What women should know before seeing 'Tully'

No more. A new crop of entertainment about motherhood has turned its eye toward the inner lives of motherhood, exploring feelings and storylines that were long overlooked. "Tully," a new film featuring Charlize Theron, is about a mother's experience with feeling lost -- and, eventually, kind of found -- after the birth of her third child.

It's joined by television shows like "The Letdown," "Catastrophe" and, to some degree, "Big Little Lies," whose plots largely revolve around the darker side of life with children. There are also the many parenting memes and hashtags that, if read in isolation, make parenting sound like purgatory.

The struggles they portray aren't new -- they're the manifestations of "the problem with no name" examined by Betty Friedan's 1963 book "The Feminine Mystique" -- but the fact that characters are hashing it out on the screen is new.

These stories do important work. They embolden many to reject the specter of idealized motherhood that still looms over women. Still, the net effect is a grim one. We've gone from a unnaturally seamless portrayal of motherhood to a pockmarked one, when the reality is often somewhere in between. We used to hear, again and again, how great motherhood is. Now we hear, again and again, how terrible motherhood is. An improvement? Sure. But it's far from ideal.

'Tully' stirs controversy

Much of the marketing and press for "Tully" focused on how relatable and honest it is. The preview featured exhaustion, spilled breast milk, soft midsections and pull quotes from reviewers calling it "razor sharp and ruthlessly honest." Coverage of the film conveys the same message. One review said it "paints a touchingly realistic portrait of motherhood," one called it "so refreshingly real," and one went so far as to declare that "This May Be The Realest F*cking Movie About Motherhood, Ever."

But when some viewers saw the film, it didn't exactly feel that way. In an essay on Motherly, Diana Spalding, the website's digital education editor, explained what felt far from real about the movie. She was alarmed by the revelation toward the end the film that (spoiler alert) the character of Tully, a night nurse hired to help exhausted mother Marlo, doesn't exist. Instead, she is the product of Marlo's postpartum psychosis, a rare and serious mental illness that, Spalding argues, the film doesn't adequately address.

"The reason that people are so excited about Tully is because they feel like it is the first time that true motherhood is being portrayed on the big screen -- but this is not true (of) motherhood," Spalding wrote. "Motherhood is hard, yes, but it is not this. This is mental illness. Brushing aside her mental illness again refuses to give it the attention it deserves."

Spalding told CNN that she wished the film had "taken it one step further and shown Marlo getting help." Instead, she is released from the hospital shortly after getting in a drunken driving accident. She is sent home with a quick mention of postpartum depression but without any reference to therapy or drugs or the fact that she actually had postpartum psychosis. Before long, the film ends -- on a hopeful note.

Though she's glad that film is stirring conversation about perinatal mood and anxiety disorders, Spalding worries that the film's vague approach to the topic may hurt moms. Those who have had such a disorder might be "thinking they are going to have a nice night out" and then get triggered by it. And those who may have one in the future, will learn to "dismiss these feelings as 'just how it is.' "

In response to the controversy created by Spalding and other writing on the movie, Diablo Cody, the film's screenwriter, told The New York Times that "the movie is about the lack of her treatment" and "is meant to be uncomfortable."

Yes, it's wrong to saddle art with advocacy and expect a clear takeaway. But in the case of "Tully," the portrayal of postpartum mental illness doesn't just muddle up the message, it also muddles the plausibility of the story. In it, self-care and psychosis are stitched together so that the disease and cure become one.

As we learn at the end of the film, the character Tully is meant to be Marlo's younger self, a reminder of who she is and how far she has come. Her delusion is akin to an idealized version of an acid trip -- through it, the film hints, she reaches some higher truth.

But in real life, perinatal mood and anxiety disorders don't tend to fix themselves.

Kate Rope, author of the new book "Strong As a Mother," about postpartum self-care, said postpartum psychosis happens in one in a thousand women. (Disclosure: Rope is married to the editorial director of CNN Health)

"Postpartum psychosis is a break with reality, when you can experience delusions, imagine things that aren't real and see things that aren't real," she explained. "That condition is very different than postpartum depression."

The good news, Rope explained, is that all perinatal mood and anxiety disorders are treatable, and there are very effective treatments for all of them. She said mothers should try to avoid using any fictional depiction of motherhood as means to assess their own mental health and should instead seek advice from a professional.

"Anyone who is not feeling like herself, or anyone who has a loved one who is not acting like herself, should reach out for help," she said.

There are many motherhoods

Despite what the headlines about "Tully" say, it is not the story of motherhood but a story about motherhood. The fact that we were so quick to make it the ur-text of motherhood reveals how desperate we are for meaningful and textured representations of the experience.

"We've seen fathers and men portrayed on screen a thousand different ways, so we don't feel a need to pick them apart this closely," Rope said.

I hope that as stories of motherhood become more common, we will move beyond the framework in which happiness and ease are seen as dishonest and the soul-crushing grind is seen as real. Because it's all real, and the more varied and textured representations of motherhood are, the more women will be able to see it.