Worried about friend with Puerperal psychosis

[howmuchyousay]

I have a friend who had puerperal psychosis after her first baby. She never fully recovered. She has recently had another baby.

I saw her recently and I don't think things are right and I was concerned (rather than alarmed) about her behaviour.

My real concern is that her family have always tended to brush her illness under the carpet. It is never discussed. I've asked her husband and parents and they both say she is fine. But I don't think she is.

What can I do? I think she has a visit from the hospital at some point in the next few weeks, to see how she is doing but I'm worried that her family will say she is fine.

What am I supposed to do? Can I rely on the hospital being able to pick up symptoms?

[madmouse]

Do you know or can you find out who her HV is? HV should listen to your concern and pay a casual visit (they can do so without discussing her with you)

[LadyBlaBlah]

I don't know, but my friend had this, and then with her second, she was being monitored quite heavily. Unfortunately it came back and she ended up being sectioned, but she was monitored.

I am not sure the treatment is entirely effective but that is another debate ( one flew over the cuckoo's nest and all that)

I hope your friend is ok.

[notnowbernard]

what wasn't "right"?

[LadyBlaBlah]

Might I say, that my friend has never been the same either

[howmuchyousay]

I know one of the health visitors in our area but I'm not sure that she is hers.

She was very strange and detached when I saw her last week. There were a few people there but she didn't once look at or hold the baby the whole time I was there. She went out to get a bit of shopping at one point (only gone 15 mins). I said that I would go for her but she said no, would I look after the baby. That in itself would be OK but when she got back the baby was crying and she didn't even come into the room to see if she was OK, just went in and put the shopping away, started on dinner.

She talked about needing a new car, new furniture, talked about the visitors and presents she had had, but nothing about the baby.

I don't know whether I'm looking for problems which might not be (I didn't put my baby down for 4 months!) but it seemed very strange.

[onepieceoflollipop]

Unfortunately there is a high chance of this condition recurring with each baby.

It is a very distressing illness for the woman and friends/family.

I work in mental health and have only seen a handful of cases.

One would hope that her GP/HV/Psychiatrist will be monitoring her fairly closely certainly during the early weeks.

It's tricky because if she is experiencing a full blown psychosis then it will be almost impossible for her and family to "hide"

However it sounds as if you are more worried about early warning signs of relapse at this stage? How close are you to her and her dh? Could you ask more about the forthcoming appointment and/or enquire if she has any other support in place?

[onepieceoflollipop]

even if the hv you know isn't hers, the hv could probably advise you further. :)

[notnowbernard]

How old is the baby?

I think (not 100% certain though) that with peurperal psychosis the symptoms will develop pretty soon after birth, and will be concerning to all. If she's had it before I would hope the MH team would be monitoring closely?

[pippibluestocking]

If you know who her GP or mental health team is, I would contact them to relay your concerns. They can then arrange contact, although they will ask her family for feedback, they will also make their own assessment of her mental state and how she relates to the baby.

[LadyBlaBlah]

I think it is quite difficult to hide for long. My friend's behaviour was very very textbook and as lollipop says, your friend's behaviour sounds like early warning than full blown psychosis at the moment. And if that hits, then I am not sure it is possible to hide it for very long.

It is such a horrific thing. My friend was in hospital for 3 months after her second baby.

[onepieceoflollipop]

As pippi said you could relay your concerns to GP/mental health team. Also you could tell them that you are concerned that her family/dh are putting a brave face on things and may not give the full picture. That makes them aware to really try and assess your friend directly.

[notnowbernard]

Peurperal psychosis would be impossible to hide

She is high-risk for PND too

[howmuchyousay]

Yes, I will call round again and ask more about the appointment. She seems to have arranged a permanent queue of visitors over the past few weeks though so it's difficult to actually speak to her!

My concern really is that her husband often has to travel with his work and has always been adamant that she is fine. I worry about her and the children when he is away.

[ElaineHanzak]

You are a very good friend and right to be concerned. I suffered from PP and got worse and worse because I too told people I was 'fine'. One poorly Mum told me that stands for 'I'm f**d up, insecure, neurotic and emotional'!
Perhaps that could be a question you push a little further. Sometimes a touch on the arm, eye contact and a gentle push of 'Is she/are you REALLY?' might be all it takes for the wall to come down.
People are often ashamed and guilty about PND in any form. I thought I wasn't the type (teacher, nice home, supportive husband and family, wanted my baby) but life feel apart. All the visitors are a pain too. Why not suggest she puts a little sign on the door and message on the phone that 'thank you for your interest in the new baby but Mum is resting now'. Sometimes arranging loads of visitors can mask a feeling of isolation/scared to be alone.
She should have a team around her from last time. As a concerned friend I would contact the local HV/GP team.
Full blown PP cannot be hidden but ultimately she could 'crack' - I did when my son was 7 months old, after having told people I was 'fine'.
have a look at my website if it helps www.hanzak.com