When I first saw the trailers for Tully, a story of a stressed-to-the-max mom and the night nanny who swoops in to save her, I was giddy with excitement. “This is me,” I thought to myself. “This is my life.” Mom friends tagged me in Facebook announcements about the coming movie, exclaiming how amazing it was to finally see real motherhood portrayed on the big screen. That’s certainly what early press implied it was.

Except it’s only a little bit like real motherhood, it turns out. This story contains spoilers, so stop reading here if you haven’t seen it yet and still want to see the movie.

How to deal with postpartum anxietyMarlo, an overwhelmed mom of two young kids and a newborn, is gifted a night nanny by her rich brother. When she grudgingly calls in the nanny after several weeks of struggling, Tully shows up at her door. Through most of the movie, Tully offers wisdom, friendship, and a much-needed break from the non-stop demands of motherhood. She and Marlo grow close, sharing relationship problems and advice—Tully even does Marlo’s makeup for her. One evening, when Tully convinces Marlo to take a night off and go to a bar with her, the two wind up driving home intoxicated and end up in an accident. But only Marlo ends up at the hospital. This is when we find out that Tully never existed. She was an invention of Marlo’s mind this whole time. The doctor asks Marlo’s husband whether she has a history of mental illness, and he looks back in confusion and says “no.” Then he thinks for a second and says, “Well, nothing like this,” and informs the doctor that Marlo was really unhappy after her son, Jonah, was born. The doctor nods knowingly, and there’s no more mention of mental illness throughout the rest of the movie.

I want to make something clear that the movie never does: Hallucinating a person into being, having a friendship with that hallucination, going out and getting hammered with that hallucination is not just any mental illness—it’s postpartum psychosis. And the movie’s writer-director team, Diablo Cody and Jason Reitman, were irresponsible in not naming it, leaving the actual diagnosis nebulous.

There’s a wide range of antenatal and postpartum mood disorders, but the one that most people are familiar with is postpartum depression. According to the Centre for Addiction and Mental Health, “PPD is clinically no different from a depressive episode that occurs at any other time in a woman’s life.” The symptoms are, for the most part, similar to any other depression: feelings of hopelessness or shame, anger, irritability, sleep disturbance. The only difference is these symptoms are focused on parenthood and typically set in several weeks to six months after giving birth. Marlo’s feeling of being overwhelmed, her lack of libido and her inability to find joy in life look like postpartum depression.

The problem is that Tully turns out to be a fabrication of Marlo’s mind. She’s a symptom of a psychotic break, which is characteristic of postpartum psychosis, not postpartum depression. Postpartum psychosis is an extremely rare condition, affecting 0.1 to 0.2 percent of mothers. Meanwhile 10 to 15 percent are diagnosed with postpartum depression. A new mother usually develops postpartum psychosis within the first few weeks after giving birth, and it comes on suddenly. She may hear voices or see things that aren’t there, or may have delusional thoughts. They represent a break in reality for the mother, resulting in irrational judgement and unusual behaviour.

As an advocate for those with perinatal mood disorders, I can tell you that there continues to be a lot of misinformation regarding postpartum depression. I have received many messages from new moms who are afraid to talk to anyone about their symptoms. They hold back on telling their family and doctors what’s really going on because they’re afraid of being judged, of losing their job, of having their baby taken away. They are under-informed, like so much of society, about the true nature of postpartum depression. And now, we have a movie that claims to portray motherhood in all its rawness…but with a mom who has a serious illness that isn’t even diagnosed.

Watching Tully was, in many ways, like watching my own life in the early postpartum days with my second baby. It’s poignant, real, funny, and it hits so many marks. The one mark it really misses, though, is telling the audience why Marlo hallucinated Tully into being.

This movie was an opportunity to further the conversation about a rare mental illness that, to most members of the public, is scary and mysterious. However, because the movie doesn’t call it what it is—postpartum psychosis—the audience leaves the theatre less informed than when they came in. Now, viewers will make their own assumptions about the diagnosis, which is more likely to be the one postpartum mood disorder they’ve heard of: postpartum depression. That’s a disservice to moms everywhere.

Read more:

3 helpful online resources for postpartum depression

Why new moms have scary thoughts about their babies