Treatment of PPP

[Simonlapaz]

Hi everyone,

My name is Simon and my wife is Diane, we are new to the group.

We gave birth to a beautiful baby 6 months ago and almost right away my wife was struck with insomnia and insane energy. Unfortunately being in Mexico right now, even though I am originally from England, my wife's condition was brushed under the table as nothing more than extra energy and hormones from child birth.

She suffered with over a month of insomnia, less than 2 hours sleep per 24 hours if that and always on the sofa after crashing out.

After 1 month of being told I am an idiot and she is fine by multiple doctors she finally cracked and started to hallucinate. Not sleeping this long does that to you.

She was committed to a Pysc ward and finally treated.

Now she is much much better having been on treatment for a few months now. However I still feel that they are treating her for Bi Polar disorder (no family history of illness) than PPP.

She is being given Lithium Carbonate after previously taking lots of other drugs to stabilize her.

The problem with Lithium is that she now sleeps for 16+ hours a day and the rest of the day is still drowsy although completely with it mentally she is getting more and more frustrated and now that the drugs are causing additional weight gain I feel she is soon going to be depressed because of it.

The Drs here are not good at all, and they are the best in the city, so if anyone can share some examples of their treatment and timelines that would be great.

They are currently saying she will be on the lithium for over 1 year more, and if the weight gain continues like that (even whilst dieting) she will become obese which is stressing her a lot as before the baby she had done great to lose a bunch of weight and become healthy.

Any ideas and support would be incredibly appreciated.

Thank you,

Simon and Diane.

[Sarah2015]

I'm really pleased to hear that your wife is feeling much better. I initially took Olanzapine which felt like moving through treacle and increased my weight. I now take Aripiprazole which does not have weight gain as an associated side effect. I was given a set of information sheets about the various medications by my psychiatrist and I chose Aripiprazole (trade name: Abilify).

I also experienced Mania and hallucinations and so far (five years on) haven't experienced the depressive side of the illness.

[Lilybeth Volunteer]

Hello Simon

I'm so pleased you have come to the forum and have already had good advice. There are lots of mums here who will be able to help as well as partners.

I'm sorry to hear the treatment in Mexico is not so good but PP is a temporary illness and your wife will eventually recover. I'm sure that seems a long way off right now but she will be well again.

I had PP twice many years ago and although I was very ill during those times, I eventually fully recovered. As this was so long ago the only medication I can remember taking was Imipramin (an anti-depressant as I'm not sure doctors in the early 70's recognised my PP) However, times have changed and treatment and medication improved here.

If you have looked around the site you might have come across the PP Insider Guides, : "Recovery After Postpartum Psychosis" and "Postpartum Psychosis - A Guide for Partners" which might be helpful. During my psychoses I had delusions, all very real and frightening at the time. There's a post here "Delusions of Grandeur and other religious experiences" which gives an insight into some of our experiences. As you may guess I'm not very good with links but if you search you will find them. I'm sure other mums will provide the links for you too.

Your wife is doing very well to be aware at this stage and is battling her way through this illness with your support. We are all here to support you both too.

Take good care.

[Jenny_at_APP Partner]

Hello Simon and Diane,

Welcome to the forum. It sounds like you've had a really tough time, I'm so sorry it took so long for your wife to get treatment and you weren't taken seriously, that must have been awful for you both.

To share the treatment I had and timescales... I had PP in June 2012 (no previous history, out of the blue), was in a mother and baby unit for a month and was on Quetiapine until October 2013. (They tried Haloperidol first which I reacted badly to but I think they tried Quetiapine next which luckily I responded to quite quickly.)

Drowsiness was definitely my biggest side effect, which I think is common with this type of drug. I don't know whether that will lessen at all for your wife. I know weight gain is quite a common side effect too which must be really horrible, an added blow on top of everything else. It won't be forever and it's good that your wife is much better mentally now but I understand how frustrated your wife must be and how hard it must be for you both, especially if you don't feel the doctors are listening to you...

I hope other people's experiences and advice will be helpful.

Wishing you both all the best, you will get through this.

[Simon_at_APP APP]

Hi Simon,

Sorry you are both having to deal with this illness.

My wife had PP too with no previous experience or family history of mental illness, she spent approx 12 weeks in a Mother & Baby unit before coming back home to continue her 'saw tooth' journey to recovery (by that I mean, it was always improving but sometimes she would take 3 steps forward and 2 back) it was a further 9 months before my wife was finally off all medication. 8 years on, there have been no further problems to date.

Initially she had a very deep depression which rapidly turned into psychosis with the dillusions and hallucinations. She luckily got a place in an MBU where they started treatment with anti-psychotics (Olanzapine in our case), along with use of Diazepam and Lorazepam for the anxiety and completing the mix was Venlofaxine for the depression.

Whilst my wife's particular cocktail of medications (seems this can be different for all) the 'low' psychosis symptoms were fairly quickly treated but the depressive lows remained, however during that time in the MBU and seeing slow but steady improvements my wife then swung into an episode of mania and the disucssions started into whether she had Bi-Polar and the possible use of lithium.

I started to keep a mood chart for my wife, so that I could try and show the team treating her, a picture of what she was 'normally' like and what was happening during this time of PP, I also charted any medication changes on it, as well as any other external factors that may have an effect. We continued to have regular discussions with the team and the use of lithium was discussed a couple of further times but we decided not to and see whether we would get any further extreme mood swings through her recovery, however, we didn't ever see the same extreme swings into psychosis again but we did have the 'saw tooth' recovery and there were a couple of 'higher' mood peaks but everything got fewer and far between.

The Olanzapine was used during the time at the MBU but had stopped before coming home, the use of Diazepam or Lorazepam was only occasional after the MBU but the longest medication used was the Venlofaxine which she was on for 9 months, with a couple of reductions along the way to lower doses and then finally very slowly reduced to stop use completely.

You may have seen these already but the APP website has loads of information on as well that may be useful, a couple of links below:-

The Partners resource page - app-network.org/partners-2/

and

The Guide for partners - app-network.org/wp-content/...

Cheers & best wishes

[bravesurvivor411]

Hi simon and diane. It sounds like you are taking all of the right steps in treatment. My medication with pp was very difficult. I experienced pp a year ago. I was given 5 different anti psychotic drugs in the hospital until invega sustanta(shot) worked. I was on that when I left the hospital. I felt like I was in the clouds when I got back home for a few weeks but suprising felt fine. Then a week or two later I had a major depressive episode and went back to the hospital there I was put on prozac (im still on a low dose) and they doubled my invega with the pill form of that drug. When coming home from the hospital I was a living zombie. Very slow and exhausted. They decreased my invega but it caused major side effects. I was on it for 6 months and I was in 2 major car accidents where I totaled my car. I was constantly falling asleep even at work and I felt no joy or sorrow. No interest in anything. And of course lovely weight gain. I finally had to be taken off because it caused high prolactin hormone. My psychiatrist wanted to switch me to zypreza which he said would cause me to be more tired. At this point I started lamictal which is a mood stabilizer for bi polar (which I dont belive I have syptoms of...never have) after coming off of invega I have continued to improve. We are keeping my meds the same of an other month. My situation is a bit different because I had to change the meds around I probably should have been on the anti psychotic longer. Your wife is not taking an anti psychotic right? Im not sure if she is just starting the lithium but your body takes 4~6 weeks to adjust which can cause tiredness. But I dont know if thats a side effect of lithum or not. If she plans on switching as about lamictal. It really has worked and is a popular choice for bi polar. Meds suck to take but I believe for the first year they are very important to use. I also use traditional chinese medical(acupuncture and cupping) I do it weekly and it has helped with my mood and recovery. Also therapy with my counselor has helped the most. Make sure your wife finds a good counselor. They make a huge difference. Good luck and hang in there!

[Simonlapaz]

Thank you everyone for your replies.

It seems like a cocktail of different drugs is a normal start until they find the right one.

I guess we will stick with the lithium for now as other than sleepiness and some weight gain everything else is perfect and fortunately our little baby girl is just wonderful.

Boy is this a scary illness. My wife almost bankrupted us during the illness with purchases and sales but fortunately I was able to rectify the majority of things before they were too late.

It's like a secret illness and the information available is just terrible. I am so glad this group exists and I hope that it grows to support more mothers and partners.

Thank you all.

Simon and Diane