Postpartum psychosis: ‘I’m a thing possessed, an animal. I am nearly sectioned twice’

My name is Jessica. I have postpartum psychosis. It is not my fault. Since my son was born, I have slept nine hours in 11 days. I have heard of the baby blues, but this is something else altogether; this feels like the baby black and blues. This feels like oblivion.

I can’t stop writing. Every thought, every idea, the name of every person I meet needs to be recorded. I mustn’t lose this thought. It must be noted; kept; remembered. The world needs to hear my words. If they are lost, all will be lost. Record it. Record what I’m saying. Make sure it’s recording. This will go viral. It will make me a millionaire. You will never have to work another day in your life.

When I arrive at the psychiatric mother and baby unit in Hackney, I am a shell of my former self. Psychosis is bringing me to my knees. I gave birth 11 days ago, and since that day the devil has singled me out as his dancing partner and has not let me rest. I have not slept, I can’t eat without distraction, and the pressure of my speech is so intense that my throat is red raw. I have transformed. I am a small, fragile bird-like creature and my husband can do nothing but stand beside the me that used to be his wife. The me he still hopes is in there somewhere.

On the journey to the ward, I have nearly been sectioned twice. I’m on borrowed time. The police may need to be called. If my baby is taken from me, I don’t want to imagine what I might do. I am frightened to live inside myself. I am ill. I am a thing possessed, an animal, caged. Whenever I have a moment of relative lucidity, I cry out to anyone who will listen – “I am here, it’s me. I fully cooperate with you. I need help. I will take any medication you need me to. I am here of my own free will. I surrender.”

But, within seconds, the Thing takes hold again and drags me back out to sea. I lash out. I will not take those pills. Get them away from me. You are taking away my human rights. I want a lawyer. You cannot degrade me like this and get away with it.

The only thing holding me hostage was the psychosis within. This thing wanted to destroy me.

People always ask me if I knew what was happening when I had postpartum psychosis. The truth is that I was painfully aware of what was happening. Until I started taking medication, and felt numbed, completely zombified, and lost two weeks of my life, I felt everything, and was utterly powerless to stop it or stem the irrepressible torment of my illness.

The tremors of the psychotic quake still resonate throughout our lives three years later. It took me about three months in the mother and baby unit to recover enough to be granted leave to go home. My baby was no longer newborn and our house had adopted the chill that homes left standing vacant absorb.

I was determined in my recovery to speak out against the thing that had kept me captive and had sought to break me. This was when my blog was born, and it came screaming into the world, determined to name the horror and the beauty of illness and recovery; the war and peace of our experience. I refused to be silent. I would not be ashamed. The blog, Mutha Courage, was my attempt to piece together the impossible jigsaw of my fragmented reality, and work out what the hell had happened and how we could live again.

I am very proud to now be in a position to talk about what happened to me and to my family, in an attempt to open the conversation and to normalise our relationship to these traumatic illnesses and episodes. The horror of what we went through cannot be denied, but I also want to share the tremendous love, growth and power that such a journey can engender.

I always say that I won the psychosis lottery, because I got lucky even in the most unlucky of circumstances. I was lucky to have such incredible NHS staff to offer me love and compassion even in this darkest chapter of my existence. I was lucky to have a husband who could speak to my soul when my mind was not intact. I was lucky to have a baby who was so patient and calm even in the most turbulent of beginnings. I was lucky to have this illness and be able to speak out about how these experiences can ultimately lead to greater understanding of ourselves and those closest to our hearts. We cannot choose what happens to us. All we can choose is how we play the hand we have been dealt. I am not the only sufferer. I am not the only survivor. We are all warriors in our own battles.

During some of my most intense psychotic episodes I was obsessed with recording what I was saying, because I was convinced that the content was essential for the world to hear. Once I listened back to the recordings, I realised that I did want the world to hear them, but for a different reason. I wanted to share them, and our story, to give insight into the debilitating nature of mental illness, something that many people and their families suffer from, and to shine a light on a subject that has, for too long, been kept in the shadows.

Mama Courage will be on BBC Radio 4 on Friday 12 May at 2.15pm.

Postpartum psychosis: ‘I’m a thing possessed, an animal. I am nearly sectioned twice’

Postpartum psychosis: research reveals full recovery possible within weeks

Sarah West says in the days after the birth of her son in 2012, she felt the emotions many new mothers describe – a mixture of joy combined with anxiety about breastfeeding and whether she was doing everything right.

But around one week after the birth, West’s new-mum anxiety went into overdrive. Despite the exhaustion that comes with being a new parent, she was unable to sleep when her baby slept. Her thoughts raced.

Her doctor diagnosed her with postpartum depression and prescribed West antidepressants. But her symptoms worsened and she began experiencing delusions and hallucinations.

She was experiencing postpartum psychosis, a severe, rare and little-understood condition that can place both mothers and their children in serious danger. It is markedly different to postpartum depression, because mothers experience symptoms such as loss of reality, delusions and hallucinations. This can be accompanied by either mania or depression.

The temporary condition is debilitating, yet research into it is scarce, especially in Australia.

But new research being presented at the annual congress of the Royal Australian and New Zealand College of Psychiatrists on Thursday found that if properly recognised and treated, women experiencing postpartum psychosis could make a full recovery within weeks and successfully bond with and care for their babies at home.

This is critical because left untreated or misdiagnosed, the consequences of postpartum psychosis can be fatal. In a small number of cases mothers may harm or kill themselves or their baby due the condition, which is beyond their control. The condition nearly always requires hospitalisation to protect the mother and her baby.

The study examined women admitted with postpartum psychosis to a mother-baby unit, Helen Mayo House, in South Australia, over a five-year period from 2012 to 2016.

It found the women often required one-on-one nursing care, and all patients received antipsychotic medication. A few also required lithium, a mood stabiliser.

This treatment saw almost all of the women make a complete recovery and able to return home to care for their babies after an average stay of four weeks, similar to the average stay for other mental health conditions. A key finding was the treatment saw 77% of the women still breastfeeding at the time of their discharge.

West received treatment after a friend told her she was not behaving like her usual self and called the National Perinatal Anxiety and Depression Helpline [Panda]. They advised that West should be taken to hospital immediately for psychiatric care, and West is now a strong advocate for the helpline.

After a four-week hospital stay which included being taken off antidepressants and prescribed antipsychotics, and visits from her baby for bonding, West was able to return home and care for her baby.

Her time in hospital and her period of postpartum psychosis remains a blur, and West says she is still not ready for her family to fill in the gaps for her.

“People can mistakenly describe what women like me go through as ‘baby blues’ or ‘depression’, but I was definitely not depressed,” West says.

“My anxiety went into overdrive, I was experiencing delusions and hallucinations, and really irrational thinking. But so few people know about the condition, and my obstetrician said I was only the second case of postpartum psychosis he had ever seen.

“I think all of the gaps in my memory is my body’s way of protecting me.”

As well as taking medication, West made changes to her lifestyle and learned to recognise when she needed time to de-stress. She has fully recovered and she and her son are now doing well. But West is still fearful of reactions when she shares her story, given the lack of understanding and empathy from some towards mothers who experience the condition.

Postpartum psychosis occurs in about one to two of every 1,000 births, and there is a 50% chance of recurrence in subsequent pregnancies. West wants other women who have experienced it to know there is support and treatment available. She also wants people around new mothers, including healthcare professionals, to be more aware of the symptoms so they can make an accurate diagnosis.

“I know women who are so traumatised from experiencing this that they won’t have another child because they’re terrified,” West says.

“I have to speak up because I don’t like the thought of other families going through what we did. This has to change and to do that we need better recognition of the condition.”

Dr Rebecca Hill from the Women’s and Children’s Health Network in Adelaide led the Helen Mayo House study, and says she believes a key part of the treatment of her patients’ was that the unit accommodated both mothers and their babies.

“While we didn’t specifically study this, my intuition is that it’s better for the mother and the baby to avoid separation because the attachment relationship is vulnerable to trauma when separation occurs,” Hill says.

“It’s distressing to think some mothers may be separated from their babies longer than necessary because they could not access proper treatment. Even a few days’ delay in treatment can expose them to substantial risk.”

But not all states have mother-baby units. In New South Wales for example, there is only one mother-baby unit, and it is only available to private hospital patients who are admitted to hospital voluntarily. Most patients Hill sees with postpartum psychosis are involuntarily admitted, and even Helen Mayo House only has six mother-baby beds.

West, who lives in NSW, agrees more mother-baby units are needed. She believes they may be able to help mothers with bonding and would see women receive more specialised treatment from clinicians familiar with the condition. She says general mental health wards cannot always provide the specialised care postpartum psychosis patients require.

The president of the Royal Australian and New Zealand College of Psychiatrists, Professor Malcolm Hopwood, says the study shows the importance of identification and early intervention for women with postpartum psychosis.

“The good news for these women is that with the right care they can bond with their babies and care for them like any other new mother,” he says.

Hill says the causes of postpartum psychosis are unknown, with most of those experiencing it having never shown psychiatric symptoms before. It usually presents within the first six weeks after birth. Some research is under way into genetic causes, but this is in its early stages. An accurate diagnosis also means early intervention and monitoring measures can be put in place for any subsequent pregnancies, Hill says.

“For the vast majority of women they will only have susceptibility to this at the postpartum period,” Hill says. “Something at this time makes them exquisitely vulnerable. But the key is that once postpartum psychosis is identified, it is so, so treatable.”

• PANDA National Helpline, Mon to Fri, 10am-5pm AEDT, 1300 726 306


• Lifeline, 24 hours, 13 11 14

Contact the author at melissa.davey@theguardian.com

Postpartum psychosis: research reveals full recovery possible within weeks

BBC antiques expert died after "postpartum" psychotic episode

A jewellery expert from Antiques Roadshow died days after being restrained by five paramedics and police officers following suspected postpartum psychosis, an inquest has heard.

The psychotic episode that struck Alice Gibson-Watt, 34, resulted in delusions so severe she believed her five-week-old baby was communicating with her telepathically.

The inquest at west London coroner’s court that began on Tuesday will determine whether the way Gibson-Watt was restrained while being taken to hospital injured her.

Gibson-Watt was a jewellery expert at Sotheby’s who had appeared on the BBC1 antiques show. Her husband Anthony described to the court the “deeply traumatic” events of 13 November 2012, when his wife began crawling on the floor and screaming that her daughter had died, despite her being alive.

She had given birth to Chiara, her first child, the previous month and was thought to be suffering from postpartum psychosis, which can cause hallucinations, paranoia and delusions. The condition affects about one in 1,000 mothers.

PC Sue Thomson was one of those who helped to restrain Gibson-Watt in the ambulance that attended the couple’s home in Fulham, west London.

The officer said in evidence on Wednesday that Gibson-Watt, who had been strapped down with restraints across her chest and legs, was screaming so loudly that talking to the paramedic was difficult.

“She was thrashing from side to side and I was worried she could harm herself or those trying to help her,” Thomson said. She joined other personnel in the ambulance to help restrain Gibson-Watt, along with her mother Miranda Phillimore.

At one point Thomson said it appeared Gibson-Watt was “trying to bite out at someone’s arms”. After arriving at accident and emergency at Chelsea and Westminster hospital, she was given a sedative that calmed her.

Thomson said she then had a “normal conversation” with Gibson-Watt before she told her “she could hear the baby speaking to her and it was saying to her that it was dead”.

Consultant psychiatrist Dr Miriam Barrett, of the North West London mental health trust, told the inquest on Wednesday that in a meeting with Gibson-Watt at 6am on 14 November she “appeared quite rational and normal, but underneath she was showing in her thinking there were delusions”.

“She was convinced that she was communicating with her baby and the baby could communicate with her,” Barrett said. “The baby was part of her delusions and that is where the risk arose.”

She said during the meeting there was no sign Gibson-Watt was in pain or discomfort from any possible injury to the abdomen.

PC Thomson told the court that at no time did she see anyone touch the patient’s chest or abdomen. She had used “calm, even pressure on the shoulders and knees” to restrain her.

Other officers who gave evidence also said they did not see any of those restraining Gibson-Watt touching her chest or abdomen, or touching her in a way that could harm her or injure her liver.

After being assessed at A&E, Gibson-Watt was taken to a mental health unit at west Middlesex university hospital in Isleworth. There she suffered a cardiac arrest and it was then decided she required urgent surgery after a tear was found on her liver that had caused serious internal bleeding.

Gibson-Watt was transferred to an intensive care unit at Kings College hospital in south London, where she died on 20 November 2012.

The inquest is expected to continue until late April.

BBC antiques expert died after "postpartum" psychotic episode