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Buy a virtual gift and help support APP

gold and navy blue wrapped presentStruggling to find a present for the person who already has everything this Christmas?

We may have the answer -  a virtual gift that helps APP to support mums and families affected by postpartum psychosis.

Not only is this a quick and easy way to tick someone off your Christmas shopping list, you'll also be raising awareness of postpartum psychosis,  helping us support even more families next year, and giving the recipient that warm and fuzzy feeling of knowing they're making a difference.

Click here to donate, then simply email fundraising@app-network.org and we'll reply with your downloadable APP gift card, ready to email direct to the recipient, or to print, wrap and pop under the tree. You can do this right up til 5pm on Christmas eve!

Your gift will make a difference. Thank you

 

Did you know you can also support APP by buying your festive greetings cards via www.bit.ly/APPcards ?

 

Ruth’s story: We had to travel from Spain to Scotland during lockdown to access an MBU

We’d been living in Spain for over ten years when I fell pregnant. My husband, Jamie, worked away a lot on an oil rig but we had a good network, had planned for Jamie to be home for a couple of months around the birth and the pregnancy was really straightforward. I felt lucky.

Our son was born in the September, and, when Jamie returned to work in the December, I made a return trip home to Ireland to visit family with our new baby.

Ruth with her toddler and her husband, Jamie, on a boat

While I was in Belfast I started struggling with bad joint pain. I’d had arthritis as a young child but hadn’t had any problems for years so it was a bit of a shock. I ended up in A&E and it made breastfeeding and holding my son really uncomfortable too. I was in so much agony.

When I got back home I got some treatment for the arthritis and everything seemed to settle back down. My baby was sleeping well, Jamie was working in Norway, everything felt like it was going to be fine.

Then, by the middle of February, I suddenly stopped sleeping and began panicking about everything going wrong – thinking that Jamie, might lose his job, worrying that there was something wrong with our son. I made the rash decision to move our son into his own room, and I would spend whole nights just staring at the baby monitor and listening to the buzz of it.

My mum came to stay and she remembers that I was just pacing the flat saying things like our lives are falling apart; there’s something wrong with the baby; he’s not well; he’ll be taken off us and I’ll be put in jail.

I went to the health centre and got an emergency appt with the nurse who prescribed diazepam to calm me down. It was around the time of lockdown so when I needed to go back it was a different nurse that I saw. The second time I was prescribed antidepressants, too.

Jamie was away at the time and I was continually phoning my best friend and cousin because I needed someone to listen. I was convinced there was something wrong with the baby, and I began struggling with breastfeeding and then bottle feeding – getting myself into this vicious cycle of feeling like I couldn’t feed my baby at all.

My friend was concerned and she made an appointment with a psychologist at the nearby clinic. I remember taking my notebook with me because I was writing down pages and pages of numbers and dates relating to my baby and his feeding patterns and routines.

Back at home, I would just lay down on the floor and cry and I was having regular panic attacks. But outside of the home, I was doing all of the right things – trying to feed him, dressing him. It probably all seemed fairly normal on the outside but in the background I was panicking, not sleeping, not eating and obsessing over my baby.

The next thing I remember is waking up in hospital…

Apparently, one morning, around 4 or 5am, I’d left the flat, left the door open, with my baby asleep and my mum sleeping on the sofa. I had no shoes on and I got into my car. I drove along the motorway and parked my car on the hard shoulder and got out. What happened after that was devastating. The only thing I can remember is someone saying quick get her a blanket. Then I remember waking up in a hospital.

I’d walked out in front of a lorry. Luckily, I survived. I had some very deep cuts, some bad injuries and I needed stitches in my head. I had some deep wounds on my foot and scars all over my back.

It does cross my mind from time to time about how the driver is today. It must have been such a huge trauma for him and I truly hope he has he recovered from it.

Left to right is Ruth’s husband Jamie, Ruth and their toddler out on a walk in the countryside I was quickly transferred to the psych ward where I was sat outside in a wheel chair, covered in blood. We were waiting hours and hours for the psych team to assess me. They eventually decided to admit me and I was taken into a shared room where my family had to leave me due to lockdown rules.

My family were looking after my son and Jamie, who was working in Mexico at the time, flew back home. Meanwhile I was in the psych ward, unable to shower properly because I couldn’t get my injuries wet, feeling as though I was in a prison, with no furnishings or comfortable surroundings and unbelievably tall walls with barbed wire so nobody could escape.

I don’t feel I received particularly good treatment while I was there. And I remember another girl who was in there suggesting I start to write things down to keep track of the doctors I was speaking to and the meds I was put on. When my sister and Jamie came in to see me I saw a psychiatrist who granted me permission to go home under my husband’s care.

We then went into full lockdown and my husband had to try to look after both me and our son at the same time. I think he has so much strength to have been able to put up with what I now know was absolutely shocking and both terrifying behaviour.

The team of psychiatrists would come to our house twice a week and I had some zoom calls with my psychologist during lockdown. They were trying to find the right combination of meds for me but apparently they weren’t working and they suggested I go back to the psych ward without my baby – and of course no visitors were allowed because of lockdown, so I really didn’t want to go back there.

One of my friends in the UK who worked in health contacted Jamie because she had found my messages really concerning. She had heard about Mother and Baby Units in the UK and Jamie, who’s Scottish, got in touch with APP to find out more and then made contact with an MBU in Glasgow. They said I could be admitted.

Jamie had to drive us all from Spain to Calais and then to a friend’s in Cumbria before reaching Stirling, where he immediately got me an emergency doctor’s appointment. By that point my paranoia and symptoms were so bad the doctor called an ambulance and I was immediately admitted to the MBU with my baby.

Ruth, her baby and her husband Jamie smiling at the camera

Because I’d come from Spain I had to have ten days in isolation, so Jamie went back to work to bring in some money because nobody was allowed to visit me anyway.

I ended up spending five months in the MBU. I was admitted in the May, and discharged in the October.

I remember in the MBU there were quite big rooms and we had our own bathrooms, a nice play area and garden with picnic benches and windmills. They organised things like crafts, cookery and pram walks which I enjoyed, and I remember me and one of the other girls used to make apple crumbles.

Unfortunately, because I still didn’t seem to be improving, I had to have ECT. I was so nervous and I appealed it but Jamie gave permission because he thought it was my only chance of getting better.

The doctor I saw before each ECT session was so lovely, I remember he always reassured me. I never got to know his name and I’ve always wanted to thank him for his kindness. I had 18 ECT treatments in total. The only thing I complained about was having a sore head, but apparently that’s quite common.

When my son was due to turn one, however, the MBU had to plan my discharge, because they were only funded to look after mums with babies less than a year old. I started going to my in-laws’ house on weekends and eventually was recovered enough to have a full discharge. However, I caught Covid, so we had to isolate in an Air BnB for a while which was really tough. Eventually, we made it back to Spain in a far better position than we had been when we left.

I’m still on medication today, but just a low dose of antidepressants. I’ve stopped the antipsychotics and things are slowly getting back to some kind of normality.

My son started going to nursery and he’s picking up both Spanish and English, which makes me so proud. And I went back to work in the September of 2021, so I had time to get back into normal life, start exercising again and focusing on me.

Looking back, it was a very scary and intense period, especially with it all happening during lockdown. But now Jamie and I are out the other side, we are both really keen to raise awareness, because nobody in my family had even heard of PP before I was diagnosed.

I’ve trained to be a peer supporter with APP, so I can share my experience and hope with other families who are going through what we did. I know that when Jamie first spoke with APP’s peer support lead, Ellie, when I was really ill, it made such a difference so I hope that we can now pass on that support. Just knowing that someone else has been where you are and come out the other side makes all the difference.

 

Gina’s story - My paranoia got worse on the psych ward – I only started to recover when I was reunited with my baby

I was taken by ambulance to an acute psychiatric mixed ward without my baby. I’d been having delusions since a couple of days after giving birth and at home things had got much worse. It was only when I was taken to Bethlem MBU and reunited with my baby that I finally started to trust people and get on the road to recovery.

My pregnancy was straightforward, a very lovely pregnancy. But I was overdue so things didn’t exactly go as planned and I ended up having an emergency c section. Unfortunately, both my baby and I had an infection so we ended up being on the postnatal ward for a week rather than the couple of days I was expecting. I had severe insomnia and I was taking strong pain medication and I think this might have all played a part in me getting unwell.

So I was in pain, medicated, emotional and exhausted. But I think the turning point was when I received a message from a friend with some bad news about another close friend of ours, which triggered some strange thoughts and symptoms in me and some extreme paranoia.

For example, I noticed that when someone sent me a message, my response wanted to say happy new year or happy Christmas and I couldn’t understand why I wanted to write it. I also believed that I was being tested as to whether or not I was a good enough mum. And every time there was a bleeping sound on the ward I thought it was because I had done something wrong.

I filled in a form to say that I wasn’t feeling great mentally, but as my paranoia got worse, I retracted the letter. I asked for it back and ripped it up. And then, even though I wasn’t well, at times I appeared, on the outside, to be fine. So it was decided that I was going home with my baby.

When I finally got home, all the paranoia ramped up and I never slept. I was stuck in the house and there were people coming and going – midwives, health visitors, family members.

It got to a point where I was really confused. I couldn’t give the midwife the correct information, and when my family visited from America I was confused about who was who and started imagining that my niece was my long lost daughter. Then I started going through phases believing that my son had died – so much so that when I went to register the birth I was convinced they were going to hand me a death certificate.

I just questioned everyone and everything felt really trippy, and I became obsessed with things like clocks, so my mum removed all the clocks from the house.

My family, realising there was something very wrong, tried to work together to get me some help. Eventually I was visited by paramedics and then a doctor who I think prescribed me an antipsychotic – they were trying to treat me at home at that point.

Meanwhile, my mum was doing her own research and found out about postpartum psychosis – so, in a way, it was my mum who diagnosed me! But I became quite aggressive and frightened, so they had to call the police and the paramedics, and I even had to be handcuffed in order to be taken to hospital.

They took me by ambulance to an acute psychiatric mixed ward without my baby.

The ambulance ride was frightening because I was convinced I was in grave danger and I thought all the medical professionals were fake – I thought they were really all terrorists.

So when I finally got into hospital I refused to eat or sleep or take medication. I was paranoid about everyone and everything.

Nothing was working and I was in full-blown psychosis, at the peak of my illness, and without my baby. Everything seemed crazy to me - but I was the one being crazy. I started doing morse code on the window, and became paranoid about different colours – anyone who had a pen or who was wearing anything in the colour blue I simply couldn’t trust.

As I wasn’t getting any better, they decided to take me by private ambulance to Bethlem Royal to the MBU there.

Thankfully, not long after getting to the MBU, things started to change.

I don’t know if I felt more comfortable because there were more women there, and because my son was able to come and stay with me, but I started trusting the staff and taking my medication.

I think it was also because there was more of a normal kind of atmosphere in the MBU and there was a really good programme with specialists who knew all about mums and babies. I had lots of help learning how to make a bottle up and how to change my baby’s nappy – something that was invaluable because, with PP, everything seems ten times harder. Plus, knowing my son was safe and close by meant I was able to start sleeping. I started getting a good eight hours sleep!

I stayed in the MBU for nine weeks.

I 100% believe that if I had gone in the MBU straight away I would have started my recovery straight away.

I think my parents and my husband were given the option of an MBU at the start, but they didn’t really understand what it all meant so I really wish there was more awareness about specialist services and why they’re so important.

Now I feel I’ve fully recovered. Since my son turned seven months I’ve been so active with him, visiting friends, going to baby groups. I love being a mum and I feel like I’ve been making up for lost time – doing all the normal things new mums do.

I’ve also gone back to work and I now work with a charity that helps people with learning disabilities and mental health problems. And I’ve started a mother and baby group to help provide peer support and a place for mums to be able to talk freely with other mums.

While the whole experience of having postpartum psychosis – and the anxiety and postnatal depression that followed - was frightening, in some ways I’m glad I experienced it. It’s helped me to relate to people, and to provide support to others because of my lived experience which is really valuable in my job, too.

I feel that its so important for me to be able to share that there is light at the end of the tunnel, there is hope - even when you’re seriously unwell like I was.

 

 

Jade’s story - Awareness is so important

I finished work for my maternity leave in February 2020, just before the lockdown. My pregnancy had been smooth but the last few weeks were awful. He was ten days late and I was just so ready for him to come out. I wasn’t sleeping, I had a 72 hour labour, and I had to switch from having a water birth to going into a labour unit because I got to around 4 or 5cm and nothing was happening. Eventually, I went into hospital and had an epidural and forceps delivery.

When my baby was born he was immediately taken away. During the delivery his heart rate had dropped so he had to be put on an incubator in the neonatal unit two floors up.

During this time I started to feel like there was something wrong with me. I wasn’t sleeping well and something just didn’t feel right so I told the nurses. They reassured me that it was probably all normal, I’d been through a traumatic birth, etc. But the sleep wouldn’t come, and I started thinking strange things and not wanting to be around my family (other than my husband) which wasn’t like me at all. I was just pacing around the hospital day and night feeling anxious.

I became really distressed and starting thinking that if I fell asleep I would die. That’s when things really hit me.

I began seeing and hearing things, with imagery of heaven and hell and other religious visions playing a big part in it. I also thought that my own body was trying to kill itself which was terrifying. Plus, I kept thinking that I could hear my baby crying which was really upsetting. But I couldn’t have heard him because he was so far away.

My husband was really worried about me and kept speaking to the nurses and doctors, but the problem was that I sometimes appeared well and lucid when they checked on me. I finally agreed for my mum to come in and see me and that’s when I told her about my fear of dying if I fell asleep.

The hospital then moved me into my own private room because I was in so much distress, which I think they thought might help the other mums around me as well. They allowed my mum to stay over night with me too and, meanwhile, my husband was still urging them to get me some more help, because he knew there was something seriously wrong.

The hospital, however, suggested that I had the baby blues and at one point even suggested I was ready to go home! So my husband did his own research and found out about postpartum psychosis. He recognised the symptoms in me straight away.

He’d read about Mother and Baby Units (MBUs) and reached out to the one in Chorley not too far away. I was so lucky that they sent somebody to see me because, just prior to this, the hospital were considering sending me to a general psychiatric ward, which would have meant being separated from my baby.

I was transferred to Chorley MBU eight days after giving birth and I am so grateful that I got a bed there.

In those first few days I was really anxious. I didn’t know what was happening to me and I’d been googling things like schizophrenia, personality disorders and bipolar. I also remember googling ‘will I die if I have a mental breakdown.’ It wasn’t until I was settled in the MBU that I first read about postpartum psychosis in one of the leaflets they gave me, which also talked about how treatable it was. It was such a relief to know what it was that was happening to me, and to know that I could recover from it. Plus, I knew at that point that I was absolutely in the best place.

I was given anti-psychotic medication and the hallucinations stopped and I started sleeping again. But, after a while, I started to feel really unhappy and detached from my baby. I felt kind of dissociated from him and from being a mother. I wasn’t actively suicidal, but I felt like I didn’t want to live. That’s when the psychiatrist started discussing postnatal depression with me, and I was prescribed with additional medication.

Prior to this I hadn’t experienced any mental health problems at all. In fact, neither had my husband, so we were both really unprepared for it.

I kept telling the MBU nurses that I might be the only one who doesn’t recover from it all, because I really couldn’t see a light at the end of the tunnel, but they kept reassuring me. They told me to distract myself, to focus on my baby, and told me that it does take time to heal.

I also met Jocelyn, APP’s peer support worker, on the ward, as well as other mums who had experienced PP and recovered and that really helped me. To know that there are other mums out there who have gone through these same experiences really makes a difference.

Finally, by the back end of April, I started showing signs of getting better and they started talking to me about going home - just for a couple of hours at first. By this point I was very detached from the outside world so it was really daunting but I did go home for a little bit which felt strange.

I was finally discharged fully on the 21st May 2020. I wasn’t fully recovered, but I’d say there was around an 80% improvement by that point. I was still on meds, still getting support visits to the house however, even though the country was in lockdown at the time, I tried to get back to some sort of normality.

It took a while to get back to feeling like me again and it really affected my marriage. My husband had struggled with the trauma of it all as well. However, eventually, by November 2021 I came off all the medication and started to feel like myself again, which strengthened our bond as a family.

Looking back, I think for us, not having any idea what was happening was the most frightening thing. We didn’t know about PP, mental health was barely covered in the antenatal classes, other than a brief mention of depression, and the midwives didn’t seem to know too much about what was happening to me either. It wasn’t until I got to the MBU and met with specialist workers and peer supporters that things started to look up. I feel so grateful to have got a place at Chorley – I know not everyone is so lucky.

It’s now 2022 and I’m in a really good place. I’ve developed such a great bond with my boy, and he’s such a happy little boy too. So I get that excitement, that joy, that feeling of love now, as a mother, which is so incredible. I’m also back at work, taking care of myself, going to the gym and, importantly, my marriage is stronger than ever.

Now I can reflect on my experience I really want to help others by sharing my story. Awareness is so important, I think it would have helped us enormously if we had been armed with more knowledge from the start. Just being able to spot the signs, to know what help is out there and to know that you can recover would have relieved so much of the distress that I felt.

APP’s Danielle Thomas shares her story with Stacey Dooley

Danielle Thomas, APP’s Wales Assistant Co-ordinator, shared her PP story with BBC investigative journalist Stacey Dooley for her latest book, Are You Really OK? published by BBC Books.

Published in February 2022, the book is an exploration of the mental health crisis in Britain and its particular impact on young people. Danielle, who is also a midwife, shared her experiences of postpartum psychosis with Stacey over a zoom call, talking about her traumatic birth and the PP symptoms she experienced after returning home with her baby.

Danielle’s story forms part of a wider collection of first person stories about mental health, as well as comments from medical experts, counsellors, campaigners and health practitioners who give detailed insights into the conditions and environmental factors that play a part in affecting mental health - including poverty, addiction, identity, pressures of social media and the impact of Covid- 19.

Are You Really OK? also includes positive stories of recovery that can inspire and offer hope to those going through mental health problems and those around them. Recovery is possible is a very strong message; just hearing it may give that bit of hope needed to keep going through the tough times. It doesn’t immediately free someone from the illness, of course, but it might help them see that with the right help they can get through a crisis, manage their mental health and carry on living as normally as possible. This book is about opening up the conversation around mental health, sharing experiences and offering hope and proof that it is possible for things to get better.

Stacey Dooley is one of the UK's most loved documentary presenters. Across her 15 year career, Stacey’s series include Stacey Dooley Investigates, Women in Dangerous Places and Stacey Dooley Sleeps over, to name a few. She has examined a variety of topics from sex trafficking and under-age sex slavery, to domestic violence. In 2018, Stacey was awarded an MBE for her outstanding contribution to broadcasting. Her debut book, On The Frontline With The Women Who Fight Back was a double Sunday Times Bestseller in both hardback and paperback.

To order a copy of the book, click here.

Peer support service launches in Morpeth for mothers experiencing postpartum psychosis

A partnership between Cumbria Northumberland Tyne and Wear NHS Foundation Trust (CNTW) and national charity Action on Postpartum Psychosis (APP) is creating an invaluable peer support service for women experiencing severe mental illness following the birth of their child.

The Beadnell Mother and Baby Unit in Morpeth, which is run by CNTW, has contracted APP to deliver this much-needed support. APP is currently recruiting for someone who has experienced postpartum psychosis to join the team as a part time Peer Support Worker.

The Mother and Baby Unit exists to support women experiencing severe mental illness in pregnancy and following birth, with specialist support available to treat conditions such as severe postnatal depression and postpartum psychosis. The Unit also provides specialist mother and baby classes, activities such as parent and child swimming and baby massage classes, and overnight facilities for partners – with the core aim of keeping families together to support a faster recovery and better quality of life.

Postpartum psychosis is a debilitating postnatal mental illness that can occur out of the blue. New mums with postpartum psychosis may develop high or low mood, or fluctuate between them, alongside delusions, hallucinations or severe confusion. Many of these mothers have had no previous mental health diagnosis prior to onset – although women with bipolar disorder are at higher risk. It affects around 1400 women and their families every year in the UK and is always a medical emergency. However, it is eminently treatable and most women go on to make a full recovery with the right support.

Allison Spiers, Ward Manager at the Beadnell Mother and Baby Unit, said: “We work very closely with APP to support mothers who are experiencing postpartum psychosis, and we are really pleased to be growing that relationship by welcoming a new Peer Supporter employed by APP into our team.  Not only will they offer vital one-on-one support to new mothers at a very distressing time in their lives, this Peer Supporter will also support group work with the women on our unit, and provide training to ensure our whole team continue to develop an in-depth understanding of postpartum psychosis. At CNTW we believe that service users and carers with lived experience of mental ill-health should be at the heart of everything we do, and employing Peer Support staff is an integral part of this.”

Dr Jess Heron, CEO, Action on Postpartum Psychosis, said: “We know that CNTW are already big believers in the value of peer support and lived experience engagement. The service that they provide to new mothers and families at the Mother and Baby Unit is outstanding, and, by combining this with the new peer support role women will receive a truly holistic and specialist treatment. Being able to support women and families at this critical stage, as they go through this frightening experience and begin to recover, is key to reducing the trauma, giving hope, and helping women and families feel less alone as they navigate the recovery process.

“This vital service will benefit women affected by postpartum psychosis and their families across the wider North East region. As a national charity we are campaigning to see more Mother and Baby Units like this one open up around the UK, to help save lives, promote recovery and to keep families together.”

Hannah Bissett, National Co-ordinator (NHS Contracts & Regional Projects), Action on Postpartum Psychosis, said: “As a woman who has personally experienced postpartum psychosis I know how isolating and afraid it can make you feel. Peer support is a vital piece of the recovery jigsaw and we now have over 2,800 lived experience users sharing their stories and receiving support from trained volunteers as part of our national peer support forum.

“Having somebody there for you who knows exactly what you’re going through and who can inspire hope will undoubtedly bring a sense of relief and reassurance to women in the region who may find themselves experiencing postpartum psychosis. We’re delighted to be partnering with CNTW on this project and I’m looking forward to starting to build our volunteer team and hearing from applicants with lived experience interested in the peer support role.”

APP already delivers successful and award-winning peer support services working in partnership with NHS Trusts around the UK, as well as managing a thriving online national peer support forum. The charity also provides peer support for partners of women who are experiencing or have experienced postpartum psychosis.

To find out more about the Peer Supporter role, click here

 

Links and More Information

For a list of England’s community teams go to: https://nhswebbeds.co.uk/community-team/list

For a list of Mother & Baby Units go to: https://nhswebbeds.co.uk

APP offer support for those affected by postpartum psychosis (personally, or at risk of PP, due to bipolar disorder. For telephone, email or Facebook support for postnatal depression and anxiety, see: https://www.pandasfoundation.org.uk/

For general advice about managing mental health, isolation and anxiety visit:

For advice specific to perinatal mental health during Coronavirus visit:

For more advice about Coronavirus:

 

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During Recovery from PP

You can find APP’s resources on recovery here.

1. How will I get medication? How will I be monitored and supported during recovery?

Urgent home visits will continue. Some routine appointments will happen via video call.

2. How can I manage my anxiety, depression, isolation during recovery while we are socially distancing?

UK wide, online resources and peer support will be incredibly important for recovering women. There is already a wide range of online resources and more are being produced each day. The links below contains further resources, recommended reading, recovery modules, and support.

APP provide support, information and a lived experience community for women & families recovering from PP. You can talk to others on our forum or get in touch to talk to a trained peer supporter via text or email. We have a variety of Facebook groups you can join and zoom activities you can get involved in.

NHS mental health services are open & here for you during this time. Contact them if you need extra help.

3. Social distancing and isolation mean my usual family support, and especially grandparents, are not available. Where can we find help?

NHS services will continue to provide outreach support during recovery via telephone, video and face to face as needed. Do ask for support if you need it.

The support that friends and family are able to provide will depend on your own situation and theirs. As someone recovering from a severe mental illness, a ‘carer’ in a non-vulnerable group can visit to provide support. Please check up-to-date guidelines here.

APP will continue our national peer support services throughout the outbreak. Our Forum is available for you to talk to other women and partners: www.app-network.org/peer-support/

We offer one to one peer support for anyone in the UK, where you are paired with an APP coordinator with lived experience, or a volunteer peer supporter. We can give this one to one peer support via messaging, email, or video call. APP also have trained partner and grandparent peer supporters. If you would like to access this support or join our lived experience community, email us here. We have a variety of Facebook groups and social media activities you can get involved in.

Resources for partners are available here, and you can join our partner’s Facebook page for more information, signposting and support.

 

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In Crisis or Developing Symptoms of PP

You can find APP’s general resources about symptoms of postpartum psychosis here and getting help here. You can find more information on common early symptoms here. You can find APP information guides about PP for women and partners here. If you are a partner, you can also join our Partner’s Facebook group for information, signposting and support from other partners who have ‘been there’.

1. If I develop symptoms of PP, how will assessment happen?

  • If you believe you are developing symptoms of postpartum psychosis (or your partner, family members is) you need to act urgently via the normal routes: telephone your GP, maternity services, or 111. If you believe you or someone in your household is in imminent danger, call 999. Services are still here for you. Urgent home visits are still being completed, but may also include phone & video call contact.
  • Every acute mental health trust in England has a 24/7 crisis line number who can direct you to appropriate services. You can find your local one here – input your postcode in the helplines section.
  • In Scotland, A&E mental health presentations are being diverted directly to mental health sites. Crisis/Out of Hours staff will work in assessment centres with extra resources, seeing people from A&E and other urgent referrals.

2. Are Mother & Baby Units staying open?

  • In England and Scotland MBUs will remain open and are doing an enormous amount of work to minimise any risk of infection on inpatient units. There are no units in Wales; women requiring MBU admission will be offered the opportunity of a bed in England. In Northern Ireland, postnatal women with PP are admitted to General Adult Psychiatric Units for care.

3. How are MBU’s managing coronavirus?

  • MBUs are following general NHS inpatient guidance on barrier nursing and staff will be using personal protection equipment (PPE) for patients with coronavirus symptoms. MBUs have set up isolation areas to care for women separately. To date there have been very few cases of coronavirus in MBUs.
  • Visitor advice varies between units. Some units have restricted visits to one named family member per patient, with specific time slots. Please contact the MBU for more specific advice. For a full list of MBUs in England click here  or here for all UK units.
  • NHS England guidance on visiting during the coronavirus crisis can be found here, and, for Scotland, here.
  • Patients will be supported to use FaceTime and telephone video calling more. Peer Support, including that delivered by APP, will be available via video call, and in some areas, peer supporters are still visiting the unit.

 

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Pregnant Women Concerned about PP

(i.e. those who have had a previous PP or who have a bipolar diagnosis):

You can find APP’s insider guide: ‘Planning pregnancy: a guide for women at high risk of Postpartum Psychosis’ here & APP’s resources on bipolar disorder and pregnancy here. You can take part in a trial of a new interactive workbook to support women through pregnancy by emailing us here.

1. What will happen to my antenatal psychiatric appointments or preconception advice appointments?

  • In England, Scotland & Wales, there are plans in place for routine home visits and out-patient appointments to continue, but some appointments will be done by telephone or video call. We will add information from Northern Ireland when we have it.
  • Perinatal Psychiatrists say that birth planning for women at high risk of PP will in some cases be offered remotely but will still be thorough and comprehensive.

2. How do I get medication during this crisis?

  • In England, Scotland and Wales, medication plans for pregnancy and the postnatal period should be made with perinatal psychiatrists in advance to ensure there is plenty of time to get prescriptions filled. Talk to your GP, Specialist Perinatal Mental Health Team, or Perinatal Psychiatrist, to ensure plans are in place.
  • Women who are remaining on Lithium throughout pregnancy will continue to need the same degree of medical vigilance. Antenatal care is still “open for business” and obstetrics/ maternity and perinatal mental health will work collaboratively to ensure the safest possible antenatal care remains uninterrupted.
  • In Scotland, medication prescribing remains with GPs on recommendation of mental health services. We will add information from Northern Ireland when we have it.
  • You can phone your GP prescriptions line / psychiatric services and they can send prescriptions directly to your local pharmacy for collection. Some pharmacies are operating a delivery service for those who are shielding or self isolating.

3. What impact does Covid-19 have on pregnancy, foetal development or risk of postnatal illness?

  • Our best knowledge to date is that Covid-19 doesn’t seem to cause problems with pregnancy, and it is believed that having CV-19 is unlikely to impact on your baby’s development. Most pregnant women who develop the illness will experience mild or moderate cold or flu-like symptoms. Pregnant women with other health conditions (e.g heart disease, or if you usually are advised to have a flu jab) should be extra cautious as they may be more unwell than other women. It may be possible for you to pass coronavirus to your baby before they are born. But when this has happened, the babies have got better. There’s no evidence coronavirus causes miscarriage or affects how your baby develops in pregnancy.
  • Pregnant women have been placed in the ‘moderate risk group’ as a precautionary measure as not enough is yet known about the virus. This means you should follow guidance on hand-washing and social distancing. You can access up to date government guidance here.
  • You should still attend appointments and scans, unless advised not to.
  • You should still seek help if you are worried about your physical or mental health.
  • Maintaining contact with friends and family, and being active, can be very important to maintaining good mental health during pregnancy, so consider how to stay connected, and what you can do, within government guidelines.
  • The Royal College of Midwives and The Royal College of Obstetricians and Gynaecologists have produced some excellent guidance for health professionals and women, which is being regularly updated here and here. You can access the Royal College of Psychiatrists advice here.
  • We do not yet know whether stresses related to the crisis will impact on women’s chance of developing maternal mental illness. We know that managing anxiety and stress in pregnancy and the postnatal period is important. You can find excellent advice from Mind about managing anxiety and isolation here and from the Mental Health Foundation here.

APP are here for you. If you are a pregnant women with previous experience of PP or bipolar, you can talk to an APP peer supporter by visiting our forum or registering for email or video support here. APP also has a number of Facebook groups (e.g. a book club, an activities & wellbeing group, various volunteer groups) you can join.

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