I remember walking south on the median strip which divides the Cobb County Parkway in the Atlanta suburb of Marietta, Georgia. I was wearing my brother’s size 12 tennis shoes and a nightgown, looking for a church where I might pray. I was totally oblivious to the dangerous traffic whizzing by. My trek was close to the Dobbins Air Force Base. Helicopters and bombers were flying overhead. I was sure I was in a combat zone.
Voices were screaming at me, “Martha, Martha.” My close friend Maggie and my husband, Blaise, somehow found me, some thirty five miles from the Lake Claire neighborhood where we lived. With Maggie’s persistent, gentle coaxing I hesitantly agreed to get in the car with them. They drove me to a psychiatric hospital that was close by. I remember being terrified and paranoid. Why was I being taken to this prison? Would I ever be released? Once in the facility’s assessment room I ate a piece of paper I found in my pant’s pocket. My certainty was that the paper implicated me in some wrongdoing and that was the reason for my imprisonment. I stayed there for the next thirty days mostly psychotic.
To make better sense of this, let me take you back in time. Several weeks prior to my “psychotic break.” I had given birth to my firstborn, a precious daughter, Megan. I was thirty five years old. The pregnancy had been uneventful; however, the delivery was anything but. It took Megan twenty four hours to be delivered and the umbilical cord was wrapped around her neck. Post-entanglement, she was perfect. Blaise and I were ecstatic, as were the eight close friends who had held vigil in the hospital waiting room anticipating Megan’s suspenseful entrance. Despite being exhausted, nothing mattered more to me than assuring her well-being. My maternal instincts went into overdrive and I became hyper vigilant. I felt a strong bond immediately.
We returned home from the hospital. Having left there uncertain about the techniques involved in breastfeeding as little time was spent on it, I experienced lots of difficulty. Frustrated and exhausted, I blamed myself. My mother came to visit and dismissed my desire to breastfeed. She had not breastfed any of her children and did not understand my strong wish to do so. We argued frequently. With great effort and assistance, I was able to find two lactation specialists who were able to get Megan to latch on correctly.
Many family members wanted to visit. Megan was the long awaited grandchild on my side of the family. Blaise’s relatives were equally excited and wanted to visit. Having people in and out of the house was extremely tiring. My sleeping patterns were growing more erratic. I felt like I was spinning out of control. My mood swings went from ecstasy to despondency. I started crying from all of the stress I felt. Blaise’ s mom and youngest sister came to help me. Although I had always had a warm relationship with each of them, my growing agitation resulted in my demanding that they leave the house immediately. Blaise became furious at me for my hostile dismissal. Out of growing frustration, Blaise asked some women friends to come and stay with me. No one was able to single out what was going on with me except to offer that lack of sleep was causing my erratic behavior. More rest was recommended by family and friends.
Blaise was beginning to feel quite overwhelmed and did not know what to do about an upcoming business trip to Las Vegas. I pulled it together enough to convince him that it was okay for him to go. I convinced myself that I could summon the necessary energy and wherewithal. He reluctantly agreed to go but only if I would stay with his sister in a quiet rural farming town in Georgia. I acquiesced thinking that sleep would be easier in a quiet place with company.
Despite all of my sister-in-law’s help and attention, I continued to feel drained. My sleep did not improve. Megan was crying more and more at night. I was a my wits end. I would have done anything to get her to sleep. One of those nights, I found a heating pad and turned it on high before putting her on top of it. I thought that heat would calm her and get her to sleep. Thankfully, nothing harmful happened to Megan. She eventually fell asleep and I remained unconcerned about the temperature. The fact that this posed a risk to my darling child never occurred to me. My judgment was growing more impaired.
My sister-in-law Terri and her mother-in-law had a small luncheon for me. During the meal, Megan began to cry. Terri offered to go and comfort her. One of the luncheon guests casually commented that Terri was such a good and caring mother. My interpretation was that I was a bad mother who did not know how to console her child. Humiliated and furious; I wanted to leave the luncheon immediately.
When I returned to Atlanta from my sister-in-law‘s, I became more delusional; the television was talking to me directly, as was the radio. Blaise decided to take a friend’s advice and call a psychiatrist. On the way to the initial appointment I was feeling very paranoid. I jumped out of the car at a major intersection. I was sure that Blaise and the psychiatrist were going to lock me up. Blaise somehow managed to get me back into the car and we made it to the doctor’s office. We talked for awhile. I was coherent enough to make the doctor believe that the problem was Blaise’s not mine. One question I remember him asking was whether there was the possibility that Blaise, a very gentle man, was being physically abusive to me. No questions were asked about our newborn or my adjustment to being a new mom. The doctor suggested that Blasie take me home for the weekend. He said he would be gone for the weekend and there would be no way that Blaise could get in touch with him. Blaise was furious. I became increasingly incoherent over the weekend. Blaise tried to reach the psychiatrist through his emergency service. After listening to many pleas for help, the doctor’s secretary agreed to call him. My absent psychiatrist suggested that Blaise take me to the Emory University Emergency Room. The staff person who saw me there immediately decided that I should be admitted to the psychiatric unit. Thirty minutes later I was taken to my room on a locked ward. Shortly thereafter, I attempted to break out through barred windows above my bed. We were subsequently informed that our health insurance would not be accepted at this facility. Once again, Blaise became panicked about what to do next. He took me home after all options seemed to have failed.
Later that night I ran out of the house with car keys in my hand. I did not know where I was going, but I knew I wanted to flee somewhere far away. I drove off into the night not knowing if there was any gas in the car. I headed out to Hartsfield International Airport. I circled the airport innumerable times thinking I would take a plane somewhere. I had no money and no identification. For some reason, I decided to return home. When I arrived home around ten, a good friend who was a pediatrician at The Centers For Disease Control was waiting for me. Blaise had called her desperate for help. As I refused to leave the vehicle, she got in my car and spent a long time talking to me. She was able to talk me into going in the house before leaving. I stayed for about thirty minutes. I then ran out of the house, shoeless in my pajamas to a neighbors house. The couple that lived there, who I did not know well, were startled at my incoherent talk and suggested that I call a relative. I called my brother who lived in Marietta and asked him to come pick me up. I told him I was afraid of Blaise. When he arrived, he was concerned about the situation and believed me when I told him that Blaise was being abusive. He did not stop at our house. He drove me to his apartment to spend the night. It was the next morning, after he left for work, that I found myself walking down the median strip in my pajamas and his shoes.
At the hospital treatment included group counseling, recreational therapy and potent antipsychotic medications. The staff never mentioned the diagnosis of postpartum psychosis to me or my family. I was offered little assurance. At one point, I was put in solitary confinement in a straight jacket for the night after going into a fetal position and crying uncontrollably in a hallway. Consoling me, in my opinion, might have been more helpful. Various sister-in-laws took care of Megan while I was hospitalized. One of them came and brought Megan. I held her, but felt afraid of her. I convinced myself that she had multiple birth defects and that I was responsible. The bonding that everyone had hoped for did not occur.
There was an occasion when I became very frightened and I barricaded the door to my room. In response, the door was taken down. I continued to have audio hallucinations. One time when we went outside in a fenced area I was certain that all of the patients were lining up to be shot.
When I was released from the hospital I was told not to return to work in the near future and to be compliant with all the prescribed medications. I went home with Blaise. He asked his sister Erika to come and live with us for six months and primarily assume responsibility for Megan. I was heavily drugged. Eventually, I returned to work and my regular routines. I saw a psychiatrist regularly and prescribed Prozac until the birth of my second child three and a half years later. With close monitoring, that birth went very well and there was not any postpartum difficulty. There is a ten to twenty percent chance that a woman could have a recurrence with another pregnancy.
Resources are available to women and their families. If a new mother is exhibiting the symptoms of postpartum psychosis the options for an intervention are: calling the local 911; phoning the National Suicide Prevention Hotline at 1-800-273-8255; or contacting the National Postpartum Hotline at 1-800-PPD-MOMS.
I remain grateful, despite all of the difficulty involved in getting a diagnosis, that there was a facility that could keep me safe for thirty days and provide me with medications that would resolve my psychosis. I never had any thoughts of hurting my child and I had strong family support. I have shared the experience with my daughter and she is aware that when/if she becomes pregnant that she needs to share with her obstetrician that her mother had postpartum psychosis. She has a greater chance of postpartum psychosis than does the general public. I still think of the experience at least once every day. Many people wrongly conclude that you are not able to remember events when you were psychotic. I remember everything. It is not something that new parents should ever have to go through. Having a baby should be a joyous occasion, not a time of great turmoil. Fortunately for Blaise and me we were able to have a second child without the occurrence of any postpartum issues.
Martha Dismer is a certified tobacco cessation instructor. She lives on Saint Simons Island, Georgia with her husband and dog Rudy. Megan is currently traveling in S.E Asia, following graduation from San Diego State University.