My journey in to postpartum psychosis was as rapid as it was terrifying

My journey in to postpartum psychosis was as rapid as it was terrifying.  

I was so excited when I found out that I was pregnant. My partner and I had fertility issues so getting pregnant seemed like a bit of a miracle. I felt stable during my pregnancy, mental health wise, and so I was full of optimism about the whole thing. However, I knew the statistics. Any woman having a baby can develop postpartum psychosis, but I had a particularly strong chance. I have a diagnosis of bipolar disorder so I had about a 1 in 4 chance of developing postpartum psychosis. It was a worrying statistic but I tried to forget about it. 

When I gave birth by cesarean section, I was filled with excitement. I had been stressed for weeks about having surgery so I just felt elated that it had all gone to plan. I had a healthy baby boy and it felt like I was the luckiest person alive. I invited all the grandparents round to visit hours after I had given birth. I had done my hair and make-up and was trying to get out of bed as soon as the epidural wore off. I was so happy and chatty. It was just hours after I had given birth and my manic symptoms were already beginning to develop. 

It starts innocently enough. You are happy you have just had the baby you always wanted. You feel ready to conquer the world. You wake up when the baby cries and can’t get back to sleep. After feeding the baby and putting him back to bed, you might end up watching the news over and over again on a cycle in the middle of the night. You believe that you should do something useful. Perhaps you could clean the bottles for tomorrow. Maybe you could clean the kitchen whilst you are at it. Maybe organise the fridge and clean it thoroughly like you meant to do months ago. Suddenly jobs that aren’t pressing seem like they are of the upmost importance. Only, you start one job and your brain skips to another task, so you abandon the first job half way through. And so it goes on. 

The first few weeks after birth are all blurry in my memory. All I know is the it felt like I was on top of everything and I convinced everyone around me, families and professionals alike, that I was fine. I was just coping really well looking after a baby and multitasking at the same time. They weren’t to blame for not realising something was wrong. I was kidding myself and persuaded everyone else that I was ok. For once, I was just coping with something most people have to deal with at some point. That was my logic anyway. 

Fairly soon after my hypomanic feelings began, they started to get a bit more manic. I would laugh wildly at inappropriate times. I would sit on the floor singing away, rolling around and making up little songs. My eyes apparently became very wild and I would stare at people in my family and get in to their personal space, poking them and pulling their legs and screaming things out loud. It became very clear to my family that something was wrong. However, I hid all of these manic behaviours in public and with friends. I was terrified for anyone to see that I was acting strangely. I still had insight in to my difficulties and knew that I could hide them well. I have always hidden my mental illness from everyone outside of my intimate circle. And I am very good at it. 

Things escalated, and I started feeling very scared. I was walking around and glaring at people. I felt that I was being looked at. For some reason this overwhelming feeling of not being safe hit me. In public places, I felt like people were watching me and were acting suspiciously somehow. I became suspicious of buildings, trees and other objects too. For some reason there was a malintent there which I couldn’t explain. This strong sense of mistrust was running contrary to other thoughts in my brain, which told me not to be so ridiculous. But it didn’t matter. However much I tried to rationalise myself out of the paranoid delusions I was having, the delusions still felt as strong as ever. I knew it wasn’t true in my head, but my gut feelings were somehow more powerful.  

My paranoid delusions took hold of me one evening when I couldn’t get through on the phone to my mum. I walked over to her house and was convinced that something terrible had happened. When I couldn’t find her, I forced my husband to phone the police. I saw a man walking in the dark outside her house and immediately assumed he was my mum’s rapist and murderer. I was terrified. In the end my mum had just gone to the cinema and was fine. I realised I had overreacted but I was still scared of the man I had encountered and felt like he had probably attacked someone. I still held on to some of the delusion. 

Aside from the paranoid delusions, my sense perceptions all went a bit haywire. When I was walking my dog in the woods surrounded by the suspicious trees, the colours in the wood would transform in to something amazing. It was like a multicolored filter that you can put over a photo. The colours were bold and striking and I felt overwhelmed by the joy of nature. Things were moving, lines were no longer straight and everything had an over-worldly feeling about it. Sometimes these hallucinations and derealising experiences made me feel deliriously happy and, at other times, terrified of my own mind.  

I was manic and I was depressed, all at the same time, which is hard for people to understand. The amazing ways of life would hit me with a feeling of euphoria, and then the distress of the complexity and sinister ways of it all left me feeling terrified and low. Although I was euphoric at times, I was also very distressed by the way the world seemed and I just wanted it all to stop. I was very jumpy and wired so I was feeling manic but in a very dysphoric way. 

I saw my psychiatrist and some other mental health professionals, with my husband, and explained what had been happening. I couldn’t hide it anymore and I had come to realise that things weren’t right and that I needed help. My psychiatrist acted immediately and admitted me and my baby to a mother and baby psychiatric hospital. I was terrified of going but I was resigned to it. Something had to be done and I just couldn’t cope anymore.  

I spent a month in the unit with my baby. A lot of it is a blur because I was heavily medicated. However, I started feeling more like myself and all the feelings of suspiciousness and strange perceptions had gone. It took me a while to recover but I was discharged and sent back home. I recovered amazingly quickly, thanks to the swift intervention of my doctors and the appropriate medication and support from the team. 

How do I feel about the whole thing now? It’s been a year and I still think about it every day. I think about how distressing being in hospital was and how scary it is to lose your mind like that. But the trauma is fading, and I'm gradually getting some confidence back. I know that my bipolar symptoms will flare up again; they always do. But the mind has an amazing ability to forget the worst and to, rightly or wrongly, be positive about the future. For now, I am just praying that something like this never happens again. But if it does, I’m more ready for it this time. 

Losing a piece of me

Every time I become ill again, I lose a little piece of me.

As with many mental illnesses, my symptoms are episodic. I am never completely symptom free but the severity changes all the time. With bipolar disorder, I get episodes of depression and mania interspersed with some relatively normal periods. I still have a lot of problems with anxiety all the time but this can sometimes improve and sometimes get worse again.

The problem with having episodes like this, is that I never know what is going to happen and how my moods and behaviour are going to change. Each time an episode hits me, I’m almost shocked that the same thing could be happening all over again. I shouldn’t be. I know that a bipolar diagnosis is a lifetime diagnosis and many mental illnesses are long-term problems. I should be prepared but I never am. 

I have many memories of how I have been when I'm ill.  I know that I have felt extreme despair, frustration, elation, anxiety and agitation. I remember staying in bed all day and recall some of the strange things I did. Surely this should prepare me to some degree for the next episode. But my mind seems to try to protect itself: the worst memories get buried and the other ones feel like a dream.

Maybe mental illness is not the kind of thing that you could be properly prepared for. It’s such a strange thing to feel like you are losing your mind. There is nothing that can quite describe it. I'm still me when I'm ill but I don’t behave the same or feel the same emotions. I feel out of control and I realise that my behaviour and mood may be affecting how other people see me. I feel so strange that it is hard to believe that I haven’t been drugged sometimes. I don’t know why I feel the way that I do when I am ill, but I know that there is nothing I can do to stop it. How could you ever be prepared for this kind of life altering switch to occur?  

Each time I get ill again something happens to me. First, I suddenly feel jolted back to the times when this has happened before and the memories come rushing back. I realise that it is all happening again and I didn’t even notice the warning signs. Then I feel myself letting go, allowing myself to fall in to misery, anxiety or elation. With this comes a certain acceptance that my life is once again going to change forever and there is nothing I can do to stop it.

Every time this happens I lose a part of myself. One of the biggest changes is to my confidence. It keeps getting knocked back and there is not enough time between my periods of being ill for me to regain back any self-esteem that has been lost. I don’t trust myself to behave properly anymore and, because I socially withdraw when I am ill, I forget how to interact with other people. This has lead to all sorts of social anxiety problems.

Also losing your mind has a huge impact on how you view yourself. Your personality can seem to change. For example, when I get depressed I can become very introverted and hostile. When I am manic I can becomes overly exuberant and over the top. Even though I know my basic personality has remained the same it is hard to match these behaviours to my sense of self. I sometimes end up feeling incredibly self-indulgent and guilty all the time. I feel like I should be able to control myself and go back to the steady self that I imagine I used to be.

As each episode of illness hits me, and my confidence and sense of self are eroded, I feel like I have lost this huge part of who I am. I remember being well as a child. I remember being quiet but sociable, being imaginative but grounded and being relatively happy. I know I must still be the same underneath, but so much has changed. Because of my mental illness, some of who I was seems to have been lost forever.

Even mental health professionals can display stigmatising attitudes

Lots of people with mental illness experience stigma in their everyday lives. Perhaps your parents think you should be able to pull yourself together and think yourself out of your problem. Perhaps your friends believe that you have control over your illness and could do more to help yourself. If only you would join an exercise class or start eating blueberries or something, everything would get better for you.

I have come to expect these sorts of sentiments from people. Sometimes it comes from a good, albeit misinformed, place. Your loved ones are often just trying to help you with something they don’t understand. This doesn’t make it any easier to hear though when you know that you are trying your hardest and nothing seems to work.

I find myself trying to do the things that people want me to do just so that I can say to them: ‘look I have tried X and I'm doing all I can to try and get better’. Ultimately though, I know that these things won’t magically cure my mental illness. It’s more complex than that. My body has shut down and my behaviours have become strange. A switch has turned off in my brain and it is going to take a lot more than going on a jog to fix things.

Hearing these kinds of things from friends and family is to be expected. Hearing them from professionals though is quite shocking.

I once went to the GP to ask for some diazepam for my anxiety problem. I had been prescribed it by my psychiatrist but I wasn’t seeing him for a while. The GP’s response? ‘You just need to WORK through your anxiety. You shouldn’t rely on medication.’ (tone was very dismissive). I felt like I was being blamed for my illness. If only I would work a little harder, all would be fixed. I was made to feel like I was taking the easy road by taking medication. Of course, if medication is the easy road so be it. I would rather take the easy road and fix the problem than struggle down the path of yoga and raw vegetables alone.*

Maybe you wouldn’t expect a GP to have an in-depth knowledge of mental health problems. However, I would expect that a mental health support worker would have this kind of expertise. I had a very bad experience with my support worker. She forced me to do things I wasn’t ready for, she made me pay for her parking that she claimed back anyway and she asked me to buy her presents on my holiday. What most distressed me though was that she knew that I had bipolar but she didn’t believe it. When she read through my DLA application she was really shocked by the description of some of my behaviours. Her attitude? ‘I have never SEEN you behave like that.’ (strongly accusing tone). Surely as a MH support worker she would be aware that people cover up their problems.

Another time I attended an anxiety and depression group. The woman that ran the group said to us right at the outset: ‘I don’t think that any of you are ill. Mental health problems are down to bad experiences, but you are NOT ill and do NOT need medication.’ Now I am not of the opinion that only medication should be used to treat mental illness. Tools such as relaxation, CBT and mindfulness are all things that may help some people with mental illness. But dismissing the idea that mental illness should be treated with medication is dangerous. Medication helps many people and has been shown to be effective in controlled clinical trials. It is not good practice for a psychologist to dismiss medication just as it is not good practice for a psychiatrist to dismiss psychological treatments. Ultimately  of course it is a patient’s choice what methods of treatment he or she uses.

When a mental health professional says these kinds of things it’s very distressing for the patient. Anyone who has experienced a mental illness knows that they cannot control the illness by will alone. It is not a problem with strength of mind or character. It is not an easy choice to take medication. We have all experienced the side effects and the feeling that you should have been able to control the situation yourself without intervention. The fact that so many professionals have these incorrect assumptions about mental illness is deeply concerning. However, they just reflect the deeply ingrained prejudice of society in general.

A mental health professional has an important relationship with the patient. It is one in which the power dynamic is unequal. The patient is deeply distressed and desperate for help. They are fully reliant on the mental health professional for help. Most professionals are aware of this power imbalance but do everything they can to listen to the patient and advise, not dictate to them possible treatments. However, a significant minority of professionals give poor advice and demonstrate the same prejudices that uninformed members of the public have. This is all the more damaging considering the power imbalance between patient and professional.

Over the past few decades we have come a long way in tackling mental health stigma. This is partly because many professionals have gone out of their way to educate people and remove some of the stigma. I do not wish to negate some of the wonderful work many professionals do. I would not be where I am today without some of the great help I have received. However we must still hold those in power to account. When a professional holds a prejudiced view they need to be challenged, because often it is all the more damaging coming from them than it is coming from your friends and family.

 

 

 

*This is not to dismiss lifestyle changes. My point is that there are many treatments available to us.

How anxiety ruined my holiday

Holidays have always been an exciting and relaxing experience for me. My mental illness means that holidays have been especially important. I have no job, no children and a very limited social life. It sometimes seems like I have nothing to look forward to. I have nothing to talk about to people because nothing ever happens to me. I thought going away on holiday would fix this.

With this in mind, my partner and I saved money for ages for a holiday. There were a few doubts I had before I  went about how I was going to cope. Although I have had bipolar disorder for many years now, I had always managed to enjoy holidays in the past. However, it has only been relatively recently that I have suffered from a severe anxiety disorder. 

Having an anxiety disorder is in some (only some) ways more disabling for me than bipolar disorder. With bipolar my symptoms are better at some times than others. I can cope with going away on holiday when I feel better. However, severe anxiety seems to have stayed with me continuously for over a year now. I have had trouble breathing, panic attacks and a crushing feeling on my chest almost every day, sometimes all day. What I should have realised is that these symptoms weren’t just going to go away when I went on holiday. In fact, going on a holiday was likely to make them worse. 

I was really nervous about the flight because having panic attacks has meant that I have a fear of confined social spaces. If I have a panic attack, I need to be somewhere where people won’t see me. I need to be able to escape quickly so as not to embarrass myself. Cinemas, buses, supermarkets and other crowded places are all tricky locations for me. A plane is the worst possible place. People are packed on like sardines and there is no place to escape. I was so focused on this fear of the flight that I almost didn’t go. 

I didn’t have a panic attack on the plane. With the help of alcohol and some (very out of date!) diazepam, I managed the journey. However, I had been so focused on my fear of the flight that I hadn’t properly considered how I would cope with the rest of the holiday. We arrived in the city and I was instantly hit with crippling anxiety. 

We were picked up by the guesthouse at the airport. The first thing I had to deal with was the social anxiety. I had to try and make small talk with the lady that fetched us. She was nice enough but I am so unused to talking to strangers that I just couldn’t speak. I could feel the panic rising in me and was worried that she would notice. When we got to our accommodation we had to walk down this hectic alleyway with scooters flying past and I just felt terrified. I used to find this kind of experience exciting but I was just a nervous wreck. 

The roads were mayhem and I was too scared to cross them. The sights and sounds were so unfamiliar and I just felt completely lost. I basically hid in the hotel room for the next few days only popping out for food. When I did I couldn’t eat properly. I am a big fan of eating so this was quite disconcerting! I felt sick and kept feeling my body trembling. I couldn’t breathe. I thought I was going to pass out. I can’t describe properly how I felt because it was so awful that I seem to have partially blocked out the memory of it. All I remember really was how I felt like I was going to die. I just felt this absolute all-encompassing fear. It was how I would imagine feeling if I was hanging off a cliff edge with a rope that was about to break. It seemed like I had only seconds left to live except that the feeling lasted all day. It was relentless. 

It all came to a head after four days where I just broke down and sobbed on the bed. I knew then that I had to go home. Things weren’t going to get better. The unfamiliar surroundings were too much for me to cope with. We had to fork out a load of money to fly home early. 

I felt terrible. My partner was really upset and I knew that I had ruined the holiday for him. This was supposed to be his dream holiday and because of me he was not going to experience it. I feel so guilty. I can’t bring myself to tell my friends about what happened. I know I have to tell them some time because they will ask how my holiday went. I’m not looking forward to the awkward silence or the negative judgements. I know that many of them will say supportive things but I don’t know what they will actually be thinking. Perhaps I am silly to worry about what they will think but I can’t help it. What people think of me means everything to me. It shouldn’t but it does. 

My parents are there to care for me when my partner is at work. I get panicked if I am left on my own so I rely on them to support me. They decided to go away on holiday at the same time as us because they thought they weren’t needed. Now they know I am at home with only my partner to look after me. They are worried and I think they may not be enjoying their holiday anymore. I feel so ashamed that everyone feels like they have to revolve their life around caring for me. 

Holidays should be a time when people with mental health problems get to relax. We deserve some time to try and heal and rejuvenate. I try and tell myself this but it is hard taking my own advice. I thought that I was undeserving of a holiday and this latest incident has made this feeling even stronger. I can’t even appreciate a holiday. Loads of people would love to go away to somewhere but don’t have the money needed to go. I feel so guilty. Why can’t I enjoy things like everyone else?

Mental health, sex drive and mood

I have always wanted to talk about my mental health and it’s relation to sex but I have had some misgivings. I am pretty much anonymous on my blog and on twitter but three people from real life know who I am. This makes it hard to talk about something so personal. In addition, you never know if you are going to stay anonymous forever. One day I may decide to shake off anonymity and I don’t want to feel like I would be embarrassing myself.

On the other hand, here I am about to talk about my sex life. After all, what’s the point in mental health blogging if I’m not open and honest about how my mental illness affects me?

When my partner and I were first together, like most couples, we had a great sex life. It was probably too good. I was high on life and felt all connected to nature. Obviously in hindsight, I was hypomanic. Yes, I was in a great new relationship but I felt overly optimistic and excitable. Everything felt so intense and beautiful. When you are in such a good mood, sex feels so much better.

What followed in our relationship were periods of lots of great sex interspersed with periods of no sex at all. My partner would find this difficult and thought it meant that I didn’t love him. Sometimes I worried about that too. I thought that if I didn’t want sex anymore, maybe I didn’t find him attractive. This made me question our whole relationship. The reality though was that my mental illness was getting in the way.

It was when I was depressed that I lost all my sex drive. I felt too tired, too weary of life. Everything was dark and miserable. I felt like my energy was being drained away from me. I couldn’t be bothered to dress, to wash, to face the world. Faced with these feelings, why would I have been interested in sex? I was desolate and you need to have some kind of life in you to have pleasurable sex. It wasn’t just that I wasn’t interested in having sex with my partner. I wasn’t interested in men at all. I didn’t even look at other men. My sex drive was non-existent.

I didn’t have sex when I was depressed and I had sex all the time when I felt high. However there was a tipping point I reached when I became so manic that my sex life was interrupted. When I got too manic, my behaviour became bizarre. If I tried to initiate sex with my partner he would not oblige. He told me later that he felt scared by my behaviour. I was laughing too wildly, eyes bulging, stare unflinching. Sometimes it was hard for him because he missed the intimacy gained through sex but he didn’t want to take advantage of me.

I am at a point now that I have started to gain an intense interest in sex again. This has come along with an improved mood. The increase in sexual activity has really brought my partner and I closer together. It is lovely to feel that deep connection again. However I am scared of what this means for my illness. I want to believe that this is just normal and that it means that I am not depressed anymore. However, I fear that it could be a manic episode coming on. I feel like my thoughts are going quite fast and I seem to be laughing too easily, perhaps inappropriately sometimes.

Sex is something many people in relationships have fairly regularly and consistently. It is hard for both my partner and I to have such an erratic sexual routine. Mental illness (and medications used to treat mental illness) can really take its toll on sex drive and therefore can take its toll on relationships. I think that it’s important to talk to your partner and try and explain that it’s not to do with them, it’s to do with the illness. If they love you they should hopefully be understanding.