Guest Post on Postpartum Psychosis and Breastfeeding

It would be cathartic to share my story and print my name and say to other women, this is real, and here is my story – but the social stigma is still too much to cope with. I knew eventually would write down my story about Postpartum Psychosis and how it threatened my sanity and made early parenting very frightening. It took a lot of years before I was far enough away from it to feel safe talking about it. Like it might come back if it heard me talking about it, or typing down the words.

I never really told my story- it was a thing of embarrassment to me. As if I lost control somehow, and it was my fault. I’m not sure who told me there was any control to be had with early parenthood, hormones, and brain chemistry but this is what I thought was true. I thought I could talk myself out of it, or meditate enough. Not possible. Needed medication.

As a new parent we tell ourselves things and believe them- particularly when we are suffering from a postpartum mood disorder. I thought there might be some choice in whether I had PPD, or postpartum anxiety, or something worse; that’s not true for any of us. We don’t choose depression, or anxiety, or PPP.

I’m not sure why it happened to me, but it did. All I wanted was a normal mothering experience, but that is not what I got. The truth is I had only one child ever because I could not willingly place myself in a position where I felt my sanity and objectivity leaking away again. My partner wanted more babies but I couldn’t do it again.

It came on very slowly. The first few days after birth were ok, but I was not sleeping at all. By day 4 Postpartum I was hallucinating people in the room talking. Objectively, I knew they were not there. I think that made it worse? It’s hard to define “worse” when you are holding your baby and your world is falling apart. If this is you, I want you to know it’s not normal, and you should not try to power through it without telling anyone.

I come from a line of highly creative people: artists, writers and several of them have some sort of bipolar issue or mental health issue. It turns out just having bipolar run in your family can put you at risk for mood disorders in the postpartum period. There is a higher risk of PPP in women that are bipolar themselves. None of these things were known to me until much later when I was trying to piece together how I ended up with postpartum psychosis. It was very very hard for me to think clearly when it was all happening. I spent a lot of my time focused on what I knew was real. This baby in my lap who was hungry again. Latching on my baby, her soft hair dewy with sweat and baby smell. The evening rolling around again. My husband watching me worriedly from his chair; I saw the fireplace, I heard the night crickets when the door was open. Some of these things were concrete and real. When I felt lucid and I was not tired, everything was ok. I also periodically heard things I knew were not in the room with me- generally two or more people talking. It always occurred when I was going to try and sleep. So I figured maybe I would just stop sleeping and that would solve it. But that is actually a sign of not thinking clearly.

I had a reasonable pregnancy combined with lots of moony dreaming, folding baby clothes and throwing up in the kitchen sink. As the months went on I saw less and less of my feet, found joy in watching animal planet on tv, and petting my baby through my body. Her small kicks and hiccups were reassuring to me. It was a very deep connection to the world, to feel life grow daily inside of me.  But I was isolated in my experience because knew no other women my age to talk with. I ate lots of soup and spicy foods that gave me acid indigestion, and speculated on the birthing process. I figured I’d read enough books to know everything and I did not seek out appropriate help or training.

My laboring time came and I spent 17 hours birthing my child. It was not what I anticipated. I had broken a rib a few weeks prior. My water broke and because I had no doula I went into the hospital at 10 minutes between my contractions. It turns out I was only 1 cm dilated but this was early 2000 and they kept me. I got an epidural after about 15 minutes at 1 cm dilated, because I was full of fear, and my RN offered it as an option. My legs went numb immediately. I had an OP presentation birth, and there was incredible pressure for many many hours. It changed my perception of what I had to do as a woman to move the baby out of my body, and I felt very disconnected to the whole process and labored with my eyes closed the whole time until my baby was out.

After my baby was born she was placed hot and steaming in my arms. I was able to get her latched and breastfeeding. I remember the overwhelming love that I felt, and waves of fierce protectiveness.  We were connected emotionally and snuggling, we looked at each other. Whatever fears I had in pregnancy were gone, and I was completely in love and attached. I didn’t let anyone hold my baby for a longtime- not even my husband.

The first two days were very challenging to navigate in other ways. I think the rapid changing hormones were perhaps too much for me. I felt very overstimulated in the hospital, with lights and noises and people barging in and out. I was worried about my daughter constantly. I was on high alert, and I was a survivor of many life traumas already and felt like I was busy keeping my daughter safe- I’m not sure from what. Never being sure who was coming through the door, and having a baby in a bassinet near the door meant I did not rest. My body was sure something was wrong, and I was frequently checking to see if she was breathing or too hot.

By day 3, I was home and trying to adjust to being a mother, to breastfeeding, to my body so raw and open. I remember sitting on the couch, and telling my husband that something was not right with me. I would look at the clock and around 9pm the waves of anxiety were always very bad for me. I had not actually slept in 3 days, even naps. No sleep at all. By day 4 there was still no sleep, and things started to change for me in new ways. My perception of the world was changing, all while I diapered and powdered this new scrawny little sweetheart I called my own. I held her and tried not to put her down, I soothed her, I sniffed her and knew she was mine.

I didn’t know about Postpartum Psychosis back then. I knew about Postpartum Depression; everyone does because about 85% of women have some sort of mood disturbance. The way I think of it is that basically someone you know has a form of at least one of the postpartum mood disorders. What we know about PPP is that it’s very rare, and can very dangerous. 1 or 2 out of 1000 women will have it, and among that group of women 5% will commit suicide and 4% will kill their infant. It has a rapid or sudden acute onset; sometimes within the first  48 to 72 hours after delivery. Most women who will get it will do so in the first 2 weeks. I had a rapid onset by day 4.

While those of use that have it cannot possibly have the same experience, I can tell you that mine wove in and out of reality, and that most of the time I knew that what I experienced was not real. It was the audio-hallucinations that I found frightening. When I would attempt to sleep I would hear two or more people in a conversation in the room with me. Most of the time I recognized the voices: my mother, old friends, a few times it was two men I did not know. The unnerving part was that I was lucid enough to know that my mother was 2 hours away, and that no one was in my room. As I was relaxing people would call out my name, as if to call me back… and I was so so tired. I could not rest. I would lie in bed with the lights off, – my husband trying to bottle feed a brand new baby on his own in the living room. I would lie there awake and people would jerk me out of sleep with their conversations. I was in an Empty room each time. I am grateful that I never had any command hallucinations that told me to hurt myself or my son; so grateful. Command hallucinations can be voices that tell you to do bad things, and they do occur for some mothers. This is part of the reason why the risk for suicide and infant death goes up with this diagnosis.

The cry of my baby brought me back  to my room,  over and over. I cried tears on her head in fear of what was happening. It was a chemical occurrence in my body, but it felt spiritual and disassociative. It was difficult to stay grounded in the everyday things of feeding my baby every 90 minutes, and each lost moment was something I could not get back.

In the most pivotal moment before I got help on day 4, I was again laying down and I was not hearing voices this time. I closed my eyes and instantly was moved into a glen, far away in the wilderness. The forest stretched out around me, the trees all moving and green. All shades. The forest surrounded the open clearing. The field was oval and I was in the middle of it somehow looking across. The tawny yellow and light green grass was about knee high, moving in the wind. Everything was moving. I was the grass and the wind. From the other side of the clearing there came a white horse with her mane flowing behind her. She was shining as white as a star, maybe the forest was the sky, the horse was the white full moon that I gave birth under. My eyes opened, and I was in my bedroom.

I stood up and started packing my clothes into an old ratty suitcase. My husband watched from the doorway and asked where I was going. I told him I needed to be checked into a psych hospital and I think he might have cried. I know that he chokingly said to me, “…but who will take care of our baby?” It was a comment that was so full of fear and pain. It was a hard time to be in my skin and to feel so out of control. I no longer trusted myself. I sat on the bed and instead we agreed to call my family Dr. When I went in to be seen, they kept me there for 6 hours in the clinic, and my whole family was in the room with me. It is important to have support, and effective medication. I was given a mood stabilizer and antidepressants, and also sedatives. I felt much better in a matter of days.

I could manage the things I needed to do for my baby but my spirit was wandering or at least that’s what it felt like. It did not feel safe and it stayed that was for many months. I have no pictures of me smiling and holding her in the first few months of her life.  Fortunately, my Doctors and family support systems rallied for me. There were a lot of psych medications for a great deal of time for me. Not something I every expected to take, having no mental health issues prior to delivering my baby. They did not fully remove the auditory hallucinations for me, but they turned the volume down on the voices so that they could not call my name loud enough to prevent sleep, or disturb me during the day. I knew that I had to keep my baby safe.

I was granted a reprieve by way of treatment. It is very very important that if you think this is happening to you that you reach out right now, and get help. I mean right this instant. Tell someone. Tell anyone.

When I was told by a psychiatrist that I had to sleep at least 6 hours I agreed to 3, and I introduced a bottle. I would breastfeed my baby, then hand her off to my husband and go lay down. Sometimes I would sleep for 2 hours in a row. My husband would pick up the next feeding with pumped milk, and then the next time my daughter woke to feed I was back on again. For me, the longest my daughter could make it was every 2 hours around the clock, and I was determined to breastfeed. It can be done while you are medicated for Postpartum Psychosis. It can be done with very little sleep. It can be done if you are determined. I never used any formula, but I did commit to pumping a little all day so my husband could give me the one nap.

It wasn’t ideal but I made it work for me and I breastfeed on demand all the other times. I attachment parented my baby, I held her close and kissed her feet. I was able to be the mother I was supposed to be with the help of my family and doctor. We went on to breastfeed for many, many years; about 6.

The shadow of PPP is a haunting one. It never really goes away because you don’t forget the experience or perhaps you don’t forget the places it takes you. The experience is uncomfortable to talk about. I am a grounded person normally, and these days are far from hallucinations or feeling crazy.

I think that my own story may be the part of why I am able to tap into how overwhelming the postpartum period is for many of us. I try to be the gentle hand that reaches out. Please don’t suffer in silence. Please get help right away!