Postpartum psychosis is believed to occur in 1 to 2 of every 1,000 women after childbirth.
When I clicked on the story about a woman in her late 20s who had stabbed her three small boys to death, before stabbing herself as well, two facts stood out to me. Her brother—the poor man who had found his sister and nephews—said that she claimed to have stabbed herself because she was pregnant, and her youngest was only two months old.
Postpartum pyschosis, I immediately thought.
I was 18 when I became pregnant, and 19 when I birthed my son. Six pounds, 12 ounces, he was long, skinny, lumpy-headed from being suctioned out, and completely, unconditionally loved by me. I had no worries about my youth being taken from me; I didn’t like the floating sensation of my teen years, bouncing from weekend to weekend, anxiety attack to depressive fit. I craved, more than anything, a real anchor to my life. I wanted to be yanked into hot sand, ankle deep, and stunned awake in the yellow-drop sun of California.
With motherhood, I was awakened. My truest self was able to emerge, making room for all the grit and joy that had before been buried underneath a dull coping, a mundane survival. I went home to my mother’s house and breastfed my son. I was a single mother, and I had never been so happy or sure of myself. I was going to start college soon; meanwhile, I luxuriated in my baby.
We slept together, and I carried him in a sling, spending long afternoons sitting on the patio with my Grandmother Elizabeth, watching her paint while I half-napped with my baby. I would do anything for you, I thought, looking at his head. I would let the sharks of the Pacific eat me, one white-fanged blood bite at a time, to save you. I enjoyed coming up with the most horrific scenarios imaginable in order to weigh them against my love for my son. What could I endure for him? Anything, I concluded.
Then, one day, when my son was just months old, I heard what I assumed to be someone leaving a message on the answering machine. It was a male voice I didn’t recognize, talking in an unsettlingly strange voice before stopping abruptly. Sitting on the couch breastfeeding, I hadn’t heard the phone ring. I didn’t move, but looked absentmindedly at my Grandpa, expecting him as usual to bolt to the phone as if it were a nuclear warning. But instead, he remained on the couch, turning the newspaper. I had an overwhelming sensation of falling, anxiety crawling up my sides and in between my ribs like ants, and then nausea. I looked down at my baby and kissed his forehead. It must be hormones, I thought.
A moment later, I asked my grandpa who called. “What do you mean?” he replied. “Just now,” I said, and indicated toward the phone. “No, no call,” he said. I gathered my son and looked over the phone. No messages.
After that, I began to feel increasingly odd. The next few weeks went by with nothing notable, but my anxiety increased, as did my sense of being slightly removed from life. I began to have moments where I’d look at my son in the way that a scientist looks at a molecule: with detached interest. The moment would quickly pass.
One morning, I was lying in the upstairs bedroom with my son. He had just finished nursing, and the day was hot and crisp, so he wore only a diaper. I held him in my arms and looked out the sliding glass balcony door, admiring the view, humming to my baby. I saw a hummingbird among the flower blooms of my mother’s garden, and then: the image of my son flying over the balcony, and the long, horrifying unfurling of nothingness inside of me, no morality, no emotion, no connection to life or any of its concerns, just a cold and impassive tug, that same kind of hard yank that pulled me fully into life with his birth. I felt a mental and physical sensation to let him go over the balcony—to drop him. I imagined my baby gone, and I felt nothing.
Deep inside of my brain, in an area that felt the size of the prick of a needle, my real self was screaming to be heard. “Don’t! Don’t you dare! Something is very wrong, this is not right, you will be sick sick sick, what you feel will be unbearable, you do not want to hurt your baby, throw yourself! Throw yourself instead!” I sat paralyzed.
The sun shone as my son grunted contentedly in my arms. I struggled so deeply against the nothingness and the impulse to throw him or myself over that balcony that my body shuddered. Carefully, I lay my baby down in the center of the bed, and moved away from him. I felt a magnetic force trying to draw me to the balcony so I could throw myself over. I moved all the way across the room and sat down. Wake up, I whispered to myself, wake up. Emotion returned. I felt sick, and I wailed as quietly as I could into my hands, rocking back and forth.
What was happening to me?
Postpartum depression occurs at the very least in 1 in 7 women, and the numbers may be even higher. Postpartum psychosis (PPP), on the other hand, is believed to occur in 1 to 2 of every 1,000 women after childbirth. But according to Katherine Stone, founder of the nonprofit organization, Postpartum Progress, “just because it’s rare doesn’t mean we should ignore it. Postpartum psychosis is a psychiatric emergency because it can lead women to behave in ways they never would otherwise, so a mom with psychosis symptoms should receive immediate care from a health-care professional.”
Onset of the psychosis is often sudden, usually within two weeks of giving birth, and it’s believed that in most cases, it represents an episode of bipolar illness. While most women who experience the psychosis do not harm themselves or anyone else, there is approximately a 5% suicide rate and 4% infanticide rate among those with PPP. The psychosis often presents with hallucinations, paranoia, rapid mood swings, irritability, and delusions. The biggest risk factors for an episode are a previous psychotic episode, or a family or personal history of bipolar disorder.
When I was experiencing postpartum psychosis, I couldn’t sleep. My son was colicky, so I was already sleep-deprived, and now, after what I thought of in all capitals as THE INCIDENT, I was afraid to fall asleep, and afraid that in my sleep, I would do something irrevocable. I was terrified to ask for help: What if someone took my baby from me? I began to have panic attacks, and then alternate between panic and numbness. Finally, I sat and talked to myself sternly. I became furious at my situation, and anger helped penetrate the fog: What is the worst that could happen? I asked myself. My instant reaction—someone will take my baby.
No! I thought. No. It’s that I will hurt him. That’s the worst thing that could happen. Make yourself ask for help.
Katherine Stone emphasizes, “The most important thing is this: If you don’t recognize yourself anymore, if you can’t function as you would like to on a daily basis, if you’ve had the symptoms of maternal mental illness for more than two weeks and they aren’t getting any better, make the call! Reach out.”
I did. I confided in someone and this person, unable to imagine that the Maggie they saw and knew would do anything terrible, told me that I would be fine, that motherhood was hard and I needed more sleep and when I got it, I’d feel better. I’d be fine.
The next day, I told a friend, and then another friend. I didn’t tell them the worst of it, but with their obvious concern, I was able to stake a tiny foothold in progress. Every day, I thought of THE INCIDENT and what could happen if I hadn’t been able to stop it. I reminded myself of the shark bites: Put yourself in front of the shark for your son, I told myself. I made a call, and an appointment with a sympathetic sounding therapist. During our meeting, the therapist promised that she wouldn’t take my baby from me. “You’re going to be OK,” she said. “You aren’t a horrible person. You are sick, and you can get better.” I collapsed in tears. I wasn’t going to get attacked, and neither was my son. We were saved.
I don’t remember my exact diagnosis (this was 20 years ago now), but I had many risk factors for postpartum mental illness, including postpartum depression and anxiety, a history of PTSD, a history of mental illness in my family, unexpected pregnancy, and thyroid disease. The therapist told me that what I had been experiencing included something called “intrusive thoughts,” defined by the National Center For Biotechnology Information as “…distressing ideas, images, or impulses that enter a person’s mind repeatedly.” Intrusive thoughts are a normal product of the brain, but in the case of the kind of severe anxiety or OCD I was experiencing, the intrusive thoughts become obsessive and terrifying.
In my therapist’s office, I wept tears of relief on my son’s face. The first step had been taken. Eventually, with her help and some short-term medication, I recovered fully.
Now, when I read new stories about women who hurt themselves or their children after having a baby, I feel a shudder of empathy and grief. Without the right treatment, I don’t know what would have happened to me or my son. It’s hard to leave that sentence there. To be exposed to that reality privately was horrible; to expose it publicly is like pulling a wound open.
Perhaps, though, my words will help someone who’s also come close to this horror decide to reach out instead.
Maggie is the author of Atmospheric Disturbances: Scenes From A Marriage (Shebooks, 2015). Her work has appeared in Guernica, Marie Claire, The Rumpus, Sheknows, and more. Her novel Agitate My Heart is in final edits. Find her at Flux Capacitor.
This originally appeared on The Establishment. Republished here with permission.