Are We Paying Enough Attention To Postpartum Psychosis?

(This post is authored by a woman who survived postpartum psychosis and hoped her story could help others find the help they need to recover as quickly as possible.I sincerely thank her for her heartfelt and courageous contribution. ~kk)

Let us start with the present.

I am a happy, mentally healthy, physically healthy(ish), 31 year old women. I have been blessed to find, date, fall in love, marry, and proceed on the adventure of life with an amazing man I am so proud to call husband. We are raising an 18 month old boy who makes us so happy and who we have deemed a genius (as most parents do).

If you had asked me on 8/23/2011 if I thought I would be in the place I am today I would not have been coherent enough to say No. That day I check into a psych ward where I spent a week of my life and the whole 3rd week of our son’s life. The psych ward was scary, cold, and very foreign. Yet, our story really starts in the labor room on 8/10/2011.

My water broke at 9:00pm on 8/10/11. We arrived at the hospital around 11:00PM and proceeded to progress until 8:00am, when my cervix got “stuck” at 8am. I agreed to Pitocin at 11:15am (I will go to my grave saying Pitocin is EVIL). At 1:00pm I “caved” and got the epidural. 5:00pmI started pushing. Stopped pushing at 6:00pm because of intense heart burn and my left groin area felt like a knife was being jabbed into it. Given a booster of the epidural and rested. Started pushing again at 7:00pm (had an episiotomy(stage 3) and suction was used) finally delivered our healthy 10 lb., 23 in long, 14 in head my son at 9:56pm. 25 hours after my water broke and about 19 hours after labor really started. At lot of little events happened during this time. However, this was the beginning of my postpartum journey.

The next 36 hours where filled with excitement, trying to figure out breastfeeding, pain from the episiotomy and delivering an enormous monster baby and little to no sleep for me. Luckily my wonderful husband who hadn’t slept at all in 48 hours and our son where resting and eating as normally as one can when you’re a first time parent or seeing the world outside of the womb. Meanwhile I was thinking about so much and the pain of the episiotomy kept me awake. We left the hospital and came home where we all spent a restless night. Breastfeeding was coming along. I thought the pain was normal and being awake was just hormones.

We took my son for his first check up where his Bilirubin count was high. Thus we had a nurse come to our house to attach a light to enormous monster baby. (This technology is amazing) For 24 hours our son looked like a Glow Bug or a character out of Star Wars. I fed him every 2 hours for 24 hours and only rested, never slept any considerable amount. He was an “over achiever” and was healthy after one day of treatment (not the norm). I was still in pain and on top of not sleeping had not had a BM since 8/11 (it is now 8/15). On 8/16 I went to see my OB about the episiotomy pain and not having a BM. The consensus was I was backed up but laxatives/suppositories would work. When I asked about how to help the episiotomy pain I was given the same advice “take baths”. That day I went home and had the worst BM of my life. The pain was at a 6/7 on a scale of a 10. My mom had to help me in the bathroom and I felt like I birthed a “poop baby” (yes that is horrible). While I felt better I was still in pain.

The next couple of days are a blur.

I kept taking baths multiple times only stopping when my son needed to be fed. I became obsessed with how our labor/delivery went. I wanted to talk about it to anyone who would listen.

On 8/20 around 3am I was moving furniture (scaring my husband).

During the day I started calling around trying to talk through what happened and get help. I was pushing everyone away except for Husband and Baby (they were not getting my full attention).

Around 11:00pm I called my mom crying, talking a mile a minute, about why all the little events happened in the labor room, etc.

The next day I text friends around 6am to come over and help. In my manic state I “made them” buy me stuff, make meals, and one friend even painted our fire place. If you know me this is the complete opposite of my normal character.

My parents arrived that night (only left 3 days before) and automatically knew I was not their daughter.

My husband already knew I was not his wife. I was still under the impression that this was all “normal” postpartum behavior.

Here is where the story turns into a comedy of errors with an earthquake and hurricane thrown in for good measure.

My mom slept in the room with me that night and my dad would bring my son into me to feed him when needed. My mom snores and my episiotomy still hurt. Thus I didn’t sleep again. The next day we started calling my OB practice. Their phone lines where down. So my father got directions, went down there, and got an appointment for me at 2pm. At 1pm my son was fed and napping and I was actually sleepy so I tried to take a nap. Only problem my wonderful father started mowing the lawn at that time. This was also the day that my parents and husband hid the lap top and cell phone so I would stop texting, FB, and e-mailing everyone. I got out of bed at 1:45 and went to the OB.

I saw the OB I had seen the most during pregnancy (not the one that delivered my son and saw me for the episiotomy checkup). The nurse and the OB knew I was not myself and referred me to a Center that deals with postpartum issues. Only problem they mistakenly thought I had to go through the ER to get there. Thus we went all the way to an ER that is 45 minutes away with my son in tow. Waited about 4 hours to get into a room, another hour to been seen by a doctor, 30 min, of me telling him my story at a mile a minute all to be sent home with a prescription for Adderall(?) and to take Benadryl until I could get the prescription filled. Around 10:45PM, at his wits end, husband called a therapist who specializes in PPD, trying to figure out what to do. My son is crying in the car seat. I start crying talking to the therapist on the phone. We decide to go home and try to go to an appointment with the therapist in the morning. I take Benadryl and sleep for about an hour. During the night husband accidentally guided me straight into a closet door that was left open causing a nice head bruise. At 6 AM I noticed a rug out of the place and told husband we have to go to the ER because I felt violent. (That rug was put in the trash about 6 months ago, would have burned it if I could have).

Second ER in 24 hours arrived around 6:30am and placed in an exam room. No one came until I started screaming “Why won’t anyone talk to me” around 8am  (Poor husband he deserves an award). A Physician Assistant and a Social Worker take me as their patient. My father comes to help husband get me help. (My mom stays with baby). A “bed” at the psych ward located in the Hospital I was at the day before is reserved for me. My father leaves and Social Worker decides on her own to call the Insurance Company and tell them that I do not qualify for the bed. This Social Worker had heard me say that I did not want to go back to that Hospital’s ER. So instead of listening to the Mentally Healthy people (husband and father) Social Worker thought it would be better to cancel the bed I had and start the process all over again with a different Hospital. Thus delaying my care another 12 hours because by the time I arrived at the psych ward (Around 5pm) the psychiatrist was already gone for the day. It was while we were waiting for all this to take place that the Earthquake of 2011 shook the hospital bed. I thought it was construction. I joke that the earth and I were having very similar days. Oh I live in Pennsylvania to put it in perspective.

(Small note here: while I have processed all these events and moved on with my life I still have a problem with that Social Worker. It is really hard to forgive an act of ignorance that led to extra days away from my son and husband. There are still times I wish that the hospital and that Social Worker could be disciplined in some way. At the very least be taught to listen to the Sane people not the Insane)

While driving to the psych ward I told husband “I am voluntarily doing this but not”. I thought I would see a psychiatrist before being admitted, no. I thought I would be screened and be able to understand what was happening, no. I was asked a few questions. Signed a piece of paper and before I knew it large metal doors closed behind me, my husband was out of sight and my world came crashing in, down, and all around me.

I only had the clothes on my back because we didn’t know to bring any with us. I called my husband to bring me a bag but he was already home, tired, and well had enough. So that night I laid in a cold, dark, scary room by myself, with a pair of summer slacks a short sleeve dress shirt and two very thin blankets. (I didn’t know you had to ask for linens).

That night I must have gone out to the nurses’ station 10 times to check the time. I tried to calm down with my mantra I made up “I come from a long line of strong determined women.” Unfortunately I was saying it out loud and the “mean nurse” yelled at me for talking to myself.

I finally saw a psychiatrist around 2 PM on 8/24. This is what I remember “Postpartum Psychosis, take a drug called Seroquel, can’t breast feed.”

So my reaction “No, I need to breast feed.” (It was a male psychiatrist who was very over stretched with patients and had no bed side manner especially dealing with women) My husband was called in to convince me to take Seroquel and once I did I started to get better.

A few things about the psych ward. I had never been in or around a psych ward. I had no idea what the rules where. I seriously thought it was like a hospital or hotel where my bed would be changed daily and towels would be in the bathroom. Other things I did not know, there was a washer/dryer you could use, using washer/dryer required someone on the staff who probably didn’t have the time or want to open the locked door, you could keep your clothes in your room (not the locked area, didn’t know this and got yelled at for asking for my clothes in the locked area), some shifts of staff would let me use my breast pump without watching me while others sat in the room with me, I thought the 72 hour paperwork was required (it is not, do not sign that it keeps you in longer), what was frustrating is that I was treated like I should know these rules already. Granted most patients where there for a second or third time, sadly, but I was a stranger to this world and I was scared. They repeat that you are safe and not to be scared yet, there are crazy people all around you and you are one of them. Scary!

After a week of being scared, feeling alone, so cold, and only seeing my son 3 times for 30 minutes each time, I was deemed ready to go home. This was after Hurricane Irene came and flooded our basement leaving my husband to bail us out all alone. (Earthquake and Hurricane, the earth and I were simpatico that week!)

That is my (our) story from 8/11 through 8/30/2011. I came home on Seroquel and formula fed our very healthy my son. I have spent the last 18 months being so grateful to my parents, husband, and my therapist for fighting to get me help. I am proud of myself for never giving up. Proud of my son for overcoming his own minor struggles (stiff legs and torticollis) and being such a smart, determined, goof ball.

I have had a love/hate relationship with Seroquel and am very happy to be off of it and thankful that there was a drug to help me.

What I want from this experience is for the medical community to recognize postpartum issues early. This is a high goal, I can always hope. Also, I hope that all mothers start sharing their stories. Let others know that birthing a baby is work but the real work starts once the baby is out. Learn how to take care of ourselves as well as the babies during pregnancy.

If something feels wrong, get help!

Never, Never, Never Give Up!

Everything will be okay in the end. If it’s not okay, it’s not the end.


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