As someone who has recently experienced postnatal psychosis, you might be experiencing a range of emotions as you begin to recover from postnatal psychosis. This is extremely common with women in your situation. Feelings and emotions you might be dealing with include shock, shame, embarrassment, anger, fear, guilt, sadness and grief.
You might feel physically and emotionally exhausted. You might also experience ongoing worry about your mental health, your relationship with your baby and/or partner, returning to work and general uncertainty about the future.
'Breaking down nearly broke me but I’m living proof that recovery is possible and that a breakdown can be a breakthrough.'
Making sense of what happened
In the early days after receiving treatment you may feel a sense of confusion about what has taken place since giving birth. Many women don’t remember much about what happened. You may also feel distressed about the way treatment was started, especially if you were admitted to hospital on an involuntary basis.
You may want to understand more about postnatal psychosis, or you may not feel ready to deal with detailed information yet. If you are feeling ready, you can ask your treating health professional for a summary of events and your treatment. You can also talk to your partner or key support people about what happened (these conversations can be equally painful for them so ensure they are ready too). Down the track you may want to write your story in a private diary or use photos or memories to put together a time-line. Some women find sharing their experience through a blog a healing process. Some women also find it useful to read other women’s stories >
Many women behave in ways that are really out of character during an episode of postnatal psychosis. Distressing thoughts about harming yourself or your baby are also common. It can be normal to feel embarrassment or shock at the things you said, thought or did when you were unwell but remember that these were symptoms of an illness and not a permanent change in you. Talking through your experience with a specialist counsellor can help. PANDA can help you find one.
Loss of confidence
As someone who has experienced postnatal psychosis you might find your self-confidence is affected, particularly in your skills as a mum. While it’s good to get help from others with looking after your baby, it’s also helpful to keep doing basic baby care as often as you can as this helps to build your confidence and strengthen your bond with your baby.
If you are feeling anxious about being with your baby you can ask you maternal child nurse (or equivalent) for practical tips for playing with your baby. At first it might feel like you are going through the motions, but in time your confidence will recover. Remember that all new mums are anxious about whether they are doing it right. Keep taking it gently. If you can, accept help from friends and family. Be clear about the help you would like, so that they resist the urge to take over.
Bonding with your baby
Bonding is a big worry for most women who have been through postnatal psychosis, particularly if you have been separated from your baby for any period of time. There can be a lot of focus on breastfeeding and skin-to-skin contact in the very early days of newborn life, and you may feel as though you have missed out on this chance.
It’s normal to feel really sad about this, but important to know that bonding is an ongoing process and just spending time with your baby as you recover will strengthen your bond. You might like to try some of these things to help you connect with your baby:
- Copy your baby’s facial expression when you are cuddling
- Read simple picture books to your baby
- Sing to your baby
- Talk about what you are doing even if it feels silly – your baby loves to hear your voice
- Hold your baby close, facing your body during feeds
Most women find that as medication begins to take effect, and recovery begins, they feel physically and emotionally drained. Try and make sure you get as much rest as possible. As well as a new baby, you have also had a serious illness so it’s really important to sleep, rest, and don’t put too much pressure on yourself. Rest or sleep when your baby sleeps where possible. Seek out practical help in the house from friends/family. Share responsibility for night feeds with your partner or support person if you possibly can.
Professional care and support
If you are recovering from postnatal psychosis it is likely that you will continue to receive support from health professionals including a psychiatrist or GP. When you leave hospital, a plan should be put in place to provide support for you while you are at home. Depending on your circumstances and where you live, you may receive support from an enhanced home visiting service. Your local maternal child health nurse (or equivalent) can also provide ongoing care and support. PANDA can also be part of your ongoing support plan.
Visits or appointments with professionals can sometimes seem intrusive, and you might worry that your ‘performance’ as a mum is being monitored. It is really normal to feel like this, and OK to talk to the health professional if you need reassurance. You may find it easier if your partner or key support person is there with you. It is also OK to ask for specific advice to help you bond more with your baby.
If you find that feelings of anxiety or low mood are overwhelming, or if you have concerns that you are relapsing, don’t wait for your next appointment. Ask to see your psychiatrist immediately. You can also contact your local Acute Mental Health team.
The ups and downs
Many women find the first year of recovery is marked by significant ups and downs in mood. It can feel like a real setback if you have been feeling well and gaining confidence, but then have a period of low energy or depressed mood. Try to remember that all mums of young children have good and bad days. You may also find it worrying if you have periods of sleeplessness and high energy. It is really worth talking to professionals about any concerns you have.
Tips to help with the ups and downs:
- Try keeping a regular weekly routine
- Set yourself small goals and monitor your progress.
- Keep a mood diary to help you see whether there are triggers for low or for energetic times.
- List activities that make you feel happy or energised and try them when you feel low.
- Do the same for activities that make you calm and relaxed and try them when you feel
- Daily self-care practices, making time for yourself stressed or high.
For many women, symptoms of depression do occur after an episode of postnatal psychosis. You may experience tearfulness, lack of pleasure in anything, loss of motivation, poor sleep and negative thoughts about yourself. This can feel like a real double blow. If you or your partner are concerned that you are depressed it’s important that you speak to your treating doctor.
Loss and grief
It takes most women at least a year to begin to feel confident in their recovery. After the first year, your mood may feel more stable and you will have some experience of the challenges of motherhood under your belt. However, it is still really normal to feel a huge sense of loss of the first months of your child’s life. You may also still be feeling sad about the impact your illness has had on your relationship with your partner and/or other loved ones.
It’s important to allow yourself to grieve for these losses, and also to celebrate what you have achieved in recovery. Talking to a trusted friend or professional counsellor can be helpful. PANDA’s National Helpline can offer you telephone counselling support or help you find a local face to face counsellor.
Planning a future pregnancy
Many women who have had postnatal psychosis go on to have more children. About 50% of women do not experience it again after having another baby – but about half do. So if you’re thinking of having another baby it’s important to plan carefully and to put some supports in place well ahead of having your baby.
You can ask your GP or midwife for referral to a psychiatrist, preferably one who is specialised in perinatal mental health. PANDA can also help you find a psychiatrist. You can do this even before you become pregnant for advice about medication and care planning. Whilst it is not always possible to avoid another episode, with the right care in place you should be able to get help more quickly and recover faster than your first experience.