Maternal darkness

Chloe Sanders thought her home was bugged. She imagined an eerie guardian angel standing on the roof of her house. She was convinced someone was trying to poison her. She believed many were conspiring against her in an evil network that included the government, terrorists and possibly even the Catholic Church.

Sanders (who asked The Forum to use her pen name to protect her family) was in the grips of a rare and severe condition known as postpartum psychosis.

Most people have heard of the mood shifts caused by postpartum depression or baby blues. But few are familiar with postpartum psychosis, a mood and thought disorder that affects just 0.01 to 0.02 percent of new moms, according to Dr. Cristina Seicarescu, a psychiatrist at Sanford Health. The condition triggers severe, potentially life-threatening symptoms such as hallucinations, delusions, confusion, mania, hyperactivity, severe insomnia and thoughts of harming oneself or others.

“You hear some people say it’s hell on Earth. It really was,” Sanders says. “It felt physically and mentally like I would die.”

Sanders shares her struggles with the disorder in a self-published book titled “A Season of Insanity: My Postpartum Journey,” which can be ordered through Barnes & Noble.

The Fargo social worker describes a nightmarish spring and summer in 2009 after the birth of her first child. In the months that followed, she bounced from euphoria to paranoia, believed she was secretly being filmed for a reality show, and was hospitalized twice.

When the psychosis finally lifted, Sanders could barely comprehend her post-pregnancy actions. It was as if someone else had taken over her body and brain.

“It sticks with you,” she says. “It’s something you have to reconcile and deal with, even though it wasn’t really me, but yet it’s part of my life experience.”

Erratic behavior grows

Prior to her son’s birth, Sanders, then 28, and her husband “Walter” were thrilled to be first-time parents.

She had been treated for depression and anxiety in the past but had gone off her antidepressants during the pregnancy to reduce potential risks to their child.

A social worker with an associate’s degree in mental health, Sanders says she was aware of the symptoms of mood disorders. “Studying it is one thing,” she says. “Experiencing it is a totally different thing.”

But Sanders’ delivery was a traumatic one. The baby got stuck in the birth canal, and suction was needed to assist in the delivery. The epidural hit her spine, causing a loss of a pint of spinal fluid. The baby had meconium (the baby’s stool) in his lungs and needed to be ventilated with a bag and mask after birth. He spent five days in the neonatal intensive care unit.

Immediately after the birth, Sanders shifted between the debilitating pain of spinal headaches caused by spinal-fluid loss and euphoria over her new son, “Alexander.” She also had trouble sleeping – an early indicator of the onset of perinatal psychosis.

Sanders’ behavior grew increasingly more bizarre after she left the hospital and returned home. She was convinced that her home was haunted or bugged. She sent disturbing, lewd text messages, in rapid-fire succession, to family members and friends. She grew paranoid, imagining someone had put poison in her tap water, food and even the house’s ventilation system.

This is typical for the PPP sufferer, who may experience a break from reality. In her psychotic state, her delusions and beliefs seem very meaningful and real, according to experts at www.postpartum.net.

To this day, Sanders says she’s grateful that her family stood beside her, even as her thoughts and actions grew more inconceivable. “There was a point when I thought my own brothers were out to get me,” she says. “I said and did things that were hurtful to my whole family.”

A slow journey back

Sanders also experienced panic attacks and flashbacks in which she envisioned her son dying. At the same time, she felt a certain separation from him.

“Oh, I loved our son,” she writes in her book, “but I had the detached feelings alongside the inexplicable unconditional love I felt.”

Sanders says she never wanted to harm her son, although some mothers with PPP do.

Seicarescu cites a study in which 53 percent of women with this type of psychosis had delusions about their baby. Those delusions ranged from believing someone was trying to steal or hurt their baby to believing the child is evil.

“Postpartum psychosis is usually a medical emergency,” Seicarescu says. “There’s a very high rate of infanticide or suicide.”

Over the next few months, Sanders was hospitalized twice for psychiatric care. Even so, she says her return to sanity was a slow one – made possible by medication, a good doctor, family support and her own strong religious beliefs.

As her mind healed, Sanders decided to write the book so she could help others. “I was inspired to write this memoir because I was amazed at what I went through, and I want to be a comfort to postpartum women who are suffering,” she says.

Walter supported her decision, telling her “through all our pains and trials, if it helps one person, it was worth it.”

Other women across the country have contacted her after reading the book, including a new mom who, in the throes of PPP, found herself naked along a Washington, D.C., freeway. Sanders immediately felt a connection with this stranger who knew what she had been through. “I want other people to not feel alone,” she says.

Today, Sanders appears cheerful and healthy as she shows off a photo of her 15-month-old son at a Fargo coffee shop. She remains on antidepressants and mood stabilizers. And although women with a history of postpartum depression are more vulnerable to PPP with subsequent pregnancies, Sanders hasn’t ruled out the thought of expanding her family.

She says, “If I ever want to have a child again, which is scary, I know I have to have a plan with my psychiatrist.”

For more information

“A Season of Insanity: My Postpartum Journey” by Chloe Sanders is available through www.bn.com and www.amazon.com. Barnes & Noble in Fargo will also order the book if it’s requested.

Facts on postpartum psychosis

Symptoms

• Mother feels removed from baby, other people and surroundings.
• Extreme confusion (not knowing where she is, what day it is), which comes and goes.
• Disorganized thinking and bizarre behavior.
• Rapid, extreme mood shifts.
• Extreme agitation or restlessness.
• Unusual hallucinations.
• Delusional thinking that feels very real and meaningful to the mother, even though there’s no basis in reality.
• Severe insomnia, even when the baby is sleeping. (Insomnia is typically one of the earliest symptoms and one of the most visible ways family members or medical providers can determine something is wrong.)

Risk factors

• A history of postpartum psychosis.
• A history of bipolar disorder.
• A family history of PPP.
• Recent discontinuation of mood stabilizers.

Two types

• One form develops within two weeks of delivery.
• A “late onset” type can develop up to six months after baby’s birth and is typically preceded by depression.

Cause

Has yet to be determined. One theory is that it may run in families. Another suggests that rapid hormonal changes after childbirth may play a part.

Treatment

PPP is serious and requires immediate medical treatment. The likelihood of suicide or infanticide is much higher in moms with PPP than it is in the general population.

It also can affect “bonding between the baby and the mother because she has this thought disorder or ends up in the hospital and is separated from the baby,” says Dr. Cristina Seicarescu, a Sanford psychiatrist. “Support is the most important thing, and another is addressing the issue so there’s a quick resolution.”

For more information on PPP or other postpartum disorders, go to www.postpartum.net.

Sources: Dr. Cristina Seicarescu of Sanford Health; WebMD

Readers can reach Forum reporter Tammy Swift at (701) 241-5525

Tags: postpartum psychosis, a season of insanity my postpartum journey, chloe sanders, life, moms, parenting, fargo, babies, pregnancy, health, books, ppp, authors