That explained so much. When I returned home, I was elated. I was compelled to explain to everyone who had ever touched my existence that I suffered from bipolar disorder, and that was why I had acted so erratically my entire life.
Clutching my newborn tight with one hand and opening my laptop with the other, I explained to my husband–with rapid, pressured speech due to a lingering manic episode, no less–my desire to email all my old college friends, strangers I had yet to meet, and everyone at church.
“Not all of them need to know, at least not right at this moment,” he said, trying to contain my compulsion. “I understand that you want to share, but explaining your diagnosis to all your old college friends, most of whom you’re not even in touch with, would be counterproductive.”
I bristled, but he continued. “You need to educate yourself about your diagnosis before you begin to share with others, so you know what it means. And, rather than focusing on sharing that you have bipolar disorder with everyone, you need to take care of yourself and our baby.”
That made sense to me. I reluctantly closed my laptop, and looked at my beautiful, fragile infant. He needed a mother who wouldn’t bend to every compulsion that struck her. I didn’t fully understand at that moment that I was compelled to share my diagnosis due to a manic episode. I wasn’t in my right mind; only halfway there.
My husband was right.
After I recovered from the manic episode, I no longer desired to shout, “I have bipolar disorder!” from the rooftops. When it came to my diagnosis, I became closed off. I would no longer spill my darkest secret–that I’d committed myself to a mental hospital and was separated from my 7-day-old baby because I was literally insane. I grew ashamed of my bipolar disorder.
Then I began writing my memoir, Committed, detailing my days spent in the psychiatric ward. I realized the story was compelling, unique, and could help people understand what it’s like to experience a bipolar mixed episode with psychotic features. And I realized that if I ever wanted to publish my work, my dream since I was a little girl, I had to be open with sharing my diagnosis.
A few months after I started writing, I formed a critique group, the Seattle Scribblers, who encouraged me to attend the Pacific Northwest Writers’ Conference in 2012. I pitched my not-yet-completed manuscript to agents and editors.
“After the birth of my son, I suffered a postpartum psychotic episode and committed myself to a mental hospital,” I told them in my elevator pitch. “My memoir, Committed, details the time I spent there while separated from my newborn.”
I explained to the agents and editors that I was grappling with a bipolar diagnosis, and that the mental illness had upended my entire life. I was met with a warm reception by some, but others were completely turned off by the “crazy” person sitting in their midst.
I wasn’t offended. Stigma is real, and I wasn’t going to change their minds about mental illness in the brief moments I had to make an impression.
Now, I have no problem telling people I’ve known even for a few weeks that I have bipolar disorder. When people ask me how I am, I tell them honestly: “I’ve been suffering from a depressive episode lately, but I’ll be okay. I have bipolar disorder, and that’s part of the cycle.”
The diagnosis is no longer shameful for me. It’s just a label that’s a reason behind why I sometimes act unpredictably. The explanation comes out naturally. Bipolar disorder is just a part of my life–a big part, to be sure, but it’s not everything.
My husband was right. Not everyone needed to know right then. I had to prioritize my own well-being and that of my infant.
But he was also wrong, in a sense. I had to grow into being genuinely comfortable sharing with my diagnosis eventually. I realized that by being open, I could help other people who might be struggling. So I started my blog, The Bipolar Parent, a comprehensive resource for parents with mental illnesses.
I faced my compulsion and my subsequent shame, conquered them, and never looked back.
Do you suffer from postpartum depression? Find out what the symptoms are, as well as 9 tips for coping with it from a woman who’s been there in this post on the Bipolar Parent!
Trigger Warning: This post contains a brief mention of suicidal ideation. If you are suffering from suicidal thoughts, please talk with someone from the Suicide Prevention LifeLine at 1-800-273-8255 or www.suicidepreventionlifeline.org.
Postpartum depression is a special kind of hell. You’ve been told that the time with your newborn is fleeting and magical. That you should be bonding with your baby. That every mother has the blues, so there shouldn’t be anything wrong with you.
But postpartum depression is not fleeting or magical. It interrupts the bond with your baby and leaves you a compromised mess. And it’s not just the typical blues “every” mother gets; if you have postpartum depression, there is definitely something wrong.
May is National Maternal Depression month. The awareness month is intended to acknowledge the seriousness of depression and psychosis during and after pregnancy. Studies show that up to 20% of mothers suffer from some form of depression in the postpartum period.
And you know what they say: “when Mama ain’t happy, ain’t nobody happy.” The damage that can be dealt to families when a mother suffers from depression or psychosis is tremendous.
Symptoms of Postpartum Depression and Psychosis
Postpartum depression symptoms can show up anytime within the first year, though most tend to show up soon after your baby’s birth. If you or your loved ones are feeling three or more of these symptoms, call your doctor right away.
Symptoms of postpartum depression can include:
Persistent sadness or anxiety
Irritability or anger, especially for no reason
Sleeping too much
Changes in eating patterns, either too much or too little
A lack of ability to focus
Changes in memory (can’t remember things)
Feelings of worthlessness
Anhedonia – Lack of pleasure in usually enjoyable activities
Feelings of hopelessness
Unexplained aches, pains, or illness
Interrupted bond with the baby
Postpartum psychosis, however, usually shows up within 2 weeks of the birth. The most significant risk factors for postpartum psychosis are a family history of bipolar disorder or a previous psychotic episode.
Symptoms of postpartum psychosis can include:
Delusions or strange beliefs
Auditory or visual hallucinations
Feeling pressured to go, go, go all the time
Inability to sleep, or decreased need for sleep
Extreme mood swings that cycle quickly
Inability to communicate at times
Postpartum psychosis is a serious disorder of the mind. Women who experience postpartum psychosis die by suicide 5% of the time and kill their infants 4% of the time. The psychosis causes delusions and hallucinations to feel real and compelling. They are often religious. Postpartum psychosis requires immediate treatment. If you or a loved one are feeling any of these symptoms, head to your nearest emergency room.
After my son was born, I suffered a postpartum psychotic break and committed myself to a mental hospital, where I was diagnosed with bipolar I disorder. I later wrote a book about the experience. After I recovered from the break, a manic episode with psychotic features, I suffered postpartum depression.
By the two-and-a-half year mark, I was writing daily suicide notes and making plans to die. It wasn’t until I weaned my son and took lithium that the clouds parted. My full recovery took a long time after that, but I was able to recover. I have since had a second child with no ill effects.
But if you have postpartum depression, how do you cope with it? Read on for 9 practical tips from a woman who’s been there.
Tip #1: Get Professional Help
Postpartum depression is a beast that screams for professional help. If you don’t already have a treatment team including a therapist, psychiatrist, and a primary care physician, then make the effort to get one.
(For a post on getting a psychiatric evaluation, click here. For a post on how to start seeing a therapist, click here.)
I know calling and vetting doctors at a time when you can barely hold your head above water sounds about as appealing as sticking your hand into a box of tarantulas. But trust me: the sooner you get help, the better off you’ll be. If you have a friend or a partner willing to support you, delegate the task of finding doctors and making appointments to your helpers.
A therapist can teach you coping skills to better handle your depressive episode. And a psychiatrist can prescribe you medication which can improve your mood and anxiety tremendously. And your primary care physician can give you referrals to a therapist and a psychiatrist.
If you don’t have a primary care physician, go to urgent care or call Postpartum Support International at 1-800-944-4773. Their website, postpartum.net, enables you to find local resources to get treatment, and support groups for new moms like you. You can also ask your ob-gyn if the hospital in which you delivered offers services to treat postpartum depression.
Tip #2: Take Your Medications
If you’ve been prescribed medication, then do take it. There’s no shame in using the tools that you’ve been given specifically to help you.
I know that you may not feel an effect for a couple of weeks, and the first medication may not even work the way you want it to, but I promise, if you stick with them, your meds will help. Stay the course. Work with your psychiatrist (see tip #1) to find the right combination of medication to help you.
Don’t stop taking them abruptly, as they aren’t designed for that, and you will suffer withdrawal symptoms. For a post on what to do if you run out of medication, click here.
You can pull through this. You just need to be patient–and take your meds as prescribed. Give medication a chance, and you’ll be well on your way to recovery.
Tip #3: Practice Self-care
Practice self-care. A lot of people think self-care ideas are limited to bubble baths and painting their nails. But that’s just not true.
Self-care is taking responsibility for your physical and mental well-being. That’s it.
Practicing self-care on a daily basis is difficult. It’s the box of tarantulas problem again. But taking care of yourself will help your depression lift.
Tip #4: Lean on Your Friends
If there was ever a time to lean on your friends, this is it.
Tap into your social network and ask for support during a time when you might be feeling vulnerable. Give your friends a call and ask them to listen to your worries, or join an online support group. If you have a church or social organization, see if someone would be willing to set up a meal train for you. Ask your friends or family to come watch the baby so you can get some life-saving sleep.
Sometimes asking for help is the hardest part of being down and out. Pride is a stumbling block. But there’s no shame in asking for help if you really need it. If you’re depressed, you’re really suffering, and you need the aid of others. Lean on your friends.
Tip #5: Journal, Journal, Journal
When faced with overwhelming feelings, you need to express yourself. Don’t stuff your worries, thinking they’ll go away. You’ll only succeed in making them bigger and harder to overcome.
If motherhood is not what you envisioned, write about how unfair this new normal is. Journal your concerns about your baby. Write down your dreams.
Talking to someone also helps. Reach out to your friends (tip #4) and speak with them about your fears.
However, if you have a rare disorder called hypergraphia, the compulsion to write, then try to avoid writing. During my postpartum psychosis, I suffered from hypergraphia, and was compelled to write multiple to-do lists with hundreds of items each. I filled up a journal my husband bought me on the day of my son’s birth within a week.
If you are suffering from hypergraphia, it is even more imperative that you seek treatment (tip #1).
Tip #6: Breastfeed… But Only if You Can and Want To
Studies have shown that mothers who breastfed for two to four months were less likely to suffer postpartum depression. But for mothers who couldn’t or didn’t want to breastfeed and felt pressure to do so, their depressive symptoms were worse.
If you can and want to breastfeed, then do so. You may feel the benefits.
But if you can’t breastfeed or don’t want to, then don’t, and don’t feel shame. You are doing a wonderful job feeding your baby regardless of how you feed them. Ignore judgmental people, and do what’s best for you. What’s best for you is best for your baby.
For a post on which common antidepressants and antipsychotics are safe to take while breastfeeding, click here.
Tip #7: Schedule Me-time
Anyone juggling the demands of a newborn needs me-time. This is doubly true if you’re depressed. Lean on your friends (tip #4) to watch the baby so you can get out for a walk, take a nap, and practice self-care.
If you can’t bear to be separated from your baby, just try for twenty minutes. You can be alone for twenty minutes. That’s enough time to squeeze in a yoga or meditation session, or read a couple chapters of a book.
You need time off to function as an adult. Losing your identity to the vast maw of motherhood is a real concern. Schedule me-time.
Tip #8: Cry
After the postpartum period, your body is flush with hormones. One of the ways to rebalance your hormonal imbalance is to cry. Our bodies secrete hormones through our tears.
Don’t be afraid of tears. Embrace them. Sometimes, if you give yourself over to a good cry, it can be cleansing.
Tip #9: Practice Infant Massage
Infant massage has a whole host of benefits. The baby’s sleep may improve. Rubbing infants down stimulates growth hormone in underweight babies, and helps all babies’ stomachs. And infant massage also helps the pain of teething.
Most importantly, performing regular infant massage can help you bond with your baby. When you’re depressed, bonding with your newborn can be extremely difficult. Connecting with your baby through your hands may help.
Postpartum depression doesn’t have to last forever. If you get professional help, take your medications, practice self-care, lean on your friends, journal your feelings, breastfeed (but only if you can and want to), schedule me-time, cry, and practice infant massage, then you’ll be well on your way to recovery.
You don’t have to do all of these tips. Pick and choose the ones that are most appealing. But if you do any of them, do the first: get professional help.
Postpartum depression is a serious condition which requires the aid of doctors. And postpartum psychosis is a medical emergency.
Don’t be afraid to reach out. Trust your instincts. If you feel that something is wrong, then do take the first steps to care for yourself.
Trigger warning: This post contains discussions of suicide. If you or someone you know is at risk of suicide, please call the U.S. National Suicide Prevention Lifeline at 800-273-8255, text TALK to 741741 or go to SpeakingOfSuicide.com/resources for additional resources.
May is National Maternal Depression Awareness Month. While up to 80% of mothers experience “baby blues,” up to 20% of mothers suffer from postpartum depression (PPD), a pervasive condition which sucks the life out of them. I’d like to share my experience with PPD in order to help destigmatize the condition and add to the conversation. I will also offer some tips on how to get support for PPD.
Women suffering from PPD endure a deep, pervasive sadness, fatigue, trouble sleeping and eating, thoughts of hurting themselves or the baby, and may isolate themselves. Symptoms may occur a few days after delivery, or up to a year afterwards, and can last for years. Treatments such as antidepressants can help.
My experience was a little different. Within a week after the birth of my first child, a son, I suffered postpartum psychosis (PPP), which is the most severe form of PPD and only affects 1-2 mothers out of every 1000 births. Symptoms of PPP include hyperactivity, hallucinations or delusions, bizarre behavior, rapid mood swings, and thoughts of hurting the baby. If you or a loved one are suffering any symptoms of PPP, contact a mental health professional or the American Pregnancy Association immediately.
During my run with PPP, I didn’t sleep for a week. I ate/drank only chocolate milk, and couldn’t stop talking. I had pressured speech, racing thoughts, and other symptoms of mania, like irritability. I often vacillated from euphoric explanations of my “plan” for the baby’s care to intense anger at nothing at all. I also suffered from hypergraphia, writing over a hundred to-do lists with multiple items on them during the first few days. I was obsessed with breastfeeding my son, and attempted suicide when the breastfeeding relationship was threatened.
I committed myself to a local mental hospital, where I was very lucky to find a bed on the day my therapist asked for one, and earned a bipolar diagnosis. The doctors there treated me with Olanzapine, a tranquilizer which knocked me out, and 1500mg of Depakote, which toned down my mania.
After enduring the harrowing PPP experience, which I’ve covered in my upcoming memoir, Committed, I suffered from two years of standard PPD. I was constantly exhausted despite sleeping well, cried often, and spent my waking hours writing suicide notes. I often thought of plans to hurt myself, and had thoughts of hurting my infant son.
I was still obsessed with breastfeeding him, and refused to take medication that would have endangered the breastfeeding relationship, like lithium. When he turned two and a half, I weaned him, and started taking ,a href=”https://cassandrastout.wordpress.com/2013/01/10/1227/”>lithium, which utterly changed my life. The depression lifted, the sun came out, and I stopped wanting to die by suicide. I was happy again, and started properly loving my baby.
I can now happily say I’ve not suffered a bipolar mood episode, either depression or mania, for the past six years. In order to reach that stability, I tried over a dozen medications until I found a combination that worked. I changed psychiatrists seven times because they kept moving to different practices, and changed therapists twice because of the same reason. I attended weekly counseling sessions for years. I learned how to never miss a dose of my life-saving medication, and how to practice good sleep hygiene. I recently gave birth to a second child, with no ill effects.
Tips on How to Get Support
If you or a loved one are suffering from PPD, or especially PPP, find a mental health professional as soon as possible. If you have a therapist, ask him or her to refer you to a psychiatrist, if you’re interested in pursuing medication. If you don’t have a therapist or a psychiatrist, ask your primary care physician or ob-gyn for a referral to one of those. If you don’t have a primary care physician, go to urgent care or call Postpartum Support International at 1-800-944-4773. Their website, postpartum.net, enables you to find local resources to get treatment, and support groups for new moms like you. You can also ask your ob-gyn if the hospital in which you delivered offers services to treat PPD.
Above all, fight stigma, especially self-stigma, which can creep in without you realizing it. You might feel ashamed or confused that you’re obsessed with your baby’s safety, or that you’ve had thoughts of harming your infant. Don’t be afraid of these feelings. They’re a sign of a mental illness which can be treated.
The difference between you as a mother suffering from PPD or PPP and the mother you can be on the other side of them is like night and day. You are not alone, either. Try to avoid isolating yourself. A therapist will understand, as will people in your support groups. Do everything you can to survive this, not only for yourself, but for your child.
Psychosis, a break from reality, is a common feature of bipolar disorder. People can suffer delusions, hallucinations, depression, anxiety, and incoherent speech. The breaks are especially dangerous for postpartum women, who may harm their infants. The causes of psychosis are varied, ranging from mental illnesses such as schizophrenia or bipolar disorder, to sleep deprivation, substance abuse, or prescription drugs.
But new research has linked psychosis to antibodies that cause encephalitis, a life-threatening disease which inflames the brain. There is hope that removing these antibodies will treat psychosis just as much as doing so treats encephalitis. Some of the antibodies act against a nerve cell protein called NMDAR, or the NMDA receptor.
Belinda R. Lennox, a psychiatry professor at the University of Oxford in the United Kingdom, led a team of researchers who conducted a study on 228 people with first-episode psychosis. The scientists drew blood from the patients within the first six weeks of treatment. They also collected blood from a group of healthy people and used that as the control group for the study.
Seven–three percent–of the patients with first-episode psychosis presented with NMDAR antibodies. None of the controls did. A previous study from 2015 found that children experiencing their first episode of psychosis also had antibodies relating to the NMDAR.
The good news is that, Lennox and her team, using an experimental immunotherapy that targets the antibodies, successfully treated patients with psychosis, and helped them recover function after their episodes.
Three percent may not be much, but it’s three percent more of people who may be able to be treated with immunosuppressant therapies. This is a significant minority, one that shows promise. Lennox and her team plan to conduct a randomized, controlled trial of immune treatment in people with psychosis in 2017.
Postpartum psychosis is a rare condition which includes symptoms of racing thoughts, delusions, hallucinations, the sensation of things “crawling” under the skin, mood swings, paranoia, and confusion. It occurs shortly after giving birth, in the first two weeks postpartum.
Psychosis affects approximately 1 to 2 mothers out of every 1,000 births in the U.S. The risks include previous history of psychosis and bipolar disorder, even though roughly half of the women who encounter it have no risk factors. According to Wikipedia, “25 to 50% of women with a history of mental illness experience postpartum psychosis; around 37% of women with bipolar disorder have a severe postpartum episode.” The risk of having a second psychotic episode is roughly 30%. The condition is not recognized in the DSM-5, but is used by doctors worldwide.
Unfortunately, there’s a 5% suicide rate and a 4% infanticide rate lumped together with psychosis. Each woman who undergoes postpartum psychoses breaks from reality. The delusions she endures are quite real to her. However, not all delusions and hallucinations tell the mother to commit harm to herself or an infant. Sufferers require immediate twenty-four hour monitoring and, in most cases, medication, to come out of the fugue.
During my episode, I was lucky enough to have a therapist who helped me commit myself to the University of Washington’s mental ward, which was the only available bed in the city at the time. Because I hadn’t slept in a week, the doctors there prescribed Olanzapine to knock me out for the first twenty-four hours, and then Depakote to help tame the postpartum mania.
I couldn’t sit still; I felt like I was going to burst right out of my skin from all my restless energy. The urge to nurse my newborn, Nolan, was intense. I tried to suffocate myself with wet towels when I found I couldn’t do it. I suffered a single hallucination in the showers: a voice roaring at me to stand up.
If you are suffering from postpartum psychosis or know someone who is, immediate treatment is essential to make a full recovery, which takes roughly six months to a year. The mood swings and delusions can last anywhere from two to twelve weeks. It is not your fault that this happened. You can recover from this.
Have you suffered from PPP or known anyone who has?