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19 years ago tonight on 19^th December 1996, I plummeted into puerperal psychosis. Each year it is a date I reflect upon because it could so easily have been when my life ended. Permanently.

I was a first-time mother to a beautiful baby boy; 32 years old; a school teacher; happily married with a comfortable home and a supportive family. So what led me to walk the cold and wet streets of that December night, barefooted and wearing just a nightgown?

In retrospect, I feel that my risk factors were numerous and included:

1. Sleep deprivation

During the latter part of my pregnancy I was unwell and had limited sleep. In the postnatal months my son would only sleep about two hours at a time. I was breastfeeding him and did not know that mixed feeding was possible or even to collect my own milk for others to give him. Even though I loved breast feeding, I felt that it was only me that could do it ‘Superwoman’ style.

2. My personality

I am usually an organised and efficient person. A new baby isn’t! Both his father and I like to have a tidy house and lived by routines. Neither of us appreciated that we could have let this slide during those early months. This definitely put additional pressures on us.

3. Physical ill-health

I had a number of infections in pregnancy and postnatally. My baby was also seriously ill when he was four months old. Although the physical care was excellent, I don’t think our mental health was ever queried until after my son recovered. At that point my GP diagnosed me with postnatal depression.

4. Stigma, shame and guilt

Even though I was relieved to have a diagnosis and took medication along with attending a support group, I still felt very guilty and ashamed to have a condition that I felt indicated ‘I couldn’t cope’. I had always longed for a baby and had every support that I thought was possible at the time. I took it as a weakness and in my efforts to ‘fight’ it, I went over the top in attempting to prove to myself and others that I was okay. For example, instead of asking someone else to do a grocery shop for us, I would choose to do it myself plus take my 80+ year old grandparents! Rather than being gentle on myself and resting and delegating as much as possible, my ‘overdrive’ status resulted in me becoming even more ill. This also meant that I wasn’t completely honest or open about how I truly felt. Three months later, what began as depression spiralled into psychotic behaviour.

5. The traumatic birth

I had planned the idyllic birth of restful music and the water birth suite. It began that way then turned into a scene of panic – the cord was round my baby’s neck and he was whisked away. I had a retained placenta and postpartum haemorrhage, needing urgent treatment in theatre. The following day a doctor said had it been a home birth or 20 years earlier, I would have died. Other than that, no-one explained what had happened and I didn’t ask. I do not blame anyone for what happened – it would have been good to know why. For many years I could not watch a birth scene on television without crying. In those early days a conversation may have helped.

6. Family and friends

They all did their very best. None of us knew what potentially could happen if I did not get treatment – i.e. a potentially suicidal walk. None of us appreciated or understood how extreme postnatal depression can become. I was also very difficult to deal with and they often described the need to ‘walk on egg shells’ around me. Perhaps we all needed someone to advise us about the need to be apparently cruel to be kind. I needed to be forced to rest more.

7. Healthcare professionals

As individuals I feel that everyone did their best. What perhaps could have been better is if everyone had spoken about me together. Perhaps if they had consulted with my family about how I really was behaving, I may not have fallen as far as I did. One perinatal psychiatrist said that in her opinion, I should have received individual, specialist counselling much earlier on.

Yet through all of these signs, no-one realised that I could ‘snap’ or warned my family about it. That night I wandered the streets 19 years ago, I honestly feel that if we had lived near a motorway or railway line, I could have walked on there and been killed. My chaotic brain would have stopped. Instead, my brother and father found me curled up on a church doorstep.

In time I got better. My whole story is documented in my autobiographical book ‘Eyes without Sparkle – a journey through postnatal illness’, (2005, CRC Press). I wrote it to show others how this illness can develop and that you can make a recovery. I am touched to know that there are at least five ladies alive today because they said my story had helped them see a light at the end of their dark tunnel.

So why did I want to write this tonight? Because I am grateful and I want to help others.

1. The joy that my son gives me is immeasurable. As he now is a confident young man studying for a degree in photography, I am so glad that my life did not end just before his first Christmas. The simple pleasures of a child as they grow, can be punctuated by this time of year. I loved the early years and the suspense of Father Christmas. I loved the years of him being involved in making and posting Christmas cards. The years that his father and I separated and then divorced weren’t easy for any of us. Yet now I hope we are back to enjoying the ‘adult’ Christmas.
2. My parents continue to be a huge source of love in my life. I know that had I not survived, they would have been devastated – and also done their best to support everyone else. I look forward to this Christmas and New Year with them very much.
3. My siblings and nieces and nephews continue to be a wonderful part of my life. Family has always mattered to me and the older I get, the more I understand and value our time together.

Christmas 2011 with my niece

1. Since I wrote my first book, my career changed from teaching to speaking and spreading awareness of the importance of perinatal mental health. Sadly there are still the headlines of women who do take their own life in the postnatal period. The MBRACE report out a few weeks ago still cites suicide as a leading cause of maternal death. So I want to keep on keeping on in what I do. I have a wonderful partner and love our life together.
2. I am keen to know that my second book, published a few months ago ‘Another Twinkle in the Eye – contemplating another pregnancy after perinatal mental illness’ will also help others. I know of several people who are getting it as a Christmas present!

In my previous blog I identified many of the reasons to be optimistic of the fact that awareness of services and treatment for perinatal mental health is improving. To keep women alive and babies with a mother, this has to be seen as priority.

For those suffering at the moment with a perinatal mental illness, remember that you will get better. Recognise that you are unwell. Ask for assistance. Suffering in silence will only make the situation worse in the long run. In my latest book I provide many examples and resources to help you and those around you.

On Christmas Day, the soap opera EastEnders will feature a major story line involving a character who develops puerperal psychosis. I hope that this will help raise awareness of the illness and seek people to get help when they need it – before it is too late.

If you have been part of my journey so far, I thank you for it. I may have made some poor decisions in my life and also some great ones. All of them lead to where I am right now. And tonight I certainly will not be walking the streets.

I wish you all a very Merry Christmas and a very healthy and happy 2016.

Elaine 🙂