'˜I became psychotic after my son's birth'

Back in February 2009, just a few days after she had given birth to her son Joseph, Maria Derbyshire was at home in Belfast watching the television programme Casualty.

Her husband Phil had popped out to pick up a Chinese - it was just a typical, normal evening, but the cosy domestic scenario soon spiralled into the surreal.

During the short time her husband was gone, Maria became delusional. She started to hallucinate believing the actors in Casualty were in the living room with her and she was part of the show.

‘‘They were larger than life, everything was bigger and brighter,’’ she says recalling the disturbing incident.

Maria and her husband didn’t know it at the time, but this was the beginning of her descent into the terrifying world of postpartum psychosis - the most serious form of maternal depression, which affects around one in 500 new mothers. Although rare, the condition has been associated with suicide and infanticide.

It begins suddenly in the days following childbirth and causes the woman to have hallucinations and delusional thinking.

It’s unclear what causes postpartum psychosis. Fluctuations in hormones and sleep deprivation could play a role, and there does seem to be a genetic basis, as a woman is more likely to develop the illness if her close relative had it. There also seems to be link between postpartum psychosis and bipolar disorder.

Maria struggles to find a reason why she developed the condition as she had no history of depression, but believes it could have been down to exhaustion.

‘‘My pregnancy was a dream, I didn’t even have morning sickness, I sailed through it. But I had a long labour, lasting two days.

‘‘By the time Joseph was born, I was exhausted and then with everything that happened afterwards I don’t remember him being born - even now I don’t remember.’’

Maria, 42, has invited me to her home to talk bravely and with touching candour about an unspeakably upsetting time in her life.

‘‘When I was psychotic I had all these images in my head - I know things weren’t true, but I’ve seen these images and they are all muddled up with the truth,’’ she says.

Maria has no recollection of holding her baby son after he was born and a few days after she got out of hospital says she ‘‘started acting a bit strange.’’

‘‘I was talking an awful lot. Talking to Phil, going over stuff that happened in the past. But I thought this was because I was a new mother and I had all this insight into life and I knew everything. Life was going to be perfect and I was going to solve everyone’s problems.’’

Worried and confused about his wife’s erratic behaviour, which was compounded by her sleep deprivation, her husband took Maria back to her parents’ home in Co Tyrone.

Over the next 24 hours she became acutely ill.

‘‘I sat down to tell my two sisters about my labour and then I lost it completely.’’

She adds: ‘‘I was screaming and shouting like a banshee. I wasn’t even fit to stand up, I was so out of it.’’

She recounts how the hallucinations intensified to an unfathomable level.

‘‘My sister’s fiance had been killed in an accident, but I could see him alive, he was in the house. I was roaring and shouting. I was so high, I was so elated that he was there and then I remember being really angry saying ‘where have you been’ - and he said he had been in Australia.’’

She adds: ‘‘I remember everybody from my work came marching into my house. I sat in the living room and I saw them all sitting there. It was so far removed from the truth, but at that time, that was the reality and I was part of it, then I would flip back out (of psychosis) and wonder, what just happened.’’

She remembers doctors and medical personnel coming to visit her, but says: ‘‘I thought they were my family dressed up in fancy dress.’’

‘‘Another image I had was that I thought I had died in childbirth. I thought that Phil had left me at home for too long and that I had to go in an ambulance to have the baby and I thought I’d died in the back of the ambulance. I could see myself lying in a big pool of blood.

‘‘I then thought that I was in heaven, and I could see what was going to happen next on earth, and I had the power to change what was going to happen.’’

Maria says she couldn’t control what she said, she would curse, which was totally out of character for her, and make inappropriate comments - including to a doctor. ‘‘I remember being very attracted to him and telling him this, every time he came into the room I would say ‘you’re sexy’.’’

‘‘Most of the hallucinations were very scary and graphic, but some of them were very funny - I can remember making my sister sing ‘I can see clearly now’ over and over again.’’

Maria was sectioned under the Mental Health (Northern Ireland) Order 1986 and taken by ambulance to St Luke’s Hospital in Armagh.

Becoming emotional, she recalls the harrowing details of her admission.

‘‘Apparently I was screaming my head off. I can remember being held down, and I don’t know if this is true or not because nobody was with me at this stage, by a big man with tattoos on his arms. There was a whole load of them round me and then they injected me and got me sedated. It probably wasn’t true - I was probably held down and injected, but I don’t know about the big man with the tattoos.’’

She adds: ‘Phil said him and Nuala (her sister) stood outside the door and I screamed my head off for hours. They’ll never forget that.’’

Maria was sedated and given anti-psychotic medication, she doesn’t remember anything of the next 10 days.

She spent three weeks in St Luke’s separated from her son.

After her discharge, she was still incredibly unwell so she stayed with her parents for about four weeks as she had no support in Belfast.

‘‘I was still very ill, physically ill, I remember going to the shower and Phil having to blow dry my hair because I didn’t have the energy to lift my arms.’’

She describes her husband as a ‘‘walking saint’’ for the unflinching support he provided.

‘‘It was so hard on Phil. He became the mum, the dad, the cook, the cleaner, everything in the house. I do not know how he got through it.’’

Eventually Maria was transferred to the Belfast Trust. She was placed under the care of the only perinatal psychiatrist in Northern Ireland and her team and began her long journey to recovery.

Thankfully, despite the fifty per cent chance of her becoming ill again, Maria remained well during her second pregnancy; her beautiful daughter Lily is now a two-year-old.

And today Maria is content and well.

She works as a travel agent and, like a lot women, is trying to get fit and shift a few pounds for the summer.

‘My story has a happy ending it could very easily have had a tragic ending. Only people were around watching me when I was really ill I could have done something stupid to me or my baby.’’

Maria backs campgaign for mother and baby unit

There is currently no specialist mother and baby unit in Northern Ireland, or indeed Ireland, for those with a mental health need during or after pregnancy.

This means that if a woman needs psychiatric health treatment postnatally she will be placed on a general psychiatric ward; her baby will not be allowed to stay in hospital with her.

Alternatively,the woman and baby will be sent for treatment at a specialist facility in England or Scotland.

Maria is backing the Everyone’s Business campaign by the Maternal Mental Health Alliance charity for the establishment of a mother and baby unit in Northern Ireland, describing the current services as ‘‘just adequate.’’

‘‘I just got through it by taking one day at a time. Now I’m recovered I am a stronger person.’’

‘‘It took me well over a year to bond with Joseph, whereas if you are in a mother and baby unit there will be specialists helping you with that.

‘‘You leave a general psychiatric hospital and walk into your home and there’s a five-week-old baby sitting there - it’s scary.’’

Maria firmly believes her recovery time could have been dramatically reduced if she had been treated in a specialist unit.

‘‘I was under psychiatry for four years after Joseph was born, that time could have been cut in half if I had spent time in a mother and baby unit and got the specialist help that I needed.

‘‘Why should women and their families in Northern Ireland be denied this service when it’s available in other parts of the UK?’’

Maria has backed the campaign at Stormont and spoken publicly about her devastating experience in the hope it will help others.

‘’I can’t change what happened to me, but I am backing the campaign in the hope it could stop another mother having to go through what I did. ‘’

lFor more information on the Everyone’s Business campaign visit: everyonesbusiness.org.uk and on Twitter: @MMHAlliance using the #everyonesbusiness.

If you would like to get in touch about your own experience contact [email protected] or tel: 02890897720.