There’s a story I’d like to tell you, but whenever I try, I stumble, unable to explain exactly how it happened.
One thing I can pin my finger firmly on is the day I finally realised that I was ill.
A few months after the birth of my daughter, Beatrix, when I was 31, I clearly heard a child’s voice behind me, counting, ‘One, two, three . . . one, two, three . . .’ in a Glaswegian accent. I looked around for its owner, but I was alone.
Later that evening, I watched a psychedelic display of lions and roaring tigers cavort on the bare blue wall opposite me. I wondered how this could be happening, and suddenly knew that something was very wrong.
Given that all of this was happening in my room on a psychiatric ward, my realisation had come rather late.
There had been other not-so-subtle hints in the weeks before I got there: my belief that my baby had been swapped at birth, for instance, and that road signs were specially tailored messages just for me.
I never considered these ‘truths’ to be odd, let alone symptoms of an illness. Yet that’s precisely what they were — evidence of a struggling brain, one that kept coughing up delusions.
I was diagnosed with postpartum psychosis, a severe mental illness affecting about one or two in every 1,000 women soon after having a baby. It can cause a litany of symptoms, from anxiety and profound sadness to chattiness, hyperactivity and euphoria. Women with postpartum psychosis can rapidly cycle between moods and may experience hallucinations and delusions.
While it’s more common in women who have bipolar disorder (affecting 25 per cent of those with the condition, compared with 0.1 per cent of the general public), it can affect women who have never had mental health issues before. A psychiatric emergency, it requires urgent treatment as symptoms can start suddenly and quickly worsen.
At its most severe it poses a risk of suicide. It can even lead to accidental harm to the baby or infanticide, though this is very rare.
Women who suffer postpartum psychosis often worry about the stigma of revealing they’ve had the disease, and many don’t seek help. One study found that of women who had symptoms of postpartum depression, 41 per cent had not sought help nine months after the birth.
Many said they believed their symptoms were normal and would go away on their own.
I can identify with those women. I feel the fear of stigma keenly as I write this, afraid of how I’ll be judged.
For months, I thought my symptoms were a normal part of motherhood. The symptoms of postpartum psychosis can wax and wane, so sometimes I didn’t feel so bad. Yet at the peak of my disease a nurse told me I was one of the sickest women she’d ever seen enter the ward.
This shocked me. I was a bit anxious, a bit bothered, but surely not seriously ill? I had made every excuse for what was happening to me: sleep deprivation, the shock of becoming a new mother, the stress of losing blood and developing an infection after my Caesarean section. I lacked any awareness of how bad I truly was.
One in five mothers suffers from depression, anxiety or psychosis during pregnancy or the first year after giving birth, according to a 2016 report by the Independent Mental Health Taskforce for NHS England. Yet in England, fewer than 15 per cent of local clinical commissioning groups provide effective peri-natal services for women with severe or complex conditions.
Over 40 per cent provide no service at all. All this despite the fact that, in the UK, suicide is the leading cause of maternal deaths in the year after giving birth.
Beatrix was my first child. After discovering she was breech, a plan was made for me to have an elective Caesarean section.
As it happened, I went into labour in January last year, before the scheduled procedure date, meaning I needed an emergency Caesarean before my 8lb 7oz of pink, screamy gorgeousness was born.
Reflecting on my expectations of bringing her into the world versus the reality, I see a dark, vast cavern. I expected to be the first one to hold her, imagining a celebratory moment as Beatrix, my husband and I were together as a family for the first time.
Instead, thanks to the cocktail of drugs I had been given, I spent most of my C-section trying to throw up. I lost a third of my blood volume so, when it was over, I began to shake violently and was unable to hold my little girl. A nurse later tried to help me breastfeed Beatrix, but I was still shaking too much.
In those first few days, the daggers of disease began to stab my mind. I thought all the nurses were talking about me, and had an ever-growing suspicion that my baby had been swapped.
Back home with Beatrix, I felt increasingly anxious. I thought social workers were spying, plotting to take my baby. I felt I had to prove to the world I was a model mum, so they wouldn’t see any signs of weakness.
I hid my thoughts and fears from everyone, even my husband — my best friend and confidant for more than 13 years.
But he knew from my behaviour something was wrong. At his behest, six weeks after the birth, I went to see a GP.
She said it was a ‘red flag’ against my care for Beatrix that I had said I didn’t want a particular health visitor, who had been dismissive of the pain I suffered following my C-section.
The phrase set me off and I exited sharply, convinced she was part of the baby-thieving conspiracy. Without the help I needed, I became manic.
Five months after Beatrix was born, things had reached the point where I was terrified of leaving the house. I had a new health visitor, who saw something was amiss and began visiting every two weeks.
When one day she found me speaking rapidly and unable to stop pacing, she put the wheels in motion to get me help, urgently.
So, on an otherwise ordinary Sunday afternoon last June, I was admitted voluntarily to the mother and baby psychiatric unit (MBU) at St John’s Hospital, Livingston. Unlike general psychiatric wards, at MBUs babies accompany their mothers on the ward.
My mum and husband persuaded me it was a good idea, but it didn’t seem like one when I arrived. As we approached the MBU, I heard a baby scream and I instantly ran down the bare brick-walled corridor in the opposite direction, convinced the unit existed to collect up bad mothers and swap their babies for robots.
It was a week before I could leave my hospital room. As time passed, the antipsychotic medication helped heal my beleaguered brain. Over the six weeks of my admission I came to see the MBU as a place of safety. My husband came every day from 10am to 10pm, while Beatrix was there the entire time, either sleeping in my room or the nursery, so I could get on top of my sleep deprivation.
The ward offered baby massage sessions, weaning classes and play activities, enabling me to be the mother I wanted to be. I met other women going through the same thing. My confidence, so decimated by the disease, began to return. Other women, too, say spending time with their newborns was crucial to recovery.
Hannah Bissett, 38, who works for her local council, gave birth to her first baby in September 2009 by emergency C-section. Two weeks later, she was admitted to an adult psychiatric ward — where she was separated from her child — with postpartum psychosis.
‘I could barely put sentences together,’ she recalls. ‘I couldn’t remember how to dress myself.’
Hannah was sectioned and spent three-and-a-half months in hospitals in the North of England, on two general adult psychiatric wards, then in a small MBU.
Her memories of the early weeks are hazy. She acknowledges the wards kept her safe. But the separation from her baby was ‘awful’, she tells me. ‘I had this one photo on the wall by my bed and it was really well thumbed.’
In contrast, she speaks of the MBU with a smile: ‘It was my little haven to be with my baby and for my husband to come in and spend family time together.’
This family time can’t be underestimated. Sally Wilson, 36, gave birth to her first baby, Ella, also by emergency C-section in March 2015 (studies have not definitively shown if a C-section affects a likelihood of developing psychosis).
‘I couldn’t understand that I’d had a baby,’ she says. Doctors initially looked for a physical cause for her illness, conducting a CT head scan and blood tests. They found nothing, and Sally’s condition progressively got worse.
Things escalated until Sally, a university lecturer, collapsed: ‘I had what I’d describe as an out-of-body experience that I’d killed Ella and I was dead myself and living in an afterlife.’
Sally spent a week in a general adult psychiatric ward until she lied about how ill she was in order to be
A home treatment team visited her house every day for a month, then weekly, then monthly until a year after Ella was born.
She says it took her two years to fully come to terms with what happened and to bond with her baby.
Like most women with post- partum psychosis, I was offered medication. An antipsychotic called olanzapine was key to my recovery, and luckily was the first I tried. But there are many different pills available, and not everyone finds a drug that is effective for them the first time.
Sally went through six and found none that really tackled her disease, leaving her still suffering psychotic symptoms eight months after Ella’s birth. Eventually, her husband found a game-changer: electroconvulsive therapy (ECT), which involves passing an electric current through the brain to induce a seizure.
When he told her of ECT, Sally was surprised because she didn’t think it still existed. But after enlisting the help of a specialist perinatal psychiatrist, she found it to be a success. ‘It is not a nice thing to have to go through, but it basically saved my life,’ she says.
Hannah also had ECT, and was similarly sceptical. ‘To Joe Public, it’s barbaric,’ she says. ‘If you’d asked me about it ten years ago, I’d have thought of One Flew Over The Cuckoo’s Nest.’
These days, ECT is a quick, clinical procedure that can provide rapid relief from life-threatening symptoms. Doctors, however, still don’t know precisely how it works — it’s believed the induced seizure, rather than the administered electricity, is therapeutic.
Whatever medication women take, the recovery process can leave them with deep, troubling doubts about their health.
As I got well, my fearful thoughts were replaced with questions, such as: what had happened to my brain? I had never suffered from mental illness before and was used to trusting my mind implicitly.
It had earned me a double first at Cambridge, a medical degree and a Master’s from Harvard. What had happened to make it betray me at what was supposed to be a beautiful time in my life?
I turned to Jessica Heron, a senior research fellow in perinatal psychiatry at the University of Birmingham and director of Action on Postpartum Psychosis (APP), a charity providing support and information for those affected.
She said: ‘The best guess at the moment is biological and hormonal factors are involved. We do know it runs in families.’
Unfortunately, the road to recovery from postpartum psychosis is often beset with challenges. Three months after being first discharged, I developed postpartum depression, an experience Heron tells me is more common than not after postpartum psychosis, and I was hospitalised in the MBU for a further three months.
The second time I came home, it was only to be admitted to hospital for a third time, though for just a few days.
Each time I left hospital, however, I assumed I would now be ‘normal’ me. But this was far from the case. Hannah, too, believes real recovery began only after she walked out of the hospital doors.
‘I describe it as being shattered into a million pieces then rebuilding it all gradually,’ she says.
I don’t know if my husband and I will have another child, but as I continue to put myself back together, I am hopeful my family will be stronger than ever as a result.Source Daily mail.
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