The following is an article by the Canadian Perinatal Mental Health Collaborative as part of their #thisismystory campaign shedding a light on the need for improved perinatal mental health care in Canada.
Sandra Jessop and her husband Tim of Sault Ste. Marie, Ontario, both wanted their kids to be close in age. So a little over a year after their daughter Madison was born, Jessop became pregnant with their second child, Austin.
“We wanted them to grow up close with one another,” Jessop told us. “So our kids are just under 24 months apart.”
Both pregnancies were problem-free but Jessop worried about labour.
“I felt confident in my ability to take on the responsibilities in caring for a newborn,” Jessop said. “But I was more concerned with the possibility of complications during the delivery process. Otherwise, I looked forward to growing closer with my husband and sharing this new chapter of our lives together.”
While Jessop’s first labour went well, her second didn’t go as smoothly.
“The biggest difference between the births was the size of the babies,” said Jessop. “My son was eight pounds, eight ounces with an above average head circumference. I definitely experienced more pain and needed more sutures.”
Jessop was discharged from the hospital that same day. In the weeks following Austin’s birth, Jessop says she was tired but still confident in her abilities as a second-time mom.
“I felt somewhat assured that I knew a bit more of what to expect with a newborn,” said Jessop. “About three to four weeks postpartum I was still healing but my baby was doing great. Austin was sleeping and nursing well. The only difficulty I had was discomfort with sitting and bending. Mentally, I felt great.”
Jessop didn’t have a history of mental illness and perinatal mental illness wasn’t on her mind at all. She was not screened for a perinatal mental illness during pregnancy or postpartum but says her midwife would often ask her how she was feeling.
“I feel very naive in saying this but I did not actually know very much at all about perinatal mental illness,” said Jessop. “It was not even a concern for me at the time, or through either pregnancy. I felt good and everything felt pretty normal.”
That all changed three months postpartum with Austin when Jessop began to notice a shift in her moods.
“I felt unusually stressed,” said Jessop. “Normally feeling confident in my role as a mother of two, I woke up feeling guilty, worried and anxious about different things. I never thought much about it but that soon led to me not getting enough sleep at night and striving to be super mom.”
Jessop began waking up and cleaning the house before her kids got out of bed. She planned and executed to-do lists and thought she had it all together yet wondered why she felt so anxious about going out to meet a friend for a walk, something she previously enjoyed doing.
“I started feeling like a shell of myself and I was becoming very distracted, guilty, anxious and I avoided going out,” recalled Jessop. “One day, I decided to keep my daughter home from daycare (due to guilt about sending her to daycare), but I became even more distracted and paranoid and wasn’t at all myself. It was at that moment I knew something was not right. I was not ok.”
At first, Jessop tried dealing with her symptoms on her own but they were getting worse and more than she could handle. Jessop began hearing voices and having hallucinations. Her mind was constantly racing. She was exhausted yet she couldn’t sleep.
“I honestly carried on through the initial stages of my anxiety and dismissed it thinking I would feel better. With enough sleep, water, and vitamins, I thought I would be ok,” Jessop told us. “But I went from feeling confident and amazing to crumbling into pieces. I don’t think even my husband knew anything was wrong until my words started making no sense and I wasn’t able to understand what was going on.”
Tim reached out to Jessop’s midwife and who insisted she go straight to the emergency room for help and that’s exactly what Jessop did.
“I was put into the Sault Area Hospital mental health ward for three to four weeks,” said Jessop. “I’m not sure I was ever officially diagnosed, but I was being treated by a psychiatrist who explained what I went through was postpartum psychosis. I was monitored by nurses and staff at the hospital but never felt like there was any support for specifically what I was dealing with.”
Postpartum psychosis is considered rare, affecting one to two women in 1000. Women can also have psychotic symptoms with postpartum bipolar disorder and in fact 21 to 54 per cent of women with postpartum depression have a diagnosis of bipolar disorder.
Postpartum psychosis and psychosis symptoms requires immediate attention. Postpartum Support International has a Postpartum Psychosis Coordinator that can provide assistance to women and families who are not in an emergency situation. (Contact Michele Davidson, at 703-298-3247, at michelerdavidson@gmail.com.)
“My hallucinations were seeing and hearing a person in my house who was not actually there. I was also convinced that I was being watched/followed to see how I was parenting,” explained Jessop. “During my stay at the hospital I vividly remember having panic attacks through the night because I would wake up hearing gun shots and was convinced that I was going to become a victim. I never felt safe or comfortable in the hospital environment especially due to the police presence in the addictions/mental ward but eventually with time the paranoid thoughts passed.”
Jessop’s postpartum psychosis symptoms lasted two weeks. Following her hospital stay, Jessop continued to deal with depression and anxiety. With medication, it took her a full year to recover.
“If I could give any piece of advice to another mom or dad about perinatal mental illness, it’s to be open and honest about how you are feeling and if you are not feeling yourself,” Jessop said. “I deeply regret not making myself a priority and taking the steps to take care of myself when I first started struggling with my sleep and noticing signs of anxiety. But I didn’t know any different because I never knew these were signs and symptoms of mental illness. I didn’t actually know about postpartum psychosis until it happened to me and I wish I had talked more openly to my husband about how I was feeling. I wish I would have spoken to my family doctor or midwife as soon as I started feeling a bit anxious and struggling with my sleep.”
Jessop wants our elected officials in Canada to know that postpartum mental illness is serious and that if left untreated, could result in a terrible tragedy.
“Women need to feel supported. Information needs to be shared and the stigma around mental illness needs to come to an end,” said Jessop. “Help needs to become a priority and services need to be available for mothers and fathers who may be struggling with their mental health.”
Jessop would also like to see Canada open mother and baby units for those who are deeply suffering, who need the healthcare support so that they do not need to be separated from their child in recovery which she says only causes more anxiety and fear, along with disconnection and isolation. Unlike other countries such as the U.K., Australia, and the U.S., Canada does not have mother and baby units to treat perinatal mental illness.
“I have personally never felt so alone and depressed as I was during hospitalization,” Jessop recalled. “It was by far the worst experience I have ever had to go through and I strongly believe my experience in recovery would have been so much better with my baby by my side and my daughter being able to visit. A year-and-a-half later and I am still reflecting on the precious time I missed with my kids during hospitalization. We all have rights and every mother who is suffering should never have to be separated from her baby for any length of time. If recovery is the goal in mind there should be nurses and doctors encouraging more time to bond and care for their babies. That kind of support needs to be available to mothers and families who are struggling with mental illness.”
If you would like to tell your story and contribute to the #thisismystory CPMHC campaign, please email us at canpmhcc@gmail.com
Due to a request for confidentiality, names in this article have been changed.