What I Want You To Know About Postpartum Psychosis

Five years ago today my little man was born.

As for any first-time mom, the excitement and energy of the rush to the hospital to meet him is a bit of a blur, especially given the five years that have flooded my memory since then. Sure, we had the same fears and concerns as any new parents: is he sleeping and eating enough? Are we using the right baby products? When will his umbilical cord heal? Are we doing enough tummy time? But for us, the beginning of our story is quite different than that of most new families starting out.

Because right after he turned four weeks old, I had to be hospitalized for postpartum psychosis.

I knew I was experiencing hypomania from the time that he was placed in my arms around four a.m. the morning after he was born. He tried nursing for the first time and the physical exhaustion and emotional release of having just given birth started to set in. We sent him to the nursery so that I could try to catch up on sleep, but with the nurses checking my vitals every hour due to the C-section, sleep was nearly impossible.

Some people may wonder why I hid my symptoms from the people who could help me. The doctors and nurses who saw me when they came to check on the baby while we were still in the hospital never noticed that I was struggling. My therapist, who saw me when I was three weeks post-partum didn’t detect anything unusual. My husband and my parents could sense something was different about me, but we were all so caught up in the new baby that we pushed my mental health issues to the side and put the needs of the baby first.

I love my son with everything in me, but I know from all that I’ve been through over the past eight years living with bipolar disorder that I need to put my mental health first in order to be the best mother I can for him and his sister.

But in the first few weeks of his life, I didn’t know this. I was just a new mom. Trying my hardest to not screw up. And at the time I thought that meant staying off medication to protect my baby.

I was absolutely determined to breastfeed him. I put so much pressure on myself to make it work that the first week I was barely producing any milk because I was so stressed out and the internal fear that my body wasn’t going to be able to actually make food for my baby was doing just that: stunting my ability to lactate.

We did finally figure the whole breastfeeding thing out, me and Owen. And I nursed him for the first four weeks until I was no longer able to hide the fact that I was losing touch with reality.

I felt as though I was invincible and hardly needed to eat or sleep. The less I slept, the more energy I seemed to have. I never napped when the baby napped because I’d always find something to do around the house that was of course more important than catching up on sleep.

Everything around me had a certain sparkle to it. It was as if I were living in a dream world where everything was amplified and so vivid that I had to stay awake to soak it all in. There was no pain, only the soothing sounds of my baby cooing or crying softly before I picked him up.

It was all very surreal. But when hypomania turns into mania, and mania escalates to psychosis, things can go very wrong.

I am so thankful that my husband realized what was happening and knew exactly what to do in order to fix me.

As hard as it was for him to call 911 and have the police and EMT’s take me to the hospital, he knew that I needed to be separated from my baby for a week in order to get well.

And as much as I mourn the week that I lost with my son, I’m grateful for what I learned and how sharing my story has the potential to help other moms and families out there.

Not enough is shared about postpartum psychosis. Even though it is not nearly as common as postpartum depression, doctors still should discuss the potential chances of the occurrence, specifically in patients like me who had a previous bipolar disorder diagnosis.  Society doesn’t understand it and therefore, families aren’t on the lookout for symptoms in new moms. And I’d like to change that.

Women who experience postpartum psychosis are just normal moms who unfortunately have a chemical imbalance in their brains. Some of these women have thoughts of harming their children, and some of them act on those violent thoughts. I was one of the lucky ones who didn't have those intrusive thoughts, but even if I did - that doesn't make me a monster, as my friend Robin wrote on her blog recently.

I’m just a mom, with a 5-year old little man, who wants to prove to the world that our struggles don’t define us. They only provide us with opportunities to make a difference in the world. I’m beginning to work on explaining this to him every chance I get.

I’m loving watching my son grow into a smart, funny, caring, determined and stubborn little guy who has stolen my heart with his hugs and his smile. I’m still in complete awe of the fact that he grew inside of my belly, remembering the pressure of his little feet apparent from the outside. Bringing him into our lives was a miracle and we couldn’t imagine life any other way.

The other day I asked him what he thought it would feel like to turn five. “I’ll be all grown up! A big kid!” was his response. So much like me, he’s eager to make his way in the world, try new things and move mountains. I’m trying my best to just let him be little, to enjoy the carefree afternoons at the playground or the library. To linger over snacktime at home with him while his sister is still napping. And to savor every small moment we have together like our morning hugs and bedtime stories.

Five years have gone by so quickly but I’m not sad about them passing. The collection of countless precious memories which I’ve tattooed onto the inside of my mind are what I carry with me in my heart from the past.

I’m eager to see what the years ahead hold. Both for him, and for his mom who will always be looking on with pride.

Postpartum psychosis - how it happened to me (Part I)

I was online this afternoon and came across a story in our local online newspaper about a woman who had experienced postpartum psychosis after the birth of her second child. She stopped her car in the middle of DC afternoon rush hour traffic, took off all her clothes, and was running along the shoulder of the road towards a bridge over the Potomac River. She was convinced that she needed to be baptized in the water because the world was ending. The details of her story are eerily familiar to me. I feel for her that she had to go through something as embarrassing as stripping down naked in public. Could you imagine?

But at the same time I am so incredibly proud of her for standing up and telling her story - publicly. She is a brave woman and I truly respect her. She is not afraid of speaking out about this rare disorder that affects only one to two women out of 1,000. It doesn't sound like many at all, but when you do the math, that computes out to 4,100 to 8,200 women in a year based on the average number of annual births.

I think it's about time that PPP gets a voice. There is so much information out there about postpartum depression, but if you ask anyone if they know anything about postpartum psychosis, I would venture to bet that they'd bring up Andrea Yates, the Texas mother who killed her five young children by drowning them in the bathtub in June of 2001. But only five percent of women with postpartum psychosis commit suicide and only four percent commit infanticide.

Those numbers could be so much lower, if the general public were aware of the signs and symptoms of postpartum psychosis so that they could intervene before a tragedy could occur. When a woman finds out she is pregnant and begins reading the various pregnancy books out there, there is always a chapter on postpartum depression. I wish those authors would cover the other side of the spectrum too. There are lives at stake.

It happened to me after the birth of our first child in September of 2008. He was a healthy 6 pounds, 12 ounces, delivered via emergency C-section. (He wasn't tolerating the contractions since his heart rate was taking a nosedive with each one, and I wasn't dialating past 5 inches, so the decision was made and at that point I was so exhausted I just couldn't wait for him to be out.) I was absolutely determined to breastfeed him, yet had no clue what I was doing. I just felt all of this outside pressure to make breastfeeding work - all of my friends had breastfeed their children, the books and magazines you read all say that "breast is best" and of course all the literature at the doctor's office was the same. Even the formula company's marketing materials pushed breastfeeding. So of course I put a ton of pressure on myself to make it work. It made those first few days and weeks with baby boy so grueling, draining, and sad. Due to the C-section, and the added stress I was putting on myself to be successful at nursing, my milk took almost a full week to come in. I was breaking out in hives up and down my legs every night because I was so stressed out. Instead of enjoy my baby, I was feeling like I was failing as a mother because I couldn't feed him. The pediatrician had us start supplementing with formula at his 2-day check-up because he had lost too much weight. I was barely sleeping at all. That is how the mania started to spiral me into psychosis.

The days and nights started to mush together as I started to live life in 2-hour increments. The baby would nurse for 45-minutes, then we'd do a diaper change, then he'd nap, but in the hour that he napped I felt as though I had a million things to do so I never napped myself. And it wasn't as if I didn't have help with me. My parents stayed for a week after the baby was born and my husband was off from work for two weeks. So I did have times when I could hand over the baby, but yet, things still had to get done.

It was about seven days after he was born that I remember breaking down in tears in front of my mom with the phone in my hand, outstretched to her, pleading, "Please call my OB and ask her what med I can take that will help me sleep! I can't sleep!"  My mom called and they said I could use Tylenol PM while nursing, and so I did that afternoon and slept four hours straight, the longest stretch of sleep I had gotten since having the baby. The next day my mom changed her flight so that she could stay a few extra days to help out.

I remember feeling as though my mind was starting to race uncontrollably at times during those first four weeks after my son's birth, but somehow I was able to hide it from my husband and my parents. I wanted to be able to breastfeed my son and I knew I couldn't do that while taking medication. So I continued to fight the racing thoughts, but they quickly caught up with me in a big way.

We had our son baptized when he was four weeks and two days old. My parents flew back into town for the ceremony, and stayed with us for that weekend. I drove them and my brother and sister-in-law to the airport on Monday morning. On Tuesday morning I had become manic to the point of psychotic, and had to be hospitalized because I refused to take medication.

I spent a week in a psychiatric facility where the doctors stabilized me using a combination of anti-psychotics, sleep medications, and the mood-stabilizer Lithium. I could not believe that I had missed out on my son's fifth week of life. Completely.

The insomnia was the first and most prominent symptom for me. The delusions and hallucinations are a close second. I refused to eat at times. Each and every sound I hear is amplified one hundred percent. These are the symptoms that I experienced every time I had been hospitalized. Which up until that point had been twice.

The common theme that I experience when I become manic to the point of psychotic is the feeling that the world is ending. Let me tell you - it has got to be the scariest feeling in the world when you are absolutely convinced that it is happening. The time I lost touch with reality after our son was born, I remember that I had been sleeping upstairs since my husband said he would take care of the baby so that I could get some rest. I woke up at some point in the middle of the night and went downstairs to find him asleep on the couch, the gas fireplace blazing, with our son snoozing peacefully on his chest. For a split-second I thought about grabbing my camera to take a picture, but I had no idea where it was or else it seemed like too much of an effort to find it, so I didn't bother. I just woke my husband up and we went upstairs to bed, putting the baby down in the bassinet by our bedside.

A few hours later I couldn't sleep because I kept thinking I heard the baby crying. But he wasn't. My husband kept telling me to go back to sleep. But I couldn't. When he woke up an hour or so later to get ready for work, he knew right away that I wasn't right and he needed to call for help.

(To be continued...)