Going back to work: I have a family... - Action on Postpar...

Action on Postpartum Psychosis

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Going back to work

Illberidingshotgun
Illberidingshotgun

I have a family member who has been through a lot this year, with postpartum psychosis and severe depression. They are worried about being made to go back to work before they are ready, and that if they are never ready, that they will be made homeless. No matter how much reassurance we give, it doesn’t seem to register at all. Does anyone have any suggestions or advice please? They are no longer experiencing psychosis but is still depressed and doesn’t like to leave the house anymore or be around other people.

Thanks in advance

16 Replies
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Jocelyn_at_APP
Jocelyn_at_APPAdministrator

Hi Illberidingshotgun,

Thank you for getting in touch with us on the forum.

I remember going back to work after I had PP. I was in Brazil at the time and unfortunately you only get 4 months maternity leave there!

I think that if you have a really supportive employee that your family member can be open and honest with about expectations, that is really helpful. How is your family member's employee? Could there be a possibility of a phased return?

Mind has some good resources here, that might be useful:

mind.org.uk/information-sup...

I hope that helps a little bit.

We are here for you!

Thank you for your reply. They were due to return in September as they work in a school, but were signed off until December with the hope to return in January. However they are still not ready to return to work and it’s unlikely that’s going to change in the next month. They want her to come back, so hopefully a phased return will be an option. Thank you so much for sharing the link too 🥰

Dear lllberidingshotgun,welcome to the forum, you will find lots of mums here bravely sharing their experiences. My daughter suffered with the awful trauma of postpartum psychosis and thankfully was able to take a year before returning to work. I am so sorry that you have a family member who has suffered with PP and subsequent depression. I wonder how long ago did your relative have her baby and if she is still under the perinatel mental health team, sadly at the moment after a year it normally changes to general mental health team. Is it worth asking if they could suggest something. Perhaps the health team could help her to establish a phased return to work, as Jocelyn suggested. I do hope that she has an understanding employer which would obviously make all the difference.

Your relative is fortunate to have you caring about her and it will help her

confidence to know she has your support.

Best wishes

Judith x

Thank you for your lovely response. She had her baby in September 2019 and she is still under the perinatal team, though it looks like they are soon going to discharge her, so she will be under community mental health team, which haven’t been very good at all so far. We have raised our concerns about how much she is overthinking it as it is causing her a great deal of anxiety and no amount of reassurance seems to be helping her. She is just so fixated on being made homeless. Yes perhaps we could get them to speak to her employer so that they can arrange something a little more flexible. Thank you 😊

Hello Illberidingshotgun,I am sorry to hear about your family member suffering from pp and depression after that.

I can imagine that the prospect of restarting work can be quite stressful after the big trauma that pp is, and how debilitating the depression that follows it is.

Jocelyn and Judith have already given good advice about having a chat with the employer if you think they will be understanding of the situation, and arrange a return part time first so as to ease into the job, this is not unheard of for any mum returning after mat leave. If she is still under a perinatal mental health team she may have access to ocupational therapists that could guide her on how to approach the subject of mental health with her employer and her rights as an employee.

I hope your family member finds good support at work and home to be able to balance work and family.

Take care

Hi EmiMum, thank you for your reply. She does have access to an occupation therapist already, but she won’t even listen to their reassurance, it’s just a massive anxiety thing for her at the moment. I don’t know how we can get through to her that she won’t be made homeless. Thank you for your suggestions 😊

Hi Illberidingshotgun,I am sorry that things are difficult at the moment for your family member. Anxiety can snowball to the point of getting on edge about the most everyday things. I remember my first time in the underground after pp like a nightmare, I overheard every conversation in the carriage and was convinced they were all taking about me, I told my husband that I had been "outed" whatever that meant, and it took a lot of willpower to make it to the next stop. Big crowds and people rushing around was a trigger for me, but also evenings and feeling suddenly left alone.

Would your family's member job allow her to work from home with the current restrictions or would she need to travel? Does she have access to a counselling service? CBT can be very helpful in treating anxiety. Her perinatal team can make the referral for her, but there is also self referral services through the borough.

I hope she feels better soon, pp is a big trauma and we need time to recover from it

She works in a school so is unable to work from home unfortunately, just wish we could give her a confidence boost so that she feels comfortable with even stepping back into a workplace. Postpartum psychosis is a horrendous condition, people just don’t realise how much it affects that person afterwards as well as during. She has psychology but not counselling so maybe that’s something we can try and arrange. I know that there are lengthily waiting lists but hopefully the perinatal team can arrange something. Thank you x

Trying to work the subject of anxiety with her psychologist may help, there are some techniques like mindfulness or relaxation that could be beneficial, is not really a one size fits all, but rather trial and error and see if there is something that resonates with her. Perhaps she has tried them all by now.

Others have already given excellent advice on other avenues to explore, discussing with her employer, getting notes from her medical team or GP, maybe a prescription to help overcome that first hurdle of stepping back into the workplace.

I remember my worst fear after pp was thinking I would not be able to go back to the person I used to be, it takes time and recovery is very up and down, but it does happen. I wish you both well in the next few months and that a phased return can be arranged with her school.

Take care

Frankieb
FrankiebVolunteer

Hello, sorry to hear this. It sounds as if she may also be suffering from extreme anxiety, I found this happened to me when in severe depression too.

It can blow all rational thought out of the window and cause you to fixate on things.

Can she talk to her GP or mental health contact, they may be able to offer clearer advice or possibly prescribe something to help ease this.

It's a common thought that it will never get better, that life will not resume, I can promise that it will get better, unfortunately it takes time.

I've had PP twice and recovered, I now have bipolar. I manage to lead a happy normal life but remember the struggle to get well.

As others have said, speak to the employer, explain ahead of time if possible.

I wish her all the best

Does she come on here? Might it be helpful?

We also offer a 1 to 1 message service if she does not want to speak on the open forum

Take care

X

Hi there,

I’m sorry that your family member went through this. As others have said, it does sound like she is still suffering from anxiety alongside the depression.

It also sounds like she isn’t ready to return to work yet. Could this be discussed with her mental health team, along with treatments for the anxiety & depression. I appreciate there will be financial considerations too, which it sounds like are on her mind too. As others have said, good to speak to the employer...perhaps they have an occupational health contact?

I returned to work after a year off with PP, and in retrospect, wish I had taken a few more months off, as I wasn’t really ready....but it was difficult for me to get perspective at the time.

Your family member will feel better with time. It can be a long process. It’s great that they have your support.

Take care,

X

Hi

I agree with keeping in touch with her employer and discussing the situation fully. If they are left in limbo, they may think she might never return and might start to question whether they can hold her job open indefinitely.

Has she thought of requesting a sabbatical from work? It is stressful being on long term sick leave with the worry of feeling constant pressure to return and the uncertainty that creates. A fixed term sabbatical might give her the breathing space she needs, and also give her the security that her job is protected and reassure HR that she does want to return at some point. The current uncertainty for her will undoubtably be making her recovery harder.

I don’t know what her local authority policy is or what her role in school is, but she could discuss what options she might have for maybe being allowed to do some volunteer work somewhere else as part of her recovery if and when she’s ready, and what type of things would be allowed while in sabbatical. Maybe they might allow her to seek temporary paid work in a different job should she be up to it during her recovery. If there are things that can help her to work towards getting back to her normal job, then they might support it.

She could then consider returning part time or a phased return at the end of the sabbatical.

If she’s not got a sympathetic Head Teacher, maybe she could speak to her Union first to see if they could advise her on her options.

Please pass on to her that there are people who completely understand what she’s feeling as they’ve been there. Things can and will get better. I was often advised to be kind to myself, and it’s very true. She has been through something completely overwhelming that was not her fault-she’s been ill. She needs time to heal and to process what she went through.

Lilybeth
LilybethVolunteer

Hello Illberidingshotgun

I’m sorry this is such a worry for your family. You have already had some good replies and I’ve not much to add. I have to say your family member has been through so much. Although the psychosis has faded, dealing with severe depression is very draining, feeling helpless and hopeless from one day to the next, which is how I felt.

Many years ago due to other life events after PP and depression, when I eventually returned to work I suffered from work related stress. My GP was very helpful at the time and for months he decided that I was unfit to return and issued notes for my employer. Do you think your family member’s care team or GP could issue something similar so that she won’t feel pressured to return?

I also found Citizens Advice Bureau helpful for any worries I had. Due to Covid 19 there are differences in how the operate but they are still offering links to their helpful advice and phone lines.

I was also in turmoil about my home and taking over a mortgage. I had many sleepless nights and made a appointment with the lender. After explaining my circumstances it was agreed that I could stay in my home with my sons and pay the interest portion of the mortgage only. I’m not sure if this would be offered today but it did make things easier, as although I didn’t pay much off the amount owing we had a place to call home.

I think all you can do is reassure her that you are with her every step of the way until she feels ready and safe to make any choices. It is an awful experience .... overcoming psychosis is a milestone in recovery so she has been amazing and with your loving support she will find her place again. Take care.

Your response has been really helpful, thank you! Didn’t even think about citizens advice, that’s a really good idea. Thank you 😊

Lilybeth
LilybethVolunteer

Thank you, that’s good to hear. During my contact with citizens advice there was also a Solicitor to talk to, free of charge, so that was very helpful for me. Take care :)

Ellie_at_APP
Ellie_at_APPAdministrator

Hi Illberidingshotgun (love your user name - and the song :) )

It's great you've found us, and you've already got lots of great replies already. I had PP in 2011 after the birth of my son, and returned to work 9 months afterwards when I was still in the middle of depression and anxiety after experiencing PP.

I'm probably going to repeat what others have said.

I remember very well, in the midst of depression, focusing on something very negative that might happen, and becoming obsessed with it almost, which sounds similar to your relative. As others have said it sounds like she's definitely experiencing anxiety. I found that the 'fantasy' was often worse than the reality.

There were a couple of things that really helped me in returning to work. Firstly my care coordinator / CPN met with my supervisor, separately I think as well as with me. They explained fully what had happened, and what PP was and what kind of support they thought I might need, and what mental health support I had around me too. I'm not sure what kind of support and relationships your relative has at work, and what their supervisor is like? I was very lucky that I had a really supportive supervisor, who was very reassuring, and told me there'd be no expectations of me when I came back, and I could take it slowly, but that he firmly believed that I would get better fully in time.

I also worked with my psychologist who helped me to plan about things that I was worried about. E.g. I remember when I had to have my first meeting supervising someone, which I was getting very worried and anxious about, and she just helped me to think through what I needed to do, and made a plan. I found going back to work initially hard, and there were some days I felt very emotional and thought I'd never be able to do my job again, but I think going back was good for me. I found I slowly built up my confidence and got better, but that was because I had a very supportive supervisor who didn't put any pressure on me.

I also agree with others suggestions too. I wonder if you relative could go into work for some 'keeping in touch' days, so literally just to visit, and not to 'work', to ease in slowly? It might increase a confidence in going back. And when she does go back, to ask for a staggered easy start?

I also wondered if you relative would be interested in accessing our peer support as well? We could link her with one of our peer support volunteers for one to one support ? Our peer support page is here where she can request support: app-network.org/peer-support/

It made such a massive difference to me to realise my anxieties etc were normal for having experienced PP and I wasn't alone with all the feelings I had.

Take care, and I really hope your relative can get all the support she needs,

Ellie

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