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Action on Postpartum Psychosis

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Resurgence of PP at menopause and in times of stress?

Sonobana profile image
7 Replies

Hello,

Does Postnatal Psychosis condition commonly re-occur at menopause or in times of stress? We suspect it has in a friend who "isn't herself" and wasn't during menopause. She was diagnosed with PP twice.

What steps to take?

It seems less serious this time around.

Any advice welcome.

Many thanks.

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Sonobana
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7 Replies
Mamma6 profile image
Mamma6

Hello Sonobana

I would advise you to persuade your friend to see her GP to be referred to Mental Health Team.

PPP happened to me during the menopause, but it was a particularly stressful time too.

If your friend seeks help now, it will avoid it getting worse.

Go with her to her GP. Support her with this.

All the best

X

Ellie_at_APP profile image
Ellie_at_APPPartner

Hi Sonobana

Welcome to the forum, it's good you've found us and reached out for some support and information for your friend.

I just wanted to direct you to our frequently asked questions, in regards to whether psychosis can return during menopause or times of stress. More research needs to be done, but what we do know is detailed on our website:

"The long-term outlook after an episode of PP tends to be very good and women recover fully. However, some women who have had PP will have further episodes of illness unrelated to childbirth.

Just over half of women with Postpartum Psychosis will experience an episode of depression, bipolar disorder or related illness at some point in their lifetime. (This estimate includes women with and without experience of mental illness before their PP episode, and so the risk may be lower for women whose PP episode was ‘out of the blue’.) For more information see our research on recurrence rates or view to our survey of recovery in APP members.

It has been suggested that some women who experience PP may be vulnerable to relapse at times of major hormonal fluctuation, such as during the perimenopause (the time from the onset of menopausal symptoms, such as hot flushes and irregular periods, until the menopause itself).

A case series review of post-menopausal women with a history of PP, found that 30% reported an episode of illness (including depression or mania/psychosis) during the perimenopause. Strikingly, most women who relapsed during the perimenopause had been well during the years in between childbirth and the menopause. Further studies are needed to explore this potential risk period more fully and identify which women might be at risk of perimenopausal relapse. Women, their partners and families should be vigilant for signs of relapse during the perimenopause and seek help from their GP or mental health team should symptoms develop. For more information about relapse planning, see page 14 of our Insider Guide on Recovery after PP."

For myself personally I'm aware that I am more at risk of becoming unwell, particularly as you say at times of stress, or in the perimenopausal period so I know I really need to look after myself, and that I would need to seek help if I was feeling unwell.

I do hope your friend can get all the support she needs. And do let her know about our information and peer support, if she'd like to access it for herself.

Take care,

Ellie

Lilybeth profile image
LilybethVolunteer

Hello Sonobana

Thank you for your post on behalf of your friend. I think it would be a good idea if your friend sought advice from her GP, if she hasn't already. I also had PP twice many years ago and it was a very frightening time.

Due to fibroids I had an early menopause. Perhaps APP's frequently asked questions page at app-network.org/what-is-pp/... might be helpful? The last question "Am I likely to have an episode of psychiatric illness at other times" explains in the third and fourth paragraphs :

"It has been suggested that some women who experience PP may be vulnerable to relapse at times of major hormonal fluctuation, such as during the perimenopause (the time from the onset of menopausal symptoms, such as hot flushes and irregular periods, until the menopause itself) .....

A case series review of post-menopausal women with a history of PP, found that 30% reported an episode of illness (including depression or mania/psychosis) during the perimenopause. Strikingly, most women who relapsed during the perimenopause had been well during the years in between childbirth and the menopause. Further studies are needed to explore this potential risk period more fully and identify which women might be at risk of perimenopausal relapse. Women, their partners and families should be vigilant for signs of relapse during the perimenopause and seek help from their GP or mental health team should symptoms develop. For more information about relapse planning, see page 14 of our Insider Guide on Recovery after PP".

A few years ago Radio 4 Woman's Hour highlighted "Postpartum Psychosis and the Menopause" which is still available to listen to.

I hope some of this will be helpful to your friend. Take care.

AndyHenderson profile image
AndyHendersonVolunteer

Agree with Mamma6. After a long period without symptoms (my wife suffered from PP after each of our two children were born), she suffered recurrence of all the same symptoms coming up to menopause.

Obviously hope for the best, but it would be good to be prepared for the worst.

Andy

NanaJudith_APP_Vol profile image
NanaJudith_APP_VolVolunteer

Hi Sonobana,

You have had such great informative replies, I can't really add much. However, I just say that menopause symptoms can be distressing enough for some women without the worry of recurrence of psychosis, so certainly it would be best if your friend sought help and reassurance from her doctor, perhaps a referral to a specialist.

Your friend is fortunate to have such caring, supportive friends.

Best wishes

Judith.

Sonobana profile image
Sonobana

Many thanks all for the considerate replies and pointers to additional material. My question about the menopause was somewhat irrelevant as my friend has already been through that and had, what we considered to be, a milder resurgence of symptoms. However, as far as I know, no official diagnosis was made at that time.

She is suffering stress now and seems to have become unwell, but it could be mild or serious... Unfortunately, she is very unwilling to accept any suggestion of illness (which has been a symptom in the past), and is responding very negatively to suggestions of help.

Not 100% sure what to do!

Lilybeth profile image
LilybethVolunteer

Hello Sonobana

Thank you for your update. It must be difficult for you to know how to encourage your friend to get the help you feel she needs. I'm sorry she has become unwell due to stress and is unwilling to accept any suggestion of illness. I think all you can do is be as supportive as you have been, so that if she becomes too stressed she will know you are there for her as a very caring friend. Take care,

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