Teresa Twomey: Understanding Postpartum Psychosis

Teresa Twomey opens up and shares her experience with postpartum psychosis and talks about her book: Understanding Postpartum Psychosis. 

Seventeen years ago I had postpartum psychosis (PPP) after the birth of my first child.  It was the worst experience of my life.  (And to put that in perspective, I was raped when I was in my mid-teens and I've been through breast cancer.)  The only information I could find was either insufficient ("It is rare and a medical emergency") or focused on infanticide or suicide.  I did not know if there was ANYONE out there like me -- a normal, bright, successful person (I had my own law practice) -- who had this illness.  (Nor did I realize that many of those women who do commit or attempt infanticide or suicide are “normal, bright, successful” women just like me!)

When the Andrea Yates tragedy occurred, I knew I had to act.   I began working on a book, became a Postpartum Support International Coordinator in Virginia and began giving talks about postpartum or perinatal mood disorders and my own experience.  I gathered the stories of other women who’d had psychosis.   Every single story made me cry – even though almost none ended in “tragedy.”  The horrors, stress, pain and sorrow these women suffered from this illness often made my own experience pale by comparison.  

My intentions for the book included: 

1.  To educate the general public and prevent tragedies from happening.   This illness comes on so fast and often to women and families who have no idea what is happening.  The more knowledge the woman and her family have, the better chance they have to avoid tragedy.   The family really is the “first line of defense” against the risks that accompany this illness.
2.  To educate people in the media.  The way the media depicts this illness can serve to reinforce faulty assumptions and stigma or it can serve to educate and therefore help to prevent future tragedies. Even well-meaning reporters and writers have badly misrepresented the realities of this illness.
3. To educate people in the legal and political fields.  Society and our legal system often embrace the convenient “blame the woman” view.  Although many likely do this because they find the horrors that can occur as a result of this illness so incredibly repugnant, this treatment serves to continue the stigma which can lessen reporting by women and families and therefore, ironically, increase the likelihood that we will continue to have these tragedies. Prevention of the tragedies requires diligent professionals, educated communities and families, a sense of safety in seeking help, so these women can receive prompt and effective treatment.  A system that treats mental illness in a callous manner is fundamentally at odds with prevention.  
4. To help women and families heal.  Just as I felt the stories had helped me, I knew others could benefit from seeing they were not alone in their experience.    

I did not realize at the time that writing my book would serve another purpose – my own emotional healing.  In my book I mentioned the struggle women who’ve had this illness tend to have with what I call the “post-recovery recovery.”  That is, after the symptoms of the illness subside, the emotional recovery from having had such a soul-wrenching experience begins. 
Or so I thought.

After my book was published I became curious about what had helped other women in their “post-recovery recovery.”  So I did some informal research, sending a short survey with a list of items that might help with this healing, such as: medication, talk therapy; meeting another survivor – and so forth.  When I received the responses I was shocked and dismayed by the single most common answer.  Shocked, because it had not even been on the list – it was a write-in response.   Dismayed because the essence of these write-ins was, “I’m not recovered emotionally – not even close.”  Some of these women had given birth only two or three years before, so that might have been a foreseeable response for them. But some of these women had experienced psychosis more than thirty or forty years before.  

Looking back I feel I should have anticipated I would have gotten that answer.  After all, I’ve talked to many women who have kept their illness a secret from all but their closest families.  Some have held onto their pain for decades.  I’ve met women in their seventies and eighties who still, as one said to me, “feel the pain just as if it were yesterday.”   These were women who had not suffered a tragedy due to their illness. Nobody was harmed. Well, nobody but the woman who’d been afflicted with this illness.  It is a terrible thing to go through something so horrific and then feel you cannot speak of it.  
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But I do understand. It wasn’t easy for me to come forward.  As I’ve said to my husband, “I never wanted to become a ‘poster-child’ for anything – let alone something as misunderstood and stigmatized as this!”  It still isn’t easy, even after all this time.  But sharing my story and helping other women has made me realize I really am not alone and has helped exorcise the demons of “Why me?” that haunted the first few years of my recovery.    Although I still cannot talk about the worst part of my experience without crying (I hallucinated that I’d killed my daughter), in my day-to-day life I’m blessedly free of the shadows of shame, grief, fear, sadness and self-doubt that plague so many.   
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I don’t know the best route to healing any more than I did before I sent out that survey.  But I do know that keeping the experience and the feeling that follow it locked up inside isn’t it.   It seems that perhaps this is one of those burdens that will only lessen by sharing it with someone else.   
Now, whenever I see another woman sharing her story – on a blog, a video, a TEDx talk, a television program, a magazine or a book – I cannot help but smile to myself.  For I know that although I know there is risk in doing so, I also know there is healing. 


​Teresa M. Twomey, is the author of “Understanding Postpartum Psychosis: A Temporary Madness” (Praeger, 2009); creator of the Postpartum Psychosis Forum Facebook page; and former State Coordinator and Legal Resources Coordinator for Postpartum Support International. 

She is one of the leading advocates for raising awareness about postpartum psychosis and has shared her knowledge through interviews and talks throughout the U.S.  
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You can see her TEDx talk here.

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