Getting my head round this.

[Catinlondon]

I understood that I had suffered from 'hypomania' 2 years ago after the birth of my son. It was treated before it got to the mania stage. Please could someone explain to me the difference between the terms hypomania and postpartum psychosis? Thanks C

[Sarah2015]

PP is severe and serious. As I understand it -and I think I'm answering my last post- PP can consist of full mania, hallucinatory depression or a combination of both.

I was manic and hallucinatory and (thankfully) never suffered the depressive element of the illness.

When I say I had full mania, I mean I was running around thinking I was something like Lara Croft and I was throwing things and breaking things. I needed sectioning. Hypomania -as I understand it -is a little less severe.

I'm sure the after effects of Hypomania are similar though -lack of confidence and not understanding why it happened to you(?)

[Catinlondon in reply to Sarah2015]

Thanks Sarah. That makes sense. I think I had a mild episode. I was dosed up on antipsychotics 11 days after delivery. The whole thing was a pretty horrible experience at what should have been a magical time and I seemed to get off pretty lightly compared to others like yourself. How are you now? I would just like an answer as to why this happened - there were so many factors in my case. It is tough knowing that I will never get that answer!!

Best wishes and thanks for responding. C

[DEb12W]

Hypo, usually means low. Hyper, usually means high.

I have had a mixture of labels, and it depends who I'm talking to as to which one I use! Not sure how much the title means, as much as it does to be understood.

Postnatal mania, postnatal psychosis, postpartum psychosis, or is it bipolar triggered by pregnancy/childbirth?

Have had anti-depressants, anti-psychotics, mood-stabilisers, ECT.

Usually I find myself just describing it as the opposite to Postnatal depression, because that is something people are familiar with.

[JaneHW]

As I understand it, I was hypomanic for quite a while after my last baby, but that eventualy escalated into mania, then psychosis. The differences btw those states are not clear cut but in broad terms are marked by decreasing control over or insight into actions; increasing paranoia, believing things that cannot be true, hallucinations, hearing voices, thinking the TV is talking to you etc.... Hope that helps.

[Catinlondon in reply to JaneHW]

Hi Jane,

Thanks. That makes sense and confirms why the HTT kept asking me about whether or not I had hallucinations.

Thanks C

[Vee82]

Hi C , I was diagnosed with puerperal hypomania a week or so after the birth of my first child. Until recently, I thought PP was a different condition but it seems hypomania can be a manifestation of PP. I was admitted to the psychiatric wing of my local hospital and treated with anti psychotic drugs (haloperidol), I was in for about 8 weeks and then discharged only to end up with crippling depression. That was so much worse. In the aftermath I felt very ashamed, isolated, embarrassed and lost a lot of confidence in myself. This was 33 years ago, there was no follow up or support afterwards, I just had to put it behind me and get on with my life. I had no problem following the birth of my second child or no problems since.

It was quite by chance I recently discovered this site and felt inspired to actually post my experiences. I'm fast approaching my 60th birthday and it meant so much to have the opportunity to finally terms with this frightening condition. I wish you all the very best. X

[Hannah_at_APP Administrator in reply to Vee82]

Hi Vee82

That's really great that you've found the site inspiring. Being able to share experiences and know that we are not alone is so valuable. Xx

[Catinlondon in reply to Vee82]

Hi Vee,

I am glad you too have found this support network. It sounds as if you had a horrific time. I find people don't want to talk about mental health issues and I felt very isolated during my maternity leave when I was recovering. The forum is brilliant for hearing other people's experiences.

It is great that you have had no problems since and you avoided PP after your second delivery.

Very best wishes Cx

[Vee82 in reply to Catinlondon]

Hi C, yes it was an awful experience especially as I was sectioned and I agree about it being a very isolating experience. The hard thing is the complete lack of insight at the time and then feeling absolutely dragged down by the medication and then the depression to add insult to injury. It is hard going having to cope with the aftermath of PP and being a new mum as well. It is fantastic though to know that those using this forum are not alone and have a really supportive network of friends who understand the reality of the frightening condition. All the best. X

[Sarah2015 in reply to Vee82]

Vee82 I'm so sorry you had such an awful experience. I was put on Haliperidol but fortunately avoided the depressive side of PP. My mum suffered with PP 41yrs ago when she had me and I know there was an even greater stigma attached to mental health problems then.

I'm really glad you've found this forum helpful and that you've found it.

[Vee82 in reply to Sarah2015]

Thanks Sarah, you're right about the stigma but thank goodness mental health is no longer so stigmatised. It is great to see that mental health is a central theme of the Edinbugh Festival Fringe this year. However, post natal depression is widely known and 'acceptable' while PP is less understood perhaps even among health care professionals?

[Sarah2015 in reply to Vee82]

I think you're right about PP being misunderstood by many health professionals. I've been lucky enough to have fantastic care and intervention (even if I didn't recognise it at the time). I have to say, I feel the stigma of mental health. My dad is 79yrs and his attitude to mental health isn't progressive and never has been. I've spoken to very few people openly about my PP.

[Hannah_at_APP Administrator]

Hi Catinlondon

This is an interesting one and not something I'm too sure of to be honest, I wonder if we can get any feedback from the clinical experts at APP on it. I know that my diagnosis was a clear postpartum psychosis one. But mania was a big part of my early symptoms and behaviours which were definitely psychotic. It's so confusing isn't it? I think with pp and a lot of mh illnesses being quite misunderstood by even professionals sometimes, the likes of us patients have no chance!

Xx

[Lilybeth Volunteer]

Hi Vee82

Good to 'see' you on the forum. I remember your brilliant post on here a while ago, similar to mine many years ago although my second PP was 34 years ago now. I just wondered if you had managed to complete your online mental health and psychology course? I'm sure you passed with flying colours having had 'hands on' experience!

Best wishes.

[Vee82 in reply to Lilybeth]

Lovely to hear from you Lilybeth and I so valued your responses to my tentative post. It was such a big thing for me to drag up from the shadows but so glad I did. Yes, I did complete the course which was a good introduction to the various debates surrounding mental health and was useful both in my personal and working life. All the best to you.

[Lilybeth Volunteer]

Hello Vee

Good to hear from you too. I agree that it's such a big step to come out of the shadows after all those years of hiding away for fear of being judged. So glad we took that step though as now we have a forum to keep in touch and share our experiences with other mums here. Well done for completing the course and I look forward to 'meeting' you here again.

Best wishes.

[andrea_at_app Volunteer]

Hi Catinlondon,

Yes it's really hard to understand our diagnoses, not only for us but for some professionals too - there're so many terms which seem to overlap & merge into each other. It took me many years to fully understand my PP from the snippets of info everywhere & to piece together what had happened - it was something I felt I had to do to accept it all & move on really. My exit meeting from my care team (after 3 years) would have been a good opportunity to answer some questions but the chance didn't come up & I'm not sure they had the answers anyway. I wish this forum was around back then, there are some great answers above!

I'm not a health professional but from what I've learnt, hypo means low & it refers to it being just less than mania, which is still pretty awful to have. Different clinicians will use different cut off points for diagnoses. Psychotic symptoms like delusions & hallucinations seem good to use as that cut off point. So if someone has all the symptoms of PP - too much energy, unable to settle, running from one thing to the next, thoughts racing, can't concentrate & often high or irritable in mood, but no voices & no delusions & perhaps (but not always) some insight into what is happening, hypomania seems a reasonable diagnosis. Often it's the precursor to full manic (ie with voices & delusions) symptoms. The aim is to treat quickly at this stage & often a full manic episode can be avoided. The problem with PP is it all happens so quickly & often there isn't the chance to get treatment that early. Sometimes it can with very closely monitored 2nd pregnancies, but even then it sometimes just escalates too quickly.

I think this page about the early PP symptoms listing the early signs in the order of frequency is very important: app-network.org/early-sympt...

It's hard to get your head round so I hope this helps a bit, I would suggest chatting to a specialist perinatal psychiatrist if you need to know more & they'll be able to answer any questions. All the best x

[Catinlondon in reply to andrea_at_app]

Hi Andrea,

Thank you for your reply. It makes a great deal of sense to me. I looked at the link to the symptoms and I suffered the majority of them. The cut off was the hallucinations which I did not have. I did have a few panic attacks which were uncharacteristic of the well me.

I felt my experience was pretty horrific for everyone involved but I got off pretty lightly compared to other girls and avoided hospital.

Thanks C