Help and advice for PP Partner!

[atlovell7]

Hi everyone Alan from Northants here. I am going through a tough time at the moment as my wife and 9 week old daughter were admitted to a mother and baby unit 48 hours ago. My wife has been diagnosed with PP and has severe delusional feelings about her self worth and how she is raising our daughter which is completely at odds to the fantastic job she is doing in reality. I understand her care plan and what needs to be 'done' but am struggling a bit with just reading articles that explain the illness as opposed to real life ways of how I can best help as her partner. I realise it's going to be a long haul approach but would really appreciate any advice. I think its fantastic that forums like this are available

[EmmiLou Volunteer]

Hi Alan

I am very glad you have found this forum and I hope that we are able to help with the journey you and your wife have ahead. Hopefully this forum will be a comfort to your wife too when she starts her road to recovery.

It is very early days for you and your family, and it is going to take time for your wife to become better. My partner and I both read articles on the internet but sometimes it is best not to read too much at the beginnig as some of it can be very daunting and scary.

I am really glad your wife has a care plan in place, that must be comforting to know you have that. It is very hard at the beginning and you both will be very exhausted both mentally and physically with all that is happening. It must be very difficult seeing your wife in the MBU but this is the best place for her to be at the minute with professionals helping with her and the baby. I was on a MBU for 8 weeks and whilst it was awful being on the ward, I know now that I needed to be there in order to recover from the illness.

Keep giving your wife lots of reassurance that she will get better. Ask for support and help from family members and friends if you can. My partner tried to struggle on his own but I know friends say now they wish they had known what was going on so they could have helped. Most importantly look after yourself as it is very easy to stop taking care of yourself through this difficult time.

Please let us know how everything is going. You must remember that your wife will get better but this does take time. Ask as many questions on here as you need too. We are all here should you need to ask anything or need any advice.

Take Care.

Emma.

[AndyHenderson Volunteer]

My main advice would be to look after yourself. Make sure you get enough sleep. Seek help from your GP if stress gets on top of you.

As Emma says, just being there for your partner is the most important thing. It's a frightening experience for her and her confidence will have taken a blow. Quiet reassurance will help her get it back. Be patient (easier said than done, I know).

Don't beat yourself up thinking you've said or done something wrong to make her ill/worse. The illness doesn't work like that.

I found it useful to keep working, but I let my manager know what was happening so I could get time off at short notice.

It can be helpful to keep a diary. Note down the medications and doses your partner is getting. It might help later on to have a reminder of what she's taken and whether it was effective or caused side effects. The NHS isn't always good at keeping track of a patient's notes!

Andy

[andrea_at_app Volunteer]

Hi atlovell7, hello & welcome to this community & well done for finding us. Yes those early days can be really tough indeed but please be reassured that it's temporary & it does get better. There's some excellent advice from Emma & Andy above (thanks both) & I'm sure other husbands/partners will be able to add to this.

Whilst it's helpful to get a good understanding of the illness (plenty of info on the APP website app-network.org/), I think good, practical advice is really helpful too especially early on when you can feel really lost. If you've not found it yet, have a look at this 'Carers Survival Guide', it's written for an Australian audience so some procedures might not apply but it's full of useful info: app-network.org/wp-content/...

Also, this 'Recovery After Postpartum Psychosis' guide might be of use for you/your wife a bit further down the line. It's written by mums who've recovered & given their tips for the first year of recovery & beyond. app-network.org/wp-content/...

Are you juggling work the moment too? I think things get easier when you've got into some kind of routine with work/visiting etc. It sounds like you're doing a great job already & as Andy says, do take extra care of yourself too. Let us know how you & your wife are getting on.

[atlovell7 in reply to andrea_at_app]

Hi Emma, Andy and Andrea first of all a massive thank you for the fantastic practical advice. I'm blown away by the supportive nature of your responses and already have a greater degree of confidence.

It is scary and unsettling and obviously leaving my girls in a MBU each night is distressing, as are the procedures and protocols in place which I fully understand are totally necessary.

My wife's diagnosis has changed somewhat from what I was initially told. It is depression with psychosis apparently. Either way sheik suffering from the same delusional issues as fits the description of PP and is convinced are baby is very ill despite the fact that in reality she is thriving wonderfully. I realise this is the illness but it's still hard to see deal with.

A further problem is that my county, northants, does not have a MBU and it's 50 miles away from home which brings it's own pressures. I will certainly try to apply the advice of getting sleep and looking after myself. Also I'm struggling with fielding the amount of updates friends and families want. I might need to employ a switchboard operator!!

A further question I wanted to ask is regarding signs of 'recovery'. My wife is on sertraline and Olanzapine and I have been told that this could take weeks to have an affect. How does it feel when you start to get moments of 'normality' I wonder? And then when medication has done its stabilising what is the next step?

Sorry,lots of questions there! Apologies for any typos. I'm in the little courtyard of the unit typing on an iPhone whilst trying to find a square yard of sunshine! Thank you again for the advice. Regarding work I am a teacher so have a few weeks off yet but hopefully they willbe flexible given the travel aspect too. It's petrifying and im up and down but I have utter belief after your collective comments that she will return again. Have a great weekend x

[atlovell7 in reply to atlovell7]

Just spotted all the typos and grammatical errors!!its the iPhone! Honest!

[lrbs]

Hi,

To add to what's been said I would also reiterate that a MBU is the best place for your wife and daughter.

When I had PP the onset was sudden and my husband had to make a decision on my behalf about where I should be treated: I ended up on a general psychiatric ward because the MBU was an hour's drive and my husband wanted to be nearby: however being separated from my daughter was devastating for me, and I needed to see an infant mental health specialist further down the line; I also felt angry with my husband and the medical professionals who advised against the MBU. So, don't worry about the distance: it's the best place.

[lrbs]

Hi,

To add to what's been said I would also reiterate that a MBU is the best place for your wife and daughter.

When I had PP the onset was sudden and my husband had to make a decision on my behalf about where I should be treated: I ended up on a general psychiatric ward because the MBU was an hour's drive and my husband wanted to be nearby: however being separated from my daughter was devastating for me, and I needed to see an infant mental health specialist further down the line; I also felt angry with my husband and the medical professionals who advised against the MBU. So, don't worry about the distance: it's the best place.

[Ellie_at_APP Partner]

Hi I just wanted to comment as well, though I think others have already said everything maybe I would want to say. I had PP two years ago and was in a MBU for nearly three months. My partner doesn't drive and the MBU was two hours by train, he'd come up every weekend and stay in the MBU with me (which was great) and work during the week. I know it was so tough for him. I guess I can only write from my perspective but I think getting a break and support for yourself is very important, I know one weekend after a few weeks he actually didn't visit us and went and stayed with a very good friend who he could just relax and be himself with. I think this is important to give yourself a break and get some support. In terms of support for me, just him being there, phoning every day, buying me things I needed, I remember he bought me slippers that were pink, just the kind I would choose myself, that meant a lot. It was a really tough time, but as others have said it's definitely temporary and she will without a doubt get better slowly. And as others have said MBU is definitely best place for your wife, I found the support I received amazing and just what I needed at the time, and they really helped me bond with my baby - it was really important we weren't seperated.

In terms of medication and what next etc its important to remember everyone is different. In terms of my story the psychotic episode I had went within one week on Olanzapine, and it was more recovering, the staff kept saying its like breaking a leg except you can't see it, my 'mind' was broken and needed time to heal, so yes it was prone to depression and anxiety afterwards....after 6 weeks I think I became very anxious and had depression (but it sounds like your wife is already suffering from this). I was on Olanzapine for a over a year, and I still take anti depressants but am slowly reducing them. I was on Escitilipram (I think that's how its spelt) for depression - I know it is an expensive drug, I was in a private MBU and they prescribed it and luckily my health authority agreed to fund it afterwards. Once I was discharged from MBU I was with the early intervention team - a local psychiatric team - and I had a psychiatrist and psychologist and a mental health worker who I met very regularly. I am still with them but just meet them every few months now. The support is for 3 years after the episode. I met the psychologist very regularly for a while, she mainly did CBT etc, this was SOOO important to my recovery, I can't stress how much, she helped me get my confidence back a bit, and to change my negative way of thinking, that I was a 'bad' mother etc.

I'll be thinking of you, I really hope your wife continues to recover. Don't hesitate to come on here and ask all kinds of questions, I really hope you're finding it helpful. Take care.

[caroline-p in reply to Ellie_at_APP]

Hi, sunnyandwild I know the distribution of NHS MBU's is very patchy, but had no idea there are private MBUs' as well. Where was yours I wonder?

[Ellie_at_APP Partner in reply to caroline-p]

Hi I was at the Eastbourne Clinic, which is a private clinic but my place was funded by the NHS. I had a brilliant midwife when I was admitted to A&E who fought for me to go there rather than an NHS one in London, as she said the Eastbourne Clinic was better. God knows how much it cost them. It was really good though, I got really good support and the staff were brilliant.

[Simon_at_APP APP]

Hi,

brill advice above. My wife and little one were in an MBU and at the time it felt terrible, like I'd lost them both but it soon became apparent that it was the best place for all.

For fielding calls, I used one person from each family and a couple of good friends and colleagues to be the go to points, which limited the amount of calls to me.

I found going to work helped, but I had an understanding boss and colleagues but it gave me a chance to have something normal in my life.

Try and look after yourself, which is so much easier said than done, cause my mind was constantly thinking about my wife and baby...

I can't add anymore than has already been said, so best wishes and keep us upto date.

[andrea_at_app Volunteer in reply to Simon_at_APP]

That's a really good tip about fielding the phone calls Zapple as it is really draining. If you're a regular Facebook user, I think creating a 'secret update group' (make sure it's set to secret) & just inviting close friends & family can be a quick/easy way of updating everyone who needs to know - make sure everyone understands you'll only be updating it occasionally though, or maybe delegate a single friend to update it & it's probably a very good idea to run it by your wife first.

[andrea_at_app Volunteer]

Hi atlovell7, for me Olanzapine worked very quickly & I was only on it for a week before changing to other meds (can't remember which without checking my records, it's all a bit hazy). After that first week though & after the psychosis had subsided, as the others say above it was all about recovery & the time it takes to rebuild yourself - I felt very fragile/ wobbly indeed during the next few weeks. I think patience is a huge benefit here & taking it slowly day by day, one day at a time (for both you & your wife) really helps get you through it.

As for the 'moments of clarity' amongst the psychosis, I found these pretty scary times indeed & times when paranoia hit me. I knew I was manically talking/stuttering & behaving oddly but at the same time I knew I was perfectly sane & knew what was going on (kind of) but had a really hard time making the professionals believe me & trusting that they actually understood what was wrong with me & could help me. The main thing I needed at that time was lots of repetitive reassurance! You're probably giving your wife lots of this already but I don't think you can't go wrong if you give her lots.

Hang in there, all the best & keep up the good work!

[Hannah_at_APP Administrator]

Hi Alan,

Just to add my support to the responses from others. I had PP in late 2009 and was also in an MBU - my husband was a great support and visited me every day, so the first thing to know is that your wife really will appreciate everything you are doing for her. Husbands/ Dads are such heroes at such a difficult time, although I know how hard it must be to leave your family there when you are visiting.

I had a total of 3 months in the MBU (plus a disastrous time in a general psych ward at a different hospital before that), and I know that it really is the best place for your wife to be supported to get well. As others have said, it will be a long road and I hope you can find some support on here and elsewhere from family, friends & professionals to continue to help you both through it.

I too had Olanzapine and it did really help in my recovery. I had other meds before it that just didn't appear to work and as others have said, I think the signs of recovery started after a week or so of being "lost" to the PP. I also had a course of ECT that probably contributed to the recovery. My mania/ psychosis had passed after a relatively short (but hellish) time, but I did suffer from panic, anxiety and a major loss of confidence for some time. Whilst I was stabilised enough to return home, it did take a while longer to build up to some sort of normality and get on with life after the trauma of being ill.

I was on Olanzapine and also Lithium added to the "mix" whilst in the MBU, which was then continued when I went home. I had support when back at home from the Early Intervention Team - a lovely nurse who visited me at home, took me out (as I couldn't drive), helped me with every day normal things (both baby related and not) and took me for coffee and cake, which I loved! When that involvement ceased after about a 12-18 months, I continued to see the consultant psychiatrist from EI until I was discharged from them last summer, after reduction of meds over time.

Again as others have said, please feel free to come back and ask more questions and updates as and when you need to. And if your wife would benefit from some of the info through APP, I hope this will be useful to you both too.

Take care & all the best

[maryraff]

Hi Alan,

How are things going now with your wife. I hope you are coping ok. I would like advise you to take one day at a time. It may be good to keep a dairy as your wife may not remember this time clearly and she may have alot of questions.

You are probably doing this already but take pictures of your family. I spent 3 weeks in hospital in Feb 09 with PP in a general psych hospital (there are no MBU in Northern Ireland). My memory of my time in hospital is very hazy but my partner took a few pictures of the times he brought our son in to visit. Even now we sometimes get the photos out and Joseph loves to look at them.

The advise about apointing somone to field calls is very good. I know people mean well but at the moment the important people are you, your wife and your baby.

Also reassue your wife she will get better, I was on Olanzapine and it made me feel numb and tired all the time. For a long time I didn't think I would ever recover and I had issues bonding with my baby. It may take a few months or a few yrs but she will recover. Just make sure you get some support as well.

I wish you well and remember you are never on you own. This is a great website for support and it's good to know that other people have been thru this illness as well.

Take care

[bpdmum]

Hi Alan,

I also just wanted to say, that an MBU is the best place for your wife and baby to be, although I know from my hubby's recount of the experience, that it is also distressing for the husbands. I'm not sure which MBU your wife is in, but it could be worth asking if they have a carers support group. My husband used to attend one, at the unit, for one hour after visiting time (I think) so the 'dads' could get together and chat, and a doctor/nurse was present to answer any general questions. Best wishes x

[atlovell7 in reply to bpdmum]

Hi everyone!!! Can I just say a massive thank you to all of the wonderful people that have replied and the fantastic practival, medical and emotional advice that you have given. It has been invaluable and has really helped me to cope over the last few weeks.

My wife has been in the Leicester MBU for 15 days now on olanzapine and an anti depressants. Progress is incremental and she is still delusional but I am thankfully seeing signs of improvement. She is still massively fixated on her perception that our daughter is terminally ill but thankfully (and amazingly) her levels of care for our little girl are fantastic. She has had her obs levels reduced to general observations and we even went out for a walk yesterday so small steps but encouraging. I just find the persistent delusional thoughs difficult to deal with over such a prolonged timescale considering this was happening at home for a stretch too.

In terms of myself I have had to visit the GP as I find sleep really difficult but I am trying to follow the general advice on self care. Just find the travelling and worry makes this difficult. I am back at work today but thankfully they are being flexible with my hours in the short term. Have learnt alot in the last 2 weeks about PP and we are heading in the right direction but I find the nature of her care ( a new nurse every day it seems) difficult from a consistency perspective. I guess this is just the nature of the beast with the NHS. Most of them are superb though.

Finding it difficult to get my head round timescales and judging what actual improvement is. It feels a bit 1 step forward 2 back some days. Did you guys have gradual 'releases' from your respectve MBU's i.e. a day out, a night at home, etc. The consultant is a bit matter of fact and I find her quite difficult in terms of co-ordinating the care plan and having my input considered. Maybe thats just my perception as I'm tired and anxious!

Thanks again for all of the advice. This network is amazing and you have all given me hope that there is a masssive amount of light at the end of the tunnel. On the plus side our daughter is thriving fantastically and I think we will bringing a very different daughter home from the one we took in! Thanks again and I may bend your collective ears for more advice as we start to approach my wife and daughter coming home. all the best. Alan

[Lilybeth Volunteer in reply to atlovell7]

Hi Alan,

As I noticed all the good advice and support here for you, I have not replied before. It's good to know that you now feel you are heading in the right direction. There will be days when it's not all plain sailing but you are doing so well supporting your wife.

PP hit me twice, the first 'occasion' being almost thirty eight years ago before the days of MBU's! I was in a general psychiatric unit, without baby, but later transferred to a nerve centre where my baby was allowed with me. It was all very traumatic for my husband and family but although I so wanted to be home, I wasn't well enough. However, I remember later on in my care as I was improving, I was allowed home firstly for a few hours at the weekends and then for whole weekends until I was discharged. My second PP experience followed a similar pattern.

It's not easy for you trying to cope. You might take a moment to find the Blog on this forum, written a few months ago, entitled 'Delusions of Grandeur and religious experiences'. Some of our delusions were out of this world although very real and frightening at the time!

Rest assured your wife will recover slowly but surely and I wish you both well on your journey.

[Hannah_at_APP Administrator]

Hi Alan,

Great to see your update and it sounds really positive that there are signs of improvement and you're also managing to look after yourself at such a difficult time. Just to add my experience on the "gradual release" from MBU that you queried - and that's definitely how it felt! I was allowed to go for walks for a set period of time around the grounds, then out with my husband to visit other family members in their homes but again with very firm deadlines of when I had to be back at first, usually no more than a few hours.

"Leave" I think is how they termed it, and it did work up to an overnight but this took a while and felt like a massive step all round. But it was successful - I loved being in my own house so much after feeling so cooped up - and then as it was reviewed, it was offered more and more regularly. The consultant we had was also quite matter of fact and practical but the link nurse we had was very human and approachable which helped. Unfortunately at the time when I did have a bit of a relapse, after about 2 months in the MBU, I had some leave cancelled and I remember this feeling like the end of the world. It's probably too black and white to see it as a carrot/ stick situation, but I understand that they had to have the various risks appropriately assessed and not take any chances. Going home overnight would not have been a good idea when I was such "hard work" for my husband to deal with, as it's definitely something that your wife will want to benefit from rather than feeling like it's too much all round.

The leave was built up and then used quite flexibly, once I'd turned back round a tricky corner, which worked well for us. For example, I'd be told that overnight leave was agreed and then we could call in and discuss how it'd gone and they would consider a 2nd night. This placed responsibility on my husband, but I think he appreciated being involved. Being an informal patient after my section ran out, it was our choice anyway but definitely firmly in our interests to work with people rather than battle against them. And he would have said no as needed, it's got to work for all parties. Gradually it all built up time-wise and my actual discharge date was never finalised until I'd had leave extended and then agreed that after a number of nights, this could become permanent. It worked well for us like I say, but not everyone's the same I guess. It's also worth noting that some of this was over periods of bad weather and minimising travelling will have been a factor (rightly or wrongly!) in extending if informally like this.

I hope the "1 step forward" you describe will soon feel more the norm than the "2 steps back". In our experience of PP (and my husband lived through it all, bless him), it was a definite challenge but one that you can make it through together and support each other through. It does take time, but it sounds like things are getting there for you. All the best with it.

[Ellie_at_APP Partner]

Hi Alan,

it was really good to hear your update of how your wife is doing. That's so good that she has been reduced to general obs. I remember the gradual decreasing of the observations and that's definitely a key sign she's getting better. It's also so great to hear how good she is at looking after your daughter, and that she has obviously built up a bond with her. I know the feeling of one step forward, two steps back, I think I shared before that I was 6 weeks in the MBU and then when I was about to be discharged home I got very anxious / paranoid again and then that's when the depression came in badly. My obs were back up, they increased my anti psychotic etc, It was awful. From what I've read it seems to be a feature of PP. But somehow day by day I got better and better slowly, and now I feel great, am working again, absolutely love being a mum, and love my life.

In terms of home visits, lots of people in the clinic were having home visits but it wasn't possible for us at the beginning without a car etc, and I think that was a mistake the clinic made, deciding to discharge me before home visits. I think they should have insisted on home visits. I think they're so important. The feeling of being discharged without home visits I just panicked and got anxious, thinking I couldn't support my son etc. So it will be really important for your wife to have home visits, and I'm sure the MBU will organise it when they feel it's ready.

In the end I had three home visits, the first one the staff just drove me there for a few hours and drove me back because they knew I got so anxious when I was meant to go home, just to break the ice. I think this was unusual that they would offer that kind of support, and I think I mentioned before it was a private MBU so maybe they would do things a bit differently. And then I went home for a weekend maybe 1 night I think,at the time I didn't think it went that well, I felt depressed etc, but looking back I think it went ok. And then I went away for another weekend (2 nights I think), and felt great at the end, went back to the MBU and they basically discharged me there and then. I think they felt for a long while I'd be better at home.

Anyway, hope things keep getting better, and that you are managing ok with work etc. Take care

[Ellie_at_APP Partner]

PS I also just wanted to say I was gradually allowed out of the MBU first with my partner / family, and then by myself. I'd go for walks, a cafe etc. At one point I was on very low obs and could basically do what I wanted.

[EmmiLou Volunteer]

Hi Alan

Just wanted to check in with you to see how everything is going with you, your wife and baby daughter. I am so pleased that your daughter is thriving and it is great your wife is giving her amazing care. It must make you feel very happy to hear those positive aspects that are going on. I was similar in that I gave my son a high level of care even though I was very poorly. It meant my partner was able to worry less about that side of things.

Glad you are following the advice about self-care, this is also important when your wife and daughter come out of the MBU. It’s really good things are heading in the right direction. I too had different nurses during my time on the MBU but don’t worry as like you say a lot of them are very good and understand the illness.

I started to have time away from the MBU after about 5-6 weeks. I was allowed to go out for the afternoon with certain family members for a couple of hours, then would be able to go to the main hospital for a walk in the grounds. A week later I was allowed to stay at home for one night which gradually built up to 2 then 3 nights until finally I was allowed a week at home. It was frustrating with how slow the process took and I wanted to be at home straight away but it is important to take your time. It definitely will feel a bit like 1 step forward and 2 back but this will improve over time.

Let us know how the last few weeks have gone and come on again to ask any questions.

Take care.

Emma.

[atlovell7]

Hi everyone its been several months since I posted on here but just wanted to do so again to say thank you for all the fantastic advice that I received after my wife and daughter were admitted to an MBU in Aug 2013 with PP.

It felt like a long and painful process but in early Oct they came home and now my wife is on the lowest possible dose of olanzapine with a view to finishing medication shortly. The help that we received from everyone in this community was amazing and I would like to thank you all for getting me through some very dark days.

My wife is doing fantastically well and her positivity around motherhood and life in general is simply joyous to behold. Our daughter was oblivious to the whole episode and is a crawling whirlwind of exploration and smiles we would both like to help others suffering from PP in anyway we can and again, my deepest heartfelt thank for the guiding and supportive words. Meant and stills means a great deal

Best wishes to you all

Alan

[andrea_at_app Volunteer]

Hi atlovell7,

Thank you so much for the update, it's wonderful to hear that your wife, daughter & yourself are all doing fantastically well - just lovely! Yes recovery feels like a long, painful process & there're plenty of bumps along the way, but it's great to hear that the community here gave you some comfort in the dark times. Coming off medication is another milestone & it can have it's challenges too but we're here if you need us.

You mention helping others, if you're interested we're putting together resources for partners & are holding a workshop for partners: app-network.org/news-events.... Also we're holding an event in April to meet people who are interested in helping us with fundraising, telling their story (media), peer support or Regional Reps. If you're interested, do get in touch. Don't feel you have to in any way at all though, especially if you're busy or the time isn't right for you.

All the best & keep in touch.

Andrea

[Ellie_at_APP Partner]

Hi Alan

How wonderful to read your new message saying how well your wife is doing!! It's just so great to hear having heard so much of her story.

I too am always thinking how I might support others in a similar situation.

Ellie

[Ellie_at_APP Partner]

Oh and Andrea I may be interested in taking part in the April event, should I email APP? or is it not officially organised yet? I just need to have a good think about my availability and what I could offer. thanks

[andrea_at_app Volunteer in reply to Ellie_at_APP]

That's great Sunnyandwild! It's in the early days of organising & no date has been set yet but if you're interested, please do email [e-mail] for more info.