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'Raising awareness is critical': Mother, doctor raise awareness about postpartum psychosis

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CLEVELAND — Time together is time treasured for Meghan Cliffel and Colin Weaver. Enjoying a quiet lunch together is special because when the kids are home, the kitchen is a lot busier.

Married 13 years this summer, their life has been filled with babies, birthdays and lots of love and laughter. However, between the mundane and the marvelous, a crisis that almost took it all away from them nearly eight years ago.

"I just can’t stress enough how lucky I feel," said Cliffel. "And, to get to a place to be able to talk about it took a lot of work, but I feel really, really lucky when I know things could’ve ended much differently.”

In 2015, the two were living in New York and welcomed their second baby girl.

"I had the perspective that comes with a second baby," said Cliffel. "I was enjoying maternity leave; I had her on me walking around SoHo, just enjoying being a mother.”

But things felt different she said after returning to work.

"I just started to say that I didn’t feel like myself,” she said. "My husband would say, 'What do you mean?' And I'd say, 'I don't know, I just feel anxious and a bit sad."

Cliffel said she wasn't sleeping well, was still breastfeeding, and when she’d wake in the night her mind would often race with work stuff.

That feeling persisted, she said, until a few months later when life as Cliffel knew it changed forever- from one day to the next.

“I think just how quickly it can happen and how real the thoughts are,” she said.

Over the course of a day, Cliffel descended into a frightening false reality; her mind deceiving her through delusions, hallucinations and paranoia to believe everyone around her was trying to get her to join a cult.

“It was like, ‘Oh my gosh, my whole life’s been a sham!” And then there’s a moment where my friend asks me, ‘Who’s watching your kids?’ And I was like, ‘My husband, Colin,’ and at that moment I was like, 'Oh, she’s threatening me. She’s saying that my kids are going to be killed if I don’t join this cult," she said.

Cliffel even believed her husband was in on it. Keeping it all inside, her break from reality ultimately accumulated the next morning with Weaver calling the police.

“I’m in the ambulance and still believing that our kids are dying back at our apartment and trying to get the EMTs to let me go back to them," she recalled.

Cliffel spent 12 days at a psychiatric hospital, receiving treatment and beginning to understand how her thoughts had betrayed her and put her and her family in danger.

She was told she had postpartum psychosis.

Cliffel had never heard of it before, and that's a big reason why she is sharing her story today: to raise awareness about postpartum psychosis, and more broadly to increase awareness of the importance of maternal mental health.

She discussed her experience with postpartum psychosis alongside Dr. Susan Hatters-Friedman, Professor of Psychiatry at Case Western Reserve University and a Maternal Mental Health Psychiatrist at University Hospitals.

"I'm so happy that Meghan is sharing her story because I hope that people can understand it better instead of just this rare disorder, really understand what can happen,” Friedman said.

Postpartum psychosis is a medical emergency.

It is the most severe mental illness a woman can experience after having a baby. It occurs in one to two per 1,000 deliveries. Usually, developing suddenly in the first few days or weeks but it can happen later.

Friedman said a history of bipolar disorder is a risk factor but for other women like Megan, that’s not the case.

She said genetics, hormones, sleep and stress are also believed to play a role, and educating women and doctors about what to look out for is critical to early intervention, treatment and improved outcomes.

"It is so important to get help if someone experiences it because you can live a happy full life,” Friedman said.

RELATED: “Postpartum Psychosis: A Life-Threatening Emergency.” Postpartum Psychosis: A Life-Threatening Emergency

Raising awareness and advocating for change is what Cliffel's doing today.

She and Weaver moved back to Northeast Ohio to heal from the trauma and better-balanced life.

They also joyfully welcomed a third child under the care of Cliffel's medical team at University Hospitals, including Friedman.

Cliffel said if she could go back and intervene at a point after having her second baby, she said it would be when she wasn't feeling like herself.

"Stop, go see somebody, prioritize yourself, and sleep, and don't worry about work or your need to prove there, and your kids are going to be okay if you're okay," she said.

The effort is not unnoticed by her partner.

"I'm incredibly proud of her,” said Weaver.

He said he has the same message as his wife about the importance of shared awareness among parents preparing for a baby.

"Really make sure that the moms in your life are getting the time and space to make sure that their mental health is front and center,” he said.

Cliffel said surviving postpartum psychosis has changed her life’s trajectory.

"I think there’s a real gap in supporting mothers and learning how to mother themselves,” she said.

Cliffel is now working to fill that gap. She teaches mindfulness through yoga, writing and coaching, with a focus on the well-being of moms.

Through her advocacy work, Cliffel is helping break down the barriers and stigma that surround maternal mental health.

"Now it feels okay to tell it because it feels healing, but in the beginning, it felt like I would never have any worth again,” she said, noting the years of work it took to treat the trauma and PTSD. "It is really hard to be on the floor, and we’re stronger than we think, and with support and resources we can pick ourselves up.”

Resources include the Maternal Mental Health Hotline. It is free, confidential and available 24/7. You can call or text: 1-833-9-HELP4MOMS or 1-833-943-5746.

Other resources include:

Maternal mental health conditions are the most common complications of pregnancy and childbirth, affecting one in five women. Yet, 75% of people experiencing maternal mental health conditions do not get the care needed for recovery, according to the Maternal Mental Health Leadership Alliance.

There is a spectrum of conditions including baby blues, postpartum depression, postpartum anxiety, and the most severe-postpartum psychosis.

Friedman said postpartum psychosis is not the same as postpartum depression, but says they’re often conflated. She says the occurrence of postpartum depression is much higher but the onset of symptoms and treatment are different.

Currently, postpartum psychosis is not listed as a diagnosis in the DSM-5-TR (2022), which is a classification of mental health disorders.

The American Psychiatric Association said a proposal to include it has been submitted and is currently being reviewed.

Friedman said the hope there is that having it in DSM would improve education, diagnosis, and outcomes. Cliffel added that she believes it would also validate a woman’s experience.

Cliffel hopes that women and their doctors talk more openly about mental health, their personal risks, and plan for it to try and prevent it, begin treatment sooner and improve outcomes.

"It is really hard to put words to it," Cliffel said. "It’s one that I don’t think we want to scare women about, but if we know that it exists, we can have really positive outcomes for women. So, I think raising awareness is super critical.”

Coming up on May 3, 2023, will be the third annual Pregnancy and Postpartum Psychosis Awareness Day, and the first U.S.-based international fundraising effort for the cause as well.

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