Trigger Warning: This episode involves topics related to postpartum psychosis, suicide, and infanticide.

In this eye-opening conversation, one mother is sharing her raw and unfiltered story of navigating a postpartum psychosis diagnosis, shedding light on this often misunderstood and stigmatized perinatal mood and anxiety disorder.

After the birth of her second son, Chelsea battled with intense challenges with postpartum depression, which eventually snowballed into postpartum psychosis.

As we delve into Chelsea’s story, we aim to foster a space of empathy, understanding, and support. I hope her openness invites you to connect with the human side of maternal mental health struggles, acknowledging that each tale contributes to the larger call to action for early intervention and better support for women in healthcare.

Dr. Sarah (00:00:01):

Please be advised, this podcast episode discusses sensitive topics related to postpartum psychosis and suicide. This content may be distressing for some individuals and is not suited for children. As always, the information provided in this podcast is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. If you or someone you know is struggling with mental health issues, seek immediate professional help. If you’re in crisis, call 911 or 988 in the US or contact your local emergency services.

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The stories that we hear about postpartum psychosis are often horrific and even sensationalized, but there is another story not often shared. The times when new parents triumph over these struggles without tragedy occurring, the more that we can shed light on the reality of postpartum psychosis, the less stigma and shame will surround it. And hopefully this can allow for more people to receive the help and support they need to overcome this diagnosis. After hearing a previous episode that I recorded with Paige Bellenbaum of the Motherhood Center, my guest today reached out to me to let me know that she had recently been diagnosed and was in treatment for postpartum psychosis, and she wanted to share her own story on the podcast with the hopes of combating the isolation and the stigma associated with this condition and championing for more appropriate and better care for all new parents who suffer from a perinatal mood and anxiety disorder. I am so deeply grateful that Chelsea volunteered to share such a moving personal and honest account of what she experienced, and I know her courage will help so many others feel less scared and alone.

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Hi, I’m Dr. Sarah Bren, a clinical psychologist and mom of two. In this podcast, I’ve taken all of my clinical experience, current research on brain science and child psychology, and the insights I’ve gained on my own parenting journey and distilled everything down into easy to understand and actionable parenting insights. So you can tune out the noise and tune into your own authentic parenting voice with confidence and calm. This is Securely Attached.

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Hello, welcome to the episode today. Today we are going to be talking with a very special guest, Chelsea Ramsey. Thank you for being here.

Chelsea (00:02:38):

Thank you for having me. Very excited.

Dr. Sarah (00:02:40):

I’m excited too, I think. So this is unlike an episode we’ve ever done before. This is really, really cool because I think we’re going to have an opportunity to talk about your personal experience with postpartum psychosis. And one, I just kind want to name how incredibly grateful and honored I am to be able to talk with you about this and how incredibly brave it is to talk about this and to be willing to just be open and talk about this in a way that shines a light on something that can very often, I think, be held in shadow. And I think the more we talk about it and the more we create real human stories that exist in connection to this, more people can not feel ashamed or hide this stuff. And the more it can come out into our life and more people I think will get treatment as a result.

Chelsea (00:03:45):

I hope so. Yeah, I think that the more awareness that’s brought to it, the more people will feel comfortable getting help. And because getting help is so, so hard to do, but so important. So yeah, I’m really happy to be able to share my story and just encourage people that there’s a positive outcome and you can get treatment and get help and be okay.

Dr. Sarah (00:04:11):

Yeah. I remember when we were talking about recording this episode, you said something that has very much stuck with me, which was that we do hear stories of postpartum psychosis in the news, but those tend to be the most extreme circumstances that have the most tragic outcomes, and they get highly sensationalized, and that paints a very specific picture of postpartum psychosis that really, that’s very much one of many outcomes. It’s like if you think of the bell curve of postpartum psychosis, those are the tail end experiences, and we don’t often hear, like you said, stories that are hopeful and in recovery and end in very, very positive outcomes, which your story is like that.

Chelsea (00:05:11):

Yeah, we always hear about the awful ones. And of course those are important as well because they do bring such awareness of how important treatment is and how important early treatment is because especially in my case, by the time I developed postpartum psychosis, I was already eight weeks postpartum, but I knew two days postpartum that something was wrong. So if something had been caught maybe a little bit earlier, maybe it wouldn’t have gotten to that point. So both sides of the coin are very important too, to share, I think.

Dr. Sarah (00:05:45):

Yeah. Would you be open to just sharing the story? What happened? And I think as a psychologist, whenever I’m meeting with a patient, my first inclination is not actually to start with what’s happening now, but what happened before now, because I think we don’t really quite realize how significant all the things leading up to the apex of a particular moment are. And so I’m almost wondering if you could start before you started to have symptoms and what did you notice shifting for you?

Chelsea (00:06:33):

Yeah, absolutely. So I have two children, two boys. My eldest is five, and then the baby now is 14 months. And before either baby, I never had any mental health struggles, just has not been something that I’ve ever had to deal with before this. I’ve always been very privileged to not have any experience with it. Truly, my husband and I have been married for, oh gosh, for a long time, 10 plus years, and very stable, very happy. We did struggle with unexplained infertility with both boys, so there was no reason that we weren’t able to get pregnant. We just weren’t. And so something that I learned after I was diagnosed is that women who go through infertility have a higher likelihood of being diagnosed with a perinatal mental health disorder, which I had never heard of, was never brought to my attention. So that’s kind of my only risk factor for having a PMAD essentially.

Dr. Sarah (00:07:42):

Which is interesting because I think a lot of times people, and we do know there are certain things that make for greater risk when it comes to developing a PMAD history of mental illness or of mental health challenges in the past can put people more at risk, but it’s very notable that in the absence of almost the vast majority of risk factors, you still experienced symptoms of postpartum psychosis, which again, talking about bell curve, statistically, that’s relatively rare.

Chelsea (00:08:20):

Yeah, super rare. Yeah, the psychosis part, yeah, especially is so rare. So it truly can happen to anybody, which is another reason that I think advocacy is so important because you never know if it will affect you until it does. And so having awareness about what it’s like or what it could be like, it’s just so important so that you know you’re not alone essentially.

(00:08:53):

When I was pregnant with Nicholas the baby, when I was about 15 weeks pregnant, I was diagnosed with a retro placental hematoma, which is a bleed behind the placenta. And so it looked like we were going to lose him for a little while there. Thankfully we didn’t, and everything was fine, but I think looking back now, I think that that’s when my mental health shift would’ve happened is I started preparing myself for a loss, I think. And so throughout the pregnancy, I wasn’t very connected. I didn’t feel that maternal bond. And at the time I just justified it being like, oh, well, I’m busy. Carter my oldest. He was four at the time. Well, you just don’t have as much time to focus on your second pregnancy. So I kind of rationalized it that way. Then when he was born, the day he was born, I knew that something was off, that something didn’t click.

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When Carter was born, I had that moment of like, oh, my baby that love, he’s finally here. And that love at first sight moment with Nicholas, I didn’t have that, and I didn’t really realize that so many women don’t have that moment. But for me, because I had it the first time and I wanted both of these babies so much and fought so hard to get them, it really caught me off guard that I didn’t have that moment. And then, yeah, the rest of the time that we were in the hospital, I didn’t really feel that need to have him with me or it didn’t bother me for other people to hold him, or I didn’t feel it. I really, I just kind of felt numb, I guess, is what I would say.

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Yeah. So I didn’t say anything at the time because I wasn’t sure yet what exactly I was feeling. I knew that something was amiss, but I didn’t know what, and then I would always be able to say, so I didn’t say anything to anybody for about six weeks, and I kept rationalizing things As I got home, I would say, okay, well, I only feel like this because in the hospital, so when we get home, things will be better. And then we got home and we had a rough time with the 4-year-old adjusting, and then I was like, okay, well, once Carter adjusts, it’ll get easier and I’ll see them interact and I’ll feel this love and feel this bond. Because at the time, I wasn’t feeling any sort of motherly connection with Nick. It was more of, okay, I’m feeding him because he has to be fed and I’m dressing him because he has to be dressed.

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It wasn’t that motherly love and desire to be with him. And so I kept just being able to find an excuse for the way that I was feeling and kept saying to myself, these feelings are going to go away because it’s just because of this one thing. And it was always something new. So now looking back, I can see these big red flags that I just couldn’t see when I was in it. And so I was officially diagnosed with postpartum depression when Nicholas was six weeks old, and that came about because I had a breakdown in the middle of the night. One night I just was holding him for three hours sobbing for hours and hours and hours, and I couldn’t stop, and we’re just sitting in the pitch block, everybody else in my house is asleep. And I just was sitting there thinking, I don’t want to do this. I don’t want to be your mom right now. I just don’t. And that thought really scared me.

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So once I kind of collected myself a little bit, I went and I told my husband that he needed to get up, and this was probably three in the morning. And I said, here, you need to take him. There’s something wrong. And he said, with you or the baby? And I said, with me, you need to take him. So he took him and I went back to sleep. And then the next day we kind of talked about what we were going to do, and I knew that it was time to reach out for some help. And so here, I’m in Alberta, in Canada, and here we have public health nurses that you check in with postpartum. So they used to come to your house, they don’t anymore. You get a phone call a week later, and then they’re like, Hey, call us if you need anything. So I called them, told them what was happening, and they unofficially diagnosed me there. And then I saw a doctor the next day who officially diagnosed me, but at that time was just with postpartum depression. So nothing, I hadn’t gotten to the psychosis part yet.

Dr. Sarah (00:13:58):

Were you having psychotic symptoms and they didn’t catch it or they hadn’t yet emerged?

Chelsea (00:14:03):

They hadn’t come out yet? No, I hadn’t had anything yet at that point. When I went to the doctor the very first time was mostly because I was so sad and I was so detached. I was very much so seeing my life be lived around me. I wasn’t the one living. It is how it felt. It was like that feeling in the movies when they’re looking down on their life and they’re watching them walk through, that’s what it felt like every day. I was just going through the motions and feeling nothing.

Dr. Sarah (00:14:37):

That’s sort of what we would usually describe as depersonalization.

Chelsea (00:14:43):

Yeah, it was very much so that I wasn’t there anymore. And so that kind of clicked enough for me to be like, okay, I should probably get some help. And I truly thought, okay, I’ll get some medicine. I’ll get medication, and I’ll take it for a week and I’ll be good. Because nobody really talks about the treatment of PMADs and how long medication can take to go into effect or all the different things that go in with it. So I got medication on a Thursday. I started it that day. It was a low dose. It was 10 milligrams of Lexapro, and I have never taken any medication before, so I’ve never had any issues. And so this was such a low dose. That was on a Thursday. By Tuesday, I started having severe thoughts of self-harm and ideations of wanting to just really hurt myself. It wasn’t suicidal, it was just I wanted to make the thoughts in my head, stop was what I was thinking. So I often thought about hitting my head on things or driving into oncoming traffic, things like that. And so that felt like a big escalation from where I was the previous week. And so there was a night on that Tuesday night where it all came to a head, and I had burned myself accidentally when I was cooking supper. Well, I think it was an accident. I don’t know. It might’ve been on purpose. I honestly don’t know.

Dr. Sarah (00:16:31):

It’s that foggy, huh? Your memory of that period of time.

Chelsea (00:16:36):

Yeah, from January up until June, I have very little actual memories, especially at home. I can remember very well in the hospital, but I don’t know really at home, everything’s like a big blur. So I do know that that night I was at home with Carter, my oldest, and I was making supper, and I ended up burning my hand and it just sent me into a tailspin. I just broke down. I ended up sitting on the kitchen floor sobbing, and Carter’s coming over to me asking, mommy, what’s wrong? Are you okay? What’s happening? He was crying because he’s scared and we’re the only two people home. So I texted my mom and I asked her to come over, and she had Nicholas, she had the baby. So she came over and told me to go upstairs and just relax and pull it together, basically take a breather, and I wasn’t able to get it together.

(00:17:37):

So by the time my husband came home, it was probably about an hour later, two hours later, my mom was freaked out. She was like, okay, we need to do something. So she gave me an ultimatum of she either takes both boys to her house for the night and I stay home with Dan, or I go to the hospital. And there was no in-between, and I of course didn’t like either of those options. I didn’t want the boys to be away from me. Nick was only six weeks. I didn’t want him to spend the night away from me, but I also didn’t want to be at home with Dan. Being at home was very triggering. I was sitting outside of Nicholas’s room, staring at the crib, being like, why am I feeling like this? I wanted him so badly, and now I don’t want him like him taking care of him as a burden. Every time he cries, I want to tell him to shut up. Those are the thoughts that I was having in my head constantly 24/7.

Dr. Sarah (00:18:41):

And were you feeling, I mean, to me that sounds like there’s really intense affect deep inside, which often is another symptom of postpartum depression or other postpartum psychos, like that rage, that experience of just irritability.

Chelsea (00:19:02):

It was, yeah. I was so irritable, so angry at a lot of things, and it eventually even started trickling down to Carter. Carter and I have always had a very tight bond and have always been two peas in a pod basically. And everything he was doing was starting to annoy me, and I was starting to yell at him, and I’m not a yeller and be very mean to him and not want to spend time with him either. And I truly just wanted to be away from everything. I wanted to go to my, not my bed, go to a bed somewhere else that wasn’t in my house. I didn’t like my house, and I wanted to just shut the world out completely.

Dr. Sarah (00:19:43):

And this is all very different from what you normally feel, right? This is all a big, because another symptom I’m hearing you speak of is a big shift in personality, a big shift in the way we’re showing up in the relationships we already have that don’t match the way that we were before these symptoms hit.

Chelsea (00:20:00):

No. Yeah, a huge change. Everybody that knows me knows that I’m very much so about my people. I recharge by spending time with my people, and I love being around kids. I’m a teacher, so all of a sudden not wanting to spend time with anybody, and especially my kids is not me, but nobody around me noticed either, which is, I think that’s a really important point is that I was able to mask it for a long time. I was able to go out and do things with the boys, and we would have play dates. And I remember for Valentine’s Day, so that’s two weeks before I was admitted to the hospital, to the psych ward, I remember I went all out. I had all these balloons and all these gems and all these presents, and we don’t normally do that, but I did that so that I could post a picture and everybody would think everything was great. So I really overcompensated for how I was feeling. And looking back now, I’m like, well, if those are some big red flags, but if you don’t know about peds and you don’t know what to look for, those would look like positive things when they weren’t.

(00:21:15):

So I ended up going to the hospital on the Tuesday night because I had an incident when my mom was taking the boys, she was packing them up. That’s what we decided to do that night, was she was going to take the boys and I was going to stay with Dan, and we’d regroup in the morning. And when she was taking the boys, when she was packing up and getting them all dressed and stuff to go, we were sitting on the stairs and I was hysterically crying, and all I could think about was bashing my head against our railing. We have this metal railing with these ornate square decorations, and I wanted to bang my head against them so badly. And the only thing that stopped me is that Carter was there. And I told myself, don’t let him see you do this. So then I was able to refrain from doing that, and then they left and I told Dan, I don’t think that I’m safe by myself anymore, because I was thinking that the next morning he was going to go to work at six the next morning, and my mom was going to come back at eight with the boys.

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And so in my head, I had those two hours that I was going to be alone, and I was afraid that I would hurt myself in those two hours. I knew I couldn’t be alone for those hours.

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So yeah, we went to the hospital and I was seen by a psychiatrist in the middle of the night who decided that, or, well, he asked me if I wanted to be admitted to the hospital, and I said yes, because I said, I think that that is what I need, but I did not realize what I was saying yes to. I truly thought that I was going to go up to the maternity ward and stay where the postpartum moms go and be able to go home when I was ready kind of thing. I didn’t know what I was agreeing to.

Dr. Sarah (00:23:23):

Which was an inpatient hospitalization at a psychiatric locked ward, correct?

Chelsea (00:23:29):

Yeah. So I was basically agreeing to, and actually in the end, I probably wouldn’t have had a choice anyways, but he did ask me. And so basically I agreed to be put on a 24 hour hold under the mental health act that we have here. So what that meant is that they were going to admit me into a general psychiatric ward, and they filled out a certificate, is what it’s called. So they formed me. And so that meant that I was no longer able to leave. It wasn’t up to me anymore.

Dr. Sarah (00:24:06):

So it was a voluntary admission, like admitting yourself to the hospital voluntarily. But once you admitted yourself because of your risk that you were endorsing, they determined that you weren’t safe to then leave.

Chelsea (00:24:22):

Right. Yeah. Yeah. That’s what happened. Yeah. So they filled out the form, and here how it works is one form signed by one doctor is good for 24 hours, and if you get a second form in those 24 hours by a second professional, then you’re now certified for up to 30 days, which I didn’t find out about that until I got my second certificate the next day. So in Red Deer where I live, there was no beds in the psych ward here. So I was transferred to Ponoka City about 45 minutes away, and they have a center for mental health out there, a hospital specifically for that. And so I was sent there to the psych ward there, and the psychiatrist that I saw that day also felt like it was not safe for me to leave. And so he signed a second certificate and told me that, yeah, I could be there now for up to 30 days, which was a very hard realization. I just remember I actually said out loud, I was like, what the did I do? I am now going to be away from my children for 30 days. I just panicked. I didn’t know what I had done.

Dr. Sarah (00:25:48):

I can only imagine how scary that was to be faced with that reality. You here, you are aware that you are having very scary thoughts, and also the alternative to staying home and being at risk of hurting yourself, which you were afraid of, was to be separated from your kids and your family, which probably was equally scary. And so I think this speaks to how challenging it is for people to raise their hand to get the care because the options for care feel so daunting.

Chelsea (00:26:31):

Yeah, so daunting. You literally feel like you are in the worst of two worlds. Neither option is good, but I truly think that if I had known what to expect, I probably would not have gotten the help. So I do think that it worked out well in my favor specifically that first time going.

Dr. Sarah (00:26:53):

Just out of curiosity, just since you’ve done, you went, you got help, it’s almost as though it sounds like in that moment, which again, you’re clearly and to your own admission, you’re not in your correct state of mind. You are in a very altered state of mind because of the postpartum depression and what eventually is going to show up as postpartum psychosis, but it’s still looking back. What do you think could have made it easier for you to say, I will get help? Because I’m mindful of if there’s a mother listening to this right now and is thinking to myself, wow, okay, for sure not going to get help. Now, how do we help them sort of see the light at the end of that tunnel, even if it’s really hard to go and get the treatment?

Chelsea (00:27:45):

Yeah, for sure. I say that I wouldn’t have gotten help just because of being scared of staying there. But in the end, getting help was the absolute best thing I did. And I’m so grateful to have been able to get the help and even to have been hospitalized. It was exactly what I needed. And so what I would say is that you really need to know that they are going to help you and that you will not feel like this forever and that it might be a temporary time away from your kids. But I always tried to think of it as I’m away from them now so that I can be there for them forever. And so it was like if I am there now, I might not be there later, but if I am at the hospital now doing the work and taking the time away for the good of everybody so that I can be there permanently, I remember I have a journal entry from either the first or second hospitalization I had saying to my future self, don’t go home right now because you won’t make it to see Carter’s first day of kindergarten.

(00:28:58):

You won’t see Nicholas’s birthday if you go home now. You will not see these huge milestones that are coming. And so thinking about those things, I needed to be there for Carter’s kindergarten. I wanted to see Nicholas’ first birthday and his first Christmas and Easter was coming up. So I really had to keep that framework, that mindset in mind, that going away temporarily to be there forever is the best thing that you can.

Dr. Sarah (00:29:32):

And it also sounds like there were moments of lucidity and clarity because for that journal entry, there had to have been some real awareness of what was really going on. And also I imagine there were waves of the absence of that.

Chelsea (00:29:48):

Yeah, it’s very up and down. It’s very ebbs and flows. And there would be full days where I knew exactly what was happening, and I knew that I needed to participate in this program fully and get the help and get all the sleep and all of that. But then there was also days that I just didn’t really understand why I was there. I was like, well, I’m fine. I can go home. And I would try to convince people, tell my family and stuff. I was like, I’m feeling a lot better. I should be home anytime. And it’s so up and down, it’s very much a roller coaster of some days, you’re fine, some days you’re not.

Dr. Sarah (00:30:29):

Which is also, I think, good for people to be aware of, especially people like family members, kind of like you were saying with the Valentine’s Day stuff. There are moments where our families might be looking and saying, oh no, see, they’re fine. See, here’s the evidence that I was maybe secretly hoping to see, right? Maybe I am starting to worry, but oh, oh, look, okay, good. We’re fine. We don’t have to worry. And it’s actually the opposite of what’s really going on.

Chelsea (00:31:01):

It really is a cycle. It really does come and go, and it can come and go for a long time. I am now, today actually is the year anniversary of my first hospitalization, and my last hospitalization was in May. So I’ve been out of the hospital for months and I’ve been stable for months, but I still have periods of lows where I’m not okay. And even though I am okay, and I do consider myself mostly recovered, but it still comes and goes. And so having family members be aware of what does a low look like for their family member? What are some of the initial signs that you can see that there may be dropping a bit so that you can put a plan of action into place, I guess, and you can take care of them. That awareness of knowing that, yeah, you’re not just going to be sad 24 7 or angry 24 7, it’s going to be a range. And so you have to pay close attention to what’s happening.

Dr. Sarah (00:32:13):

Yeah, so you started out with depression symptoms. And at what point did it become clear that this was more than depression, but there was signs and symptoms of psychosis?

Chelsea (00:32:26):

So I spent a week in the hospital the first time, and the plan for that one was just to get sleep. That was the big, I hadn’t been sleeping for a long time. So for months before I had Nicholas, I hadn’t been sleeping. And after I had him, I was maybe getting two or three hours a night. It was very little sleep, which contributes a lot to the psychosis. So in the hospital, we didn’t change any medication, we didn’t do anything. We just focused on getting sleep. And then they sent me home after a week. I got home on a Wednesday and I went straight back home to the boys and was going to just be better. I was like, okay, I guess we’re healed, so let’s go back to real life. And then that Saturday morning, so only after being home for three days, Saturday morning, I woke up with my older son in my bed.

(00:33:20):

He had been sleeping with us, and I turned over and it was early. He woke me up at five 30 or six or something. And I didn’t have a good sleep the night before, and I was very irritable. And I was, the night before two, I had met up with a girlfriend and I had relived everything so I didn’t sleep well because all those thoughts are running through my head. So anyways, I wake up to him waking me up and hear this really loud voice, say, smother him. You need to smother him because he’s a threat to you. He’s ruining your sleep. He’s the reason that you’re sick. And it was terrifying because it was not my thoughts. It was not my voice saying it. And I actually even looked around the room. I was like, where is this coming from? Because it was very real.

(00:34:17):

There must be somebody here telling me this. And I have never been so scared in my entire life because it really felt like it really felt like it was real, but it also really felt for some reason that I needed to listen to him, to the voice. It was almost like something was pulling at me to listen. And so thank goodness I freaked out and told Carter to leave. I said, mommy cannot get up right now. Go find daddy and tell him that mommy cannot get up. So thank goodness that I was able to get him away from me because I don’t know what would’ve happened if it would’ve only taken a second for something tragic to happen, which is an awful realization to have as a mother. You don’t, sitting with that with yourself is very hard. I’m very proud of myself that I did get him away, but then I also deal with a lot of shame and guilt of the fact that I even needed to get him away from me. So I’m still processing that, but I am happy that he was able to be safe, of course. So that was my psychosis symptoms, I would say. So that hallucination.

(00:35:45):

And so that day I slept till noon, and then I finally got up and decided to tell my husband what happened. And we both didn’t know what to do because there’s no manual on what to do when your wife starts hearing voices. So we both kind of figured, well, maybe I just need a break from the kids. Maybe I should go stay at my friend’s house and we’ll regroup in the morning kind of thing. So I did come to my friend’s house and I told her what happened, and both her and her mom, the looks they gave me when I was going through the story were just lovingly horrified. They were like, okay, something is really wrong.

(00:36:34):

And because I was still trying to pass it off as like, oh, I must’ve been dreaming, or it was just a one time thing, but I was really scared. So they did convince me to go back to the hospital that night. So I readmitted myself back to Ponoka and I wanted to be there for the long term. I was like, okay, something is wrong. We need to fix this. And I was still sort of dealing with a lot of not knowing what was reality and what was fake. I think you and I chatted about this before where I was even at home before these symptoms started, the hallucinations, I was starting to have a hard time knowing did I feed him or did I imagine that I fed him or is Dan really here or is that a shadow? Or I was at really losing touch with reality, not knowing here nor there, which was very confusing and very scary.

Dr. Sarah (00:37:45):

I imagine. So that would be, we were talking before when you were feeling like you were floating up above your body and just watching your life as though you weren’t really participating in it, that we call that symptom depersonalization. And then this symptom you’re describing where it’s like I’m sort of here with the reality and not, it’s like, I’m not really sure where the edges are of real and not real is derealization. So those would be two symptoms for sure, that as a mental health professional, speaking with someone who has symptoms that I would be listening for, and if I heard for that, it would certainly, I’m just trying to translate some of this for if anyone is listening who is wondering if my is showing some concerning behaviors or symptoms postpartum or if I’m experiencing these, what are the things that we’re actively looking for when we’re trying to make these diagnoses? And you’ve, in beautiful illustration, kind of showed what they look like, but I just feel like naming them, indexing them.

Chelsea (00:39:02):

Yeah, they say, oh, I’m not sure if that happened or I feel like I’m watching this happen, or things like that. Those are big indicators for me. Also, just any change in personality, whether it’s positive or negative, those big things. And they might just be small changes, but really tuning into how the postpartum person is acting is key. And noticing any changes are good to just bring up and be like, Hey, did you notice this change? Are you kind of gauge it with them? Yeah. So then when I was in the hospital the second time, they only kept me for four days and they told me, the doctor told me that they needed to discharge me because there was nothing they could do for me and that they were only a stabilizing unit, and so I needed to leave. And that baffles me still that they considered me stable enough to now go home to these two small children that just four days prior, I was told, in my opinion, to suffocate one of them. There was nothing they could do for me is what she said, which…

Dr. Sarah (00:40:24):

And did they change your medication at any point at that hospitalization?

Chelsea (00:40:28):

No. No. They maybe upped the dose, but they didn’t change medications. They didn’t, oh, sorry. No, that’s not true. They did put me on an antipsychotic at that point. Yes, they did do that, but they were saying at that time that they didn’t think it was postpartum psychosis, that they just thought that maybe I was delirious from sleep, but that they’ll give me the antipsychotic just in case. And I was like, okay. So I disagreed with them. I thought that was ridiculous.

Dr. Sarah (00:41:00):

Was there any sort of second opinion you were able to, was they available to even seek at that point?

Chelsea (00:41:05):

No. When you’re there, you get a care team and it’s one psychiatrist and a nurse basically. So no, whatever your psychiatrist decides is what is going to happen.

Dr. Sarah (00:41:21):

And I’m wondering if this psychiatrist is trained in perinatal mental health or is it just general psychiatry?

Chelsea (00:41:28):

It’s a general psychiatrist. Yeah. So the unit I was on was just a mixed, so men and women, general psychiatry, no specializations whatsoever towards perinatal disorders, which is also something that I think needs to change, especially here in Canada, we have no national perinatal health strategy. There’s nowhere for me to have gone to have gotten specific trained perinatal psychiatric help, which I mean that needs to change.

Dr. Sarah (00:42:05):

Yeah, that’s really scary. And I think this makes me think, I mean, I live in New York and we have The Motherhood Center in New York, which is an inpatient and intensive outpatient mental health full service place that is specialized specifically in maternal mental health. And they have it like a nursery so that mothers who are admitted to the inpatient unit and who are I think in the intensive outpatient can have their children with them safely, which I think is actually really important, the treatment process for the ability to, because like you were saying, one of your first symptoms that you noticed was a difficulty bonding with your baby. And one of the things that we do, and we want to treat this any PMAD, but especially that symptom, is to have therapeutic interventions where we help repair that connection and help parents tap into that connection again. And that’s actually incredibly healing.

Chelsea (00:43:18):

So healing, I think that that would’ve been so beneficial for me. I was able to advocate to have my kids come visit, so they were able to come visit for 30 minute visits every day or whenever they could. And those visits were incredibly healing, of course, but ending those visits, knowing that I wasn’t going to get to see the baby again until whatever day was actually more detrimental because I would go back to my room so depressed that I just gave my baby up again is how I would see it. Right now, I’m leaving him again. And so having a mother baby unit like you were talking about, or I know the UK and Australia do this really well, their prenatal or perinatal mental health system is fantastic. From what I’ve been researching, I would really love to advocate for that here, but being able to have my baby there would’ve made such a difference.

Dr. Sarah (00:44:17):

Absolutely. And I’m thinking too, I don’t know, I don’t know the resources in Canada, but a resource that’s also coming to mind right now for anyone who’s listening is Postpartum Support International, which I mean they don’t have physical locations. There’s no inpatient mother baby unit that they run to my knowledge, although I should check that fact. But they’re a virtual organization that helps connect people to supports locally. So they literally have a directory that you can type in your zip code or whatever your geographic location, and they have an incredibly robust directory to help connect people to resources that are local to them. Now, obviously that’s limited by your geographic resources, but if anybody needs anything and they just don’t know where to start, go to Postpartum Support International’s website. I’ll link it in the show notes and the show description.

Chelsea (00:45:19):

Yeah, I’ve done so much looking at their website too, and they do have so much, even if you can’t access anything locally, they have virtual support groups, they have peer support. There’s so many good resources there, what you said. That’s an excellent way to get started. They also have support groups for families of people who are going through postpartum, which is huge. They have groups for dads. They also have, I found a brochure on postpartum psychosis specifically and what it could look like and how to recover from it and everything, which I think is really important. One thing about postpartum psychosis I wanted to note before I forget, is that people, it’s often associated with that they don’t know that they’re in it, which is very much so often the case. But there are cases where mine, I did know that something was wrong. I was aware that I was hearing voices and I didn’t know exactly whether they were real or not or whatever, but I did know enough that I was hearing them. So just knowing that that also is a version of psychosis still an emergency still needs to be treated right away is important.

Dr. Sarah (00:46:41):

Yeah.

Chelsea (00:46:41):

Because I had another incident. They let me out of the hospital. They discharged me after four days and I didn’t feel comfortable going home. So I went to live with my brother out at our cabin, and I had another incident of voices that was even louder where I was driving, and the voice was like, there was a mom in front of me in her car, and I could see she had a bucket seat and she was laughing with the baby, and the voice was like, you hit her. You need to run into her. She can’t be happy with her baby because you’re not happy with yours. And I did rev up. I felt my car. I didn’t consciously do it, but I did eventually notice that I was getting very close to hitting her. And thankfully I was able to stop myself and pull over. But you’re not in control. They take over and you really do think that you need to listen to them because they are telling you the truth. It’s a very scary illness.

Dr. Sarah (00:47:45):

It’s really scary. It’s interesting because what you were saying about very typically when we distinguish intrusive thoughts from postpartum anxiety or postpartum OCD versus intrusive thoughts, sort of psychotic thoughts, thought disordered thoughts in postpartum psychosis is usually the way we distinguish it is if it’s an intrusive thought, it’s not psychotic. We hear it and we’re like, whoa, ugh. No, that’s really disturbing and I don’t want to do that. And with psychosis, very typically, there isn’t that awareness that it’s not supposed, the technical term is like ego syntonic versus ego dystonic. Ego dystonic is like, I hear it, but it does not fit what is happening. Ego syntonic is where we hear it and we’re like, yep. Or we’re not aware. It folds right into our other types of thoughts, and we can’t distinguish that they don’t fit.

(00:48:55):

And that’s typically due to the fact that it’s hard to judge what’s real and what’s not real. But what you’ve been describing all along in your presentation was this, and which I think is also true in postpartum psychosis more often than we are made to the pictures painted as it’s not always a full on psychosis all the time. It’s like these waves of in and out of lucidity when we’re in that space in between where it’s like I’m a little bit lucid and I hear maybe auditory hallucination. I might be lucid enough to say like, oh, this is horrifying and I don’t want to do this. But if you’re in and out of that space, when you’re in the space, there isn’t like the foot that revved the gas was egosyntonic, the thought that said, whoa, whoa, whoa, I got to pull over. That’s egodystonic , and you move in between the two.

Chelsea (00:49:49):

So it’s really both, because at first when I very first heard it, I was like, oh, no, what? But then I revved up and I was like, well, yeah, no, if I’m not happy, nobody gets to be happy. Nobody deserves that if I don’t have it. And I was talking to myself out loud at this point in the car by myself, and I was having a full blown conversation looking around and thinking, I’m talking to the person that is telling me this, and I am saying, yeah, no, you’re right. And I’m going faster. And then it’s so in and out like you were saying, and you can be lucid in the knot. And that’s where I think that those stories that get sensationalized is that often the people that are in it probably were in that moment of full blown psychosis where they are. It is reality to them. And so I’m very thankful that I was able to have moments of lucidity because I very easily could have been one of those sensationalized stories. We were very close. That woman was very close in front of me.

Dr. Sarah (00:51:01):

Which is why any symptom of postpartum psychosis has to be seen as an immediate emergency because we flip in and out of that lucidity and psychotic state fast and unpredictably, and it only takes a moment of that loss of connection with reality where something tragic could happen. So it’s like if we are even wondering, and this is where your point earlier of that genuine and very, very valid conflict of being like, I don’t want to go to the hospital. I don’t want to admit that this is happening. I don’t want to be separated from my kids all so valid and think, gosh, you went and did get support, and it sounds like you had to really, really advocate multiple times to get the right support. We haven’t even gotten to the part where we finished addressing. You are now in the story. You’re in your second post discharge, still psychotic. What happened? At what point did you finally get a formal diagnosis and an effective treatment?

Chelsea (00:52:09):

I actually don’t think that I ever really got a formal, I did get a formal diagnosis of postpartum psychosis. Well, actually no, that’s not even true. They weren’t sure they were going back and forth, so they put me on the antipsychotic. Risperidone is the one that I took, and I took that for about a month, I think, and then they took me off of it. I did after that last time of that last moment of the voices telling me to hit the car, I never heard anything else after that. But I took it upon myself to very much so restrict what I was doing with the boys and all of that and my treatment. So I made my own treatment plan with my family and my support system. And so I stayed at the lake. I only saw the boys for an hour or two at a time, always well supervised because I was able to have the resources to make that plan for myself. But if I was somebody who didn’t have a big support system or didn’t have the educational background to think about these things, the lack of care is just ridiculous.

Dr. Sarah (00:53:29):

Or even your point, the lucidity, if you didn’t have those moments, it sounds like because you were able to have moments of very clear judgment and non disordered thought, you could recognize the risk and do something about it in those moments. And so it just really speaks to the fact that there needs to be more access to care and you shouldn’t have to fight this hard for it.

Chelsea (00:53:57):

Yeah. So in the end, I took, yeah, no, you should never have to advocate for help when you’re in a psychotic state. So I took the risperidone for about a month. I very much so distanced myself, and I was able to very slowly kind of reintegrate into things. But then I took the risperidone for a month, and then I ended up actually in a very severe suicidal depression for maybe about, it was probably six weeks after I got out of the hospital the second time, and I just was having so many feelings of the treatment plan not working. So in my head, I was taking the medication, and by treatment plan, I mean the one that my psychologist gave me, which was take the medication exercise three days a week or 30 minutes a day, do the therapy. That was it. So in my head, I was doing all of what they…

Dr. Sarah (00:55:03):

What was the therapy? Was it weekly talk therapy? What therapies were you doing?

Chelsea (00:55:07):

Yeah, sorry. I was doing weekly CBT therapy with my psychologist. I hadn’t started EMDR yet. The eye movement detection therapy. I did start that in May when I was in the hospital, but I hadn’t started it yet. So at that time it was weekly sessions of CBT and talk therapy. So yeah, I was thinking that I was doing everything I was supposed to and it wasn’t working, nothing was getting better. And so that fueled me into a very suicidal episode where I had a plan and I was very close to I trying to commit that act. So I was hospitalized again this time for longer, for 11 days until I got better. And this is the time that my treatment plan really changed. And so it took me seeing this psychiatrist and he said, okay, you’re not coming in and out of the hospital anymore. You are here until you get better. We are trying another medication. So they added another one. We are like, you’re going to do your therapy twice a week and you’re going to stay here until you get better. And so it took a third admission and it took me being suicidal to get finally the right help and as much help as I needed, which I wish that it hadn’t come to that, but in the end, I’m very thankful that it did because that admission is what led me into recovery.

Dr. Sarah (00:56:54):

Yeah. Thank goodness for that.

Chelsea (00:56:57):

Yeah, thank goodness it was, and that was the lowest point of the whole thing was actively planning a suicide was the absolute lowest. So being able to, I get the help then that truly worked and that I truly needed, I’m very, very grateful for.

Dr. Sarah (00:57:27):

And what has recovery looked like for you? We talked about how the fact that there’s so many moments that this could have become that tragic story and it didn’t, and you did get support finally, thank goodness, and you are in recovery and it is a hopeful story. And what is life after an effective treatment and probably an ongoing effective treatment? What does that look like?

Chelsea (00:57:57):

Yeah, so it actually was night and day when I was in the hospital. Once we got me on the right medication, the next day I woke up and my head wasn’t foggy. I was seeing the light at the end of the tunnel. I was hopeful. So that was huge. So post, yeah, so since since June, I started out staying at home one night a week and then gradually two or nights a week or whatever. Now I’m home every night with my boys. I’m back to work two days a week. I’m still working through going back full time, but I’m with my boys. I’m very happy with them. I do all the normal mundane mom things every day. I still take my medication. I’m not off medication yet, and I have no plans to explore that anytime soon. I still do therapy, but it’s once every two weeks. Now maybe every three weeks I’m working on doing some EMDR to process everything because that the emotional part of it I think is still what I struggle with the most right now is just all the leftover feelings of it, like processing any feelings of guilt or shame or any of that. But those are big reasons why I share my story because I know that it wasn’t my fault that this happened, and I really want other women to know that it’s not your fault and you can recover. And there were days that I thought that I would never be back at home with my boys and that I would never have a bond with Nicholas and I would traumatize Carter forever. And none of those things are true. I’m home. Nicholas and I are very connected. That bond is truly there. I feel all of that love now. I don’t see any residual effects in him. He doesn’t know anything happened. I always was fearful that he wouldn’t know who mom was, but he knows when he’s sick, he wants mommy, and I’m the one that can calm him down when I sing, which is just the most amazing feeling ever. And also the personal part of recovery is I am coming out a much better person. I now have a consistent workout routine where I never have one before. I’m physically stronger. I know myself quite a bit more now. Yeah. So it’s just a journey. But I feel like I am very much so very far deep into my recovery, and I’m very happy to be with the boys and just be at home.

Dr. Sarah (01:00:58):

That is a really wonderful ending to that story because I think obviously I’m so, so grateful that you got the right treatment and that you were not just like that, you got the treatment, but that you were able to reconnect to the parts of yourself that you lost for a moment there, like the bond for sure. But also your relationship to you, your trust in yourself, your identity as a mother who is worthy of being with her children and who see you as their protector and their soother and the one that they call up for when they’re sick, and the one that soothes them when they fall down. All of that is still, so it didn’t go away, and you were able to reconnect to that and reclaim that. And I’m so glad you’re also, I think there’s layers to this. Yes, we have to treat the symptoms of psychosis and depression, but it sounds like there’s also been work to treat the trauma of having gone through this, and that is just as critical.

Chelsea (01:02:11):

Yeah, it doesn’t stop. No, it doesn’t stop. I was actually just journaling about it last night because today’s the anniversary of the first, and it’s a big day for me. It feels like a big thing. And I was journaling about it and I was in there. I wrote that there has not been a day since this started that I have not thought about it or thought about the diagnosis or thought about what it’s meant. But now my thoughts are more about being grateful for what has come out of it. I’m not going to say I’m grateful that I had it because I think that would be a lie, but I’m grateful that I can see the positive that has come out of it and that I can really focus on those things. And I can really appreciate that my relationships, like you said, are strong and that irreparable damage did not happen. That I think is the biggest thing, is that it felt like everything was going to be ruined, and that’s just not true. I’m just as good of a mother now as I was before I had this, and also just as good of a mother as I was when I was going through it.

Dr. Sarah (01:03:20):

That is a very loving statement to yourself, and I’m so happy that you could share that with everyone listening. Thank you. Thank you so much. I cannot express my gratitude for you coming on here and sharing this with me and being a light shiner, for lack of a better phrase. But this needs light on it. It’s not shameful, it’s not dark. It is scary. And the more that we let things that are scary live in the shadow, the more we prevent people from actually getting help and getting into the hopeful light-filled space.

Chelsea (01:04:00):

Thank you. Thank you for allowing me this space and this time to share. It’s, I appreciate it so much. And I just want to say to anybody that’s listening that is going through it or has a family member going through it is that just keep pushing. You will get to that hopeful side even though it feels like you won’t, you will. I promise.

Dr. Sarah (01:04:27):

That is such a hopeful message, and I hope that people who are listening can really feel that. And also obviously if people are listening to this story and they’re hearing what is very much the reality is like you had to fight really, really hard and advocate yourself in an extremely horrifically challenging moment in your life, and thank goodness you were, but the reality is that shouldn’t have been on you. And if you’re listening to this episode right now and you’re like, oh my gosh, this is, we are failing mothers. If this is the state of maternal mental health care and its accessibility and its people being able to access the right care that they need in these moments without to have multiple hospitalizations before they’re even getting effective treatment, and you are like, I want to do something about this. We can pull together some advocacy resources and link them in the show notes and the show description as well, because I mean, I’m so moved by your story and I’m also enraged and furious and all the things too, really.

Chelsea (01:05:51):

I agree. I feel the exact same that there’s, we are absolutely failing mothers right now, and the statistics for it are awful. If you really look into the statistics for maternal mental health, it’s not good. And mothers need this. This is a crisis in healthcare right now, and we need to be doing something. One resourceful note is the Canadian Perinatal Mental Health Collaborative. We’ll send you guys the link for so that you can include it. It’s a good one for advocacy in Canada specifically. And then also Canadians can write to their MLAs and to advocate for better care. And then we didn’t even get to touch on the care in the hospital and all the how that could be improved. At the last hospitalization, I wasn’t allowed to go outside for an entire week. I spent eight days inside. I had no fresh air in a tiny little unit. They only go for a walk once a week. That is not good care. There’s so many things that could be improved.

Dr. Sarah (01:07:07):

Yeah, and I think obviously the entire mental healthcare system at large has a lot of room for improvement. And also specifically being able to have access to specialized maternal and perinatal mental health care for these types of crises is so important, and that is incredibly lacking. And so I am going to do my due diligence before we air this episode of just putting together some resources. And if anybody has other things they want to add, if they have advocacy groups that they want to make people aware of, if they have things they want to share, email me and I will make sure to share them with anybody through the podcast platform as well. So thank you so much, Chelsea. It was really, really wonderful talking with you.

Chelsea (01:08:09):

Thank you. I really, really appreciate it.

Dr. Sarah (01:08:18):

If you or someone you love is struggling, don’t wait to seek help. To learn more about the signs of perinatal mood and anxiety disorders, go to the episode description to find links to several resources including Postpartum Support International and other Securely Attached podcast episodes about PMADS in both women and men, and what to be aware of before, during, and after a pregnancy. I cannot thank Chelsea enough for being so brave and vulnerable in sharing her story of hope and recovery. And I thank you for listening to this episode that I know is difficult to hear. Don’t be a stranger.