense and was paranoid.”
On the way to the hospital, Ziegler got out of the car. Police found her and took her home. Then, she pushed past the police, Coates and Polson and took the children — Max was 3 months, and Owen was about to turn 3 — into a bedroom and locked the door.
“That was traumatic. It was intense,” Polson said. The police were able to coax her out of the bedroom, and then they took her to the hospital.
“That was the easiest time to get her into the hospital because it was done involuntary,” Polson said. “She didn’t have a choice.”
While doctors prescribed medications for Ziegler, she often didn’t take them, or she would break them into smaller pieces and take just a piece. Polson said that was a point of contention for them.
Ziegler seemed OK for a while, but then her psychosis fired up again, and she was hospitalized a few months later. Polson recalled taking her to see a psychiatrist. He said Ziegler thought there were unmarked police cars that were waiting for them.
“That was a pretty scary time, and I wondered if she would recover,” he said.
“Aimee was someone who was just full of life and was the center of what was going on. She was just vibrant, and that was gone. I mean, that was gone at home and around me. Whatever she had left, she used it when she was around other people.”
Free State High School principal Ed West described Ziegler as the go-to person on many issues, especially ones dealing with mental health or at-risk youth.
“She was energetic, positive. Everybody just loved her for her energy and disposition and attitude, and she was a successful guidance counselor. She worked real well for us,” West said.
As a guidance counselor, she managed the class schedules of between 350 and 400 students, making sure they were on course to graduate.
“She was just so knowledgeable,” he said.
West said that some of her colleagues knew she suffered from depression and that she was trying to cope through exercise and diet. But not many, if any, knew she suffered from psychosis.
“She hid it very well,” he said.
Polson said Ziegler wanted a third child but he didn’t, and he thought they were taking the necessary precautions.
“I remember the day she told me,” he said about her third pregnancy. “I just felt like someone hit me with a wrecking ball. It was a total surprise. I just started to cry.”
Polson’s mother, Joy Polson, who had helped take care of her grandchildren and Ziegler over the years, decided to sell her house in Clay Center and move to Lawrence.
“I had seen Aimee very tense and not the old Aimee for a while, and it had gotten worse the last few years,” she said. “I didn’t know, but I was pretty sure she would need help because she had so much trouble with the other two.”
Everyone was on high alert and prepared when Elliot was born Dec. 15.
“She promised me in the hospital. I still remember making her promise me that she was going to take the meds,” he said.
But she didn’t.
“She made it through that,” Polson said.
A few months later, Ziegler returned to work, and Polson said she seemed OK until a few days before she died. She had called and said she was going to stop at a fast-food restaurant and asked what everyone wanted.
“When she brought the food in, I could tell something was wrong,” he said. “She said, ‘I need to talk to you.’”
They went outside, and he saw the familiar signs. Then, she started to tell him about someone who was out to get her and was going to make her lose her license.
“She said she was going to go to jail,” Polson said.
He said he was able to reason with her unlike times before, and they had a full schedule of events the next day. He had a forensics tournament in Wichita, and she was scheduled to take Owen to a soccer game and then attend a baby shower that she was throwing with Coates and another friend.
Coates said Ziegler was late to help set up at the baby shower, which was unusual. When she finally arrived, Coates knew something was wrong.
“The way she took the food out of the bag that she brought in. My heart just sunk. I could tell,” Coates said. “I just thought, “Oh my God. Oh my God. Oh my God.”
She knew her friend was in trouble, and she said Ziegler isolated herself at the shower by saying that she needed to feed Elliot.
“Aimee left early, too, and she was searching for a reason to leave. She made an excuse,” Coates said.
She said another friend walked Ziegler to her car, and she agreed Ziegler wasn’t OK. Coates said she had to leave town after the shower and then work the next morning, but she planned to catch up with Ziegler the next day when they could be alone.
That evening, Ziegler watched the KU men’s basketball team play in the Final Four against Ohio State with her family.
“It was a great game and win; then we went to bed, and she had a rough night,” Polson said.
Polson called his mother to come watch the children early the next morning because his wife was having another psychotic episode. It was the first time Joy Polson had witnessed one.
“I would explain it as a catatonic state,” she said. “She was just standing and staring and saying, ‘No. No. No.’”
Polson said he took his reluctant wife to the LMH emergency room in hope she would be hospitalized or receive medications, but she received neither after a mental health assessment. Instead, she went home around lunchtime with a prescription for sleeping pills and an order to call a psychiatrist in two or three days.
“I felt so defeated that day because I was doing what I thought was the right thing,” he said.
That day — it was a Sunday — Ziegler hung out at home and held the baby a lot. Polson had sent Coates several text messages to let her know about the situation, and she decided to let her friend get some rest.
Early Monday morning, Coates received a call that there was trouble at the house. It was similar to the call she received when Ziegler had locked herself in the bedroom with her kids.
“I thought, ‘OK, I’m ready. I will go over and get her to the hospital,” Coates said. But on her way, she learned that her friend had died.
“I just thought we had time,” she said. “I thought we had time, and we didn’t.”
“I’ve asked myself a million times if there was more I could have done,” Polson said. “Grieving is a long process, and I am by no means through it.”
He copes by writing, reading and exercising, but it’s his boys who help him get through each day. His older sons have a full slate of summer camps and classes. In their spare time, they enjoy playing basketball, going swimming and watching movies with dad. They also help take care of Elliot, their baby brother.
Polson described Owen as tender-hearted and Max as a thinker. One day Max came home after studying snakes and told his dad: “You know, baby snakes don’t need their mommies.”
Those moments are tough.
He said they know that their mother died in a train accident and that she wasn’t feeling well.
“I’m going with the best advice I have, which is to answer the questions as they come and don’t be afraid to talk about it, but don’t force it upon them when they are not ready,” he said.
Coates described Polson as a wonderful father and husband.
“I’ve watched him with her through her illness, and he’s just been very loving and supportive,” she said. “I just kept thinking that a lot of men would have given up because it was so hard for so long. He just wouldn’t give up. He stood by her and tried to give her everything she needed and just loved her.”
WHERE TO GET HELP
• The Pregnancy & Postpartum Resource Center of Kansas City — 866-363-1300.
• Postpartum Support International's Kansas coordinators — 785-550-6795, 785-505-3081 or 913-530-3837.
• Headquarters Counseling Center’s 24-hour service — 785-841-2345.
• Bert Nash’s 24-hour service — 785-843-9192.
• National Suicide Prevention Life-Line — 800-273-8255.