Three leading mental health charities have helped EastEnders to dramatise a debilitating mental illness affecting women after childbirth - postpartum psychosis - for one of the soap’s biggest storylines over Christmas and into the new year.

Experts from APP (Action on Postpartum Psychosis), Bipolar UK and Mind, together with women who have themselves experienced this condition, advised the script writers over several months. They also met the actor Lacey Turner, whose character Stacey Branning becomes ill after giving birth on Christmas Eve, and her on-screen partner.

APP, Bipolar UK and Mind welcome EastEnders raising awareness of postpartum psychosis and bipolar disorder through Stacey’s story, which will hopefully reduce stigma and encourage affected individuals to seek support.

Postpartum psychosis is an episode of severe mental illness that normally occurs shortly after giving birth and escalates rapidly. Around 1,400 cases occur each year in the UK i.e. one or two cases in every thousand deliveries. It often occurs without warning to women with no previous mental health problems. Symptoms include hallucinations; delusions; mania (elation), depression, or anxiety; and extreme confusion. Other symptoms can include being unusually talkative, racing thoughts, feeling very energetic, excessive irritability, agitation, and having trouble sleeping. It’s an emergency situation and women experiencing postpartum psychosis should receive specialist treatment in a Mother and Baby Unit.

It is not a form of postnatal depression. Postpartum psychosis differs from postnatal depression in terms of the symptoms experienced; severity; risk factors; treatments required; and illness course.

Dr Jessica Heron, Senior Research Fellow in Perinatal Psychiatry at Birmingham University and Director of Action on Postpartum Psychosis (APP), which provides information and support to women and families affected by the condition, says:

“The lack of public awareness of Postpartum Psychosis and its symptoms mean that diagnosis and treatment may be delayed, leading to longer, more severe and traumatic episodes, and risking tragic outcomes. The lack of public knowledge impacts recovery too; women and their families feel ashamed, stigmatised and isolated, reluctant to talk about their experience, even to friends and other new mums. Being able to talk to others with personal experience is really important to the recovery process. APP provides an online forum where women and families affected by the illness can talk to others who understand what they have been through.”

With the right treatment and support, the vast majority of women make a full recovery. Whilst unwell, women need help to care for their baby, but most retain a strong bond and enjoy a thriving relationship with their infant. It is extremely rare for babies to be removed from women with Postpartum Psychosis.

High risk women include those with bipolar disorder, schizoaffective disorder, and women who have previously experienced the illness. For these women likelihood of developing this after birth is 25-50% and referral to specialist perinatal mental health services before delivery is vital. Women whose mother or sister have experienced Postpartum Psychosis have a higher risk than the general population (around 3%), unless they have a history of severe mental illness themselves, in which case their risk may be in excess of 70%.

It is not always possible to prevent this illness in high risk women, however medication during or straight after the pregnancy/ birth as well as support (such as help with night feeds, monitoring early symptoms) can help to minimise the risk. Women with a diagnosis of Bipolar Disorder who are thinking of starting a family should talk to their health professionals and request referral for specialist preconception advice. During this appointment, you will be able to discuss your current medication, your risk of postpartum psychosis and the care you can expect during pregnancy and following childbirth. Women who are considered high risk should always be assessed before leaving a labour ward.

Alison Kerry, Head of Media, Mind says:

“We have been working with the EastEnders team to develop this storyline over several months and have been impressed by the dedication they have shown in portraying Postpartum Psychosis sensitively. We accompanied some of our supporters who have personal experience of Postpartum Psychosis to Albert Square to meet with the researchers, actors and writers, and we have been involved with ongoing script consultation where the researchers send us different versions of the script and we feedback with comments and suggestions.

“One of the main aims of our input into this storyline is to ensure that we challenge the myths including the idea that women who have Postpartum Psychosis are always a danger to their children, that the illness is a form of postnatal depression and that women never recover. We have also advised the programme to adopt a realistic timetable to ensure that Stacey does not become unwell and then recover in the space of a week!  

“Mind’s media advice service works with soaps and dramas to inform storylines when a fictional character has a mental health problem. The main aim of the service is to tackle incorrect and outdated stereotypes.

“We know that soap storylines about mental health problems are very impactful at encouraging people to seek help. A Mind poll found that 25 per cent of people who were experiencing mental health problems were prompted to seek support after seeing a soap or drama cover the topic. We also found plot lines are a fantastic way of getting people to think differently about mental health, with 44 per cent of people saying storylines had helped change their opinion about the kind of person who can develop a mental health problem and a third saying soap stories encouraged them to have conversations about mental health issues.”

Suzanne Hudson, Chief Executive of Bipolar UK, says:

“Women with bipolar are at a higher risk of becoming unwell during pregnancy or following childbirth and postpartum psychosis occurs after about 25% of births to women with bipolar. Women with bipolar are at an even greater risk if they, or their mother or sister, have already experienced postpartum illness. Women with bipolar have more issues to think about when considering starting a family.  With relevant information and careful planning, the majority of women take the decision to try for a baby and make excellent mothers. 

Bipolar UK welcomes the opportunity to raise awareness of bipolar, and particularly postpartum psychosis, and in doing so hopefully reduce stigma and encourage affected individuals to seek support.”

Women, families and health care professionals can access information on postpartum psychosis, to find out how to recognise the symptoms of the illness and how to get help, from APP, Mind and Bipolar UK:

 

Action on Postpartum Psychosis (APP) - www.app-network.org

Mind - www.mind.org.uk/Stacey

Bipolar UK - www.bipolaruk.org/get-support

 

The causes of postpartum psychosis are still unclear. Studies have found that genetics can play a part. Hormones and disrupted sleep may also be involved, but more research is desperately needed.