Psychosis During Pregnancy and What It Taught Me

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Baby Viv

My postpartum psychosis episode in 2008 after the birth of my first child provided me with a deep understanding of the importance of medication in my long-term recovery plan. But it was the severe psychosis I experienced during the early weeks of pregnancy with my daughter that taught me the extent of the deficiency of certain chemicals in my brain and how I would need to adhere to my medication if I wanted to there for my kids. And I did. Without a doubt.

We had been trying to give our son a sibling for about nine months without luck, but in March of 2010 I saw the definitive pink lines on the home pregnancy test and I knew it was real. I’d been visiting my family in Florida over Easter with just my little man since my husband had to stay home to work when the timing was right to take a test. I couldn’t wait, so I did it late at night and when the lines showed up I called my husband right away, texting him a picture to show off the proof.

“Well, don’t get too excited in case it doesn’t stick.” he cautioned, reminding me of the miscarriage we had before our son was conceived.

“I know, I know. I just have a good feeling about this one. I think it’s going to work out.” was my honest reply.

He encouraged me to try to sleep, sensing how amped up I was by the news. And I was. My skin was buzzing with anticipation for the nine months ahead of us. I couldn’t stop thinking about the fact that there were cells dividing and multiplying inside of my belly and those cells would grow into our baby. I didn’t take my usual medication that night since I had discussed coming off the med upon learning I was pregnant with my doctor. The miracle of life was starting within me, I needed to protect it, and I was so incredibly happy.

So happy I barely slept that night. My son and I had to be on a flight home at 7:15 in the morning, so we were up packing away the last of our stuff at 5am to get to the airport on time.

The hypomania was in full effect, but I kept it well-hidden from my parents as we kissed and hugged goodbye, my stomach in knots because I wanted so badly to tell them the exciting news, but also wanted to get home and confirm it with my OB-GYN before telling them they’d be grandparents again in December.

They didn’t have to wait long though, because the following week I was manic to the point of psychosis and had to be hospitalized. I was five weeks pregnant. They immediately flew up to help.

After returning home from our visit in Florida, I could barely sleep at night I was overwhelmed with the expectation of another baby joining our family. To try to get myself to fall asleep, I’d run through baby names in my head, my husband snoring melodically beside me. My technique didn’t work and the three hours of sleep I was eventually able to get each night weren’t nearly enough to prevent the mania from taking over my mind.

By the time my husband called 911 to safely get me to the hospital, it was evening and we had already put our little guy to bed. In hindsight I bet he did this to prevent our son from witnessing an event that may have been traumatic for him. But at eighteen months old and with his obsession with police officers and police cars, I remember thinking the exact opposite in the moment the officers stepped into our bedroom to talk me into going with them to the hospital. I even asked them if they would say hi to him before we left the house, as ridiculous a request it was, at the time it made perfect sense to me. That was how far gone I was without my meds.

My mother-in-law arrived to take care of our son, and my husband followed the police car to the hospital where I was held under a temporary detention order until the doctor evaluated me. By this point I was experiencing extreme dissociation and confusion along with hallucinations. The following morning I was finally admitted to the psychiatric ward, and was stabilized with medication over the course of the next four days.

No medication is completely safe during pregnancy, but together with my doctors I chose one I felt comfortable. One that brought me out of the psychosis and back to reality. Back to life, with a life growing inside me. I saw a High-risk OB-GYN, my psychiatrist, my therapist, and my regular OB-GYN throughout the duration of the pregnancy.

Taking medication during pregnancy is a gut-wrenching decision for a mother. But in my case, the benefit of me being on the medication that allows me to function as a human being greatly outweighed the risk to the fetus. Having kids while living with a mental illness has its challenges. The obstacles I overcame during my childbearing years were ones I wouldn’t wish upon anyone; rather, I hope people can learn from what I experienced.

There is no ideal way to do this. There is only the intense desire to have a family and the need to work closely with your doctors and therapist to achieve the best, safest, most ideal outcome possible.

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Pregnant After Postpartum? There Is Hope.

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pregnancy depression, antenatal depression, prenatal depression“What if it happens again?”

That’s one of the biggest question on the minds of many mothers when they find out they’re pregnant after postpartum depression or other perinatal mood and anxiety disorders. They remember the struggle and want to know if they’ll be okay.

Having a perinatal mood disorder after one child doesn’t mean a mother will automatically suffer a relapse after subsequent deliveries. In many cases, suffering the first time allows mothers and their support teams to better prepare for future pregnancies so that they don’t suffer again.

I’m happy to welcome Warrior Mom Alyssa to Postpartum Progress today to talk about being pregnant after postpartum OCD and how she’s preparing for life after her second child is born.

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We had been trying for six months, so this was no surprise. We had wanted to expand our family not long after our first daughter turned two, and we are on track to do just that. Due on May 24th. Ready for go, number two.

If I want to I can focus purely on the joy and excitement that come with that. Another baby! Teeny newborn squeaks and coos. Nursing again! Snuggling and seeing my little girl become a big sister. There’s a lot of joy to be had.

There is also some worry. After my daughter was born, I suffered at the hands of various perinatal mood and anxiety disorders. I had a traumatic birth that left me reeling, and PTSD became my daily life. I was afraid of everything. I had terrible intrusive thoughts. I was on edge 24-7. This caused postpartum anxiety, of course, which also trickled into some postpartum OCD. I spent a few months ignoring the reality and being afraid in silence. Finally, with the help of my intuitive husband, I faced my issues and got into therapy. I was able to manage my issues without the use of medication, and after a good year in therapy, things started to go back to normal.

And then? Things went from normal to amazing. I felt better than I had in years. I realized that I have had anxiety issues for some time, and dealing with my birth helped me manage those issues, too. My life fell into a perfect balance of motherhood, teaching, being a wife and a good friend. I have been truly and purely happy. It’s downright scary. [Read more...]

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It Is Okay To Not Be Okay During Pregnancy

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pregnancy depression, antenatal depression, depression during pregnancyDear mama,

I wanted to word vomit all over our Facebook group when I saw how quickly you backpedaled about not enjoying pregnancy.  I wanted so badly to share my story, but I knew it was not the time or place.  I am writing this open letter to you and all other mamas who do not like pregnancy.  It is okay to not be okay during pregnancy.  I struggled physically and emotionally with my second pregnancy.  In hindsight I clearly had undiagnosed antenatal depression and anxiety, a revelation that my therapist and I discussed.  I had so many warning signs.

I worried about everything constantly.  I was irritable, and it wasn’t just the hormones.  My irritability was a precursor to my postpartum rage.  I lost weight initially, partly due to the restrictive meal plan for my gestational diabetes.  I could not sit still at all which was also a precursor to my severe postpartum anxiety.  I was making lists of all the tasks that had to be done and completed by the time the baby was born.  List-making made me feel like I was in control.

Society does pregnant women a disservice by showing us these photos of airbrushed women who blissfully smile down at their baby bumps.  I rarely smiled or laughed when I was pregnant.  Besides the gestational diabetes, I suffered from sciatica and an umbilical hernia.  I had to wear a postpartum support girdle which alleviated some of the strain on my back.  I have had friends valiantly struggle with sciatica, symphysis pubic dysfunction, pre-eclampsia, irritable uterus and days and weeks of contractions.  Until we change the conversation about how demanding physically, mentally and emotionally pregnancy can be, we will continue to feel like we have to put on the mask.  I very much wanted and planned for my darling baby girl, but I would tell anyone and everyone who would listen that this was my last pregnancy.

People used to laugh like I was a hormonal pregnant woman who should be pitied.  I felt like people thought I was exaggerating my level of stress and discomfort with my last pregnancy.  Those feelings made my rage and irritability even greater.  Do not condescend to pregnant women.  We are adult women who are growing another human(s).  We deserve care that recognizes our entire selves, not just as an incubator for the baby that we are carrying.  My feelings, my emotions, and my health were just as vital and important as that of my unborn child.  I struggled with undiagnosed antenatal depression and anxiety even though I had a supportive medical team that included my ob/gyn, my certified diabetes educator, and my endocrinologist.

Mama, I wish I could learn more about your story.  I have so many questions for you.  Did you struggle too?  Would you like to know more about my story?  Can we get together for coffee and really talk about how difficult pregnancy can be?  Can we stop trying to pretend that it is all sunshine and rainbows?  It is okay to not be okay.  It is okay to admit that you hate pregnancy and that you are miserable.  This does not mean that you do not love your child.  You are brave for reaching out and asking for help.  If you are struggling, please know that you are NOT alone.  Many mamas, including myself, have been in your shoes.  Talk to your therapist, to your partner, and to your doctor.  Check out the resources available here along with testimonies from other Warrior Moms who have struggled with antenatal depression and made it through to the other side.  It does get better, I promise you.

Love,

Jen Gaskell

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Pregnancy Registry Evaluates Impact of Antipsychotics On Infants

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The MGH Center for Women’s Mental Health has a special registry for women who take atypical antipsychotic medications during pregnancy. This is a very important registry given the lack of information that exists about certain types of medications and their potential impact on the health of babies.

Atypical antipsychotics are often used to treat mania or bipolar depression. They include such medications as Abilify, Zyprexa, Seroquel and Risperdal.

The MGH National Pregnancy Registry for Atypical Antipsychotics is the first hospital-based pregnancy registry for atypical antipsychotics in North America. The Registry is dedicated to evaluating the safety of atypical antipsychotic medications that may be taken by women during pregnancy to treat a wide range of mood, anxiety, or psychiatric disorders. The primary goal of this Registry is to determine the frequency of major malformations, such as heart defects, cleft lip, or neural tube defects, in infants exposed to atypical antipsychotics during pregnancy.

You are eligible to participate in the study if you are a pregnant woman aged 18-45 who is currently treated with one or more of the following atypical antipsychotics:

  • Abilify (aripiprazole)
  • Clozaril (clozapine)
  • Geodon (ziprasidone)
  • Invega (paliperidone)
  • Risperdal (risperidone)
  • Seroquel (quetiapine)
  • Zyprexa (olanzapine)
  • Saphris (asenapine)
  • Latuda (lurasidone)

Participation involves three brief phone interviews over a period of approximately eight months.  To participate, call toll-free 1-866-961-2388 or email registry@womensmentalhealth.org.

If you are a healthcare provider interested in referring someone to the Registry, please have your patient call or email them, because this is a patient-initiated registry. 

Please share this information with anyone who might benefit.

 

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