Part of Channel 4’s ‘On the Edge’ drama anthology, Cradled is a powerful portrayal of postpartum psychosis.
The writer of Cradled, Nessah Muthy, is an established TV and theatre writer, working as part of the Coronation Street script team, as well as juggling multiple solo TV and short film projects. Nessah talked to us about why Cradled was such a personal journey.
Please note both the film and the interview contain references to suicide and intrusive thoughts about babies. Please take care when reading/viewing.
APP: Many in our network have praised Cradled for being such a moving and powerful portrayal of postpartum psychosis. How did it come about?
Nessah: It’s actually about 90% autobiographical. Although my experience was/is of Obsessive Compulsive Disorder (OCD) rather than postpartum psychosis (PP), many of the incidents leading to my crisis, and the outcomes from it, were similar. With OCD, the voices sometimes, to me, feel psychotic - but they’re not actually psychotic as they aren’t coming from an external place.
As I got more and more poorly with my second child however, it grew increasingly difficult to tell where exactly the thoughts were coming from and, truly scary to admit they might be manifesting inside my own brain.
With my first child, I had awful thoughts thinking I might hurt my baby. It became so bad that I couldn’t bathe her and I didn’t want to change her nappy. I was petrified of being alone with her so I was always taking her to the library, to playgroups, to parties, like Maia does in the film, just to be around other people. It was exhausting.
APP: In our network, many mothers had no prior experience of mental illness. However, we also know that past experiences of psychosis or being diagnosed with bipolar can also trigger PP. Had you experienced mental health problems prior to giving birth?
Nessah: Yes. My OCD was something I had lived with since I was a young kid. (Although I had no idea it was OCD or indeed what OCD even was.) Growing up in the 90s and early noughties, with no internet and not as many people talking about mental health, I basically thought I was some kind of monster. There’s a history of mental ill health in my family, but I had no idea that intrusive thoughts were a thing. So I remember being so ashamed and not being able to tell anybody the true extent of the thoughts I was experiencing. I may have tried once or twice but the look of horror on people’s faces made me feel unable to speak out about it.
I spent a lot of my childhood in church and looking back now, praying became one of my compulsions. I would pray for my family to stay safe and believed that if I didn’t do the prayers (and other things like getting to the lights before someone else) something really bad would happen.
As I got older, I became scared of having children because I thought I might hurt them. Of course, I felt there was no way I could tell my husband this, I was deeply ashamed and fearful of what he might think of me.
Overtime I ignored the thoughts as much as I possibly could and managed to bury my fears so deeply that I was able to have a baby. During this pregnancy however I experienced hyperemesis gravidarum - basically prolonged and severe nausea and ended up losing a stone in weight. Looking back, this probably contributed to my ultimate crisis and certainly increased my anxiety.
When we brought my first new born home I distinctly remember saying that she was too good for me. You love this precious thing to the ends of the earth but you’re also utterly terrified of them.
Following her birth, the thoughts weren’t as intense as I thought they might be, however, they were definitely there. I remember having moments when I was sliding down the door, as Maia does, feeling overwhelmed by it. There was never a major kind of crisis point, I just tried to push through and push through, but, amongst the joy, there was a lot of intense anxiety and worry. With my second child, however, the birth was very traumatic and that really triggered my OCD.
APP: Many women in our network experienced traumatic birth prior to the onset of PP as well. What was your experience?
It was the most horrific birth, I essentially had a very high 3rd degree tear and spent two hours in theatre almost immediately after delivery.
A few days later I was back home and trying to settle in with a major significant injury. Then, my baby projectile vomited blood all over the wall, it was like something from a horror movie. It turned out to be residue from the birth canal, but was one of the worst things I’ve ever witnessed.
As my family of three tried to adjust to becoming a family of four, life was tricky. Juggling a two year old, as well as a new born who would vomit her milk after every feed, (due to lactose intolerance) and, then, as she grew older bang her head repeatedly against her wooden cot, things started to reach breaking point. With sleep deprivation thrown into the mix, my world began to spin and the intrusive thoughts increased during these stressful times. I felt like a monster had grown inside my head, that the monster was me, the worst Mum in the world.
APP: How did intrusive thoughts affect you?
Nessah: As a writer I was weirdly writing/analysing my own narrative - and it wasn’t a good one! I was also starting to self-harm. I became very suicidal because I was so scared of hurting my kids that I just thought I’d be better off not being here.
My husband was scared of going to work but he had to go to work, because I was on mat leave and we needed to pay the bills.
This is what I tried to show in the film - the fear of being left alone but having no choice as a family to be by each other’s side round the clock.
I also wanted to show ‘the fear’ of becoming unwell and how, in some ways, knowing that you are getting sick is more petrifying than succumbing to the illness itself. When I did finally say, out loud: “I am unwell, I need help” there was actually a sense of relief and release…but then came the challenge of trying to convince my family that I was poorly… At times it felt like everybody wanted me to get better, but nobody wanted to accept that I was ill… I remember trying to explain that will alone, as in, willing me to get better won’t get me better, this is going to be a long journey and you (my family) need to accept this. This again was something I wanted to show in Cradled, often it is the people around the person who is unwell, trying to convince them that they need help, for me, it was the other way around.
One day the façade finally fell, it all got too much and at a health visitor appointment I fully broke down. The health visitor was supportive as was my GP, but in the end I said I just think I need to go to A&E. From here my local mental health crisis team took over, they came out every day, twice a day, and they were amazing. Knowing that someone else was coming was so reassuring. Family members and friends were also hugely supportive, they sat with me, effectively on suicide watch.
I was given citalopram (an antidepressant), which helped, but they took a while to kick in and I could literally feel my brain adjusting to the drug.
A few weeks later I started to have CBT - (which I’d had before) but I was more honest than ever about the content of my thoughts and it really was time to face the fear. I had to do immersive stuff on my own - like going in the bath with the children, or changing a certain number of nappies every day.
I still have intrusive thoughts but in a weird way, the crisis was also the best thing that ever happened to me, because now I don’t live consumed with the weight and monstrosity of those thoughts. I don’t feel as desperately lonely, as desperately fearful. I’ve been able to tell others and I’m also able to tell myself/recognise that’s an intrusive thought, it’s not who I am.
It probably won’t ever fully go away but, as my husband said, we used to live from one panic to another, but the therapy and the tablets just stabilise things and prevent me from reaching crisis point.
APP: What made you decide to focus on PP rather than OCD for Cradled?
Nessah: There are elements of my experience that were almost psychotic, like the mirror stuff that I showed Maia experiencing in the film. There were mini hallucinations that I started to develop, and it’s difficult to unravel whether they were indeed hallucinations or just really strong intrusive thoughts. As a child, I spent time around adults experiencing psychosis so I had personal experience of it to draw upon as well.
More technically, when you render, or portray, intrusive thoughts for dramatic purposes people will likely think that it is a form of psychosis. So it just made sense to me to portray PP and because my experiences were so close.
Other similarities between mine and Maia’s experiences include vividly imagining my babies drowned in the bath. With writing, you have to find the core image of that, the core emotional beat which is, I am responsible for my baby’s death. For me it’s the most powerful beat in the film, but it’s also the hardest moment to watch because I am right back there in the heart of my intrusive thoughts. I was so lucky to work with Chloe Wicks, the director, and the actor Ellora Torchia, who were/are both absolutely phenomenal, but of all the scenes that’s the most breath-taking and painful for me.
APP: It was so lovely seeing the ending where Maia and her partner, Lenny, were clearly in a supportive environment with their baby and a health professional, playing with toys. It reminded us of a Mother and Baby Unit. How did you come up with this ending?
Nessah: Maia and Lenny were indeed in an MBU at the end of the film. I didn’t personally go to an MBU, but I did a fair bit of research around MBUs. Watching Louis Theroux’s documentary, Mothers on the Edge, made me question that, if it wasn’t for MBU’s, and if I had been admitted to a unit, who would have looked after my children? How would my husband have coped? I really wanted to show the family together and I wanted that scene to be gentle and warm and, ultimately, for there to be hope.
APP: Finally, why was it so important for you to write Cradled?
Nessah: My personal story is ultimately a survival story and Cradled is too. I wanted to show that there is hope but also to create a strong and authentic portrayal of mental illness. Before I was diagnosed with OCD I didn’t know what it was and felt so ashamed, so raising awareness was so important to me. I remember going to mother and toddler groups and meeting other mums who were like: “oh, I take that drug too” or “I felt that too” just knowing you’re not alone in your experiences is so powerful. I hope Cradled will make people feel less alone and that even if you are experiencing what Maia is experiencing, you can get help, that you can get better.
You can find out more and watch Cradled here
If you have been affected by anything in this article or in the film, need any support, or want to meet others, visit our Peer Support page.