How I Survived Postpartum Psychosis - Cup of Jo

When I was pregnant with my son and loading up on articles and podcasts about new parenthood and mental health, I came across only fleeting references to psychosis. Postpartum psychosis happens with one or two of every 1,000 births, and symptoms include delusions, hallucinations, paranoia, agitation, severe insomnia, and extreme mood changes. The gist was "it's very rare, so don't worry about it" – supremely unhelpful advice when you end up becoming that one in a thousand. Particularly when, like me, you have no personal or family history of serious mental health conditions and no reason to believe you'll be the unlucky one.

My symptoms set in almost immediately.

When Wells was four days old, I was washing bottles in the kitchen when my husband, Dane, came in and told me Wells was awake and ready to eat. I flew into a rage. I was breastfeeding at the time, and I accused Dane of minimizing my humanity and treating me like nothing more than a milk machine. As I grew angrier and angrier, I stalked him through the house, screaming about the unfair treatment of women by society. Dane was terrified.

When I finally calmed down, my memory was hazy. I had a vague notion that I had gotten upset and might owe Dane an apology, but I couldn't put my finger on what I had said or done. When Dane suggested he call my parents and ask them to come over, I thought he was overreacting. But by the time my parents arrived, I had become convinced they were actually child services agents coming to take away Wells. In my altered state, I was certain Dane had told officials that I was an unfit mother because I didn't want to exclusively breastfeed. When my mother walked in the door, I threw myself to the ground and covered my face with a pillow, attempting to hide from the stranger I thought was coming to snatch my baby away from me.

Dane immediately set to work trying to find me help. A friend told him about an intensive outpatient therapy program for pregnant and postpartum people, and he scheduled an intake interview. When I arrived at the doctor's office for the interview, I believed the basic medical forms they asked me to complete were designed to trick me into admitting something that would result in Wells being taken away. I took more than two hours to finish four pages of simple forms, blanketing them with asterisks, disclaimers, and social commentary. After quickly reviewing my forms, the interviewer told me I was eligible for the program and should start that week.

Before I could begin the program, however, everything fell apart. A minor disagreement with Dane over how long the pediatrician said Wells could sleep between feedings led me to believe Dane was having a mental health crisis and Wells and I weren't safe. I locked myself in a closet at 2 a.m. and begged a friend to come pick me up. When I overheard Dane speaking on the phone in the hallway and realized he had called 911, I called the emergency line myself and reported that my husband was in crisis and needed immediate help.

The paramedics came and loaded me into an ambulance. I was convinced I was just there as Dane's support person. When we arrived at the hospital and the nurse asked me to change into a gown, I felt confused, but complied. Several staff members came to speak to me, and they brought Dane in and asked each of us why we thought we were at the hospital. We each reported, with absolute certainty, that the other was having a mental health crisis. I was utterly shocked when the doctor gently told me we were there because of me. After much convincing, I begrudgingly admitted myself to the psychiatric ward. Wells was 10 days old.

I spent my first few days in the ward convinced it was a highly specialized, experimental program created just for me. I thought it was like an escape room with clues I had to solve to earn my freedom, and the other "patients" were actors hired to interact with me. I also thought God was communicating with me through a series of loud clanging sounds and that it was my mission to set up a legal clinic in the ward's day room. But after six days of antipsychotic medications and regular sleep, I had returned closer to reality and was stable enough to go back home.

I transitioned to the intensive outpatient program right away, where I remained for four months. Four days a week, for three hours a day, I attended group therapy sessions and educational classes with around 20 other women who were each battling their own severe mental health challenges. Getting to talk to other women who had experienced psychosis and could relate to me was a very validating and healing experience. Each day I felt a little more hopeful about my future. Slowly, I began to come back to myself.

By the time Wells was six months old, I had fully recovered and wanted to make meaning out of the worst time in my life. I decided to write a book chronicling my first two weeks of motherhood, both to shine a light on a postpartum mental health topic that doesn't get nearly enough attention and to provide a sense of solidarity and hope for others dealing with similar struggles. I published my book, Super Sad Unicorn: A Memoir of Mania, in early 2023.

One goal I have for the book is to help educate expecting parents and their support networks about the warning signs and symptoms of psychosis. I wish this was something ob-gyns regularly shared with their pregnant patients so people could be better prepared. I especially wish I had known that lack of sleep was one of the major triggers for psychosis. Medical professionals tend to preach the virtues of exclusive breastfeeding, but fail to warn pregnant people about the dangers that can come from the resulting sleep deprivation.

While I wouldn't wish postpartum psychosis on anyone, I love the person I have become through the experience; I am more empathetic and less judgmental. My priorities have shifted in ways that have made my life richer. I am a survivor.

I am one in a thousand.

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Jessica Ekhoff is an attorney, author, and maternal mental health advocate. Her memoir, Super Sad Unicorn, is about her experience with postpartum psychosis and the road to recovery. Jessica has co-led the Chicago chapter of Climb Out of the Darkness, an event supporting Postpartum Support International (PSI), and she facilitates PSI's support group for pregnant and postpartum women with bipolar disorder. She lives in Chicago with her family. On weekends, you can find her reading, doing crossword puzzles, and keeping tabs on the international figure skating circuit.

If you're a new parent struggling with your mental health, or know someone who is, you can find support at The Motherhood Center in New York, or find a clinician or free support group in your area at Postpartum Support International. xoxo

P.S. '10 things I always tell pregnant women,' and Joanna's story of postpartum depression.

(Photo by RZCreative/Stocksy.)