Psychosis – and how I got out
compare the experience of an MBU with that of a general adult psychiatric ward. In September 2009, she gave birth to her first baby and, two weeks later, was in an adult psychiatric ward with postpartum psychosis. Hannah spent three-and-a-half months in hospitals, initially in two general adult psychiatric wards and then in a small MBU. She acknowledges that the wards kept her safe. But the separation from her baby was “awful”.
She speaks of the MBU with a smile in her voice: “It was my little haven to be with my baby and for my husband to come in and spend family time together.”
As my time in the MBU progressed and I became well, my fearful thoughts were replaced with a lot of questions, such as: What had happened to my brain? I turned to Jessica Heron, a senior research fellow in perinatal psychiatry at the University of Birmingham and director of Action on Postpartum Psychosis, a charity that provides support and information for those affected.
I asked her what we know about the risk factors for postpartum psychosis. “Very little, really,” she said.
“The best guess at the moment is that biological and hormonal factors are involved. There have been some studies into the most likely candidates and they haven’t found anything consistent. We do know it runs in families more often than you’d expect. We know there’s a strong link with bipolar disorder. So some of the risk factors that have been found in bipolar, like sleep disruption, [may be implicated].”
Unfortunately, in to the neurobiology of both bipolar and postpartum psychosis, there are many theories — genes have been implicated and chemicals that have been incriminated — but no clear answers. I asked Heron why so little of the biology of postpartum psychosis has been elucidated.
“Because it’s been perceived as rare, I think funders haven’t seen it as a priority,” she replied.
The knowledge drought around my illness left me feeling that science, my usually faithful mistress, had failed me. Thankfully, a new friend came to my rescue and provided the insight and understanding I sought: storytelling. Recording my story was therapeutic.
This started in the hospital, initially through the medium of photos because I couldn’t focus or stay still long enough to write anything.
Despite the rich medium of imagery, I was pleased when I could once again communicate using the written word. Like taking photos, writing was therapeutic and formed a key part of the healing process for me. I wasn’t alone.
A 2006 review of 146 randomised controlled trials of written or spoken “experimental disclosure” (disclosing information, thoughts and feelings about personal and meaningful topics) found significant positive effects across a range of measures, including psychological health and physiological functioning.
The following year, Matthew Kreuter and his colleagues devised a hypothesis about why narrative communication, such as storytelling, journalism and testimonials, might benefit cancer patients. They suggest narrative writing allows you to impose order on the chaos that disease foists on your life. I think this applies to mental illness too and gets to the heart of why, for me, storytelling has been integral to my recovery from postpartum psychosis.
I had felt like I was standing in a hurricane of these terrifying thoughts, and writing was like stepping into the quiet eye of the storm where I could physically pin my thoughts on to the page and stop them constantly whizzing around my brain. For someone used to being in control, this was a godsend.
With the combined therapies of medication, the MBU and storytelling, I became well enough to go home after six weeks. Unfortunately, the road to recovery from postpartum psychosis is often beset with challenges. About three months after being discharged, I developed postpartum depression, an experience Heron reassured me is more common than not after postpartum psychosis, and I was hospitalised in the MBU for a further three months.
It wasn’t until I spoke to Hannah that I realised recovery really begins when you walk out of the hospital doors. She says: “I describe it as being shattered into a million pieces and then rebuilding it all gradually, the main thing being [having] the confidence in my own abilities.”
Writing this article is part of the process of rebuilding my confidence.
Being adept at writing is core to my identity. As well as understanding and processing what has happened to me, I needed to do this to prove post-psychosis me could still write.
Women who have experienced postpartum psychosis have more than a 50% chance of another episode following a subsequent birth.
It’s a bridge that my husband and I will cross in the future. For now, I’m focused on the present and grateful that the MBU and various forms of storytelling have helped me to move from a place of acute illness to being at home and well with my baby girl.