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Action on Postpartum Psychosis
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Post traumatic stress disorder

Hello. I had PP in 2006 after the birth of my Son who is now 12. I had a very traumatic delivery which ended up with an emergency c section. I didn't get ill straight away but had very bad sleep deprivation which at the time I put down to being v traumatised by the birth. I was treated at home initially by the local crisis team and moved in with my mum to help with my Son but eventually ended up in a general psychiatric ward for 2 days then luckily spent 3 months in an MBU where I had ECT treatment. I went onto have my daughter in 2011 with no relapse at all (I had a very good care plan in place just in case and really looked after myself after the birth and managed to successfully breastfeed). I have had several periods of severe anxiety over the last 12 years, always at times of stress which results in sleep deprivation - I get very bad physical symptoms of anxiety, wake up if I do manage to sleep with nightmarezms/panic attacks. zopiclone has little effect on me so I end up going back on olanzipine which is the only thing that seems to help me sleep. I actually feel quite high when I have anxiety and feel v motivated to clean up at , believe I'm a string person to have got through the PP/period of anxiety. But then when the anxiety subsides I find myself going into a deep depression again. I often wonder if I have bipolar but my Dr just says the treatment is the same ie: taking antidepressants and olanzipine. i sometines think i have post traumatic stress disorder from the PP as everytime something stressful happens my sleep is affected and i end up with severe anxiety/panic attacks. Does anyone else feel like this or has anyone else been diagnosed with post traumatic stress disorder? I am feeling quite depressed at the moment following a period of bad anxiety back in feb/March this year after my Dad was in hospital (He is now better).

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Hi KellyAsh,

Your story rings a lot of bells with me. It's good to hear that you didn't have a second PP.

I had a lengthy labour which ended with a c section and then couldn't sleep after, becoming psychotic about day 4.

Since initial recovery I'm now into my second relapse which starts with anxiety and insomnia then depression joins the party. I have wondered about post traumatic stress disorder as one bad night usually precipitates a series of them, and i was reading a book on anxiety where the author felt her initial panic attack at night led to PTSD. I suppose psychosis is really traumatic so that would make sense. I've never been given any other diagnosis than PP, yet.

I have questioned bipolar too however I don't think I've ever been manic since PP but anxiety was a problem prior to PP so I see the issue as being linked to that...

I don't know about you but I think part of my problem is setting being on medication as a failure. I think I'm being forced to accept that actually it's a helpful coping strategy to be able to seek and receive help when you're unwell, not a failing!

Hazello

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Hi KellyAsh,

I'm sorry you've had such difficult experiences with the birth of your children.

You said you're on medication. Have you tried any sort of counselling or talking therapy? Do you think that would help you? My counsellor was a specialist in PTSD although I don't think I had it.

You sound like you are dealing with a lot as well as things with your dad.

Be kind to yourself and look after yourself.

Xx

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Hi KellyAsh,

Welcome to the forum, like Hazello I can really identify with your story. Although I didn’t have an emergency c section, my birth was traumatic ( mainly as my psychosis started in labour) and sleep deprivation and anxiety have featured in my recovery, I think it is incredibly common. It’s great to hear that you stayed well with your daughter - coping with that after such a traumatic first delivery is amazing.

Like you stress can trigger sleep deprivation for me which leads to very bad anxiety. This has only happened once since I was recovered, but did also happen early in my recovery when weaning off Olanzapine. It’s so awful don’t you think? I can find them both quite debilitating and it takes a lot to get through a day ( and night when you can’t sleep!) and the lack of sleep also massively affects my mood. Zopiclone also does nothing and it’s Olanzapine that gets my sleep back on track, so very similar to you.

As I said this has only happened once since my recovery ( I had PP in July 2015), but with this and flashbacks that I had when visiting the labour ward my GP highly suspects PTSD and I was referred for therapy at the beginning of the year. I am still waiting for an appointment but thankfully have been fine since my sleep got back on track and an antidepressant was used for the anxiety. In hindsight I think given how traumatic we all know PP is, it is logical that it would cause PTSD in some people.

Sorry to hear your dad has been unwell - family illness can be such a major cause of stress and I am pleased that he is better now. Have you spoken to your GP about this? It might help to explore what your options are - if it is PTSD there are treatments for it.

Keep us posted on how you get on

Helen xx

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Thankyou all for your replies. I have often wondered whether counselling would help so I am going to book an appointment next week to pay for it privately as last time I asked my GP he said the waiting list on the NHS is 9 months. I have also recently started doing an 8 week CBT NHS run course on anxiety (which i referred myself on via the minds matter team back in March) which is helping but my anxiety has subsided and the depression has set in - however I am hoping the CBT will help the next time I get anxiety. I think I will go to my GP on Monday and ask to increase the sertraline I am on and ask whether he can refer me for some sort of assessment to see if I do have bipolar or PTSD. Counselling is something I have always felt I should have had but have - I did recently request all my medical notes from when I had PP when i was feeling quite strong after the anxiety symptoms had subsided - and i did find reading through them useful - upsetting reading some of the things - but it did make me realise how v poorly I was at the time and i did feel it helped putting some of my jumbled memories of the time back in order.

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Hello KellyAsh

I can't add much to the supportive replies here but wonder if APP's Prof Jones at the Second Opinion Service might be able to offer his invaluable advice, the link being app-network.org/what-is-pp/... help/second-opinion-service/. He might be able to offer his specialist insight into bipolar and reassure you. Prof Jones is based at Cardiff University but I think it is possible to arrange Skype calls if you are not in the area. A few mums here have been guided by Prof Jones and I was fortunate to meet him and some of the team years ago when I was looking for confirmation of my two PP episodes.

Perhaps this is something you might consider if you are going to your GP on Monday as he will be able to refer you as this is a free service? It might be helpful to book a double appointment to make sure that your GP listens to your concerns and helps you.

It sounds that, like many of us, you have been through the mill and I'm sorry depression has set in. I had what seemed like an endless depression during recovery from my second PP and found some days very challenging. I also received ECT on admissions and as an outpatient in times of crisis during both episodes, which was helpful in bringing me back from being lost!

I requested my medical notes last year from my GP during the times of my PP, like you to fill in some of the blanks. My PP episodes were years ago and my sons now happily have families of their own. It was very upsetting to read about this young wild woman who was very poorly, not communicating and under mixed general psychiatric care, fighting to find her way through the stigma and secrecy of mental health in those days.

Take very good care of yourself. I hope the therapies will help ... talking therapy is a good way to express all the thoughts you have kept a lid on :) It goes without saying that you are always welcome to talk here.

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Thankyou Lilybeth I was thinking to ask my GP about referring me to a service that could assess me to see if I do have bipolar / post traumatic stress disorder - I will mention about a referral to Prof Jones.

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Hi KellyAsh

I hope your appointment goes well with your GP and the link to the Second Opinion Service worked. Unfortunately it didn't when I checked but I hope you will be able to find it. Best wishes.

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Here is the link to Second Opinion Service (I hope!) I found it really beneficial in my second pregnancy and Prof Jones is very supportive and knowledgable

app-network.org/what-is-pp/...

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You are not the only mum who has had trouble with mental health after sleep deprivation. The good thing is you are watching all the signs and taking good care of yourself. I had bad stress when my dad was in and out of hospital when my husband had been ill as well so understand your problem. You sound a happy family with a son and daughter. I expect you know all about other medical conditions which can tip the balance

including infections, delirium, diabetes, thyroid conditions which can lower your immune system and make you more prone to tiredness. The other factor which may not be recognised today is based on the research and life work of Katherine Dalton who pioneered hormone therapy for hormone imbalance for pre menstrual tension, with fluid retention, and peri natal mental health problems, and post natal depression/psychosis.

I have read some back posts of mothers who were tested for their progesterone levels, and were given supplements of progesterone which helped to prevent post partum depression and psychosis. I find it difficult to understand why mother and baby units seem to omit a major cause of Puerperal Psychosis. Is this because men are in charge of

mental health issues? As for the postnatal stress disorder from the difficult birth - that is harder to come to terms with. I just hope the good things in your life are in the present

and the importance of you as mum in your family is paramount. You have to be strong for your children and realise that no one would want you to be unhappy at any stage of life.

All the best. GG

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Thanks to all those who have shared their experiences here. PP is certainly a traumatic illness and I know when I've spoken about my episode, which was almost 9 years ago now, some have said that it sounds like PTSD in some ways, as they had mostly not heard of PP. I also had a birth experience which I would definitely describe as traumatic and I think may have played a part in my PP - along with lots of other factors, although nobody really knows for sure. Some people sadly become ill after even the most straight-forward of births, so it's not always easy to say; we each have our own, personal experiences.

I also wanted to share some information about progesterone and Dr Katharina Dalton, as this also comes up on other posts. APP’s experts say:

"Although hormonal changes may well play a role in PP we need more research to understand this better. Katharina Dalton advocated the use of progesterone therapy for prevention of postpartum mood episodes a number of decades ago, and reported a number of positive case studies. However, there is still a lack of good evidence for it helping and there may in fact be a higher risk of depression in the group treated with progesterone. There haven’t been any studies examining progesterone and PP specifically.

The key clinical guidelines in the UK and around the world (e.g. NICE, SIGN) do not recommend oestrogen or progesterone in the treatment or prevention of PP. More research in this area would be very helpful."

I hope this provides some further info for you Kelly Ash and also those reading and who have shared their experiences. PP whilst a horrible and cruel illness, is still hugely under-researched and treatment can vary by each person's experience. I hope the link to Prof Ian Jones' service is useful to you; this can also be accessed by Skype, as I had a consultation with him that way in my second pregnancy.

Take care, xx

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