I Experienced Post-Partum Psychosis After The Birth Of My First Child

The following extract is from Inferno: A Memoir by Catherine Cho, an exploration of how after giving birth to her first son she found herself in an involuntary psych ward, grappling with psychosis. The result is a powerful study of psychosis and motherhood, at once intensely personal yet holding within it a universal experience – of how we love, live and understand ourselves in relation to each other.

The rules of time don’t exist in a psych ward. Each of us counts the time differently. There are some who count in days, others in weeks and months. And then there are those who don’t count the time at all, they’ve been here for so long. The ones who count in days, they are the ones who pace. I am one of them. 

I’m wearing foam slippers, pale blue with smiley faces on them, government issued. I claimed them from the bin, they’re now a treasured possession. 

I walk past the glass enclosure of doctors, past the TV room where the sound of the 24-hour news cycle is blaring, past the activity room with the conference table, the hallways of resident rooms, to the heavily locked doors, and then back again. 

I’m not sure how long I’ve been here. I think it’s a few days. But I count today as day one. The first day that I’m aware of where I am. 

In my pocket, I have a folded piece of paper where I’ve written my truths in purple marker. These are words that I cling to as reality, or at least the reality I hope for. I’ve repeated the phrases so often I know them like the words of a prayer. 

I am alive. Real.
I am married to James. Real.
James loves me. Real.
I have a son. Real. 

My son is three months old. Real.
My husband and son are waiting for me. Real.
I have post-partum psychosis. Real. 

I have post-partum psychosis. I had never understood what it meant to doubt your own sense of reality, to be removed from time. The closest way I can describe it is those moments in dreams where you’re not sure if you’re awake or still sleeping, but in psychosis, no matter how many times you try, you don’t wake up. 

The medical definition of psychosis is a mental illness in which an individual has difficulty determining what is real and what is not – it’s a loss of objective reality. I had never heard of post-partum psychosis before my own diagnosis. Pregnancy had brought a list of worries – episiotomies, prolapse, pre-eclampsia. I was so preoccupied with the idea of losing my body, it had never occurred to me that I might lose my mind. 

When I woke up this morning, my memory was in fragments. I was flooded with glimpses of past versions of my life, real and not real, as though I’d been copy and pasting a paragraph of my life on repeat. 

When I reached for my body, I didn’t recognise it. My breasts were a network of red angry knots from not breastfeeding, my ribs were protruding and I could feel the edges of my collarbones. I was wearing a hospital robe and my wrists were sore with the marks of restraints. My hair was damp, tied in a strange way, someone else must have tied it. I wasn’t wearing a wedding ring. Wasn’t I married? I was sure that I was. I remembered a lace dress, roses and ivy in my hands. I tried to remember the song that played at our wedding. But which wedding? I remembered a few, the groom’s face was blurred in all of them. 

As I pace the hallways, I’m trying to find the molecules of myself, to collect myself in the present, to contain myself. Any time I try and remember something from before_, to hold on to what was certain, I come up against loops, tangles of repeating memories, replaying with different outcomes. 

I remember living and dying, again and again, each lifetime of decisions splintered into possibilities. 

I go back to my truths. I am Catherine. I am married to James. I have a son. 

Counting my footsteps makes me feel reassured. Numbers are certain; they hold a linear logic. It occurs to me that no matter how many steps I take, I will remain constant, in this place. 

I try to remember, but I can only recollect moments. I remember a baby. The curl of a small fist. The feel of a breath against my arm. 

I remember a balcony in Hong Kong, counting the seconds while surrounded by the grit of an orange sky, listening to the man pacing inside, hoping he will forget about me and go to sleep. 

I remember sitting with my brother under a maple tree, watching the clouds descend, revelling in the silence, waiting for the tornadoes to come. 

I remember my first conversation with my husband. His smile. The swirl of bourbon in cut glass. 

Mostly, I try to remember who I am.