A mom died by suicide 9 days after welcoming twins. What her husband wants you to know

This story discusses suicide. If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline. You can also text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.

Tyler Sutton, a police officer in Massachusetts, was cautiously optimistic when his wife, Ariana, became pregnant with twins.

Ariana experienced postpartum depression (PPD) after welcoming their first child, a daughter named Melody, in 2018. According to Tyler, Ariana's symptoms were so severe that she was hospitalized twice.

“I was very nervous,” Tyler tells TODAY.com in an interview. “But being a mother was Ariana’s favorite thing in the world. And I thought if I stayed vigilant, everything would be OK the second time around.”

They had a plan in place, Tyler notes: Ariana was seeing a psychologist weekly, and her OB-GYN was aware that she had a history of PPD.

Everly and Rowan were born several weeks premature on May 22. Nine days later, Ariana, 36, took her own life.

“We were both so excited to be having twins. I can’t even begin to describe how happy she was,” Tyler says. “There were no signs that anything was wrong. You’d never have a clue. She was always joking about her swollen ankles and how she couldn’t wait to drink a big cup of coffee.”

The voice in her head, screaming

"I never dreamed this could happen. It came on so rapidly, and so suddenly," he says.

Tyler says Ariana was devastated when the newborns were whisked to the neonatal intensive care unit (NICU).

“She started talking about how she wanted them back in her belly. I was like, ‘Honey, they’re going to be fine. They came early, but they’re healthy and they’ve got a great team of people watching them around the clock,’" Tyler recalls. “But I couldn’t get through to her. No one could get through to her.”

Tyler says he remembers a conversation he once had with Ariana in which she described PPD as feeling like a “little person had taken up residence” in her head.

“That little person would drown out all the positive things that people tell her. And it would be screaming at her, ‘You’re a bad mom! You’re not doing your job! This is your fault! Everything’s your fault!’” Tyler says. “It was as if she couldn’t hear anything else over that voice.”

On the morning that Ariana died, she pumped breast milk for Everly and Rowan. Tyler remembers feeling relieved that Ariana was out of bed.

“The hardest time for her was the morning — that’s when she’d be stewing in her thoughts. As the day would go on, she’d get better. But then come nighttime, she’d be dreading going back to sleep because she didn’t want to have to go through it again the next morning,” he says.

Tyler says Ariana left him a suicide note.

“In her letter, it was clear that she was depressed. She said she felt like a burden. She was anything but a burden,” he says. “She just needed some help. I wish she had just waited for me to get home so I could have helped her.”

Recognizing the signs

When Ariana experienced PPD after her first daughter's birth, it took several weeks for her symptoms to develop. Tyler remembers Ariana becoming “borderline obsessive” about cleanliness. She also started to fixate on the family’s water supply.

“She was concerned there were bad things in our tap water, and would call the water department in town to discuss it with them — and even after she was assured that everything was fine, she couldn’t drop it,” Tyler says.

Recognizing that Ariana needed help, Tyler took time off from work so that Ariana could focus on her mental health.

“I was thinking, ‘This will give her the opportunity to relax and take care of herself, but it ended up having the opposite effect and made things worse. She was like, ‘My husband is doing my job, and I’m a bad mother,’” he says. “She would lay in bed crying."

After two inpatient hospitalizations for PPD, Ariana slowly got back to her old self.

“It took months to find the right medication and the right dose,” Tyler says.

Ariana went off of her antidepressants when she became pregnant with the twins. Tyler says she was worried they would harm the fetuses.

Studies show most commonly used antidepressants are safe to take while pregnant,  and experts say you should discuss with your doctor what's best for you and your pregnancy.

There is generally no need to taper off antidepressants, including selective serotonin reuptake inhibitors (SSRIs), during pregnancy, according to Dr. Angela Bianco, a maternal-fetal medicine specialist at Mount Sinai Health System.

“All of the data that we have to counsel patients is very reassuring,” Bianco previously told TODAY. “We have a decent amount of retrospective data that seem to be associated with excellent pregnancy outcomes.”

Nicole Warren, an associate professor at the Johns Hopkins School of Nursing, warned that if a person goes off an SSRI, they may start to experience worsening symptoms of depression.

The fact that Ariana’s symptoms came on so quickly with the twins could indicate postpartum psychosis, experts said, an illness that affects one to two out of every 1,000 new mothers.

“It is an illness that is most commonly associated with suicide and infanticide,” Rebecca Brent, a clinical psychologist at Allegheny Health Networks Women’s Behavioral Health Program, tells TODAY.com.

Postpartum psychosis typically occurs within the first two weeks postpartum. It is associated with “bizarre thinking, cognitive disorganization, racing thoughts and a decreased need for sleep,” according to Brent.

Other symptoms can include seeing or hearing things that aren’t there and delusions, or false beliefs.

“A mother might believe she’s still pregnant even though she’s two weeks postpartum, and you can’t convince her otherwise,” Brent explains.

Related: Warning signs and resources for postpartum depression, anxiety and psychosis

Brent says postpartum psychosis is tricky because it can wax and wane, making it hard for a doctor to diagnose.

“One minute she’s hearing things, and then in the next moment, she’s totally lucid,” Brent says.

Tyler says he’s sharing his story in hopes that the medical community will start paying more attention to perinatal mood and anxiety disorders.

“When newly pregnant women walk into their first appointment and they’re talking to their OB, they should be learning about postpartum depression — the risks and the signs,” Tyler says. “And they should continue having these conversations throughout the pregnancy.

A GoFundMe has been set up to help Tyler raise three young children as a single dad. He has a long road ahead.

"Ariana was Melody's favorite person in the world," Tyler tells TODAY.com. "She was the picture perfect mom."

This article was originally published on TODAY.com