When Eastenders announced the postpartum psychosis (PPP) story line of Stacey Branning, who also has bipolar disorder, there was excitement within the online community of PPP campaigners who all want to raise awareness about the condition. Careful consultation with Action on Postpartum Psychosis (APP) was taken to ensure an accurate depiction.
In the Eastender's storyline we see how Stacey becomes delusional, believing her baby is special, makes constant allusions to god, is paranoid and manic from chronic sleep deprivation, becomes disorientated and suffers hallucinations. What is crucial to remember is that each person's experience of PPP is unique and will vary.
By creating art that dealt with my PPP it helped to soothe my brain (mixed media on A3 paper, 2012)
Personally, PPP struck on the third day after giving birth when I experienced heinous visions that involved harming my baby. Other symptoms included being garrulous, an inability to sleep, mania, paranoia, amplification of sounds and I could be rebarbative to those close. Stacey accurately portrays the mental spiral as you get sucked into a vortex of false narratives. Since I'd experienced psychosis before I recognised the symptoms and informed the midwife. I was kept in hospital for two weeks before being transferred to a mother and baby unit for one month during which I deteriorated. The visions intensified when I breastfed because I experienced dysphoria due to the upsurge in oxytocin when my baby latched on - a condition known as D-mer. Far from making a full recovery after release I was vulnerable to mini episodes when sleep deprived. The visions of harming my baby and/or myself didn't abate until I stopped breastfeeding.
Drawing of view from hospital window, which I was told to draw by a voice in my head a few days after giving birth (pen and ink on A4 paper, 2010)
What was unfortunate is that my psychiatrist at the time, who knew I had a history of psychosis, didn't forewarn me that I could be vulnerable to maternal mental illness; my obstetrician had no experience of dealing with a pregnant patient with a mental health issue; and the hospital psychiatrist didn't deign it necessary to see me. When psychosis struck the midwives were also unsure of the correct protocol. I was apparently their first case of PPP. When I sought help panic ensued. It was as if the hospital wanted to cover their back - all the focus was on the welfare of the baby not the mother.
During my second pregnancy I thought I would get the care I needed but it was not the case. Six weeks before I was due to give birth I was threatened with induction and told if I didn't agree I had to find a new hospital. There is no evidence that induction prevents psychosis. It was lamentable.
Disillusioned with the mental health care available and follow up support, I found myself dealing with the gruesome visions that came firing daily on my own and responded by firing bullets of logic back to dispel them. They could appear up to 30 times a day. To suffer suicidal ideation is hard enough, but for these thoughts to be transferred to my children was horrendous. After time I realised that these delusional ideas were mental aberrations and should not be given any credence, however the toll on me mentally was heavy since I felt my children were in constant danger.
Drawing both my children while breastfeeding or when they slept helped me to slice through the visions, get through PPP and calmed down my hot brain (mixed media on A4 paper, 2010-2013)
The isolation of dealing with PPP as well as the toll on my partner, who suffered just as much but didn't get the support, was profound.
Because psychosis is traumatic for the brain it is better to avoid an episode and I believe if measures are implemented at the outset it can be bypassed. PPP is serious, mothers and babies have died from it (albeit a small percentage) but these deaths are preventable. It should be mandatory for all mothers with a known history of mental health problems to be forewarned that they could be vulnerable to postpartum disorders. These women should be carefully monitored during the first days of giving birth, allowed to sleep and be supported in their breastfeeding. It's a simple campaign but it could make all the difference. (Mothers without a history of mental health problems are also vulnerable to maternal mental illness, but those with a history remain a high-risk category).
Mothers with mental health issues are sometimes fearful that disclosure could lead to their babies being removed from their care. They might also be stigmatised socially, case in point trolls have responded cruelly to Stacey Branning's Eastender's PPP story line. These mothers need reassurance to encourage them to seek help.
I wrote my book 'Schizophrenics Can Be Good Mothers Too' (written under the pseudonym Q.S. Lam) to help other mothers who have gone through or are vulnerable to psychosis. A woman from the US wrote to me about her friend and daughter, both of whom died due to PPP. When I hear stories like this it makes me more determined to continue my campaign. Let's hope that the storyline on Eastenders will help to make people more aware of the symptoms and propel the government into taking action by investing the shortfall of millions required for better maternal mental health care in the UK. A report written with the London School of Economics, found that the NHS needs to spend £337 million a year to bring perinatal mental health care up to scratch.
The long-term socio economic impact of perinatal mental health problems is billions. But the impact on mothers and children is tragic leading to generational mental health problems.
As a result of acute lack of funding, mothers and their babies are being failed on a daily basis. Better perinatal mental health care is a matter of urgency not just in the UK, but globally.
Sanchita Islam is the author of Schizophrenics Can Be Good Mothers Too (Muswell Hill Press, 2015) written under the pseudonym Q.S.Lam and writes the blog firstname.lastname@example.org