Letter #1: My Arrival

This is the first of a series of letters recounting my experience with postpartum psychosis.

A woman with a stroller in the woods

Dear Rowena,

You first became aware of my existence when you were 18 years old. You suffered a psychotic break because you were so stressed during finals week and didn’t sleep. When the psychiatrist sat you down to talk about the road ahead post-hospitalization, she mentioned that there was a chance you would have postpartum depression. Since you always wanted to be a mother, you tucked that bit of knowledge in the back of your mind, ready to retrieve it when it was time to have a child.

Little did you know that 10+ years later you would find yourself going through IVF to have your first child. Kerrigan Leigh Winkler was born right at the start of the COVID-19 pandemic, which brought its own set of unique challenges. You and your husband Derek kept an eye out for PPD symptoms, but they never came.

Newborn baby girl.Kerrigan Leigh Winkler, 1 day old

Three years (and another fresh IVF cycle) later, you were pregnant with your second child. Roberto Francis Winkler didn’t arrive during a pandemic, but he did leave you feeling frustrated and uncomfortable as he was induced at exactly 40 weeks after lots of Braxton Hicks contractions and prodromal labor. You pushed him out in 4 minutes, and you celebrated the successful labor and delivery with bubble tea and sushi. You were tired but triumphant — ready to start the process of caring for a newborn all over again.

Derek, Rowena, Kerrigan, and Roberto Winkler at the hospital.Our family of four, now complete.

Only this time it was different. 

You soon realized that caring for a second child wouldn’t be as seamless as you had thought. First and foremost, you now had a toddler to care for (and entertain) in addition to a baby, so you were always exhausted. Your son had different preferences when it came to feedings, diaper changes, and clothing. He also had his own little quirks…like his noises.

4Handsome little man.

Robbie would make gaspy/coughy kinds of noises in the middle of the night when he was trying to go to sleep. They were totally normal and fine, but to you they sounded concerning. So one night, when this was happening more frequently than usual, you didn’t sleep. You put your pillow at the foot of the bed so you were closer to the bassinet and could hear him breathing. Your anxiety was getting worse and worse as you ruminated about the fact that your baby might choke and die in the middle of the night. 

How could you possibly sleep now? 

And this is the part of the story where I, your postpartum psychosis self, creeps in. The next day after you didn’t sleep I caused you to start acting differently. You started saying things that didn’t make sense, and your thoughts were constantly racing. You thought you had COVID at one point because your sense of smell was heightened and different. After Kerri returned from a playdate (an attempt to give you an opportunity to rest — unfortunately, it didn’t work), you thought your toddler was given a script and that you were part of a play.

When I, your psychosis side, came at such an alarming rate that your affect changed around caring for Robbie, your husband Derek called 911. Someone from crisis intervention services arrived at the house and I caused you to sing show tunes and cry about needing to pump while worrying about your kids being taken away from you. 

Your friend Stephanie drove you to the ER while Derek stayed with the kids, and when you got to the check-in desk even I couldn’t stop you from being your usual professional self, standing up straight and tall, clearing your throat, and saying, “Postpartum Psychosis, please!” as if you were ordering from a restaurant. 

Rowena demonstrating how she acting in her postpartum psychosis state at the ER.A gif reenactment. It's funny now but at the time it was kinda scary.  

Things got even stranger as you slipped further and further into psychosis. So much so that you barely remember what I caused you to do that entire night, only that you ended up being sent to the Behavioral Unit at Suburban Hospital the next day. 

I'll end with this — a journal entry four days later. My next letter will contain more of your journal entries, but I wanted to give you a sense of your mental state at the time:

I am very confused

I do not know what the eff is happening here

I am not sure what actual day it is

I am unclear about who is helpful and who isn't

The things everyone is saying is very confusing to me

And I am not sure who I can trust.


Until then,

Your Postpartum Psychosis 

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