Trigger warning: Suicide, Postnatal depression
My last blog was when my son was around 8 months old, he is now 15 months and something has clicked. Maybe not clicked, because that sounds small and insignificant, something has shifted, and I am finally enjoying him. I can feel myself tentatively building a relationship with this person who I’ve been unable to connect with for over a year. I am so nervous about returning to my postnatal depression that I am hesitantly stepping into this new period of motherhood with one eye over my shoulder. It feels so novel to feel in love with this person and want to spend time with him. As we form a new relationship together I have been reflecting on my pregnancy and postnatal period, able to look it in the eye now. As someone with Bipolar Disorder I wanted to share my journey for Maternal Mental Health week.
As someone with Bipolar you have a 25% risk of postnatal depression and a 25% risk of postpartum psychosis. You are therefore encouraged to connect with a perinatal mental health team even before you get pregnant. This is how I found myself in a meeting with a Psychiatrist discussing a hypothetical pregnancy. From day one I was acutely aware of the possibility of becoming unwell following birth but was reassured that the chances of staying well improve the longer you’ve been well prior to pregnancy. As someone who was on top of my day to day management of Bipolar, I thought of my involvement with the team as precautionary rather than necessary.
Once I was pregnant I was assigned a Community Psychiatric Nurse (CPN) and a Psychiatrist. The CPNs role is to support you through pregnancy and build a relationship with you so that you have a good rapport once you’ve given birth. The Psychiatrist can advise on medications and conduct reviews if your CPN is concerned. My CPN also arranged for me to have a midwife and consultant who specialised in mental health. I had regular meetings to discuss medication, birth plans, my mood and concerns. My birth plan took into account the significant risk of my mental health deteriorating and so we put things in place to mitigate the risks:
- I would have an induction so that I wouldn’t spend days labouring at home without sleep
- I would have an epidural to provide more time to sleep before needing to push
- I would be given a side room on the ward so I could sleep as much as possible pre and post birth
- I would be disturbed as little as possible post birth so that I could sleep
- I would have safe sleeping tablets to take if needed
Basically, we would do whatever we could to get me the hell to sleep.
Except of course labour does its own thing regardless of your birth plan, despite all our arrangements I barely slept; he wouldn’t feed properly, we were disturbed constantly for checks, for meals or for feeding support. I felt completely overstimulated, exhausted and alone. I sent my partner home overnight so at least one of us got some sleep and would spend the night sobbing in my pants, trying desperately to feed. A Nurse kindly offered to take him overnight and feed him, I woke every few hours hearing babies crying and wondering if it was mine, I’d already failed.
When we got home I felt shell shocked, ‘congratulations’ balloons were strung up and I stared at them struggling to comprehend what we were celebrating. I cried all the time and felt no connection to my son, handing him over to anyone that would take him.
The next few months I watched from the periphery as mums in my antenatal class began to find their feet. I either felt like I was watching my son through a bubble, detached and blurry, or like I was raw and exposed, acutely feeling every painful emotion. I waited for this big love to kick in but it didn’t happen, if someone called him my son or described me as his mum it felt itchy and uncomfortable, I felt like I was looking after someone else’s baby not my own. After around 9 months of maternity leave I returned to work, hoping that connecting with my old life would magically change my experience at home. Instead, whilst I found work enjoyable, I also found it completely overwhelming; I was still suffering with my mental health and trying to balance a long commute, the logistics of childcare and being competent in work again. It became too much and I went on sick leave.
Things deteriorated following a weekend alone whilst my partner took my son to visit family. I spent the weekend in my own company, feeling like myself for the first time in months, there were no expectations of me, I wasn’t overwhelmed, I didn’t have to sit with the feeling of failure. As they began their journey home I felt panic rising, I couldn’t return to feeling that despair, I felt hopeless and couldn’t see a way out. I had done everything I’d been told to; I’d adjusted medications, seen specialists, done bonding techniques, nothing had worked. I sat on my bathroom floor and counted out pills, needing a sense of control over the situation.
Once my partner was home my CPN came and explored our options and we agreed I would go to a mother and baby unit, a psychiatric hospital where the mum and baby go together. As we pulled up to the unit I noticed the garden, outlined by a high, curved fence, exactly like every other psychiatric hospital I had visited. As we entered I felt flushed with panic, I was shown to my room which had no bathroom door and a bed that was stuck to the floor, covered by a hospital blanket. I removed my shoes and was searched for banned items, we stepped out of the room whilst my suitcase was examined and my charger and medication were removed and placed in a locker in the nurses room.
I sobbed as a member of staff spoke to my partner and I about the benefits of staying, that I would get the support I needed and it would no longer be all on my partner to look after me and my son. That first night I was checked on hourly, woken by a torch casting light over my room and the cot. The next day I was shattered and on edge. Everything was new and everything was locked. The staff were kind but with regular shift changes it was hard to keep track of who people were and I felt nervous leaving my son with endless strangers. The activity worker had left so days were spent listlessly hovering around a small lounge trying to entertain my now mobile son. I was allowed on accompanied walks to the concourse and around the hospital site, making small talk with staff. After 2 on and off weeks I decided I would be better at home, seeing friends, having my partners support and in my own bed with my cats. Home had never felt so wonderful.
At home I still struggled to look after my son but I had time to focus on my recovery and staying well, I was able to keep things calm and low stimulus in the day, meaning when my son was home I had more energy to engage with him. I eventually returned to work with the support of occupational health and my manager, building my hours up slowly over a couple of months. I began to enjoy work and connecting with myself again and benefited from the routine and structure. When I returned to full hours I struggled but have managed to persevere and am finding predominantly working from home is helping to keep things feeling manageable. My mood has stabilised and I am finally spending more time socialising and finding ways to manage the overwhelm of working and parenting.
This has been a truly awful time but it has made finally bonding with my son all the sweeter. I want to spend time with him, don’t feel panicked when I have him alone and feel more confident taking him out. I am so grateful to have had an amazing partner and family during this time who have supported me and never made me feel judged. My advice to anyone struggling during the postnatal period would be to engage in support and be vocal about how you are feeling, there is so much pressure and stigma attached to parenting but I have been amazed at the number of people who have been open about their difficult experiences once I shared my own. There is something very powerful about balancing out the homemade bread clan with the mums who also feed their kids fish fingers after a long day at work, and don’t tidy the house because they just need a breather. So do whatever you can to look after you, remember you don’t need to be perfect, you are ‘good enough’ and that’s all a small person really needs. You’ve got this.
P.S Bipolar 