“You maligned us! You broke our confidentiality! You terrible, terrible man!”      

Sury Freund was a young mother with overlapping depression and anxiety following the birth of her first baby.

She and her husband were from Brooklyn and they were nearing the two-year anniversary of their time together in Eretz Yisrael as a young kollel couple.

“I just feel down.  But not just down — completely squished.  Like a balloon they let the air out of that’s barely floating.  And the fear I have of something happening to the baby is absolutely awful,” she told me as she continued to describe her symptoms, painting a classic picture of postpartum depression.

Sury had been referred by her husband’s rosh kollel, a sweet fellow I knew from the Romema neighborhood in Jerusalem. Often there is a lot of denial about this condition, which causes unnecessary pain and heartache. But Sury knew something was off and desperately wanted to get her life back on track.

“You’re not trying to give me any false reassurance?” she asked nervously, when I outlined a treatment protocol that would combine mental health therapy with a safe-for-baby antidepressant.

“Straightforward cases get a straightforward treatment,” I explained optimistically.

Sury was relieved by the hopeful news that there might be light at the end of her dark tunnel. Her husband, however, wasn’t as confident.

“Dr. Freedman,” said an agitated Duvi Freund, “are you sure my wife needs meds and all this stuff? Because I was speaking with my mother, who raised 11 of her own kids, and she claims every woman feels a little down after childbirth and one just pushes forward and snaps out of it. She says psychiatrists like to create stories in order to boost their business….”

I calmly explained that PPD isn’t just “baby blues,” which tend to last a few weeks due to added stress and hormonal changes. The most distinguishing factor is the time frame — baby blues should subside within a few weeks, but Sury was already four months after birth and exhibiting signs of moderate to severe depression.

I could see that Duvi was feeling conflicted, a young married man caught between the advice of his confident, opinionated mother and the suffering of his wife. But by the end of our appointment, they both seemed significantly reassured and we scheduled to meet again the following month after beginning the protocol.

By the time Sury and her husband came into my office for a follow-up visit five weeks later, she was doing significantly better.

“We love the therapist you put us in touch with, Dr. Freedman,” she told me right off the bat. “I’ve already met with her six times and I’m doing really good work.  And I think the medication you gave me is starting to kick in,” she added.  “I know you said it can take a month or two to have its full effect, but I just feel… well, I don’t know exactly how to say it, but I feel lighter.”

“It’s true, Dr. Freedman, she’s really back to her old self,” her husband Duvi told me. “I don’t know what you did, but it worked! I’m gonna let my mom know that this postpartum thing is real.”

Our next follow-up appointment showed continued improvement, and because Sury was also seeing a therapist, we made up to reevaluate in six months.  As it turned out, the Freunds ended up moving back to Brooklyn where Dovi would learn part-time and take a job in his father-in-law’s real estate business. I made the appropriate referral for ongoing care via my friend at Relief Resources and didn’t plan to hear from Reb Duvi or his rebbetzin again.

But Hashem had other plans, and15 months later I received an email from the Freunds asking for a time to speak. Two hours later, there was an email from the same friendly Duvi with a decidedly angrier tone, demanding an immediate phone call.  I was actually planning to call him after my last appointment, when I received a third, overtly furious email: “Dr. Freedman, I have half a mind to take you to beis din if I don’t hear from you immediately regarding that lecture you just gave in Beit Shemesh!”

Whoa! This was a real shocker, given how well everything had gone with his wife’s treatment, but I literally had no idea what he was referring to by referencing the talk I’d given to 100 parents the previous month.

I went to daven Maariv and had my secretary schedule a time with him for later that evening.  By the time I got in touch with him, it was clear that Dovi Freund was simply fuming.

“I can’t believe you did this to us!” he yelled from the other end of the phone.

“Did what?” I asked. “Is your rebbetzin okay?”

“Yes, she’s great.  Baruch Hashem she’s fine, which, as you know, is part of the problem. I should have listened to my mother. You double-crossed us!”

He was going to be tough to reason with, but I had literally zero idea what he was talking about.

“You maligned us! You broke our confidentiality! You terrible, terrible man!”

“Reb Duvi,” I spoke calmly and slowly to try and de-escalate him.  “Let’s try to figure this out and see what I can do to be helpful.”

“Too late, Dr. Freedman — you already spoke about us in your recent lecture, which was livestreamed. Now, the whole world already knows about how Sury Freund had postpartum depression!”

Now I really had no idea what he was talking about because I’d never done such a thing.

“The Persian family from Great Neck where the woman had a depressive episode with anxiety after her twins?  You think I didn’t know that was talking about me and Sury? Did you really think that we are so stupid?  That you could just pull a fast one on Duvi Freund and tell the whole world about his wife’s postpartum depression during that lecture you gave?!”

I finally understood what he was talking about.

“Reb Duvi,” I continued to talk in as relaxing a tone as I could muster under the circumstances.  “I never speak about patients I’ve seen or treated as a psychiatrist without their permission. That would be illegal in a court of law and assur in a beis din.”

“Then how do you explain the story about the Abrahamians — a kollel guy whose wife ends up having problems after she has a kid? I heard it myself! It was exactly what you claim happened to us!”

“Reb Duvi, as you saw yourself in that lecture I gave, it’s because this is a very common story.  One in ten women will experience postpartum depression, and there are thousands of kollel wives here in Jerusalem alone.”

“Oh,” he said, and was then silent for a few moments.  “Well, they were American… so are we!”

“There are tens of thousands of Americans here in Israel at any given time, Reb Duvi.”

“Wait, Dr. Freedman, are you saying this really wasn’t about me?”

“Nope. Any similarities to a particular individual are coincidental, because the themes are so relevant and prevalent.

“Oh…” he paused for a moment.  “I mean, I guess I’m sorry, Dr. Freedman,” he said sheepishly. “I thought we were like the only people this happened to.”

“No worries, Reb Duvi. The ikar is that your wife should feel good.”

“Amen…. Uh, Dr. Freedman, I want to tell you something. I was really upset about that lecture, but honestly, my wife was sort of relieved. She told me, ‘Duvi, don’t you see? This means we’re not alone.’ ”

Identifying details have been changed to protect the privacy of patients, their families, and all other parties.

Dear Readers,

It’s been an amazing experience to have been a part of your week these past five years. Mishpacha Magazine is a powerful force and I am grateful to have worked with such dedicated editors and colleagues. When I first started out writing this column, my goal was to improve the dialogue around mental health in our community, and I couldn’t be more honored to have been on this journey together with you. As this chapter of “Off the Couch” comes to a close, please don’t hesitate to be in touch if I can ever be helpful. Stay grateful and be healthy! 

Yaakov Freedman, MD 

Jacob L. Freedman is a psychiatrist and business consultant based in Israel.  His new children’s book — Me and Uncle Baruch — is available through Menucha Publishers.  Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com.

(Originally featured in Mishpacha, Issue 912)