How to Support

My cousin is currently in an inpatient mental health facility suffering from postpartum psychosis. She has mania, auditory & visual hallucinations, and delusions. She has been in for four days and has not yet been responsive to any medication. We've heard that people typically remember everything once the psychosis ends. We've been asked to point out delusions or tell her when thinks are not real. I've been visiting her often but want to know how to talk to her - Since she's completely disconnected with reality and exhibiting mania, it's hard to get in a word, but I want to interact with her in a way where I'm not having to point out the delusions. For any of those who have experiences Postpartum Psychosis, was there anything that got through to you? Was there anything that comforted you? This has been so surreal.

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  • Hello Aflynn83,

    Firstly, please be reassured that your cousin will recover from this. I hope she starts responding to medication very soon, it must be very frightening for you all.

    I had PP 3 years ago and spent a month in a mother and baby unit. I can tell you a bit about how it was for me but it will all be quite individual to different people I'm sure. I remember a lot of my psychosis but I think many don't remember anything.

    In my experience, I don't think it really mattered what people said to me in that acute phase of the illness. I didn't trust anyone and didn't think anyone was real so pointing out a delusion wouldn't have made much difference I don't think. In that state of not knowing what's real and what's not, everything that I saw or heard tended to become the basis of a new delusion. I had moments of drifting back to a more lucid state, where people made a bit more sense but then I'd drift away again and be all the more confused. I remember there being a lot of staff around and they all represented different things to my psychotic mind. I remember my husband being there but I didn't believe he was real so I wouldn't look at him.

    I would suggest that the way you say things, a calm presence and expression are maybe more important than what you say. I think as I was coming out of the more acute stage I asked a lot of questions and kept saying 'nothing makes sense' and the reply 'it will' just fed my belief that there was some mystery answer to all of this that everyone else was 'in on' and I had to solve. I also remember telling a doctor I thought I was in labour again and she said 'well that can't be true can it' but all that did was ensure I didn't say anything to her again as she didn't believe what I told her!! But like I said, it'll be different for everyone.

    Perhaps talk about home and familiar things. Maybe hold her hand if she'll let you. Tell her this will all end. But don't underestimate the confused state of her mind at the moment, there's no way to reason with someone who's psychotic, you can't talk her out of it, so just be there to ride the storm with her and she will come out the other side.

    It's great you're visiting often and reaching out here to find ways to support her, she's lucky to have you.

    I hope this helps a little...take care and I hope things start improving very soon.

    xx

  • Thank you so so very much. What you're saying makes so much sense. New information gets tangled into new delusions and hallucinations, so I hesitate to add more to the conversation. I am so thankful this group exists. It makes me hopeful that she will get better and that there is support out there. Thanks again for taking the time to respond, it means more than you know!

  • How about just being there with her quietly and gently,

    and maybe, if she's able to cope with human touch, just

    holding her hand for a few seconds, even stroking her hand a little.

    all best

    Lauraine Leigh Klugman

  • She's often in a manic state so she doesn't sit still very often, but she is typically someone who enjoys contact. Thank you for your response!!

  • Hello Aflynn 83

    Welcome to the forum where you will find lots of support as you try to help your cousin through this difficult stage. It is very sad that the joy of having a baby is overshadowed by this debilitating illness. However, it is only temporary, although at times seems never ending but your cousin will eventually make a full recovery.

    I had PP twice way back in the mid 70's and early 80's. Treatment has changed so much for the better so please be reassured that for the moment your cousin is in the best place.

    Like JB-55 it didn't really matter what people said to me and I was suspicious of everyone. During my psychosis in 1975 my behaviour resulted in being sectioned to a general psychiatric asylum where I received treatment and was later transferred to another psychiatric unit so that my baby could be with me.

    This must have been a very difficult time for my family but as much as I would have wished to be well, I was very ill and did not respond. However, there are now Mother and Baby Units where mums can be with their baby and receive excellent care. That said, I am very grateful for the care I received and support from my family.

    It is very confusing for your cousin at this early stage. Is she in a Mother and Baby Unit? I had delusions which no one believed but they were all very real and frightening at the time. I'm sure when the right medication is found to work for your cousin you will see a slow and steady improvement.

    I'm pleased you found this site as it will be able to support you through the challenging time ahead. There are APP Insider Guides available, i.e. "Recovery after Postpartum Psychosis" and "Postpartum Psychosis - A Guide for Partners" which you might find helpful.

    Please take care of yourself too during this worrying time. We are all here to offer our support.

  • Thank you sincerely for your response. While logically I know this is temporary, the lack of progress at this point overshadows that knowledge. Seeing responses from people who have been through this is reaffirming, though - so helpful.

    Right now she is in a small general mental health facility close to her home, which is in a small town in the states. This is a completely new condition for the professionals there and because it is a general facility, she has been unable to see her daughter. We have been in contact with someone who is a specialist here and they recommend that if the delusions and hallucinations continue on Thursday that they should have her go to a specialized program out of state. The program there sounds perfect - baby interaction, family therapy, nurses and doctors who treat these specific postpartum disorders. It is halfway across the country but would be so beneficial for her.

    From what it seems, there is so much more knowledge and support in the UK - the online support and ability to connect with people everywhere is such a blessing.

    Thank you for being so open to sharing your experiences. I will be seeing her again tonight and the input I've received here will definitely help me interact with her in a supportive way.

    All the best to you!!

  • You're doing a wonderful thing just being there for her and as she recovers (which she will) she will be incredibly grateful for your care and time. I craved visitors as I got better. There wasn't too much to look forward to in my days in hospital and my visitors meant a huge amount.

    Before the medication took effect I'm not sure I was worth visiting. When she is better she might not want to talk about her irrational thoughts and behaviour.

    You're doing a fantastic thing being there for her when many would shy away.

  • Hello Aflynn83

    It is distressing for family watching a loved one going through PP and feeling helpless. In a way, for me, it was as if I were a different person, acting out of character and believing my delusions. There's a very good post on here, probably from a few years ago now, entitled "Delusions of Grandeur and other experiences" which you will be able to find in 'search'. This gives an insight into delusions which some mums here had at the time of our PP, quite strange now but all very real and frightening for us at the time.

    I really hope your cousin has the specialist care she needs, even if it is a long way from home. Perhaps she might recover more quickly in such a specialist environment. We have all had the same diagnosis but each road to recovery is different.

    We are very fortunate in the UK .... thankfully mental health is more out in the open than it was years ago. I hope your visit to your cousin is not too distressing. It will seem as though she has "switched off" and not communicating but with good medical care and support she will eventually recover.

    Take good care. We are all here to lean on.

  • Hi welcome to the forum. I'm so sorry to hear about your cousin. You must be really worried, scared etc. But I do want to reassure you, as others have said, that she will most definitely get better. I had my son 4 years ago, it did take me 18 months - 2 years to recover, but each person is different. I have returned to work, have had no problems since recovery, and have an amazing relationship with my son.

    It does sound like the other unit would be better for her. I was in a Mother and Baby Unit here in the UK, which sounds similar, and I don't think I would have recovered as well, or as quickly, without it. It was so important, and healing, to be with my baby as much as possible.

    I would reiterate what others have said. Things that helped me when I was in the middle of the psychosis, as others have said, physical touch. I remember the first night in the MBU the staff member sitting with me, holding my hand, and trying to ground me "you are in the Eastbourne Clinic. Your baby is OK, he is in the other room. Tell me where you are?" and laughing and making a joke of it when I couldn't remember where I was. It was so reassuring!

    I also wanted to say that though she may not seem in touch with reality now, she will remember, when she recovers, that you were there for her. At least that was my experience. I have many precious memories of my family, partner etc being there for me even in the middle of everything and it did make a huge difference though it might not have seemed it at the time. for example I remember my mum hugging me, telling me I was her baby, and that she loved me. At the time I didn't react at all but it went in and I did feel it on some level. So telling her you're here for her, you love her, she is going to get better I am sure will help.

    I also wanted to check if you have found the USA organisation Postpartum Progress postpartumprogress.com/ which supports mums in the US with perinatal mental health problems? I am sure they will be able to offer you, and your cousin, advice and support if you contact them.

    Take care, and I really hope she recovers well.

  • Thank you so much for your response. For me, and the rest of my family, this is the first time we've ever encountered mental illness to this extreme. It's a bit hard at first to look beyond the actions and words that are so in characteristic. But she is still there - somewhere in there and thanks to your affirmation, I'm realizing that she will know how much we love and care for her. The timeline and length of recovery is still so scary, but one step at a time.

    I was wondering...before it came on, did you have any signs/symptoms that you felt may have indicated the onset?

  • For me the onset of psychosis started with lack of sleep, extreme irritability and I started swearing lots which is very out of character. I couldn't concentrate on anything that involved some amount of thought -I tried, and failed, to order a book on the internet. I degenerated quite quickly.

    Lack of sleep seems to be one of the first symptoms/ indicators. It's hard to know if lack of sleep triggers the illness or if the illness triggers the lack of sleep.

  • Hello Aflynn83

    As it's Thursday I wondered what had been decided about specialised treatment for your cousin? Have the delusions continued so that she might now be transferred? If so, I know it must be unsettling for you to witness how poorly your cousin is at the moment but I'm sure with specific care tailored to her needs she will soon show signs of improvement.

    As with many of the mums here, PP struck out of the blue. With my first PP we had been married for just over a year and were so looking forward to our first baby. I had an emergency C-section due to baby being in distress and things took a turn for the worse after that. We went home and I became depressed and wasn't coping, delusions / hallucinations / voices kept me awake at night. I would wake in the early hours and draw the bedroom curtains, convinced it was morning, even though it was pitch black outside. I was sectioned to general psychiatric care.

    When my second baby was born (six years later) unfortunately even though I had an elective C-section as I believed anaesthetic had played a part in my depression first time round, PP struck again. This time my husband noticed my strange behaviours (I thought the radio was talking / playing music just for me) and delusions, uncharacteristic behaviour followed and I was sectioned to general psychiatric care.

    I hope you will be comforted to know that, in her own time, your cousin will be well again. It might be an idea to start a photo album of the baby if you have not done so already, so that your cousin will be able to share the very early days through pictures as she is separated from her child at the moment.. I have such an album of my sons' very early days when I was without them and although very sad to recall, I'm happy to revisit such precious memories.

    Take good care during this difficult time for everyone. Rest assured your cousin will be well eventually and so thankful that she has the support of her loving family.

  • Hi I too hope your cousin is coming out of the psychosis soon, and she can be in a place that is more suitable?

    Each person's journey of PP is different, from this forum I know some people have a gradual build up over a few weeks, increased anxiety etc leading to psychosis. For me I became very acutely unwell on day 3, so very sudden and quick onset. I think I was acting a little strange from day 2, not able to sleep, everything seemed amazing and then it was like my mind snapped, I was like a zombie and thought I'd killed my baby and then had all kinds of other delusions quite quickly.

    Take care, I hope you and your family are OK too

  • Dear AFlynn,

    Check out the information guides available on the connected websites with this forum.... Someone else can share the link?

    I wish we had that information through our experience, particularly for my husband and family stuck on the outside, in 2009 and 2013.

    Also get a copy of Day Six, by Jen Wight (through Amazon or on iBooks). It will help you understand what it's like for her from the inside.

    Don't worry about what doesn't make sense. She won't remember the worst of it, that is one blessing of the illness. Listen, even when you know it doesn't make sense, still listen. And particularly listen for when a snippet might make sense. If you know her well, you will be able to pick up on truths, that her professionals will not understand.

    For example, it was really important to me to have a Bible with me, and to be visited by the hospital chaplain. Before and after the illness, I am a strong committed Christian, so those things are important to me. But because religious grandiosing can be a symptom of the illness (ie thinking you are God, or your baby has a connection to God), any professionals ignored and sometimes ridiculed those requests.

    In Day Six, she shares an example of when she got food poisoning in hospital, but the nurses wrote it off as a clash of medication, and no-one would believe her that she was feeling so ill.

    Take photos, and perhaps even videos. Of both her and the baby. We don't take photos during tough times, but that can mean those early months of mother and baby are missing. And that is even harder when you have been separated from the baby, or struggle to remember the times you had together.

    If she can't be in a mother-baby unit find ways to have private mother-baby bonding. I was allowed visits with my baby, but the only place we could get to from the hospital in the given time was the local park. So things like skin-to-skin cuddles (since breastfeeding had gone out the window), were not made available, just because they were impractical. Make it possible!

    I hate when people ask what ages my babies hit their milestones, because I have to say I just don't know. I wasn't there, I don't remember, and everyone was so busy with me, no one recorded rolling over, sitting up etc etc.

    Keep things even if you don't know why she wants you to. I wrote a lot when I was in hospital. It didn't make sense to people at the time. But I can now read back over it, and explain what it was about.

    The real her is still there,she is just trapped inside the illness. She can take in a lot more than you expect, so keep giving positively. The fog of the illness makes it hard/impossible to communicate with the outside world. And then the medication adds another layer of fog and confusion.

    Take stuff for her to do. It can get really boring in there. But nothing too taxing on the brain. Colouring in, or simple crafts (I made threaded loads of bracelets and necklaces for my then 4 year old daughter). With help I could still knit, play scrabble, play piano.

    Afterwards you will talk about 'real her' and 'sick her'. Sometimes it is clear to distinguish who was doing what. Sometimes it will blur. Be aware that 'real her' is trying to survive despite 'sick her'.

    Sorry for ranting,

    Please keep asking for any other particulars!!

  • Hello Deb12W

    I just wanted to say what a great supportive reply you have given here. Your comment about milestones struck a chord with me as I always felt uncomfortable if anyone asked me, as I didn't know either.

    Keeping things is also a good idea ....... there's a note in my records to say "She's writing poetry again (with a big exclamation mark next to it). Unfortunately my 'poetry' wasn't kept but I would love to know what I had expressed in those lines.

    I don't remember making things during my hospital confinements but there is a video where I'm in the garden at home with family, proudly showing off a knitted bag I had made for my niece. This was during my second PP where I was mostly treated at home, except in times of crisis where I was admitted to general psych care. I had wondered why my parents were apprehensive about watching this shot but after reading my notes I now realise that at the time I was very ill (although it didn't appear so) and had to be watched 24 / 7.

    Thankfully we recovered ...... eventually ..........

  • How is she doing? And you and her partner?

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