From pain, a new purpose — (The Chicago Tribune)

The sliding-glass door to the patio looked out on a cloudy sky that, before midnight, would erupt in thunderstorms. Jennifer Mudd Houghtaling began to ask her husband questions he didn’t want to answer. Had he heard on the news that day about the new mother in Chicago who killed herself?

But Jennifer didn’t want to talk about that. She just kept asking questions. Where did she do it? How did she do it?

It was June 11, 2001, almost two months since the birth of their son, Brandon. Already, Jennifer had been hospitalized once for postpartum depression. Now, she was back home in suburban Milwaukee, but she wasn’t the lively woman one friend described as “light from the sky.” The vitality and energy had been drained out of her.

That morning, Melanie Stokes, who was 41, like Jennifer, and the mother of an infant daughter, had jumped out the window of a hotel on Chicago’s North Side.

For the better part of three months, Melanie had struggled against a postpartum mood disorder, the mental illness her mother called “the monster in her brain.” Three hospitalizations and 10 different medications later, she gave up.

Jennifer was in the midst of her own fight, surrounded by a family desperately trying to protect and save her.

In a sense, she stood in the same place Melanie had just after dawn that day, poised between the world of laughter and love and babies sleeping in their bassinets, and a fall into oblivion.

A raucous, loving family

Sometimes, if you walked into the house where Jennifer grew up, you’d find all five Mudd children sitting on the kitchen counters. Legs swinging, eating right out of the grocery bags waiting to be unpacked, laughing and telling stories with whatever assortment of friends and neighbors had drifted in.

There was always something happening in the rambling old house on Sheridan Road in Evanston. The children rigged a fort with its own telephone line. One brother started a junk-collecting business in the garage. Two teenage neighbors with family problems moved in for a time. A neighbor girl was discovered upstairs one day, taking a bubble bath.

Jennifer’s childhood was loving and loud and chaotic. She cherished it and idealized it and, some people close to her thought, wanted nothing more than to recreate it.

Well into adulthood, Jennifer retained a guileless outlook on life, landing her in predicaments that she would later describe in one of her famously funny stories, acted out with voices and gestures. The most famous story of all was the one about Jennifer’s roommate

At the time, Jennifer was in her late 20s and living in a Bucktown apartment building owned by her two brothers, Kevin and Charles. They called it Mudd Manor. When Jennifer needed someone to share her apartment, she chose a woman who introduced herself as a law student.

In calls to her friends and sisters and brothers, Jennifer recounted her roommate’s quirks: the exotic lingerie hanging in the bathtub, the large amounts of cash she always had on hand, the frequent calls from men. Almost everyone suspected the truth before Jennifer did. It wasn’t until she found a notebook, listing names and preferences, that she realized she was living with a prostitute.

She was a bit of a late bloomer. As a teenager, she developed cystic acne, which made her self-conscious and shy. In her 20s, Jennifer began taking Accutane, which brought the acne under control, and she lived out the adolescence she never had: going out dancing, wearing miniskirts, dating her first serious boyfriend.

Her skin continued to flare up occasionally. The breakouts made her unhappy and Jennifer thought the acne looked worse than it did. Once, just before she turned 30, she sought the help of a psychiatrist, who diagnosed her with a bipolar disorder and prescribed lithium. Jennifer stopped taking the medication after a few days, saying it made her face break out.

She apparently did not see a psychiatrist again and, if Jennifer did have a bipolar disorder, she did not display any symptoms that raised concern among her family and friends.

They knew her as someone who could make people laugh so hard they couldn’t breathe. She had so much to say that it sometimes took her three or four calls to complete a voice-mail message. Her empathy drew her to write strangers whose misfortunes she read about and to befriend an elderly, blind woman she visited regularly until the woman passed away.

Although she had a degree in marketing from the University of Illinois and later earned teaching certification at Loyola University Chicago, Jennifer worked mostly as a waitress or administrative assistant. She didn’t want the stress or responsibility of a career, she told her friends. She wanted time to walk her dog, to hang out.

If life were just, her friends thought, Jennifer would have been married and well on her way to having half a dozen children by the time she was 30. But she never met the right man and since she was not one to dwell upon disappointment, she eventually decided that she would adopt a child on her own.

That’s when Jeff Houghtaling showed up in a speedboat. They met in the middle of Grass Lake in Antioch, at a bar on an island, during the Thursday night boat races. Taller than almost everyone around her, with long blond hair, blue eyes and a wide grin, Jennifer was, Jeff thought, “just beautiful.”

She was a doctor’s daughter from Evanston. Jeff lived in Milwaukee, an only child who sold parts for dump trucks and excavators. But they immediately hit it off. Her friends and family suspected he was the one for her when he good-naturedly agreed to her suggestion that he cut his hair. When she followed that request with the announcement that she was 10 years older than he thought and in the process of adopting a baby, he didn’t even flinch.

As it turned out, Jennifer didn’t adopt. By the time she and Jeff got married in August 1999, she had recovered from a miscarriage and was hoping to try again.

The following August, after a series of infertility treatments, she got pregnant.

Jeff didn’t want to know the baby’s sex. Jennifer couldn’t wait.

Every morning, when she signed on to her computer at the Milwaukee bank where she worked as an administrative assistant, she typed in her secret.

B-r-a-n-d-o-n.

A difficult start

From the moment that Brandon Jeffrey Houghtaling arrived, on April 16, 2001, motherhood was hard.

The delivery went well until Brandon was born and Jennifer began to hemorrhage. Three days later, she went home from the hospital weak and exhausted, with two units of someone else’s blood.

Breast-feeding was painful but Jennifer refused to give up. She saw lactation counselors. She pumped her milk and fed it to Brandon in bottles. One day, she drove to Evanston so her sister Laura, who was nursing the youngest of her three children, could breast-feed Brandon. Nothing worked. When she had to switch to formula, she was disappointed.

The difficult delivery and problems nursing were the most recent in a series of stressful events in Jennifer’s life. She had moved to Milwaukee with Jeff and was living in an isolated suburb, away from the friends and family who had surrounded her all her life. Shortly before Brandon was born, her beloved golden retriever, Kyle, had died of cancer.

Psychological and social pressures can contribute to the onset of depression. If Jennifer did have an underlying bipolar disorder, that, too, put her at much higher risk for a postpartum mental illness. What she told her husband, about three weeks after she had Brandon, was that she just didn’t feel right.

By Mother’s Day, when Jennifer’s mother and her sister Laura drove up to meet her for lunch, it was apparent that she was struggling. At one point, Jennifer turned to her sister and said, “Sometimes, I wish I could shut the door and never come back.”

`Very, very blue’

The sixth question on the form at the psychiatrist’s office asked Jennifer to describe her mood.

“Very, very blue,” she wrote.

The 14th question asked if she had feelings of hopelessness, helplessness or worthlessness. The 15th asked if she had increased crying. The 16th asked if she had thoughts about death or wishes to not go on living.

Yes, she wrote.

Yes.

Yes.

It was two days after her Mother’s Day lunch. Jennifer’s obstetrician had referred her to a psychiatrist after Jennifer called, saying she felt depressed.

The psychiatrist prescribed Prozac, an antidepressant, and a sleep medication. In someone with a bipolar disorder, which is marked by wide mood swings, an antidepressant can trigger a manic episode, so a mood stabilizer is usually given with or instead of an antidepressant. Why that didn’t occur in Jennifer’s case is unclear; her bipolar diagnosis appears on the psychiatrist’s initial assessment form.

In any event, Jennifer deteriorated so quickly that by the time she visited a friend in Evanston three days later, her sister Laura says, “her soul was gone.”

She spent most of her time pacing the sidewalk, with her baby in her arms, talking with her sister Samantha on the telephone. Samantha was so worried she flew in from Los Angeles the next morning.

That afternoon, a Saturday, the two sisters went for a walk in Jennifer’s neighborhood. Confused and upset, Jennifer confessed that she couldn’t stop thinking about killing herself. She sat down on the ground and began to cry.

“I’ve gone crazy,” Samantha remembers her saying. “What’s wrong with me?”

That night, she stopped taking Prozac but didn’t feel any better.

Three days later, on May 22, she stood in her kitchen with a vacant expression on her face. She asked Jeff for the car keys, saying she wanted to go for a drive.

Jeff was worried. Jennifer had been making some unsettling comments, saying she felt so awful she wanted to jump off a building or jump in front of a train. He didn’t think she wanted to go for a drive.

He called her mother, who had been staying in a Milwaukee hotel with Samantha. Joan called the psychiatrist and then called Jeff back. Call 911, she said, and tell them she is threatening to commit suicide. It’s the only way to get her admitted against her will.

When the police arrived, Jennifer agreed to go voluntarily to Columbia Hospital in Milwaukee. She was placed in a general psychiatric unit.

In Great Britain and several other countries, women who become mentally ill after giving birth can stay in special wards with their infants. There are no facilities like this in the United States. For Jennifer, the experience of being hospitalized in a psychiatric ward, away from her husband and baby, was wrenching. All she wanted from the moment she arrived was to leave.

She was placed on a new combination of medications: Depakote, a mood stabilizer, and the anti-psychotic drug Zyprexa. After a couple of days, Jennifer was playing ping-pong in the common room with her brothers and sisters.

When Jennifer came home after five days, the woman who had been helping take care of Brandon had left her a note.

“Jennifer,” she wrote, “I hope you get better soon. You’re a wonderful woman–remember! Many people love you so much, especially Brandon, your little angel.”

Jennifer taped the note inside Brandon’s baby book.

A few good days

Even on her bad days, Jennifer could describe the way she felt as matter-of-factly as if she were describing the weather.

See this gorgeous day, she would say to her sister Laura. I can’t feel it. I know it’s beautiful but it’s not in me.

But there were good days, too, days when she wanted to buy a new pair of jeans, when she could laugh about someone eyeing her on the street. Once, in a telephone conversation with her sister-in-law, she talked about her hospitalization as if it had happened to someone else.

Can you believe it? she asked. Did you hear about Melanie Stokes? she asked. Wow, that could have been me.

On June 20, a mother from Algonquin was found dead. A sailing instructor saw Amy Garvey’s body floating in Lake Michigan, wearing a black T-shirt and jean shorts. Her glasses and shoes were found on a concrete wall at Montrose Harbor.

Her death was ruled a drowning, but there were strong indications she had taken her own life. Garvey, who was 29, became mentally ill soon after her daughter’s birth, her mother says, and had made at least one suicide attempt.

Jennifer was aware of Amy Garvey’s death, but she didn’t say much about it.

When Jennifer visited her obstetrician for her six-week checkup, she appeared better–“seemed her old self” the doctor would write in her notes later–but as her period approached, she took a turn for the worse. The hormonal fluctuations of her menstrual cycle may have exacerbated her depression.

About the same time, her face began to break out. The unhappiness she felt about her acne came flooding back.

Jennifer had a difficult relationship with her psychiatrist. The experience with Prozac had upset her so much she was afraid to try an antidepressant again. And she didn’t like the therapist the psychiatrist had recommended.

Joan began calling different psychiatrists, trying to get Jennifer an appointment with someone new, but no one had an opening for several weeks. She looked for a local support group for postpartum depression but couldn’t find one. Ultimately, she found a clinical psychologist in Highland Park who specialized in postpartum mood disorders.

The psychologist worked an hour away from Milwaukee, but she offered a thread of hope.

Someone who understands

The afternoon before she took her life, Jennifer sat slumped on the psychologist’s beige couch, her mother beside her.

Jennifer had turned more and more to her mother for support. When she made plans to visit a friend’s new baby, she asked if she could bring Joan with her. That week, she had spent several nights in the condominium in downtown Chicago where Joan, who is separated from Jennifer’s father, lives.

This was Jennifer’s fourth visit to Susan Benjamin Feingold, a clinical psychologist who works out of her home in Highland Park. Finally, her family thought, they had found someone who seemed to understand.

Feingold began treating women with postpartum mood disorders after she became depressed following the birth of her second child, in 1992. She keeps a changing table in one corner, a box of toys next to the couch and on the wall by the stairs, two items that offer the shorthand version of her journey.

A frame contains a scrap of legal paper a neighbor pushed under her door with a notice for a group called Depression After Delivery and a note that reads, in part, “I’ll do whatever I can for you. We care!” Next to that is a plaque honoring Feingold as the national organization’s president.

This afternoon, Jennifer told the therapist she felt confused. She was unhappy with her psychiatrist, who was away on vacation, and wanted to find someone else. Feingold had already called other psychiatrists on Jennifer’s behalf and called again. She found someone who could see her the following week.

Before Jennifer left, Feingold asked her if she had any thoughts of suicide. Jennifer said she felt she wouldn’t get better, but no, she didn’t have a plan to kill herself.

Yes, she said, she could promise she wouldn’t act on any suicidal thoughts she might have.

Jennifer didn’t mention the suicide notes she had written in Milwaukee the night before and hidden beneath the mattress of her bed.

A family keeps watch

They made sure Jennifer was never alone.

Her brother Charles took her out for dinner Friday, and she spent the night at her mother’s Gold Coast condominium. Jennifer didn’t sleep much and just picked at her breakfast Saturday morning.

Joan, worried, called the psychiatrist who was filling in for Jennifer’s doctor while she was on vacation.

Should Jennifer stop taking the Depakote, she asked, sitting at her dining room table. Could the doctor give her something to help her sleep?

Jennifer interrupted her mother. I’m going downstairs to buy a Sprite, she said.

No, Joan replied, there’s some in the refrigerator.

The psychiatrist said that she couldn’t change Jennifer’s medication until Monday, when she would have a chance to review her chart in the office, according to notes she made.

Call back then, the psychiatrist said.

How long is Jennifer going to need medication, her mother persisted.

Postpartum depression does get better, the psychiatrist answered. She probably won’t need to be on medication the rest of her life.

Jennifer approached her mother again. I need to go downstairs and buy some tampons, she said.

Joan nodded, distracted, the phone clamped to her ear.

A few moments later, she hung up and ran downstairs to find Jennifer. When she didn’t find her in the store, Joan ran back to her condominium. She saw her daughter’s purse on the bed.

Just past 11:45 a.m., as the southbound Red Line train approached the station at Chicago Avenue and State Street, a woman wearing a white sweater and purple shirt climbed down from the platform.

She turned her back and lifted her arms above her head.

When the emergency medical crew arrived, Jennifer was pinned beneath the train, still conscious.

“Get this thing off me,” a paramedic remembers her saying. “Get this thing off me.”

For 20 minutes, the rescue workers tried to free her. As they began to lift her out, she died