Are the statistics right?

[Sarah2015]

I've just spent a lovely couple of days with a friend I've not seen for a couple of years. She has a four month old. The first evening I was there she mentioned being loopy after her birth, to which I replied "...yes, I've been there" and she challenged "No, not like this." the conversation soon covered my being sectioned and she explained that after the birth of her baby she was discharged -with medication- as she knew what was happening and had asked for help. Her episode is undiagnosed and presumably not a statistic. She firmly believes that plenty of women suffer from PP to differing extents and fall under the statistics radar.

She felt really glad to talk to someone she considers 'normal' that had experienced something similar.

In six years I've never talked to anyone outside of the MBU I went to with a similar experience. I thought one in a thousand was a reasonable statistic?

[Jenny_at_APP Partner]

Hi Sarah2015,

It's an interesting question and I don't doubt there are many women who go undiagnosed. The statistic that I see used mostly is 1-2 in 1000 so anything from 1 in 500 to 1 in 1000. I think that acknowledges that it's not overly precise or known exactly how many are affected.

I think mental illness is very complex. There are obviously lots of diagnoses out there and each must have a scale and severity of symptoms within it, and some will overlap.

In my mind, to be psychotic you would need antipsychotic medication, and to be prescribed antipsychotic medication without a diagnosis would seem odd (but I'm certainly no expert and not a health professional!).

And something I wonder about - if you know you're at risk of PP (existing bipolar disorder, second pregnancy...) and so take medication either before any symptoms or because you spot early symptoms, and the illness therefore doesn't escalate in the way it might have done, would you be given a diagnosis of PP?

I don't know the circumstances of what your friend went through, did she know what was going on because she knew she was at risk of PP? Did the medication then make it manageable? I hope she is recovered or recovering well.

I do think a lot of people suffer a range of mental illnesses / symptoms after childbirth due to the hormonal changes, and to varying severity. I've had friends tell me about odd thoughts they had or intrusive thoughts, being so sleep deprived they started hallucinating... There's PND, post traumatic stress, severe anxiety... It's not all PP though, I think there are specific symptoms associated with psychosis. I know it can present in different ways though and can go undiagnosed or misdiagnosed, I don't know to what extent.

So those are more thoughts and ramblings than any kind of useful response, it's an interesting one to think about though

[Sarah2015 in reply to Jenny_at_APP]

I think you're right. PP is psychosis of some form; depressive, hallucinatory, delusional or all three. And you're right that there are other diagnoses to be given after giving birth.

Thank you.

[Ellie_at_APP Partner]

Hi Sarah2015

Your post is interesting about your friend.

Yes, I do wonder if more women go through some form of minor psychotic symptoms after childbirth, and just that those who have a diagnosis of PP just have a more extreme version of it.

J-B-55 is right, the stats are 1-2 in 1000 women.

From being on this forum though I know that each person's experience and journey with PP have been completely different. For example some people have a slow build up to full blown psychosis etc over a few weeks brought on by a few factors (eg traumatic birth, lack of sleep etc).

For me I had a very sudden and acute onset - basically completely losing it on day 3/4 with not that much 'build up' to it. It makes me think that my mind basically just had a very bad reaction to childbirth - an almost physical reaction to the hormones. I didn't have a particularly traumatic birth (though perhaps every first birth is traumatic in some way). Which is probably why I'm pretty reluctant to have anymore children just because I have this feeling I would likely get it again, because it didn't seem like it was that much to do with the psychological things around being mum (which I could perhaps control more second time round) but more just a strange physical reaction if that makes sense.

Hope that helps

[Sarah2015 in reply to Ellie_at_APP]

I don't really know much about this but my husband spent a lot of time Googling PP when I was going through it. He was convinced that it was a reaction to birth hormones and the hormone when your milk comes in. I really did peak with my high when my baby's milk came in. I felt incredible, immense and, in retrospect, unnatural love for my baby.

Medication was the answer for me the second time. A very large amount of medication too. I had a C-section and afterwards I was left by everyone to breast feed my new baby in a room outside theatre. It's a moment I treasure. I was then transferred to a side room on the main ward and the mid-wives looked after my baby through the night until I transferred to the MBU who looked after me and kept me well.

My mum suffered with PP and was then diagnosed bipolar -my parents split up. I was always terrified of having children and reliving history. I'm glad my husband persuaded me that I was ready for my first and I realised I did want a second, after much denial, about two years later. I cried when a friend told me she was pregnant with number two.

I'm really sorry you're -understandably- scared. And I don't know what else to say. PP sucks!