My mental illness was born with my first baby.
I never considered my mental health as part of the decision to have a baby, because when I first fell pregnant within a month of trying, I had never experienced mental illness.
The pregnancy was uneventful.
Then I went into a thirty-three hour labour on two hours sleep. This severe sleep deprivation and the swirling hormone levels woke a slumbering monster, a genetic predisposition, which ensured that by the time my baby was one week old, psychosis had wrenched me away from reality. I found myself in the Special Care Unit of a private psychiatric hospital trying to explain my way out of my delusions, while my husband and mother cared for my daughter at home.
Welcome to motherhood.
I was privileged to be able to afford the golden key of private health insurance, which unlocked my access to excellent care for me and my baby during this traumatic time.
The next four months were a blistering gallop through early motherhood, spent mostly in the mother baby unit of the psychiatric hospital. The psychosis settled, I flattened out. Then I crashed into depression. Catatonic depression. Unresponsive to antidepressant after antidepressant. Until finally a course of Electroconvulsive Therapy three times a week for four weeks shifted it, and I eventually left the hospital with my baby.
Twenty months later I was able to come off the last of my medications, and I was fine.
You would think a second baby would be out of the question having survived that hell ride for baby number one. And yet… there I was, going well, off all medication with an ache for another baby keeping me up at night.
If the decision to have the first baby without having a history of mental illness was a challenge, the guts to bring a second baby into being, knowing I’d be risking my sanity, and possibly being absent from my first child while I healed for months in hospital, felt almost reckless.
My logic tried hard to strongarm my emotional ache out of the second baby. In the end it failed because it couldn’t push past the evidence:
The worst had already happened. And I had recovered completely. If it happened again, I knew (with excellent care) I could recover again.
Then, it was almost as though my reproductive organs were trying to compensate for the shortcomings of my brain, because the second pregnancy also happened within a month.
I feared what might lurk in my future but was relieved to be off the swinging pendulum of indecision. At six weeks I saw my psychiatrist to discuss my options:
‘If you stay well it’s best to avoid medication in the first trimester. After that we can use it preventatively during the pregnancy or start immediately after the birth.’
I asked about the risks to the baby with medication.
He considered his answer:
‘There is a slightly higher incidence of birth defects in the literature, but I am not seeing that in practice. The baby may have some withdrawal symptoms after the birth, but we usually manage that with weaning down your medication dose before the delivery.’
He paused to let me absorb this information and then unleashed more honest words:
‘You have to balance this with the risk that if you get sick again your risk of suicide is much higher without medication, and that would be the worst outcome for everyone.’
I got lucky. I made it to seventeen weeks before I got sick and needed not only medication, but six weeks in hospital.
The moment my second baby was born (perfectly healthy) by elective caesarean was glorious. I knew instantly I’d made the right decision for our family, and I have never regretted it.
But it wasn’t easy.
The first year after his birth was riddled with mental illness and hospital stays. When my son was six weeks old I survived another psychotic episode. It was followed by episodes of depression. He and I spent more time in hospital in the mother/baby unit than out of it during that year.
My illness was definitively diagnosed as Bipolar 1 Disorder. I had to learn to accept that unlike most of the mothers in the mother/baby unit, my disorder wouldn’t slink away once I stopped having babies. I would be stuck with this for life.
Thankfully, I never ached for a third baby. So, I haven’t had to go through the war zone of my logic facing off against my emotions again.
I am beyond grateful I didn’t know what would happen to me before I decided to have my first baby because I would never have had her. I am also happy that when I was wildly swinging between whether or not to have my second baby I didn’t catch a glimpse of the first year, because I wouldn’t have had him.
I don’t ever take the privilege of getting to have my two children for granted, and I feel great empathy for the women whose choice of motherhood is stolen from them by a mental illness
May 6 is World Maternal Mental Health Day. The impact mental illness can have on our decision to have a baby is less discussed than the specific perinatal mood disorders. And yet this brain borne infertility can be just as devastating as the kind that affects our reproductive organs.
If you are experiencing a perinatal mood disorder or think you may be, there is help available. The best first point of call is your GP who can refer you to a psychologist or psychiatrist who specialises in maternal mental health, as needed. You can also check out the following online resources:
The Gidget Foundation: https://gidgetfoundation.org.au/
SANE: https://www.sane.org/ for support with complex mental illness
If you are in crisis phone Lifeline on 13 11 14
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