I am pregnant. I had postpartum psychosis after the birth of my first child. I am quite worried about getting sick again. Any advices?

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  • I had postpartum psychosis after the birth of my daughter in late 2008. As she was born 2 months premature (I had pre-eclampsia), she was put in a neonatal unit.

    Five days after her birth, I was hospitalised in a psychiatric ward in the same hospital complex. My symptoms were so great, the psychiatrist thought I was on drugs.

    I stayed in hospital for a month but was still quite unwell for months afterwards But stopped taking medication in March 2009.

    Two years later (Sept 2010), after the suicide of a family member, I had a second psychosis. That one took me 6 months to recover from. I stayed in hospital for 2 months, and was on medication (quitiapine XL) for a year and a half.

    I am medication free since March 2012 and I am 6 months pregnant. I am not too worried about getting sick now. I am getting a lot of help from health professionals and from my partner. But I know that as my due date looms closer, my stress level might rise up.

  • Hi tenrob

    Firstly welcome, and thank you so much for sharing some of your story with us. Secondly, well done for coming through your first episode of PP and a subsequent psychosis. I am so sorry you have have an incredibly tough few years. You will know from your own recovery story that you are a really strong mum, and that PP can be overcome in time.

    I too decided to have a second pregnancy, and actually with about the same gap as you (my eldest daughter was 5) You will be very well supported in this pregnancy I know - but like you too as my due date loomed I was definitely more nervous. That's OK though - it's natural, and being thoughtful about your own wellness will help you to recognise any 'early warning' signs and put your plan into action.

    Not sure what options you've chosen but I decided to 'watch & wait' but had my antipsychotic prescribed and ready to go in the postnatal ward. Our second baby was prem and in intensive care for a while, and at 7 days my mood did go a little high so I took the medication and it calmed things right down. Sadly I did have a period of depression until she was around 1 year old but nothing like the intensity of the first psychotic episode.

    I guess the tough thing is that no-one can promise you won't become unwell again. However what you will have is a great team of professionals and your partner around you, the knowledge to get treatment straightaway and also the reassurance that you have recovered twice. I know for most women who did have second pregnancies on this site, we were definitely more well second time around - because we knew what medication/treatment worked for us. A good 50% of women didn't have any symptoms second time around and have spoken a lot about the joy of being well for a second baby. But you know, even though I didn't have it perfect - I'm so glad I have my 2-year old now (she is stuffing Skips into her mouth as I type!)

    Here for you whenever you need to chat as you move into your last trimester.

    Have a lovely Easter

    Naomi

  • Dear Tenrob,

    So glad you have found the APP Network. It is a great resource for you. I, too, experienced postpartum psychosis after my son was born. Unfortunately, I never had a successful second pregnancy (my husband and I did try). It took many years after my son was born to become educated about postpartum psychosis, etc.

    As a former Coordinator for Postpartum Support International (www.postpartum.net), I have provided emotional and informational support to moms and families experiencing mental health issues related to childbearing. So I have seen moms, who had experienced postpartum psychosis with their first child, go on to have successful pregnancies and postpartum periods. It is so important to have a preventative plan in place. I know the UK is much more advanced and proactive than the USA so I am sure you already have something in place.

    If you are interested, you might find it helpful to read a blog I wrote on "Can Postpartum Psychosis Be Prevented?". The answer to this question is definitely yes but you must be proactive, which reaching out through this network is a great way to learn more.

    Here is the link to my blog: jennifermoyer.com/2012/can-...

    I wish you the best and look forward to hearing a positive report from you as you move forward in your pregnancy and postpartum period.

    Blessings!

    ~Jennifer~

  • Hello there,  You are absolutely correct when thinking that The US is behind The UK in post partum prevention. Post partum depression and psychosis are  not even taken into consideration when you're pregnant or afterwards. After the birth of my first child I called my ob/gyn. He said to take over the counter pms medication. I had severe post partum psychosis and that was his suggestion. When I talked to another obstetrician many years after having my 15 year old she said maybe I shouldn't have any more kids since I had ppp with my first child. It's unbelievable how they completely avoid and ignore this illness. Most mothers that need to be in a psychiatric hospital  in The US have to worry that child protective services will take your child from you. God bless The UK for being many years ahead of us when it comes to having children .

  • Hi tenrob & a big welcome to the site. It sounds like you've come through an incredibly tough few years. Well done for posting the question, I think it's great that you're being well prepared & understanding that your stress levels might rise nearer your due date. It must be such a fearful time but I think there's a wealth of tips here that you'll find useful & will hopefully help to reduce some of the worries.

    Like JenniferM I didn't go on to have a second pregnancy, but many here have & have shared some insights in the threads I've posted below. You might have already found them & some may not be relevant, but there might be some useful tips you've missed.

    Care plan for second pregnancy?

    app-network.healthunlocked....

    Advice re care plan/preventative medication for 2nd baby following PP?

    app-network.healthunlocked....

    Danger zone timescales in subsequent pregnancies?

    app-network.healthunlocked....

    What were the early warning signs of PP?

    app-network.healthunlocked....

    If there's anything on your mind that hasn't been covered, please do feel free to ask away.

    As Naomi says, the knowledge from previous experience & the fact that most women here who did have second pregnancies were more well second time around, is such a positive thing.

    Keep in touch & let us know how you're getting on.

    We're here for you x

  • Thanks a lot for your answers.

    As most of you know, the care received on the NHS is very good My doctors and myself have put a plan in place and medication that woks for me. But it is nice to hear about people how have gone thought it.

    I have already decided to go on the anti psychotic medication right after birth and not to breastfeed. And I am visiting the hospital next week. Including neonatal unit and wards as I don't want any bad memories from the last time jumping back at me at a later stage.

    I am stopping work next week and if I give birth at term, I shall have 3 months to relax.

    Thanks a lot

  • I am the proud Mummy of a 3 year old boy that I did become ill after his birth and almost 6 month old twin girls and I am pleased to report that I did not become ill after their birth despite a very stressful postpartum period and almost loosing one of my girls to Broncholitis. I had a preventative care plan put in place and decided to take medication straight after delivery and am pleased to say this worked for me. I took quetiapine and this worked for me and didn't have such awful side effects that Olanzapeine had for me first time round. I hope that you have a good post partum period this time round I have found it very healing, but also very sad st the same time as it made me realise just how poorly I was after my lovely boy was born.

  • Hi hel212000

    So lovely to hear your update - many congratulations on the birth of your twin girls, and I'm so glad that your prevention plan worked despite all the stress you went through. I also had my second child in intensive care for 2 weeks so know how tiring and full-on that can be. Well done!

    Can't believe the twins are almost 6 months already!

    Naomi

  • Hi tenrob and welcome to the site. As you've updated, and others have said, having the plans in place are really key in this I think. I had an episode of PP in 2009 after the birth of my son and he is my only child, so I don't have first-hand experience of this. But I think awareness both by professionals and family members and having clear ideas about what should work for you and what won't, especially around meds, (based on previous experience) is the best way to come at this one. I guess you are finished work now and hopefully relaxing - I've not logged onto the site for a few weeks so have just read your message. I hope as time passing things are going as they should and you are continuing to get good support. I hope the hospital visit went well too, as someone who had a traumatic birth too I would think that's important and all part of the preparations and steps you can all take. All the best for a good outcome for you all. You sound as though you have everything planned and I'm not sure I've added anything new, but feel free to come and post an update in the future if you'd like (and get chance!) Sharing experiences is so valuable I think. Take care.

  • Thanks to all of you for your support.

    I have now given birth to a lovely son 2 weeks ago.

    So far no symptoms of psychosis. Just enjoying my time with the new baby, last time I couldn't.

    This time every thing was different. From the birth to the postnatal care in hospital. Overall a very good experience. The planning, guidance and support of professionals made all the difference. I know I am not fully out of getting sick again, but with each day that passes, the risk goes down.

    Thanks a lot to all of you, Marie

  • Hi tenrob

    Only just seen your update - thank you so much for posting when your little boy was born. I'm so glad to hear that by two weeks you had not experienced any symptoms of psychosis and I hope that you continued to be well.

    It's great to hear that you had a good birth and postnatal care - like you say planning, guidance and support during pregnancy are so important. Thanks again for sharing your story.

    Naomi

  • Thanks lady for this thread, we're trying for baby no 3 and I've been desperately looking for information. I saw Dr Jones in Cardiff and he estimated a 60-70% chance of reoccurrence so I really want to have something concrete in place. I'm not even pregnant yet and fretting! Feeling more positive though that at least we'll know what we're dealing with if it does happen. X

  • Hi Vix28

    Good to hear that you have had the opportunity for a preconception consultation with Ian Jones. Like you say it's really important to have concrete plans in place, being 'forewarned, forearmed' and knowing what works and what doesn't work for you is I guess the silver lining of having been through PP before.

    At APP we are currently working on a pregnancy planning guide for women who know that they are at high risk of PP - as soon as it's published on the website I will post on the forum to let everyone know. The guide pulls together professional advice and families' experiences of developing a care plan for pregnancy and looking after yourself after the birth. Medication, choosing where to deliver to minimize stress, having a clear plan for postnatal care with a private room if possible, getting support with the nights early on, and ensuring that you have a team of professionals around you who all know the plan if symptoms do occur seem to be the key things that come up when women talk about their care plans on the forum.

    Good luck with your planning for baby number 3 and we're here any time you need us.

    Naomi xx

  • Hi Naomi, that'd be great...hopefully chat to you in person soon! X

  • Hello vix28, I've just refreshed my memory by reading your blog from a while ago "My Scary Baby Journey 1". That must have been such a frightening experience for you. Very wise of you planning ahead to be prepared if baby no 3 comes along.

    Wishing you the very best of times ahead, without PP. We are all here to support you along the way.

    Take good care.

  • Thank you x

  • Please help. I am going through postpartum psychosis bad and my daughter is going to be a year next month and I am not getting better. I have seen Dr's and am on medication. I was getting better and then went downhill and I don't know why. I love my daughter I don't know how I can have horrible thoughts about her :'(

  • Hi aarchul1,

    I'm so sorry you're having such an awful time. You've done so well reaching out here, it's not easy to do so well done. There's lots of us here who also had those horrible thoughts & we're here for you & can share things that helped us get through it. They're not your fault & don't mean you love your daughter any less. It's really tough feeling that you're not getting better, I think we all had times like that or felt were going backwards. That's not the case, it's just that it's a bumpy road with ups & downs, but day by day we were actually moving forwards all the time.

    How about starting your own thread (by clicking on the orange 'write a post' button on right-hand side) to make it easier to find your posts? You could tell us a bit more about the thoughts there & about how you're feeling & what you're finding particularly hard at the moment. Have you been diagnosed with postpartum psychosis? Do you have friends/family nearby to help out?

    Hang in there. We're here for you & everything will be OK.

  • Hi I'm so sorry to hear that you are still struggling a year on. As Andrea has said as well recovery for me was a long one too, and up and down but slowly I somehow got better though sometimes it felt like I would never be better. I particularly struggled with depression for a year and a half afterwards.

    You will find a lot of support on here. I wonder what support you have as well. Do you meet a perinatal psychiatrist regularly? do you have a mental health team to support you? Do you have family and friends support?

    Hang in there and as Andrea says if you feel able to start your own thread where people can maybe offer you more support.

    Take care x

  • Hi aarchul1

    Really sorry to hear that you are struggling with such a bad patch at the moment. It's really hard, but also very normal, to have significant ups and downs in the first 1-2 years after an episode of Postpartum Psychosis. Lots of us on this site went through periods of depression after PP, and it can be so hard to believe you will make a full recovery - but with time, support and sometimes changes in medication it is possible to get out of this downhill time.

    I wondered if you have seen the Recovery Guide on the APP website? - it gives loads of practical tips from other mums about regaining your confidence, and managing your mental health after PP - here's the link: app-network.org/wp-content/...

    Do you have any ongoing support from a mental health team at the moment? It might help to talk through with someone how low you are feeling, and to see if there is any counselling available either with the mental health team, through the GP or at your local Childrens Centre.

    We're here for you to lean on so feel free to ask any questions you have

    Naomi

  • Hello aarchul1

    I'm sorry you are no better after a year. Hold on ... help is here. There are mums here to offer support.

    Take good care.

  • Hello aarchul1,

    How are you? Have you been able to see your GP about your medication and discuss how stressful things are at the moment? There is no shame in feeling that you are not coping, just speak out and please don't suffer in silence.

    We are here for you to lean on.

    Take good care.

  • Hi aarchul1,

    I hope you've been able to read some of the replies to your comment on this post - as Andrea mentioned, you could start a new thread if you'd like which will go to the top and everyone registered will then get a notification - it helps to remind me to go and log on, in the general busy-ness of life!

    I'm sorry to hear you're feeling this way a year after your baby was born. Have you got a CPN or someone from the mental health team supporting you in the community? Can you tell them how you feel? As others have said, the recovery from PP can be a slow and gradual process, but you will get there - like we did. I had PP in 2009 and I remember being so frustrated and impatient with myself to feel better, but it just comes and you will be able to look back and recognise this when you're feeling better.

    I hope you are getting some good information from the forum and feel able to reach out to us again by posting soon to let us know how you're getting on. The Recovery Guide that APP produces might also help you - app-network.org/what-is-pp/...

    We're thinking of you, take care. xx

  • I just had a pregnancy without meds. Didnt have a relapse. But it depends person to person. See how you are feeling, your stress levels , amount of rest you are getting and level of support you have. I would not have liked to take meds during preg but if necc it is much beta than having a relapse and goin on meds nway. The risks of some meds are quite low. Some are safe like lithium after 26 wks. Its really 1st trimester best to avoid if poss. At delivery i had epidural planned (turned out i had to have one anyway)

    This helped greatly i cud rest and the pain relief till almost end was v gd. I restarted on lithium post preg and a small dose of quetiapine. I had neva tried quetiapine b4 but it was v gd at helping me rest and sleep post delivery. I tuk 50mg sumtimes 25mg. After delivery there will be noise so an anti psychotic like this helps you rest. Ask for a private or side room. This shud be in ur plan or go home in a day or two if you can more rest there. Get help frm family / partner for night feeds. These things were diff frm my last post natal exp and the severe PPP episode i had last was avoided this time as a result with a few prayers too 😊