Postpartum Psychosis – the long and winding road to recovery

It’s taken me a while to get onto writing this second post about my ongoing journey through postpartum psychosis. I think that’s partly because the recovery phase was the most painful for me. In those early weeks my uncontrollable emotions were projected outwards as mania, which was highly alarming to those around me but relatively joyful for me as I lost my grip on reality, worried about nothing and believed lots of exciting things were possible. The following months were the polar opposite, as once the medication had brought me down from the high my thoughts and emotions became increasingly inward facing and desperately negative. I lost myself in feelings of shame about how I’d failed my baby and my family, guilt about getting us into debt and a sense of hopelessness that I’d ever be able to regain a normal life, return to my career and be a good mum. Most of all I internalized the full impact of the stigma of being diagnosed with a mental illness, which had a hugely detrimental impact on my recovery because it stopped me being honest with myself and others about my continuing distress. The course of events is a blurry memory now, but I’ll attempt to describe some of what happened.

The sedating medication I was initially prescribed did make me sleep, almost solidly for 3 days in fact. No consideration had been given to breastfeeding, so I had to abruptly give that up once I took my first dose. That may have been the right decision given the state I was in, but I’ve since learnt that stopping breastfeeding abruptly can be detrimental to mental health. Anyway, I continued to take medication for 4 weeks, which gradually calmed the mania. During this period I had frequent visits from midwives, health visitors and mental health professionals. My husband had to take time off work as I wasn’t allowed to be alone with my baby, and friends and family rallied around to help. That is, those we chose to be honest with helped, but we hid the reality from many others. I can’t really understand now why we did that, but I suspect that stigma played a big part. In those early weeks there were some discussions about admitting me to a mother and baby unit (MBU), but we didn’t take that option, partly because it was too far away for my husband to visit easily, and also because the idea terrified me. What was I afraid of? Yet again, I think it was primarily the stigma. Looking back now I sometimes regret not taking up the MBU bed as I can see that intensive specialist support may have enabled a more complete recovery and better bonding with my baby, and I think it would have been really helpful to meet other women in the same situation.

Instead of being admitted I stayed home with a desperate desire to put it all behind me as soon as possible, go back to “normal” and cope like other mums did. The medication I was on prevented me from waking for night feeds, so when I was recovered enough for my husband to return to work I weaned myself off it, so I could take full responsibility for my baby. Within 2 months I managed to convince myself and my care team that I was well and I got myself discharged from their care. It was such a relief to believe I’d recovered, and that I no longer wore that label of having a mental illness. Retrospectively I want to slap myself for letting internalised stigma prevent me from seeking, and holding on to, as much specialist support I could, and for not being honest about the anxiety and depression symptoms I was now experiencing. I truly hope that the societal shifts we now see with the anti stigma work of Time to Change and others will, over time, lead to more people being more honest about how they are really feeling. Oh, and by the way, I absolutely do not recommend stopping medication without medical advice and supervision. It was very foolish, and could have had terrible consequences.

Instead of being honest I tried to ignore and hide my continued unease, and carry on with the daily activities of caring for a baby. I coped reasonably well despite the distressing and negative thoughts that were invading my mind, and I was able to join a postnatal group set up by local health visitors for new mums. I count myself extremely lucky for that, as that group of mums have become lifelong friends, and our growing families have shared memorable times together for over 10 years now, starting as weekly meet ups, and developing into regular outings, camping trips and many a boozy girls night. It’s hard to imagine now that it took me 6 months to tell those lovely ladies that I was “different” as I was suffering from postnatal mental illness. They probably still don’t realise that our early times together were often painful for me as I felt so ashamed and inadequate, whilst they all seemed to be coping like  “proper” mums should. I believe that if those early group sessions with the health visitors had included information about postnatal mental health issues it would have been easier to be honest with those other mums, and to ask for the type of support and reassurance I really needed.

Eventually, after a few months of outwardly coping but being in secret emotional turmoil I could no longer contain it, and I broke down in tears during what was supposed to be a fun cinema outing with my husband. I finally admitted that I wasn’t really coping and needed more help, and I went back under the care of the community mental health team, on a new medication regime and having regular visits. The medication took many weeks to properly lift my mood, so I continued to experience very negative thoughts and to worry constantly. Some of those thoughts are too painful to share, but I’ll just say that I sit here today greatly relieved that I didn’t act on them. I didn’t always find the support from well meaning professionals helpful, as I wasn’t given hope that I could fully recover, and the underlying issues weren’t really addressed. Thankfully in the ten years since then mental health services have become much better at focusing on recovery and instilling hope.

What undoubtedly helped me hugely during that period was when I finally got to see a specialist perinatal mental health team, who explained my diagnosis and told me that most women with postpartum psychosis do fully recover, learn to love being a mum, and regain fulfilling lives.  And over time my own experience has showed that to be true. There were certainly many emotional struggles for many more months, and it’s taken many years to let go of the guilt and shame, and to feel like a “good enough” mum, but I was able to start a gradual return to work when my baby was 9 months old, and I’ve successfully continued to develop my career in mental health, juggling that with the joy of bringing up my incredible little boy.

And here’s the other great thing – I went on to have a beautiful daughter too! In my next blog I’ll talk about how the perinatal mental health team supported me to enable that to happen, despite the fact that there is a 50:50 chance of postpartum psychosis recurring in women who have had it before. For more information about the disorder you can visit the action on postpartum psychosis website here: http://www.app-network.org/