All The Right Ingredients

This is a guest post written by my good friend and work colleague Jasmine Gable about her experience with Postpartum Psychosis.

Just over 17 months ago I became a mother. I had a planned c-section so I knew the exact day my little one was arriving and my husband had arranged to take a month off work. I was looking forward to spending this time getting to know our daughter and adjusting to parenthood. Unfortunately fate had a different idea for those first few weeks. You see I have bi-polar, an illness where one’s mood can be extremely high (mania), or extremely low (depression). Some people with bi-polar can experience psychotic symptoms.

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photo by: Jennifer Klementti

Within the first few days of being home after our daughters birth both my husband and I noticed that my mood, behaviours and sleep patterns were not normal. This was to be expected as after birth the drop in hormones can wreak havoc on mindset and mood. In addition lack of sleep is one of my main triggers. We quickly realized that what I was experiencing was more then just lack of sleep and a hormone imbalance and that I needed some additional medication. At our little one’s first doctor’s appointment our family doctor prescribed me some anti-anxiety medication that I had used in the past. We also bumped up my psychiatrist appointment and saw him within the first week of my daughter’s life. I was put back on the mood stabilizing medication that I had stopped in order to conceive.

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That first week we packed up and moved in with my in-laws. My husband needed the help, as he had to care for me and our new born. Over the next few days things got worse. I slowly started to lose touch with reality, something that had not happened to me in 10 years. In the beginning I was fully aware of my psychosis. I kept a journal of the “First 100 Days of Motherhood”. In it I wrote “On Monday I saw my psychiatrist. He doubled my meds. I have never done such a big med increase without being in hospital. The first night I hallucinated things crawling on the wall”.

As the days past I became more and more manic. I was irritable. I was super talkative. I cried a lot. My mind was racing with ideas. I had no filter when I spoke. One night after my father-in law spent a lot of time making dinner I announced I did not like the food in a jovial voice, and heading into the kitchen to make a sandwich. This was very out of character for me; I am one of the most polite people you will meet.

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Soon enough my thoughts were not making much sense. Here is an example “I am sick with fever and flu and all other things. Let’s cut off my head, tie it in a knot and bring it to the dump. Then we will bring it back and screw it on straight”.

Finally I became disorganized and was having delusional and grandiose thoughts. One afternoon I left my in-laws house, as I thought I was meeting my sister. I had the day wrong. I walked around the neighbourhood thinking I was being filmed by a helicopter flying overhead, and I was giving a tour about all the houses that were for sale. At this point my husband and family had no idea where I was. Eventually they called the police and reported me missing.

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My husband did find me, and brought me back to my in-laws house. I was too upset and embarrassed to enter the house. My sister came and helped me through that very hard moment.

After that incident my husband got in contact with my psychiatrist who advised him to bring me into the Emergency Department (ED) for assessment. I remember while we were driving there I thought I was going to be meeting my family at the hospital for a radio interview on living with mental illness and growing up with a brother with Autism. Upon arrival to the ED I then strongly believed that my father, who had passed away 2 years prior, had actually faked his death and was somewhere in the hospital.

I don’t remember much else from that night in the ED. I remember going for a CT scan, and an ambulance ride. Supposedly I made up a song to the tune of a Gwen Stefani “What You Waiting For” about being on Instagram, and swore at the nurses a lot. Something my husband and I laugh about now. I woke up the next day at a different hospital hooked up to an IV. The nurses told me my husband had just left and would be back soon. It was very scary to wake up alone and have no idea what was going on.

It turns out I had a very high fever, and endometritis. In the past the majority of my manic episodes have been brought on by extreme stress, lack of sleep and illness. The first two weeks of my little one’s life provided all the right ingredients for postpartum psychosis.

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I spent 3 nights in the hospital. The last night I spent on a family psychiatric ward, where my husband and baby were welcome to stay with me. My husband stayed and my daughter spent the night with my in-laws. That night was horrible. There were patients yelling all night for their lawyer. It was a locked unit. It was exactly the kind of place I had worked so hard not to be in since my early twenties.

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The next couple of months were a challenge. It was still a couple of weeks before my husband felt comfortable leaving me along with our daughter. Eventually his mom convinced him to do it. After my mood came down I fell into a mild depression during my first winter as a mom. I felt very isolated and alone. I cried a lot. By spring my mood was stable, and I was excited to spend the rest of my maternity leave enjoying the gorgeous summer months.

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I have been thinking a lot about those early days. I am preparing to try for baby number two. That means coming off my mood stabilizers again. There are a couple things we will be doing differently this time around. I’ll go back on my medication during the end of the last trimester in hopes of helping my mood in the first few weeks after birth. I will also be followed by a high risk team (who I did consult with the first time). They have a special program where mom and baby stay in hospital for a week to make sure mom’s mood and sleep are stable. I can’t say I am not scared. I am scared that I will get sick again, and this time around 2 little ones will suffer from my instability. But the benefit of my daughter having a sibling helps me to focus on the positive, and gives me the strength to try.

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Jasmine Gable is a community mental health nurse in Toronto. She had her first psychotic episode at the age of 17 and was diagnosed with bi-polar disorder. It took a few years and several hospitalizations to determine the right medication combination. It was Jasmine’s experience as a psychiatric patient that led her to specialize in psychiatric nursing. Jasmine is currently enjoying motherhood to the fullest and is looking forward to giving her daughter a sibling.

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