Hannah shares her experiences of being diagnosed with bipolar disorder following the birth of her first child, as well as receiving a diagnosis of ADHD at age 38 years.

I started my mental health journey from an extremely naive place. At 29 I was happy, motivated and excited for my future. I had a successful human resources career, had studied psychology at university, was recently married and was due to have a baby in a matter of weeks. At this point in my life, I had no experience of poor mental health and am ashamed to say that I believed that only ‘certain’ people were affected by mental illness. And I was definitely not one of those ‘certain’ people.

My husband and I even smirked at each other during antenatal class when they talked about postnatal depression. We were a strong and resilient couple, with stressful jobs and busy lives. If we could manage that, then surely we would manage a new baby. Postnatal depression was not something that was going to knock on our door. Looking back, I am often exasperated thinking about those two people. Brimming with confidence and completely lacking in awareness. I also know that no amount of awareness or preparation would have changed the outcome. So perhaps those two people were meant to be blissfully unaware.

Motherhood and Mental Health

I had planned a perfect birth. With music and a birthing pool. My plan wasn’t exactly watertight; my actual experience of birth was an induction, a failed epidural, a distressed baby with a dropping heartrate, forceps and a haemorrhage. I wonder if that trauma played a huge part in my eventual diagnosis. Specialists have had varying opinions on the trigger, but it seems likely.

Over the coming days things started to go pear-shaped. Not with my beautiful baby girl, she was a very easy baby. I was the one going pear-shaped. I remember feeling incredibly charged, how I imagine someone to feel after eight cups of coffee. I felt on top of the world, I felt like I was a super-mum, I didn’t want to sleep, and I would stay awake between feeds at night and research weird and wonderful things. I started to become extremely obsessed with my appearance and my clothes. I wanted to look like a perfect mum and made it my mission to look like that.

As each day passed, my behaviour became increasingly odd, and my mood became more unpredictable. Four days postpartum I was getting my hair done at the mall, on day 5 I bought eight cardigans, to look more ‘mum-like’. I was flying off the handle at my husband and wanted to tidy every drawer and cupboard. The problem with that was that I would start a task and quickly move on, so our very small house looked like a warzone.

On day 10, my obstetrician called and she could tell something was wrong when I told her I had not slept the night before because I was looking for tweezers for my eyebrows and was sure they had been put in the dishwasher. She booked me in for a maternal mental health phone assessment. In the few days between my call with her and my assessment things derailed more. I tried running away. I slammed the glass patio door and cracked it. I hysterically cried in the rain. The adult psych team were called, and I was sedated.

One of the biggest learnings from these few weeks was the lack of information for my husband and family. Nobody was looking out for them, giving them information or helping them, or it was done in a very haphazard manner. For me to stay well I needed my support system more than ever, and nobody was nurturing that support system. My husband would often go into work having had only a few hours’ sleep and would spend hours researching online.

Getting Help

The maternal mental health team called. I was asked a series of questions to ascertain whether I was having a manic episode and was told that I had 10 out of the 10 symptoms. I vividly recall being thrilled by this; I had scored a perfect A+, wasn’t I just amazing!

What followed from there was what I have often described as a ‘circus’. For someone in the throes of a manic episode, you would think that ‘calming me down’ would be a priority. However, we had a constant stream of people coming in and out: carers, support workers and visitors. I remember thriving on the constant chatter, the different personalities and the number of people I could talk to about my symptoms. I was treated at home because there was no inpatient centre in Auckland at the time, and in many ways I am so grateful for that. I had DHB-provided carers day and night and many of them were kind and caring. A few of them were not and had no idea what to do or say around me. But I also feel that the constant stimulation made it hard to feel calm and slow my mind down. I wrote thoughts and tasks on post it notes which piled up in their hundreds. I wrote emails to my boss and my colleagues talking about my desire to be the next Minister of Health. Thankfully, my family realised this was happening and turned my emails off! I tried to sell our house by calling a real estate agent from the spare bedroom. I wrote letters about the mental health system and what I would do to change it. I stared at myself in the mirror and tried new makeup techniques for hours on end. It is exhausting typing this. It was incredibly exhausting living through it. The only time my brain would stop would be when I took my sleeping pills, and I was knocked out for the night.

The biggest learning curve for us all was navigating my own experience of the manic episode compared with that of my loved ones. While most of the time I felt energised and excited, full of ideas and plans, my husband and family found me volatile, noncompliant and extremely difficult; it was like living with an out-of-control teenager. Months later my husband said that each night when he went to bed with me it was like lying next to a stranger. An awful, unpredictable stranger. I can’t imagine how horrible this must have been for him, and so isolating. I have since thought how he so desperately needed some support from someone who knew what was going on. He was struggling with a busy job, a new baby and a manic wife, and trying to keep his mental health afloat. Like me, he had never experienced any mental health issues or had ever known anyone who was struggling, so this was completely uncharted and frightening territory.

I would say the most awful things to my husband whenever he tried to say no or to guide me in another direction. An example was when I became obsessed with finding fabric to make new cushions for our bed and couches and kept wanting him to drive me to fabric shops. Bearing in mind that I could not sew to save myself, they were very pointless excursions. One day when he said he would not take me, I lashed out and demanded a divorce and proceeded to try and book flights for a solo vacation to Fiji.

I can remember almost all of my manic episode. In total it lasted around 6 weeks as it took time to find medication that worked. I never broke from reality, I never had hallucinations or thoughts of harming my baby or anyone else. I loved my baby, much like a child loves their doll. But I was incapable of caring for her with my mind a million miles an hour. In total, I spent a huge amount of money, including a $900 phone bill one month. Above all I missed out on those precious first weeks with my baby. And my husband experienced a huge amount of trauma which I would say he is still affected by and still dealing with almost 10 years on.

Bipolar Diagnosis

Once the mania had subsided, we had an appointment with my maternal mental health psychiatrist to review and plan. It had never crossed my mind that I had experienced anything more than a ‘simple’ manic episode. So, when she told me that I was in fact being diagnosed with bipolar disorder, I cannot describe the crashing feeling inside. Every movie, every book, every textbook at university I had read about people with bipolar disorder flashed across my mind. By the tense body and hand gripped in my mine, I knew my husband was feeling the same. But what was even more frightening was when she told me that I was to expect a depressive episode and that unfortunately, it was likely to be severe. I do remember leaving the appointment with no notes, no resources and no advice.

We went home to process this. I could not work out how to process any of it. We had just survived a manic episode that almost broke all of us. How would we cope? I eventually convinced myself that I would not become depressed because I was a happy and positive person. I was surely protected because of this.

One week later I went to bed and went to sleep as normal. In the morning I woke to the feeling of someone lying on me and suffocating me. At first, I thought it was my husband. Nobody was there. It was a feeling. An awful, disgusting, overwhelming feeling that I often liken to the feeling of a stranger walking into your bedroom and stroking your face and hair. Foreign and frightening. My depression had arrived like a thunderbolt. It came with crippling anxiety; I was barely able to function. Every part of life and every part of motherhood became a series of incredibly difficult micro moments. Time felt like it stood still, and I longed for night-time where I could take a sleeping pill and hope that I would be myself again in the morning.

I again had carers coming in to look after me day and night. I was so unwell. I wanted so desperately to be a good mum and the most I could do was to lie next to my baby on her playmat and rest my hand on her tummy. And tell her that I would come back to her soon and that I was fighting hard.

Food didn’t taste of anything. Colours seemed muted and sound was distorted. I couldn’t remember what happiness felt like and I couldn’t remember what it was like to laugh. The depression stripped everything from me.

The most helpful advice and care that I received during this time was a Karitane nurse who came to help me with some sort of routine and to recognise different signs with my baby. She was the most caring and wonderful person and had been through depression after her births, so I felt heard and understood. I also could see her thriving and could see that she made it through. It was the start of me realising the power of mental health advocacy and storytelling.

I had three serious bouts of depression that each lasted about 2 weeks, with 10 days of being well between them. It was like a light switch turning on and off. Eventually my mental health team realised that I was rapid cycling, and it was due to my antidepressants. Once that was resolved, I thankfully have never had another bout of depression since. I lived in fear of it reappearing for so long and have only now started to feel at peace with it.

Picking up the Pieces

When we moved to Christchurch, my daughter was 2 years old and the trauma of our experience had caused my husband and I to decide that we would only have one child. The risks were too great. Thankfully we were able to have an appointment with the maternal mental health team who helped us come to the decision that we would try for another baby. Once pregnant, I was supported by the team to stay on my medication throughout the pregnancy and through breastfeeding. We had an amazing plan and had a beautiful boy in late 2016. I stayed well-managed and happy throughout the whole time. I got to experience what I had missed out on with my daughter, and I am so thankful for that.

Although I went back to my human resources career, I realised that I wanted to make a difference in the mental health space, and this led to me launching a mental health app for mums. This then led into other areas, including corporate well-being and eating disorders. At the same time, I decided to share my story openly as I knew that speaking out could potentially help many other mums and other people. I quickly became used to being open about my experience and was very focused on trying to reduce the stigma and also normalising serious mental health issues like bipolar disorder. I believe I have made some sort of difference in this space.

Running my own tech company as a solo female founder came with many challenges. This is where some of my derailing types of behaviours came out to shine (although I don’t think I would have identified them as derailing at the time). During my career, I had always struggled with time management and deadlines and found it difficult to focus. My procrastination would become severe when it was a task that I perceived to be boring. I was always extremely social and talkative and would become very hyperfixated on certain things, such as the latest fad diet or a new book series. I also had a very addictive personality whether that be shopping, overeating or gambling. However, these behaviours were magnified when I was working for myself in an area I was passionate about. There were no rules and no boundaries, and I could indulge in everything I loved doing. This came at the cost of business growth, sales and revenue-generating activities. My life felt like it was veering off course with my constant inability to organise and focus.

Attention Deficit Hyperactivity Disorder (ADHD) Diagnosis

It was not until a female entrepreneur I know was diagnosed with ADHD that it even crossed my mind that this was what was happening for me. I started listening to podcasts, reading articles and following ADHD accounts on social media. Everything seemed to add up. I decided to talk to my GP who knows my mental health inside and out, and she agreed that it was worth getting an assessment. I ended up paying over four times the amount for an assessment because of the complexity with my bipolar disorder, but at this point I was desperate for an answer. I was prepared for the psychiatrist to say that it my bipolar rearing its head and not ADHD at all. It did not take long for the diagnosis that, yes, I did in fact have ADHD at a moderate level, and that we would start with Ritalin.

The fear came back straight away. What if the Ritalin affected my medication? I was told that in some cases Ritalin can cause mania in some patients. I then encountered a new challenge when I shared my diagnosis with my husband and my family. The common responses were, ‘well, that’s just you’, or ‘doesn’t everyone have those symptoms’ or ‘you don’t need more meds’.

I have found the stigma around being a woman with ADHD to be far greater than that of my bipolar diagnosis. There are many misconceptions about late diagnosis for women and it can be an extremely isolating process. There is not enough information for families about what it means and there is a lot of stigma in the workplace. I have connected with many women who are very secretive about their diagnosis and in many cases have not told their family or friends.

I am grateful that my ADHD medication has been life changing for me. I can focus and complete large pieces of work without getting distracted. My binge eating has gone, my nail biting and ‘leg jiggling’ have gone. I am calmer and can manage all my tasks and life admin. I can clean the house much quicker because I work on one task at a time. I still feel creative and can still have the same strategic thinking at work. I am just a better version of myself who can be productive and focused. I am also a much better listener, and don’t spend the whole time wanting to interrupt the person who is speaking to me. It is like someone has turned down the volume and I can focus.

My ADHD diagnosis has made me a better mental health advocate. I often wonder whether these experiences were meant to happen to me so that I could make a difference. Through the highs and lows, I have learned so much and have become a much more compassionate and empathetic person.

What I’ve Learned and How You Can Help Others Like Me

  • Focusing on better ways to support spouses and carers is so important. Understanding the learning style of each individual and what types of support are needed is key. Some people prefer research articles and written material, whereas videos or podcasts would suit others. Different family members may need different resources that are relevant to them and their learning and processing style. Everyone has different experiences of mental health themselves and this needs to be considered. Trauma support or clinical mental health support for carers needs to be more accessible or available.

  • The difference between a great support person and an ill-informed support person can be the difference between someone recovering quickly or not.

  • Giving people hope, by sharing stories of people who have survived and who are thriving, is extremely valuable. It is easy to get focused on the diagnosis and the immediate treatment plan. Having people see that there is a way forward and something to fight for can make such a huge difference. When I was unwell, I could not find anyone who had got through a postpartum bipolar diagnosis, which affected my ability to see a way forward.

  • There needs to be better resources to explain what a late diagnosis of ADHD in women looks like. Giving people mini scripts of how to respond when other people make comments like ‘doesn’t everyone have ADHD traits?’ There is nothing worse than feeling like you don’t have a good enough answer, or when you question your diagnosis yourself.

  • Self-esteem and confidence resources are also key during this time. Any sort of mental health diagnosis can shatter your self-image and your perception of your abilities, so intertwining this in some way to treatment and sessions could be incredibly helpful to the patient or client.