Overcoming Postpartum Psychosis

Giving birth is a major emotional, physical, and social stressor in a woman’s life. Postpartum psychosis is a rare mental health emergency that occurs in some women after childbirth. Symptoms, including hallucinations, delusions, paranoia, rapid changes in mood, confusion, and behavior changes, usually appear between two and six weeks after giving birth. It affects only 1 or 2 per 1,000 women and requires immediate hospitalization and treatment (Cleveland Clinic, 2022).

A lack of awareness about postpartum psychosis, combined with stigma about perinatal psychiatric disorders and the lack of appropriate treatment options, means that postpartum psychosis is often missed by obstetricians and psychiatrists alike, sometimes with tragic consequences.

Postpartum psychosis isn’t new—Hippocrates described the first case known in medical literature back in 400 B.C., a mother who experienced delusions, confusion, and insomnia within six days of a twin birth (Osborne LM., 2018). Postpartum psychosis can become dangerous and is certainly overwhelming; however, most women respond well to treatment and demonstrate fast recovery and remission (Raza SK, Raza S., 2023).

For Laura Dockrill, a respected English author and performance poet, overcoming postpartum psychosis offered valuable insight into the importance of accepting all emotions without judgment and being prepared for life’s “gray” days.

'GRAY' by Laura Dockrill

Source: Laura Dockrill/Candlewick Press

Can you share briefly about your background and what inspired you to write a children’s book about emotions?

In 2018, after the traumatic birth of my son, Jet, I was hit, out of the blue, with a debilitating mental illness called postpartum psychosis (PP). I had never experienced mental illness before, and my family and I were completely thrown upside-down by it.

I spent two weeks in a psychiatric hospital, separated from my son, who was just three weeks old. Of all the horrendous symptoms of PP, one of the hardest to confront was shame. During my recovery, I couldn’t believe that nobody told me it was possible to get so unwell from something as everyday and universal as childbirth but also that it was possible to get better! How do we not talk about this to young people? But we are taught algebra?! It would have made my experience a lot less scary.

I recovered using stories of lived experiences from others, any stories of people overcoming hardship. I taught myself CBT and wrote a lot: I honestly believe that writing my memoir, What Have I Done? saved my life. But I still wanted to have an open conversation with my son about mental illness to remove silence and shame. Gray is not a scary book but a comforting one, a tool to open dialogue before bed—whatever “gray” means to us. And, of course, it’s a story of unconditional love.

In your book, the child explores feeling gray. What feelings does this color capture?

The colors were something I wanted to tackle as I have written for young people for much of my career, and when we think of children’s books, we often think of bright colors. I always dress brightly and enjoy clashing colors, so it was a strange time sitting in this colorless time where the brightness of the world was turned down, and everything felt washed out and muddled. I knew the colors of my life were there, but I couldn’t access them.

Recovery came when I accepted the illness and where I was at that point in my life; then, I began to see gray as a nuanced and sophisticated color, a color that was soft and gentle—protective, even. It is a color I once called boring, but it is anything but.

It teaches flexibility; it allows movement like clay. It is a quiet and wise color. Lauren Child has done such an incredible job of celebrating that color and the characters in the book; I have adored working with her on this special book.

The adult voice in the story validates that “It’s OK to feel gray. You don’t have to be bright every day.” This is such a valuable statement for young readers. What might it be like if we all (grown-ups included) embraced all of our feelings, including the “negative” ones, rather than suppressing them?

Thank you, that’s so lovely to hear. Before becoming unwell, I might have been guilty of advocating “positive thinking”—i.e., looking on the bright side. In fact, I think I became so unwell because I masked the illness and pretended I was OK when I wasn’t because I wanted to look “strong” and “capable”—I didn’t want people to think I was weak or a failure, or put people out, or be a burden.

Now, I wouldn’t think twice about asking for help; it’s the bravest thing a person can do. Since the illness, my view has completely shifted. I am a different person—in a good way—because of the illness. I am grateful. I am more empathetic and kinder to myself and others.

Self-compassion was a huge part of my recovery, practicing speaking to myself how I would to my little boy. I would never want him to blame himself for becoming sick or to suffer in silence and shame.

How do you cope with gray days, personally?

For me, it’s all about slowing down. I feel “gray” when I take on too much, move too fast, or when my social batteries are running low. It’s when I put too much pressure on myself. Feeling gray is often invisible, so we have to listen closely and speak up.

When I feel gray, the first thing I do is tell my family how I’m feeling. I’m very lucky to have a close support network, so I will let my partner and sister know that I don’t feel myself, and then I’ll slow down as much as I can. I see it like a sick day: be in my PJs and watch TV, eat well, etc., rather than powering through.

I treat a gray day like a day of food poisoning or a cold. I don’t pretend I’m OK. This usually does the trick! I don’t hide that from my son because I want to normalize this for him: It’s a good thing to take care of ourselves.

The adult in the story emphasizes that all feelings are OK, saying, “I love you however you are feeling... and my love won’t change, even when you are gray.” Who has loved you through your darkest moments, and what impact did that have on your life?

What a lovely question. My sister is my rock. We are three years apart, and we talk about everything. We are very similar, so it’s very easy to speak to her in short-hand without judgment; she completely gets everything, and I can be open and myself with her.

The irony is, the more myself I’m able to be, the quicker I feel more myself again—which goes to show that pretending to be OK is a big part of the problem. That’s why I want to continue to smash the stigma surrounding mental health and illness. Especially for young people, before the shame comes in!