After our first son was born, I gradually lost all connection with reality. There was no history of mental illness in our family. This came completely out of the blue and hit our family like a tropical cyclone.
It started with feeling happy and excited after our son was born – a happiness that grew and grew until it evolved into a euphoric state of mania. This quickly developed into a dangerous psychosis where logic escaped me and my brain came up with nasty and deadly serious notions.
It has been important for me to understand that nothing I did caused my puerperal psychosis. There was nothing I could have done differently that would have changed the evolution of events. I have no shame or guilt. I was just unlucky.
The symptoms developed gradually over a two-week period. After giving birth, I felt a bit like it was the night before Christmas. I was very excited and chatty. I remember clearly that food had intensified flavour. The world had a weird clarity and I felt I could remember everything I'd ever learnt.
This was followed by a passion and energy for cleaning that I had never enjoyed before. I didn't feel tired and spent the nights cleaning, writing, sorting, making lists, tending the garden by moonlight, and feeding as the need arose. I had boundless energy and enthusiasm despite barely sleeping.
Some people say they become manic if they don't sleep. For me, the mania would not allow me to sleep. I had fascinating ideas that required lots of thought and experimentation. The theories hatching in my head were enthralling. I was obsessed with them and was sure if I could just round them up and write them down into sensible sentences, I could publish a book that would change the world. I wrote feverishly. Too busy. Too much to think about. Too excited to sleep. Not tired anyway.
When the mania tipped over to psychotic behaviour, I was still at home. I had craftily hidden the mania by lying and being deceitful. The day I was admitted, the mania took off like a kite in a tornado and I lost control as the strings of rational behaviour broke.
I made wild accusations. Strange sentences erupted out of me at a horrifying pace. I told graphic and inappropriate stories. I threw myself around the house like a basketball, causing injury to myself and the walls. I begged my husband to understand, but there was no logic left. I was there but I had no control.
Nonsensical sentences escaped my mouth. I wanted to catch them back and put them in a tight-lidded jar where they could do no harm. My husband sat astride me on the kitchen floor where I had crash landed while he rang the hospital to ask what to do. I was thrashing and screaming at him while trying to tear his clothes.
'I had never heard of postnatal psychosis, there had been such a focus on postnatal depression.'
My mind was whirling out of control while on the world's highest swing. Swinging from dangerous insanity then briefly back to reality. I grabbed at reality but each time the swing pulled me back toward that awful place where nothing made sense and the things that came out of my mouth did not belong to me. It was terrifying, exhilarating, and exhausting all at the same time.
When I was finally admitted to a psychiatric hospital and sedated, it was such a huge relief. I had slept for less than 20 hours in over two weeks. My brain was an out of control beast and I couldn't harness it.
The psychosis raged during the first few weeks in the psychiatric hospital. I spent three days in the intensive care unit before transferring to the mother and baby unit. I reluctantly resigned myself to medication after the fighting became tiresome and the security staff familiar. My behaviour was dangerous. My baby was given back to me but I was watched continuously for both our safety. In many ways, he somehow anchored me to life. When nothing was left of me, I clung to him.
The drugs thrashed away at the mania, chewing off portions of my happiness piece by piece until there was nothing left but a few crumbs on the floor. I crawled around frantically trying to piece it back together, but could only find fragments of myself there. The more the drugs battled, the further I withdrew and seemed to disintegrate.
Not only was any shred of happiness gone, but as the days turned into weeks, I felt 'myself' had been destroyed. The empty shell that remained was numb and lifeless. Emotionally paralysed and sedated by medication, any ability to try was long gone. I mechanically attended to the banality of the day's activities hoping myself could be found in the debris.
I barely spoke. I distrusted myself and what might come out of my mouth. When I had to speak, it was slowly and carefully. Stunted. I compulsively told the truth. If I couldn't, I didn't say anything. Was it possible that I had once been a respected nurse? I was certain I would never again be able to work in critical care, or anywhere for that matter. I was a patient now.
I read into everything. I manipulated words. Things that people said were twisted in my brain and misconstrued. I lost trust. I heard undercover detectives listening in on phone calls. Poisonous thoughts boiled dangerously in my head. Everything I heard, saw, or read had at least two meanings. Profound messages fed the crippling paranoia and anxiety. Being psychotic was a rollercoaster ride through the darkest places I never wanted to visit.
What led to your diagnosis?
I had some insight into not feeling quite right, but by the time I was ready to tell someone, I lost that insight and didn't want it to stop. From the patient's point of view, an episode of mania is full of benefits. The dangerous insanity seems irrelevant compared to the benefits.
I said to my husband one year later, with full insight into the enormity of what happened, "I wish I could have just a little bit of mania back … the energy, the creativity, the clean house."
So, despite knowing it wasn't quite right, it was very hard to tell anyone as I admit I enjoyed feeling happy, motivated, and full of ideas.
In hindsight, were there earlier signs?
I had never heard of postnatal psychosis, there had been such a focus on postnatal depression. Psychosis was never mentioned in our antenatal classes and is either not, or barely, touched on in baby and pregnancy books.
When I first felt my mood was a bit elevated, I did a lot of reading and put it down to hormones and later possibly a high preceding a possible low. I was admitted to hospital on day 14 postpartum. Only one week earlier, on day seven, we had a check-up with a midwife. I very quietly divulged that I wasn't getting much sleep and I "felt a little manic". She seemed strangely thrilled and explained kindly that all new mums are tired and the breastfeeding hormones cause a feeling of euphoria. It had taken a lot to share this secret with her, so I just nodded, thanked her, and walked off.
Please, take note, I never said I was tired. She never asked me to elaborate or explain. It would not have taken much to get me talking and I would have desperately loved to tell her all about my writing, my sparkly clean house, my disinterest in sleep, my new super-mum status, my baby who slept like a wind-up toy and woke exactly every four hours for feeds, and my new obsession with moonlight gardening. Yes, there were signs.
Do you participate in ongoing treatment or self-help?
I continue to take medication but a plan to trial life off mood stabilisers is in the works.
I see my psychiatrist regularly and try to lead a healthy and active lifestyle. I speak regularly at training days, conferences, and for perinatal mental health certificate courses and have found this to be extremely therapeutic.
I also sew. I have had periods of feeling very flat and found that 'procrastibaking' was only supporting emotional overeating and an expanding waistline. So now I sew myself out of these flat moods with bright fabrics and loud music.
Did receiving a diagnosis affect you?
When I was diagnosed, I felt an enormous relief that I would be getting the right help.
This was rapidly followed by bright-red terror. I realised I wasn't going home with a paper bag full of meds and some instructions, I was being taken to a psychiatric hospital against my will.
I was so unwell, I thought this would mean my baby would be put into care and that I would never again see the outside world. I went so far as trying to escape with him.
What misconceptions can you dispel about your condition?
I have spoken to many groups and enjoyed (and suffered through) many open question times.
I have been asked over and over: did I have a traumatic birth? Do I attribute my illness to lack of sleep? Do I eat processed food? Do I get out in the sun regularly? Am I getting enough exercise?
I find all these questions frustrating and a bit insulting. I did not cause puerperal psychosis through lack of sunshine, exercise, or eating KFC. I did not sleep as a result of the mania, not the other way around. I had a terrific uneventful birth. I am just a really normal person who drew a very unlucky card. It can happen to anyone.
What aspect or symptom won't let you forget it?
I will not forget the profound effect it had on my family. In many ways, I was not there. I was worlds away. My family had to see my outrageous behaviour and hear the awful things I said.
The mums had to take the call from my husband 1000km away that I had been put into a psychiatric intensive care unit. My sisters and brothers had to find out over the phone too. Our friends, many of whom did not know until much later, had to find out by mail.
When we made the huge decision to have another baby, it wasn't the risk of psychosis that worried me, it was the impact another episode would have on our family. I didn't want to put them through that again. We wanted our son to have a sibling, though, so with loads of support went ahead optimistically.
The strain for them must have been truly awful.
How open are you about your condition?
I'm generally happy to discuss what happened if the context and time is right.
I have opened up to many of my colleagues. I work with a lot of women who are either of childbearing age or have children having babies. I want people to know this illness exists and that time is not your friend if it is suspected.
I also think that I am really normal. People have said, "but you are so normal and level-headed". Exactly! I want people to know mental illness can happen to anyone and that it is possible to recover and lead a meaningful life.
I also give presentations for various groups because if I can help just one person understand the horrifying state of psychosis, then my job is done.
How does or did it affect your relationships?
My husband was amazing throughout the acute period. He held tightly to the knowledge that I would recover. I was in the mother and baby unit for eight weeks. Five of those weeks I was held under the Mental Health Act. We needed help at home for another six months.
I was heavily sedated overnight and drowsy during the days. It must have been very hard for him. We were very well loved by our friends and family and continue to enjoy unconditional support.
On the days or weeks I feel flat, I tend to shut myself off from friends, not wanting to be a burden. In all likelihood, seeing friends is a great way to improve your mood, but it's just my way of protecting them.
In what ways do you think your experience has influenced your personal trajectory?
I'm still coming to terms with the effect this has had on me.
When I was sick and on huge doses of medication, I felt like my entire brain was completely wiped. Of everything. I lost a hold on who I was, what I knew, where I fit, what I enjoyed. I spent an entire year feeling numb, empty and lost following the psychosis.
As I slowly pieced it all back together, there were holes and gaps. In many ways I continue to recover but may never be the same person I was. I find it hard to learn new things and retain information. Things that came easily before are challenging now.
I sum it up like this in my presentations:
"For us, life goes on. It has taken a really long time to fully comprehend this strange illness and the impact it has had, and continues to have, on our lives. It took well over 12 months till I felt 'myself' was starting to glue back together. My illness will need a lifetime of management. I am OK with this. I am often overwhelmingly tired. I think all mothers can relate to this. But sometimes mine is a sad tiredness of dreams shattered, months half lived, and a blissful happiness that really never existed. I remind myself regularly to climb from that strange place that haunts me and simply live each day. I make a point of asking my friends how they really are, and try to focus forwards, on a future that is mine to write."
Mel Maginnity is a critical care registered nurse, mother, wife, mental health advocate and SANE Australia speaker.
This interview first appeared in Muse Magazine.