Postpartum psychosis

[NMG1991]

Hi all, hope you're well. May I please ask if anyone has had postpartum psychosis and gone on to have more Children? What was it like? Did you have support from medical professionals and if so from what point in the pregnancy? Did you get PPP again with a second, third etc? I really would like another Baby but I am petrified of becoming ill again and it not only impacting me but more importantly impacting my Family. I think I have PTSD from the experience. Genuinely one of the scariest things I've ever gone though. Thank you for taking the time to respond, I appreciate it ❤️ x

[RachelK_at_APP Moderator]

hi NMG1991,

I had pp with my daughter back in 2016, I went on to have a son in 2020, I did not get pp this time,

Yes I had lots of support when planning and having my second child. I saw a perinatal doctor when planning a second pregnancy who went through what would happen if I were to get pregnant.

What the doctor said would happen and what actually happened were two different things due to Covid/lockdowns.

I was seen (on video call) a couple of times by the perinatal doctor through my pregnancy. I was allocated a perinatal nurse as my care coordinator who did visit me at the end of my pregnancy and in the postnatal period. I had two allocated midwives as I’d opted for a home birth. They came daily for the first two weeks after having my son.

I had counselling for ptsd after what happened in the hospital back in 2016- I was on a mixed mental health ward not a mbu. So I understand your reservations in choosing to have another child.

I used the 1:1 peer support service throughout my pregnancy (through app) so consider using that.

I’m glad you’ve posted on here, this is a great forum for others’ stories and advice.

Take care

RK

[NMG1991 in reply to RachelK_at_APP]

Hi, thank you so much for your reply.

Thank you for sharing your experience of what would happen should I have another Baby and what support would be in place.

So sorry to hear what you went through with your first baby. So glad to hear you didn't get PP with your second - that's really good news.

May I ask why you weren't placed in a ln MBU as opposed to a mixed mental health ward? That must have been terrifying.

May I also ask if you were placed on any medication such as Olanzapine as a preventative during your second pregnancy or post birth?

May I also ask how long you were medicated for? I have been on Olanzapine for two years and I'm scared to come off but I'm going to 5mg from 7.5mg after Christmas to try and slowly wean off it.

May I also ask whether you got counselling through your Doctor or another avenue?

Thank you again, TC x

[RachelK_at_APP Moderator in reply to NMG1991]

Hi

Back in 2016 I was placed in a mixed mental health ward, they did mention an mbu but said it was difficult to get a bed on one and the midwife for my second pregnancy said ‘she didn’t think they tried hard enough’

It was very scary and traumatic to be there and I hope no one has to go through that.

Yes I was placed on olanzapine. I had already been weaned off olanzapine before I got pregnant. (Stopped fully around 15 months after starting)

I was given three options

1. Take a low dose of olanzapine towards the end of my pregnancy and after giving birth.

2. Take a low dose of olanzapine after I gave birth.

3. Take no medication and see what happens.

I opted for option 2, it worked best for me.

Your doctors will be able to advise on the options for you. I then took olanzapine for around 11 weeks but as I’d had no symptoms I stopped after that.

The counselling I got was through the nhs my doctors arranged it for me.

How does your partner feel about a second baby? I know with my husband it really affected him too.

Take care

RK

[NMG1991 in reply to RachelK_at_APP]

That's so sad they didn't try hard enough for you - I think this would have meant your experience would have been that bit easier on you at a time where you likely felt you had the world on your shoulders. My friend had postpartum psychosis and I met her in the MBU. Prior to the MBU she was admitted to a general mental health ward and she, like you, had a really bad experience - so much so that I've advised her to make an official complaint - she was treated so badly. The MBU I was admitted to was amazing - they had a very kind and understanding approach although I was still petrified. I'm so sorry that you were taken away from your Baby, that's the last thing you need when going through such a scary experience - you need to be kept together.

How did you stop Olanzapine? I want to stop but I know that you need to do it safely. I've tried to wean off once before and I wasn't able to sleep at all and got scared I would get ill again form the lack of sleep so I went back on them. Did you sleep ok? I also had no appetite but I was able to force myself to eat.

That's what I've been advised, to take a low dose should I go ahead with another Baby. So glad to hear that option worked for you ❤️.

I will try and get counselling through my GP, I think that would help as the illness has scared me so much. I just can't comprehend how your brain can go from being ok to so confused and reality not necessarily being reality anymore.

My Partner is scared, my family all are to who were there with me during my illness. How did you get your husband to come around? Did it take a lot of reassurance from your side?

Take care x

[Jenny_at_APP Partner]

Hello NMG1991,

Welcome to the forum and thank you for reaching out

I’m one of the national peer support coordinators at Action on Postpartum Psychosis (APP), I wanted to share my experience with you and also let you know about the information we can offer.

I’m so sorry you experienced PP after your first baby, it’s such an awful thing to go through. I had PP after my first son was born back in 2012. I went on to have a second son in 2016 and didn’t experience PP the second time. We always planned to have more than one child but it took a while to decide whether to try for a second after having such an unexpected and frightening experience after the first, I know it’s not an easy decision and different for everyone.

For me, it was a very different experience knowing the risk of PP was there. I got a lot of information and support via APP - we accessed the second opinion psychiatry service at Cardiff as there wasn’t a perinatal mental health team in my area at the time and discussed the risks and options. I think there are perinatal mental health teams in all areas of England now and your GP could refer you for preconception counselling to discuss your options in this way. I was then under consultant-led care antenatally and saw a mental health specialist nurse later in my pregnancy who helped me to plan and ensure everyone involved in my care was aware of my risk of PP. Again with there being perinatal mental health teams you would get a lot of support if you did decide to go ahead with another pregnancy.

APP has an insider guide for women planning a pregnancy who are at high risk of PP, I found this very helpful as well as reading about others’ experiences and planning here on the forum. The insider guide can be downloaded from APP’s website here: app-network.org/postpartum-...

If you’d be interested in accessing 1:1 peer support now or at any point in the future, do get in touch. You can read more about this here: app-network.org/get-help/pe...

PP is such a traumatic thing to go through. I’m really glad you’ve found the forum and hope you find the shared experiences here really helpful

Best wishes,

Jenny x

[NMG1991 in reply to Jenny_at_APP]

Hi Jenny,

Thank you so much for reaching out. So sorry that you too went through postpartum psychosis, it is such a scary thing to experience.

I'm so glad to hear you went on to have a second and didn't experience pp with your second baby. May I ask if you were on medication as a preventative measure or did you go ahead without any medication?

It's definitely not an easy decision having a second baby remembering what you went through the first time around. I envy friends who make that decision so easily as they didn't suffer with their mental health during or after pregnancy - I'm so glad they didn't though ❤️.

Not having a perinatal team must have been hard on you all but I'm glad you found other support networks to lean on - I imagine you definitely needed that support.

Thank you for the information you've kindly linked, I will take a look.

May I also please know how long you were on medication with your first and how you weaned off it? That's something I've also struggled with. I've been on Olanzapine for two years and have tried to wean off once before and I couldn't sleep and had no appetite and I went back on them as I was scared with these two things I was going to get ill again.

Take care x

[Jenny_at_APP Partner in reply to NMG1991]

Hi,

I chose to take a low dose of anti psychotic medication (quetiapine) after the birth second time and stayed on it for 6 months. My PP started about 3 weeks after birth and I was told it would likely follow a similar pattern if I had a recurrence so I felt that if I took a ‘watch and wait’ approach it would be a really anxious 3 weeks so I started it after coming home from the hospital. I know some women start medication in late pregnancy and I’d have considered that if my PP had started straight away after birth. This would all be discussed with you though so you can make an informed decision that you’re comfortable with, if you decided to go ahead.

When I had PP I was on quetiapine for 12 months and then weaned off over 3 months, so 15 months in total. I know it can be a difficult process and I think weaning off very gradually over a longer period of time can help with any side effects but it’s something to do under medical supervision and when you feel ready to try again.

Yes it’s hard watching friends make these decisions so easily and so important to have good support in place. Know there’s support out there and here

Best wishes,

Jenny x

[NMG1991 in reply to Jenny_at_APP]

Thank you again for your response ❤️

That makes complete sense to take it after you've given birth given your psychosis started 3wks later. Mine was after two weeks and before it started I had what is called mania so I was on a huge high and so happy. I agree the waiting approach would definitely raise the anxiety and you'd likely be questioning every thought you had which would be awful and tormenting. Does Quetiapine caused weight gain? That's unfortunately been a side affect for me with Olanzapine which is known for it.

I'll definitely do it with medical supervision - fingers crossed this time around it goes well. I think I need to go slower so I'll try that.

Thank you. Take care x

[Jenny_at_APP Partner in reply to NMG1991]

Weight gain can be a side effect of quetiapine, yes, I think the risk may be lower than with olanzapine but I think it can be a side effect with a lot of antipsychotics (maybe all of them, I don’t know). It seems so unfair doesn’t it, but so important to treat those symptoms.

I was very anxious in those early days and weeks and can look back and see it wasn’t ‘normal’ new mum anxiety but you don’t know what’s normal with your first do you… Second time I did feel forewarned was forearmed.

Take care and keep in touch x

[NMG1991 in reply to Jenny_at_APP]

It is a horrible side affect as it can really affect your confidence with gaining weight, it's tough but like you said you have to treat the symptoms so you don't really have another option - you have to have treatment to move forward.

I know what you mean. Like you said, you don't know what normal anxiety is with your first and I don't know about you but I'd never heard of postpartum psychosis prior to suffering with it so I wouldn't have even known what to look out for.

Take care x

[Laneybug1710]

Hi there

My name is Ailania. I had postpartum psychosis in 2019 when I gave birth to my son. I've now had my second baby and did not become unwell. I had a fantastic midwife and chose not to take preventative medication.

I also chose to give birth in a different hospital, in case of triggers from my first experience.

I'm still under care of a psychiatric nurse who checks in with me fortnightly.

[NMG1991 in reply to Laneybug1710]

Hi, thank you so much for your response.

So sorry to hear you also had pp, it's such a scary experience to go through.

I'm so happy to hear you've gone through a second pregnancy and not had the same experience, that's fantastic news! It really gives people like me hope. Congratulations on the birth of your second baby ❤️.

May I ask if you were on medication with your first and how you came off it when the time was right? I've been on Olanzapine for two years and tried to wean off but I wasn't sleeping and had no appetite so I went back on through the fear of becoming ill again.

Take care x

[Laneybug1710 in reply to NMG1991]

So I wasn't on medication during my first pregnancy. Once I was diagnosed with pp I was treated with a variety of medication. Sertraline worked best for me, I've been on and off it since I had my son. I also had fantastic CBT

[NMG1991 in reply to Laneybug1710]

Oh wow! I didn't realise you could treat pp wit Sertraline, I've also been on that for low mood but decided to stop taking it.

Take care x

[Cheryl-2021 Volunteer]

Hi NMG1991

I had a second baby 17 years after experiencing PP. I accessed Perinatal Psychiatry services when I found out I was pregnant and was supported throughout. I went onto Olanzapine and Lithium after birth and did not experience PP again. I am so glad I took the plunge as I was petrified at the time. I always say to people it is a different experience going in with the know. Hope this helps 💜

[NMG1991 in reply to Cheryl-2021]

Hi, thank you so much for your response. May I ask how long you stayed on medication for after the birth?

So sorry to hear you experience pp with your first baby but so happy to hear you had a positive experience the second time around.

Take care x

[Cheryl-2021 Volunteer in reply to NMG1991]

I was on the Olanzapine just under a year. The plan was to keep on it for a year, but I asked to come off it a little earlier when I was doing ok. The Lithium I did take for a year and when I first came home with baby, I took sleeping aids and the husband did the first early weeks of feeding in the night. Just to make sure I wasn't becoming sleep deprived.

Thank you for your kind words. It is an awful experience to go through and I totally understand your worries. I am sorry it is making you scared but there is so much help and support for you. I did make a plan for if I was admitted into a MBU again and I think that also set my mind at rest for the worst case scenario. Happy to answer any other questions 💜

[NMG1991 in reply to Cheryl-2021]

Thank you, that's good to know how long I'd be on it if I were to go on it as a preventative.

That's a good idea to take sleeping aids also to ensure good quality sleep and it's great to have had your husband's help at the beginning ❤️.

That's a good idea to have a plan for every scenario so you're prepared whatever gets thrown your way.

Take care x

[HelenMW Volunteer]

hello there, I would like to reply to you and share my experience of PP, And going on to have two more babies with no recurrence of PP.

I had PP in 1988. Totally out of the blue and quite a shock for me and my family. I was sectioned on day 5 in a mixed psychiatric unit. I recovered 3 months later but stayed on medication for 1 year. Lithium and Amytrypteline.

My marriage failed and I remarried in 1995. I thought long and hard with my husband and family with regard to trying for another baby. I liaised with 3 specialists at that time. The treatments I could have were lithium, oestrogen or progesterone. I opted for progesterone as I could still breast feed. I am aware this treatment is not offered nowadays and to be honest I will never know if I needed it or not as I had a strong support plan second and third time round.

The plan was made and I had support from GP and midwife. I opted for an epidural to avoid a stressful labour which I had in 1988. I had approached my local mbu just in case!!

My mum moved in for 2 weeks after each birth and I really had nothing to think about other than feeding the baby and sleeping! My mum just kept on insisting I had another little nap.

It was lovely to be well during the postnatal period and no PP.

Happy to answer any questions and look forward to hearing how you get on.

With warm wishes, Helen x

[NMG1991 in reply to HelenMW]

Hi Helen, thank you so much for sharing your experience. I really appreciate your response.

So sorry to hear you were put into a mixed psychiatric ward. That must have been scary for you! Does that mean you were separated from your Baby for 3 months? 😔

The hope is that you wouldn't have needed the medication but I think it's great to have had it there as a preventative to hopefully have eliminated any risk of you becoming ill again.

I think the epidural is a good idea and something I have had mentioned to me before. When I had my little one I had no pain relief at all as they didn't believe I was in labour despite me telling them, because of this by the time I was put down to delivery my contractions were too bad and they couldn't risk given me any pain relief so I went through it alone.

That's lovely your Mum moved in for two weeks after each birth, I'm sure this would have given you reassurance to know that if something wasn't right you'd have help immediately.

So happy to hear you went on to have two more babies with no pp. I can imagine being well after these births allowed you to really treasure and appreciate every moment post birth.

Take care x

[HelenMW Volunteer in reply to NMG1991]

Hello again, I was separated from my daughter when I was sectioned. From what I have been told I was given meds and was ‘out of it’ for a few days. Over time my daughter was brought in to the unit for short visits but I didn’t really know who she was and I couldn’t look after her. Once the section ended after 28 days I was allowed home for short visits but found it incredibly stressful. Once I was well again I could hardly put her down as I just wanted to hold her and love her and make up for our separation. I have to say we certainly bonded and we are extremely close now and she has gone on to have my first grandchild, a little boy! I was able to support her 100% during the post natal period which kind of made up for the months I missed after her birth.

Every blessing, Helen

[Pikorua Volunteer in reply to HelenMW]

Good Morning Helen, so happy that you have such a close relationship with your daughter. Sending you much love x

[NMG1991 in reply to HelenMW]

Hi Helen,

Thank you again for your response. Thank you for sharing what you went through.

I'm genuinely so sorry to hear you were separated from your Daughter, at the time it all happened that must have been so upsetting and scary. I can't imagine how hard that would have been for you.

So happy to hear you are close, that is such a lovely thing to have that unbreakable bond. It's lovely you were able to support her through having your first Grandchild - congratulations to you all. I can imagine during her pregnancy and birth you were likely scared because of what you went through but by the sounds of things everything went smoothly for your daughter which is so lovely.

Take care, x

[Isabella5991]

Hello xx

Bless you, it sounds like we are both similar in being very traumatised from the Illness. I had pp in 2020 after my second. Since then I have developed PME each month, had a milder episode when I stopped breastfeeding, but I would love a third one day perhaps. But Im not very confident I would be well considering I still have on going mental health episodes each month and very hormone sensitive. It’s hard isn’t it to think about it.. but lots people are ok after another baby! We’re all different.

I would personally be very medicated if were to have another (I still am over three years later and will be for life). Several diff options though as others have said xx

I hope you decide what is best for you and all goes well xx I personally don’t think I could ever be as ill as I was previously because I’ve been through all of that and dealt with it. I do think it’s likely I’d get manic and psychosis symptoms but I don’t think I’d have a full snap of my brain like before if that helps! I have seen other people who did get some symptoms second time, but were dealt with quickly and wasn’t nearly as bad the first time so that’s positive! xx

[NMG1991 in reply to Isabella5991]

Hi Isabella,

Thank you so much for your response.

Sorry to hear you too have suffered from PP. It's definitely very traumatising! It must have been awful for you too as in 2020 we also had the pandemic so I'm guessing it may have been hard to access the help you needed?

May I ask what PME is? Sorry I've not heard this abbreviation.

You're right, we are all different so it could mean I may be ok, as others have been🤞. May I ask why you've chosen to stay on medication long term? Is it because you're afraid to be off it? I know I am scared to be off it 😔.

That's good you don't think you could become as unwell as you were previously. I think that's the great thing about having a team with you throughout to ensure any symptoms are managed straight away.

I hope you're able to go for baby number 3 and that you're in good health ❤️ x

[Isabella5991 in reply to NMG1991]

Thanks dear xx

PME is like PMDD, but already having existing mental health conditions, but exasperated on your period. So I’ve been told likely on bipolar spectrum and a dissociative disorder plus many other things, but manageable on meds. I was also not well at all prior psychosis and should have been on meds, but didn’t get the right help until it blew up into the psychotic breakdown during the first lockdown. I’ve been on and off antipsychotics since I was a child for hallucinations and then anger most likely due to undiagnosed mild autism. (Having the assessment) I know lots mums who had Pp had no prior mental health conditions or ones after, but I have had them my whole life unfortunately and come to realise my brains not been made too well 😅 but I’m grateful for being mostly well and managing best I can! I’m actually coming down on aripiprazole currently because Im having awful side effects, but remaining on sertraline and seeing psychiatrists Friday to see what’s next! I’ve read lots women slowly come off their meds and be ok! So don’t be put off. I might see if it’s possible to try being only on sertraline, may be a massive mistake, but I may try and see if feel a bit less tranquillised, only under psychs guidance. Could you book a doctors appointment to get referred to start planning your pregnancy? I know they like you to book that first when you’ve had pp, before trying for a baby m if at all possible Xx xx

[NMG1991 in reply to Isabella5991]

Hi Isabella,

Thank you again for your response.

That sounds awful. I've just read up a bit on both to educate myself as I hadn't previously heard of these conditions but it sounds really unpleasant. Sorry to hear you suffer from this.

When you say you weren't well prior to getting PP and you should have been on meds was that the health team that missed your mental health worries or did you not seek help despite your struggles?

I do think sometimes mental health can be a chemical imbalance. I suffer quite often from depression and I always think my brain mustn't work as it should.

Sorry to hear you're having terrible side affects from aripiprazole. Sometimes with medication it's a lot of trial and error to find the right fit for you. Hopefully you're able to just have the sertraline 🤞. Did you find you had side affects when starting the sertraline, I know a few people who have.

I think once I'm off Olanzapine I will book an appointment to start planning the next pregnancy. I would love to be off it first with the hopes it all goes well once off. I'm tapering down from January and will taper down further every two months. I hope that's the right way to do it.

Take care x

[Isabella5991 in reply to NMG1991]

Sounds like a great plan for you! I really wish you all the best and your baby dreams come true! I have positive hope for you xx

Thanks for your sweet words! I did have therapy for a couple years, but I wasn’t getting better. I was really struggling with ptsd and hypomania when triggered by the ptsd triggers. And had anxiety and ocd since childhood. But blew up after the traumatic incident. I became completely neurotic and obsessive about health and veganism over the years slowly developing orthorexia until one day in lockdown my brain snapped and I couldn’t eat or drink water at all which was incredibly traumatic and it then turned into a desperate psychotic breakdown with extreme mania. Before the psychosis I was stuck in this high functioning but not very well brain, I had trauma relating to being taken away to hospitals as a child and teen from my mums doing so I was too terrified to get proper help and medication. (They also medicated me as a child) I also didn’t realise I could get better. I just thought I was also going to have to struggle with bad anxiety etc. but meds really do work I since realised! I’m now really good after being on meds and having had loads of therapy and mostly healed from the trauma that triggered the ptsd etc about 8 years ago. I do have dissociation fairly often, so my therapist has referred me for cbt now because she thinks I’m keeping memories locked away that needs to come out, so let’s see if that helps! But generally I am good, functioning and mostly well apart from a week a month so I’m pretty grateful considering how incredibly ill I was.

I’m so sorry to hear you struggled with depression so often. It can be pure misery and so so suffocating. I agree, definitely a combination of a chemical imbalance, hormone sensitive, trauma, genetics, situational and childhood! Sometimes we are the result of the perfect storm unfortunately xx

Do mental health issues run in your family? Xx

[Naomi_at_app Volunteer]

Hi MNG1991

I'm conscious that it can be difficult to hear from a mum who did experience PP second time around - I had PP in 2005 and 2011 after the birth of both my daughters, but I do hope it's helpful to share the things I've reflected on in hindsight and how we got to the other side!

I chose to 'watch and wait' for any symptoms after baby number two, with a really supportive perinatal mental health team and a clear plan of action if I did develop symptoms. All seemed calm and well initially - but my daughter became very unwell and was admitted to the NICU, where my mania and delusions returned but I was still aware of what was happening so started on Olanzapine.

Things normalised very quickly, but in 2011 my follow-up was with a community mental health team, not a specialist perinatal team. I was keen to stop Olanzapine as soon as possible to reintroduce breastfeeding and avoid weight gain - but with hindsight I would definitely choose to take medication preventatively and stay on it for longer. Unfortunately I developed a depressive psychosis, and this took a really long time to recover from fully. I think at the time I was so confident that I knew my own mental health well that I wasn't as "belt and braces" as I could have been.

However, now that my girls are 18 and nearly 13 - we can talk about mental health openly and are all very proud of each other that we made it through some of the most difficult times together as a family. My oldest daughter was involved in a beautiful animated film to support other young people whose mums experience mental illness. It's part of our story, but not the whole...

I'm so glad that perinatal mental health teams can now be involved in birth planning and support up to 2 years after baby is born - and with a cautious, supported approach, as you can see from all the lovely responses you've had, the vast majority of people who've had PP don't have a relapse. Keep writing - it's so understandable to have questions and nervousness, but also excitement and hopes for a second baby.

Warm wishes, Naomi

[NMG1991 in reply to Naomi_at_app]

Hi Naomi,

Thank you for your response. I appreciate hearing from both sides but I am genuinely sorry to hear you went on to experience pp a second time around. Once is enough to scare you so I can't imagine how getting it a second time would make you feel.

I'm sorry to hear your daughter was admitted to NICU, I really feel for you as my Son was admitted to hospital and I understand first hand how upsetting and scary that experience is. I'm so glad to hear she pulled through ❤️. How long was she hospitalised for? I know trauma can really affect mental health. Do you think without your daughter being admitted to hospital you may have been ok?

Sorry to hear after stopping olanzapine your symptoms returned. It is the first time I have heard of depressive psychosis but it sounds awful. How long did it take you to recover and did you go back on Olanzapine? Were you yourself hospitalised at any point or were you able to be at home?

I've heard the perinatal team is brilliant so I'm sure the support will be there should I choose to go ahead with another Baby (this is what I would like and I would love a sibling for my little Boy) but I'm still petrified of becoming ill again and people not noticing or me thinking I'm ok when I'm not. From what you said it sounds like you noticed when things weren't right?

I completely understand the breastfeeding side of it, I stopped when I went on Olanzapine and I was gutted. The hospital I was admitted to did say I could continue but I chose not to, no judgement whatsoever toward people who choose to continue to breastfeed. It's definitely personal choice. The weight gain is tough too, I've put on 2.5stone since going on Olanzapine.

Take care x

[PPwarrior]

Hi

It is a scary thought having another child after having PPP but I did 5 years after having it with my son I had a daughter and I am really glad I did and it was absolutely fine.

I had amazing support from a lovely midwife/health visitor and mental health worker that both did lots of home visits and I could message them too so it really helped so much to know I had that support and I was ok and didn’t get PPP second time around and enjoyed it much more with my second. I tried to get out more and go to little groups to chat to other Mums which also helped.

Wishing you all the best and hope you stay well as I know what you mean it is very frightening but I think with the right help and support it is ok. Take care, Vicky xx

[NMG1991 in reply to PPwarrior]

Hi Vicky, thank you so much for your response.

I'm so happy to hear you went on to have another Baby with no reoccurrence of ppp. May I please know if you took medication as a preventative or if you went ahead without it. Did you do anything different the second time around which could have meant you stayed well?

Thank you

Take care x

[PPwarrior in reply to NMG1991]

Hi

Aw no problem 😊 thank you xx

I didn’t take any medication but I was open to go back on it if I had needed to.

I think because I had the support it made a big difference and I went out much more and maybe I was more aware of the signs of becoming unwell before it helped me to stay well. It’s a big decision but if you have lots of people around you it definitely helps.

It’s great on this forum to get advice from lots of people that have been through PPP isn’t it? That has helped me over the years too.

Take care xx

[Fatimahg]

Just a note on incidence. My wife has had seven children. Bless her. She was married before and had three. On the third child, a little girl, she had PP. It was very serious. She couldn't remember anything, so I never knew.

Then with me, four children!

Boy - no PP;

Girl - No PP,

Girl - PP very serious,

Boy (unplanned by us - they're always the best an absolute joy!!!) PP was serious - perhaps marginally not as bad.

Where we are, there are practically no support services, no chance of hospital admission really (super-expensive), and my wife was unmedicated for most of the first with our girl and all of our boy. It was highly traumatic for everyone. Thankfully we had the help of our Indonesian nanny, bless her, we survived.

Antipsychotics can be effective during the third trimester. However, really it is unknown in respect to harm to the foetus. Onset of PP was one three weeks after our little girl and literally immediately as the waters broke for our boy. This gives a reasonable window for treatment immediately after birth - avoiding risk to the foetus.

I wish you all the best!

[NMG1991 in reply to Fatimahg]

Hi,

Thank you so much for your reply.

So sorry to hear your wife has suffered with PPP more than once. That must have been very traumatic for everyone involved especially traumatic when she didn't remember anything, that must be really tough and upsetting.

Thank you so much for sharing your experience. It's so interesting to know she didn't suffer with all 7 of her babies, I sit here wondering what was different and what could have caused the PPP.

Thank you so much for sharing the timelines for the onset of PP, that's really helpful. I was two weeks PP before I became ill but it's good to have the insight that it could come on quicker if I was to get it again (please God I don't).

Thank you again.

Take care x

[Quinoline]

Dear NMG1991,

The question to ask yourself perhaps, is how effective was treatment? Generally, if it worked, and you became ill after birth, then you have a solution really. It is rare that an expectant mother becomes ill - it isn't called postpartum psychosis for nothing! Hence, you could plan to start taking medication after birth or very late in the third trimester.

If the medication worked, then perhaps there isn't a reason really to not have another child. Children are a huge blessing!

With all my best wishes!

[Libby02]

Hi,

I had my daughter in 2016 & had PP and was sectioned & very unwell. (No prev mh issues). Stayed on quetiapine for 18 months after. Then had my son in December 2019, we always wanted 2 children so was determined to not let it put us off. From the day I found out I was pregnant I was in touch with the local perinatal team. The sane nurse I had with my daughter was still there and was there for me again from day 1.

I also got in touch with the MBU & they kept in touch incase I needed admission. I had an emergency c section 1st time round. Second time round I had a planned c section, was due over Christmas (we decided to have baby 19th dec to ensure all services were there). I had gestational diabetes too so that was an added extra!! I had 100mg if quetiapine ready & the agreement was if my family thought I needed it I would take it until my perinatal nurse could see me. She saw me on the 30th December & the decision was made to self admit to the MBU.

So different 2nd time round, would go as far as saying ‘nice’ to have the same 1/1 time with my son as had at the end with my daughter in the MBU. It was strange as was allowed ‘out’ on my own from the night I arrived which never happened with my daughter even at the end! I never had a PP diagnosis 2nd time round but ‘adjustment disorder’. Basically anxiety around getting it again, it was hard as I felt ok but my mum thought I wasn’t. It was more of a relief to be in the MBU to learn to trust myself & I lost so much of that first time around. I honestly believe knowledge is power & 2nd time around you will no exactly what helps/doesn’t, what to avoid etc. For me the key was sleep so even at the hospital after my c section they kept me off the main ward in a side room & let my husband stay. I didn’t even want to breast feed so my husband could do all the nights feeds etc.

Please don’t let PP put you off having more children & sending lots hugs to both you and your family. Here too if you want to talk, plus my husband would to yours if wanted aswell x

[Maria_at_APP Moderator]

Hello NMG1991, you have had so many good replies already that I hope they can give you a broad view of what could be to plan a second pregnancy after pp.

I also went on to have a second baby after having pp with my first. Pp did not reocurr for me, but I did experience some depression 3 months post partum. In my case I took medication on the last couple of weeks of pregnancy. It meant my boy and I stayed for a few days in hospital for him to be observed by the peadetricians. There were no concerns raised and we were able to go home on the third day.

I think one of the main factors in me remaining well the second time, aside from the medication, was having a plan to protect my sleep. I feel that helped me a lot, but it might as well have been a combination of factors, for sure. We are still finding out the causes of pp and it is sometimes referred to as the perfect storm.

Take very good care and wishing you all the best,

Maria

[Dolly292]

Hi, I'm so glad you posted. I had or have almost the exact same question..

I had Pp almost 3 years ago after the birth of my first and currently only son with no prior mental health.

I was on olanzapine in the MBU, then was switched to aripiprozole. I gained a huge amount of weight with both, (2.5stone) but particularly olanzapine. (I just remember feeling unbelievably hungry even after a meal.... & I just ate so much, like I was starving). I began to reduce & finally came off all antipsychotics when my son was about 18 months. I was then off all medication for a year (although looking back I was quite fragile and wobbly).....but I gradually got better & went back to work 3 days a week.

I remember coming off aripiprozole (& as I understand it all antipsychotics have the same effect)... In that they DO sedate you & therefore do impact your normal sleep routine. It took me 4/6 weeks coming off medication+ took a bit of zopiclone+ promethazine as & when to help with sleeping. But I do recall very clearly a very difficult few weeks of very poor sleep after coming off antipsychotics.

Unfortunately for me, a recent stressful situation at work in October caused me to struggle with sleeping & I e had to start on antipsychotics again.

Fortunately this time round, I'm taking quitiapine (spelling may be wrong) a low dose at 100mg & 6 weeks in I'm not noticing any weight gain, as yet.

However, I too would like to think about another child, but I suspect now that I've started this medication doctors would be reluctant to advise stopping or may suggest switching to one of those 1st generation drugs.

Do any ladies have any experience of the options given at preconception meetings?

I would like another child, but am terrified of the risk of illness again and also dreading the thought of having to take highly sedating drugs, that make you feel lousy, gain loads of weight and make getting through the day and uphill battle.

L x