Relapse question: Hi everyone, hope all... - Action on Postpar...

Action on Postpartum Psychosis
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LovinHubby
LovinHubby
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Hi everyone, hope all is well.

My wife has been doing great and medication free for 5 months and is roughly 11 months removed from her initial psychosis. This past Saturday she had a manic episode that was pretty traumatic, mainly triggered by excessive alcohol consumption (is my assumption). She did not go to the hospital and the next day, seemingly when the alcohol wore off and she took a few good naps, she seemed much better. After a good night sleep, she went to work the next day and has some heightened anxiety and minor paranoia. She got through the day by using a lot of good coping mechanisms she learned from therapy but is concerned about what she is going through. The anxiety is something we have dealt with in the past, but its these small bouts of paranoia and questioning reality that is a concern for both of us. She has not had any other relapses since her first manic episode 11 months ago and has been doing great and completely back to normal since she has been off the medication (olanzapine), we've just dealt with the bouts of anxiety and depression. My question is, has anyone had a relapse once off the medication? If so, did you just let time take it's course and see if it got better or did you go back on the medication? Olanzapine was a life saver and a nightmare. We are really hoping to avoid that all together. Again, she is functioning at work and at home. We are 3 days removed from the episode, she is just having these moments throughout the days that we are concerned about and don't want it to turn into something more serious. Some, she can control real easy and others she needs to really take a step back and try and get a grip back on reality. I can't wait to hear from some of you

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lillyofthevalley37

My husband refused to take Olanzapine after being on it for 10 years for the sake of me and our two children he was like a zombie on it and I knew it wasn't fair to continue

The problem was what to do if when he got high.

Alcohol can often trigger mania

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Sally_at_APP
Sally_at_APPAdministrator

Hi LovinHubby,

It is nice to hear from you and that your wife has been well for the last few months without medication.

I am sorry to hear that she had a manic episode this weekend, it must have been quite traumatic for you, especially as she has been well for a long time since her first episode.

I had postpartum psychosis in 2015 and I was on Olanzapine. I came off medication gradually and I have stayed well since then. As I was recovering, I did have periods where I still questioned reality sometimes, although nothing quite like when I had the psychosis. I felt like it was a bit of a sliding scale and when I had disturbed sleep or felt a bit stressed, then things did feel worse. For me, when this happened, I felt a bit surreal and paranoid sometimes, but nothing like when I was ill with psychosis. However, I probably wouldn’t call this a relapse, more a bit of a roller-coaster of recovery if that makes sense.

You say she didn’t go to hospital, but did you speak to anyone else about what happened at the weekend? I can understand you wanting to avoid going back on medication as it sounds like the side effects were really hard for your wife last time. However, it might help to talk to someone who has been involved with your wife’s care, to talk through your worries, especially as you are concerned in case it turns into something more serious.

I know some women on the forum who have had relapses after their initial episode, so they may be able to offer you some more insight and might help you with your questions.

I hope things go ok over the next few days and things settle after the weekend.

Take care and we are thinking of you,

Sally x

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LovinHubby

Hi Sally

The way you describe the surreal or paranoid moments is very much like what my wife is going through. At any moment, a simple conversation that she is having with someone could trigger that moment. She misinterpreted a text message from my sister that led her to believe that people thought she was faking this whole thing and then she immediately wondered if she really was faking it. Literally after a few seconds, she calmed herself down, realized it was not what she perceived it to be. These have happened maybe just 2 to 3 times a day at any random moment, but she catches herself, takes the proper steps to breath and calm down and is rationally able to articulate the situation.

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Hannah_at_APP
Hannah_at_APPAdministrator

Hi LovinHubby, good to hear your update but I'm sorry to hear your wife had a manic episode at the weekend. I've not experienced relapse myself to share I'm afraid but I know that this is something I am aware of and try to be careful around my mood, sleep, rest, lifestyle and other areas - it's really positive to hear that your wife has been able to use some of the techniques she has learned, together with rest and sleep to get back to functioning as you describe. In terms of anxiety, I also experienced this in my recovery from PP and like your wife and others here, also found Olanzapine to be a really effective medication, which I took for almost a year. Is your wife able to talk to a healthcare professional and discuss her concerns? I don't know if she is still with a perinatal team or mental health team, or can talk to a health visitor or GP? Perhaps it's something you can also support her with, it is wonderful that you are beside her and supporting in her ongoing recovery. I'm sure it's been shared before but there is also some info and tips in the APP Insider Guide on Recovery: app-network.org/wp-content/...

Take care, again it's so wonderful that you are there to support your wife - I am sure she appreciates it more than you will know. xx

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Lilybeth
LilybethVolunteer

Hello LovinHubby

I'm sorry to hear your wife had a worrying episode a few days ago.

I didn't take Olanzapine but during my recovery years ago I did relapse. I was trying to restrict my medications ..... I thought I was doing well and didn't need so much. This was a bad idea on my part as I went downhill very quickly, almost back to square one. It frightened me so much and I can understand your concern. Reading from my notes at the time I assured my Psychiatrist that I wouldn't do it again and thankfully recovered, apart from depression which followed.

I'm sure it's a great comfort to your wife that you are so supportive. I think you could ring your GP for advice and ask if he could call you back, just to put your mind at rest? Perhaps the episode was triggered by some sort of anxiety since you mentioned in your other post that your wife has returned to work? Take care and look after yourself too.

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LovinHubby

Thank you for the responses. Unfortunately, the mental health system in our country is so poor, that reaching out for immediate help is almost impossible. She did manage to get in to see her therapist today, but was told that her psychiatrist wouldn't be available till the end of December and was only offered a PHP program or a once a month Post Partum help group. Again, compared to our first experience, this is much more minor and she and I are responding to it much better. She is able to control most of the heightened anxious triggers and is sleeping pretty well at night. She said that her most anxious and panicky times are when something, and it could be anything, triggers her and she thinks that she doesn't have control. She then takes her CBT techniques and can bring herself back to reality pretty quickly. She had a moment yesterday at work that reached a pretty extreme height and she couldn't really calm herself down until talking to me, once she did, she calmed down and was able to gather her thoughts. Her situation is such a mystery to me considering she was doing so well, off the medication, for so long. I don't know if it was the perfect storm of stress about the holidays and our sons birthday, mixed with the excessive alcohol consumption and the being the first time really being away from me and my son for the weekend. Her moments of heighted anxiety she explains are like losing control or feels like everything that is happening is happening for a much deeper meaning. The moments are very short and controlled.

I know playing a guessing game can be a messy situation but of course we can't help to think that if she was home, not under the influence of alcohol (we do drink, just this was excessive) would the episode have happened. And, is what she going through now a continuation of he episode or her brains response to what happened. Once of the nurses called and told her that the psychiatrist recommended going back on Olanzapine, 2.5mg, but my wife is just not comfortable doing that without explaining the situation directly to the doctor. She is not against medication, just not sure if an antipsychotic is right for this moment.

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Anna_10

Hi LovinHubby,

So sorry to hear about your wife.

I had ppp in 2013 and was on setraline and olanzapine. I was in hosp for 1 month and slowly came off all meds after 2 yrs. I was back to normal and felt well until summer this yr. I've now found out, I started the menopause early and hormone changes can trigger ppp again. I had a really bad patch through the summer, when I couldn't stop crying, felt detached from reality and unable to do a lot. I felt so depressed and suffered extreme anxiety. I went to my g.p and she put be back on sertraline, anti depressent. My g.p wanted me to take another anti psychotic, but I asked for sertraline again, as I felt it was more of a depressive phase than psycotic. I'm still on it and so glad I am. It has really helped me through a bad patch. I was so scared it was all coming back. I'm not sure if this is similar to your wife, but I just thought your story sounded similar to mine. I hope your wife is ok. Kind regards Anna

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Lilybeth
LilybethVolunteer

Hello LovinHubby

I'm sorry to hear the mental health system in your country is poor. I wonder if support from Postpartum Support International might be helpful, the link being postpartum.net/? Under 'Get Help' you will find a link to International Support and also a link to Postpartum Psychosis Help. You are very welcome here but might find help locally as they have support for dads too.

I think your wife has done very well to return to full time work. Is it possible that she could perhaps do a less stressful job in the company until she feels more confident in her role? Or even consider a less stressful job, which is something I did after recovering and felt much better. I'm sure your wife feels so supported by you and I hope in time her regular therapy and CBT techniques will make a difference until she can see the Psychiatrist next month.

Best wishes to you and your family.

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Pikorua
PikoruaVolunteer

Hello LovinHubby,

I am always cautious with regards to commenting on PPP cases as we just know a small slice of the events from an overall traumatising experience. The after effects throughout recovery is extremely diverse when you read about those case studies on this forum.

Of course I am convinced that professional support is absolutely vital in order to move on with the recovery process. My hospital stay was a very negative experience and my partner had to pick up the pieces looking after me full time/part time.

My struggles continued and triggers kept with me, especially when stressors were exceptionally high and here we are talking mayor events such as loosing my dad and mum in law short after PPP.

Eventually after 8 yrs an underlying undiagnosed chronical condition was identified as BP1 by a Professor at Cardiff University (recommended via APP).

A loving and supporting environment and your kindness will get your wife back on her feet.

PPP is a serious illness and in my opinion one has to take it in stepping stones-work can be rather stressful. I like Lilybeth suggestions. I was unable to go back to work, but through my volunteering in-put in mental health and art work, my level of confidence gradually had improved.

Therapeutic avenues have helped me throughout the years including group therapy.

I attend yoga classes and meditate regularly. Reiki sessions were of great help, but exercising in general helps a lot such as enjoying nature walks and swimming.

Wishing you well, look after yourself, too.

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