Unfortunately It's struck again. PP S... - Action on Postpar...

Action on Postpartum Psychosis
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Unfortunately It's struck again. PP Second time around. Warning early mania in progress.

BronSyd
BronSyd

Firstly I've already put in place a plan for tomorrow. My husband and sister are aware of the plan so I'm using my mania to get this out now at 12:30 at night. The plan is to get an emergency appointment with my psychiatrist and hopefully be prescribed a very low dose of Seroquel (Quetiapine).

So I've come to the conclusion that I'm heading down the track again. It was quite a sudden realisation that things had turned. Partly I suppose because like last time I was quite enjoying the clarity of thought that early mania brings. I will miss that. Although perhaps this time around I can take some of that clarity and use it to slightly twig my life in the ways that I like.

I like being more organised and decisive. It would be good to keep up those traits. I like not being as self-conscious and speaking up. I like that I reach out to friends more. I really hope that I can keep that up. I like the ambition that it gives me. I hope I can do some of the things that I've just thought "I have to do that" perhaps not now but in a few months I'll start. I'm sure there are more things I like.

So here are my fears. That the low dosages won't help and I get worse. (I was really enjoying the first few days of early motherhood). But I know that I can simply go to the MBU if that's what's required. At this stage I'm not letting people know except my Husband, sister and sister-in-law. That's hard for me because we are a close family. But I don't want to have to deal with them as well as what's going on with me. So my main worry about the MBU is that my family will then find out.

I'm also sad that I've worked hard to establish good breastfeeding with my daughter but now I'll have to be more aware of when I feed her and may not be able to do night feeds for a while. Hopefully I'm more successful at expressing than I was last time. I really should have got the pump and bottles ready.

On top of all this It's my Birthday on Saturday. That just sux!!

Hopefully everything can start getting sorted tomorrow. After already spending 5 days in hospital I really don't want to go back to another one.

Thank You for this forum. I don't know what I would be doing now without it. I'm sure it's going to be a source of great reassurance over the next few bumpy weeks.

26 Replies
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Lilybeth
LilybethVolunteer

Hello BronSyd, I'm really sorry that you feel PP is on the horizon again. It's a good thing that you recognised things are not quite right and I hope you have managed to arrange the emergency appointment with your Psychiatrist. I think early intervention is the key and I hope you can discuss your fears at tomorrow's meeting.

I have to say I admire your courage and I'm so impressed how organised you are. I'm sorry you have had this setback. I had my second PP episode six years after my first (in the mid 70's and early 80's) and made a fully recovery each time.

We are all here for you over the next few bumpy weeks and beyond.

Take care.

Hi BronSyd, Sounds like you're doing exactly the right thing, Quetiapine at a low dose would be what I would do in the same circumstances. Its really good you've managed to spot it rather than just thinking everything's fine because you're feeling happy, I think would struggle to do that. I totally understand your fears about getting worse but it sounds like you're really catching it early this time, ill be checking in on this forum so keep posting if you need some support. Hope goes as well as it can do tomorrow (or I guess today for you now - I'm in the UK) xx

andrea_at_app
andrea_at_appVolunteer

Hi BronSyd,

I’m so sorry that you've got to deal with all this & I hope you've got that emergency appointment with your psychiatrist by now, or if not soon.

Well done for recognising the early symptoms & doing something about it before it progresses. It must be hard to realise & admit that it could be happening again. As the others have said, early detection & treatment will make a huge difference – it all goes towards an earlier recovery.

I think this time will be a very different experience from last time, hopefully a much shorter, ‘lighter’ experience. I hope that knowing what it is already, not having that horrendous ‘out of the blue’ shock & knowing that you WILL recover & feel normal again will make it a little easier this time. Also, just being more aware about what helps with looking after yourself & self-care will be hugely beneficial.

Try not to worry about the medication dosage, just speak to your psychiatrist & let him/her know your worries. They know what they’re doing & keep asking questions until you’re clear & reassured. The good thing is that you know how important medication is right now. I’m sure you’ll have a good chat about breastfeeding & medication too & find the best options for you & baby. It’s hard when things don’t go to plan so try not to be sad or hard on yourself, you’ll find something that works for you both.

I think it’s wise just telling only hubby, sister & sister in law for now. Try not to take it on yourself to tell everyone that needs to know, can your hubby shield you from all that & all the phone calls, visits etc. & do the telling in due course? It’s great that you’re a close family so that you’ll have plenty of help when the time comes. I fully understand not wanting to go to another hospital after 5 days in one already but an MBU will be the best place. It means you & baby can stay together & you’ll be in the best place to recover quickly.

If you’re up to it let us know how you’re getting on, but really don’t feel you have to reply (I don’t want it be another one of those chores that you have to do when you should be resting).

We’re all here for you, thinking of you & wishing you all the best for a speedy recovery x

Hi BronSyd,

I can only echo what others have said, I'm really sorry to hear it seems to be happening again (its so unfair) but, as Andrea and I think others have said, early detection & knowledge of what it is should help greatly in terms of recovery. My advice would be to just try and concentrate on the really important things if u can - you & your new little one. Get as much rest as you can and accept the help you need (I know that can be hard). Take it as easy as you can on yourself, try not to be superwoman! All that matters is that you regain your health and you get to start building the life with your family that you deserve. We are all here for you, thinking of you and wishing you well xx

I'm so sorry. Best wishes and prayers sent your way. Take it day by day. You will succeed. Happy early birthday.

Thanks everyone for support and advic

All is going well. Had appointment yesterday. No room in MBU yesterday so prescribed meds. After first dose slept well last night hubby even managed to get bubs to feed off me with minimal disturbance to my sleep. Had to drag myself out of bed at 10 so dose might be a bit high but otherwise had a good day. There is a bed in MBU but I'd still prefer not to go esp after last night and today went well. Will discuss with Dr tomorrow.

Hardest thing at the moment is dealing with hubby stressing. We are usually very good with each other very rarely even fighting let alone yelling. But my tolerance of his stress levels and moaning about how his feeling is low. So I've been snapping at him seemingly out of the blue.

Thanks again

Sounds like you're doing great, hope it continues to go well, can I ask what dose of Quetiapine you were prescribed? ~Just interested as that's what I would take - don't feel you have to answer, I'm sure you've got a lot on! xx

Last episode I was on 300mg Quetiapine + sodium valporate (in lieu of lithium so that I could breastfeed).

At this stage I'm taking 150mg of Quetiapine but no sodium vaporate.

I'm hoping to reduce it sooner rather than later.

andrea_at_app
andrea_at_appVolunteer

Hi BronSyd,

I hope you had another good night last night. How are you feeling today? What you're going through is really hard on you & it's also stressful for hubby too. With everything going on it's understandable that you're frustrated & short tempered with each other. The lack of routine, lack of sleep etc. for you both doesn't help either. Try to accept this & be kind on yourself for snapping & be kind on him for feeling stressed & offloading on you. Hearing problems from loved ones can be upsetting & frustrating when you feel helpless to resolve them. Maybe you could explain to him that hearing his moans actually makes you more stressed? I think in times like this being extra patient & tolerant with each other helps. Don't worry, it was just one day & I'm sure things will settle back to normal between you soon. Hoping today goes well for you x

Lilybeth
LilybethVolunteer

Hi Bronsyd,

Sounds like you're moving slowly in the right direction. The journey you are on now is one which you hoped to avoid, so it's natural for you to be stressed and snap at your husband. Also as you're sharing your predicament with only your closest family, your husband is limited to family he can confide in. His stress is seeing you in distress. Perhaps when you see your doctor you will both be reassured about the best care plan for you, even a short stay in MBU?

Slowly but surely you will be in tune with you husband again. It's just our coping strategies that go haywire along the way. There must be a hug on the horizon for your birthday? It's not easy for you both but it does get better in time.

Take good care.

So glad you are doing better. Small gains are better than no gains. I really hope everyday is a victory for you and the husband. Best wishes. You have cheerleaders in all of us.

Ellie_at_APP
Ellie_at_APPAdministrator

Hi I have been following your posts about this second pregnancy and birth. I haven't commented because I only have one child, and won't have another I don't think, so didn't think there was much input to give. but just wanted to say that I hope that you are doing well and getting better. I admire your courage and determination in having a second child, and your amazing wisdom and insight in your precautions and planning. Thinking of you.

Thanks for everyone's support and advice. I'm doing really well. My husband and I are basically back to normal. It just required a bit more sleep and some more tolerance from both sides. From 2pm yesterday my daughter wanted to feed/suckle with only short breaks. She was still going at 10pm so on discussion with my husband I decided not to take the Quetiapine so that I could feed but not be worried about being nocked out with my husband also falling asleep. With my son I would often feed and be able to sleep (when I wasn't taking meds). I know it could be a risk but I think it was worth it. Especially since its my birthday today. So I was able to get some good sleep. Abbie went into her cradle about 2 am and slept till 5am went back to her cradle 5:30 then didn't wake till 8. So I actually slept a fair bit and didn't/don't feel that my brain is racing. That may change later today but if all goes well with Abbie tonight will take the Quetiapine.

Does anyone know if there are major problems with skipping dosages. Apart from obviously the risk of relapse short term. I'm monitoring my mood today. So hopefully no problems. I'll probably discuss with Dr at next appointment on Thursday unless things change.

You sound like you're doing great and making sensible decisions as they crop up and discussing them with your hubby rather than just deciding yourself which is the best way. I work in mental health myself (not a medic or a nurse though) and would think missing one dose is probably not going to make too much difference but I would try not to skip tonight as well as that might have more of a negative effect. Speaking to your Dr is the best bet but they're always going to tell to you not to skip a dose and would probably prioritise that above the need to breastfeed but I know how important that is as well - I was only able to breastfeed for a few days and if we did go for baby no 2 would love to be able to breastfeed longer so would be in a similar boat with regards to meds. Anyway keep up the good work and enjoy your birthday as a new mummy!! x

Lilybeth
LilybethVolunteer

Hi Bronsyd

Great news that you're doing really well. I'm not sure about Quetiapine medication so I can't help I'm sorry but I'm sure many mums here will be able to. I agree with Mrs B though that talking to your Dr is the best thing to do Time to celebrate on your birthday how far you've come already.

We're all here for you.

Naomi_at_app
Naomi_at_appVolunteer

Hi Bronsyd

Just wanted to add my admiration for the wise choices you've made. I experienced a very similar start of mania symptoms too with my second, and I know how disappointing it is - and also how hard it is to catch it at the right time. You're doing a great job with keeping lines of communication open with your husband, and talking about the balance of maintaining feeding but also looking after your rest & sleep. I too had to start taking my antipsychotic at 7 days in and it worked really well. Things felt well under control within about 2 weeks of taking my meds (Olanzapine for me). I have everything crossed for you that you continue to stay well and that you can enjoy these precious early weeks. Well done you! We are here for you to chat and let off steam whenever you need.

Naomi xx

Hi, are you the lady who came to the author talk at Waverley library? I'm so sorry you are having diffiulculties but it sounds like you are making good decisions. If you or your partner want to get in contact my details are on my blog (see the back of the book).

Jen

Lilybeth
LilybethVolunteer

Hi Bronsyd,

Just wondering how you are? Early days yet, so take it easy.

All the best.

All has been going well. I've managed to keep stable on my meds. I've started reducing them (150-125mg) with Drs approval. They are still a bit sedating in the morning so hoping to reduce them further in the coming week. And hopefully be off them altogether in a couple of months.

Btw I am the woman from Waverley library.

jgal81
jgal81
in reply to BronSyd

So glad you are doing well. You are very courageous and seem to have great family support. Best wishes

Lilybeth
LilybethVolunteer

Hi Bronsyd,

Thanks for taking the time to reply. I'm so pleased you are well and stable on your meds.

Best wishes.

Thats really good to hear, thanks for keeping us updated!

A bit of a setback last night. My Dr had changed the medication I was taking from Quetiapine to respiridone to relieve the sedating effect. Unfortunately it seems that the respiridone is not effective.

The last few days I've enjoyed being more alert in the morning. I was still sleeping fairly well considering bubs is only 6 weeks old. Sleep wasn't as deep but that was expected.

However last night I wasn't able to get to sleep. I initially thought it was because I'd had a 3hr afternoon nap. But when it reached 1am my mind went from relatively normal thinking (about the day and plans for future) to a weird racing feeling. It wasn't thinking as much as it was just feeling fast. Then it was like it was screaming at me. Again nor really in words. But screaming is the only way I can describe it.

So I took a 1/4 of my usual dose of Quetiapine (25mg). I didn't want to take too much as it does nock me out

especially after a few days without it and it was already late. It took me an hour or so to get to sleep but had to drag myself out of bed about 9am.

Because I've not taken my full dose of Quetiapine for 5 nights I'm planning on taking 50mg tonight and then 75mg tomorrow night. I'll then ring my Dr on Thursday to let her know what's going on. Hopefully she'll be happy for me to continue on 75mg and if I'm still a bit sedated in the mornings after 2wks to drop down to 50mg. I've got an appointment with her in a month so we'll reassess then anyway.

Just thought I'd share as it's good to get out what's going on in my head. I had to use some self control not to post this last night while I was awake.

Thanks for listening.

Lilybeth
LilybethVolunteer

Hello Bronsyd

Thanks for sharing what's in your head. Sorry to hear about the setback with the change in medication. I'm not able to comment about Quetiapine but know that others here will be able to offer advice and support. It's awful if you can't sleep, your mind races and goes over every thought in your head. Do you think your G.P. will want to see you on Thursday instead of just chatting on the 'phone, a month seems a long time to wait?

Baby sounds happy and contented, you're doing so well. Try not to worry, easier said than done, I know.

Take good care.

Naomi_at_app
Naomi_at_appVolunteer

Hi BronSyd

So sorry to hear that a change in meds has led to a bit of a scary time. What's really good is you are clearly very aware of these pre-mania symptoms and you are taking really sensible measures to prevent escalation. Do you have a care co-ordinator or anyone at the psychiatrist's office that you could ring just to keep them in the loop or will you have to wait until later in the week to speak directly to your psychiatrist? It's such a fine balance getting the right treatment dose to prevent hypomanic symptoms but not getting too much sedation. I remember my doctors 8 years ago being very reluctant to reduce my dose of Olanzapine even though I felt something like a tree-sloth and could sleep for England. I do understand their caution, however.

Hope it all goes well with restarting Quetiapine over the next couple of days. And well done not for posting in the middle of the night - wee small hours on the computer is one of my pre-mania warning symptoms too.

You're doing so brilliantly at self-monitoring, hope that sleep soon re-establishes and you feel less 'racing' very soon.

Naomi xx

So I've only been taking 50mg the last couple of days. I've been sleeping well and also been able to get up early. So I'm happy. I was questioning some things but I'm happier at this level so will continue as long as I can sleep.

There's only a slight elevation in mood which can just as easily be my normal holiday self. Plus we bought a new car and am enjoying the earlier mornings.

Thanks again for the support this forum is giving.

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