Woman diagnosed with postpartum psychosis five months after birth opens up on 'horrific' symptoms
Warning: This article contains discussion of psychosis and suicidal behaviour which some readers may find distressing.
Postpartum psychosis affects around 700 to 1,400 women every single year in the UK - which equates to around one in every 1,000 births.
Dr Jess Heron, the Chief Executive at Action on Postpartum Psychosis (APP), tells us that it's a serious postnatal mental illness and, while some women with existing diagnoses (such as bipolar disorder) are at greater risk of developing it, in about 50 percent of cases it occurs completely out of the blue in people with no prior mental health problems.
With that said, however, Dr Heron notes that while it is a medical emergency requiring immediate treatment, postpartum psychosis is treatable and women can recover from it.
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And we spoke to one incredible woman who proved just that.
Tyla sat down with Ruth Hanna, who hails from Northern Ireland but lives in Spain, who was diagnosed with postpartum psychosis five months after giving birth.
During our chat, Ruth opened up to us about the warning signs that led to her diagnosis, what an episode looked like for her and how ECT - known as 'electric shock treatment' ended up saving her.
The 40-year-old mum-of-one gave birth to her son, Koa, back in September 2019 and had a 'really easy' pregnancy.
Ruth told Tyla: "We ended up having to have a cesarean birth, which was not what I wanted but it's what we were kind of advised to go for."
But in February the following year, things started to take a turn.
"I started to really obsess that he [Koa] wasn't developing properly, that he wasn't going to develop properly [...] silly things like the shape of his hands were wrong, the shape of his feet were wrong, he wasn't growing enough, he was going to be disabled, or that we'd somehow harmed him which wasn't the case at all - he was a very healthy baby," she explained.
Ruth continued: "I wasn't sleeping.
"I was pacing the flat during the night obsessing at how he wasn't developing, he wasn't feeding properly, that he was going to get taken off us and that my husband and I were going to end up in jail because we had somehow harmed him."
The mum-of-one recalled: "It was bad. It was really strange. I was kind of manic, doing lots of things, trying to talk to everybody that I could to try to explain the situation to try and convince them that my son was unwell.
"I had a notebook where I was obsessed with writing down every time he'd fed, the millilitres, the lists and trying to show it to people."
Ruth then had an 'emergency appointment' with a GP where they advised her to start taking diazepam to 'calm down' and, after another appointment, she was advised to start taking an antidepressant.
After this, one of her friends got Ruth an appointment with a psychologist who dealt with perinatal issues.
She said: "I remember going into that meeting with my notebook and trying to explain everything to her. So, in my eyes, I was kind of asking for help or expressing that things weren't going well, but nobody really picked up on what was going on.
"I don't even think they used the words postpartum depression even at that stage."
Ruth had to endure two 'very bad intense' weeks of not eating, sleeping, pacing around the flat, lying on the floor crying and 'being quite hysterical sometimes'.
"You're not meant to sleep with a newborn but it wasn't because he was keeping me up, it was because I was keeping me up with my thoughts," she explained.
However, even with all that going on, Ruth was still incredibly able to feed her son, get him up and dress him.
Then, one night, something absolutely horrific happened.
Ruth bravely told Tyla: "I woke up in the middle of the night, or didn't wake up because I was awake.
"At five o'clock in the morning, I decided to get into the car in my pyjamas with no shoes, and I drove to the motorway and I walked in front of a lorry.
"So I was very lucky to survive."
She continued: "I don't really remember what it was that I was thinking. But I think it was just the nonstop of the thoughts.
"I was very lucky, I had to get stitches and I had some bad cuts and stuff on my body."
Ruth was then admitted to a general psychiatric ward - which she described as 'horrific' - for three days without Koa and was later discharged into the care of her husband, Jamie, at home right when COVID hit.
"It felt very much like a prison that ward," she recalled. "They had a very tiny patio, there was barbed wire on the patio to try to stop people from escaping."
A psychiatrist, who saw Ruth a couple of times a week, later struggled to find the right medication for her.
Then, a friend of her husband Jamie told him about mental health wards in the UK that are specially designed for mums to be with their babies while they have treatment.
So, in May, the family drove from Spain to a Mother and Baby Unit in Glasgow where Ruth was admitted alongside her son and was 'able to get better while being a mum' in a 'much more of a welcoming space' than the previous general psychiatric ward in Spain.
It was here that Ruth was finally diagnosed with postpartum psychosis after being sectioned.
Doctors tried different doses of medication to help the mum with her symptoms alongside trying out therapy, too.
However, unfortunately, Ruth's symptoms didn't improve and ECT (electroconvulsive therapy) was eventually suggested.
"It got to the point where the medication wasn't working for me so there were two options: I would have to go on to take lithium or the ECT," she said.
ECT was something Ruth and Jamie were 'very, very wary of', adding: "I didn't know anything other than the scary things that you'd seen in films, from old films with ECT."
In August, Ruth started the treatment and had 18 sessions in total.
It was only around the halfway mark of the sessions, however, that Jamie started to see 'little glimmers of the old me coming back'.
Ruth, who had no mental health issues prior to this, was then discharged five months later in October, just after Koa had turned one, and returned to her home in Spain.
"We came back and I was put into the care of a local general psychiatrist here, and I picked up sessions with the psychologist who I was already seeing and I was seeing through my episode that I had here," she added.
Ruth was instructed to carry on taking her medication, which she found 'very hard to come to terms with' as she wanted to 'turn a page' and 'start her life again' following her discharge.
She continued: "But it was a very slow process, it took three years.
"I came off my last meds in October. So it was a three-year period of the psychologist weaning me off because it was a lot of medication, and it was a high dose."
In September 2021, Ruth went back to work as a teacher and, a couple of months after that, she reached out to the Action on Postpartum Psychosis (APP) team to share her experience.
"It was so enlightening to hear and just to be able to talk to people who had had what you had," she said. "Nobody in my surroundings had ever had postpartum psychosis or have heard of postpartum psychosis."
As for advice to other women who may be wondering whether they have postpartum psychosis?
Ruth says: "I would say check out the APP website, because then you will realise that you're not alone and, you know, these things are real and can happen and it can be more than just baby blues or postpartum depression.
"Go to your GP. Just keep pushing and keep pushing and, with your family as well, get them to keep pushing for you.
"Because if you can get the right help then you can get better. That is the amazing thing.
"You can be so sick, like I was so ill, but I'm not now. I've been able to go back to having a normal life."
Ruth continued: "Yeah okay, there's a lot of things that I regret, like, I missed so much of my son's life, I didn't see him crawl and start to eat - five months of his life, I was completely out of it which is a hard thing to come to terms with, but you can get better.
"It's not a diagnosis for life. It's not, you know, you're not dying. If you can get the right help, it's all about the right help.
"Because without that, you just don't know which way to go, what direction to go."
Likewise, Dr Heron's advice to women who suspect they may have postpartum psychosis is to 'ask for help straight away'.
She told Tyla: "If you think something’s not right, it’s worth raising the possibility of postpartum psychosis with a health professional.
"It can be difficult to identify what's real when you’re struggling with psychosis and many women feel afraid of letting their doctor or partner know that they are hearing voices, for example. But with help you’ll get better quickly."
She continued: "Early diagnosis and access to an MBU is the best course of action and will encourage earlier recovery.
"So please be as open and honest with your health professional as you can and remember, APP is a huge network of strong, positive women who have experienced this illness and are now living full and happy lives as mothers.
"We are here to provide hope, support, understanding and evidence that you will recover."
What are the symptoms of postpartum psychosis?
The NHS states that symptoms usually start suddenly within the first two weeks after giving birth - often within hours or days of giving birth.
More rarely, however, they can develop several weeks after the baby is born.
Symptoms can include:
- hallucinations – hearing, seeing, smelling or feeling things that are not there
- delusions – suspicions, fears, thoughts or beliefs that are unlikely to be true
- mania – feeling very 'high' or overactive, for example, talking and thinking too much or too quickly, restlessness or losing normal inhibitions
- a low mood – showing signs of depression, being withdrawn or tearful, lacking energy, having a loss of appetite, anxiety, agitation or trouble sleeping
- sometimes a mixture of both a manic mood and a low mood - or rapidly changing moods
- feeling very confused
Dr Heron also noted that postpartum psychosis is different to postnatal depression.
"The treatments required are different. It has different risk factors and long-term outcomes are different too," she explained.
For more information, advice or peer support, visit the charity for mums and families affected by postpartum psychosis.
If you're experiencing distressing thoughts and feelings, the Campaign Against Living Miserably (CALM) is there to support you. They're open from 5pm–midnight, 365 days a year. Their national number is 0800 58 58 58 and they also have a webchat service if you're not comfortable talking on the phone.
Topics: Real Life, News, UK News, Pregnancy, Parenting, Health, Mental Health, Advice, NHS
Rhiannon Ingle