Fiona Putnum suffered from postpartum psychosis following the premature birth of her daughter, Matilda*. After experiencing the crisis and recuperation, she has become a strong voice on the subject, raising awareness on the radio and at charity conferences. She is now pregnant with her second child.
I had an anxious pregnancy and bad morning sickness to begin with, but then I got the news from the doctors that she was small – under the 3rd percentile – and they diagnosed placental inefficiency. When I got to 28 weeks it was a huge relief because she was viable. Then, at 31 weeks, they noticed that she was in distress and I was told that I’d be having a c-section that day. Matilda was born that evening weighing under 2lbs - that's just 860g. She was so small, she could be held in one hand.
I only saw a glimpse of her next to me before she was whisked away to intensive care. I was coming out of the drugs from the c-section so I didn’t feel loss in that instant, I was still too fuzzy. I wasn’t allowed to hold her for four days - all I could do was put my hand in her incubator, sing to her, and spend time beside her.
I’d had steroid injections during pregnancy to promote her lung growth, so she was able to breathe on her own when she was born. I now know that there is evidence of a connection between the steroid injections and postpartum psychosis.
Postpartum psychosis affects 1 in 500–1000. There’s a higher chance of having postpartum psychosis than having a down syndrome child, yet most of my friends hadn’t heard of it. There are no mental health issues in my family; this is something that can appear out of the blue. There was no information on NCT two years ago when I looked, and even now I think psychosis is a dirty word within mental health.
Warning Signs
Four days after she was born - which is the classic timeframe for psychosis to hit - I held her and had this euphoric experience. I was overwhelmed with love. My husband, Henry, held her and I got jealous that he was handling her so well. I started talking to him about an “experiment” that “they” did on us – reality and fantasy were becoming blurred. There were other classic warning signs: I didn’t need to sleep, I was frantically writing notes about her - profound thoughts about how much I loved her that I thought would be published. I’d pretend to go to sleep, but I’d write about her - reams of text on my phone. I called her “The Duchess.”
I was recovering from my c-section quite well, so when my friend Amy came to see me I told her I was going to discharge myself from the London hospital. I’d seen a doctor and complained about having racing thoughts. I’d been rabbiting on so they had given me sleeping pills. I believe that if there had been continuity of care they’d have known that it wasn’t in my character, but they allowed me to leave. It was awful to say goodbye to Matilda, but I was just so tired. I was feeling stunted – a well-documented precursor to the mania.
These symptoms are so similar to normal symptoms after having a baby that I found myself just laughing about it with Amy. It’s really easily missed. It was so lovely to be home and I felt really relaxed, just putting my feet on the carpet felt so luxurious. Amy went out and Henry was away working. I was sitting expressing milk, in a calm state, when I thought I’d heard a mouse in the cupboard. It flipped me into mania.
The Sudden Episode
I raced around the house and wrote on the walls that the hospital had sent me mad. I rang 999 – thank God I had the foresight to do that because they scrambled a helicopter – and I wrote a suicide note. I didn’t really know then what I was going to do myself, but I wrote a list of the people I loved.
I hauled myself up onto the roof through the skylight. I was topless and ranting, and looking for somewhere to smash my head in. I thought they were going to take Matilda away from me because I was mad, so I thought in killing myself I’d be closer to her. There’s a greenhouse next to us and I jumped head first into it. A huge shard of glass slid into my hip. I fractured my spine in four places. I landed on cactus – an amusing twist in the story – and for weeks I was pulling cactus fronds out of my legs.
I pulled myself out of the greenhouse, grabbed a garden fork and ran half-naked through the garden of an old people’s home. I was scaling a fence with the fork in my hand and heading for the barbed wire on top - the psychosis can make you really strong – when I fell down and the medics from the ambulance suddenly pinned me to the ground. Amy had found the suicide note and came looking for me, so I was tranquillised and taken to hospital with her at my side.
Aftercare
I was on an open ward in a regular hospital and at one point I tried to put a chair through the window. I banged my head on the floor (I now have a Harry Potter-like scar on my head) as again, I thought they’d take Matilda from me. It was Amy who convinced me I’d be able to keep her. Those simple words brought me down from the psychosis and I realised what had happened. Amy was tough yet compassionate, and I credit her with saving my life.
Then there were the shockwaves. They sent me home after ten days and I began behaving erratically. I gave a homeless person £50 on a whim. I was tearful and then emotionless. I went into a meditative, Zen-like state.
I was sent to a psychiatric unit. All my stigmas about mental health came out – I thought I was in the wrong place, and that I was sane and they were mad. But I was still suffering delusions: I thought “they” were making a documentary about my life. Ultimately, the psychiatric unit was quite eye-opening and wonderful - there was a sense of sisterhood there - and it changed my life.
Finally, after three weeks, I had the courage to hold Matilda for the first time since the psychosis hit. She cried, I held her, and it was beautiful. They sent me to a mother and baby unit, and two weeks later she joined me. She was doing really well. The next day my postnatal depression set in. I couldn’t look her in the eyes or change her nappy. I didn’t want to go near her. I used to think that depression was really selfish, but now I understand how bleak it can be. You can’t perceive of a life feeling like that forever. I was diagnosed, medicated, and after two months I was home. I had weekly checks for a year afterwards.
Next Steps
I was tough on myself as a mum, and I wished I’d relaxed more - it took me a year to really enjoy it. I now see that the whole notion of becoming a mother is anaesthetised in the press – it’s often baby showers, naming ceremonies and getting back into your old jeans, but getting oneself back mentally is the most important thing. Those first few months are the steepest learning curve you will ever have, and its often reduced to something glossy and fun.
Through children’s activities, I met the most wonderful group of women. I opened up to them about what happened to me and they stuck by me. I’m so grateful to them, and my husband Henry, who told me I was a good mum every day. I don’t want this to define me, but it has strengthened me. I’ve shared my story on Women’s Hour, will be part of a radio documentary out this September, and will speak at conferences for Action on Postpartum Psychosis.
I’m now pregnant again – 21 weeks - and I’m a lot less anxious than last time. My placenta is attached to the c-section scar so it’s going to be a rocky road ahead. Fears are kicking in, but I’ve learned to keep my mental health in check. Like exercise, we should be doing something meditative every day. I wish I’d done that before I hit a crisis. I do make time for myself every day now - I live in the moment, and I’m far more compassionate.
I’m proud that I recovered and have such a wonderful relationship with Matilda. I don’t remember when she first smiled, or when she first sat up, but we’re so close now and thankfully she seems unscathed. I’m one of the lucky ones: I’ve been supported by my husband, family and friends, and many women don’t have that network of care. Strangely, I think this experience has been the making of me.
You can find more information on Postpartum Psychosis at Action on Postpartum Psychosis (APP): www.app-network.org
*name has been changed