Time to talk about: Postpartum Euphoria/Hypomania
Many people, after an unusual experience, write to make sense of what happened to them, how they felt, what they might do differently next time. I write this, almost 3 months after giving birth, because in hindsight I probably came quite close to a harmful postpartum mental health experience, and I hope to discuss and raise awareness of an under-diagnosed and under-discussed condition affecting some women after labour.
Disclaimer: I’m not a healthcare professional. This is an account of, and thoughts about, my personal experience.
This concerns my second childbirth experience, but I’ll briefly explain my first. Skip this paragraph if you’re in a rush. Labour with my first daughter, went the way of many first-time labours. It was hard — surprisingly hard. My body and mind were completely unprepared for how it would feel, and I spent the labour and the following weeks in complete shock. I was nervous about labour on a rational level, but as a fit, strong woman who was generally “good” at physical endeavours (sports), I was convinced that I could “mind over matter” the whole process and simply smash it out of the park on the day. The arrogance of a vaguely fit person attempting to run a marathon with no training or preparation. On the day, of course, pain ensued and with no coping mechanisms in my armour, so terror and panic followed. I felt a little foolish and disappointed that labour wasn’t the breeze I imagined it would be. That was pretty much as far as it went. I recovered well and bonded with the baby. She was tongue-tied, so breastfeeding took 3 weeks or so to stop being agonising, but otherwise I was out and about, hiking in Richmond Park with the sling, taking the train into London for lunches and mooches in galleries with friends. I went back to work as a teacher after 6 months. It all felt new, sometimes scary, but pretty OK.
It wasn’t an obvious decision to have a second baby, mostly because we were enjoying our lives as a family of three. Why roll the dice again when we had a good thing going already? But as for many, the niggling desire to have a second won. I fell pregnant immediately. After 8 weeks or so, there was some bleeding. Waiting for the scan to hear the worst was a turning point, and I felt not relief but elation when the sonographer found a healthy-looking baby. This elation stayed with me for the next few months, through the challenges of teaching and parenting from home during a global pandemic.
I had learned my lesson: my deluded approach to my first labour had led to (albeit mild) feelings of disappointment. This time I would be more prepared. I would be realistic — plan for the worst while hoping for the best. I would actually learn what would happen to my body — when it would hurt and why. I had learned to swim since having my first and would use what I had learned about breathing to remain calm.
And remain calm I did. There was plenty of pain and discomfort, and some danger in the form of a short hemorrhage, but the experience was a million miles from the stress, confusion and fear of the first. I felt mostly in control; I mostly trusted my body, and thanks to some talented doctors and midwives, the baby and I emerged in pretty good health.
However, after labour was where my reality started to deviate from my perception of it. In the hours and days after giving birth, I ecstatically told nurses and midwives that this was “the best thing I’ve ever done”, “the best experience of my life”, that I felt “on top of the world”.
More than once I used the phrase “medical marvel” to describe my recovery, and described myself as “euphoric” when people asked how I was feeling. I felt energised and fearless. I wandered into a hairdressers and asked for a dramatic haircut (elbow length locks cropped off to a pixie cut — no questions asked by the hairdresser); I begged my husband to let me quit my (much loved) job and take my eldest out of nursery as I missed her too much. I genuinely felt euphoric, elated, that my life suddenly made sense, that I could do anything, that the world was lit up in a new bright way. Although there were raised eyebrows, none of this seemed to raise any red flags with family, friends, or medical professionals. “Lucky you”, was the stock response. Only one friend was brave (and astute) enough to use the phrase “a bit manic”.
At the same time, I was easily irritated. If I were not furnished with a cup of tea every 30 minutes or so, I would seethe with anger at my husband’s thoughtlessness. Our car needed a new part and the garage did not have it; I was apoplectic and burst into tears.
This, I now realise, was dangerously close to postpartum euphoria or hypomania (terms I only learned after curiously typing “a bit manic and euphoric after birth”) into Google during one night feed. Postpartum euphoria, I learned, can quickly become dangerous if the elated person crashes into a black hole of depression or exhaustion. Signs and symptoms include:
- More talkative than usual
- Engaging in potentially “risky” behaviours (alcohol, sex, gambling, excessive spending)
- Impulsiveness
- Loss of inhibitions
- Bursts of energy/productiveness
- Feelings of extreme happiness/wellbeing
- Feelings of being smarter/more creative than before
- Racing thoughts
- Getting by on less/little sleep
- Changes in appetite (particularly eating less)
There are a number of factors that, I believe, allowed my euphoria to dissipate safely:
- I have a stable, safe home. After a year of us all staying home more than we ever thought we would, I do not take for granted the good fortune of this.
- Having the toddler necessitated a rotating schedule of house guests in the form of my parents and my husband’s parents in the days before and after the birth. These people are positive, calm and healthy influences. My mother in law reacted with infinite kindness to the alarming sight of me returning from a walk sans hair.
- The toddler herself necessitated a routine of meals, short walks and periods of rest and quiet.
- My husband is a very kind, patient, calm person and we have created a life low in chaos. Making rash decisions simply hasn’t been on the menu for years.
- London entered tier 2 restrictions a couple of weeks after the birth, putting the lid on the option of lots of activities that might have escalated into chaos or exhaustion.
- I was simply lucky that my brain chemistry didn’t take me to a dark place this time.
I am grateful to be “on the other side” of what I now look back on as a largely positive postpartum experience. But, like many other women, I can see now I came closer than I would have liked to a potentially dangerous mental health episode. I would love to see greater awareness of this aspect of the postpartum mental health landscape.
Thanks to/further reading:
https://postpartumprogress.com/the-difference-between-hypomania-mania
