I wrote here recently about my pregnancy experience, and the impact it had on my mental health and overall wellbeing.

To summarise: it was a pretty difficult time for me. Since that post my lovely baby has joined us. My birth was very different to the one I had hoped for: a water birth in the midwife led birthing centre, surrounded by fairy lights with minimal intervention. At 39 we found out he was breech in a stroke of luck, so a week later on his due date I was having a c-section, which is essentially the most medicalised birth you can have. I was initially really upset by this but my birth ended up being peaceful, light hearted and safe. It wasn’t what I imagined but I would certainly do it over again if I needed to. I also predicted that mental health wise I’d be starting off better because I hadn’t experienced the pain and exhaustion of labour, not accounting for the fact that the pain and recovery time of a major surgery afterwards in addition to the sleeplessness involved with taking care of a new baby, would still be extremely taxing. 

I was riding an adrenaline high for the first few days after his birth and it was the first time I hadn’t felt depressed in months. After that passed I experienced a crash bigger than any I can remember having in years. I cried non stop for days. I thought my baby hated me and I’d made a mistake and I wanted to just run away from everything. I felt like I couldn’t look after him and that I couldn’t do anything right and that he deserved better than me. I was afraid of other people holding him because he was so tiny and vulnerable. In short, I was a mess. That absolute low point did get better but back to my baseline depression level I’d experienced throughout my pregnancy. I spent the next three weeks feeling moderately flat to very very low. I wore the same clothes for days, had no motivation to shower and didn’t wash my hair for six weeks. It was hard to get out the house because the surgery recovery was initially very hard and going in the car was painful and anxiety provoking, so I was also somewhat of a prisoner in my house for a couple of weeks. Although this was rubbish, I somewhat naively felt that I’d escaped any episodes of elevated mood and that the difficulties had gone the other way.

However, four weeks into my postpartum experience the hormones and lack of sleep, on top of the stress of new parenthood, all caught up with me. I woke up buzzing with a million jobs that I felt I needed to do: deep cleaning, getting rid of half my wardrobe, going through all the baby clothes at 5am. I was agitated and restless which became elation and excitement a couple of days later. The baby was making odd noises in the night and I felt I couldn’t sleep or he would die. I had seen my CPN during this time who said she felt like a different person had answered the door because of how out of character I was behaving to her. The next day I was prescribed a second antipsychotic and discussions were being had about thresholds for admission to the mother and baby unit. Though this is a last resort, the criteria for this tends to be more cautious than to a generic psychiatric ward. These were all options I knew about and were part of my crisis plan, but one that I didn’t think in reality would ever need to be raised.

I have a beautiful little velcro baby who cries a lot when he’s not on me, which was a challenge when I was so driven to do activities. He’d fall asleep, I’d put him down and run around doing things, he’d wake up five minutes later and we’d repeat the cycle. It should have been exhausting but it wasn’t. I was told I’m talking too fast, laughing for no reason and playing down how I had been behaving during the day. Fortunately enough people saw through this and I was instantly given daily contact with the PMHT, in the form of appointments, phone calls and visits. I took the medication even though I didn’t want to and although I didn’t think an admission was likely or that I was particularly as unwell as people worried I was, I was able to recognise that they clearly saw some risks developing and wanted to stop it in its tracks as quickly as possible. I am very grateful for that and have been doing exactly as I’ve been advised. However, I did feel somewhat bitter about it. I’ve been in a depressive episode almost the whole time I was pregnant and since then. I actually felt happy for the first time in as long as I can remember and it was instantly snatched away. I know it wasn’t real happiness, but that didn’t make it feel any less real at the time.

I have been under mental health services of one type or another for 24 years – basically most of my life. This is by far the quickest and most responsive care I’ve ever had and I’m extremely grateful for that, despite the outcome feeling challenging.

It’s been a long time since I had a manic episode, to the point I’ve even questioned if my diagnosis is wrong. It clearly is not, and has been well managed with medication for a long time. It is again now being treated with additional medication, which capped the mood elevation but took a while to resolve the impulsivity and restlessness. I have been told the additional antipsychotic is short term, which I assumed would be a few weeks. I’m now told that as I have recently been acutely unwell, what the psychiatrist sees as short term is likely to be a number of months, until everybody feels confident that things are under control. I am upset by this but I understand the cautious approach, and I too would like to feel confident in my stability. Maintaining wellness for the sake of people around me has always felt important to me, largely because I don’t like people worrying about me or having to look after me. I have always struggled with the guilt of this, because I feel like the people I am close to, particularly my husband, are often required to look after me more than I am of them. I hate the imbalance of it all. The feelings of wanting to be well for others is further intensified when I need to take care of a little baby, who frequently shows how much he needs and loves me with his need for cuddles and his emerging smiles. 

I don’t really know how I feel now. A mix of sad, disappointed, guilty, anxious, grateful, frustrated and relieved. Episodes like this are always confusing and unsettling, even with exceptional care (personally and professionally). Going forward I know I’m now going to be hyper vigilant to any shifts in mood and unfortunately that is likely to be the case for some time. One of the hardest parts of living with bipolar disorder isn’t just the mood shifts, but the constant awareness of your mental state and dissection of your emotions and behaviours. Although this was nipped in the bud quickly, I will now be monitoring myself to a frustrating extent, just in case. 

I am proud of myself despite the last couple of weeks. I did exactly as I was asked and my priority is looking after my baby. Part of my level of engagement with mental health services has always been my pathological need to be considered a ‘good patient’; someone who is compliant and polite. I am consistently referred to as ‘pleasant’ and ‘lovely’, something which I now feel trapped by in fear of coming across as ‘difficult’ or hard to work with. However, sometimes this does go in my favour as it means I often do as I am advised and to be honest, it’s almost always in my best interests and almost always helps.

So for now, I keep taking my medication cocktail, I keep being honest and I keep asking for help – from mental health services and people around me. I would like things to be different but we are where we are. I am back in a state of feeling low, drained and somewhat panicky at times. But I am being well looked after and I am grateful for that.

All you can do is keep moving forward.