Psychosis during pregnancy

[Summerflowers44]

Hi ladies,

I just wanted to ask if anyone has had psychosis during their pregnancy rather than, or as well as after birth ? I’m currently pregnant with my 2nd and had ppp with my first 13 years ago. I Spoke to my perinatal mental health nurse, and she mentioned starting olanzapine during pregnancy if symptoms started earlier - I guess I’d never thought that was something that could happen and always thought it would start after the birth. I’m now feeling even more worried.

thanks x

[Lilly53 Volunteer]

Hi Summerflowers44

Sorry to hear you’re feeling worried but I think it’s really good to hear you’re already in touch with your perinatal mental health nurse.

Everyone’s experience can be so different but your question really resonated with me.

My first episode of PP happened 11 years ago when awareness of the illness was fairly poor. My symptoms started in my third trimester not after birth as is more common and no one even knew what was going on in my head. It was an horrendous and confusing time.

I have no experience of medication though and others will hopefully comment on that.

I was experiencing a lot of work stress at the time of that first pregnancy, my mood was lowering and I wasn’t sleeping at all. Plus I’d been assessed as a high risk pregnancy due to a fibrous lump in my womb. Although the latter caused absolutely no problems in the end, the consultant said worse case scenario I might die in labour….which in hindsight I think played on my mind a lot!!

I got PP again with my second son. But that time was 10 days after birth and an all together better experience. My family now recognised I was getting ill again (as did I) and I accessed 1-1 support at home from a psychiatric nurse. But I must say one of my symptoms was not trusting family. So a key part of my getting help was them all very gently asking me questions and that part of me that wanted to get better to keep talking! Do you have wider family or social support I wonder? They know us best and can spot the signs. My signs were apparently asking lots of philosophical questions, getting mood swings and having very ‘stary eyes’.

It’s understandable you feel worried but I think being in touch with health professionals already is such a positive step. Hopefully they (and other comments on here) can provide you with reassurance of how best to proceed. None of us can predict the future but I think getting all the advice you can at this stage is a great step.

I think you must be very strong to have got through PP before and I send you love and best wishes for this pregnancy.

xxx

[Summerflowers44 in reply to Lilly53]

Hi Lilly53, thanks for your reply one of my symptoms also was not trusting my family, thought they were always whispering about me- which to be fair they probably were, because they were so worried and trying to figure out what was wrong with me. It will be my partner and my mum as my support system, it’s a lot of pressure on them so I do worry and feel bad for them . x

[Maria_at_APP Moderator]

Hi Summerflowers44,

I took olanzapine during my second pregnancy around week 36. I started it at a low dose and increased it after the birth. From other's stories in the forum, many mums take olanzapine in the last weeks of pregnancy when at high risk of pp. Also, olanzapine takes some time to build up in our bodies, so it makes sense to ged tocam it, as babies can come a bit earlier than 40 weeks.

On hindsight, I did have some small mania in the last weeks of pregnancy with my first baby, before developing pp after the birth. I felt I could deal with any problem on the way, so confident, I was talking fast too and of course the sleeping is not great when we are so big, so I did not remark on it. It was by far not the psychosis I experienced after having my baby. That was my personal experience, we are all uninque in our journeys.

I am very glad you are under the perinatal mental health nurse and you will be followed closely by the perinatal team. For me it was a very different experience second titme around to have all this support around me, I knew early warning signs will be picked up quickly and acted on.

Do take good care, let us know how things are going for you, and reach out to your team for anything you think may benefit you, counselling, group therapy, they are there to help you.

[DaniellaCharlotte]

Hi Summerflowers44,

I had ppp in 2020 (not during pregnancy) and I was put on Olanzapine 50mg which I'm still on now, but now 2.5mg. I spoke to a specialist mental health nurse about future pregnancies and they said they will put me on 5/10mg when I plan to have another. They said I won't necessarily have ppp during pregnancy or after birth, however it's a precaution and want to prevent ppp, even though I may not have ppp next time.

In my case, I still rely on a small dose of olanzapine, eventhough its not clinically a dose to treat ppp.

Hope this helps.

Daniella

[Zebunisa_at_APP Moderator]

Hi Summerflowers44 ,

Thank you for reaching out to us.. and Congratulations on your second pregnancy!

Second time round can be daunting I can imagine especially after having PP the first time. I know when/if I do have a baby the second time I will try to prepare mentally for it. I think this is the best thing to do: prepare for postpartum and generally.

Here’s a useful guide which APP has called planning pregnancy and on Page 8 it says details about medication, pregnancy and postpartum psychosis. I hope this helps

app-network.org/wp-content/...