0:00:02 > 0:00:06This programme contains some scenes which some viewers may find upsetting.
0:00:06 > 0:00:10The birth of a baby - one of life's happiest moments.
0:00:10 > 0:00:13But for some women, about one in 500,
0:00:13 > 0:00:17childbirth can trigger a terrifying roller coaster with the sudden
0:00:17 > 0:00:21onset of severe mental illness.
0:00:21 > 0:00:23Are your thoughts jumping around a bit?
0:00:23 > 0:00:26I'm mad as a box of frogs.
0:00:26 > 0:00:29There were all these rows of trees and I thought about hanging
0:00:29 > 0:00:31myself from one of them, but I don't want to do that.
0:00:31 > 0:00:33It's a challenge to you. You're my psychiatrist.
0:00:33 > 0:00:35You want to know what's going on in my head
0:00:35 > 0:00:38and I want to know what's going on in your head.
0:00:38 > 0:00:40What Hannah and Jenny are experiencing is
0:00:40 > 0:00:43a condition that is almost unheard of.
0:00:43 > 0:00:45Postpartum psychosis.
0:00:45 > 0:00:50New mothers are overwhelmed by extreme low or high moods,
0:00:50 > 0:00:53strange and dangerous thoughts,
0:00:53 > 0:00:56paranoia, delusions.
0:00:56 > 0:00:58Good God!
0:00:58 > 0:01:01I might be Prime Minister by the end of the day.
0:01:01 > 0:01:05Postpartum psychoses are the most severe illnesses that we
0:01:05 > 0:01:09see in psychiatry, but it is also an episode of illness that women
0:01:09 > 0:01:14recover from and can recover from quite quickly.
0:01:14 > 0:01:18But with a severe shortage of specialised psychiatric care,
0:01:18 > 0:01:21it's a postcode lottery whether mothers get the expert help
0:01:21 > 0:01:23they urgently need.
0:01:23 > 0:01:27Over 80% in the UK don't.
0:01:27 > 0:01:29- I just want to be better for my daughter.- Yeah.
0:01:32 > 0:01:35We follow Hannah and Jenny as the team at Winchester's
0:01:35 > 0:01:38mother and baby unit help them fight this frightening illness
0:01:38 > 0:01:41and keep mother and baby together.
0:01:44 > 0:01:46OK. I'll be a good girl.
0:02:01 > 0:02:06# I love you and you love me
0:02:06 > 0:02:11# We love each other cos it's you and me
0:02:11 > 0:02:15# I love you and you love me
0:02:15 > 0:02:19# And we love each other cos it's you and me. #
0:02:19 > 0:02:2312 weeks after she gave birth to baby Esther, Hannah was
0:02:23 > 0:02:26admitted to the specialised psychiatric
0:02:26 > 0:02:29unit at the Royal Hampshire County Hospital in Winchester.
0:02:30 > 0:02:35There was a time when she completely believed that she was God.
0:02:35 > 0:02:40And that clearly isn't the case
0:02:40 > 0:02:45and it's not something that she normally believes.
0:02:45 > 0:02:47There's a good girl. Oh, you're such a good girl.
0:02:47 > 0:02:50Hannah is 27 and a trained nurse.
0:02:50 > 0:02:54If I could explain just how amazing my husband is,
0:02:54 > 0:02:59I don't think there would be a word that could encompass it.
0:03:00 > 0:03:04Andy, for me, has been such an amazing support.
0:03:04 > 0:03:08He was the beginning of the end for me, really.
0:03:08 > 0:03:11She met Andy three years ago.
0:03:11 > 0:03:14They soon married and decided to start a family.
0:03:15 > 0:03:18It's indescribable. Having a new little baby that we've
0:03:18 > 0:03:21brought into the world is something quite special.
0:03:23 > 0:03:26But three months on, the joy of Esther's
0:03:26 > 0:03:30birth was overshadowed, as Hannah began to have delusions
0:03:30 > 0:03:32and suicidal thoughts.
0:03:32 > 0:03:34I almost didn't recognise her.
0:03:34 > 0:03:37It was like looking at a different person.
0:03:37 > 0:03:40You would talk to her, try and engage with her,
0:03:40 > 0:03:41try and comfort her,
0:03:41 > 0:03:45and no matter what you said, there was no comforting her.
0:03:45 > 0:03:49What Hannah was experiencing is a condition far more severe
0:03:49 > 0:03:51than postnatal depression.
0:03:52 > 0:03:56Things came to a head one day at her parents' home.
0:03:56 > 0:04:02She just collapsed into a foetal position and screamed
0:04:02 > 0:04:04and screamed and screamed.
0:04:04 > 0:04:08I mean, I can only say that it just struck me as complete
0:04:08 > 0:04:11and utter madness.
0:04:11 > 0:04:13I think, in terms of mental illness,
0:04:13 > 0:04:17I don't think I've seen anybody as sick as that.
0:04:17 > 0:04:22I literally couldn't explain what had happened to my own daughter.
0:04:22 > 0:04:25It was horrific, absolutely horrific.
0:04:25 > 0:04:29I'm finding it difficult to talk about even now
0:04:29 > 0:04:34because I just didn't want to see her ever like that.
0:04:34 > 0:04:35I didn't expect that at all.
0:04:37 > 0:04:39I remember when we were at her parents' house.
0:04:39 > 0:04:42We were sat down on the sofa and Hannah was really struggling
0:04:42 > 0:04:45and very, very anxious and at that time I whispered to her that
0:04:45 > 0:04:47"I married you in sickness and in health."
0:04:53 > 0:04:55Hannah was brought to Winchester,
0:04:55 > 0:04:59where staff took her in under what's known as a section.
0:05:00 > 0:05:04When we detain someone under the Mental Health Act,
0:05:04 > 0:05:10we do it because there is no other way to ensure they get the care,
0:05:10 > 0:05:12the help, the support and the treatment that they need
0:05:12 > 0:05:15and in Hannah's situation,
0:05:15 > 0:05:18she really doesn't have a very good understanding of how ill she is.
0:05:18 > 0:05:21SHE BABBLES
0:05:21 > 0:05:24Is your name Esther? Ah, yes.
0:05:24 > 0:05:27Two weeks on, the team think Hannah's
0:05:27 > 0:05:29showing real signs of improvement.
0:05:29 > 0:05:31Esther.
0:05:31 > 0:05:33Specialist psychiatric care,
0:05:33 > 0:05:36as well as round-the-clock support with her baby, has enabled
0:05:36 > 0:05:42Hannah and Esther to stay together, rather than a damaging separation.
0:05:42 > 0:05:46I think it's absolutely crucial for Hannah to be together with Esther.
0:05:46 > 0:05:48Do you like your bath?
0:05:48 > 0:05:52There is lots of evidence now that that makes a difference to the
0:05:52 > 0:05:55outcome for mum and for baby.
0:05:55 > 0:05:58Do you like your bath time?
0:05:58 > 0:06:01The tragedy is that there are lots of parts of the country where
0:06:01 > 0:06:03women have no access at all
0:06:03 > 0:06:06to the specialist care they need.
0:06:06 > 0:06:09I kept thinking I was going to hurt Esther, not deliberately,
0:06:09 > 0:06:12but because I felt so weak, because I was so anxious.
0:06:12 > 0:06:14I was worried I was going to forget something,
0:06:14 > 0:06:15but then when I said to people
0:06:15 > 0:06:18I was worried I was going to hurt Esther then I think
0:06:18 > 0:06:22they thought actually physically, but I meant through neglecting her.
0:06:22 > 0:06:25The team at the unit use a range of treatments,
0:06:25 > 0:06:27but the cornerstone is medication.
0:06:28 > 0:06:32So Hannah's on olanzapine, an antipsychotic.
0:06:32 > 0:06:36That's a regular prescription, so she receives that daily.
0:06:36 > 0:06:40She also has another antipsychotic called haloperidol
0:06:40 > 0:06:43which she can use as and when she wants.
0:06:43 > 0:06:47It helps with intrusive thoughts, racing thoughts, delusions.
0:06:47 > 0:06:49Can I have some haloperidol?
0:06:49 > 0:06:51- Yeah, sure. Sit down.- Thank you.
0:06:51 > 0:06:54With Hannah responding well to treatment,
0:06:54 > 0:06:57she is now allowed to take short trips outside the unit.
0:06:57 > 0:07:00I just wondered if I could have maybe a couple of hours leave
0:07:00 > 0:07:03with Mum and her friend and my auntie.
0:07:03 > 0:07:05- Will you take Esther with you?- Yes.
0:07:05 > 0:07:09- Have you got everything you need for her ready?- Yes.- OK.
0:07:09 > 0:07:11Any dark thoughts or morbid thoughts?
0:07:11 > 0:07:16No, no dark or morbid thoughts, just very grateful to be here.
0:07:16 > 0:07:20Hannah's mum, Pippa, who herself nurses the mentally ill,
0:07:20 > 0:07:23has come to be her daughter's chaperone.
0:07:23 > 0:07:26We're good to go. We're good to go.
0:07:30 > 0:07:36I'm in a patterned dress with beige shoes and a navy cardigan.
0:07:36 > 0:07:38I'll write down what Hannah is wearing.
0:07:38 > 0:07:41That is in case you were to go AWOL, really.
0:07:41 > 0:07:45We would need to notify the police as a missing person so that they
0:07:45 > 0:07:49could have an idea of who they were looking for in the community.
0:07:52 > 0:07:57The most noticeable thing showing that Hannah still is quite
0:07:57 > 0:08:02unwell at the moment is that the range of her emotions is
0:08:02 > 0:08:07still very large, laughing and suddenly being terribly,
0:08:07 > 0:08:11terribly cheerful and then quite quickly becoming quite upset
0:08:11 > 0:08:14and almost tearful.
0:08:14 > 0:08:18Hi. I'm just ringing to say I'm sorry I haven't made contact sooner.
0:08:18 > 0:08:19Anyway, I love you.
0:08:19 > 0:08:22The phone call to her husband Andy is enough to trigger
0:08:22 > 0:08:24a change in Hannah.
0:08:24 > 0:08:27Just sometimes the way he looks at me.
0:08:27 > 0:08:31He might leave me and I know this is a lot for him to deal with
0:08:31 > 0:08:34and I don't ever want to put him through more than what he can bear.
0:08:34 > 0:08:36Listen, he loves you very much and
0:08:36 > 0:08:39he's been a wonderful husband so far.
0:08:39 > 0:08:42He has. That's the thing, because I don't think I deserve it.
0:08:42 > 0:08:47He's my rock, because ever since I met him, stuff's got better.
0:08:52 > 0:08:55Oh, dear.
0:08:55 > 0:09:00Jenny is 37. She gave birth to her second child, Libby, six weeks ago.
0:09:00 > 0:09:02They can't read me and it terrifies them
0:09:02 > 0:09:04because they think I'm going
0:09:04 > 0:09:06one way or the other and I know exactly where I'm going.
0:09:06 > 0:09:09I'm going from A to B, backwards via Z.
0:09:09 > 0:09:13Every option, Ferris wheel.
0:09:13 > 0:09:17Jenny has become ill postnatally.
0:09:17 > 0:09:20Her mood is elevated. She's high.
0:09:20 > 0:09:22She's quite irritable at times.
0:09:22 > 0:09:24If you stand there washing your hands,
0:09:24 > 0:09:26you cannot actually see that sign.
0:09:26 > 0:09:28So there's no point in having it there.
0:09:28 > 0:09:31If you're going to have it, have it on the window, have it just there.
0:09:31 > 0:09:34It's certainly not right to assume that just
0:09:34 > 0:09:37because someone is high, like Jenny is
0:09:37 > 0:09:40most of the time at the moment,
0:09:40 > 0:09:43that that is a wonderful, pleasant, great experience.
0:09:46 > 0:09:49Jenny and her husband Henry, a GP, have been together
0:09:49 > 0:09:52since they were 17.
0:09:52 > 0:09:54They married at 22.
0:09:54 > 0:09:57People don't really know who Jenny is because she's unwell
0:09:57 > 0:09:59and she's not her normal self.
0:10:02 > 0:10:04But for me, Jenny is a...
0:10:04 > 0:10:06She's a really caring person.
0:10:06 > 0:10:10She's someone who always is looking out for people.
0:10:10 > 0:10:13She's got a really good sense of humour,
0:10:13 > 0:10:16which comes across in a different way when she's unwell.
0:10:16 > 0:10:19Hello. Hiya. Oh, lovely.
0:10:19 > 0:10:21Hello? Hello.
0:10:21 > 0:10:23Knock, knock, knock. Hello?
0:10:23 > 0:10:27I often think of it as being a state of your brain being in overdrive.
0:10:27 > 0:10:34So your thoughts race, you have many more thoughts than you would
0:10:34 > 0:10:37normally do all happening at the same time,
0:10:37 > 0:10:43but things you are thinking about become less grounded in reality.
0:10:43 > 0:10:45Right, let's get this off of you.
0:10:45 > 0:10:48Oh, that is a stinky one.
0:10:48 > 0:10:52Jenny's first manic episode was quite dramatic.
0:10:52 > 0:10:58She was out shopping with me and then suddenly disappeared.
0:10:58 > 0:11:02She threw my phone into the river and then took off in the car and I
0:11:02 > 0:11:06didn't know where she was going and then she was missing for three days.
0:11:06 > 0:11:10And we had the police out looking, police helicopters,
0:11:10 > 0:11:15and I really didn't know whether she was going to be found injured
0:11:15 > 0:11:19or dead or alive and that was terrifying.
0:11:22 > 0:11:26This episode led to Jenny being diagnosed six years ago with
0:11:26 > 0:11:30bipolar, a mood disorder which causes extreme highs,
0:11:30 > 0:11:34known as mania, and severe depression.
0:11:34 > 0:11:37Jenny's bipolar disorder has had a massive
0:11:37 > 0:11:39impact on her life.
0:11:39 > 0:11:42It's because of that that she had to give up her career
0:11:42 > 0:11:48as a patent attorney and recently she's been working as an artist.
0:11:48 > 0:11:51We thought for a long time we weren't going to be able to have
0:11:51 > 0:11:55children at all, because of Jenny's illness.
0:11:55 > 0:11:59SHE SINGS
0:11:59 > 0:12:02A range of psychotic illnesses place women at risk.
0:12:02 > 0:12:06For Jenny, having bipolar meant she knew
0:12:06 > 0:12:11she had about a 50-50 chance of becoming ill after having a baby.
0:12:11 > 0:12:13Three weeks after Libby was born,
0:12:13 > 0:12:17Jenny began noticing early warning signs and asked to be admitted here.
0:12:17 > 0:12:21She is not held under section, but now obsesses about trying to leave.
0:12:21 > 0:12:25You know, there's a way out of these buildings.
0:12:25 > 0:12:28I think I know most of the door codes by now.
0:12:28 > 0:12:30Lots and lots of ways in and out.
0:12:30 > 0:12:34I've been in this place for too long.
0:12:34 > 0:12:37One of the things Jenny finds very hard is her intensive
0:12:37 > 0:12:40programme of medication.
0:12:40 > 0:12:43But with her condition deteriorating,
0:12:43 > 0:12:46today staff are increasing her dose of an antipsychotic.
0:12:46 > 0:12:49I've got your tablets here. Tablet.
0:12:49 > 0:12:52Do you want to have it after your breakfast or is it OK...?
0:12:52 > 0:12:55What did we agree on the haloperidol?
0:12:55 > 0:12:57Well, you had 1.5 milligrams yesterday
0:12:57 > 0:13:00and that's gone up to 5 milligrams this morning.
0:13:00 > 0:13:04- Five all the time?- Yeah.- For how long?
0:13:04 > 0:13:08Well, probably until you can achieve a good pattern of sleep.
0:13:08 > 0:13:11Do I really, really need to take this?
0:13:11 > 0:13:13Yeah, because come tonight, that is going to
0:13:13 > 0:13:15help you to get to bed as you want.
0:13:15 > 0:13:17- As long as I won't be a zombie all day.- OK.
0:13:17 > 0:13:21And you can watch me take it. It's not gone under the tongue.
0:13:22 > 0:13:25OK. I'll be a good girl. Thank you.
0:13:25 > 0:13:28I think Jenny's attitude to medication is quite a good
0:13:28 > 0:13:32barometer of how well she is.
0:13:32 > 0:13:37Because when she's really, really unwell, she won't see the need for
0:13:37 > 0:13:44any medication and will go to quite cunning lengths to avoid taking it.
0:13:44 > 0:13:49When she's well, she understands that she needs medication.
0:13:49 > 0:13:51- How you doing?- Yeah, getting there.
0:13:51 > 0:13:54I just hate the way that the plan gets changed all the time
0:13:54 > 0:13:57and then you get more and more confused and haloperidol and we
0:13:57 > 0:13:59have run out of this so you've now
0:13:59 > 0:14:01got two tablets and it was one tablet.
0:14:01 > 0:14:05And you just get handed a whole pile of stuff to stuff inside yourself.
0:14:05 > 0:14:08Yeah.
0:14:08 > 0:14:09I know you think it's the right thing,
0:14:09 > 0:14:11but it just winds the hell out of me.
0:14:11 > 0:14:13I know. I know it does, babes. I know.
0:14:13 > 0:14:16It's a trade-off, isn't it?
0:14:16 > 0:14:19Jenny's also irritated by something that's been
0:14:19 > 0:14:21happening on the ward.
0:14:21 > 0:14:25We've had two fire alarms. Two hours that fire alarm went off.
0:14:25 > 0:14:27Nobody in the building could turn it off.
0:14:27 > 0:14:30Two hours? Yeah. 11 o'clock.
0:14:30 > 0:14:35- I know. That's really unlucky. - Yeah. That's one way of putting it.
0:14:36 > 0:14:39It was getting to a level of severity where
0:14:39 > 0:14:43she was acting on some of her fears and thoughts and concerns,
0:14:43 > 0:14:47so for example, she's become very
0:14:47 > 0:14:50preoccupied by the idea that there might be a fire
0:14:50 > 0:14:53and how would she be able to escape in case of a fire
0:14:53 > 0:14:59and she even went as far as putting Libby in her bath in her
0:14:59 > 0:15:03bathroom, because she thought that that would be a good
0:15:03 > 0:15:05place to keep Libby safe.
0:15:05 > 0:15:07There we are.
0:15:07 > 0:15:12I don't think there's any chance that she would do anything to harm
0:15:12 > 0:15:15the baby, but she might through her distractibility do
0:15:15 > 0:15:18things that might make Libby a bit more vulnerable.
0:15:18 > 0:15:20We just did it wrong once. OK, let's try...
0:15:20 > 0:15:23But evidence shows that mothers are a far greater risk to
0:15:23 > 0:15:26themselves than their babies.
0:15:26 > 0:15:29There are various things Jenny does only
0:15:29 > 0:15:33when she's unwell that are really significant in her mind
0:15:33 > 0:15:37and putting the magnet over her face in that family portrait is
0:15:37 > 0:15:41obviously one of those really significant things.
0:15:41 > 0:15:44I'm just wondering how they'll cope if I'm not here.
0:15:50 > 0:15:53I'm actually really missing normal family life at the moment.
0:15:53 > 0:15:56I'm finding it much easier to deal with Esther.
0:15:56 > 0:15:58I'm actually starting to enjoy it again.
0:15:58 > 0:16:01It doesn't scare me any more, going home.
0:16:01 > 0:16:04You're making great progress. You're recovering.
0:16:04 > 0:16:08You're not quite there, but you're on the road to recovery.
0:16:08 > 0:16:11Dr Gregoire decides to lift Hannah's section
0:16:11 > 0:16:13and allow her home for a night.
0:16:13 > 0:16:16Hannah coming home today is quite a big moment for me.
0:16:16 > 0:16:22She hasn't been home for probably nearly a month now.
0:16:22 > 0:16:26I think he was absolutely terrified that they would take me
0:16:26 > 0:16:28away from him long-term.
0:16:28 > 0:16:31I guess the only thing that's slightly daunting for me
0:16:31 > 0:16:33is that if she goes downhill while she's at home,
0:16:33 > 0:16:36but I'm hoping that's not going to happen.
0:16:36 > 0:16:40I'm going to go and make you a feed for when you wake up. Yes, I am.
0:16:40 > 0:16:43I'm going to make you a nice big feed.
0:16:43 > 0:16:46Her four weeks in the unit has allowed Dr Gregoire to build
0:16:46 > 0:16:49a picture of Hannah's moods and behaviours.
0:16:49 > 0:16:51There's been a breakthrough.
0:16:51 > 0:16:55He's been able to diagnose Hannah with bipolar disorder.
0:16:55 > 0:16:59I can't tell you, after 14 years of knowing I wasn't right,
0:16:59 > 0:17:00to finally have a diagnosis
0:17:00 > 0:17:04and treatment is like the best thing you could possibly imagine.
0:17:04 > 0:17:07Like, it's so freeing and it just makes me
0:17:07 > 0:17:10feel like I've got a future.
0:17:10 > 0:17:12I've really got a future.
0:17:12 > 0:17:14I'm sorry.
0:17:22 > 0:17:24- Thanks.- Just through there.
0:17:24 > 0:17:25Thank you.
0:17:26 > 0:17:29- Hi, baby.- Hey. How are you?
0:17:29 > 0:17:32Fine, thanks. You?
0:17:32 > 0:17:34BABY CRIES
0:17:34 > 0:17:37Do you want your daddy?
0:17:37 > 0:17:39BABY BURPS
0:17:39 > 0:17:42- Oh, my gosh!- Mummy was right. - Oh, dear!
0:17:42 > 0:17:45It's lovely to see you, isn't it? It's nice to see you.
0:17:45 > 0:17:47Mummy got a bit mad. A bit sad.
0:17:49 > 0:17:52'The time of going home is a high risk time,
0:17:52 > 0:17:56'in terms of people becoming ill again, very challenging,
0:17:56 > 0:17:58'very demanding,
0:17:58 > 0:18:02'going from a situation where we're there 24 hours'
0:18:02 > 0:18:07a day for her on the mother and baby unit, to support her, to watch out
0:18:07 > 0:18:12for her, to a situation where she's at home, but it has to be done.
0:18:12 > 0:18:14She can't stay in hospital for the rest of her life,
0:18:14 > 0:18:16nor would anybody wish her to.
0:18:16 > 0:18:20So at some point, she's got to take that big, big step for her.
0:18:23 > 0:18:27I love my husband so much and I haven't seen him for ages, but
0:18:27 > 0:18:31really I'm kind of worried that I just might not be able to
0:18:31 > 0:18:33control my emotions. I guess I worry that I'm going
0:18:33 > 0:18:36to get overexcited and go into a mania.
0:18:36 > 0:18:39But I think I'm becoming more and more aware of my medications
0:18:39 > 0:18:40and what I need to do with them.
0:18:40 > 0:18:44- I want to give you a hug, is that all right?- Of course you can.
0:18:45 > 0:18:47Right, here goes.
0:18:49 > 0:18:51- See you later.- Take care.
0:18:55 > 0:18:56Oh, going home.
0:18:59 > 0:19:01You all right, sweetheart?
0:19:01 > 0:19:03OK.
0:19:06 > 0:19:12- Why through all of this haven't you left me, like I asked you to?- Um...
0:19:12 > 0:19:17Cos I love you, but also because I knew that you would get better,
0:19:17 > 0:19:18ultimately.
0:19:18 > 0:19:22Do you understand now why I always used to say to you I thought
0:19:22 > 0:19:23I was better off on my own?
0:19:23 > 0:19:27Yeah, but that was because you were ill, wasn't it, and you weren't...
0:19:27 > 0:19:30- I just knew that I was hard work. - You needed some help.
0:19:30 > 0:19:33Your sister was right. I was high maintenance.
0:19:33 > 0:19:37You are high maintenance, but in a different way.
0:19:37 > 0:19:40We're on the home stretch. I always remember this corner.
0:19:40 > 0:19:43Oh, I'm really excited.
0:19:43 > 0:19:46I love our house. It's almost a little bit Lords of the Ring.
0:19:46 > 0:19:49I have no idea what you're on about.
0:19:49 > 0:19:53Lord of the Rings! That is a film, isn't it?
0:19:53 > 0:19:55Lord of the Rings is fictional,
0:19:55 > 0:19:59much before 1860 when that house was built.
0:19:59 > 0:20:02That's what I mean! It's like a little Hobbit house!
0:20:02 > 0:20:05- Oh, OK.- I'm not mad!
0:20:11 > 0:20:13Is... Oh!
0:20:16 > 0:20:18It looks amazing!
0:20:27 > 0:20:28Oh, dear.
0:20:28 > 0:20:31Oh, my gosh! Look at the garden!
0:20:32 > 0:20:34Oh, I love it!
0:20:34 > 0:20:36I want to stay here for ever!
0:20:45 > 0:20:48I'm sorry, it's only cos I'm happy.
0:20:48 > 0:20:51It's OK. I'm glad you're happy to be home.
0:20:51 > 0:20:53I love you.
0:20:55 > 0:20:58- We're going to be OK, aren't we?- Yeah.
0:21:02 > 0:21:06- Have you come across those drugs before?- Yeah.
0:21:06 > 0:21:10So quetiapine and haloperidol are both mood stabilisers?
0:21:10 > 0:21:13- Antipsychotics? - Yeah, that sort of thing, yeah.
0:21:13 > 0:21:16- But I haven't got psychosis, have I?- Well...
0:21:16 > 0:21:20I think last week they would have said that you were quite unwell.
0:21:21 > 0:21:25- You don't like me saying that, do you?- No, not really.
0:21:25 > 0:21:29- Well, they described you as being manic last week, didn't they?- Mm-hm.
0:21:29 > 0:21:32The only problem is that I'm not really manic.
0:21:32 > 0:21:35My brain's going really fast, and no-one else can keep up.
0:21:35 > 0:21:37They don't like that.
0:21:37 > 0:21:41The problem is with other people's brains, rather than your own?
0:21:41 > 0:21:43Is there a possibility that's true?
0:21:45 > 0:21:48Well, I think you're probably the only person
0:21:48 > 0:21:51thinking that it is true.
0:21:51 > 0:21:57Despite questioning the medication, Jenny's been persevering with it.
0:21:57 > 0:22:00But she's not finding the side-effects easy.
0:22:00 > 0:22:03You know, the most noticeable thing for me at the moment is that
0:22:03 > 0:22:05I can't see myself.
0:22:05 > 0:22:09Because my vision is so blurred by the side-effect of haloperidol
0:22:09 > 0:22:12that I actually can't see my face in the mirror.
0:22:13 > 0:22:17- So, how are things going with you? - Well, I slept more last night.
0:22:17 > 0:22:19- I'm sure that's been handed over. - Yeah.
0:22:19 > 0:22:22I think eight-and-a-half hours in a go...
0:22:22 > 0:22:24- And your sleep is really important, so...- Yeah.
0:22:24 > 0:22:27Anything that interrupts your sleep, we need to try and do something.
0:22:27 > 0:22:29Because then I have to resettle.
0:22:29 > 0:22:32It's actually quite helpful to have to live in one room.
0:22:32 > 0:22:35Really and truly, the night staff want us
0:22:35 > 0:22:38in our rooms after medication time, so 11 o'clock,
0:22:38 > 0:22:42- potter around in your room, lights out at midnight.- Yeah.
0:22:42 > 0:22:46- Which is sensible. Promotes sleep. - Get into the bed and sleep...- Yeah.
0:22:46 > 0:22:49So, by 11, I know I can't tinker around out there.
0:22:49 > 0:22:52What would your plans for leave be now?
0:22:52 > 0:22:56- My main priority is to get some time with Reuben, my two-year-old.- Mm.
0:22:56 > 0:23:00And for him to just feel connected.
0:23:04 > 0:23:08Dr Gregoire has allowed Jenny home for one night.
0:23:10 > 0:23:14# Oh, you're so happy...
0:23:14 > 0:23:17# Boo-boo boom-boom. #
0:23:19 > 0:23:21Reuby cube!
0:23:21 > 0:23:24# Doo-doo
0:23:24 > 0:23:26# Doo dum. #
0:23:26 > 0:23:29That's Reuben smiling. What are you doing there?
0:23:29 > 0:23:31- Sleeping.- Sleeping.
0:23:31 > 0:23:36It's so lovely to have Jenny home. I think it's lovely for all of us.
0:23:36 > 0:23:40I certainly have worried that being with Reuben at home might be
0:23:40 > 0:23:44a bit too stressful, but it's just been lovely so far.
0:23:45 > 0:23:51She's been relaxed and has seemed to find it really therapeutic.
0:23:51 > 0:23:55I miss just holding him. Picking him up and cuddling him.
0:23:55 > 0:23:57Smelling his hair and being close to him.
0:23:59 > 0:24:00Look at that!
0:24:02 > 0:24:06When Reuben was born, Jenny showed signs of becoming unwell,
0:24:06 > 0:24:10but with increased medication and psychiatric support at home,
0:24:10 > 0:24:11she quickly got better.
0:24:13 > 0:24:16- Are you better?- Pardon?
0:24:16 > 0:24:18Is Mummy better?
0:24:18 > 0:24:20- Yeah.- Yeah, Mummy is better, isn't she?
0:24:20 > 0:24:23You're not going to Winchester?
0:24:23 > 0:24:26Well, I have to go back to Winchester in a little bit.
0:24:26 > 0:24:29But I'll be here in the morning. We'll go to preschool together.
0:24:34 > 0:24:36OK, see you later.
0:24:36 > 0:24:39Bye. Can we go this way?
0:24:39 > 0:24:43Next morning, things haven't gone quite to plan.
0:24:43 > 0:24:46I think she only slept about three hours last night.
0:24:46 > 0:24:48Ready, steady, go.
0:24:48 > 0:24:50And we know that if she has several
0:24:50 > 0:24:54nights like that, it can be really detrimental to her mental state.
0:24:54 > 0:24:57I'm just going to fling some things together.
0:24:57 > 0:25:00The unit wants me at half 12 at the latest, do they?
0:25:02 > 0:25:05For Jenny, as for most people with bipolar disorder,
0:25:05 > 0:25:08lack of sleep is a major risk factor.
0:25:08 > 0:25:12The risks are that she could be up all night
0:25:12 > 0:25:15and that would not be good news, actually.
0:25:15 > 0:25:18Well, in my head, I've got three nights.
0:25:18 > 0:25:22If I have a bad night and it's a signature bad night, which is
0:25:22 > 0:25:26absolutely no sleep all night, that's not good.
0:25:26 > 0:25:29I've got two days to rectify it and if I haven't rectified it,
0:25:29 > 0:25:31then I'm on my way to mania.
0:25:31 > 0:25:33And that's like skateboarding down a hill
0:25:33 > 0:25:35when you don't know how to stop.
0:25:35 > 0:25:37It's kind of fun, but it's terrifying.
0:25:37 > 0:25:41I did notice that the bathroom cupboard had been reorganised
0:25:41 > 0:25:42this morning when I went to shave.
0:25:44 > 0:25:48When her brain's doing what it is now, she feels that it's all
0:25:48 > 0:25:53a process she needs to go through in order to feel calm.
0:25:53 > 0:25:56But sometimes, it can just spiral and get worse and worse.
0:25:56 > 0:25:58It's just so disheartening when she's made quite
0:25:58 > 0:26:02a bit of progress in the last few days to then have a bad night.
0:26:02 > 0:26:05It does make me scared that things are going in the wrong
0:26:05 > 0:26:07direction again.
0:26:07 > 0:26:09Take care. Look after Libby for me.
0:26:09 > 0:26:11Likewise, Libby.
0:26:11 > 0:26:12Yeah.
0:26:16 > 0:26:21I'm sorry, I know it's embarrassing. I'm sorry, I'm sorry.
0:26:21 > 0:26:23I'm trying.
0:26:23 > 0:26:26Over the past week, Hannah has been granted three further
0:26:26 > 0:26:28overnight visits out of the unit.
0:26:29 > 0:26:32But her behaviour is alarming her mum, Pippa,
0:26:32 > 0:26:35who has decided to bring her to see Dr Gregoire.
0:26:35 > 0:26:38- Come with me, Hannah.- Yeah. - Shall we go and find Dr Gregoire?
0:26:38 > 0:26:42- You are having a difficult time? - Yeah.
0:26:43 > 0:26:46I don't want to be back here, I want to be at home.
0:26:47 > 0:26:49- Is that what is making you feel a bit rotten?- Yeah.
0:26:49 > 0:26:53So, have you been feeling like this just today, then?
0:26:53 > 0:26:55No, yesterday it was just as bad if not worse,
0:26:55 > 0:27:00- but I was able to control it with an hour-long walk.- Mmm.
0:27:00 > 0:27:02It's the olanzapine, it's too high.
0:27:02 > 0:27:05Mm-hmm, and what is telling you that, that it is too much?
0:27:05 > 0:27:07My body. I keep getting a headache here.
0:27:07 > 0:27:10It wasn't the headaches that were the first thing, was it?
0:27:10 > 0:27:12- It was the lows.- The lows, yeah.
0:27:12 > 0:27:15When you were in hospital you were taking all of these
0:27:15 > 0:27:17- medications fairly regularly.- Yeah.
0:27:17 > 0:27:22Things were going reasonably well, then, and then you went home...
0:27:22 > 0:27:24And I tried to get better too fast.
0:27:24 > 0:27:28And you started cutting down on some of the medications
0:27:28 > 0:27:30and things got a bit worse.
0:27:30 > 0:27:34Is it possible that actually the olanzapine
0:27:34 > 0:27:38and lorazepam are helping?
0:27:38 > 0:27:41Maybe you're right. I don't trust my thinking, so I needed...
0:27:41 > 0:27:45- That is why I needed to see you today, to know what to do.- Mmm.
0:27:45 > 0:27:48I'm so sorry, I thought I was doing the right thing.
0:27:48 > 0:27:49I'm so stupid.
0:27:49 > 0:27:50I thought I was clever.
0:27:52 > 0:27:56What you have learned is actually really useful, which is
0:27:56 > 0:27:58- that you have a bit of a more difficult time.- Yeah.- Yeah?
0:27:58 > 0:28:00- I'm sorry, I wasn't trying to be naughty...- No!
0:28:00 > 0:28:03..I was genuinely trying to get better and I...
0:28:03 > 0:28:07This is your illness, it's your mind, your body and your medication.
0:28:07 > 0:28:11It sounds like you need that little bit of extra support and help.
0:28:11 > 0:28:14There is also one other consideration that I'm quite keen
0:28:14 > 0:28:17- on checking out, and that is that you are going to be safe.- Yeah.
0:28:17 > 0:28:21- Because I can't get you better if you're not alive.- No.
0:28:21 > 0:28:24Are you at the moment wanting to be dead?
0:28:24 > 0:28:26No, I just want to sleep a lot.
0:28:26 > 0:28:30Right, so you want to just not be feeling how you are feeling,
0:28:30 > 0:28:32- get away from that.- Yeah.
0:28:32 > 0:28:35Are there times when you want to be dead?
0:28:35 > 0:28:37Yeah, but I talk to Jesus and it stops.
0:28:37 > 0:28:39Mm-hmm.
0:28:39 > 0:28:42I just say, "Please stop it, Jesus, please stop it."
0:28:42 > 0:28:46When Hannah talks about ending her life, I would say it is
0:28:46 > 0:28:49probably one of the most distressing things a mum can hear
0:28:49 > 0:28:54because you as a mum do everything from the time they are born
0:28:54 > 0:28:59to preserve life and to enhance their life,
0:28:59 > 0:29:06and for her to feel that her life is not worth continuing
0:29:06 > 0:29:08is really difficult.
0:29:12 > 0:29:16Physical illnesses can cause suffering in some cases,
0:29:16 > 0:29:22so terrible cancers can cause people to be distressed and in pain,
0:29:22 > 0:29:26but mental illnesses are suffering.
0:29:26 > 0:29:29They are at the very root of where suffering lies,
0:29:29 > 0:29:33which is of course in our heads, in our brains,
0:29:33 > 0:29:36and that is gruesome to watch in somebody else.
0:29:36 > 0:29:40Have you got to the point where you have decided right now,
0:29:40 > 0:29:42"I am going to do it?"
0:29:42 > 0:29:45No, because I look at my baby and I say that she needs a mum
0:29:45 > 0:29:50- and I can't do that her.- Right, OK.
0:29:50 > 0:29:51That's why I like waking for her,
0:29:51 > 0:29:54- because it keeps my perspective on her.- OK.
0:29:56 > 0:29:59- We are here to help you.- I know.- OK?
0:29:59 > 0:30:02You are all being really nice. I just want to get better.
0:30:02 > 0:30:06But we want you to get better and if we can work together to get
0:30:06 > 0:30:10you better, that is going to be the most efficient way of doing it.
0:30:15 > 0:30:20After six weeks in the unit, most women would be well into recovery.
0:30:20 > 0:30:22But Jenny's condition has suddenly worsened.
0:30:22 > 0:30:25Towards the end of last week things were generally OK,
0:30:25 > 0:30:27but since Saturday night, really,
0:30:27 > 0:30:30has become increasingly chaotic in her presentation.
0:30:30 > 0:30:34Calm at times, frustrated at other times, argumentative,
0:30:34 > 0:30:36tearful and laughing loudly.
0:30:36 > 0:30:40Sleep hasn't been good at all, so this morning we are kind of seeing
0:30:40 > 0:30:43a continuation of this behaviour, really.
0:30:43 > 0:30:47And her mood, is that predominantly high, low?
0:30:47 > 0:30:49- It's more high than low.- Right.
0:30:49 > 0:30:51But she set off the fire alarms,
0:30:51 > 0:30:54then she was holding Libby in a sling.
0:30:54 > 0:30:57She phoned the fire brigade to tell them it was a false alarm.
0:30:57 > 0:31:00She was in the blaring noise right by the alarms,
0:31:00 > 0:31:03not aware of Libby's needs or concerns.
0:31:03 > 0:31:05I haven't seen it before.
0:31:05 > 0:31:08I don't know she is actually aware that she has become unwell.
0:31:11 > 0:31:13While Libby is being cared for in the nursery,
0:31:13 > 0:31:16Dr Gregoire wants to assess Jenny for himself.
0:31:16 > 0:31:19So, how are things with you?
0:31:19 > 0:31:20Absolutely tiptop.
0:31:20 > 0:31:24- 20/20, Tinker Tailor Soldier Spy. - Right.
0:31:24 > 0:31:26I scream in the night.
0:31:26 > 0:31:29Have you heard that before?
0:31:29 > 0:31:31I have not heard you say that before, no.
0:31:31 > 0:31:33I scream...
0:31:33 > 0:31:35- Ice cream.- Mm.
0:31:35 > 0:31:38- You're playing on words quite a lot, aren't you?- Yes.
0:31:40 > 0:31:41Are you enjoying that?
0:31:42 > 0:31:45It's very tiring. You have to have a lot of water to do that.
0:31:45 > 0:31:47Is your mind just doing that even
0:31:47 > 0:31:51- when you are not particularly trying to?- No.
0:31:51 > 0:31:53Are your thoughts jumping around a bit?
0:31:53 > 0:31:57- I am mad as a box of frogs.- Right.
0:31:57 > 0:32:00- Do you think you are not so well at the moment?- I think...
0:32:00 > 0:32:03- Seriously. - Tout le monde est un peu fou.
0:32:03 > 0:32:05- Tout le monde est quoi?- Un peu fou.
0:32:05 > 0:32:08- Un peu fou, oui.- Oui. C'est ca. C'est vrai?
0:32:08 > 0:32:11Yeah, I think there's some truth in that. Everybody is a bit mad.
0:32:11 > 0:32:15- Je peux parler le francais un peu. - Tres bien.- Merci.
0:32:15 > 0:32:17You want to know what is going on in my head
0:32:17 > 0:32:19- and I want to know what is going on in your head.- Yeah. Do you?
0:32:19 > 0:32:21That's actually what it is, yes.
0:32:21 > 0:32:24And I want to rip off that disguise because it doesn't fool any of us.
0:32:24 > 0:32:26HE LAUGHS
0:32:26 > 0:32:29- You are Hercule Poirot.- No, but I will continue to hide behind it.
0:32:29 > 0:32:32I suspect that you think you're not that well at the moment.
0:32:32 > 0:32:35- Would that be right?- Tiptop.
0:32:35 > 0:32:39Which kind of means, "I'm very well,"
0:32:39 > 0:32:42but I suspect you're not completely convinced by that.
0:32:44 > 0:32:46Would that be fair to say?
0:32:46 > 0:32:48- Tick tock.- Mm-hmm.
0:32:48 > 0:32:49Tick tock.
0:32:49 > 0:32:53- I would like to lie down and go to sleep right now.- OK.- Everybody out.
0:32:53 > 0:32:56I will leave you in peace, but can I just say,
0:32:56 > 0:32:59what I would like to do is just increase the quetiapine dose.
0:32:59 > 0:33:02- Above 800?- Which is above the 800.
0:33:02 > 0:33:05That is a challenge. How high can we go?
0:33:05 > 0:33:09Well, that's always difficult, but we can certainly go to 900.
0:33:09 > 0:33:13- Up to 1,000 probably won't kill me. - But it may be that it works for you.
0:33:13 > 0:33:16- Yeah.- No, I'm sure it won't. We can keep an eye on you.
0:33:16 > 0:33:19We will do, say, an ECG just to check
0:33:19 > 0:33:21that your heart is OK and so on.
0:33:21 > 0:33:24- So I become... - A little bit of extra checking.
0:33:24 > 0:33:26..a rat.
0:33:26 > 0:33:30No, you don't, or the guinea pig, but you are an individual
0:33:30 > 0:33:33- and some people...- Or a chimpanzee.
0:33:33 > 0:33:35- It is not an experiment. - It is an experiment.
0:33:35 > 0:33:38I think it is too risky to leave it.
0:33:38 > 0:33:43I think you need to have some more mood stabiliser.
0:33:43 > 0:33:47- I think I need to have a lot more sleep.- OK.
0:33:47 > 0:33:50Well, shall we go for both?
0:33:50 > 0:33:55- Yes.- OK. And let's see what happens over the next few days.
0:33:55 > 0:33:56So it is kind of a compromise.
0:33:56 > 0:34:00I'm not saying a huge increase, a small increase...
0:34:00 > 0:34:01I'll only do it if it's a game,
0:34:01 > 0:34:03because I am fed up of being in this place.
0:34:03 > 0:34:06You play your bit, I'll play my bit
0:34:06 > 0:34:09- and we might both win.- Yes.
0:34:09 > 0:34:12- Good to talk to you.- Great to talk to you. We have made a deal.
0:34:12 > 0:34:15- We have made a deal. - Gentlemen's agreement.
0:34:15 > 0:34:18Well, poor Jenny is having a really tough time at the moment.
0:34:18 > 0:34:22Her thinking is all over the place, I think is the most striking thing.
0:34:22 > 0:34:26She is manic, I think she probably is psychotic.
0:34:26 > 0:34:29- I will bow down to you, because... - Don't do that!
0:34:29 > 0:34:31It's in my culture.
0:34:31 > 0:34:34I will bow down to you, because you are giving me a way out.
0:34:34 > 0:34:38- That's the point.- OK. - You are my brother.
0:34:38 > 0:34:42- Let's get it sorted out. - Kindred spirits.- Yeah.
0:34:42 > 0:34:47I am surprised that she has become ill again, returned into a state
0:34:47 > 0:34:54of illness so quickly after getting better so substantially.
0:34:54 > 0:34:59She wasn't fully better but she was well on the road to recovery.
0:35:02 > 0:35:06She seems to me more unwell than she was in the first episode.
0:35:06 > 0:35:10- She is more unwell.- I find that... I don't understand.
0:35:10 > 0:35:14And yet she definitely improved on this medication regime.
0:35:14 > 0:35:16He just said that she is very subtle,
0:35:16 > 0:35:17the way she takes her medication.
0:35:17 > 0:35:20- You might think that she swallows but she doesn't.- Henry said?
0:35:20 > 0:35:23He says it is just something we have got to be mindful of
0:35:23 > 0:35:25when we give it to her.
0:35:25 > 0:35:29I am a little bit quizzical about why it has happened and there are
0:35:29 > 0:35:34a number of avenues we need to check, and a kind of obvious one is
0:35:34 > 0:35:36whether the individual, whether Jenny,
0:35:36 > 0:35:42has actually been taking her medication exactly as she was
0:35:42 > 0:35:45meant to because if she were, that makes this...
0:35:47 > 0:35:49..this relapse even more surprising.
0:35:51 > 0:35:55Good God. Whoo! I might be Prime Minister by the end of the day.
0:36:05 > 0:36:10Dr Gregoire and his team are also concerned that Hannah's condition
0:36:10 > 0:36:13is continuing to deteriorate.
0:36:13 > 0:36:16So, this is Hannah's words for her weekly review with you.
0:36:16 > 0:36:19"Things have stayed the same the past week -
0:36:19 > 0:36:21"anxiety and dark thoughts.
0:36:21 > 0:36:23"Things that have got worse and have started to trouble me
0:36:23 > 0:36:26"in the first week - the intensity of the dark thoughts
0:36:26 > 0:36:28"when they do come." I've got a quote here saying,
0:36:28 > 0:36:31"Just wanted to go to sleep and never wake up.
0:36:31 > 0:36:34"Struggling, hopeless.
0:36:34 > 0:36:36"Hopelessness."
0:36:42 > 0:36:46She had to be sedated last night to sleep because she was very,
0:36:46 > 0:36:51very anxious and really had dark thoughts,
0:36:51 > 0:36:53which were really tormenting her.
0:36:57 > 0:37:01She was high risk yesterday and again today
0:37:01 > 0:37:05and so they very discreetly place a chair outside of her room.
0:37:05 > 0:37:10She has a nurse one on one just sitting, observing,
0:37:10 > 0:37:14waiting for her to move and if she moves, they move with her,
0:37:14 > 0:37:17so she is not actually left to her own devices
0:37:17 > 0:37:19and she is never vulnerable and on her own.
0:37:21 > 0:37:23Just everything seemed bleak
0:37:23 > 0:37:26and we would be better off without her, and she would be better off
0:37:26 > 0:37:29not here and Esther would be better off without her.
0:37:33 > 0:37:39It is extremely rare that we come across women who might pose
0:37:39 > 0:37:42a risk of physically harming their infants.
0:37:45 > 0:37:51It is extraordinary that even though Hannah is very, very ill,
0:37:51 > 0:37:53suffering gruesomely,
0:37:53 > 0:37:58her ability to squeeze the last bit of determination
0:37:58 > 0:38:03out of herself in order to give some care to Esther is still there,
0:38:03 > 0:38:05that she is still able to do that.
0:38:05 > 0:38:10To be aware of when she can't so that she is asking for help
0:38:10 > 0:38:11from members of staff -
0:38:11 > 0:38:15and that's what we are here for, to help her with that.
0:38:24 > 0:38:27A few weeks later, Hannah's condition becomes critical.
0:38:36 > 0:38:40I received a call from a member of staff called Sam at the unit,
0:38:40 > 0:38:43picked up the phone and heard Sam's voice
0:38:43 > 0:38:44and I just thought the worst.
0:38:47 > 0:38:51She had obviously got so desperate she realised that she needed
0:38:51 > 0:38:54something that was actually going to do the job properly,
0:38:54 > 0:38:57and that was when she broke a jar of Esther's food
0:38:57 > 0:39:02and used the glass to cut her neck and her arm.
0:39:02 > 0:39:06And was really lucky she didn't end her life because she was
0:39:06 > 0:39:11so close to hitting major vessels,
0:39:11 > 0:39:13which would have been the end.
0:39:17 > 0:39:20Most counsellors... People want to live.
0:39:20 > 0:39:23Even though they are suffering, they want to keep living.
0:39:23 > 0:39:26It is really not until the suffering is unimaginably gruesome
0:39:26 > 0:39:28and hopeless that they want to die.
0:39:30 > 0:39:33People with these severe mental illnesses, even though
0:39:33 > 0:39:37we, the doctors, are telling them that they will get better,
0:39:37 > 0:39:43they are in such depth of suffering that the idea of living
0:39:43 > 0:39:46is impossible for them.
0:39:49 > 0:39:52I was just desperate to see her better.
0:39:52 > 0:39:54When someone is not responding to treatment
0:39:54 > 0:39:56and there doesn't seem to be any way out and you just see them
0:39:56 > 0:40:00struggling day after day after day, you think something has got to give.
0:40:00 > 0:40:04There has got to be something which is going to have an effect.
0:40:05 > 0:40:09We were increasing her medications,
0:40:09 > 0:40:11adding new medications,
0:40:11 > 0:40:13changing medications.
0:40:13 > 0:40:16We had been doing all the psychotherapies
0:40:16 > 0:40:19and psychological approaches to treatment that we
0:40:19 > 0:40:23have at our disposal, but despite all of that, she had reached
0:40:23 > 0:40:26a point where this was dangerous.
0:40:29 > 0:40:33I knew that the most effective treatment
0:40:33 > 0:40:38to get her better quickly and actually,
0:40:38 > 0:40:42if we are honest about it, save her life, was ECT.
0:40:42 > 0:40:46This is a treatment that has a lot of stigma attached to it.
0:40:46 > 0:40:51It is actually extremely safe, not in the least bit barbaric.
0:40:51 > 0:40:56The reality of this treatment is that we know it is the most
0:40:56 > 0:41:02effective treatment and the fastest treatment for severe depression.
0:41:04 > 0:41:07I was very much against ECT.
0:41:07 > 0:41:11I couldn't accept ECT has a...
0:41:13 > 0:41:15..accepted treatment, really,
0:41:15 > 0:41:19because there was no explanation as to how it actually works.
0:41:19 > 0:41:21- How are you feeling today? - All right, thank you.
0:41:21 > 0:41:24- Have you noticed any improvement? - Yes.
0:41:24 > 0:41:28I didn't want her to have it and I expressed it in verbal form
0:41:28 > 0:41:31as well as written form to Dr Gregoire.
0:41:31 > 0:41:34But Hannah said to us,
0:41:34 > 0:41:38"I can't go on like this and if it means that there is a chance
0:41:38 > 0:41:43"that ECT will help, then I have given consent already."
0:41:43 > 0:41:45All right, a little bit of fresh air to breathe.
0:41:45 > 0:41:47Just take some nice, deep breaths.
0:41:49 > 0:41:52Hannah is having a series of sessions of ECT.
0:41:54 > 0:41:56She is anaesthetised first
0:41:56 > 0:41:58and feels no pain as the treatment is given.
0:42:00 > 0:42:02REGULAR BEEPS
0:42:11 > 0:42:12OK, testing.
0:42:14 > 0:42:16It's good. And treat.
0:42:16 > 0:42:18PROLONGED BEEP
0:42:35 > 0:42:3723.
0:42:37 > 0:42:39- DR GREGOIRE:- Just as with an electric shock
0:42:39 > 0:42:43that we use for shocking the heart when that is not working properly,
0:42:43 > 0:42:47this electric shock is delivered in a very controlled way.
0:42:47 > 0:42:51But the electricity causes a seizure.
0:42:51 > 0:42:53It is very like an epileptic seizure
0:42:53 > 0:42:57and it is this element of the treatment that seems to be
0:42:57 > 0:43:00the bit that is effective in treating the depression.
0:43:02 > 0:43:04Now there is some hope.
0:43:07 > 0:43:10Only 20 minutes later, Hannah is waking up.
0:43:12 > 0:43:14- Can you balance?- Yeah.
0:43:14 > 0:43:16I sometimes have a headache
0:43:16 > 0:43:20- and if I now have a headache I have a jaw ache.- Yeah.
0:43:20 > 0:43:24- Is that after each treatment? - Mm-hmm.
0:43:24 > 0:43:28It's difficult, really, because it often feels quite surreal.
0:43:28 > 0:43:30Erm...
0:43:32 > 0:43:35- I just want to be better for my daughter.- Yeah.
0:43:38 > 0:43:39She is precious.
0:43:47 > 0:43:51I am really nervous right now about going in to see Jenny,
0:43:51 > 0:43:54which is a horrible feeling because, you know,
0:43:54 > 0:43:57in any other circumstance I just wouldn't be able to imagine
0:43:57 > 0:43:59being nervous going to see my own wife.
0:44:01 > 0:44:06Staff have called Henry to the unit as Jenny's condition is much worse.
0:44:06 > 0:44:08ALARM WAILS
0:44:16 > 0:44:19That sounds like the fire alarm going off again.
0:44:19 > 0:44:23I wonder if that isn't Jenny setting off the fire alarm again?
0:44:23 > 0:44:27She did that yesterday and she has a pattern of doing that
0:44:27 > 0:44:32because when she is ill she has a tendency to think about any
0:44:32 > 0:44:35means of getting out of the building.
0:44:45 > 0:44:48Jenny was really, really unwell.
0:44:48 > 0:44:51It was really horrible to see.
0:44:51 > 0:44:54Very disordered and sort of chaotic.
0:44:54 > 0:44:57It was quite hard to spend any more than a few seconds with her
0:44:57 > 0:45:01and obviously not able to settle with her mind on one
0:45:01 > 0:45:05particular thing, and getting increasingly bizarre.
0:45:05 > 0:45:10Half the time I really didn't have any idea what she was talking about.
0:45:10 > 0:45:15So it was pretty hard, and then just now she started running up
0:45:15 > 0:45:17and down the corridor and was very loud
0:45:17 > 0:45:20and I just couldn't get away quick enough, really.
0:45:20 > 0:45:22It was really hard to be there.
0:45:25 > 0:45:29Staff have begun to notice that Jenny is not taking her medication.
0:45:29 > 0:45:36I think it was first noticed when Jenny was taking her liquid
0:45:36 > 0:45:41medication with water and was spitting it back out into the water.
0:45:41 > 0:45:45She had suspected she didn't need it because she wasn't ill,
0:45:45 > 0:45:47but also that it might potentially harm her.
0:45:47 > 0:45:50So if that is what you believe,
0:45:50 > 0:45:53I can well understand that you wouldn't take it.
0:45:53 > 0:45:58I know for sure that she really needs this medication in order
0:45:58 > 0:46:01to get better and get back to her normal self.
0:46:01 > 0:46:05If our mums become sort of quite acutely unwell,
0:46:05 > 0:46:09if they are posing any kind of danger to other babies on the unit
0:46:09 > 0:46:13or other mums on the unit, sometimes it is not appropriate for us
0:46:13 > 0:46:15to keep them here just in terms of safety.
0:46:15 > 0:46:19So we have had instances where we have had to unfortunately
0:46:19 > 0:46:23have some of our ladies transferred to more of an acute adult unit.
0:46:23 > 0:46:24Babies can't go there,
0:46:24 > 0:46:27so that would mean they would have to be separated,
0:46:27 > 0:46:29which in terms of their recovery
0:46:29 > 0:46:32is quite a setback in terms of bonding with baby.
0:46:32 > 0:46:35They are really throwing everything they can at it...
0:46:35 > 0:46:39at the situation, and doing everything they can for Jenny.
0:46:41 > 0:46:44I just hope that that is enough to keep her here, really.
0:46:49 > 0:46:52BABY GURGLES
0:46:52 > 0:46:56Over the next ten days, Jenny's behaviour becomes too
0:46:56 > 0:46:59difficult for the staff on the mother and baby unit to manage.
0:46:59 > 0:47:02She is now sectioned in a high-security psychiatric
0:47:02 > 0:47:05intensive care unit 100 miles away.
0:47:07 > 0:47:11Having Libby at home has been the most amazing silver lining
0:47:11 > 0:47:13in this horrible dark cloud.
0:47:13 > 0:47:16It is really weird that simultaneously you can have
0:47:16 > 0:47:19such joy at getting to know your daughter
0:47:19 > 0:47:23and also such misery at seeing your wife in such a horrible place.
0:47:24 > 0:47:28Jenny at the moment is so ill that the unit she's in
0:47:28 > 0:47:30has advised Henry not to visit her.
0:47:31 > 0:47:35It feels like we are really as... probably as separated
0:47:35 > 0:47:39as we have ever been in 15 years of being married.
0:47:42 > 0:47:44And I don't know how long that is going to last.
0:47:51 > 0:47:55I think what I really miss about Jenny is being able to have
0:47:55 > 0:47:59conversations with her about stuff that crops up -
0:47:59 > 0:48:05news from friends, decisions that I have had to make about her care
0:48:05 > 0:48:07or about Libby's care,
0:48:07 > 0:48:11where I have intuitively thought, "Well, when I talk to Jenny
0:48:11 > 0:48:13"about it, we'll decide," and then I remember that I won't be
0:48:13 > 0:48:17able to talk to Jenny about it for probably quite some time.
0:48:17 > 0:48:19So I think that is the hardest,
0:48:19 > 0:48:24apart from just the day to day, you know, not having
0:48:24 > 0:48:29her around the house and not having my closest companion around.
0:48:35 > 0:48:36Just give me a moment.
0:48:53 > 0:48:57Hannah is back on the unit after another ECT session.
0:48:57 > 0:49:01- How was the ECT this morning? - Yeah, it was all right.
0:49:01 > 0:49:05Even compared to yesterday, you seem much better to me.
0:49:05 > 0:49:09I anticipate with Hannah that she will get substantially better
0:49:09 > 0:49:11from this episode of illness.
0:49:12 > 0:49:15She is now dealing with the realisation
0:49:15 > 0:49:19of quite how ill she was, of how suicidal she was.
0:49:19 > 0:49:24The dark periods are so dark that you just don't get a choice.
0:49:24 > 0:49:29Every time I wake up I kind of hope that it is just a nightmare,
0:49:29 > 0:49:31but that is my constant physical reminder.
0:49:31 > 0:49:34I don't want it to be a reminder of a nightmare,
0:49:34 > 0:49:36I want to turn it into something beautiful,
0:49:36 > 0:49:40so I am hoping in time to maybe have a tattoo
0:49:40 > 0:49:42with a verse, a biblical verse.
0:49:42 > 0:49:47And it is Jeremiah 29:11, and it talks about having a purpose
0:49:47 > 0:49:49and a plan for your life and that that will bring hope.
0:49:49 > 0:49:53I guess I was lucky that I do have a future
0:49:53 > 0:49:57and I have a baby who has been my focus throughout this,
0:49:57 > 0:50:01I'm so glad that I am beating the illness now
0:50:01 > 0:50:02and it is not beating me.
0:50:05 > 0:50:06"How could I be like that?"
0:50:06 > 0:50:09And of course the answer is that it isn't her.
0:50:11 > 0:50:14Just like if you can't walk properly when your leg is broken
0:50:14 > 0:50:17you don't say, "Well, I'm a person who can't walk properly,"
0:50:17 > 0:50:20you say, "At the moment I can't walk properly because my leg is broken
0:50:20 > 0:50:24"and it is the broken leg that's causing that, not me as a person."
0:50:25 > 0:50:28And of course, that applies to everybody around her
0:50:28 > 0:50:31and indeed the whole of society.
0:50:31 > 0:50:34You know, we need to have compassion and understanding
0:50:34 > 0:50:36and blame these nasty illnesses,
0:50:36 > 0:50:41not the poor unfortunate people who bravely have to live through them.
0:50:47 > 0:50:50You had another one this morning. How are things today?
0:50:50 > 0:50:55I am feeling better. I have not had any dark thoughts today.
0:50:55 > 0:50:59And I'm feeling more in control.
0:50:59 > 0:51:03I think that is the bit that it has given me, is control back.
0:51:03 > 0:51:06I feel like my memories have actually improved,
0:51:06 > 0:51:07which I wasn't expecting.
0:51:07 > 0:51:11You can get a bit of memory loss with ECT,
0:51:11 > 0:51:14but the memory loss from severe depression is dramatic,
0:51:14 > 0:51:18and because we are treating the severe depression effectively now,
0:51:18 > 0:51:21what you describe doesn't surprise me that much.
0:51:21 > 0:51:24I would predict the improvement will continue.
0:51:24 > 0:51:28We'll keep at it and you will get better.
0:51:28 > 0:51:29I actually believe that now.
0:51:29 > 0:51:32- Well, that's a big change. - I didn't believe that.
0:51:32 > 0:51:33That's a big change!
0:51:33 > 0:51:36- Right, you can see yourself getting fully recovered.- Yeah.
0:51:36 > 0:51:40- That has changed even from yesterday.- Wow, that's fantastic.
0:51:40 > 0:51:44And I can see that I am actually doing a good job with Esther
0:51:44 > 0:51:47- and that is new...- Fantastic!
0:51:47 > 0:51:52..because I constantly worried that I wasn't doing enough.
0:51:52 > 0:51:56I want to start to take some more pride in my appearance again,
0:51:56 > 0:51:59so, like, have my eyebrows done, have my hair cut.
0:51:59 > 0:52:02That's really good as well. That is nice.
0:52:06 > 0:52:08And cuddle the baby.
0:52:08 > 0:52:12After a month being treated away from the mother and baby unit,
0:52:12 > 0:52:17Jenny is well enough to come back and be reunited with baby Libby.
0:52:17 > 0:52:19There she is. There she is!
0:52:19 > 0:52:23When she arrived back it took quite a while for us
0:52:23 > 0:52:25to see any improvement.
0:52:25 > 0:52:27Erm...
0:52:27 > 0:52:29But she is getting there now.
0:52:29 > 0:52:33And I guess over the last probably ten days or so,
0:52:33 > 0:52:35she has got a lot better.
0:52:35 > 0:52:37Hello. Hello.
0:52:37 > 0:52:40Hello.
0:52:40 > 0:52:41After four months of treatment,
0:52:41 > 0:52:46three times longer than average, Jenny is finally turning a corner.
0:52:46 > 0:52:51There have been lots of times over the last 18, 19 weeks
0:52:51 > 0:52:54when I have really not looked forward to coming in at all
0:52:54 > 0:52:56because it has been too upsetting.
0:52:59 > 0:53:02So it is nice to be able to be a bit more positive about it.
0:53:04 > 0:53:07I just remember the times when I wasn't with her
0:53:07 > 0:53:11and feeling really empty at not having either child with me.
0:53:11 > 0:53:16And I was on a unit which wasn't a specialist unit, so I wasn't
0:53:16 > 0:53:22with other mothers and it was an experience that was quite isolating.
0:53:22 > 0:53:24It was a relief to get back here
0:53:24 > 0:53:26and this more like normal life for me,
0:53:26 > 0:53:28to have a baby to look after.
0:53:28 > 0:53:31Within a couple of days I had her back in a cot in my room
0:53:31 > 0:53:33and that was really good.
0:53:33 > 0:53:36That was really positive, to have worked towards that again
0:53:36 > 0:53:41because it's so nice to wake up in the morning to her little noises
0:53:41 > 0:53:45and to be able to give her that first feed.
0:53:45 > 0:53:47Hello. Hello!
0:53:47 > 0:53:50You are doing really well with this meal.
0:53:50 > 0:53:53Yeah, are you enjoying that?
0:53:53 > 0:53:55Hey, babes.
0:54:00 > 0:54:01Nice to see you.
0:54:01 > 0:54:04Jenny's improvement came with the help of an intensified
0:54:04 > 0:54:09programme of medication which she is now agreeing to take.
0:54:09 > 0:54:14But also key to her recovery is rebuilding her bond with Libby.
0:54:14 > 0:54:17We videoed you and Libby together
0:54:17 > 0:54:19and now we are going to look back at it together.
0:54:19 > 0:54:21So, what do you think you are going to see?
0:54:21 > 0:54:25- Probably less eye contact than I'm expecting.- Right, OK.
0:54:25 > 0:54:28I think I tended to focus on giving her what
0:54:28 > 0:54:33she needs in terms of her, sort of, physical requirements
0:54:33 > 0:54:38and maybe less in terms of emotional stuff and bonding.
0:54:38 > 0:54:41Well, that's really interesting you have said that
0:54:41 > 0:54:43because I have had a look at the video
0:54:43 > 0:54:46- and I have picked a moment that I would like to show you.- OK.
0:54:46 > 0:54:48LIBBY SQUEALS
0:54:48 > 0:54:51JENNY SQUEALS
0:54:51 > 0:54:54You do a fantastic job, though, of copying her.
0:54:54 > 0:54:56Yeah.
0:54:56 > 0:54:58THEY SQUEAL
0:54:58 > 0:55:01What is happening right now between the two of you?
0:55:01 > 0:55:04- We are having a little conversation again.- You are!
0:55:04 > 0:55:08- She is doing more noises and I am trying to copy all her noises.- Yeah.
0:55:11 > 0:55:13So, what did she do it just then? Did you notice?
0:55:13 > 0:55:17Yes, she turned to look at me because I moved down to her
0:55:17 > 0:55:19- and she could see me.- Yeah.
0:55:20 > 0:55:24So, is that a surprise for you, given what you said a minute ago?
0:55:24 > 0:55:28- Yeah, it is, actually. I didn't realise that I was doing that.- Mm.
0:55:28 > 0:55:31It has given me a bit more confidence to keep trying
0:55:31 > 0:55:36the things that I would naturally do and also shows me that instinctively
0:55:36 > 0:55:43there are things that I am doing that are, you know, positive things.
0:55:43 > 0:55:46And normal parent things as well.
0:55:46 > 0:55:50Libby! Hello, hello.
0:55:50 > 0:55:52Hello!
0:55:52 > 0:55:54# Five little ducks went swimming one day
0:55:54 > 0:55:56# Over the hill and far away
0:55:56 > 0:55:58# Mummy duck said... #
0:55:58 > 0:56:00HE IMITATES A DUCK
0:56:00 > 0:56:01THEY LAUGH
0:56:01 > 0:56:05I am hoping for Jenny to return to herself
0:56:05 > 0:56:09and I think today is the best I have seen her
0:56:09 > 0:56:13since she first came in around three or four months ago.
0:56:15 > 0:56:18# Only three little ducks came back. #
0:56:18 > 0:56:21Things are improving, but I am still very aware of it
0:56:21 > 0:56:24every time I talk to her. There is still quite a way to go.
0:56:24 > 0:56:26It is like the very first bit of spring,
0:56:26 > 0:56:30when you start seeing bulbs coming up.
0:56:30 > 0:56:34There is a bit of hope that things are going to get better
0:56:34 > 0:56:36and there's lots of stuff to look forward to.
0:56:36 > 0:56:39Good girl.
0:56:39 > 0:56:44Good little girl. You had a busy day today, had some time with Daddy.
0:56:44 > 0:56:46And now it's time to go to sleep.
0:56:47 > 0:56:49Good girl.
0:56:50 > 0:56:53- BABY CRIES - It's coming.
0:56:55 > 0:56:59Dr Gregoire is confident that Hannah is now recovered from her episode
0:56:59 > 0:57:03of illness, so she has been fully discharged from the unit.
0:57:03 > 0:57:06It is her first day back at home.
0:57:06 > 0:57:09It does feel amazing, just to be at home.
0:57:09 > 0:57:12Because there was times when I was ill when I wondered
0:57:12 > 0:57:15if I would ever be able to get home.
0:57:15 > 0:57:17Mummy loves you.
0:57:17 > 0:57:22It was lovely yesterday, when you said, "Mum, Mum, Mum, Mum, Mum."
0:57:22 > 0:57:24I don't know whether she did actually say Mum.
0:57:24 > 0:57:28Are you sure it wasn't a figment of your imagination?
0:57:28 > 0:57:30You had just had ECT.
0:57:30 > 0:57:32- SHE LAUGHS - No, she definitely did.
0:57:35 > 0:57:39Dr Gregoire had said that he felt 11 ECTs would be enough for me,
0:57:39 > 0:57:41so the rest will be medication
0:57:41 > 0:57:44and just rebuilding my confidence at home.
0:57:44 > 0:57:47They are going to support me over the next six months to a year
0:57:47 > 0:57:51and they're just making sure that obviously I have no slips back.
0:57:52 > 0:57:56Right now it feels really different.
0:57:56 > 0:57:59It feels like I am actually going to be able to enjoy
0:57:59 > 0:58:01watching my daughter grow up.
0:58:07 > 0:58:10I really thought I would lose friends.
0:58:10 > 0:58:15I was so embarrassed, I was scared, I was shocked, and I thought
0:58:15 > 0:58:19life was quite fulfilling before, so, yeah, I'm excited.
0:58:19 > 0:58:22And there's a little lady in the mix as well.
0:58:22 > 0:58:24It just feels...
0:58:24 > 0:58:27I don't know, it feels like a fresh start for me.