Guilty Of Postnatal Psychosis

(Content Note: suicide and infanticide are mentioned in this post)

Who am I?

I am a veterinarian.

I had my first baby at 32.

I developed postnatal psychosis after the birth of that baby.

I had no history of mental illness before that.

I have a perfectionist personality.

This is me.

But given this information, you could mistake me for Melissa Arbuckle.

If you’ve read even just the headlines this week, you will know Melissa’s baby Lily died in horrific circumstances, as a direct result of Melissa’s undiagnosed postnatal psychosis and depression.

Melissa’s story is an important one. But I have yet to read a story by a journalist who gets the narrative of postnatal psychosis (or any form of psychosis) right. Journalism around psychosis, even decent journalism, focusses on the sensational.

But despite the inevitable sensationalism, in this case the journalists got one thing right. They investigated the lead up to this horror story. And that shows us the number of times this horrific outcome could have been prevented.

Melissa’s baby was born in April 2021.

The Age reports ‘Maternal health notes showed that as early as May 19 the new mother revealed she was having difficulty coping and became teary, later telling a lactation consultant she felt ‘out of control’.

According to News.com ‘Victoria’s Supreme Court heard that in the weeks leading up to Lily’s death, Ms Arbuckle had been ‘really down’ and she believed she injured her baby after rocking her bassinet too vigorously.’

She hadn’t injured her baby at that point, but her thoughts (believing she had injured her baby) were delusional, for weeks before her daughter’s death.

The Age also reports ‘The night before the incident, Arbuckle told her husband she was having suicidal thoughts, but assured him she could never go through with it.’

Lily died and Melissa nearly died after being struck by a train on the following day, July 11 2021.

Melissa was diagnosed with postpartum depression and psychosis the day after her daughter died.

When I think of all the points on this timeline that Melissa’s and Lily’s odds could have been dramatically improved, anger steals my breath.

Regarding the Maternal health notes made in May 2021:

‘Maternal health notes’ imply a nurse or midwife assessed Melissa at some point and, aside from making some notes about her difficulty coping and being teary, did nothing.

Midwives and nurses need to be taught: The baby blues and mild anxiety are not always the cause of a teary mother who is having difficulty coping. They need to know when and how to refer a new mother for assessment with a psychologist, psychiatrist, a mother baby unit, or at least a GP. And they need to err on the side of caution!

I am not surprised a lactation consultant didn’t know what to do with a mother feeling out of control. Lactation consultants tend to be laser focussed on getting breast milk into babies at all costs. But again – educating lactation consultants to look far enough beyond ‘latching issues’ and ‘milk supply’ to consider referral to qualified mental health care professionals when red flags are raised, would be a good idea.

In the weeks before Lily’s death, when Melissa is described as ‘really down’ – these were the weeks that preceded the night before Lily’s death.

The night when Melissa told her husband she was having suicidal thoughts.

From my standpoint and lived experience, I struggle to give Melissa’s husband much benefit of the doubt here. I understand (based on the article in The Age) that her husband lost his own father to suicide as a teenager. So, there is possibly a barrier of unresolved grief and trauma that prevented him from reacting appropriately to his wife’s symptoms.

But presumably he noticed Melissa being ‘really down’ for those weeks. Did he attempt to get help for her? And if not then, what was stopping him when she expressed suicidal thoughts to him on that night? The fact that she claimed she wouldn’t act on those thoughts? Did he not consider the amount of mental pain one needs to be in just to have suicidal thoughts?

For everyone reading this: If anyone ever expresses suicidal thoughts to you, PLEASE ACT! Even if there is no option but an ambulance to the nearest hospital. And if the person experiencing suicidal thoughts tells you they won’t act on them, not only are they too unwell to make that assessment, they are also suffering intensely and need help!

Yes, our public mental health system needs a lot of improvement, and there are nowhere near enough public mother baby units available. But even if the ideal of a private psychiatric hospital with a mother baby unit, was not available or an option for Melissa and Lily, a public hospital might have given them a fighting chance.

Back for a moment to the journalists reporting on psychosis. They tend to give all the characters surrounding the person living the horror of psychosis a voice, even if some of those voices are irrelevant and add to the stigma psychosis is already steeped in.

In Melissa’s case that person is her baby’s great aunt. In The Age article, this great aunt doesn’t want to be named, but she does suck up more than her share of oxygen. She has publicly expressed that she thinks Melissa’s actions were ‘catastrophic’ and ‘cruel’.  Catastrophic – absolutely. But ‘cruel’ implies the malicious intent of someone whose mental health is totally uncompromised. She used the words ‘Melissa’s actions’ but what she communicates is ‘Melissa is a cruel woman, and that is why she killed her baby.’

To that great aunt, I would say this:

If people like you didn’t perpetuate the stigma surrounding illnesses which feature psychosis by giving uninformed stigmatising quotes to journalists, then Lily’s father may have had some clue about what to do when presented with the symptoms of severe mental illness that were obvious in his poor wife for months before they led to such unbearable pain for everyone. If you want to blame something, blame this horrible illness, in the same way you might blame cancer for taking loved ones too soon.

News.com reports ‘The case has revealed just how quickly the 32-year-old’s life spiralled out of control after she developed severe major post-partum depression and psychosis following the birth of her daughter in April 2021.’

Melissa’s life didn’t spiral out of control quickly. She developed a life-threatening illness, the symptoms of which were either ignored or not acted on for months, until it was too late. Reporting it was quick, implies it was too quick to do anything about.

My postnatal psychosis set in by day 6 of first-time motherhood. By days 7 and 8 I was completely detached from reality, denying knowledge of my baby and my husband.

And when I was accurately diagnosed with postnatal psychosis in the safety of a mother baby unit in a private psychiatric hospital, my husband asked what he should have done if this had happened at home. This is what he was told:

‘Call an ambulance. Postnatal psychosis is a psychiatric emergency, but it is treatable.’

My greatest sympathy and compassion go out to Melissa. She was failed at so many points.

My memoir Abductions From My Beautiful Life was published last year and (among many other events) includes details of my experiences with Postnatal Psychosis. You can find an excerpt here: Book and it is available to buy online, including at Booktopia, Fishpond, and Amazon. If you are Brisbane based, you can also buy it at Avid Reader and Riverbend bookshops and Ruby Red Jewellery at 107 Romea St. The Gap.

If buying a new book is not in your budget, Abductions is also available to borrow from the Brisbane City Council Library Catalogue.

Other Thought Food posts that may interest you are:

My Sliding Doors Encounter With Our Public Mental Health System

Welcome To Motherhood

Lifeline 13 11 14

The mental load 2.0 : Airing your dirty dishes on socials

huge heap of dirty disgusting dishes in the sink waiting to be washed by unreliable flatmate

Has it really come to this?

To the women who document their displeasure about the unequal distribution of their mental load passive aggressively on social media:

The likes and laughing emojis you get from hundreds of strangers might give you a quick sugar hit of instant validation, but will they solve the issue of your unequally distributed mental load, or will it just corrode what sounds like the already leaking vessel of your marriage further?

The writers appear to feel more solidarity with the anonymous commenters than with the person they are in a partnership with. Underneath the jokes sits violently simmering resentment.

Let me back pedal to the source of my lack of admiration for this approach for a moment.

The first was a recent article a woman wrote about the (extensive) difficulty she was having getting her dog to feed her husband. Sorry her husband to feed the dog – although with the tone she used to describe her husband’s ineptitude, she could easily have meant it the other way around.

The second – I think it was on Youtube – an account of a woman who ‘went on strike’ and stopped washing the dishes and then posted updates about the ‘apocalypse’ unfolding in her house as a result of this. Piles of dirty dishes. The husband in question using a baby spoon to stir his coffee rather than doing the dishes.

I am not trivialising or dismissing the message these women are attempting to send their partners, but their delivery is conflicting.

In one breath it’s attempting humour and in the next red-hot anger.

Clearly we are not dealing with one of those minor sources of marital discord that can be shrugged off as a normal part of any relationship here.

The unequal distribution of the mental/domestic load is real and needs to be taken seriously. But is turning it into a farce and publicly infantilising the people whose behaviour you want to change the way to go about it?

Returning to the article about feeding the dog for a moment. The writer explicitly stated that in the four years she had off work outside the home, before returning to her career, she took on 100% of the domestic load. Feeling (rightly) entitled to a break, she then seemed surprised when the hand over of one chore (feeding the dog) didn’t run as smoothly as she wanted it to.

She also displayed another classic trait of the mental load martyr: overcomplicating a simple task, by insisting on her husband’s dog being fed a thermomix cooked diet for the sole reason that she thought ‘It made the dog’s coat shiny’.

Having read her article, I posted the following response:

As a small animal vet: The best diet for your dog is a high quality dry biscuit, something like hills science diet, water, and (if your dog tolerates them well) fresh raw bones for their teeth. You are wasting everyone’s time, energy, and to be honest a lot of words in your article on preparing fresh food for your dog. 

As for the distribution of mental load: You mention that in your four years off you shouldered 100% of the domestic load. Why? Did you both consider your husband less of a parent or part of the household in that time? If he worked long hours, he may not have been able to do as much of it as you, but does that mean he should have done nothing in that time? If he had been living in a hypothetical share house instead of your family during the time he worked long hours, would his housemates have been happy to do his laundry, dirty dishes, and feed his dog?

So maybe setting the bar so low during those years is making it harder now? The martyrdom of women shouldering and complaining about the mental load is real. Change your dog’s diet for everyone’s sake – including your dog’s. Tell your husband if he doesn’t feed his dog you will report him to the RSPCA. If you stop treating your husband like a an inept toddler, he might stop acting like one.

To be clear – I don’t think there is anything wrong with giving your partner a wake up call to shoulder their share of the domestic load, by letting things slide. But make a choice – it’s either something funny that you don’t really care about that you post on social media, or it is a serious issue in your relationship, in which case yes, let the dishes pile up until your partner gets the message, but don’t then simultaneously trivialise and weaponise it by posting it on social media. Doing so might get you the hit of anonymous likes, but it’s not going to solve the problem in your relationship.

I have previously written about the equitable division of mental and domestic load in my relationship. Your Mental Load = Your Responsibility We both have careers. We share two children, and a menagerie of pets, and all the mental load. I have been called ‘lucky’ because of this.

I am not lucky.

I made a choice to be with my husband. We work on communicating well and from the very beginning of our relationship I have never given him the illusion that I would carry 100% of the domestic load.

But if either of us ever resorted to shaming the other on social media, if we had a significant issue in our marriage (such as the unequal distribution of the domestic load) I suspect we would each seriously re-examine our choice to stay with each other.

Post script: This post is not in any way aimed at those living with or who have escaped domestic violence or who are living with mental illness or any other disadvantage. It was intended as a prompt to reflect for the women who do not live with domestic violence, but do live with straight, white, cis-gender, non-disabled, privilege and who have choices but prefer martyrdom.

You may also like to check out:

Your Mental Load = Your Responsibility

Don’t Try This At Home: Schooling

Rewards For Reports: Entitled or Deserved?

Vulnerability And The Exploitation Of Kanye West

vulnerability image

Kanye West is unwell again. Hurtling through a manic Bipolar episode while the world laughs. And as someone who lives with Bipolar 1 Disorder, I feel for him.

In the early years after my diagnosis, during one manic episode (while hospitalised) I started discussing my sex life with strangers. My friend who was visiting me steered me gently away.

Kanye doesn’t seem to have anyone to steer him away, gently or otherwise.

Kanye is a wealthy, influential man, who probably has access to the best mental health care available. But I don’t believe his problem is accessing top quality care.

His problem is that he lacks insight and no one around him is game to have the difficult conversations with him. The conversations that point out that while he may be a brilliant artist when he is relatively stable, when he develops manic symptoms his brain needs a break from the world, and the world is not entitled to its contents.

Instead, when Kanye becomes unwell his mania is left to run free.

He has been open about his choice not to take medication to help manage his Bipolar Disorder. That is his right. Medication doesn’t work for or agree with everyone.

But he seems to be unaware that to successfully manage this illness without medication, you need to employ other strategies. You need to hone your insight. And if your insight when you are unwell is shaky, you need a mental health directive.

This means sitting down with your doctors and people closest to you when you are well and discussing how you would like to manage your symptoms when you are unwell. And if you experience manic episodes, one of the most basic requests may be to not have access to the media – social or otherwise – while symptomatic. Why?

Because mania can gobble up your inhibitions, make you see the world through a paranoid lens, and sprout delusions of grandeur.

Kanye recently gave an interview to Forbes magazine during which he rambled for four hours, to this effect:

‘…They want to put chips inside of us, they want to do all kinds of things, to make it where we can’t cross the gates of heaven. I’m sorry when I say they, the humans that have the Devil inside them. And the sad thing is that, the saddest thing is that we all won’t make it to heaven, that there’ll be some of us that do not make it.”

“Clean up the chemicals. In our deodorant, in our toothpaste, there are chemicals that affect our ability to be of service to God.”

If Kanye were a homeless man on a street corner sharing these ideas with the world, the interviewer from Forbes magazine would probably have walked past quickly, maybe shuddering at such overt insanity.

Instead that interviewer sat and listened to him for four hours. Noted down delusional quote after quote and then published an article in which they even describe Kanye’s lack of awareness:

‘If it all sounds like a parody, or a particularly surreal episode of Keeping Up With The Kardashians, West doesn’t seem to be in on it.’

Of course West isn’t in on it! He is walled off from reality by illness.

Did that interviewer ever pause to consider why much of what Kanye was saying made no sense? I suspect (with disgust) that they were fully aware their high profile subject was mentally unwell, but chose to exploit him while he was most vulnerable.

I have written thousands of words I thought were brilliant, while in the grip of mania. But once my symptoms recede, I am relieved no one else has read these largely nonsensical word vomits. Because if they had, that would invalidate the quality of my writing when I am healthy.

But Kanye’s word vomits are out there for all the world to snidely pick at, to brand him a rambling idiot and someone to be sniggered at.

At the time of publishing this post, headlines announcing Kanye’s withdrawal from the presidential race are emerging.

I understand stress and sleep deprivation are a president’s companions for most of their time in office, that pushing through is a corner stone of juggling the demands of the job.

Stress and sleep deprivation are the perfect fertiliser for Bipolar episodes to flourish. Bipolar episodes, once active, can’t simply be pushed through. They have no respect for deadlines or work demands – let alone international or national emergencies.

Whether Kanye recognised the risks of pursuing the presidency himself or whether someone in his circle came forward to have the hard conversations and steered him gently away, I am relieved for him.

 

You may also be interested in:

Misunderstood Mania

Psychiatric Medication And Stigma

If I Were Kanye Westwritten two years ago with a different angle to this post

 

 

 

You Don’t Die Of ‘Mental Health’: Why Wording Matters

words have power foto
Spot the error in the lay out

(CW: This post mentions suicide)

I just read an article that described one of singer Guy Sebastian’s friends as having:

‘lost his life to his battle with mental health’

Tragic. Another young man has become a statistic that should be at least partially preventable. Sadly, we can’t bring him back.

But there is something we can do to inch our way towards better describing why this happens. We can use accurate language when we write and talk about these tragedies.  Language that doesn’t mislead. On the surface it may not look like there’s much wrong with the above quote.

So, why do I feel exasperated about it?

Continue reading “You Don’t Die Of ‘Mental Health’: Why Wording Matters”

Lies Of Omission: What You’re Never Told

Psycho Killer Shatters Young Family!’

Thoughts?

I had an interview with a PhD student from Melbourne Uni last week. It was for a study into what can be done to improve media reporting around severe mental illness (SMI) to reduce stigma. The media is largely responsible for the way people like me are perceived by the general public. So, I was delighted to contribute to this study.

Our trusted news sources are slickly practiced at generating gory headlines that draw eyeballs to them like magnets. If SMI is thought to contribute to a crime, it is either ignored or thrown into the story as a cold, hard after thought. Something that can’t be changed and is barely acknowledged as an illness.

The main characters in these horrific accounts may have an undiagnosed, poorly managed, or unmanaged SMI, but the journalist in the by-line doesn’t dig deep enough to expose the reasons for this:

Society does not care about or for us in the same way they do for others with serious, chronic, intermittent potentially fatal illnesses.

Continue reading “Lies Of Omission: What You’re Never Told”

Media-Made Monsters

SV400601
Day six

(Confronting Content Ahead)

I don’t dwell on what might have happened had I been sent home on day five after my daughter was born. But whenever the news throws up sensational stories reporting murder, infanticide, or suicide, and there is even a slim possibility the perpetrator might have been psychotic – then I think about it. Because that could have been me.

Continue reading “Media-Made Monsters”

The Chosen Ones

fire hot instagram burn

Are you aware something incredibly special happened last weekend? I wouldn’t have believed it if I hadn’t been a participant.

A group of magicians gathered in a non-descript conference room last Thursday evening, Friday, and Saturday. We had all been chosen to be part of this gathering. To begin with this meeting resembled thousands of others. Polite introductions, bottles of water, ring bound folders, pens, name tags, dishes of individually packaged mentos lollies on the table, a white board. The reason for meeting could have been anything.

Continue reading “The Chosen Ones”

Wedding Breakfast Spoiled

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I had plans for this post to be much softer than the last. No politics or indignation…

I started with excellent intentions. I slept in, made banana pancakes for breakfast, a big plunger of coffee, got the paper, and planned to read about the royal wedding preparations, the politics of which I am not particularly invested in.

So, I opened The Weekend Australian. I never got to the royal wedding preparations on page three.

On the front page the following words tore at my eyeballs:

‘Killer grandfather had acute depression’

Continue reading “Wedding Breakfast Spoiled”

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