Q&A with Ruth M Stacey: "Postpartum Psychosis has shaped me, not scarred me"

Ruth M Stacey is a local author and mother. Two weeks after giving birth to her son, Eddie, Ruth was diagnosed with postpartum psychosis and admitted to a Mother and Baby Unit where she stayed for over a month. 

Ruth’s memoir, Everyone is Here to Help: A healing account of postpartum psychosis and recovery tells a story of postpartum psychosis from the heart of the experience. She has also published a collection of poems, Dichotomy of Me.

This Maternal Mental Health Awareness Week (May 5-11) we’re thrilled to be sharing an extra Q&A with Ruth, who has a goal to make more parents and families aware of – and less afraid of – postpartum psychosis.  

Thank you for joining us Ruth! 

Q: When did you start to become unwell? Did the people close to you notice? 

I started to show signs of being unwell around a week after I gave birth. At 17 days old, I was diagnosed with postpartum psychosis and admitted to a Mother and Baby Unit.   

The signs of becoming unwell included: very unpredictable and out of character behaviour, being 'up' one minute singing songs at the top of my voice, then having crashing lows with extreme anxiety and paranoia. I noticed strange behaviour, like sorting out all my pens and becoming obsessive about it. I have a Bipolar Diagnosis and had a previous psychosis in 2007, so I was extremely high risk.  

During the process of being sectioned, I thought I could read people's minds and change the outcome of the assessment meeting just with my thoughts. I was very delusional already. I came out thinking I'd done really well and they would let me leave. Obviously that didn't happen. That's quite hard to reflect on even now. I get a bit embarrassed about certain things.  

I made notes in my diary, and to an outsider (my husband and family or anyone looking in I mean) my illness was pretty clear. 

Presentation of Postpartum Psychosis can be very unpredictable – the messages to my husband are pretty fine and I seem lucid, but then minutes later I was writing mad notes in my phone where I am very delusional. It can be confusing and shattering for all parties.  

Q: How long did you stay in the Mother and Baby Unit? What did your recovery plan look like? 

I was in the unit for 5 weeks, 5 days. On admission they removed me from the medication I had been on since 2008 which I don't think was the best call. They put me on another antipsychotic and Lorazepam for extreme panic and agitation (then later, Diazepam) and Zopaclone to sleep.  

Their first priority was to get me to sleep, as sleep deprivation is the main cause of mania that leads to psychosis. I unfortunately wasn't allowed Eddie in with me for the first 2 weeks (he slept in a cot down the corridor which broke my heart) and I had to stop breast feeding due to my medication. I was on 15 minute observation and both Eddie and myself had 1:1 staff with us at all times. Even someone sleeping by my bed. That was tough.  

Recovery from postpartum psychosis is also about eating well and sleeping, as well as medication compliance. We did a lot of holistic wellbeing things for me and Eddie too - baby massage, psychological intervention,  art therapy - there was a lot on offer. And we had nursery nurses there too all the time, to help me be a mum, which was very tough after a c-section, severe neck injury after birth and then being seriously mentally ill.  

Q: Can everyone expect this kind of care if they develop PP?

Postpartum Psychosis affects around 1 in 1000 mothers – and most will receive help at a Mother and Baby unit. However, if no beds are available they will end up in an adult psychiatric ward where they can't be with their baby. We desperately need more Mother and Baby unit beds – there are around 177 available in the UK at the moment.  

Q: How has your relationship with your son been since this time? 

I feel exceptionally lucky never to have had any negative feelings towards Eddie but one of the other mums I met did. Thoughts of harming your baby can be a part of postpartum psychosis, but it isn’t everyone’s experience. My bond with Eddie feels unaltered but I would be lying if I don't reflect on MBU regularly but that becomes less and less.  

The only thing I saw in my notes was 'baby removed from mum for hugging him too tightly'. 

Q: What should someone do if they think they or someone they love has postpartum psychosis symptoms? 

Postpartum psychosis is a treatable medical emergency, which has an extremely quick onset. Don’t wait for things to get worse – phone 999. The worst outcome is that you feel a bit foolish – the best outcome is that you or your loved one receive immediate care for a fast-acting illness.  

Q: Are there any good ways someone offer support to a friend or family member who has been diagnosed with postpartum psychosis? 

I think the key is to be calm and not to question them too much. Even if you know they’re 'wrong' and delusional as the delusions I experienced were as real as my well reality. It's frightening for people to question you. Be out in nature, distract from illness, be mindful and present and kind and compassionate; and treat them like a mum first and foremost, not a patient in a mental health facility.  

In my book there are 'what helps' sections which I have continued to write about for the charity Action on Postpartum Psychosis (who the book raises money for). 

Q: How are you doing now? 

Really well. The charity APP always say 'with time, you will get better' which is true. I made a very quick recovery really (about 10 weeks) whereas it may take other mums up to 4-6 months but I had already had a psychotic episode and apparently your brain learns how to mend from it. 

I'm busy which I like and continue to write to help me with the ups and downs of life, motherhood and Bipolar all rolled into one! I published a poetry book on the 'madness and magic of motherhood' a week after my memoir came out and have written a children's book explaining postpartum psychosis for children whose mums go into a Mother and Baby Unit. It is written completely in verse and is yet to be published.  

Q: What would you like people to know about mental health after having a baby, particularly postpartum psychosis? 

It is so important that if anyone suspects anything ('new mum seems strange?' is the phrase used on the APP posters) don't delay, as postpartum psychosis is a treatable medical emergency. 

It can happen to any mother at any time (although usually in first 2 weeks) and you don't need to have had mental ill health prior. It happened to me even though we were aware, even with an advanced statement (a kind of plan I made with my team to help keep me safe in case of mental health struggles) and support from the perinatal mental health teams. I also had had a planned C-Section to avoid unplanned birth trauma which can be a trigger, but it still happened to me.  

Try and sleep, or rest if you can't sleep. And keep yourself well first and foremost. Let your partner or family help with feeds, use formula if you need to, listen to other people's advice too. I had the Perinatal Mental Health Team involved and they were amazing. 

Don't try and be Wonder Woman, accept help, try journaling to deal with big emotions and don't be afraid to voice dark thoughts and or imagery as it is completely normal. 

I just wish that every expectant mother and father knew just a little about postpartum Psychosis, maybe from midwives or NCT groups - that would be a goal for me and the influence of my book. I'd like to get it on some sort of training or reading list so that postpartum psychosis wasn't feared or so taboo. That people thought 'this could happen and I would know what to do'. And when that happens, the stigma around the word 'psychosis' will hopefully dissipate.  

“I say postpartum psychosis has shaped me, not scarred me. Meeting me and Eddie, I don't think you'd know.” 

Q: Where can people learn more about your story?

Both my books are published by Ensemble Publishing and are available at Hunting Raven Books, Frome and online at Amazon.

My memoir is available also from Mr B's Emporium in Bath and from Waterstones. 

If you think someone is exhibiting the signs of Postpartum Psychosis, call 999.