My blog about postnatal psychosis

How to get help from your Perinatal Mental Health Service

I am a 33-year-old British Sikh woman. I have always strived to be a high achieving perfectionist. I studied medicine at university and became a doctor at the age of 23. I met my husband shortly after graduating and got married at the age of 25. After finishing my postgraduate training, I had my first son. The whole of pregnancy was a beautiful experience and went smoothly without any complications. Unfortunately, in the first two weeks after having my baby I developed postpartum psychosis for which I was hospitalised in a mother and baby unit for 6 weeks. This experience was completely unexpected as I had never suffered with any mental health issues in my life previously. I did eventually recover from postpartum psychosis with medication, family support and cognitive behavioural therapy

Just before lockdown started, I found out that I was pregnant again. It was a planned pregnancy and I felt fortunate that I may experience the positive motherhood experiences that I was not able to enjoy the first time around. Shortly after this news the country went into national lockdown due to COVID. I found it devastating that my social circle was eliminated, our local place of prayer was closed and that my son was no longer able to go to nursery. Managing entertaining my son and dealing with symptoms of early pregnancy was very challenging. The lockdown meant there was also no support throughout the early pregnancy period from local family members which I found very difficult and isolating. I was already under the perinatal mental health services at this time due to my previous history of postpartum psychosis. To keep myself in good spirits I would go for a drive and a walk on a daily basis. I found having to do constant activities with my son very tiring and draining.

During lockdown I missed the local temple programmes the most. Prior to the lockdown we would attend our local temple three times a week. We loved attending services as a family and also had a good social circle there. Sikhism plays a very important part in my life, being a baptised Sikh, and not having these programmes and interaction with the local congregation proved very difficult. We tried to set up local virtual services, but this was just not the same.

I was also working throughout pregnancy and lockdown but my work was limited to telephone consultations only which was completely different to how I am used to working. This was an isolating and challenging experience as giving advice without seeing patients face to face and examining them was a tremendous change.

In the final few weeks of pregnancy several members of my family came to stay for support and I was started on prophylactic antipsychotic medication. Having more people in the house felt so nice as I was not solely interacting with immediate family only. Cooking, eating and spending time together was very enjoyable. This highlighted to me how important it was to have interaction with other individuals.

Myself and my perinatal mental health team were quite optimistic that I would not suffer with psychosis again due to being on prophylaxis and having so much support during the last few weeks of pregnancy. My labour and delivery was very straightforward and this gave me more hope of not having to suffer again. Unfortunately in the first few weeks of giving birth I started becoming psychotic and manic. On this occasion I was able to identify what was happening as I had been through this before. I quickly liaised with my perinatal mental health team and was admitted into the mother and baby unit for less than a week before being discharged. My medication dose was increased, and I started a speedy recovery. This time around the psychosis was a lot milder and I was able to comfortably function with life and as well as the responsibility of looking after my children. My family were key to my recovery as they offered an immense amount of support.

Having psychosis a second time was completely different from the first episode. This highlights to me the importance of identifying and treating it for any mother the first-time around. This gives them hope that any subsequent pregnancies will be managed appropriately and they will not have to suffer as much, if at all, compared to the first time.