Keeping Children away from PP mother during her recovery?

[Little_jay]

My sister is diagnosed from PP 8 months after her second delivery. She is currently residing in Pakistan with her husband and parents. She is in Quito pine, kemadrin and alp. Yesterday she complained of hearing voices. She is currently being treated at Home. Her behaviour has put off her elder son who is 4 now. I wanted to ask is it okay if we take her son away from her? Will this effect her recovery?

[Bluelady-sing]

When you take care son away is that because you're worried she cannot care for it

[Little_jay in reply to Bluelady-sing]

Yes, but if we take him to even the market or someplace near. She starts getting paranoid that something bad might happen to them. What should be done in that scenario?

[Little_jay in reply to Little_jay]

She is under supervision 24-7 and her son is being taken care of by a nanny.

[Jocelyn_at_APP Partner APP]

Hi Javariah,

Thanks for reaching out to the forum. It sounds like you are being really supportive of your sister and helping her as much as you can.

It is such a difficult position to be in but your sister sounds very ill and it must be upseting for your nephew to see his mum like that. I am sure you are trying to do your best for everyone.

There are some guides on the APP website about recovery that may be useful to read:

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

You mentioned your sister is hearing voices. Are there any health professionals you can reach out to for support? Or would that be the 24 hour supervision you mentioned? Sorry I don't know what is available in Pakistan.

Thinking of you.

Jx

[Little_jay in reply to Jocelyn_at_APP]

We have a weekly appointment with her psychiatrist. Otherwise she is completely supervised at home by her parents and husband.

Just wanted to know is it necessary for the patient to be close to her children? Will this effect her recovery if they are taken away?

[Jocelyn_at_APP Partner APP in reply to Little_jay]

I think this would vary from person to person..... I don't think there is a right or wrong answer. You need to weigh up how upset your sister would be versus how upsetting it is for your nephew. It's a really difficult decision to make but you, being so close to your sister, would only make the best decision for her and you nephew.

I'm sorry I can't be more helpful but these situations are so unique to each lady that while it is useful to hear other's views sometimes deep down only you will know what is best at that point, in that moment.

Xx

[Lilybeth Volunteer]

Hello Javariah

It must be very worrying for you and your family that your sister is so unwell at the moment. It is a shame that the joy of a baby should be overshadowed by such a traumatic illness. I had PP twice many years ago, hearing a commanding voice and experiencing delusions, which were all very real and frightening at the time.

During recovery from my second PP I was mainly treated at home and watched by my family 24 /7 for my own safety. In times of crisis I was treated in hospital. My first son was then six years old and cared for within the family home by my husband and some family members. I'm sorry that your nephew has been upset. I think if you take him away from your sister she will wonder where he is and might think that something has happened to him? It can be very hard for her to think rationally when she is feeling so vulnerable.

I hope the PP Insider Guides suggested by Jossykate will be helpful. As it is early days in your sister's recovery it might be reassuring to read that PP is a temporary and very treatable illness. I'm not sure about treatment abroad but hope your sister is receiving regular medical reviews as she fights to be well for her family. Please remember to take care of yourself too as this must be a stressful time. We are all here to listen.

[Little_jay in reply to Lilybeth]

Thank you so much lily Beth for all your support at this tough time. How did your husband and family manage your 6year old son? While you were at home and not well. There is little to no help regarding this matter anywhere

[Lilybeth Volunteer in reply to Little_jay]

Hello Javariah

To be honest I was so ill when my when my second son was born that it's quite blurred how my husband and family managed. Before PP struck a second time we were quite glad that our baby was born in the school summer holiday. This was because here in the UK school children had seven weeks holiday. We were so happy for a few days and then my late husband noticed my odd behaviour, much like when I had my first PP. The professional medical team were called and I was again sectioned for my own safety.

I was in hospital for quite some time. My husband had to cope with our sons as there were no facilities in the hospitals back then for the baby to be with me. After the summer holiday ended and my son returned to school, my parents and sister helped with taking and collecting my son until my husband came home from work. Unfortunately when I eventually returned home I suffered with depression during my recovery and this took its toll on my ability to parent. I thought of myself as a 'bad mother' and was very low for a long time. My husband also had a breakdown but we came through it all and went on to have very happy family times.

I'm sorry there is little or no help for you. There is a support group, Postpartum Support International with an India Resource Page for PSI at postpartum.net/get-help/loc... which might be a useful contact? If you go to the page and click on 'Get Help' you will see a link to Postpartum Psychosis Help, for support. Take good care of yourself .... it must be very tough for everyone as your sister is trying her best to be well. We are all here to listen.

[Little_jay in reply to Lilybeth]

Do you suggest that we move her to Sweden? She was on holidays when she had her first manic episode. Her sons and her family is Swedish national. I am not sure what support the government provides there for PP moms and families? I really want whatever is best for her. Would they hospitalise her? Because I am really not sure at what stage of recovery is hospitalisation required? Is hospitalisation better for her and her kids in the long run?

[Lilybeth Volunteer in reply to Little_jay]

Hello Javariah

I'm sorry I can't really comment on whether you should move your sister to Sweden and what help is available there for PP moms and families. I was sectioned as I was a danger to myself but I'm not sure what the criteria is in other countries. Perhaps if you contact Postpartum Support International they will give you some guidance? Take care.

[Little_jay in reply to Lilybeth]

Last night, she tried to suffocate her 9 month old son. We have taken all kids away from her to my home. Her psychiatrist has doubled her anti depressant dose. Is there anything you would advice that we should for further precautionary measures?

[Lilybeth Volunteer in reply to Little_jay]

Hello Javariah

I am so sorry to hear about your sister's struggle but she isn't able to help herself at the moment, although she has responded to an increase in medication. It will be a case of finding the right balance of medication and treatment which works for your sister and then hopefully she will show signs of improvement.

There is a page on frequently asked questions at what-is-pp./faq and although much of it is geared to support in the UK you might find some helpful notes. There are also shared experiences on the page so perhaps reading them might give you hope. It's good that you are in touch with the Psychiatrist daily as this is a good way for him to monitor your sister's mood, etc and make changes as necessary. Is it not possible for her to be admitted to hospital as she is so vulnerable and her thoughts are not her own?

The anti-depressant medication I took made me very slow but did keep me stable. So I hope eventually you will begin to see signs of improvement. For some it is a slow process but with good medical care and all your loving support your sister will be well again. At the moment she is struggling to come to terms with her thoughts and feelings. Take care.

[NanaJudith_APP_Vol Volunteer]

Hello Javariah,

I am so sorry that your sister has suffered PP, such a shock and trauma for her and the whole family. It's great that you can be there for her. My daughter too suffered with this traumatic illness, I know that she valued the support of her sisters and family. Each Mum and recovery is different but most, I think, would be less anxious if they have contact with their children, with other loving, caring family around, to fill in the gaps, I don't think there can be harm, children are more resilient than we think. You have had helpful replies from the brave on the forum. You know your sister, perhaps also be guided by the professionals.

I fully understand your anxiety, do take care of you too.

I hope your sister gets well soon.

Best wishes

Judith x

[JenniferM]

In my opinion, until she stabilizing on appropriate medication, she needs support and taking her son may aggravate the situation. Talk openly about the illness with her son so he knows she is sick but with the right treatment she will get better. If professional therapy is available in Pakistan, the family can benefit. There are even online support groups now. Appropriate Therapy helped me and my family tremendously. Thankful my son is 23 amazing young man getting his master's degree and that his dad and I miraculously will be celebrating 31years of marriage this summer.

Being supportive, loving her and helping her through the illness is the best thing you can do for your sister. She is blessed to have family support.

[Little_jay in reply to JenniferM]

Thanks for your reply Jennifer. Last night, she tried to suffocate her 9 month old son. We have taken all kids away from her to my home. Her psychiatrist has doubled her anti depressant dose. Is there anything you would advice that we should for further precautionary measures?

[Chick44nzrn]

hello Javariah . You have some big decisions to deal with along with the concern on a daily basis for your sister who is ill . She is fortunate to have your loyal help and care at a time she is most vulnerable .

Does she have moments of clarity when you are able to explain you want to do the best for the little boy ? If there was such an opportunity , you could ask her if she would like him to have a break but yes I agree that seeing him “ spirited away” could be very distressing for her and exacerbate her illness. Especially if she is having paranoiac thoughts . At four years

I think he may understand mummy is sick but a lot would depend on the others in the house ; if they are calm and confident it would help the wee boy , who might enjoy periods in the day going on nice outings but coming home again . This is only my personal opinion , from recent experience with my daughter who had to go to hospital with her new baby leaving her 2 small children at home. Separation anxiety is so hard for little ones . And for mums.When I had PP years ago and my newborn son was not with me I was massively anxious and harassed the nurses constantly until I could see him .

I hope by now the path forward is clearer and whatever you decide I know it will be for the very best outcome for your sister, and family . I sincerely hope she gets excellent medical help and starts to improve , with your love and support.

Thinking of you

Denise. X

[Little_jay in reply to Chick44nzrn]

Thank you for your reply Denise. Last night, she tried to suffocate her 9 month old son. We have taken all kids away from her to my home. Her psychiatrist has doubled her anti depressant dose. Is there anything you would advice that we should for further precautionary measures?

[Chick44nzrn in reply to Little_jay]

Dear Javariah . I do hope things are a little easier for you all. A brief suggestion , is to keep a diary daily of all communication about the little child and your sisters state of health . ( of course without anything punitive or critical ) there might come a time when all is back to normal and you can refer to it .

I must rush to an appointment !

Denise x

[Hannah_at_APP Administrator]

Hello Javariah, I’m so sorry to hear of your sister’s situation - it must be so terrible for her and the whole family too.

I had pp myself after my first child was born and whilst I never wanted to hurt my baby I know that I was very unsafe at times and did spend some time away from him until I was well enough to be in a mother and baby unit and reunited.

I’m afraid I don’t know about the healthcare system in Pakistan but wondered if there was any specialist team that can help with Perinatal mental health? You mention that her psychiatrist has adjusted her medication - getting the right dose and combination was crucial for me, and lots of other Mums here too. I took antipsychotic mediation and whilst it took a few to find what worked, that was helpful and the worst of the psychosis and mania was then starting to get better although it was a tough journey for us all.

I don’t think there’s anything more I can say other than how much I am thinking of you and holding your sister in my thoughts. I hope things get easier for you all soon and in the meantime I’m sure it will be a comfort for the family to know that her children are safe and cared for with you. Your sister might not realise it at the moment but getting treatment to be better is the main thing for now for her & I’m sure that professionals will be able to help with this. Take care, xx

[Little_jay in reply to Hannah_at_APP]

Hey Hannah, after increasing her anti- depressant yesterday. She is feeling very normal today. Like she is back to her old self. But we all are still very afraid and cautious that she hurt herself and her baby. Does the infanticide thoughts go away that quickly?

[Little_jay in reply to Little_jay]

We are in constant touch her psychiatrist, but I also wanted to hear from first hand experiences like that of yours

[Hannah_at_APP Administrator in reply to Little_jay]

Hi Javariah, the thoughts are very much part of the illness and from my own experience I’m afraid I don’t remember an awful lot of that time. As I said, it was more about being unsafe and unable to look after myself let alone a baby. I’m sure that once the medication is working your sister’s symptoms such as the thoughts you describe will start to improve. Wishing you all well for her recovery soon. Xx

[Little_jay in reply to Hannah_at_APP]

How long does it usually take for symptoms to start showing their effects, it’s been a month that she has been on anti psychotic meds. Started antidepressant a week ago, when she had started auditory hallucinations?

[Ellie_at_APP Partner in reply to Little_jay]

Hi javariah

I’m so sorry to hear about your sister. I’m another of the coordinators here at APP and had postpartum psychosis myself after the birth of my son.

It’s very difficult to answer your question as each person is different and responds to the medication and treatment differently. My psychotic symptoms began to improve after about 2 weeks on my anti psychotic but as I said this is different for each person and people respond to different medication.

I’d really encourage you to keep a record of your sisters symptoms, behaviour and thoughts and show this to her psychiatrist so they can see clearly whether the medication is correct or not.

She will come through this, I really hope you can all get enough support. I’m glad you have found us for information and support.

Take care

Ellie

[Little_jay in reply to Ellie_at_APP]

Thank you for your advise ellie

[Lilybeth Volunteer in reply to Little_jay]

Hello Javariah

I experienced what I now know were auditory hallucinations. My parents took me to their home but didn't understand what I was seeing or hearing so I retreated to bed. I stayed there as it was my safe space. I was waiting for a Psychiatrist to visit but was eventually sectioned, taken to A&E and transferred to a psychiatric unit.

It took some time for the right balance of medication to be found which worked for me together with treatment. Eventually the voice and hallucinations faded but I was then hit with depression and had treatment and medication until I fully recovered. I think if you are having daily contact with the Psychiatrist he might be able to give you an idea of the time frame for your sister's recovery Take care.

[boat1]

If the son ia in danger yes but otherwise chikd shud be kept in home. Perhaps see for one day if she misses him. Then perhaps some time away from home but i think just removing him for long will not be good esp as she fets better. She may get paranoid about this. Just re check her medicine is it best for her symptoms, are there any alternatives. Higher lower dose. It does take time.but in shaa Allah/ God willing she will get better. We all been through same experiences. I had two more children after with no relapse. Just medication after birth, rest v important, epidural helped alot as bad labour can trigger. But as she is already ill now best things is to focus on medication , rest , better to be at home so thats good. And prayer

[Little_jay in reply to boat1]

Thank you boat1 for your absolutely tremendous reply. Yes, I take her sons to her everyday but bring them back. Her condition is very unpredictable at the moment. She good some days and some days like today, she’s having the same thoughts again.

[boat1 in reply to Little_jay]

What medicine is she taking ?

Usually it is an anti psychotic like Olanzapine and a mood stabiliser like lithium for example. Is she having high moods like cant relax, too much energy, too active and paranoid. I had like this. Or maybe she hasmore depression/ low mood medication may be different for that. Perhaps ask others too what they took. Their symptoms. What does dr say

[Little_jay in reply to boat1]

Yes she’s on olanzapine now. Quitipine didn’t work well for her. Besides that she’s on ALP. She’s more on the depression side nowadays. But usually does get paranoid when she wakes up

[Pikorua Volunteer]

Dear Javariah,

I am so sorry about your sister being in a different country and so terribly poorly. It must be a very difficult situation for family members and close friends.

You have had plenty of information and I believe that Post Partum Psychosis affect us all very differently including the level of poorliness. We are unique, and responsiveness to treatment is very diverse.

Like Hannah and Lilibeth, I was extremely poorly in 2010 and only traditional medication finally helped me to overcome hallucinations. Unfortunately I was secluded when sectioned and treatment was inappropriate...thus recovery took so much longer. I was nursed and looked after by my partner full time once discharged from the mixed psychiatric gender unit.

I can not remember much of the first year as the brain did shut off in order to protect myself...because of the traumatising experience.

I just would like to say from the bottom of my heart your sister needs love and kindness from her family, a support network in order to meet her and the baby's needs. It is important to work together with professionals. Yes, I do believe note keeping about your sister's emotional and physical condition is important...thus running a journal for communication purpose, whereby facts through observations maybe most useful.

My partner always reflected on my situation and spoke to my Psychiatrist at the time every two weeks and supervising my meds and teaching me how to look after myself and gaining more confidence with my baby. In your sister's case of course safeguarding for everybody involved is important, but in my view point children should not be taken away from mums, whether it is an older sibling or the new-born...

I am thinking of you and my heart goes out to your sister and you. I am so pleased you've found this forum. It had helped me a lot with my recovery. We are all survivors and amazing mums. Your sister will recover.

Look after yourself, too.

[Little_jay in reply to Pikorua]

Thank you for the excellent advice on keeping a journal. I’ll definitely try this. Earlier her condition was so miserable that we didn’t think of this. She’s improving now, her psychiatrist switched her to olanzapine. She has shown great improvement in the first week. I really hope she keeps improving. I take her elder son to meet her everyday for 2-3 hours. Her newborn is with her 24 hours now. But under supervision of course.

[Lilybeth Volunteer]

Hello Little_jay

So pleased to hear your sister has shown great improvement. She is very lucky to have your support so that she can see her elder son on a regular basis. It's good that she has her newborn with her under supervision. I'm sure you feel more hopeful that she will recover as we all have even though it took a while. Please remember to take a break for yourself too.

[Little_jay in reply to Lilybeth]

Yes, she has entered into the depression phase now. Where she is least concerned about her children or herself.

[Pikorua Volunteer]

Hello Little_jay,

what a fab sister you are! I am pleased that your sister is improving gradually. It is a very traumatising illness and everything will be in stepping stones.

I am so happy that your sister is not isolated from her older son, you are doing a great job.

I am so grateful to my partner that he brought in pictures of my baby into the psychiatric unit to remind me...on some occasions he came in with the baby...

I do not remember much, but deep down I know it was of great significance for my recovery and healing process.

Your sister will get better.

Thinking of you at such a difficult time.

Take good care of yourself!

[Little_jay in reply to Pikorua]

Thank you for the all support at this time