Original subtitles

The first thing we look for

is Rupert in the right mood for a massage? What do you think?

Well, he's quiet.

And he seems quite relaxed.

You OK?

Well done.

It's just Rupert's leg.

That's all it is, the same leg he's had all the time.

Same little legs that kicked you during pregnancy.

OK. How's Rupert doing, do you think?

I think he's OK. I think he's OK, too.

This is nice, Rupert.

How are you doing?

OK.

Now I've got my hands on him...

..it's actually not as bad...

..as I thought it was going to be.

I was spending time with women dealing with mental illness

brought on by having babies.

WHISPERING: Hello.

For all its joys, new motherhood can be a time

of extreme psychiatric difficulty.

In homes and in specialised units,

I was with families and staff

working to find a way back to recovery.

WOMAN CRYING

Exploring the wrenching challenges of caring for two people

in the most vulnerable states of their lives.

In Southeast London, I was on the Mother and Baby Unit

of Bethlem Hospital.

May I?

Hi, Catherine.

How are you doing?

Louis. Hello, nice to meet you. Nice to meet you.

This is Jake.

Hi, Jake.

How are you? You going to say hello? Oh, wow.

He's just excited about life, isn't he?

He is.

May I? Yeah, of course.

He's just started sitting up, as well. How old are you?

He's six months tomorrow.

Oh, wow.

It's your six months birthday.

Let's say hi.

How are you doing?

O-oh.

So, how long have you been here?

Four weeks now. Four weeks.

That's quite a while.

It's very long.

This is the nursery.

Yes. You have a little quick look in there,

that's where the babies sleep.

So overnight, there'd be a few babies in there? Yeah.

Yeah, Jake sleeps in there still.

And have they given you an idea of how long you will be staying here?

No, I think they've added a couple of weeks into my stay

from a couple of things I did last week, so... Oh, really?

Are you under section?

Yes. So you if you wanted to leave, it would be quite difficult?

I couldn't, they'd restrain me. Or if I managed to escape,

the police would end up bringing me back.

And as I understand it, you're on a one-to-one right now.

So, you've got your...

How are you doing? What's your name?

My name's Karen. Karen.

Louis.

So basically, in shifts,

someone will always be with Catherine? That's right.

24 hours a day basically, she's got somebody outside her room at night

and following her around all day.

That's quite full-on.

Yeah, I tried to take an over... I did take an overdose.

So, that's why.

When was that?

Last Wednesday.

So, the idea is to prevent you doing anything...

..harmful to yourself?

Yes. May I? Yes.

What happened?

Is that fun?

A project coordinator at a large business,

Catherine had a history of eating disorders and self-harm

as a teenager.

After Jake's birth,

she'd struggled with severe feelings of anxiety and depression.

Five months later, a psychiatric perinatal team

found her a bed at Bethlem.

I don't want to sound naive.

I would never have known you were unwell.

No. Are you just good at hiding it, or...?

Yeah, I'm very good at hiding it.

I think that's what... Like, with postnatal depression,

you could stand next to someone in the supermarket queue

and you'd never know that they might go home and completely fall apart.

Is that what it is, postnatal depression, in your case?

Or is it something else?

I think I've had a lot of issues bubbling under the surface

for a long time, for most of my life.

And it just exacerbates that.

Having a baby, it's such a massive change in your life, as well,

and no-one can prepare you for that. Mm-hm.

And we had a termination last year, about halfway through the pregnancy.

We had a diagnosis of a rare form of Down's syndrome.

So, we decided to terminate the pregnancy

and then we got pregnant with Jake quite soon after,

and I think that anxiety in pregnancy was so high

something might go wrong, we'd have to make the same decision again.

Once Jake was here, it was just such a shock to have a healthy, living

baby and even when we got him home,

it didn't feel real.

When I had to go in and give birth to the last baby we had,

even though it was only 17 weeks, it was still an actual real baby,

with fingernails and toenails and hair on his head

and Jake was born three weeks after the first anniversary...

..of his birth, as well. And he was a boy.

So everything just merges together for both of them

and every time I think I look at Jake, I'm thinking,

"This is what I can't do for my last baby."

He's a reminder of all that grief?

Yeah. And I think that's why I just struggled to bond with him, as well.

Just because I couldn't differentiate between the two.

But do you enjoy cuddling him and sort of nuzzling with him?

In all honesty, I don't.

And that makes me so sad to say that, as well.

I think that's one of the main reasons I took an overdose,

just trying to kill myself cos I don't feel I can be his mum.

Or he deserves better than me, or someone else should be looking

after him that can love him.

That was his four month picture.

Because he's a rainbow baby,

I decided to do a rainbow-themed picture. Really?

Every month until... What's a rainbow baby?

It's a baby born after a loss.

So, it's like a rainbow after the storm.

"Our beautiful rainbow is five months old."

"He has a smile for everyone and is definitely a charmer.

"Much like his dad."

"Baby Jake. Cute baby. Cute babies of Instagram."

It's almost like I've got to pretend that everything's OK.

That's role-playing a little bit.

It almost feels like Instagram has to portray a certain image.

Mm-hm.

And I had to pretend everything's OK and I can tell everyone I can cope.

When the reality at home was such a massively different story.

The Bethlem Mother and Baby Unit is part of a network

of similar facilities around the UK,

dedicated to helping mums experiencing serious mental illness.

Mothers are admitted due to a risk of doing harm to themselves

or to their babies,

living together with their babies on site.

Treatment takes the form of medication,

along with therapy and classes in parenting.

Do you think you know each other a bit more now?

I know him.

I don't know if he knows me.

The lead psychiatrist at Bethlem is Dr Trudi Seneviratne.

We're incredibly lucky in Britain because we will have 21

Mother and Baby units in this country.

Actually, we know that it's good for both of them, mother and baby,

to be treated together.

To sever that biological connection

and psychological connection would be a disaster

at this point in time.

How is it that pregnancy or new motherhood

can lead to mental illness?

Is it the physical trauma of the birth?

Is it hormones?

It's an absolute perfect storm of all of those things.

It can be the most planned or wanted baby,

but then you have the most traumatic delivery.

You haven't slept for weeks, days leading up to the delivery,

and then you don't sleep afterwards.

It's a very high-risk period when it comes to suicide.

At the worst end of the spectrum, you have a dead mother

and a dead baby. Doesn't get more awful than that.

A new mum was on the unit.

The diagnosis was postpartum psychosis.

Hello.

Barbara, from Spain, had come in two days earlier,

sectioned by police after displaying delusional thinking

and worrying, high-risk behaviour.

As with many such cases, she had no history of mental illness.

She was with husband Jordi and their daughter, Julia,

and was still experiencing confused thoughts.

So, how did you come in?

Can you tell me what happened?

Because Jordi got a job.

We... We decided to go to...

Sorry, I'm not feeling comfortable.

No, don't worry.

Why don't I ask Jordi? Jordi, what was it...

Yeah, I'm just part of...

You're just listening.

Yeah, and now we're curious because we've been talking other...

I don't want to interrupt you.

No, no, no, please stay.

Stay, I won't make you uncomfortable.

You stay, you'll be fine.

I want you, like, comfortable.

I'm very comfortable. I'm not.

Oh, no. What can we do to make you comfortable?

I don't know.

Don't make me feel part of...

Yeah. OK. Shall we not talk to you too much? No.

OK. Jordi...

If I want to... You'll chip in?

Yeah. Thank you.

Do you want to tell me, Jordi, what happened?

How is it that Barbara and Julia came to be here?

She's been going through some stress,

or maybe there's been too many worries

which are part of maybe living away from family.

And then last week, we had my parents over, for example,

and that was an extra worry for her.

I think just all of these together, we've reached this boiling point

when she kind of...

Her brain snap or kind of broke.

I would say...

I'm not making him comfortable.

No, I'm fine. He's fine.

I'm just trying to remember exactly what happened,

because I don't want to be saying lies or anything like that.

So, she couldn't sleep, and during the sleep,

she was just worrying about all the things, everything again.

That we were going to leave her.

That we were going back to...

..we're going back to Spain without them, and all this kind of things.

And she then ran away from home and she went to the train station.

She said that she was going there because she wanted

to commit suicide or something.

She wanted to throw herself into the train.

And sometimes, like now, she's also having these kind of thoughts.

Well, I was going to ask. So, how are you doing?

You OK?

Yeah, yeah, I'm OK. Was it OK listening to that? Yeah.

Yeah? Do you remember that?

Yeah, I remember, more or less. Yeah.

How are you...

I think he's having the postpartum...

How is called?

Psychosis. Psychosis.

Who is? Jordi.

You think Jordi's having postpartum psychosis?

Yeah.

It is part of all the confusions that she is having.

And, like, when we came here, for example,

she was saying that she wanted to leave

and go home because I was the mother.

So, it was me, the one that had to stay here with the baby.

Jordi was saying there was a time when you were distressed

about his parents, and also that you went down to the train station.

Do you remember that? Yeah.

And you do remember that you...

Was it your feeling then that you wished to harm yourself?

Yeah. Because I'm not having like a postpartum...

Psychosis?

I'm having, like, a depression of all of my life.

I had the thought that Jordi's going to be the...

I don't know, maybe the brother of Julia.

As well as the father?

And the father, yes.

And then, for me,

I've been the mum of Jordi.

Have they given you any idea of what to expect here in the next...

..few days or weeks or however long it will be?

I don't think we have an expectation

of what we should be expecting, apart from that she needs

to get some rest and she will get better.

But we don't know, like, when.

I don't know...

..how to find the way that this unit is helping me.

I haven't found anything.

An average stay at a mother and baby unit is around ten weeks,

though this can vary widely.

Mums are discharged when staff decide symptoms are under control,

or when the baby turns one.

How are you feeling?

I feel quite scared. Yeah.

In Melbury Lodge, a Mother and Baby unit in Winchester,

I was with Lisa and her psychiatrist, Dr Catherine Bundle.

Lisa was close to being discharged.

I don't want to be here, but I am terrified.

Of going home? Yeah.

What's your biggest fear?

That I'm not going to be good enough for my family. OK.

That I'm not going to get back to...

..me.

I think you have come a long way, Lisa. I agree you're not 100% well,

and the rest of that journey needs to happen at home.

But, you are so much better, objectively... Yes.

..than you were when you came in.

Oh, gosh. Oh, gosh, yes.

Has she still got the baby smell, do you think? Yeah.

Got the baby cheeks.

Oh, yeah, she's got those baby cheeks.

Do you want a Mummy cuddle?

Lisa and Isabella, or Bizzy, were the longest term

patients on the unit.

She'd had postnatal depression with previous children,

and had come to Melbury after a series of psychotic episodes.

Is that your new buddy?

Have we made friends? I think you have!

Can we talk about how this all started?

Yeah.

After I had Isabella, I felt like I was absolutely nailing it.

I was taking all the kids out together.

When she was about three weeks old,

I took all three of them to the cinema.

And I'm like, "Yeah, I've got this."

So, this sort of...

I mean, maybe, "Came out of the blue", is a little strong,

but it was unprecedented?

Yeah, it was.

Isabella had been exclusively breast-fed

and I had a hen do in Marbella.

She was being a real pickle with taking a bottle.

So...

We almost had to go cold turkey.

And then when I came back, the Wednesday night,

I called Andy and said, "You need to come home from work early.

"I can't look after these children."

And then, from then on, I pretty much stayed in bed for two weeks.

Well, so was it? There was...

So, the hen...

Do you think the hen...

You're not saying a hen do had anything... It was the drop.

So, what they're saying is that because I dramatically

stopped breast-feeding, the drop in hormones...

..triggered psychosis.

Can you talk more about that feeling of being overwhelmed

when you got back?

There was a moment you called Andy, did that just creep up on you,

or was it... It was instant.

I called him and said, "I can't look after these children."

Why did you say that? Because I didn't want to be near them.

There was a complete overwhelming of me.

I think there are lots of parents who've had kids in the house

and they've called their other half and said, "I can't deal with this."

This was different.

This was like...

..almost like a total breakdown.

I couldn't speak, I didn't wash for days.

I was eating dinner with Andy and I...

I just said to him, "The house is about to be invaded by clowns."

Clowns? Literally...? Clowns.

Like, killer clowns.

Killer clowns were going to come in,

and rip us apart, destroy our house. Like, it...

And it was graphic, what I could see.

At the time when this was happening, it made sense to you,

the idea of the clowns? It was real.

It felt real to you? It was real. Yeah.

You're not in touch with why that made sense to you, then?

No. You can see now that that was ridiculous, right?

But I can still feel the fear from it. Can you? Yes.

I'm interested in this thing you said about,

it was almost instantaneous when it happened.

In that moment, your life changed.

You had a life of being mentally well, and then...

And then, it sounds like in one moment, you went through something

that was transformative.

Something changed in that moment.

And...

..led me to the path where I am now.

The family home to which Lisa will soon be discharged

is an hour's drive away in Horsham, Sussex.

I'd arranged a visit with her husband, Andy - an IT salesman.

We met when I was about 24, I think Lisa was 21.

We fell for each other.

We split up, we got back together.

That's a nice one.

Lisa looks beautiful in that.

Yeah.

Beautiful lady.

She said that when Isabella arrived, for the first few months,

she felt completely on it.

She felt like she was in control, as she described it.

You know, she was just nailing it.

Would you agree?

Yeah, I would.

I don't like using the phrase, I think it's a bit silly

but SuperMum comes to mind with Lisa.

She's the most caring, motherly woman.

So, to suddenly see this behaviour,

I knew there was something very, very...

..wrong.

One evening,

she phoned me up and said, "I'm struggling. Can you come home?"

And I didn't really think anything of it at that time.

You know, she's allowed to be tired.

She was looking after three children.

So, I just assumed she'd had a tiring day.

She didn't seem completely out of character, or...

No, no, she did just seem like she was tired.

But over the next two weeks,

the decline in her mental health I watched, was utterly alarming.

Watching her personality disappear and...

..not really knowing what on Earth to do about it.

How many months has it been that she was...

..she was at the unit?

Three and a half.

Three and a half?

How have you found that? Really hard.

I've tried to play mummy and daddy to Amelia and Jake.

Obviously, Amelia being six, that means she's aware.

What have you told her? Mummy's unwell.

The illness is in her brain.

When she first went into hospital, I said, "Have you noticed Mummy

"hasn't been fun Mummy the last couple of weeks?"

She went, "Yeah." I said, "That's why she's gone to hospital,

"because fun Mummy isn't there at the moment,

"and they need to try and help her to get back

"to who she normally is."

Have they given you...

..an indication of what to expect in terms of recovery?

No, there's no timescale associated to it,

but given the time and the support she needs,

she will get back to who she was beforehand.

The physical and emotional trauma of giving birth and coping

with a newborn is, in many cases, aggravated by a sense of unrealistic

expectations of what having a baby is like.

The gap between how society tells mums they should feel

and the reality that may be more complicated.

I'd been spending more time with Catherine.

Hello! Hello!

Oh, Jake, you do stink.

What, has he done a poo?

Yeah. You know you have.

You can change him if you want. I can take a little...

Are you sure you're ready for that? Yeah!

Been a couple of years but the skills are still there.

Oh, my goodness.

Get those wet wipes ready.

Here we go.

Oh, yeah.

I recognise that.

Not too bad.

At this age, it's not really poo. It's sort of...

There's been some awful ones.

Once you give him food, it's... Oh, it stinks.

It made me gag the other day. I take that back, it is a bit like poo.

It's not brown, though. It's mainly milk.

It's like a mustard. Yeah.

Yeah. Yeah, I know what I'm doing.

Yeah. Willy's pointing down.

OK.

Catherine was off her one-to-one.

She'd also received a new diagnosis

of emotionally unstable personality disorder.

A set of traits, often involving impulsive behaviour and self-harm,

that can't easily be treated with medication.

A few days earlier staff had filmed her playing with Jake

to build her confidence in parenting.

The developmental psychologist Robin Schacht was offering her feedback.

Well, the first time I met with you, I said,

"I think you have really good instincts."

It just seems that...

As you said, they can't come out.

So, what I wanted to point out here were a couple of moments

where I thought you were...

..doing it.

So, I think what he actually really enjoyed here

was getting the eye contact with you.

You kind of got down in his line of vision and connected with him.

It wasn't the toy.

It was you that brought the smile.

That's quite sweet. Yeah.

It makes smile watching, actually.

Can I chip in a tiny bit? Yeah.

We've spoken quite a bit, Catherine and I.

And what's always struck me is that she...

That you are really good with Jake, basically.

And that you know what to do.

And you know how to look after him.

But what's always struck me, as well, is that you've spoken

about not feeling connected.

So in a way, it doesn't surprise me that Catherine's got the skills.

What I'm wondering is, how do...?

Does this help?

Can we help with respect to the feelings?

Does that make sense? Yeah.

I've never had any doubt that practically, I can care for Jake.

It's just the emotional connection, really.

So you've got this fear that you need to grow the feelings

to make them enough to get well?

Yeah, that's quite an accurate description, actually.

And hopefully that's what this will help.

And spending more time with him and learning to love him, I think.

There's a part of me that always wants to say,

"Well, I think you do love him."

I think you...

I see that you love him.

And yet, if you don't feel that, then that's different.

So, it's complicated, isn't it?

I don't want to sort of invalidate what you're saying.

I think what I'm expecting is a rush of love.

And I had that for the last baby,

when we saw him there was a rush of love.

The one that died?

When Jake was born, there wasn't that feeling there at all,

because there's still an overwhelming feeling that something

is going to go wrong, because it did last time.

So part of it is self-protection? Maybe.

The feeling of connecting would then mean

a risk of you feeling awful,

if and when something went wrong.

It might be that my baby died before I could make the decision,

and that's like the worst thing that could possibly happen to someone.

If I didn't get attached to Jake,

and the worst thing possibly happened to him,

then I won't be hurt.

You said you felt a rush of love for the other baby.

The other baby,

was he dead when you saw him?

Yeah, he was effectively stillborn. Yeah.

I mean, that's one of the saddest things I could imagine

and the feeling of love would be in a way...

..just very uncomplicated.

In the sense that it's a sense of grief

mixed with love, which is very powerful.

And you've got all these feelings for a baby

that you haven't met properly or you don't know.

Right, and there's strange feelings of sort of regret

and maybe, probably, a feeling of guilt.

Guilt. Massive guilt.

And there's remorse.

And remorse.

And then when you see Jake, it's different.

You're not going to feel that.

It's a different feeling when Jake comes along.

And there's still guilt.

In that I don't feel the way I felt for the last baby,

and that is horrible,

because Jake wouldn't be here

without having to make the decision we did either.

And then Jake was such a wanted and planned-for baby.

And yet the feelings for him are completely different.

But I want, I do want to feel something for him,

and I do want that rush of love

and I want that overwhelming urge to protect him.

So that I don't...

So I can say that I will do anything for him,

like most people would say that they'd do anything for their kids.

And by the time I leave here, I hope that will happen.

Listening to Catherine describe her difficulty feeling a connection

with Jake was sad and strange.

Part of me questioned if they were her real feelings.

But I also wondered about my urge not to believe that a woman

could be indifferent about her child.

When people say they don't feel anything for their baby,

it is absolutely real,

because these things are on a spectrum, aren't they?

And even some resentment, I suppose.

Resentment, yeah. Feeling nothing.

Almost hating the baby, wishing the baby were not there.

Dead, sometimes.

It's because people hide what they're really feeling.

It's meant to be a happy time, isn't it?

The business of having a baby is supposed to be a really happy time,

so, because of that,

people put on all sorts of masks to hide what's really going on.

Where Catherine was struggling with the sense of not being bonded,

with other mums the connection is there.

But feelings of depression and anxiety exist alongside it.

Come on.

Ah!

So, next Thursday, we're going home.

What's her name? Poppy.

Poppy.

25-year-old Marie had given birth to Poppy five weeks earlier.

She'd had no issues with her feelings for Poppy.

Nevertheless, she'd experienced suicidal impulses

and admitted herself to the mother and baby unit.

So we've been here about two weeks. Yep.

What brought you in here?

Basically, I had a very, like, traumatic birth,

so she's nearly five weeks in June.

And I think the first week after she was born,

I was in A&E four times, saying,

"Please help me, because I'm going to do something."

And I just was really low and felt

like I couldn't look after her and stuff, so...

Really? So when you say traumatic, you don't mean...

I thought you meant physically.

It was, yeah. Physically what happened?

Physically and mentally. I was in labour for like 36 hours.

Really? She had to be delivered by forceps, as well.

So I very nearly ended up having a C-section,

which I didn't want to have.

I didn't want to have pain relief.

In the end I had an epidural,

so everything I didn't want to happen happened.

So, that was upsetting. Yeah.

And then that had an effect on your mental wellbeing.

Yeah. ..which felt like what?

How did your experience that?

Just... I felt really low in myself, I felt like I wasn't able to

cope with her, and then I was having suicidal thoughts,

thoughts about self-harm and stuff like that.

Really?

Yeah.

One thing that's been explained to me is the idea that, you know,

having a baby is a huge physical change, and that that brings with it

emotional and hormonal changes that can be a lot to deal with.

The birth brought up a lot of stuff that had happened in the past

as well and that was kind of quite traumatic.

Stuff that hadn't been dealt with properly before.

What kind of thing? Erm...

A couple of years ago I was assaulted,

and...

..obviously, giving birth, there's a lot of people around...

..that kind of part that you don't really want people to be around.

Yeah.

And so it kind of awakened feelings of...

The sort that I end up having, like, flashbacks and nightmares and stuff,

about which I hadn't had.

That was nearly three years ago and I hadn't had any of that

for a little while.

And now it's all started again, which then obviously doesn't make me

feel great after that either.

And the good part, though, is that it sounds like your relationship

with Poppy's strong.

Yeah.

I've never had a problem bonding with her. Mm.

And she is the most perfect, the most amazing thing that I've ever

done in my life.

Which is why it makes this so much harder,

because this isn't the way it was supposed to be.

With her partner James visiting, Marie had her weekly catch-up

with the clinical team.

The first topic was a recent home leave she'd had to cut short

due to a panic attack.

So I'm just interested in what the crisis was, actually,

when you went back home for the day?

It was nightmares, wasn't it?

Yeah, Marie had some pretty vivid nightmares about our relationship.

OK.

And I think it really unsettled her. It wasn't just that.

Was it not?

No. Oh. That's what you told...

So do you want to tell us what was...

Everything that had happened before that as well.

Oh. Yeah.

It's not... Yeah.

Can you tell us?

About being attacked and stuff.

OK.

HE SIGHS You should've told me.

Didn't want you to get upset.

Well, look, one of the things we know is that sometimes trauma

from the past come back when...when women have babies.

Yeah?

So it's just... So I guess it's sort of working through that

and working out what you need at this point in time.

Just thinking, Louis, is there anything that you wanted to ask

at this stage? Erm...

I was just struck earlier on when you were talking about

your nightmares, and then you'd said that you didn't tell James

because you didn't want to upset him.

Yeah.

See, I don't understand, cos you told me the one about

the relationship.

Because I didn't want you to think... I know how you feel about

what happened, and I didn't want you to think it's still...

Basically...

..the night it happened I was already at home.

Marie sent me a message saying...

.."Can you come meet me from the station?"

And if I'd have been three minutes faster, I'd have caught him

before he could've hurt her.

So it is actually my fault... It isn't.

..that this happened. It isn't your fault.

Don't say it was your fault because it isn't your fault.

I should've stopped him.

Don't get upset, because it's not your fault.

And you couldn't have stopped him because he was

going to do it anyway.

I should've broken his legs.

I'm sorry.

Marie and James were a striking example of the way in which a mental

health crisis ripples out, affecting relationships and families.

Recovery too is a joint enterprise,

requiring understanding and support from loved ones.

Hello.

Can we come in?

I was in Horsham, Sussex.

Ready for a cuddle?

Oh! Oh, look...

Two weeks earlier Lisa had been discharged from Melbury Lodge,

though she was still getting weekly visits

from the perinatal team.

She was now living back at home with Bizzy and her two other children,

six-year-old Amelia and three-year-old Jake.

LAUGHTER

Look at that!

Mummy, I've done a big poo!

You've done a big poo?!

Oh, my goodness!

Look at the size of that bad boy!

Has he done a big poo?

Can I see Jake's poo?

Look. Wow, look at that - it's like a man poo.

Well done, Jake.

Since returning home, Lisa had been relying on round-the-clock support

from family members.

Today her parents were on hand.

She was also suffering the side effects of high doses

of anti-anxiety medication.

So how was it coming home?

It's been quite a...

..tricky transformation, or...

Transition? Transition's the word, yeah.

Up and down?

Yeah, much more downs than ups.

There's been some days where I've not been able to get out of bed

at all, and...

Oh, really? Erm...

Because of what?

Tiredness?

Like a severe... Well, yeah, I'm constantly tired but, like,

this severe anxiety - the anxiety continues to be the main problem.

And...

You go in and play in the other room, darling.

No...

I want to see Isabella.

Erm...

We can wait, if you'd prefer to wait and talk about this.

Yeah.

Do you understand why Mummy was in hospital?

Why was Mummy in hospital?

Because you weren't well.

Do you know why I wasn't well?

No, you don't really understand it, do you?

You just missed Mummy.

What's it been like having Mummy home?

Good.

BABY CRIES

All right!

It's coming, my little love.

SHE BABBLES

You want to sit there?

Yeah. What do you want?

Only ham.

Well, take the cheese out then.

BABY SHOUTS I know.

Life's like that.

Eat it properly.

Life's like that sometimes... Nicely!

Trap the car, trap the car... Trap the car, trap the car!

Collapse.

Straight arm. Here it comes.

Yay!

How are you doing?

You look tired.

Yeah, I'm quite tired... You're exhausted.

Yeah. Quite exhausted.

I just feel really flat, just nothing.

But this is the time where I'd be screwed if I didn't have support,

and I get a lot of anxiety, fluttery feelings.

You're getting that now?

Yeah.

And I should be taking her places.

I should be getting her out for walks.

I should be playing with her more.

I'm not...

I'm not.

I feel like I'm failing and I'm failing my family.

Well, it's one step at a time, isn't it?

You're still...you're still in the early stages of recovery.

Yeah.

Oh!

It's just I see the children as, like, a complete...

Complete hard work.

You don't feel you're getting pleasure in them the way

you used to? Is that what it is?

I mean, we've all felt that at times. Yeah, yeah.

Yeah. Sometimes it just feels like... Mega hard work.

Mm. Yeah.

Thank you.

CHILDREN SHOUT

Hello, Mummy!

Hi, Daddy! Daddy!

How you doing, mate, you all right?

Oh...

I left Lisa with a renewed sense of the challenges that lay ahead,

marvelling at the unfairness of what she was being put through

and the reserves of strength she was having to draw on

just to keep going.

It's a painful truth of recovery that it often involves hiccups

and back steps.

At Bethlem, making the process even more complicated was

an outbreak of the norovirus.

Many of the mothers and babies were confined to their rooms

to contain the illness.

Catherine's baby Jake had been taken home to recover,

which was contributing to her feeling unsettled.

I joined her and her partner Chris at their weekly clinical review.

The week hasn't been very good, because Jake hasn't been here.

So my anxiety is just through the roof at the minute.

I'm just trying to... Because he's not here?

Yeah. It's just because he's not here and then being with him,

reunited with him, makes me a bit anxious again, and it feels like

it's starting again, really.

Yeah.

I think what would be nice over this week is to get Jake

back in, get some normality.

Yeah. Just some interactions, have some fun with him.

Well, you have been depressed, and your Mirtazapine could go up a bit.

So I think we should increase that. Millie, what do you reckon?

Increase it to 30, I would say, because then you still have

the sedating effects at that dose, but also a good effect on mood.

And let's see if we can get Jake in today.

Yes, that'd be very good.

Did that go from all right for you?

Yeah. Still a bit weird. It's always weird.

What was the weird part?

This all seems a bit...I don't know,

like no-one really knows what they're doing.

I think they know what they're doing.

But objectively you've been doing really well, in the sense that

you went home, didn't you, and that went smoothly?

It didn't feel like it. But you don't...

But it did, but it didn't feel like it.

Why not?

To me, it felt really hard.

On the outside of it, it looked like it went fantastically,

compared to how other events have gone.

It's more about your perfection of the idea of what you think

it should be.

What I've heard from Catherine, over the sort of weeks,

is that she's a bit of a perfectionist.

There is... That is a way of describing it, absolutely.

You're very lucky you've got Catherine with no make-up on.

I know. That's unusual for us.

Later that day, Catherine was granted some unsupervised leave

around the grounds.

She failed to return on time.

Police, please.

It's a concern about an AWOL patient.

Staff were in crisis mode, attempting to track her down.

Hello, Catherine. It's Debbie from the Mother and Baby Unit here.

I'm wondering If you could give us a call, please,

when you get this message.

I returned to the unit.

With Chris, she's said that she's communicated with him that she wants

to die, saying, "I'm gone. I love you but I want to die."

That's the last communication he's had with her, so we need to get

back onto the police straight away.

PHONE RINGS

Hi, Mother and Baby Unit. Nicola speaking.

Hiya, Chris.

Right, OK.

What exactly has she said?

Yeah, we're literally on the phone to the police now -

we're trying to get through, so we'll get them to do that.

What did Chris say on the phone?

That she's basically said, "That's it, it's done",

and she's taken 65 tablets.

And he has no clue where she is?

No.

Has she done this before? Yeah...

Yes, yes, there's a history of it.

Yeah, yeah. The reason she's here is because of her relationship

with her baby.

Yeah.

Her family believe if she's saying she's taken an overdose

then she has taken an overdose.

Ten hours after she'd gone AWOL, at about 3:50am,

Catherine was found by police in a nearby hotel,

drunk, having consumed an overdose.

She was taken to A&E.

So, Hannah is with her at the minute.

Catherine is very regretful of her actions from last night,

very worried. Yeah.

We haven't had any further update but she is awake and up-to-date

and talking with staff about how she's feeling.

She will likely be in hospital for a few days.

She's on IV fluids currently.

While Catherine remained in hospital, psychiatric staff would

be keeping an eye on her round the clock.

Hiya.

Buenos dias.

Buenos dias. Que tal?

Meanwhile, elsewhere on the unit, Barbara, the mum from Spain

who'd been experiencing postpartum psychosis had made

a marked improvement.

So, look, you are our Christmas miracle, basically.

Another one.

How are you feeling?

Yeah, much better.

Yeah.

I've been seeing, like, a good improvement, yeah.

From my point of view I feel like...

Yeah, now I'm aware of everything, I'm back.

Yeah, I would say I'm back to where I was before, more or less 100%.

Nearly there, nearly there.

You're nearly there, aren't you?

Yeah.

It was really nice for you to start talking a little bit

about the whole experience that you'd had of becoming a mum,

and everyone had been really busy working and focusing

on their own lives, and then suddenly this baby had arrived and

perhaps both parents didn't feel quite prepared for that.

You're aware that you don't tend to talk about your feelings so much

and that you were thinking about whether the two of you could benefit

from just talking a little bit more as a couple about, I guess,

about being a new family.

It was less than four weeks ago, wasn't it, that you were at sort of

the depths of your illness, and you were at Balham station,

and to be that profoundly ill, and then now...

..from what I can tell, so, so much better.

Yeah. It's kind of exceptional.

At least it seems from the outside that it's completely fine

from when she wakes up until she goes to sleep.

She's been taking care of Julia day and night for almost a week now.

So...

At least she's on the right track, I would say.

In cases like Barbara's, where there's no previous history

of mental illness, postpartum psychosis

nearly always leads to complete recovery.

The only significant cause of reoccurrence is coming

off medication or having another baby.

Conditions like anxiety and personality disorders tend

to be more deep seated and recovery more difficult.

He seems happy.

He does like being a Christmas pudding!

There we go.

Catherine was back, having been discharged after four days

in A&E following her overdose.

Are you a Christmas pudding now?

Yeah, I want a piece of Christmas pudding.

We'll be the Christmas pudding guys! Look at you standing up.

All right, hang on, let's see how this goes.

No, no, no. Just careful.

Puddings, puddings! Jake! Paparazzi! Puddings!

How are you doing? Better. Mm.

I mean, I'm out of bed and I'm dressed, so...! You are.

You had quite a time of it? Yeah.

We were worried about you.

Yeah. It wasn't...

I don't even know what happened. I was like, suicidal anyway, I think.

I was quite on the edge.

Well, I'd seen you that morning. Is that day clear to you?

We had the ward round, do you remember? Yeah.

Although I'd been on leave that weekend, everyone said,

"Oh, it's gone really well", because there's no drama,

I didn't feel like it had gone very well.

I think, after a drink, I just thought,

this is my opportunity, whilst I was out.

Opportunity to do what? To kill myself, really.

I'd say. Yeah.

This guy's getting restless.

Come on.

What is it? Are you tired or are you just being silly billy?

Are you being a silly billy?

You're making some funny noises.

So, basically, erm...

..having done it you had second thoughts? Yeah.

I think once you've done it you kind of think,

oh, crap - like, what have I done?

Cos you never really know if that's definitely the end.

And then afterwards when it doesn't work, you think,

oh, you've failed again.

Especially when you're lying in a bed in A&E then...

..I was quite ill.

It sounds like, I mean, at the risk of oversimplifying it a bit,

there's all sorts of ambivalence, isn't there?

Sometimes it just feels so horribly overwhelming,

the whole thing of just being a mum and the responsibility

that you have of raising a little human with their own issues.

I don't know, maybe there's... Sometimes I...

..I can see where I want to be.

I can see where I want to be at home and how I want to be.

But it's like a weird mental block of actually getting to that point.

How are you doing, Jake?

Jake?

What? You all right?

I do think, cos it's the first five months of his life,

I just pretended everything was OK and tried to manage at home.

And if I admitted earlier that things weren't right,

and I had come here when he was a lot smaller,

perhaps things would've been a lot more different now.

And I think that the love...

..or let's say the connection...

..that there is there,

sometimes you struggle to feel it, to see it,

that it...

..that it is there. And with time you will come to...

..see it more clearly.

Yeah.

Or I'm not allowing myself to feel it, maybe.

I think that's half of it as well.

Catherine's expression of feelings was encouraging to hear.

At the same time I couldn't help recalling it was just a week earlier

that she'd attempted to take her life.

Recovery may be in part a process of not pushing too fast

and recognising how much is realistic.

Hi, guys! Hi, Jake. How are you?

Don't you know there's no such thing as a gruffalo?

It was now two months since Lisa had been at home,

and six months since her first symptoms.

I love you. Do you want me to take that?

Her continuing feelings of anxiety meant she'd largely been confined

to the house.

Today would be the first day of her doing the school pick-up.

Her best friend Charlie was coming along to offer support.

What's he doing? He's getting closer.

He's doing something with that camera thing up there.

That construction thing.

But he might actually do something to us?

No, he's absolutely fine. We're nearly past him.

No, I don't like... I know.

You all right? You're all right, OK? I promise you, you're fine.

Do you want to stop for a minute? Yeah. Yeah?

I don't know where the children are. They're up with Louis.

She just needs five minutes, sweetheart. OK?

I know I'm ridiculous.

And that is the worst thing, because I know I'm ridiculous.

But you're not, and you've handled it really well.

Lisa and Andy were still relying on family support

throughout the week.

She was also having regular visits from her local mental health team.

While Lisa's in-laws did the night-time routine,

I had a moment with her and Andy.

Lisa had mentioned there were a tough couple of weeks,

sort of over the holidays,

where she was not in a good place, mentally,

wishing to do herself harm, among other things.

Yeah. Throughout all of this I'd always said I'm not suicidal.

Yeah, but then when you did feel it, you did.

When I did feel it I was like...

It was - I can't remember exactly where we were or how it happened now

but you literally turned to me and said, "That's it. I now feel that way."

And I just thought, oh. What way?

That she wants to end herself.

Really? Yeah. You're also aware you have a husband who loves you.

You've got three children who love you and need you.

Erm, that these are things that you need to consider.

Was that in your head? No, not at all.

Going through that, I understand why people kill themselves,

whereas I've called people selfish...

..I, erm...

..I totally get it.

But some - but I was... But why?

Is it just an overwhelming irrational...? It is,

almost like a craving, desire,

this strong overwhelming desire

that didn't leave me for nearly three weeks.

I was going to say, it was a period of two or three weeks.

Is it still reasonable to expect a full recovery?

Yep. That's still basically what they're saying? What they're going for, yeah.

I'd be lying if I said I didn't have moments of thought

where I think, crikey, will it?

It's just a case of managing how we try and get you back there,

because, as you say... Well, I don't think I'm ever going to be the same Lisa,

because I don't think I can be after this.

I mean, you'll be a different person.

You're someone who's lived through a serious...

..sort of emotional or mental episode.

Do you think you'll be reduced in some way?

Is that what you mean? Or are you just...?

Time's creeping on, and...

..I'm still bonkers.

It's an illness and it means that you're not...

..not where you were.

I just want to wake up and feel...

..not scared of everything and...

This is really crap.

Like, really crap.

Lisa's continuing issues were a reminder that the road back

to health could be long and difficult.

And yet it was also true that even in the most trying cases

there were reasons for hope.

People often come in and ask me, "How long is it going to take?"

I always say, you know, "I haven't got a magic wand here."

These are not quick win conditions.

It's also important to say that actually even when mothers do

have mental health problems they do their utmost to make sure

the child is OK.

So just because they've had a mental health problem does not mean

that they will be an adverse effect on the child.

Although we're dealing with the most severe mental health problems

all the time, and the most severe end of risk,

you know, it is joyous to see new babies

arriving all the time and it's, you know, utterly joyous to see people

getting better and going home.

There had been some good news.

Look out! Trouble. The...

BABY CRIES Escape attempt!

Prisoner has been apprehended.

How are you doing? Good to see you.

Catherine was back living at home with Chris and Jake,

having made a remarkable improvement.

So are you living here now? Yes.

What do you think...

..was the turning point?

They did increase the medication. That did help massively.

Really? Anti-depressants. Yeah.

And I think there has to come a point where you have to change your thinking.

A lot of the work they've done in there is, you think, oh, it's never going to change,

it's never going to help. I don't know why they're doing this.

And sometimes before you know it, like, things have changed.

Does that make sense to you as well, Chris?

I mean, what does it look like from where you're sitting?

We're clearly in a much healthier place

in terms of, erm, coping

and the tools and the support that we've been given.

It is one day at a time, but it is clearly night and day difference.

Absolutely.

You know, a lot of what we talked about from the beginning was,

you know, connection. I mean, how do you feel about that now?

With Jake? Mm.

Absolutely fantastic now. Really? Now I have really good relationship.

Yeah. Isn't that something?

Now, I think coming through this,

I can actually say, "I love my baby."

Catherine's apparent recovery was heartening to see,

a testament to the possibility of change.

Aw, that's nice.

In speaking to all the mums I'd met, I'd seen the most extreme versions

of feelings familiar to many new parents,

but that had tipped over into acute mental health crises.

Making it worse was a weight of expectation about motherhood.

But I'd also been struck by the courage of mums opening up

about their worst fears and anxieties,

doing their best for their children in situations of the utmost adversity.