Saturday, 20 February 2016

My Baby, Psychosis and Me

Like many others involved in the campaign to raise awareness of, and improve services for, postpartum psychosis and other perinatal mental illnesses - I tuned in to BBC One's "My Baby, Psychosis and Me" earlier this week.  The documentary was aired as part of the BBC's #InTheMind season, and achieved both impressive viewing figures (for being on so late) and astonishing viewer reactions.  I gathered just a selection of the Twitter response to the programme in this Storify:
https://storify.com/katgrant30/my-baby-psychosis-and-me 



A few days later, I wish to record some of my own thoughts on it all.  Before I begin I declare the following interests (baggage?):
1) I am a huge fan of Dr Alain Gregoire (the consultant in charge of the Winchester MBU, where the documentary was filmed) and his whole team.
2) Like the two women featured, Hannah and Jenny, I survived PP through being hospitalised for a significant length of time and medicated using powerful antipsychotic drugs.  I am hugely grateful to Psychiatry and the allied professions.

Ok, with that out of the way, let's begin our analysis...

We are introduced to Hannah and Jenny with no pleasantries.  They are both acutely unwell and in desperate need of a Mother and Baby Unit bed.  There were rumblings from some quarters of the audience about not knowing enough of the women's backgrounds, their history, their psychology.  But I think the filmmaker's approach in this case was to mirror reality: in a psychiatric emergency there is no opportunity for lengthy introductions or even so much as a how-do-you-do.  I liked the way the women came into the film: at the start they were their illness.  The psychosis in each case had largely consumed them, and it was the job of Dr Gregoire to find them again.

At times the film was almost unbearably sad.  It was during those times I, personally, retreated to the relative safety of Twitter and took a "social media management" approach to viewing the show.  My husband (who was in London, while I was visiting my family in Scotland) texted me to say how he thought I was "more of a Hannah psychosis than a Jenny psychosis".  I think he may be right.  I found Jenny's illness fascinating (the links to her bipolar, the ebb and flow of her mania, her paranoia)... But it was in Hannah that I really recognised myself: the sheer desperation, the terror, the restlessness, the crippling anxiety and self-doubt.  Watching Hannah in this state made me want to reach into my television and hold her tight and whisper intently into her ear: you will be ok.  You will get out of here.  You are a brilliant mum.  Hold on.  Hold on.  Hold on.

One thing the cameras didn't quite manage to convey (and perhaps this was deliberate) were the actual hallucinations.  Seeing things that are not there, hearing voices, experiencing the world completely differently from those around you, that is the nub of psychosis and the truly petrifying element of the disease.  I can only imagine that in those moments the cameraman was perhaps shepherded away.   In my own case, when I was "floridly psychotic" (how I love that term!), the other patients and any visitors to the ward would be ushered away to the safety of the communal nursery where the heavy door would clunk shut and a member of staff be on guard until it was safe for them all to come back out.

The cameras didn't capture these moments, but I'm sure they were experienced by Jenny and Hannah nonetheless.  And allowing a film crew to capture even just the recovery from this absolute Hell is a testament to their strength and courage.  We viewers were privileged to see ward round discussions (an absolute insight to the staff's continual balancing act of risk and recovery), the side effects and treatment effects of various medications, and even Hannah's experience of Electro-Convulsive Therapy (ECT).

I had seen ECT before but only in movies (remember Requiem For A Dream?).  Seeing it performed on Hannah "in real life" was gut wrenching and shocking.  But it worked.  And I kept thinking only how brave and determined she was: willing to try anything in order to just get better and be there for her daughter.  She wanted to die so much - and yet she desperately wanted her daughter to grow up with a mummy.  It was true incredible to watch.  And it seemed to work!

There have been a few comments online about how medicalised the programme was, with its focus on medication and ECT.  Yes, there was a lot of psychiatry on show.  But, again, I think this is realistic: postpartum psychosis is a psychiatric emergency.  There is a huge amount for psychology and other types of complementing therapy to do - but only after the PP is under control.  I personally would have loved a second part of the documentary, which went on to show the role of clinical psychologists, psychotherapists, family therapists, peer supporters, art therapists, occupational therapists and so on. But there was only an hour and given this was a documentary about the experience of PP it seems right that the focus was on psychiatry.  And what a psychiatrist!  I think even the most skeptical anti-psychiatry voices were won over by Dr Gregoire.
He explains his considered thoughts on mental illness and the brain so eloquently.  If even just a tenth of Dr Gregoire's compassion and understanding could be captured and inserted into every single health care professional we would go a long way to treating mental illness properly.  To achieving that "parity of esteem" our current government loves to speak about.

And I wish everyone could listen to Jenny's husband Henry as he speaks of his wife - how funny, how kind, how caring she is.  All of which is at first hidden by her illness.  I think Dr Gregoire and his staff "get it".

I was lucky to have just spent a day at the Winchester MBU where I witnessed first-hand how therapeutic the whole environment is.  Without compromising safety (always a huge priority in any acute mental illness ward) the staff are all trained and guided to be therapeutic at all times.  Every interaction is an opportunity for them, from taking a patient for a walk to the shops to helping them with baby's sleep routine at night.  The patients are encouraged to cook meals together (with the help of their very popular young Occupational Therapist), to take part in gardening projects, to do lots of messy play and crafting activities (with and without the babies).  None of this was captured in the documentary - it wasn't the focus - but I do wish to reassure any viewers who might be left with the impression that all the patients were treated with were pharmaceuticals.

I will leave it at that.  I'm off to watch it again on iplayer (still available here: http://www.bbc.co.uk/iplayer/group/p03hybyj ).  I want to watch it alone, with my smartphone switched off, and just let it all sink in properly.  

4 comments:

  1. This is an excellent recap! I wasn't able to watch this program in the U.S. despite using Hola!, but hopefully it will get posted on YouTube along with "The Not So Secret Life of the Manic Depressive".

    A note about ECT. I had it done for postpartum bipolar and it saved my life. My treatments were actually relaxing and I looked forward to them! I didn't see what the doctors and nurses were doing, thank God, but I'd have it done again in a heartbeat if I needed it. My writing mentor had them done a few weeks ago (she suffers from bipolar one) and she said they were a miracle - I was so happy for her. Here's a post I wrote about it in case you know anyone considering it - the TED video by Dr. Sherman Nuland, who had ECT himself, in particular is very moving and apparently is one of the most popular TED talks ever done.

    https://proudlybipolar.wordpress.com/2015/10/21/how-shocking-that-i-got-shocked-the-amazing-dr-nuland/

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