Preventing a repeat episode with pregnancy no two

[Twinmumtobe]

Hi, three years ago I suffered from post-partum psychosis with my first son. I was hospitalised 4 weeks after the birth. Now I am pregnant with twins and am looking at all options to avoid a repeat experience when the twins arrive next month. I hated being on Olanzapine and ideally want to breast feed the twins without any anti-pyschotic in my system. At the moment I am favouring the wait and see approach to drug taking but my husband is petrified by the idea. Looking back the symptoms were showing for at least a week before being hospitalised, anyone who has had post partum psychosis twice, did your illness present itself any faster the second time? I want to know if I show symptoms can we control it before things deteriote too much.

Thanks for any advice

[Lilybeth Volunteer]

Hello Twimmumtobe

Welcome to the forum and thank you for sharing your experience of PP three years ago. Congratulations on your second pregnancy with twins. There will be mums here to share their experiences and support you.

Please be reassured that there are mums here who did not have a recurrence of PP with subsequent pregnancies. There is a link under frequently asked questions app-network.org/what-is-pp/faq and under the penultimate question "Will I get Postpartum Psychosis again after a future pregnancy?" there is a window with further links to the APP Insider Guide "Planning Pregnancy : A Guide for Women at Risk of Postpartum Psychosis" which you might find helpful.

Try not to worry and rest as much as you can ..... we are all here for you.

[missot]

Hi twinmumtobe, I had pp with my son 6 years ago so I had a support plan put in place when I had my daughter almost 3 years ago. I had perinatal cpn come out and see me once I had my daughter and 3 weeks after I gave birth I noticed things weren't right and I was put on medication straight away. I deteriorated and ended up in the mbu at 6weeks. I only stayed for 3 weeks and left. Needless to say I ended up back in the mbu about a month later and this time I stayed for 2months. My pp was worst then. I ended up back in mbu when my daughter was 8months as the depression was really bad and I couldn't keep myself safe. I was definitely aware of not feeling right and having to speak up. With my son I was denial for months but things with him didn't start till about 2months in. I really hope that u are lucky and escape it this time round x

[Hannah_at_APP Administrator]

Hi Twinmumtobe,

Congratulations on you pregnancy and thanks for posting here. I had PP in 2009 after my first child was born and had a further child in 2013 and remained well. I think having plans and thinking about your options is really key to trying to do all you can to minimise the risk, or at least this was how we approached things. We had a plan in place which involved a low dose of anti-psychotic on delivery and for me this was important - along with keeping things as calm and quiet as possible, a planned c-section after a horrific emergency one before, longer stay in hospital and having everyone rally around etc. I would have done anything to try avoid PP and whilst I have no idea if it worked, I consider myself lucky really. The Insider Guide which Lilybeth mentions has a lot of useful information in too.

Do you have a perinatal team where you live? At the time of my 2nd pregnancy there was no specialist service and I really struggled to get any MH input without any other diagnosis. I did eventually see a psychiatrist but waited a long time. APP offer a 2nd Opinion Service with Prof Ian Jones in Cardiff, which can be accessed by women with a history of PP and this was hugely helpful to me. There is no charge to your local health authority but you will need a GP or psychiatrist referral. Here is the link: app-network.org/what-is-pp/...

Whilst I didn't get ill again, I put in my care plan my preferred treatment options if they had been needed. Part of this was an MBU bed if possible, as I know from my 1st child how helpful this was (as I also spent time on a general ward without my baby). Some MBUs may offer a consultation in pregnancy to look at your options around this and whether you may be able to have a short stay there after giving birth. I know I didn't want to be at home and that MBU would have been best for me. This may not be an option for you, but something to think about.

My over-riding thought about my 2nd pregnancy and any outcome was that things couldn't have been as bad as the 1st time and that symptoms would be picked up and treated (as this was problematic the first time, with no perinatal service or MBU nearby and no history of mental illness). The other thing which I held tightly to was the knowledge that I had overcome the illness before and could do again, if needed. As the FAQ link says:

"Even with the best advice and planning it is not always possible to avoid another episode, but with the right care in place, if you have another episode, you should be able to get help quickly and recover more quickly the second time."

All the very best and I hope that some of this been useful to you. Please do ask further questions and I hope that things go well for you. Take care, xx

[swylie]

I just recently had my 2nd child after pp with my last son, i had a perinatal mental health nurse looking after me this pregnancy and I had meds on stand by as I wasn't keen on taking anything.

The only issue i had is once baby arrived i was looking for the illness if that makes sense? Every little thing had me on guard and then anxiety kicked in again so we made the decision for me to go back on the meds they worked straight away I took olanzipine and clomipramine, I think because we knew what we were looking for this time we got on top of it really quickly and didn't progress. My daughter is now 12 weeks old and I've been off the olanzipine a week with no negative thoughts or anxiety, but they are keeping a close eye on me.

I think my main issues were lack of confidence and looking for every tiny little thing and thinking/panicking that I was poorly again.

I feel great now and I've been very well supported I'm really enjoying spending time with my little lady and I'm confident now that it will continue. Hope this helps in some way xx

[Lilybeth Volunteer]

Hello Twinmumtobe

I hope you are keeping well.

We are all thinking of you. Take care.