This is a post about my recovery from PPP. It talks about dark moments in my illness but ends with recovery and hope. It's a bit long.
Although I’ve been anticipating this anniversary all summer, this morning I somehow forgot about it as I prepared pumpkin pancakes while my 14-month old ran around naked and my partner cleaned our living room. He has an unexpected day off work (he’s a freelancer) so we started planning what we will do today- perhaps take our daughter to the swimming pool as the weather has gotten a bit chilly for outdoor swimming. My daughter ate a bowl of strawberries and two small pancakes all by herself, something she’s never done before. I looked at my partner and said “I’m so happy today! Oops.. let’s not talk about it, don’t wanna jinx it”. I’m a bit superstitious like that.
Only two hours after getting up did I realize it’s a year ago today that I was admitted to a psychiatric hospital for the first time in my life.
I live in the Czech Republic, though I’m not from here. There are no mother-baby units. The state of psychiatric care is quite outdated, perhaps something like the 1970s in the UK.
My pregnancy was relatively normal, though I do believe that losing our apartment when I was 6 months pregnant was a massive trigger for me. I know the hormonal crashes and sleep deprivation are believed to be the main causes of PPP but I can’t help but think that when the apartment we had been preparing for our baby was taken from us by my partner’s parents (long, sordid story) and I had to move in with my mother (with whom I have a difficult relationship to say the least), the path towards my breakdown had already begun. I have no history of depression but I do have a history of anxiety and panic, as well as depersonalization (dissociation) following a traumatic event (losing a boyfriend in an accident when we were both 22), as well as a history of childhood trauma (war and separation from my family from the ages of 6-9). I thought that was all behind me, though. I had been very healthy, happy, and settled for many years.
The birth was long, 72 hours in labour, 16 of those in active labour, 6 hours of pushing. I wanted to do it all the “natural” way, no epidural. But the umbilical cord was wrapped 3 times around my daughter’s neck. In the end they gave me a shot of picotin and had to partially pull my daughter out of me. They had also given me local anesthesia as there was a plan for episiotomy which never happened, so I didn’t actually feel her coming through. Being a person who is generally “not in her body” very often, I think it was damaging not to feel her coming out. I also passed out briefly during the birth and felt like I had visited some other dimension briefly. I begged God to save her, and take me if someone had to die.
She was blue and still when they pulled her out, but soon was crying, and then latched on to my breast without a problem. We were separated that first night, which devastated me, and caused some guilt as I had agreed to it where I could have refused. I was just so tired I couldn’t lift my head or even chew. I wasn’t able to fall asleep for a while, then slept just an hour or two perhaps.
The first two weeks were about as normal as having a newborn can be, but around the 2-week mark I started to feel very low. I would cry for no reason, feel hopeless. My daughter Lyra had also started to have some sort of all-day colic and was only calm when my partner bounced her on an exercise ball, and only occasionally when feeding. I had pregnancy-induced carpal syndrome in both hands so couldn’t hold her or change her nappy which made me somewhat resent my partner who was doing it instead of me. I felt like he was bonding with her and doing what I’m supposed to be doing.
The engulfing sadness got worse. I spoke to my mother and partner about it. My mother said it will pass. I called every mom I knew, everyone said it’s “normal”. One even laughed on the phone as I cried and said “Aw, sweetie, don’t worry, it gets so much better after 3 months”. She meant it kindly.
I went to the ob/gyn and she recommended valerian and st.john’s wort, both of which I had already started taking. I went to a naturopath and started following all her tips, taking vitamins and supplements plus gave up wheat, soy, dairy, beans, brassicas, anything that I thought could be giving my daughter gas.
Lyra didn’t like being in the wrap, carrier, stroller, or even just carried in anyone’s arms, not even mine. Just the bouncing ball. I’m now sure it was birth trauma. I begged my partner to stop working. I felt like I was drowning. He agreed. I stopped being able to sleep, even when Lyra slept. I started developing anxiety and depersonalization, but much worse than I had ever experienced. I couldn’t do anything but pace around and breastfeed. I tried to read, the sentences didn’t make sense. I tried to listen to an audiobook but little things would trigger very dark feelings. A description of terminal illness made me feel like life is nothing but suffering and then death. I couldn’t complete simple tasks. I went to a GP, blood tests came back normal. She said “just push through, by 6 months you’ll be fine”. I went to a holistic therapist who recommended shiatsu massage and grounding exercises and advised me against medication. After an unsuccessful attempt to go to the country and relax, I ended up at an emergency psychiatric clinic in the middle of the night. “you just need to sleep”. They gave me some antihistamines for anxiety and ½ a pill of mirtrazapine for sleep. Just 5 day’s worth. We bought formula and my partner said he’d take the first few night wakings. My breasts were so full that first morning, but I had slept for 7 hours. Seeing him bottle-feeding her hurt though. We bought a pump, I tried to give her only breast milk but each moment of my day was filled with a deep nameless dread and sorrow. 10 days later, back at the emergency clinic. They gave me a low-dose of Zoloft, suggested I stop breastfeeding so I can be put on a higher dose. Also Xanax but I was told I can’t breastfeed for 8 hours after taking it. It was all too complicated for me at the time. Leaving the clinic, my partner pointed out a car with the license plate “BE BRAVE1”.
I thought the Zoloft would sort me out, had a bit of hope, but 3 days in the low feelings turned into a monstrous beast that swallowed me. I sat at the kitchen table weeping and my boyfriend called me to the bedroom. There was a tiny bird on the window, sleeping. It was greenish with a gold head. We figured out it’s a goldcrest, the smallest European bird. I thought we needed to do something to save it, but when she woke up I realized we just needed to let her go. My partner thought it was a good omen. I thought otherwise and became terrified. She flew out of my hands and as I watched her fly, I noticed she passed by this man I had been seeing on the street the whole summer since my daughter was born. I decided we had to speak to him. We went for a walk with Lyra, who had started accepting the carrier on occasion. I approached the man and asked him where he’s from as I had heard an American accent. He said he was born in America but “took his body from there a long time ago”. He said he was now enlightened and he “recommends it to everyone”. I panicked. “I’m losing it, this can’t be happening”. But I kept talking to him, I couldn’t stop. I think he was schizophrenic. I became convinced that it is my time to become enlightened but that it means being mad/insane. I desperately wanted to escape it. We went to a park and I walked around barefoot trying to “ground” myself though I was on an emotional rollercoaster that dove into the depths of hell for moments, then came up for air, then back down. It felt like tripping on magic mushrooms, which I had done in my youth. Except darker, stronger, much more frightening. And REAL. I found an acorn on the ground and felt it was going to give me strength for whatever lay ahead.
A friend came over that afternoon to check up on me. There was music playing, a very sad song that started to bleed in to my perception of reality. I had pressured speech, I NEEDED to tell my friend the story of my dead boyfriend, of how bizarre my life has been. I felt if I could just figure out the “secret”, the mystery, I would be fine. I just needed to put all the pieces together. She told me we should talk about my symptoms. I told her I felt that I was destined to kill myself, that I had given my soul to Lyra so that she would survive the birth. I didn’t believe it 100% but it was there. They called the emergency clinic, spoke to the doctor who had prescribed Zoloft. “Take her to the hospital immediately”.
In the psychiatric hospital: awful, Czech, 1950s style sanatorium. I was put on the acute ward although I had "insight" into my illness, so would generally be placed in the freer ward, but that one was too full.
On the acute ward there were about 20 beds, all in one large room. Mint green walls with Klimt reproductions (strange choice!). At one point two of the schizophrenic patients were taking the pictures down and putting them in different places.
On the first night, they were trying to be nice to me, terrified foreign girl, and placed me in the isolation room so I could have some privacy, but then the nurses closed the doors by accident- the doors lock automatically. I needed to pee so I got up and couldn't open the doors. The bed had straps on it. I thought I had been tricked and that I was much sicker than I realized and was going to be strapped down. I banged on the doors and it took them a while but then they opened them and apologized.
There was this schizophrenic girl named Magdalena (as I later found out.. she was very seriously ill. She was taken away by police on my last day there because they had found a knife in her belongings. Oh, they took away anything dangerous including pencil sharpeners.. it was like kindergarden prison). That first night she kept walking into my room (she was an insomniac) and saying odd things to me in English. I thought she was giving me secret messages, that she could "see" something about me that I didn't know. She ended up taking a liking to me and throughout my stay there, would come up to me and say odd things. I didn't know how to be nice to her, I didn't know what she needs. I found her smoking in the bathroom and told her "Don't be afraid, I won't tell on you". She looked at me with a blank expression (she had that trait that some schizophrenics have, showing no emotion in the face) and said "I am not afraid."
Sitting on the bed of another schizophrenic, named Nastia (she was Russian I think). She was very friendly, very talkative, very motherly (she has two kids). She gave me a massage one night, she worried that I would get mastitis (they gave me pills to stop lactation. The nurses tied bandages around me twice a day. They kept reusing the same bandages so they started to get this smell, until I asked them to please use a new one). I sang American Pie and she loved it and kept asking me to sing it for her.
Another schizophrenic, I don't remember her name as she came near the end of my stay there. She was "infantile", and kept telling me. She sang beautifully. We were drawing during art time and she sang "Somewhere Over the Rainbow" and I cried. I cried a lot at the end because I was really scared. I wasn't getting better and I had no idea what was still ahead of me, and I didn't understand what was wrong with me. She saw me crying and said "Be happy! You are leaving tomorrow!" It was very humbling, being comforted by her. Then a few of the women, 3 of them in their 40s and 50s, who had all tried to commit suicide, and all had husbands they were angry at, they comforted me too. "Oli," they said "you have a baby and a nice husband. You are getting out tomorrow. Be happy."
My partner could only visit from 3-5 pm, but my daughter wasn’t allowed.
He would come again around 6 pm and throw a rock at the windows. Usually one of the others would see him first and call me over. He would come with Lyra, and I would look at them through the bars in the window. Everyone was really excited whenever he came to the window. I think it gave everyone a good feeling to see them.
One of the worst moments in my life. I had a nightmare, my second night there. In the dream, I was running through a building that was collapsing and warping, and "madness" was chasing me. I was looking for my mom but couldn't find her anywhere. I woke up in a cold sweat, and into a nightmare, which was my reality then.
The psychiatrist with huge bulging green eyes. They came for rounds every morning and he would ask "Soo... Ms. Knezevic.. How are you today? Any feeling of depersonalization? Any suicidal thoughts?"
Taking the Rorschach test, trying my best to suppress any weird thoughts. Apparently you can't lie on a Rorschach. I don't think that's true.
Taking a depression questionnaire and lying.
I just wanted to get out as quickly as possible. I had “behaved myself” (I felt like I was in “reality prison”) so they let me out for the weekend. I begged my partner and my mother not to make me go back. We signed a paper saying I accepted all the risks, but I had to go back there in person to do that. They gave me a contact for an out-patient clinic. I was on 100 mg of quetipaine, no antidepressant, anxiety meds as needed which was constantly.
A week of hell, then the outpatient clinic. Begging the doctor for help. She upped the quetipaine to 200 mg.
Then a private psychiatrist. A very arrogant-seeming man who kept discussing me with my partner as if I weren’t in the room. He upped the quetipaine again, added Abilify, and 3/day clonazepam. That made a huge difference. I thought I was coming back.
Then the post-psychotic depression hit. The deepest darkest hole I could ever have imagined. Plus dissociation, constant. Plus residual psychosis. I begged the doctor for an antidepressant but he said “you’re not depressed. All women are unstable, that’s all. Especially after they have babies”.
My cat ran off, I got even worse.
Another doctor, a woman. She mainly focussed on my issues with my mom and said quetiapine works as an antidepressant as well. I still wasn’t sleeping as I woke up every hour to pee. The doctor said the side effects aren’t important if the meds are working. I would need to take them for a year, regardless.
I told the male doctor about the sleep/pee problem, and he started reducing the antipsychotics very quickly. The final dose, when I was off completely, was following instructions they had sent in an email. I was scared of what would happen. Still nothing for the crushing depression. I tried to be admitted into a hospital over Christmas but my mother guilt-tripped me into not doing it.
Finally, I took matters into my own hands. I had been given a prescription by the outpatient clinic to take low dose escitalopram for anxiety but I hadn't used it as I was on clonazepam for anxiety. I started taking it for depression. I finally found a good doctor, through a woman I had met at the psychiatric hospital who was schizoaffective bipolar. The doctor upped the Lexapro, added mirtrazapine for sleep.
I found a therapist I really like. She's a clinical psychologist too, and works at a psychosis clinic so has a lot of experience with severe mental illness. She's also kind and warm and really listens. I still see her every week.
I began to crawl out into the daylight.
Early summer. We found an apartment, moved in. I was taking care of Lyra on my own, my partner was working again. I weaned off mirtrazapine and was going to sleep on my own. One evening, a neighbour found a black kitten, almost newborn, and couldn’t keep it so she gave her to me. I took her home and she slept with me all night. She woke me up at 5 am but I was so happy I started taking selfies with her.
My life was coming back to me. I was coming back to myself.
All along, this forum was my dearest companion. There were days early on when all I could do was read the posts on here all day. I followed the ideas given by other members: Write down 3 good things every day. Try to go for walks. Spend time with your child. Hope. Believe. You will make it through. It does have an end. A happy end. Hold on. You’re not alone.
And what can I say? They were right. Somehow, unbelievably, indescribably, you come back, you really do.
You can wake up one morning and not immediately think of your illness and make pancakes and laugh with your family and plan a swimming trip. It's a journey to the underworld, to be sure, but that journey ends with a return to the light. I read a great quote from a woman online who also had PPP:
"If you're going through hell, KEEP GOING!"
With gratitude, and love,
*edited to add photo of my kitten