First of all I want to apologise, this blog has nothing to do with rowing!
I wanted to use this entry to talk about the work I’ve been involved in with a charity called Action on Postpartum Psychosis (APP) http://www.app-network.org
What is Postpartum Psychosis? Well, this is what the APP website says:
“Postpartum Psychosis (also called ‘Puerperal Psychosis’, ‘Postnatal Psychosis’, ‘Postpartum Bipolar Disorder’ or PP) is a severe episode of mental illness, which starts suddenly in the first few weeks following childbirth. PP occurs following 1-2 in 1000 deliveries, and can be very severe and serious. There are some groups of women, women with a history of bipolar disorder for example, who are at much higher risk.
There are a large variety of symptoms that women with PP may experience. These include:
• symptoms of “high” mood (mania) – for example, high mood, racing thoughts and pressure to talk too much.
• symptoms of low mood – for example depressed mood, lack of energy, poor appetite and poor sleep.
• psychotic symptoms – such as believing things that are not true (delusions) or seeing or hearing things that are not there (hallucinations).”
So, why am I involved with this group? Well, my family has been through it and come out the other side, let me explain….
2004 our first child was born and everything seemed perfect, it was “the best of times”. The baby (a boy) was beautiful, healthy and happy. My wife also was beautiful, healthy and happy. For a week I was the happiest I had ever been, I was a dad, I had a beautiful family, I finally felt like a grown-up.
My wife was amazing, she had so much life and energy, and we were really enjoying parenthood and showing off our new son to friends and family……but….after about a week I began to notice that my wife’s behaviour was getting a bit…. unusual…she was still happy and energised but now it was as if she was too energised…the volume had been turned up to 11. She started coming up with bizarre schemes to make our fortune becoming obsessed with one particular idea. I discovered she had donated large sums of money to charity and was starting to arrange all our possessions by colour. She spoke about how colours appeared particularly vibrant, sounds were amplified and smells were overwhelming. Finally she began to have conversations with her dead father…obviously something was going very, very wrong.
The crisis came after I returned to work. My wife was due to attend a “Birth reflections” session at the hospital (where new mothers share their experiences of pregnancy and birth). The poor organisers didn’t know what had hit them! So concerned were they at my wife’s behaviour that they told her to go and see a Dr. this was precisely the right advice, given to precisely the wrong person. She took it very badly (seeing their advice as a direct challenge to her perceived view of the world). But, knowing we had private health insurance she presented herself at the local private hospital demanding to see a psychiatrist.
That’s when I got the phone call and my life began to fall apart….
When I got to the hospital it was clear that my wife was in the middle of a severe psychotic episode. We saw the duty psychiatrist (who had no experience of post-natal mania) the experience was best described as “difficult”…well…my wife started throwing things at him. After 20 minutes we were packed off with some tablets (I never did discover what they were) and the telephone number of a crisis team should the need arise. We were to return to the hospital the following morning for a more detailed assessment…..we never made it.
At home that evening things went from bad to worse. I was desperately trying to get my wife to eat and to sleep (having been told that rest was “critical”). But, that was the worst thing I could have done. Trying to get someone to sleep whose brain is busily frying was impossible. What made it worse was that she saw me as an obstacle to her achieving what she wanted, in her eyes I was the one with the problem and I must be removed from the equation. I don’t what to go into exactly what happened; even now 9 years on the memories are very raw…
I tried phoning the crisis team….the number I’d been given was wrong. I tried and tried again, changing the last digit until finally I got through. Two women turned up 30 minutes later (by now it was 11:30 at night). My wife instantly went on the offensive, smashing jars and bottles to create a glass barrier between us and her so they couldn’t get to her. The decision was made that my wife needed immediate hospitalisation (no shit Sherlock!). Now we were faced with another problem. To get my wife to hospital required the authorisation of a psychiatrist, the duty psychiatrist that night was unavailable for several hours. We couldn’t wait that long. I was told the only other option would be the police; they had the power to detain under section 35 of the Mental Health Act. 20 minutes later a police van turned up with two burly coppers. I was then told that their power to detain only extended to public areas, they could not enter my house to detain my wife, even with my permission. My only option was to “persuade” my wife to leave the house. There was no way that was going to work so I had to physically pick her up and carry her outside where she was detained.
The police stuck her in the back of the van and then they and the crisis team drove off into the night leaving me, quite literally, holding the baby…he was 16 days old.
In the space of 48 hours I had gone from being the happiest, proudest dad in the world, to seeing the woman I’d spent 15 years with, the mother of my first-born destroyed by an illness I had no idea even existed….it really was “the worst of times”
What to do now….there I was, in the middle of the night, suffering from shock, holding a baby who would need feeding within the next 2 hours. Then I found out who my friends really are. At 1am I phoned my best mate who lived 30mins away, his wife was at my front door 45 minutes later. She was wonderful. She phoned the hospital and got a duty midwife to call with supplies of formula. She swept up the broken glass and shattered crockery and, most importantly made me a cup of tea.
The following morning I made my way to hospital…the secure psychiatric unit…a truly dreadful place, somewhere I never, in a million years, thought I would be seeing. My wife was sedated. I was told it was likely she would only be there for a day or two before transferring to a specialist Mother& Baby unit (MBU). 10 days later she was still there. I would visit twice a day with our baby (all visits were strictly supervised), this enabled my wife to feed the baby and attempt some sort of bonding.
Eventually after 10 days a bed became available at a specialist unit 35 miles away. We transferred on the 11th morning, my wife in a secure van and me following in the car with the baby. Little did I realise how familiar I was to become with the MBU over the coming months. Once she and the baby were settled the duty nurse sat me down and tried to explain what had happened to my wife. Finally there was someone with experience of this illness, which I was told was called Puerperal Psychosis. It was explained that after birth a hormone is released that gives a sense of euphoria. In the vast majority of cases this euphoria is very mild and the supply is quickly “shut-off”. In puerperal psychosis the opposite happens. Production goes into overdrive until eventually the brain “blows a fuse”. But, the most important 3 things the nurse said to me that day was:
1. don’t worry
2. Your wife and your baby are safe
3. She will get better
It’s only subsequently when reading up about PP that I realised how important no.2 was. There are cases where, tragically, help did not come in time and the mother harmed herself and/or the baby.
So then began the slow process of treatment and “normalising”. I was expecting my wife to be in hospital for a week or so…how naive…..I was told she would most likely be an in-patient for 3-4 months….and full recovery would like take 12-18 months.
I started to struggle, physically and emotionally. At this time my work involved a 40 mile commute. Unfortunately it was 40 miles in the opposite direction to the hospital. I got into a routine of driving to work, doing a full day at the office and then driving the 70 miles to the hospital to get about 45 minutes with my wife and son and then drive the 35 miles home. After 10 days of this I was exhausted and needed a break. I wasn’t eating very well (lots of take-away’s and ready meals) and I must admit I had a drink or 3.
The worst thing I felt during the drive from work to the MBU was not knowing what I would find when I got there. Would my wife be lucid, “normal” or sedated? Even worse was arriving at the unit and going into the nursery and not recognising my son…I honestly didn’t know what he looked like…I had to recognise him by the teddy he had. This was the straw-that-broke-the-camels-back. I couldn’t take any more, I was in a very bad place….
After a couple of days, and thanks to my mate for providing a shoulder to cry on, I got myself together and was able to cope a little better. But, what this highlighted was the lack of support for partners of women suffering post-natal mental illness. My wife was safe; she was being cared for and treated. I was on my own, having to hold down a job, dealing with questions from friends asking about the baby and my wife…trying to be normal.
After 3 months we were told that my wife and child could come home and the next stage of our lives as a new family could begin. This turned out to be more challenging than anything that had happened in the previous months. There was the misconception that, as she is being discharged she must be better, surely. Nothing could be further from the truth. I was completely unprepared for her return. I was told that she needed rest and peace and quiet. I had to minimise all stimulus. All the “New Baby” cards were taken down, all the presents put away. My wife was totally unable to make a decision, a simple question like “would you like rice or potatoes for tea” would send her into a spiral of confusion and doubt that could take hours to recover from. I quickly learnt not to ask her again.
A few weeks ago I read “Touching Distance” by James Cracknell and Beverley Turner, they talk about James’ recovery from a traumatic brain injury (TBI) after he was knocked off his bike in the USA. So much of what Beverley said about the change in personality cause by the TBI resonated with how I felt about my wife in the months that followed her discharge from hospital. The incredibly bright, vivacious, funny & decisive woman I had fallen in love with at university was nowhere to be seen.
But, and it’s a very big but, there was light at the end of the tunnel. We had a truly brilliant Community Psychiatric Nurse. She visited every day and gradually over the next 6 months I could see the life returning to my wife’s eyes, her personality was coming back. We also were put in contact with a brilliant organisation called “Home Start”( http://www.home-start.org.uk/) They put us together with someone who would visit to offer practical help looking after the baby to give us a break. She was brilliant and has, in the years that followed, become a close personal friend and “honourary granny”.
So, after about 10 months we had reached a stage where my wife was probably 75% back to “normal”. The turning point was realising that she could laugh out loud without those around her worrying she was becoming manic. She was making decisions and generally feeling “in control”.
In 2007 we decided to have another baby. This was a pretty momentous decision as we were told there was a 50/50 chance of another episode of PP. But we decided that, with the proper care plan in place, we would risk it. Our reasoning was that we knew the warning signs and could get help before things escalated. Our 2nd son was born in February 2008. The care plan swung into place immediately. We packed our eldest off to his grandparents for the week, my wife was given a private room at hospital where she would have complete rest. We had been told that if we reached 14 days without any symptoms then we would be OK. Needless to say, they were a pretty intense 2 weeks. We were also told to avoid all stimuli, so we had the bizarre situation of having a new baby, but not being able to celebrate. No cards, no presents, no visitors.
Day 14 was wonderful; we had made it and at last could begin the (muted) celebrations of a new baby.
Now, 5 years later, we are good. My wife is the woman I met and fell in love with and is coping as well as any mother with two boys can.
I still find it difficult to talk about those months in 2004, writing this has not been easy, but it has been cathartic and is long overdue.
As I mentioned earlier, I’m part of a group of husbands and partners who have been through this and we are working on improving the information available to families trying to cope with this illness. I also wanted to use this blog to raise awareness of the work that APP do and raise awareness of the illness itself.
Thank you for reading this….I promise my next blog will be rowing related!
ps. I forgot to mention if you would like to hear some of my wife’s thoughts about this experience she took part in a BBC Radio 4 programme called “Unravelling Eve”. You can listen to it on the APP website: