Returning to work after postpartum psychosis

Puerperal psychosis is a little known mental illness which can affect women following childbirth. Dr Nicole Driscoll gives some advice for women who are affected, including tips on returning to work after the illness.

Returning to work after 12 months of maternity leave can be a jolt to the senses, to say the least. I spent part of my career in mental health, working exclusively with women, and found postpartum illnesses to be one of the most moving aspects of my job. Coming to terms with having a mental illness is an admirable challenge for anyone, and it doesn’t always come easily. But coming to terms with a mental illness that mysteriously appears after giving birth, amidst the excitement and sleep deprivation of caring for a new-born, can be utterly bewildering. What a time to get ill, even with a common cold!

Postnatal depression is one of the more commonly recognised mental illnesses following birth. Puerperal (postpartum) psychosis is less well known and can be a frightening ordeal for the new mum and her family. Symptoms can range from euphoria to deep depression, with audio and/or visual hallucinations, and delusional perceptions and beliefs about herself, her baby or someone close to her. Treatment nearly always requires hospitalisation in a Mother and Baby Unit to find the most effective medication regime (ideally that doesn’t affect breast-feeding), followed by long-term outpatient and community support.

There have been cases in the past where women who experienced puerperal psychosis tried to return to their job after their maternity leave ended, but were subjected to capability hearings and dismissed on the basis of their illness. Some have had to go through the ordeal of taking their employer through a gender discrimination tribunal, but how many new mothers, with a young baby at home, have the energy to take this route?

The science of hormones and brain chemistry is complex, and their relationship can become chaotic for a little while at the end of a pregnancy. If you have suffered from postpartum psychosis and are worried about returning to work, be assured that this illness is protected under the same anti-discrimination legislation that defends your right to work if you are well enough. If you run into difficulty with your employer after maternity leave, get a good, understanding union representative on your side, and legal representation if needs be. Returning to work on medication for postpartum psychosis is no different to returning to work on medication for a long-term mental illness. If the medication is working, you are not drowsy, and you are perfectly capable of doing your job, so your employer cannot discriminate against you.

Meanwhile, make the best use of your supports – community health nurse, GP, psychiatrist, family, friends and anyone else who has been involved with you since your illness developed. They will support you to get back to work and will keep in touch with you to make sure that everything goes fine once you do return. And remember, once you are back in the normal run of things and your symptoms are under control, you are not obliged to tell your employer about your illness.

Really, there’s no way to compare the severity of one mental illness over the other, but psychosis can be one of the most frightening because the thoughts and feelings it produces cause a very warped sense of reality. Give yourself some warrior points for getting through it, enjoy being a mum to your new baby and enjoy returning to your old ‘work self’!

Dr. Nicole O’Driscoll is a career coach and life coach with a special focus on women’s issues and mental illness, in everyday life and in employment. When she is not working she divides her time between writing, arts reviewing, and Ashtanga yoga. She does wonder at times if she’s a crazy cat lady but she gets her best ideas while talking to her three cats first thing in the morning. You can contact Nicole at her email address: [email protected] and read more of her blogs here.

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• Health Maternity & Parental Leave Pregnancy