Amanda2

Age at interview: 35

Amanda was 35 years old at the time of the interview living with her husband and three children ages 8, 5 and 3 years old. Amanda had a history of anxiety.

Amanda experienced an increase in anxious and intrusive thoughts in the postpartum period after her first child in 2014, Amanda sought mainly natural/therapeutic interventions, and her mental health returned to baseline as her daughter got older and she returned to work. Amanda experienced two miscarriages prior to getting pregnant with her second child who was born in 2017. Initially, Amanda felt well, but a series of stressful life events, coupled with insomnia seemed to precipitate an increase in anxiety and a drop in mood when the baby was around three to four months old. Again, she tried therapy and natural interventions but eventually took an antidepressant. Amanda enrolled in an outpatient maternal mental health program but found this very unhelpful. After several months taking an anti-depressant, and her return to work in the fall of 2018, Amanda was doing much better. She unexpectedly became pregnant with her third daughter and this time, Amanda and her husband knew to prepare for a relapse or return of her depression and anxiety. Amanda discontinued her SSRI, but resumed psychotherapy, had a supportive network of family and friends and made sure her midwife and family doctor were aware of her history.  

In 2019, Amanda gave birth to her third daughter. This delivery was stressful – her daughter’s heart rate was dropping, and the risk of a caesarean loomed; her daughter was born and investigated for inner uterine growth restriction. Amanda recalls her anxiety spiking immediately following the birth, and while still in hospital she did not sleep and began researching intensely about her daughter’s health. Upon returning home, Amanda continued to research about her own and her daughter’s health, and the anxiety subsided briefly; life seemed ‘normal’ for several weeks. But later that year, Amanda began to have insomnia, an increase in anxiety and in hindsight, paranoid and intrusive thoughts. She was seen by her family doctor and a private psychologist; she refused to go back to the maternal mental health unit outpatient program. Amanda was eventually put back on an SSRI and saw much improvement into the new year. However, when the COVID-19 pandemic started shortly afterwards, Amanda became unable to sleep; she was awake for 48 hours, became acutely manic, and had a serious motor vehicle accident (MVA). This pattern was later attributed to postpartum psychosis but went undiagnosed at the time. Amanda was seen following the MVA at her local rural hospital but discharged home with a referral to an outpatient mental health program. Upon returning home, Amanda unraveled and was admitted to a psychiatric hospital. Family members were unable to visit due to the pandemic, and while she responded quickly to anti-psychotic treatment, both she and her family lacked education about her episode/illness. She was discharged home but was not eligible to enter the maternal mental health outpatient program despite her baby being only eight months old. Amanda resumed private therapy and was followed briefly by an outpatient general psychiatry program. In the late summer/early fall of 2020, Amanda again became depressed, she again tried several medications to no avail. It took nearly 6 months before she was seen by a psychiatrist in a private clinic, covered by the provincial insurance program. This finally allowed Amanda to gain a proper understanding of her illness, obtain medication and begin to process the trauma around her episode, hospitalization and prior history. Fortunately, Amanda was able to remain in private therapy. Amanda is doing well now; she is committed to her wellness and is able to care for her three children.  

 

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