Postpartum Psychosis and Me.

This is for a new friend and for my Mum, without whom I’m not sure what would have happened.

Ten years ago, I had postpartum psychosis. It has taken me ten years to write this. Ten years, not to feel ashamed, which I suspect is a common emotion for women like me. Ten years to see that the illness was at fault, not me nor anyone around me. Well, apart from, to some extent, the medical profession but that comes later!

This is a picture taken at the time I was ill of the four generations of women in my family. You will see I was alot thinner…

I can talk about this now, partly thanks to a postpartum psychosis feature story, on Jeremy Vines’ show on Radio 2 in July 2017. The woman on the show was angry. Very angry. She advocated fighting back against the illness, and not being beaten by it. She was, I think, the start of a campaign to raise awareness by the charity Action on Postpartum Psychosis (https://www.app-network.org/). Eastenders also had a storyline around the same time. That combined with the Heads Together (https://www.headstogether.org.uk) campaign by the Royals, mean it’s easier to admit now.

I have suffered from depression for a long time. When I was pregnant, I knew I might get postnatal depression. I also found out about postpartum psychosis and looked it up in a specific motherhood medical dictionary, remember those! After I gave birth in hospital, I felt mentally ‘wobbly’ so asked the team there to assign me a midwife for 28 days after getting home instead of the usual 14 days; they do this if you have a history of mental health issues.

It was unfortunate that my midwife did not see the signs – as I clung to her when she tried to leave on the 28th day, her parting shot was to tell me to pull myself together… not helpful as it stopped me asking for help. My memory of that time is not brilliant now, it’s somewhat fuzzy due to the illness, so I don’t remember everything I’ve done or said and may have been weird without realising…

I repeatedly went to the doctor after that, I suspect they thought I was a malingerer, in the back of my mind I was wondering if I had postpartum psychosis… However, this was not mentioned as a possible diagnosis, in fact, postnatal depression was not mentioned either. Had it been considered by the doctors I saw, the midwife and the health visitor, they may have asked the right questions. For example, “Are you having nightmares?” “Yes, I dream my partner is sleeping on top of my baby and suffocating her. As a result, I pounce on him in the middle of the night in a state of panic.” My daughter was then sleeping in another room…

As I said, I did not want to say ‘postpartum psychosis’ out loud out of shame and for fear of the words making it true. I also did not have a supportive partner who might have told the doctor what was going on. We split when my daughter was a year old.

The truth is, I was bonkers. I’m not anymore thanks to my Mum, particularly as I was a single parent by this time.

My family knew something was wrong for a good while, but were unable to put their finger on what. Fast forward two years to September 2011, when I finally admitted to my Mum that I thought people were watching me in the car. She took me to my doctor who referred me rapidly to a psychiatrist. He was brilliant and put me on an anti-psychotic, firstly Risperidone which has unfortunate side effects for me, then Aripiprazole which is a newish drug and both an anti-psychotic and anti-depressant combined. All these drugs have side effects, some harder to deal with than others, most seem to make you fat! They also destroy your gums in my experience, so I have to floss every day. (For reference, the best book I have found to explain the drugs, side effects and with other helpful, readable advice is ‘Bipolar Disorder for Dummies’ ISBN 978-1119121862).

Yes I am fat, but I’m sane. I gained around 4 stone and 3 dress sizes in five years. And still it was a good choice to take the drugs!

I recently consulted the psychiatrist about coming off Aripiprazole to stop me gaining weight and he felt the risk was low, so let me gradually reduce the dose until I stopped taking it altogether in October 2017. So far I’ve only lost 1.6 kg but at least I’m going in the right direction… I am still bipolar which I manage through mood-monitoring, meditation and the occasional sleeping tablet, which has worked so far. I am prepared to take mood stabilising drugs if I need them.

This is me and my daughter now:

Being bipolar raises the risk of postpartum psychosis to 50%, compared to other postnatal women. As it happens, I wasn’t even diagnosed with bipolar until I had this, more serious, illness. Early symptoms include: elatedness, overactivity, overly social, busy mind, muddled, no need for or ability to sleep, irritable, anxious, in a dream world etc. (See this weblink if it sounds familiar https://www.app-network.org/early-symptoms/). Another helpful charity is Bipolar UK https://www.bipolaruk.org.

As I had it so long, my symptoms were mainly hallucinations, including believing I was a witch and had magical powers, paranoia, saying weird stuff, not being able to function with simple things like eating… oh and thinking Chris Evans was sending me messages over the radio, embarrassingly I replied by emailing the show. Sigh. I also struggled to care for my daughter at that time, though she seems to show no affect now. I have told her in simple terms what happened to me, she was only two years old at the time but may still remember some things.

I wish the understanding of postpartum psychosis had been better then. The medical profession did not even to consider it as an explanation for my repeated visits and, basically my begging for help, back then. It happens to 1 in 2000 women, so while not common, it could easily be someone you know.

I think the awareness is there now. I suspect the road to recovery still involves a fight to get the right medication, understanding and appropriate medical help.

I would like the mental health service to improve postnatal care. I hope it will.

Thank you to all my family and friends who have stuck by me even when I was acting pretty oddly. I realise it was difficult for you. Your support was and is a lifeline.

Love Ruth x

P.S. My motivation for writing this is to prevent at least one woman treading the same path. It’s a long and hard one.

P.P.S. I’ve recently been sectioned. Please find my blog about it here: https://wellthoughtthrough.com/2020/02/06/being-sectioned-timetotalk/