Hello
I am jo and am 53. I had my son 28 years ago and had ppp, was sectioned and then spent 6 months in mother and child unit.
I am now menopausal and symptoms are back. I am anxious, have palpitations, depression, paranoia.
Have g p appt next week and am on citalopram with mirena and oestrogen gel.
I am feeling lost and anxious.
The fact that I worked on a covid unit as a nurse throughout lockdown hasn’t helped.
Just wondered if anyone had any tips
Would be really grateful x
Hi Jo I’m sorry to hear that you are having such symptoms again. Your story sounds similar to mine. I had my son 23 years ago, developed PPP and was sectioned and in MBU for 3 months.
I was well for the following 17 years (including after the birth of my twins in 2002).
At 48 and in peri menopause I very rapidly developed extreme anxiety and depression and became very unwell. I remember saying to my mum that I felt as bad as I had after the birth of my first child.
I developed a full psychotic depression and was back in hospital again.
My tips would be:
Your GP is really important in all of this. When you see them tell them that you had PPP and that there is a link for some people between PPP and becoming unwell at menopause (not all of them know this).
Tell people around you and who are close to you how you are feeling. My closest friends were very important to me when I was unwell.
Tell work what you are experiencing. I work in the NHS and my boss and colleagues were very helpful and understanding
Hopefully with the right medication (I was on aripiprazole and venlafaxine) you will make a good recovery without the need for hospital.
But if you do need hospital care then I would recommend making an advanced directive about what you want and need.
It is horrible and I am sorry you are going through this but you will get better. Sometimes it might feel hard to believe that you will but there is light at the end of the tunnel
Best wishes
Hello Jo,
Thank you for posting. There was a post a few weeks ago also about menopause which you might find helpful.
I am 62, my pp was in 1988 so 34 years ago. I just saw my GP last week to talk about the feelings I have been having which are similar to yours. I have just started on a progesterone tablet and one pump of oestrogen. I am keeping a note of how I feel and I have asked my daughters to keep an eye on me! I had two daughters without experiencing pp but my circumstances were very different. So many plans were in place and forewarned was forearmed!
In 2019 I was unwell with my emotions and I was diagnosed hyperthyroidism. I take a medicine now to balance my thyroid! I shared with the consultant my pp and previous experiences. It was a scary time to feel so unwell but once I was diagnosed and put on carbimozole I felt much better.
Between then and now I have had a course of CBT to help with my thought processes. I found it very helpful and it was the endocrinologist who suggested it. I tend to slip into the same thought patterns that I had in 1988 so it has all been a bit of a worry.
I think we live in fear of being ‘back there’ and being in hospital but I think of the fact that we got through it then, and we will again. I have read as much as I can about being post menopausal.
I just finished listening to a book called Cracking the Menopause by Mariella Frostrupp. I found it very helpful and she was very straight forward and honest. We have something called Borrow Box in Hampshire and you can listen to books for free which I prefer now.
For the heart palpitations I have given up coffee. I also have high blood pressure so am doing what I can to deal with that.
I am increasing my exercise with swimming and cycling.
Trying also to eat a healthy diet!!
Talking with close friends has been vital and sharing how I feel with my family has been so helpful. My pp came so out of the blue in 1988 so acknowledging feelings and emotions now feels beneficial.
Again, as with pp we are not alone and it is so good to be able to share with one another.
Do keep us posted with how you get on.
Sending warm wishes and a 🫂
Helen x
Hi
Sorry your symptoms are back.
I suffered PPP 21 years ago and when peri menopause arrived 5 years ago I really struggled with it.
I take HRT and a testosterone gel and CBT has helped me too. I also take collagen and try to exercise as much as can but motivation lacks a lot. The testosterone was the missing bit for me. It’s not licensed for women in UK but if you have a menopause friendly GP they CAN prescribe it if you ask for it. Do your research first so you can confidently ask them for it and don’t let them fob you off! Good luck.
I work in law enforcement and worked through the pandemic too which was exhausting and difficult. It must of been much worse for you working in the NHS.
One thing I have learned is that work stress and menopause symptoms aggravate each other badly and so I do make a conscious effort to try not to get as drawn in at work as my younger self did. Easier said than done I know and I do hide in the loos from time to time!!
Symptoms are a proper moving target I’ve found - so enjoy the good days and be kind to yourself on the bad days.
Lots of love ❤️
Hello Jo,
I’m Jenny, one of the peer support coordinators at APP. Welcome to the forum and thank you for posting 😊
I’m really sorry to read that your symptoms are back with the menopause, and also that you’ve had the additional stress and demands of working on a Covid ward throughout the pandemic. It’s great you’re going to be seeing your GP next week and I hope you find the information and others’ experiences shared here helpful to perhaps support that conversation. Do try and get seen sooner if you’re concerned your symptoms are worsening significantly.
I wanted to share a few links and resources here that might be helpful.
You should be able to see other ‘related posts’ next to yours that are also on the subject of menopause. The recent post that HelenMW referred to can be found here:
healthunlocked.com/app-netw...
The current information from our clinical experts is on the FAQs page of the APP website (app-network.org/what-is-pp/... under ‘Am I likely to have an episode of psychiatric illness at other times?’, as follows:
"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."
The ‘Insider Guide on Recovery after PP’ referred to above can be found here: app-network.org/what-is-pp/...
It might also be helpful to read Val's story on our website, of someone who experienced PP, and then had a relapse during the peri-menopause: app-network.org/news-events...
Lastly, there is a webinar in the series ‘Women and Bipolar’ on the Bipolar UK site which summarises the current research situation and offers valuable advice regarding HRT from a specialist GP (third webinar on the page – ‘menopause for women with bipolar’): bipolaruk.org/blog/women-an...
I hope this is helpful, and that you have a positive consultation with your GP next week.
Take good care and as you'll already see from others' replies here, you're not alone.
Best wishes,
Jenny x
Thank you JennyThat is all so helpful.
I will look into it.
Having a really really bad day and finding it difficult to do anything.
Being on here makes you feel less alone especially as when I had my baby there was no a lot at all about for us.
So glad things are getting
better x
Thank you Jo, I'm really glad you found the forum 
I do hope things start to feel better soon, look after yourself and do reach out to your GP if needed. We're all here to listen so do write anytime x
Dear Jo
It is good that we are all talking about the perimenopause and the menopause, more research needs to be done for women who have experienced PP. I only had one child, it will be 30 years ago and I'm 51. I was advised not to have any further children and to "watch out for the menopause" by two GPs. It has felt like a ticking time bomb since that time with no sense of what the plan would look like when I reached the perimenopause. 18 months ago I posted on here as I had to make a decision on whether to have a hysterectomy. I knew it was a risk that the surgery itself even if I kept my ovaries could cause me to launch me into the menopause by the shock to my body. The most important thing I did was to find a doctor specialising in the menopause and luckily for me I was advised about a private GP from my gynaecologist. She used to run a menopause clinic for the NHS before the NHS pulled the funding (what is the NHS thinking, it wouldn't happen if we were dealing with erectile dysfunction - I watched the bipolar and the menopause webinar which was enlightening into the dominance of research into erectile dysfunction compared to the perimenopause and the menopause). Anyway, I now have my safety net plan which is helping me through this fearful time instilled by those GPs and thoroughly recommend it for piece of mind. I was happy to pay £250 for an hour initial appointment to see a specialist in this area and she wasn't freaked out with my gynaecological history, hormonal problems and PP and we got a plan together for the surgery and beyond. The GPs in my practice are great, they take her advice and prescribe what I need, although they don't have to. She was referred to as the queen in terms of her knowledge of the menopause by one doctor in the practice. I am doing well and keep the 6 monthly appointments of £130 and will do so until I'm safely through the menopause. I had remote video appointments and whilst I shouldn't probably give you her details, if you are not going to get any joy from GPs who may feel out their depth the gynaecologists referring you to a specialist clinic (they are few and far between) or being referred to the Maudsley's Hormone Clinic, then one option may be to give Dr Sarah Gray at St Erme Medical a ring. There is a 3 month wait for her though but she could point you in the direction of someone more local to your area who specialises in this area.
I had PPP 27 years ago, sent to a general psychiatric hospital, where treatment and care was a traumatic experience .. I then went to a private clinic with baby care was caring and more focused on my needs... I had been told by the social worker I would get PPP again at menopause.. so when the years went past, I became more and more anxious.. because of the treatment I was to afraid to ask anyone fear of the treatment, unbeknown to me I had just locked the trauma away... til I just broke down to my doctor...so he helped me.. I got accessed no psychosis, but had trauma from the past.. so on venlafaxine and had medication to help with the very heavy periods... am getting there and I think the antidepressants helped with the symptoms on menopause. I would say when you see your gp tell them about the PPP and your fears that things could come back. I am having treatment for PTSD from the whole experience, there was birth trauma, trauma from being unwell, I am beginning to come to terms with things .. finding here I realised I wasn't alone, as when told it was rare I thought I was the only one.. the help back in the day was none existent for me.. but on the right path, so glad I have my gp who had trained in mental health, plus has seen 2 cases before... I think he probably safe me from going in to a very dark place.
Hi all,
I just wanted to add some further links to this thread that I couldn’t add before as the NCMH website was down…
There is a second opinion psychiatry service that might be helpful for anyone who is peri-menopausal and struggling to access specialist psychiatric support. The National Centre for Mental Health (NCMH) offer the service for free, though you need to be referred by your GP or mental health team. Prof Arianna di Florio is the clinician conducting research into this area, and is able to advise women with a history of PP, and who are peri-menopausal and want some specialist advice. If you scroll down the webpage here, you will see her name, and some information about her: ncmh.info/resources/cups/
Also, Prof Di Florio is leading two projects due to start this year. The research web pages of the NCMH website can be accessed below, which includes access to the recently launched ‘MAM’ (mums and mental health) research study: ncmh.info/help-with-researc... - do have a look and get involved if you can
NCMH ‘Help with Research’ page: ncmh.info/help-with-research/
Best wishes,
Jenny
PP in the menopause ?
perimenopausal psychosis
Second episode olanzapine resistance 
Advice re care plan/preventative medication for 2nd baby following PP
PTSD
