Action on Postpartum Psychosis
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Sister with PP and depression at home

Hello to all of you, amazing warriors!

I am very grateful to all of you, who have the courage to share experience with this awful disease and help others.

My sister lives in Somerset, UK and had been diagnosed with PP 12 days after giving birth of a beautiful baby boy. At the beginning of December, she was admitted to hospital and after a month there, moved to Mother and baby unit. She seemed to be coping really well there and she was discharged after 2 weeks. She is on Olanzapine and from 20 mg she is currently on 15 mg.

Once she got home, a severe depression kicked off and she found it very difficult to bond with the baby. My sister refused to take any antidepressant medications as advised from the doctors. Her husband and my sister believed that she can "get over" it without medicine and they will do more harm to her than help. My sister is still experiencing a depression, an enormous loneliness and fear of the baby and she "doesn't know" how to look after him. One day she feels fine, on the next day she is feeling really low and she also has suicidal thoughts.

My main concern is that my parents came from abroad to help and stayed with her for 2 months, but they had to go back and my sister is now dealing with the baby on her own during the day, by the time her husband comes home from work. My sister believes that the Olanzapine should be also reduced.

How many of you succeeded in beating the depression with no medical help? Have any of you felt fear of the baby and what helped you to bond. Any advice of how to help her, will be well appreciated.

Thank you,

G.

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Hi arabelai82

Sorry to here that your sister is struggling. If I thought I could do it without tablets I would of done... but actually it's the hormones and chemicals in your brain that sometimes need balancing out, hence why ure sister is up and down. Once balanced she will feel a lot better. There is nothing to be ashamed off if u take tablets at all I have to forever but if it makes me feel insane and makes me happy so be it.

I'm on 150mg sertraline and 200mg prolong release quetiapin which seems high but it's not

Good luck with u all and take care xxx

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Dear Mamfle 08,

Thank you for sharing this! Your help is well appreciated and it makes such a difference!

Take care x

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Hello Arabela82

Welcome to the forum and thank you for your kind words. It must be very hard for your sister to cope at home on her own during the day after having the security of the MBU and help from your parents. I found that looking after my sons at home was a big responsibility as well as trying to cope with routine and the after effects of PP.

Recovery is different for everyone. During my recovery from my second PP I was mainly treated at home except in times of crisis when I was admitted to hospital due to suicidal ideas. At the time I had what seemed like an endless depression for over a year and it was very hard to lift my mood. I needed medication to keep me stable and wouldn't have been able to defeat the 'black dog' without it. I did try to reduce it myself and went back to square one in my recovery. So as hard as it is for your sister, I think she must be guided by the professionals who want what's best for her.

Perhaps your sister's Health Visitor can set up some sort of support during the day? Does the CPN still visit? I would book a double appointment with your sister's GP to ask about a continuing care plan especially if she has suicidal thoughts. As your sister lives in Somerset I'm not sure if the Devon Partnership Trust who offer support in mental health recovery would be able to offer additional help following referral by her GP?

This must be a very stressful time for you but your sister will eventually find her feet and confidence to care for her baby. She has had such a traumatic experience and needs time to heal.

Take care ..... we are all here to support you.

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Dear Lilybeth, Appreciate so much your time and advice. It makes so much difference to hear from you! My sister does get help from a mental help nurse (I am not sure if this is the correct name), who tries to socialise her with playgroups and etc. She is absolutely amazing and helps my sister so much. My sister also has cognitive behaviour therapy once a week, which is also very supportive. It is just the antidepressants, she is not willing to take and I think this is reason why she is not stable enough in her moods. I pray it all goes well for her! Stay well and take care! This group is a real godsend! x

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Dear Arabela82

Thank you so much for taking the time to reply. It's good to hear your sister has help from a nurse to help with social skills. I didn't find it easy leaving the house so she is doing well in these early months. I had CBT unrelated to PP and found it was a good way to talk openly about my thoughts and I made sense to the person listening! I think when I was recovering I found it hard to talk about my illness for fear of being judged but this was years ago when mental health was hidden.

I hope the nurse or someone will be able to encourage your sister to take her medication. When I reduced my medication myself I wanted to prove to family and friends that I was coping and felt held back by the effects. I realised very quickly that I couldn't cope and told my Psychiatrist I had learned my lesson after going downhill!

For me medication was important. I was having frightening delusions and have read from my notes that adding another medication to the 'cocktail' I was already taking greatly reduced them over time.

Does your sister have any friends who could visit during the day too as well as the nurse? Perhaps building a support network for during the day might be reassuring for your sister to have company.

I don't know whether you have seen the PP Insider Guides "Recovery after Postpartum Psychosis" and "Postpartum Psychosis : A Guide for Partners" at app-network.org/what-is-pp/app guides/ which might be helpful. There is also a brilliant blog "PP Soup" at ppsoup.com with clips and info for reassurance that recovery is possible with good medical support and treatment.

Remember to take care of yourself too as this can be a stressful time for everyone. When I found APP and the forum a few years ago it made such a difference to how I felt about myself and such a comfort to know that other mums had similar experiences to share. It's a great place to 'meet'. :)

We are all here for you ..... x

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Hi Arabela,

It sounds like your sister is lucky to have you in her team. I suffered with depression after my PPP but I did recover. I did take anti depressants which in hindsight I needed at the time. I took sertraline and managed the dose down from 100mg to 50mg, to 25mg and finally 2 weeks ago to zero. But it was a long journey as the advice I was given was that I needed to be well for 1 year to come off them. My psychiatrist was very cautious and at times I was frustrated but time is really important.

I can appreciate the reluctance to take them. I actually just read a wonderful book by Suzy Reading called the Self care Revolution. She is a psychologist and suffered with post natal depression. Her book gives you lots of tips that are complimentary to medicine. It’s not specific to depression linked to PPP but i found it incredibly useful. I would thoroughly recommend that if your sister would be up for reading.

If she’s not perhaps you could use some of the approaches to help her.

When I was at my lowest and couldn’t even fathom looking after my little girl. My mum would keep bringing her to me once a day whilst she slept and putting her next to me on the bed. She didn’t pressure me to do any more until I was ready.

Eventually I asked to go back to the Mother and Baby unit as I needed more help to get better.

If that’s not an option if you and your family can manage it just being there for your sister and not putting pressure on her to recover will be a real gift.

The bonding will come, my little girl is 18 months and we couldn’t be closer.

Good luck

Nicola

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Dear Nicolaba, thank you so much for your precious advices and your time! it is much appreciated! All the best!

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Hi I believe Olanzapine is an excellent drug for stopping mania but not to be taken all the time, my husband was on Olanzapine for 10 years and it has caused an enlarged heart I weaned him off it and he has a diet high in omega 3 so 3x 1000mg fish oil capsules and 3 x 1000mg flaxseed oil capsules per day there has been a massive improvement and if he ever seems to get high now I will give him a 5mg Olanzapine and that will bring him down and deescalate the mania obvs everyone is different but your sister should be enjoying her new baby and I think her and her husbands instincts are right about not taking drugs - but mania is a nightmare and needs to be avoided

- also don't have lots of dopamine rich foods - such as apples oranges beans and pulses as the dopamine brings on mania

so to sum up my best advice is a diet high in omega 3 and always keep a supply of olanzapine to stop mania

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Dear Raquel23,

Thank you for your time and advice! Omega 3 diet is something we are definitely going to try!

Best regards,

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Hi

It’s great you have found us and are seeking support for your sister.

Suffering from depression after pp is very common sadly. A bit like your sister I was struck with depression a few weeks after my psychotic episode, it was worse almost than the psychotic episode. I did take an anti depressant as well as an anti psychotic.

For me I definitely needed the anti depressant to knock the edge off the depression and help me to function, but also I needed so much other support. Like your sister my confidence was completely knocked and I thought I was a terrible mum and would never get better. I did have cognitive behaviour therapy (cbt) from a psychiatrist to help with negative thoughts, and regular support from a mental health nurse. I find planning small tasks each day helped me feel more positive and gave structure to my day (such as small household tasks, or planning walks out). Slowly I recovered and as you say I would have better days and bad days.

But the important thing to say is the better days got more and more and the bad days got less and slowly I recovered and became completely myself and well again, as your sister will too.

Take care, I hope hearing others experience helps.

Ellie x

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Ellie, thank you for sharing this! It makes such a difference and gives us so much hope! I admire the strength in each one of you to defeat PP and to get back on track with your life. Stay safe! x

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My daughter had very bad postnatal depression after the phycosis. She is on still several different types of medication. When she came back from the mother and baby unit after 3 months she didnt even look at her baby. I never thought she would bond with her but it started to happen slowly when the baby was about 5 months old. There were blips when reducing the olanzopine and the bond went but then returned again. Now at 18 months they are lovely together. My daughter went to lots of baby groups for singing , massage, and creative play and that kept her in touch with other mums and gave her routine and structure to her days. It also helps with bonding. We also tried to give her time for herself away from the baby so she didnt feel so pressurised and anxious. May be you could baby sit for her . When my daughter felt more confident to look after her baby after about 5 or 6 months we left her and through that she gained confidence. 16 months down the line they have a wonderful loving bond and a delightfully happy child and you would never know the struggles they have been through. I did not like my daughter being on this medication but i understood in the end how necessary it was for her. She is slowing starting to reduce her low dose of olanzapine now as she is feeling better in herself but wants to stay on antidepressents for a while yet.

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Dear Bulb, Thank you for your time to share your experience and I am glad your daughter had your support to get in control of her life again. Unfortunately, I can't babysit for my sister or help much as she lives far away from me. I hope the sunshine of the Spring will bring more light in her day. X

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Hello Arabela82

I was just wondering how your sister has been since you last posted? I hope she has now agreed to take antidepressants to keep her stable and that the CBT is proving to be helpful.

Take care. x

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Dear Lilybet,

Happy Easter!

It is so very kind of you to ask for my sister! Thank you so much!

Some days my sister is feeling better, but in others- really low. She is still against the antidepressants as she is worried that she will not be able to get off them once well.

CBT is helping indeed. She will be coming over to stay with me next weekend, so this is something she is looking forward to. Talking with her a lot, helps the most!

I hope you and your family are well!

Take care! x x

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Hello Arabela82

Happy Easter! Thank you for taking the time to reply. I think It must be very hard to shake off depression especially without medication. Many of us can relate to feeling better some days and down the next. I understand how difficult it must be for your sister to accept that medication might make a difference. I wasn't keen to be medicated but thankfully I didn't need to take it long term and had treatment in tandem.

I'm glad CBT is helping ...... it's such a good outlet to release thoughts and feelings. How lovely to have a sleepover next weekend :) I'm sure talking with you has been a great comfort to your sister.

I'm well, thank you, and have had a lovely family Easter. Take care xx

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My depression was so bad I lost a ton of weight from not being able to eat. I was not functioning. It was so dangerous at times, the depression was so dark I was convinced I was literally going to die which landed me in the hospital for nine days. I cannot tolerate SSRIs as they trigger delusions, they say I'm on the bipolar spectrum (type 2).

I take extended release quetiapine only, for my depression (atypical antipsychotic). It does help lift the bulk of it, without needing an SSRI.

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I'm a bit late to this thread but thought I would still comment. How is your sister now? I really struggled to articulate the way i felt after my first PP episode so never really explained to my mental health team regarding my thoughts. I can see in hindsight that i was definitely depressed. I never took any medication which I'm thankful for now as I really didn't like having to take an anti-psychotic while breastfeeding so having to take an anti-depressant would have been really difficult for me to accept. Having said that though, taking some meds may have made my recovery easier - who knows?? The depression did resolve on it's own with time.

I hope your sister is doing ok.

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