The Slip: Patricia's Battle with Postpartum Psychosis (Part 1)

Patricia Tomasi's voice resonates with a vulnerability that could only come from someone who has stared down the darkest corridors of postpartum mental health.

Her harrowing encounter with postpartum psychosis isn't just a personal battle—it's become a call for change in the way we support new mothers living with mental health. The April 2024 edition of @torontolife magazine features her personal story & how Flora’s Walk is uniting advocates across Canada, raising much needed awareness for perinatal mental health.

As she shares her story, from misdiagnosed perinatal mental health to the power of advocacy, it's a continuous fight to fill the critical gaps in the Canadian healthcare system, particularly when it comes to perinatal mental health.

Through the gripping narratives and heartfelt conversations in our episode, we underscore the urgency of recognizing and acting on the warning signs and the importance of prevention for expecting and new mothers.

"Symptoms of postpartum psychosis can include disorganized thinking, confusion, paranoia, delusions and hallucinations. While there’s still no clear idea of what causes it, researchers have found a link between the change in hormones during pregnancy and childbirth to be a factor, as well as weaning from breastfeeding and the resumption of monthly periods. Women with birth trauma and a history of mental illness (especially bipolar disorder) are also at a higher risk. Although rare at a rate of 1 to 2 people in 1,000, postpartum psychosis is considered a medical emergency that requires immediate treatment." - maternal_mental_health_matters

By sharing these stories, we hope to foster a deeper understanding of the complexities surrounding perinatal mental health and offer solidarity and hope to those who may be navigating these turbulent waters themselves.

Chapters

• 0:00 Perinatal Mental Health Advocacy Journey
• 14:01 Overcoming Psychosis and Finding Courage
• 18:23 Understanding Postpartum Psychosis and Mental Health

Transcript

Kayla Huszar: 0:00

Hi Patricia, hi, how are you today? I'm good. I'm thrilled to be here and to talk about Perinatal Mental Health with you.

Patricia Tomasi: 0:11

I'm so glad you're here. It's been a while since we since we talked. I think probably the last time we had a real in-depth conversation was when you guys procured this art to be on the front of your book.

Kayla Huszar: 0:26

Yes, and when you say this art, I know the listeners can't see it, but we can right now because we can see each other. Yes, your beautiful, beautiful piece of art that is the cover of our anthology. You Are Not Alone. I see it every day and I love it and I just think it's so representative and it's just so beautiful and just a source of inspiration to be the cover. So thank you once again.

Patricia Tomasi: 0:57

Oh, thank you so much for asking me. It was such a privilege and an honor to be on the front cover of a book that represents women and all of their different stories and the ways that motherhood and mental health have kind of collided for them, and pleasure to have been a small part of that very large project that you and the Canadian Peering Needle Mental Health Collaborative put together for everyone but for mothers. I know that it's referenced a lot. A few of my clients have referenced that they've read it and that they get inspiration and they also get perspective and context and all kinds of things for their own mothering experience.

Kayla Huszar: 1:48

And then it ended up in the hands of the Prime Minister. How was that? When you saw that?

Patricia Tomasi: 1:53

picture. Oh my gosh. My heart was like oh my gosh, that is a copy of my art on a book. It is about Peering Needle Mental Health, which I experienced and survived, and now seeing it in that way was yeah, it was a little bit. The words aren't even coming to me right now. It was like I had to do a double take right, because it's not. It just popped up in my feed you know the algorithm and it was like oh my god, that's like, that's my art on the book that Patricia and all of these wonderful women contributed to.

Kayla Huszar: 2:31

Yeah, it was fun. It was really great to be able to present him with that book and have a sit-down and chat about Peering Needle Mental Health.

Patricia Tomasi: 2:40

What ignited this passion for you? If you don't mind me asking, you know, a potentially really personal question.

Kayla Huszar: 2:47

Oh god, no, I'm totally okay with sharing my story.

Kayla Huszar: 2:51

That's the reason why I got into this work. I went through postpartum psychosis twice and didn't receive, didn't know that it was postpartum psychosis until I got in to see a reproductive psychiatrist at Women's College Hospital eight years after I first experienced postpartum psychosis. And how I got in there was because I was experiencing some a new wave of anxiety and a panic attack that I thought hmm, I'm getting to that age of the next big reproductive stage in my life perimenopause, so I need to get on that. So I was able to get in to see the reproductive psychiatrist. We talked about my whole life history of mental health and within an hour she said well, you're more than likely experienced postpartum bipolar disorder with psychotic onset that you know.

Kayla Huszar: 3:56

That kind of opened my eyes to. You know what I had experienced. I knew it was definitely postpartum anxiety and definitely something strange happened. But it all made sense. And so then I started writing about my experience for HuffPost Canada, and because I have a journalism background, I quickly moved from my own story to other people's stories and interviewing experts across Canada and realizing that our system in Canada is so far behind other countries.

Patricia Tomasi: 4:35

When you're collecting other people's stories and writing your own and coming to that realization eight years later. That must have been like a profound impact on how you looked back on that time, how you were processing the now and the then and being launched into this work is. It's a lot to take on, even though it maybe felt natural. It's a lot to start an organization like yours, to be advocating for mental health and then moving from Huffpost Canada to publishing a book and and moving forward in your advocacy efforts.

Kayla Huszar: 5:23

Yes, I just I love doing this work right now and it's I never imagined that I was going to be an advocate of anything. But when I went through postpartum psychosis and before what I call the slip, because once I slipped into postpartum psychosis the awareness was gone and for me the psychosis was like a religious delusion where I thought I was on a special mission from God to heal myself through spirituality. And then I like I felt like I had tapped into a magical world of spirit guides and angels. And I know that stuff exists, I know there's a new age movement, but I was when you say psychosis there's no gray area Like I fully believed it, like there was, it was happening. I was communicating with these magical beings like I. You know I never want to put anybody who believes in spirituality in a, in a group. That means they're psychotic. That's not what I'm saying at all.

Patricia Tomasi: 6:40

How did you, how did you come out of it? I guess is maybe how, how did you slip? You know, we slipped into it. How did you, you know, how did you slip out of it? So the way.

Kayla Huszar: 6:51

It's different for everybody and for me, you know, in the diagnostic and statistical manual, the DSM, the mental health Bible that healthcare professionals use or don't use to describe different mental health ailments, they don't talk, they don't say postpartum psychosis, but they say like a psychotic onset is possible and it's usually in the first four weeks. But that's not always the case and there are more studies coming out saying that psychosis and postpartum depression, postpartum anxiety, can happen well beyond those first four weeks and it can also be a result of different things as your body is beginning to, you know, go through the motions of having a baby, postpartum. They say that it takes about two years for your body to get back to quote unquote normal and part of that is if your breastfeeding weaning can have different psychological effects. So I went through a stage of abrupt weaning, so for me it started off I'll get back to that weaning in a second. After I had my first child, for me I was extremely depressed and sad and crying and and I actually thought, oh my God, do I have postpartum depression? Not knowing too much about it. But I remember, you know, like you know, I'd heard about postpartum depression for sure, and so I called the public health nurse and they ran the Edinburgh postnatal depression scale on me the set of one of one of the screening tools for postnatal depression and they asked me the questions and she said I didn't score high enough to be considered having postpartum depression. But that part of their program is that she could come by for a visit and just, you know, talk with me and see how things were going. And I was like sure, you know, I was willing to take any, anything, any help. So she came over and we sat, you know, and chatted for about a half hour. She ran the scale on me again. Again I didn't score that high and so she gave me some, you know, tips and advice and about you know, you know how life with the baby, you know, changes your, your life. You knew before, and especially in the beginning, how it's overwhelming. Don't be afraid to ask for help. And I was it and she was gone and I was like, okay, so maybe I'm just having trouble adjusting to new motherhood. You know, I'll just give myself some more time. And then, about six months into it, now I'm back to the weaning.

Kayla Huszar: 9:55

My, my baby was sleeping with me in the bed every night because I just couldn't. I couldn't stand the crying. I couldn't let my baby cry it out yet. So baby was sleeping on me and I was also napping every two hours with my baby. My, you know, my baby was very sensitive, crying, cry before a nap. So I found the only piece that I got was having the baby with me pretty much 24, seven and then six months got to a point where I just felt smothered by motherhood and I was like, all right, I need to get this baby sleeping in a crib, because I started to get irritable. The depression went, the change to irritability. So I got the baby in the crib. You know the 10, 15 minutes of the crying it out was torture, but I did it and baby slept through the whole night and I was like, oh my God, this is it. This is my turning point, this is great. Yeah, I'm gonna get better. I'm gonna really start enjoying motherhood Now I'm gonna get sleep again.

Kayla Huszar: 11:13

And all of a sudden I went from like my baby was pretty much suckling me all night for six months to nothing. I was abrupt, abrupt weaning. I had never heard of that term before. I didn't know. So my breasts were engorged, I was soaking the bed sheets. But I was just like, oh well. So I was trying to pump, but it was just making it worse Cause my breasts thought, oh, we gotta make more milk and more. So I just was like, well, get some time, they'll get it. They'll like the milk will like dissipate. But apparently in people who are sensitive to hormonal changes, like myself, abrupt weaning can really do a number on you.

Kayla Huszar: 11:53

So all of a sudden I got this major anxiety and major panic attacks and heart palpitations and muscle tightness and started to get flashes of scary thoughts, which I didn't know then were intrusive thoughts of the baby drowning in a bathtub, a flash of like knives stabbing the baby, and I was like what the heck is going on here? Okay, I need my sleep, cause the nurse said I don't have postpartum depression. I had never heard of postpartum anxiety, so I was like I just need sleep, I will get through this. Well, I couldn't sleep. I had insomnia. That was all that was part of it. That was part of this trajectory I was on. I couldn't sleep, so it was making everything obviously worse.

Kayla Huszar: 12:44

And then I started having what I call these slips of leaving reality and going into like this dreamlike state. So I'd be running a bath for my baby and then just staring at the running water and then feeling myself kind of slip into a dreamlike state and then jerk back a few seconds later and it would scare the heck out of me. And this would happen if I would go into a mall. I'd be walking the baby in a stroller and same thing. I'd feel like I was about to leave this world and leave reality. And then I would jerk back and it was terrifying, it would scare the hell out of me, but I didn't know what was happening. Then it all culminated one night and my child was seven months postpartum. The complete slip happened when my child was seven months.

Kayla Huszar: 13:43

I thought, oh God, I'm gonna have like the biggest panic attack I've ever had. It felt like coming on. I had panic attacks before in my past. I used to call 911 and go to the emergency room and they'd run a battery of tests. Everything would come back normal, I'd be sent back home.

Kayla Huszar: 14:01

But when you're having a panic attack, even though you're like, okay, this must be a panic attack, you think, oh my God, what if I'm actually having a heart attack or something, or maybe this is more serious than I think it is. So I was about to call 911 and then I just feel like my brain reached a peak of jumbledness and anxiety and tangledness that all of a sudden I just started saying you know what, I don't care, I don't care anymore, I don't care what happens to me, I don't care if I leave here tonight, I've had enough, I'm not buying into this anxiety. Like I had a choice, I was like enough is enough, I don't care, I'm not paying attention to you. And then in that moment, you know the wizard of Oz, when Dorothy spinning in the farmhouse, the tornado, and then finally the house lands with a thump, yes, and everything's kind of quiet and the storm has gone and she's about to open that door into a colorful, magical world. Yes, that is the only way I can describe what happened to me next.

Kayla Huszar: 15:17

So the chaos that was in my brain, it just stopped and instead of calling 911, I called on some kind of higher power. I felt a presence in the room and I felt like it was communicating. That's when the slip completely happened. I completely lost touch with reality and from that moment on I did some pretty wacky and wild things. For the next two years, my psychosis waxed and waned for two years and the only reason why I think it started to go away is when I became pregnant with my second child. Something happens to me when I'm pregnant the level of the hormones rising. It's a really good state for my mental health to be in. I started to regain what I call sanity again and I started to come back to reality and got extremely embarrassed and upset. But I started to notice what you realized.

Kayla Huszar: 16:26

Yes, I was like what in the world happened the last couple of years.

Patricia Tomasi: 16:32

Oh, wow.

Patricia Tomasi: 16:34

First of all, I believe everything that you've said and I thank you for sharing it so vulnerably.

Patricia Tomasi: 16:42

I know when we work in these kinds of environments and you're now in advocacy work it's just another story and it's quite normal and I'm again air quotes of normal to you to experience that.

Patricia Tomasi: 16:57

But that story is so profound and what you lived through is unique and I just I can't imagine the amount of fear and worry and like thinking that you did in that time to have gotten to the other side is and have the awareness to share the story and to you know, do the work and to have the resources and all those things like that. That's incredible, because you and I both know that that's not always the ending that people have to that story. The happy ending, the I'm going to go with the Wizard of Oz metaphor here because I love it the seeing what's actually behind the curtain and understanding that those pieces are not actually you. Right, you are you and those pieces are part of it, but they're not actually you. And when you can get behind the curtain and now make meaning of that story and now to help others is an incredible amount of courage.

Kayla Huszar: 18:15

Yeah, thanks, I mean, I don't know, I guess I've I've never been shy about about just showing people who I am. And then this happened. And yeah, of course it's embarrassing saying you were communicating or you thought you were communicating with other beings, but you know, I'm all I'm over it because, because this is one of the things that can happen. So, like you were saying to the listeners before, postpartum psychosis is considered the rarest of the perinatal mental health disorders one to two in a thousand it affects. It is an emergency. So if you have some semblance of awareness that something's not right because it does wax and wane, so if you're in that moment where you're like something's not right here, you can go to the emergency room yourself and hopefully there's somebody there, trained, who can help you. But if friends and family notice you're having paranoid thoughts and doing things that are completely out of character, then definitely they should get help as soon as possible.

Kayla Huszar: 19:31

I consider myself lucky. So that's why when I learned about Flora Babacani's story, who's a Toronto woman who sadly lost her life due to suicide, due to undetected, undiagnosed and untreated postpartum psychosis, it just really, really brings it home for me, because I know things could have gone that way, especially the second time, I experienced the beginnings of postpartum psychosis. So that was after my second child was born. So when I was pregnant with my second child and started to come back to reality and be aware that something really, really wrong happened to me, I started to do some research and that's when I started to learn about postpartum perinatal mental illness and psychosis and different things, and I really started to learn about the science of perinatal mental illness and really started to understand that it was a biological, physical illness as well as can be triggered by environmental factors, like there's, as you know, there's a whole host of things that go into why someone may or may not develop mild, moderate to severe perinatal mental illness. And so you know it had a lot of time to do, a lot of thinking, a lot of researching.

Kayla Huszar: 21:03

Everything started to click into place about my upbringing, how I ended up with recurring phases of anxiety, depression, mania, growing up, my family history, adverse childhood experiences. So everything started to click into place. As to, you know, I wanted to know why did this happen to me? And for some they never figure out why they don't have a history of mental illness. They don't check off all those boxes. It can just come out of the blue, but for me there were a lot of red flags that could have been, could have been caught. So I was ready. So I was like all right, I'm aware of this, my husband knows now, my friends know. I told my midwife throughout my whole second pregnancy. I'm like my spidey senses are on. We're all aware, we're all keeping track of what's happening. And then I felt great after I gave birth. I didn't sink into that depression like I did the first time and things were good for the first few months. Then in the third months,