41 | Chloe
“I like to think of it as the dark night of the soul, my time in there as well. That real reckoning with who you are and how you’re going to go forward and how you’ve changed. And I needed to go through that.”
It’s nearly impossible to think about Chloe’s story without thinking about all the places where she navigated the worst of her anxiety and melancholic depression: the hospital where she was left parenting in a traumatised body after a retained placenta; the inner-city Sydney suburb where, shockingly, she could not access any maternity support services; her in-law’s house on the other side of Sydney where she moved to create a village but could not sleep; and the local esplanade where she pushed the pram and fought against her suicidal ideation every day. That’s not even mentioning the emergency department, the short-stay psychiatric emergency care unit, and eventually the mother-and-baby hospital (MBU) where she was admitted for two months, all of which were integral to her story.
In each setting, Chloe not only faced unenviable symptoms, but she also had to confront her own unwillingness to ask for help, the lies depression made her believe, her own trauma around electroconvulsive therapy (ECT), and the question many MBU mothers grapple with ‘when will it finally be my turn to go home?’
This is Chloe’s profound story, what she calls her real reckoning and dark night of the soul, that explores the realities of experiencing and recovering from an acute mental health episode in early motherhood. It’s a story about losing and finding yourself again in the most unexpected of places, but above all, it’s a story about finally coming home.
Please note, this episode touches on suicide and suicidal ideation. Go gently.
“I had my daughter Emily at the end of May in 2022. And it was a quick spiral following birth. It all unfolded very rapidly.”
“What I've reflected on more recently is that perhaps the birth played more of a role than I realised. And I think I was in a traumatised body and I was looking after a newborn baby in a traumatised body.”
“So I think that things started off concerningly as it was a long labour and Emily was facing the wrong way. She was in the right position, head down, but she was facing the wrong way which meant that I couldn't have any pain relief until the possibility of her turning. And eventually she did, but it was after seven or eight centimetres of dilation and a long journey.”
“All that went well, the pushing and that, but I retained my placenta, and that was really, really scary and confronting because it was a matter of ‘we need to get this out now or you go into surgery tomorrow and we remove it’ as it's such an infection risk.”
“I thought I was done. I was like, ‘oh, yes, I did it. Emily's here!’ They're like, ‘no, we need to reach in and scrape this out of you or you can do the surgery.’”
“And I thought, ‘let's just do it. Let's just get it done.’ But that experience was absolutely horrific.”
“I was just exhausted. And you don't really get to process it because all of a sudden you've got a newborn in your arms. So I think that was definitely quite traumatic for me.”
“I would say within probably two weeks, things really started to spiral.”
”I have historically struggled with anxiety and depression since I was a teenager.”
“But I would say this time around was so much more intense. Whenever I've had anxiety or depression in the past, I wasn't looking after a newborn child. When you don't want to get out of bed, you can stay in bed, but you just can't do that. I've definitely had struggles in the past, and I've been on medication, and I've done therapy. I thought I was on top of it, to be honest. But it changes with peaks and troughs. But this was a whole other beast.”
“There were so many people trying to help me, but I couldn’t even decide what I needed in that moment. You just want someone to wave a magic wand and get you back to yourself. I think that’s probably one of the hardest things is how crippling it is and how you feel completely paralysed...”
“We don't live close to family, which is a choice that we made. I don't think you realise how much you need a village until you have a child.”
“I just could not sleep. I became an insomniac. Emily, everything was going well with the feeding, initially the breastfeeding, but she started to just become really restless and unsettled. She would just cry constantly and wouldn't sleep at all. It was just an ongoing roller coaster of all night and all day.”
“When a child is screaming, it's your biological response: you get anxious and you get into that fight or flight response. And yeah, I really started to spiral.”
“I would say that my anxiety was particularly acute at that time. I wouldn't say that the depression had hit then. I'd say it was severe, panic attacks, just racing heart all the time. And that's why I couldn't sleep as well.”
“It's an out-of-body experience, feeling so out of control. And how quickly things can spiral when you're mentally unwell in that situation. Yeah, the complete withdrawal from people, not being able to write back to simple text messages.“
“There were so many people trying to help me, but I couldn't even decide what I needed in that moment. You just want someone to wave a magic wand and get you back to yourself. I think that's probably one of the hardest things is how crippling it is and how you feel completely paralysed.”
“The crazy thing is, I was living in Paddington and apparently you're meant to have midwives come to your house as a follow up, check-up. But I was in a ‘black hole’ of support because my local hospital was technically St. Vincent's, but it doesn't offer obstetrics or anything. And they're like, ‘oh, it's just the way it is. You're just in a black hole of support for postnatal.’ I'm like, ‘how is that possible in an inner-city location?’ So I had no follow-up from midwives or anything to help with feeding or checking in, which certainly didn't help. That's certainly something I want to try and follow up a little bit more about why there are those black spots of support.”
“We made the decision to move in with my husband's family so that I could be surrounded with his family. My mum was close by, my sister's-in-law. So just to get a bit of a village as such around me, which initially was so helpful just to have connection, to have support, to have people like cook and help you.”
“But my symptoms were too severe or they became too severe for anyone that wasn't a mental health professional to manage. And I found that suddenly the depression was starting to kick in and I was having a lot of suicidal thoughts.”
“I would just be walking along the Cronulla Esplanade and picturing myself, throwing myself off the cliff. It was just this constant battle of ‘Just try not to jump off the cliff every day. You've got to stay with Emily. You've got to look after this newborn child.’”
“I think the other issue is I'm someone who has always struggled to ask for help, and I think I can just manage it by myself. And I think the acute feelings of failure were so dominant at that time. I was in so much shame that I couldn't manage. And yeah, I think I just started to withdraw more and more.”
“But it got to a where the suicidal thoughts got so intense that we decided to go to Prince of Wales ED.”
“I said to my husband and my mother-in-law, I was like, ‘I'm really feeling extremely suicidal.’ And we rung my GP. And then she was like, ‘okay, you should go to St. John of God, but I'm going to need to try and get you in. But in the meantime, maybe do go to an ED.’”
“And I'd given birth at Prince of Wales. So we're like, maybe we go there. But that experience was absolutely horrific and completely devastating because we're in there for six hours or seven hours. And by the end of it, they're like, ‘well, you can just come in here if you want to, but you can't bring Emily.’ And I was breastfeeding her at the time. So that just wasn't an option. And this is after hours of just sitting in there.”
“So just before we left Prince of Wales that day, we got a call from St. John of God saying that they had a spot, maybe two days after that. And I just felt this enormous sense of relief. And we went home and I said, ‘I can get through these next two nights before I go to St. John of God.”
“I was just in a daze. I felt like someone had taken me away. I was there, but my mind was so paralysed. It was so frozen. I couldn’t make simple decisions. I could barely hold conversations. Some of my friends had mentioned that when they came to visit, that, yeah, I was stooped over. I just looked so vacant, just in that dark, dark depression...”
Like so many of us who need an admission to a mother-and-baby psychiatric unit, Chloe did not know this service even existed prior to needing it. “I had no idea. I had a lactation consultant come to the house and she mentioned that. And we also had a night nurse come and help us a few times as well. And she said, ‘Chloe, if things really start to spiral further, there is this place called St. John of God.’”
“And I had that in my mind. I'm like, okay, there's somewhere. Thankfully, because I had private health, but yeah, so those two people raised it and then the GP as well. And she fought to get me in there. So that was great.”
In terms of waiting the two days until she could be admitted, Chloe says “It was probably better than before because I know I'm going to get some support. Someone can help me. I'm going to go to the hospital and I'm going to be surrounded by nurses and doctors and I can try and make sense of this.”
“I was definitely scared and I was deeply ashamed that, yeah, I was going to a mother-baby unit so quickly after giving birth, but there was a sense of relief in there as well.”
“So I had my first admission. It was unfortunately cut short because Emily got sick.”
“And you remember the very strict rules, obviously on any baby's being sick and the risk of infection and spreading. So the first two weeks, it was very difficult because it was a bit of the trial-and-error with medication. So not only are you feeling absolutely awful, but you're weaning off medication, going on different medication.”
“And yeah, I was just in a daze. I felt like someone had taken me away. I was there, but my mind was so paralysed. It was so frozen. I couldn't make simple decisions. I could barely hold conversations. Some of my friends had mentioned that when they came to visit, that, yeah, I was stooped over. I just looked so vacant, just in that dark, dark depression.”
“So we had to take Emily to Westmead because they were worried that it was an RSV-type situation. Fortunately, it wasn't. But I went overnight with her in Westmead, and then she just wasn't well enough to go back in, so I had to leave.”
“I was going to do the outpatient services with St John & God and still work with a psychiatrist and everything. So at that point, yeah, it wasn't the plan to go back as such.”
“I was like, maybe this medication will start to improve things. I also think I was just perhaps lying to myself, too. I thought maybe it was going to get better and I could manage with some other support in place.”
“And so my husband arranged for this amazing woman to...”
“Sorry, I'm going to get upset.”
“Something so beautiful that's come out of this is this amazing support we had from a beautiful lady who helped us look after Emily. She would come over a few days and just sit with me and hold Emily and take me to go on walks.”
“My husband thought we need this extra support, so I've got her to come and help us. But I just continued to spiral.”
“At this point, I started to think that I was never, ever going to get better. You know that feeling in that, this is me now. This is who I am now I’m a different person. You just lose all hope...”
“I would say that's when the melancholic depression really started to kick in. It was the not being able to get out of bed, the battle of trying to get yourself out of bed, trying to get in the shower, just those simple tasks.”
“I look back at that and I can really identify that was a shift from the severe anxiety into melancholic depression, which I understand is quite common. Often people can struggle with anxiety and then the body almost is so exhausted. Yeah, it goes into freeze state. So that's what happened not long after.”
“I remember one of my sisters-in-law said [to my husband], ‘your beautiful wife has disappeared.’ It's that sense of grief for them and that loss. And that's something he's working through now through his own talk therapy, that whole period.”
“Unfortunately, I did try to take my life, but I ended up in St. Vincent's Hospital in the PEC unit for a few nights, and they decided that I needed to go back to St. John of God.”
“But yeah, I needed further intervention with psychological help and to work out what was going to be the best form of treatment. And, yeah, fortunately, I was able to go back in very quickly after the PEC unit because that in itself is a very intense experience being in the PEC unit - a psychiatric emergency care unit - but that's where I needed to be. It's designed to be a short stay, like 72 hour maximum.”
“It was just me in there, and then I just wanted to get out of there. It was full on, and the doctors in there were able to contact St. John of God and arrange, I think I had two nights in there and they said, ‘okay, we've got you in in the next two days.’ So they said you could go home because in some ways I was getting worse in there, I think. Not through the fault of anyone.”
”I remember I had one night where I woke up in such a fright because I didn't know where [Emily] was in the PEC unit. There were those feelings of separation and anxiety over that, too, which were hard, but also thinking, I'm not well enough to look after this baby, and thinking, I need someone else to look after her because I'm not well enough.”
“It's such a dangerous condition because you're so acutely unwell, but you have a newborn child to look after.”
”But at this point, I started to think that I was never, ever going to get better. You know that feeling in that, this is me now. This is who I am now I'm a different person. You just lose all hope.”
“I didn't want to be anywhere. I just didn't want to be here. The thought of going back to St. John of God brought up, again, such deep feelings of shame and failure. I didn't want to be anywhere. I didn't want to be here. So that wasn't an easy transition.”
“I can remember my husband taking me there and I was just begging him, ‘don't make me go back in there.’”
“Seeing women come and go, which I was so happy for them that they were feeling better and they could be discharged. But I was also like, ‘when’s it going to be my turn?’...”
“This second stay was, I think it ended up being six weeks.”
“I think I had two weeks where the doctors were like, ‘okay, so this medication didn't work. Okay, this one didn't. We're going to try this one.’ But then they came to realise that it was treatment-resistant depression, which is that melancholic depression.”
“Within that hospital environment, obviously, they're able to rapidly take you off medications and increase because you're in that safe space. But they were like, ‘Chloe, what we're realising is that this is a melancholic depression.’”
“Those two weeks were awful. I just felt like it was just the same day in and out, getting up, going to the group talks, but being so dissociated and so vacant and just existing. And not feeling any better, if not worse, and convinced that this is it, this is my life now.”
“And seeing women come and go, which I was so happy for them that they were feeling better and they could be discharged. But I was also like, when's it going to be my turn? And I made some really beautiful connections in there. It was really hard to see people go. Yeah, but that's just part of it.”
“Eventually I did go, of course. But yeah, those two weeks, it was just existing.”
“It is catatonic for sure. People who came to visit and the doctor that I still see for psychotherapy who was with me in St. John of God, he said, ‘you walked so slowly, you were stooped over. There were a lot of sessions where you didn't say a lot. It was pretty hard to get much out of you.’”
“You know what I remember? You remember those meal cards we had to select? I could not get my head around getting that in on time. The decision about what to have for breakfast and lunch for seven days or whatever, how many days you did… I could not cope with that. And one of the staff who was always collecting the cards knew that and gave me so much patience and grace.”
“I just could not get myself together to fill in the meal card. That's where your brain's at with melancholic depression, and you're just so vacant. But the whole time that I was in there, I had this huge fear that I was damaging Emily for the rest of her life. So this was a recurring conversation that I'd have with the doctors. And that's very typical of melancholic depression as well, is that rigid thought process and that you're just so stuck.”
“And they’d say, ‘Chloe, that's not true. We're all observing you. Everyone said how wonderful your interactions are with Emily’ and friends who would come to visit would say the same thing. But I just I wouldn't listen. I was just deeply stuck that I had ruined her life.”
“They decided, because I was so entrenched in this thinking, they were like, ‘right, we're actually going to film you with Emily because we need you to see what we see.’ And only after that did I go, ‘oh okay, maybe I will listen. Maybe they're onto something.’”
“That was a big turning point for me seeing that footage after many weeks of me telling the doctors that they were wrong.”
“From what I understand now it's a very biological depression. Very physical. Hormones play a big role. There's a predisposition to this type of depression. But while it might not initially be very treatable by medication, ECT has extremely high success rates for melancholic depression. Yeah, which then with ECT can enable medication to actually work more effectively.”
“But that was extremely difficult for me to come to terms with because my father had ECT about 15 years prior, and he unfortunately had early onset Alzheimer's as well. But my memory of that time is that the ECT made him much worse in terms of his memory. But now I understand that that was probably more likely to be the Alzheimer's at play.”
“I think that the technology now with ECT is so much better, and there's been a lot more research into it, and it's actually far more common than people realise as a form of treatment.”
“But I was severely traumatised by that experience with my dad, so I did not want to do it. I was like, ‘no way, absolutely not! I saw my dad go through this.’ So there was a lot of back and forth. And yeah, sitting with the doctors and my husband, and they were like, ‘this is your only choice, Chloe.’”
“They said that the depression was too severe for TMS [transcranial magnetic stimulation]. It needed to be ECT. I remember other people in the unit getting the TMS. But yeah, they didn't even... They said, ‘No, this is severe. We need to intervene with ECT.’”
“And yeah, that was absolutely terrifying.”
“I like to think of it as the dark night of the soul, my time in there as well. That real reckoning with who you are and how you’re going to go forward and how you’ve changed. And I needed to go through that...”
“It was a hell of a lot of convincing.”
“I remember my mother-in-law came in to the hospital and we had a big chat about it and talk through the brochure and what the doctor said with my husband, and we were going through it all.”
“I have a couple of friends who were doctors, and they came in and they were telling me about the very high success rates for ECT and that it was a great option. Initially, my mum was very hesitant, obviously, because of what happened with my dad, but she actually sought some advice as well from a neurologist, and he said how effective ECT is, particularly for postnatal depression.”
“I didn't really go along wanting to do it, but I think the realisation that that was my last hope, otherwise it would have been, I think the other possibility was going on some medication that's more in line with treating schizophrenia, which has its own risks and is a real trial-and-error. They were like, you don't really want to go down that path. This is a much better option, essentially.”
“I remember with my reluctance to do the ECT, I think the hospital's protocol was to have another psychiatrist evaluate you. And unsurprisingly, the other doctor said, ‘this is absolutely what you need to do’. And I was like, damn it.”
“I made a start and I got through the first session. I didn't want to do the second session. Things started to turn probably about six sessions in.”
“I think the other hard thing was that knowing that I had to do 12 sessions, and it was three times a week, was knowing that I was going to be in there for another month, which was also hard to accept as well. But yeah, I was extremely reluctant and extremely emotional about it.”
“My doctor in St. John of God, because of how terrified I was of ECT, he came in deliberately at 6AM just to take me to the ECT suite which was just so lovely because you do it really early in the morning. But he's like, ‘I'm going to come in and take you to that first session.’ I said, ‘oh, you really don't have to do that.’ And he's like, ‘no, I'll do it.’”
“I was very scared and emotional. But yeah, that was really lovely to have him there, my husband as well.”
“But six sessions in, the light started to come back, a lightness. And the doctors always said to me, ‘you will be the last person to see it in yourself. Other people will notice it first.’”
“So my brain started to come back. It started to wake up again.”
“I can think again. I was like, I can have conversations. I started to realise things about Emily. I started to understand from another person's experience in the mother-baby unit about silent reflux, that maybe Emily had the same thing. But prior to that, my brain could not even compute the possibility of that. It was too overwhelming.”
“I was definitely able to connect more with the women in the unit because I could hold conversations and I would be more active in the groups. I even would go to the gym, like I got back into some exercise. I would go on days out with family or whatever, even if it was to the local Westfield, that was a huge win or going out and going home for a day or seeing friends. Those little achievements, those milestones of leaving the hospital. And yeah, just making really good friendships in the mother-baby unit, just coming back to myself.”
“It's a little bit murky, some of the the memories closer to that ECT, but I don't know if that's necessarily what I've come to understand the ECT as such. I think it's also depression affects your memory as well. So I think it's a combination of the depression going under general anaesthetic. But I do remember feeling so much lighter and more myself in those last couple of weeks and and being able to go out of the hospital and and do nice outings.”
“You just had to go through the motions. I like to think of it as the dark night of the soul, my time in there as well. That real reckoning with who you are and how you're going to go forward and how you've changed. And I needed to go through that.”
“And then it was my turn to go home, which I never imagined...”
“They describe ECT as a reset of the brain, and it very much was like that. The lightness started to come back, and I did my last session out of St. John of God, actually. I went home before that.”
”I think I still remember hoping that I didn't have to do 12 sessions. I was like, ‘I feel better now. Can we just cut it at six?’ They're like, ‘no, you got to do the full course.’”
“But after six sessions, I was convinced. I was like, okay, this is working. And the other thing was I went on another new medication, which was the right fit. It's called Venlafaxine, which is an SNRI, which I've never had before, but that was the right fit, finally.”
“And the ECT obviously helped that work better. And yeah, everyone was like, ‘oh, I can see Chloe again.’ Like the glimmers of who I was was returning.”
“I can't believe how effective it was. It was life saving and it got me back to be on a path to wellness and to go home and also start my journey as a mum who was well and the mum that I always knew I could be.”
“I remember the anaesthetist who was in there, he's like, ‘wow, you just you seem so much brighter.’ Like, you know I was so terrified going under anaesthetic and going into the ECT. And then suddenly I was like this convert. I was in there like, ‘yes, let's do this!’”
“And then it was my turn to go home, which I never imagined.”
“You can’t really do anything when you’re in those dark moments. And yeah, to be raising a newborn, it’s no small feat...”
“After being discharged, I've done weekly psychotherapy. And I think that has definitely helped me to view it differently, not from a place of shame, but of, as the doctor always said, he said this ‘no one could have predicted this was going to happen and why it happened. And it does happen to people. It can happen to anyone.’ But I look back at that now and go, and the other women as well that have gone through this, and I think, how incredible are we to have gone through that while raising a child? It's just you can't really do anything when you're in those dark moments. And yeah, to be raising a newborn, it's no small feat.”
“That regular, consistent appointments kept me on track. It was important for me to have those weekly sessions just to make sure that I didn't have any severe setbacks or what have you.”
“But I'm really pleased to say that hasn't been the case. And the other medication worked really well.”
“And then it was returning to work. I had a year off, which was really hard, actually, because you don't think that your year of maternity leave is going to entail going into a hospital. And so I definitely think the transition back to work initially was very challenging just because of what had happened. But it was also good. And I went back part-time, which was fantastic.”
“Yeah, I certainly have been much better. I haven't had any severe setbacks or anything like that, thankfully.”
“There's such a fear that you could go backwards and that you could have to go back into hospital. I think I had a lot of that after being discharged. It took me a while to overcome that fear of like, ‘oh, I'm going to fall backwards again. I'm going to end up back in hospital.’”
“But the more time that passes and the more you can see that you're well, that fear begins to lessen.”
“To look back… you feel like it was another life ago or something. It's a very strange feeling thinking back to that time. It's like looking back at a different person.”
“It almost feels quite unbelievable that that happened, even from this point and feeling so much better. Yeah, I look back in it now and I think, I was in the right place. I needed that support and yeah, I was just deeply, deeply unwell. But yeah, it is a strange feeling looking back to that time, I would say. It's hard to make sense of it.”
“It doesn't feel like it was nearly three years ago. It's a strange feeling to look back at that. It's hard to get your head around it. I think that's just going to take time, isn't it?”
“You were doing a good job. You just didn’t see it at the time...”
To end our conversation, Chloe reflects on the advice she would share with someone else feeling the way she did and what she wishes she could go back and tell herself.
“Reach out help. Do not suffer in silence and think that it's going to get better without support. Find that help, call on your family, your friends, whoever, and be willing to accept that help.”
“Sitting in silence and suffering is just, you can't do that in that situation. It's too dangerous.”
“I remember in the stay at St. John of God, when I was doing the deep Google searches of journal articles about the effects of postnatal on the development of a child, because that was really helpful in that situation, punishing myself! But my relationship with Emily now is amazing. We have such an amazing bond, and I like to think of it as a very secure attachment. And we have such an amazing relationship that there is absolutely no sign of any effect of what happened on her development. She's absolutely thriving.”
“And during her first year, we would go to a paediatrician because she had those issues with silent reflux and a bit of a lactose intolerance. And she would constantly reassure me that she was hitting all her developmental goals and I was doing a good job. But I can really see that now that I'm well. And yeah, we have an amazing relationship.”
“I think I would say to her that actually, in fact, you are doing a great job and that everything is going to be okay, even though it doesn't feel like it right now and that the darkness doesn't last forever. But yeah, you were doing a good job. You just didn't see it at the time.”
Listen to the full episode:
“The darkness doesn't last forever. But yeah, you were doing a good job. You just didn't see it at the time.” - Chloe
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