Postpartum Psychosis Produces Symptoms That Are Much More Extreme Than Prenatal Depression
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Ben arrived early -- three weeks early. He was a sleepy baby and seemed small at seven pounds. My firstborn, Dan, had weighed over nine pounds, and he'd acted like a baby dynamo. I kept staring at Ben -- so frail and wrinkled -- and wondered if he might have suffered damage at birth.
Fortunately, my closest friend, Ruth, had arrived to help out after Ben was born. My husband, a newly-hired college professor, couldn't take time off. Things seemed okay while Ruth was there -- she helped get Dan off to school every morning, prepared meals, and cleaned house. But after a week, Ruth needed to get back to her own life, and I was left to spend long days alone with my newborn.
A quiet beginning
Then it began -- slowly at first. I started to imagine that Ben was somehow speaking to me -- telepathically -- while he slept. I'd stand over his crib as he'd tell me that he was in pain, that there was something wrong. At first, I recognized this as anxiety -- my baby couldn't talk to me! Get a grip! I told myself.
Soon came sleeplessness. I'd wake in the middle of the night to check the baby. He'd begun telling me that he didn't want to live. I'd be zombie-like from lack of sleep and sit down on the rocking chair by the crib. When morning finally dawned, my husband would find me there -- rhythmically rocking, the chair pulled up alongside the crib bars.
My husband seemed troubled by my silence and sleeplessness, but I dismissed his concerns. On some level, I knew the baby wasn't talking to me. Yet, on another, I felt like I was mystically in touch.
Next, I began to have violent hallucinations. I saw knives piercing my baby's chest. I'd be afraid to open the knife drawer in the kitchen. I tried to shake these horrible thoughts away and kept up a facade of normalcy -- until one night when I woke, as usual, after just a few hours of sleep. I went to Ben's crib side, and as usual, he began speaking to me. But this time, I heard another plan, a more plausible-seeming one: Ben suggested that I take his little pillow and suffocate him. Then, he said, I should stab myself.
I confess that I actually took a pillow and held it gently over Ben's face until he squirmed slightly. And then I lifted it, thinking, Yes, I can do this. But gratefully, another voice followed: It's the middle of the night. Anything you can do now, you can also do tomorrow. Wait. And so I struck a bargain with myself -- I'd wait until the morning.
A steadying voice
When the normal household activity began, I seemed to wake from a nightmare of whisperings. Later, I phoned my friend Ruth, who, with her kind, forceful honesty, probably saved Ben's life as well as my own.
"I've been having violent thoughts toward Ben," I said casually to her -- intentionally sandwiching the remark between ideas for that night's dinner. But Ruth heard me, made me repeat myself, and insisted that I explain. Thankfully, Ruth knew about psychological disorders and said, "Robin, Ben's not talking to you -- this is a symptom of postpartum psychosis." And with those words, I felt released.
That night I spoke to my husband, who hugged me and made me feel safe. I had heard of "postpartum depression," but never postpartum psychosis. I went to the library and gave myself a quick education on the subject. I had all the symptoms: mood changes, feelings of deep despair, confusion, severe insomnia, and bizarre hallucinations. Because I could so easily match my symptoms with the description of the disorder, my psychosis began to fade. It became external, objective -- and suddenly, I wasn't hearing voices anymore.
I did end up touching base with a therapist. Postpartum psychosis, she assured me, can be bio-chemically triggered, and when recognized and dealt with, almost never recurs. There was no indication that an episode of postpartum psychosis predisposed a woman to further mental problems.
A taboo subject
During the next few months, I took my therapist's suggestion and sought contact with other new moms in my area. I began attending local LaLeche League meetings, and as a way of dealing with my feelings, I decided to tell my group about what I'd been through. But my first attempts at communicating failed, and quickly I began to understand that postpartum psychosis is a very taboo subject.
After leaving one meeting at which I'd tried to speak about my experience, I realized that this form of mental illness runs contrary to our most cherished notions about motherhood. Motherhood implies warmth, limitless love, self-negation, generosity of spirit -- and my talk about feelings of violence toward my baby, and my admission of weird hallucinations, were very threatening. Nevertheless, I reasoned, there might be others who needed to hear what I had to say -- so I kept talking.
Talk about it
And there were a few women in the group who came over to me privately, after our meetings, to admit that they had had similar feelings. This subject, I came to believe, is one that women needed to talk about. According the Harvard Mental Health Letter (Sept. 97, Vol. 14, Issue 3), "One out of 1,000 new mothers has a psychotic episode, usually in the first few weeks" following birth. Psychologists widely believe that the everyday stresses of contemporary life have increased the incidence of this form of illness. Because the period after birth is often isolating, mental health professionals agree that new mothers need extra emotional support.
I'm happy to say that I have never again experienced the kind of mental confusion I felt after Ben's birth. But the memory of that episode has left me sympathetic and aware.