Hi, I'm Sarah Lavonne and I'm so glad you're here. Here at Bundle Birth, we believe that your life has the potential to make a deep, meaningful impact on the world around you. You, as a nurse, have the ability to add value to every person and patient you touch. We want to inspire you with the resources, education, and stories to support you to live your absolute best life, both in and outside of work. But don't expect perfection over here. We're just here to have some conversations about anything birth, work, and life. Trying to add some happy to your hour as we all grow together. Bye nurses for nurses. This is Happy Hour with Bundle Nurses. This episode was actually not on our original schedule. When we plan out the podcast season, we have lists of guests and dream lists and different topics that have come in. Many of you suggest different topics in my DMs. You'll be like, I have a great podcast episode. I have a few of those written down currently that we're probably not going to get to this season, but we'll get to next season because we're coming back. But this particular topic was not on our list, but has become extra relevant based on the current happenings of history right now. I don't know about you, but I have been following the Lindsay Clancy case slightly obsessively, I would say. I wouldn't say unhealthily obsessively, but I have found myself very, very drawn to this case, very connected to this case. And you can imagine why. And many of you maybe feel the same same way. I also want to disclaim that there are many of you that worked with her that know her personally. And so this case is extra close to home for many of you. And so we are going to be talking about some sensitive topics today. And so as always, just be mindful of how you feel, the space that you're coming into, and if you ever need to stop and come back or just skip it all together, that obviously the most important thing is your nervous system and your mental health as well. And so with that, I have been I have felt extra extra connected to the Lindsay Clancy case because in my mind, well, twofold. One is she's a labor and delivery nurse and therefore to me she's one of us. She's part of this community. Whether she knows about bundle birth nurses or not, in my mind, all labor and delivery nurses are a part of this community. And so that feels really extra close to home. But then obviously the whole topic around perinatal mood and anxiety disorders particularly postpartum psychosis has been the topic of conversation online and following sort of what I've seen is this like uprising of particularly women a lot of them who've had kids themselves and highlighting the lack of mental health care there is for women particularly in in the postpartum period, the lack of awareness around postpartum psychosis in particular, but other perinatal mood and anxiety disorders. And so, as I've been following, for context, um, today when we are recording, this is closing statements. And so, um, some of this may feel maybe old as far as the Lindsay Clancy part, but but what we're going to talk about today, I really want to focus on that can be lasting as a learning for us surrounding particularly postpartum psychosis in learning from the fact that this has highlighted a lot of the issues in the world of OB, I'm going to say, and postpartum, but now what can we do about it? and how do we take what we're seeing in the news and with the Lindsay Clancy trial and actually apply it to our practice because this topic is applicable to us in the world of OB. So, if you don't know what's been happening with the Lindsay Clancy trial, this is my account. This is all alleged. I don't ever intend to make any judgment calls on what's been going on or the trial, but I do want to share what's been shared in trial. And that is that Lindsay is currently going through her legal trial against the state of Ma Massachusetts who is alleging that she had cause or was at fault for murdering her three young children. um back it was 2023 I believe that um her husband Patrick got home from doing a couple of errands. He was gone for about 30-ish minutes and he found Lindsay outside of their bedroom window who had fallen on her head from the second story and is currently now paralyzed as a result. She had slip marks on her wrist and um it had appeared as if there was a suicide attempt by Lindsay. He then they later found their three children in the basement that had been strangled um by exercise bands. And so, as you can imagine, this was not only devastating for their community, but also for their family and also this has this has had a lot of publicity. And so what the state is alleging is that Lindsay had had reason. She was not in a state of psychosis. She was fully aware of and it was premeditated that she murdered her children. And what her defense is alleging is that she was in a state of postpartum psychosis. Um now the other one that's come out thanks to social media is also that the jury could decide that she's actually not guilty. that there is not enough there's not there's enough unreasonable doubt that she's not guilty at all. And so currently in this very day, we are waiting for the verdict on that. The jury is going to be handed this case at some point and then we will find out what's what's what the outcome becomes. And so once again, this has brought up a lot of discussion on paranatal mood and anxiety disorders, what's been mentioned in the trial because I have watched much of it uh and the testimonies of the medical professionals. If you haven't been following and you're interested, I found it really interesting to watch the difference between different medical professionals on trial because we always talk about our license and ah I got to protect my license and someday it could be me, you know, and to see them answer to the notes that they wrote and the care that they gave and the medications that they prescribed has been really interesting. And also there's been the words thrown around of postpartum psychosis, postpartum depression, postpartum anxiety, and there was there's been slight mention of OCD. There's been mention of bipolar. And so it's it's all of it. And so we are not here to diagnose. We're actually not even going to open it up from like a clinical sense today because I am so thrilled to have Teresa Twomey here with us today who is going to share insights from her her personal experience of postpartum psychosis and from working with hundreds of others as an advocate in the world of postpartum psychosis. And so we're going to open up the conversation today and really discuss some of the myths that I have heard. I'm going to share what I've learned about postpartum psychosis throughout my career and sort of like what's the scripts in my head. Is that true? Is that one not only clinically true, but more than anything is it actually how this manifests? Because whenever we're talking anything mood, anything psych, um I think it's a lot. Not only I think I know it's a lot less concrete and for us as medical people we like the sign and symptom we like the blood pressure that is elevated or low you know we like those really concrete signs and the moment we start adding psych into the scenario things get a lot more nuanced and a lot more flexible and so I am so excited to have her here to share not only different but just like a wealth of information that she can draw from from her own personal and the experiences of others to help prepare us to feel more comfortable with this and also be more engaged, more expert level practitioners as we practice and not and not just function as if like oh I don't really need to know about that cuz that is one of the things that I was told but more than anything to bring this awareness to our brains to know the signs to look out for to know that this is also so highly treatable. And so Teresa, welcome to the pod finally. That was the longest intro ever. Um, and I'd love for you to just share a little bit about your background. Um, you know, you don't have to give your whole life story cuz I'm sure we'll hear snippets of it throughout. And then also I will say that her story is online. I will link everything in the show notes down below. She wrote a book. Um, there's a TED talk, there's other interviews online. And so we will link a lot of that. If you want to hear her full story, we can we can drop that in the show notes cuz we're not going to do like a full recap of her entire story. We're just going to pull the wisdom from where where she was and where she is now and what she's learned along the way. So, welcome to the pod. Thank you so much for that introduction to give you some basics. I was happily married with a planned pregnancy. There was a whoops during birth that caused a lot of physical problems um and probably contributed to the mental emotional ones. Completely not expecting anything like this. Hadn't heard of anything like this. Um I was an attorney. I wasn't practicing general practice anymore, although I had and I'd shifted over to being a professional mediator with my own practice. Um so it was um I was feeling great at that time in my life. After my daughter was born, I started having issues but it was hard to distinguish what was um the physical problems and I had a very bad infection uh and what was something else. But within 2 weeks um I was having symptoms that in retrospect I know were um a postpartum psychosis and that um I had a number of different symptoms of it. Um and that culminated in a very traumatic um hallucination of harming my child. Um, and then the when the Andrea Yates tragedy happened, I felt very strongly that more needed to be done to educate people because I really feel that education and awareness is the key to cutting down and maybe one day eliminating altogether tragedies that occur. But also, I've learned since then how much needs to be done to help with the healing and to prevent tragedies that aren't the big ones that get splashed across the headlines, but are sort of the normal everyday things that people with this illness face. Um, like enormous medical bills, like divorce, like loss of custody, like self harm, like harm that's short of of um end of life, etc. there's so much out there that and PTSD that we don't um really even talk about yet. I couldn't agree with you more. In fact, when I look back on my education as a nurse, so I am I'm a labor and delivery nurse. This is my specialty. And I would consider myself of a uh I was going to say like an exemplar, that's not a word, I don't think, but like a really educated person. I read all the time and it's not on everything, but I get in rabbit holes and I'm your girl who is reading the research articles, who's asking the questions, who is honestly I feel very held to a higher standard because I am an educator. I am accountable to what I teach. Now, mind you, I don't teach on this. So, that is also part of the gap. But I I mean, I'm a certified child birth educator. I've been a doula. I've been a doula and still am a doula. And so, I follow people into postpartum. and you know and so when I look back on my training there's a lot of things a lot of things and also very little that I remember learning about postpartum psychosis the biggest one that's like resounding in my head is that it's so rare like the most rare thing ever you're like never going to see it and if it were to happen it's a medical emergency you need to call 911 that your partner and like this is what I was told to teach in childirth classes is that the partner would look at like the the husband or wife or whoever their partner is would look at the postpartum person and say they are not themselves. They are clearly like delusional. They're just not there. They're in a psychotic state. I don't even recognize them. And then you call 911. So it's like super clear to the partner. And that the biggest difference is that there's there's baby blues, there's postpartum depression, there's OCD, anxiety, which we barely talk about. Those are like up and coming. But then when we talk about psychosis, it's this other end of the spectrum thing that is it happens on a flash. Like there's no progression whatsoever. It's just like boom, they're psychotic and they likely become violent. That the psychosis equals violence. Um, and so you'd be noticing like some strange symptoms of violence, harming their children, and then it's a medical emergency. Call 911, expect that they're hospitalized, there's medication involved, and then that's it. Like that that's probably and that might be a slight dramatization of my of my knowledge, but like that's what's been implied. That's the messages that I've taken away from my education. And so would you talk us through how much of that is true and what else we need to know? Well, that's largely a great list of myths and misconceptions. Oh, no. Yep. That's why we're here. But I do want to say some of the good news here is that I believe one of the most powerful groups for making a significant difference in the many layers of suffering that come with this illness and the tragedies that occur is childbirth educators. They have like a superpower because they have access at a very important time. Yep. So, okay. If there's a group that needs to know, yeah, about how to prepare women for the possibility and their families for the possibility and what are the resources on all of that. If we could get child birth educators as a group to really want to understand this and really help families, that would be such a huge shift. So, okay, that said, I'm trying to remember to go through one by one rare So, um I don't remember if I provided you with this, but there are some um some blog posts that I wrote or co-wrote that are on the Cherish Mom website about the word rare. So, one is that rare is relative. It's not an absolute term, so it's not strictly factual. Um one is that it is relative. We use it in comparison to other things and some of the things that we don't even think of as rare. And then also it's harmful and that is something that literally used to be taught when it would in the trainings it would come to that point and they'd say well but this is rare. So I mean professionals for sure that's how it was addressed in my y training. And with professionals that's a reason to dismiss it and not learn about it and not prepare for it. Mhm. On the other side of the spectrum with families, they don't need to look for it either, right? Because it's rare and they know something like that wouldn't happen to themselves or someone that they love or they know, right? They think they know. Um and then also with people who survive it, it sends the message, guess what? You're alone. Yeah. Now with social media, we're able to connect, but boy oh boy, when before social media, it was really hard to connect with other survivors. And it really was a feeling of being very alone. Y um so uh I would much prefer terms like less common, right? Less common than other things. um but um or it's infrequent but very important. So we need to learn about it because it's critically important for those who do get it and we don't know who they are. It's a dice roll. about 50% do have risk factors, identifiable risk factors prior to it occurring, but that means there's a whole lot of people who it's out of the blue or that the risk factors are only looking back and there are those. So having a really thorough life history can at least um unearth more people who are at risk but didn't know they were at risk. Right. So that's another aspect of that. So, um, it being obvious, another huge and often stated misconception. After I had mine, I was trying to, well, actually after my second pregnancy, I was trying to learn more about it because I finally had a word for it. And, um, I went and I, um, didn't find anything in the usual uh, birth type books that are available in like bookstores and stuff. So, I was like, well, when I get to a medical library, I'll find something. And I so I did and then it literally was a medical text and it said it's so obvious you wouldn't have to describe it and I knew that was false because that wasn't what happened with me. And more and more I think we're starting to learn that actually a lot of women are missed. So if a lot of women are missed clearly that's that it's not obvious. And I do think that if you are a family member and you know what to look for, it's more obvious because you know what you're looking for, right? It's kind of like I don't know if this is something you want to use on the podcast, but it's kind of like doing your breast exam, right? Yeah. If you do it regularly and you have some idea what you're looking for, you're more likely to get an early diagnosis. But if you don't even need know to do the exam, you're not even going to notice it unless it's wildly noticeable, right? Yeah. It's kind of like that. I think that had my husband had some education about it, it might have been obvious to him that what was wrong was something that was a treatable mood disorder. And what do you wish he would have known? uh that somebody like me could get severely mentally ill, right? that if I was acting odd or doing things that were outside the norm at all that there should have been more sort of intervention as to so what is going on that asking me certain questions like trying to have conversations that might unearth what was going on with what I was saying right why did I keep saying I couldn't cope or that I was a bad mother or that I didn't want to be alone what was I afraid of um there was this odd thing that was happening that I kept calling him to come home from work because I would hear somebody breaking into the house. And what I heard was somebody coming in the door, putting the briefcase down on the couch, opening the latches of the briefcase, rustling through papers, and this happened repeatedly. And I'd call him, I'd be like, "Someone's breaking in the house." He would come home and be like, "There's nobody breaking in the house." Um, and so he would get annoyed with I kept calling him to come home from work. Sure. For something that he thought I'm just hearing squirrels in the attic. The physical at that point was so bad I wasn't going up and downstairs and our bedroom and the nursery were on the top floor. So I couldn't go down to check it out myself. He had known to say, "What do you think you're hearing?" And I said, "Well, I hear this person coming in." and they put their briefcase down and and he could be like so repeatedly you're hearing somebody put down a briefcase and go through their papers in our house like this is not normal. You need to talk to a professional. I mean at that time because we so did not expect something like this to happen to somebody like me, right? I don't know that that for sure that that would have been alarming enough, but I think had he any idea about somebody without a history of mental illness could have a sudden and severe uh mental health crisis following pregnancy, I absolutely think that would have been enough for him to immediately get me help. And for you, was it a like snap of the finger or was it a slow progression? It's a little hard to tell because I had other things going on first. Um, when we brought her home from the hospital, it was raining and we had a gate and then a walkway to our house. And so we handed her off to my mother-in-law at the gate. And because it was raining, she hurried, but we had these um stepping stones that were uneven and she slipped and almost fell while she was holding my baby, carrying my baby. And I kept having like these horrible anxiety thoughts about that. Intrusive thoughts. Yep. And um and I was having nightmares, really graphic nightmares. I was having a lot of um anxiety about like when she was sleeping in the um bassinet next to me, I would not hear her breathing and I would wake her up so I could be sure she was breathing and I wasn't getting sleep because of that. So there were things like that that were more anxietyish or the nightmares maybe more PTSDish because I had things in my past that I' had PTSD about. Um but this is one of those things it's like were those a prodal up to the psychosis or were they just other things and then I also had the psychosis and I don't know that there's a way to parse that apart. Sure. But I also started having OCD type intrusive thoughts. The first symptom that I can locate looking back is when I had a a delusion that was very very similar to my OCD thoughts. It was clearly a delusion. Like it's significantly different in the experiential aspect of it. Although once I realized that that was a delusional thought, I had the same kind of reaction to that as I'd had to the OCD type intrusive thoughts. And I think this is one of the problems with when we go, oh, what was your reaction? I would have reported my reaction as the same that I would have reported my reaction to the OCD type thoughts. And I had those OCD type thoughts both before and after that delusion. I think that a lot of times we miss things when we're looking for reasons to dismiss the possibility of psychosis instead of really eliminating that as a possibility. I think we need to stop saying, "Oh, you have this reaction, therefore it's not psychosis. Oh, you're able to seek help. You have some insight, therefore it's not psychosis, etc." because those can occur without psychosis, but psychosis can occur with those as well. So then what differentiates psychosis? If you're looking at this from a p picture of how do you determine as a professional, right? Having a pretty thorough exam. So if somebody like for me, if I reported having these intrusive thoughts and someone had said known to say something like, "Are they always the same? Are they ever different? H that might have revealed the delusional thought, right? The delusional thought that I had. Um and so just a disclaimer for anybody who's watching who might have OCD, go in the other room for a few minutes because people with OCD can borrow um the intrusive thoughts of another. So mine was throwing my child down the stairs. And most of the time I would have that thought. I would have an immediate, oh my gosh, I'm a horrible mother. How could I think that? All those typical things. This time I had that thought and then I thought, well, no, if I fell down the stairs instead of throwing her down the stairs, then she would probably die, but I probably wouldn't. I'd get banged up, but I'd recover and then I would have my life back, which sounds horrible, but in my mind, my life back meant I never would have been pregnant. There really wouldn't be a loss of life. Everything would reset. Yep. And I could make different choices about what to do. Yeah, my husband would love me again and all these things that I was experiencing with my body, you know, everything would be reset. Um, then after a few minutes, I realized that's crazy thinking and and you know, literally it is. Um, and that that's not at all what would happen. And then I had that, oh my gosh, I'm a horrible mother. How could I think that? And then the other thing is was I having any other kinds of thoughts, experiencing anything else that was odd or felt uncomfortable. Right? And that might have revealed that yeah, I was hearing things that weren't there. Now, I didn't know that I wasn't actually hearing somebody break in. That was real to me. Yep. I did have other things like I had an auditory hallucination of party going on in a room and I knew that room didn't exist and I knew those two things at once. There was party there and there was no room. And if somebody had asked me about strange thoughts, you know, or other experiences, I might have said, "Yeah, it's the weirdest thing. I keep hearing this thing." Right? Which to me seemed odd for somebody else. Hopefully, that would be a red flag. Oh, you're having auditory hallucinations or or questions about my relationship with my husband or that type of thing where they would also try to surface what was it like before birth and what was it like after because before everything was good after I was convinced he was kind of out to get me. So, you know, but I I mean, and I think hopefully what this is indicating is what you want to do is surface more information than just what she is reporting because chances are the other thing that's going on is I have to be careful about what I reveal so that my child isn't taken away. Yeah. And most of us know until we don't until it's too late that we are not the kind of person who would ever harm our child because we live under this false idea that there are those kind and this kind and our kind. And that's not correct. I would bet that until moments before it happened, Lindsay Clancy never would have thought that she was the kind of person who could actually do what she did, no matter how many thoughts she had that were disturbing to her. Because we tend to think of ourselves in a particular way. And it's important to know that psychosis, postpartum psychosis particularly can can fluctuate, can wax and wayne. So you can have periods of insight. You might have periods of time where you can reveal things or even that you'd be willing to reveal things that you might not otherwise. So, it's really important not to think it's always obvious and that it always looks the same. So, that insight, a lot of times a woman with psychosis lacks insight and we cannot expect her to have reliable insight. So, we can't say, well, she had insight enough to lie, right? or we can't say, well, she had insight and looked for help and therefore she didn't have psychosis. But sometimes she might, but we can't expect that. But we can take advantage of the fact that if she does and if she knows how to get help and if she knows there's reliable help available and if she has a way to recognize what's happening to her, she may be able to help facilitate her own getting help. And that might have been what was happening with Lindsay Clancy. I don't know. But nothing in what I've seen of the symptoms of what she reported is inconsistent with the possibility that it's psychosis. Mhm. Well, and she was seeking so much help, you know, and had seen so many doctors and checked herself in, you know, especially with the knowledge of as a labor and delivery nurse, she at least had my knowledge, hopefully more. Um, but at least there was enough going on there to know I need help and she was asking for help. Right. In in your experience of working with all sorts of survivors um, and people with this history, what are some of the other things that you would want us I'm going to say the medical world to know, but also think child birth educators like as far as what to look for? Well, what I would like all of them to know, what I see a whole lot is we need more research. We need more education of providers about how to spot something etc. Right? I cannot stress enough I think one of the things we need to know is that families play a big part. A woman tends to see you at birth and six weeks later. That time gap is the single most likely time for her to have a psychosis. M if the family isn't clued in, if she's not clued in, it's a great opportunity for many different types of harm and tragedy. Yeah. And then in some ways, we rely on a crisis or tragedy before we get to the point of diagnosing or we rely on her revealing it and seeking help. But too often that gets used as a well if she is seeking help she's not psychotic right? So you have a catch 22. So if families and women know what to look for you have a thin blanket of protection but at least something that wasn't there before that's crucial. So before we get to what do professionals know to look for, we need for those who are expectant and families to know what to look for. So what do professionals know need to look for to some extent? One, the same thing that families do. Something is off. When something is off, then we need to find out what. And I firmly feel that if the symptoms can be consistent with psychosis, instead of saying, well, if she has intrusive thoughts and has this reaction, we can dismiss psychosis, instead of that say, well, we assume psychosis until we can disprove otherwise. Right? If you have an X-ray and there's a spot on your lungs, they don't say, "Well, you're not having these other symptoms." It's true. So, we're going to dismiss it because it could be this lesser thing. We say, "Let's rule out the chance that it could be something severe because that is a sign that might be consistent with something severe." So that framework of approaching it differently because then that also gives you the incentive to ask the questions and to find out what's going on that might be indicative of a psychosis but also of OCD and PTSD, right? That have a different level of or different type of access to treatment than something like generalized anxiety or depression. Mhm. And all of that sort of like let's ask those questions could be done in ways that increase trust that share resources and also get to the root of what the problem might be and provide if it's something that is not as severe an access to different coping mechanisms, right? Different things that she can do to build her support network or or whatever it might be. um or to find out if the real problem is collic and not her or whatever, you know, but to get into those questions or like sleep could actually fix it, right? Right. You know, um so I think that not looking for reasons to dismiss something, but looking for what is really going on in a much broader way. Because I think that when we're looking for reasons to dismiss and we couple that with with myths Mhm. then it's well it's a perfect perfect setup for tragedies to happen. Yeah. And then we're surprised when they do. But the reality is we haven't taken the steps to prevent them. So I think the things to look for that go to what we're seeing now is something wrong. Is she expressing that she's not getting the help that she's looking for? Right. Yeah. Especially if it's like something I'm getting help and it's making it worse. That's to me that'd be a huge red flag, right? Um if there's a level of desperation that is different than you would expect from a depression or a general anxiety, there's a really good chance it's psychosis or OCD. OCD and psychosis can look a lot alike. and OCD. So, I don't see this talked about a whole lot, but I think one place where OCD and psychosis interwin in a way that we don't expect that I have heard from a number of OCD survivors is that if they think they have psychosis, it increases the chance that they're going to uh potentially take their own life because they would rather take their own life than take the life of their child. And they think that if you have psychosis, you're gonna harm your child. And that goes to the thing that you stated about they become violent, right? Yep. The vast majority of moms who get a psychosis are not violent. A lot of the suffering is inter internal. But the thing is there's always the potential for that. There is no like, well, this is a good mom, so she wouldn't. Sure. Right. Sure. Any mom. And then and one of the tragic things about the types of tragedies that tend to occur is that frequently it's what you would call altruistic. In her delusion, she thinks that she's doing the best thing for the children. And we can all look from the outside and be like, "Well, that's crazy." Yes, it is. it's delusional or it's hallucination or it's something where she doesn't feel in control of her body, but it isn't something that makes sense because it doesn't make sense when we're applying sanity and logic to our expectations. Sure. So, there's the potential for harm, but it is not at all a likelihood. So, one of the reasons that doesn't get stressed, I think, is that we don't want people to assume that, oh, we don't really need to take her to inpatient, right? Because she's not likely to harm anyone. Um, I used to take a lot of calls from families and uh the vast majority of them did not want to have their um daughter or sister or wife go impatient because they were afraid that would be traumatic. and she was she would never hurt a flea. She would never hurt anybody and she loves the baby and all of that type of thing. Y and that's a big myth. It's not that there's a type of woman who does that. So that is not protectant of the child. It can be that she would have a delusion that leads to that anyway. It's not a protection. And to keep her safe requires a degree of care and vigilance that most people cannot provide. Mhm. And even with that, I would I would frequently say to families who didn't want her to go in and didn't feel like they could make sure they could provide enough like people there at the whole time to care for her and the child even overnight who were sort of trying to reassure themselves that they could. And I would say that that's your choice, but can you live with worst case scenario? And that generally had them be like, "Oh, what do you mean?" Well, like the tragedies you see in the news, can you live with that? Yeah. And uh because that's what the risk is. And so I think to some extent for providers looking at it and maybe this trial will have turned a spotlight on it, your misdiagnosis, can you live with the potential outcome? Yep. Yeah. And that's the accountability that the medical world needs to needs to lean into. Yeah. Yeah. And actually this um I said for a long time that I was waiting for somebody to sue the medical professionals, not because I want to see them get sued, not because I think that they don't mean well, not because I don't think that most people in the medical profession go into it because they want to help people. I think all those things are true. Yeah. But because too many people in the medical profession and the mental health profession that I have interacted with when I've tried to educate them about this illness, dismiss it, dismiss the need for the education, dismiss because it's oftentimes because it's rare, it's so rare, we don't need to learn about it. And I really felt like until somebody sues Y, there isn't going to be that kind of um Yeah. that kind of oh it's it is our responsibility on behalf of the medical and mental health establishment. Well, that appears to be at least beginning to happen because of this, you know, and it's so unfortunate the events that had to take place for that to happen. And at the same time, that's the convers that's why we're here, you know, and I I've never I've never even thought of having an episode on postpartum psychosis until this trial. I'm like, maybe we should actually talk about this. Wait, what do I know? What don't I know? What do I need to know? And so, and what do you know that's wrong? Yes. And so many things. Clearly, I have a lot of education to do on that front. So, if you were to, let's just say we're like, we meet in line at the coffee shop. I don't know if you drink coffee, but let's just pretend that we're in line at the coffee shop. We get to chitchat and we're waiting for our order and the order is like backed up, but you have like 2 minutes with me and you know I'm a child birth educator. I'm a nurse educator. I have an education business. I have an online presence with families and with nurses. What would you want me to make sure that I am passing on to famil family's side? It probably depend on how this comes up. If it was in the context of something like the Lindsay Clancy case, yes, we're talking about the Lindsay Clancy case and I'm like, "Oh, you have experience. Tell me what I need to know. I am open ears." So, what I would say that you need to let families know is that there's this identifiable illness that can happen suddenly to any woman who becomes pregnant, but it is treatable, highly treatable. most recover without having any sort of I would say tragedy to most families. Even though you could consider certain things like a divorce a tragedy, I would say tragedy um without tragedy occurring. But one of the most important things is for them to become educated about what to look for. And I say that knowing that most education that's available to families and even to people who educate the families isn't that I've seen that's out there isn't the education I would provide to families. I wouldn't say that to them but that's the reality because most of what we provide are um here are the symptoms. Families don't need to know the symptoms. They need to know the signs. Families don't have the ability to clinically diagnose. But if you know as a family member that I used to be able to read but now I can't or that if something seems off and I ask you to give me directions to get somewhere and you can't give directions when you used to be able to or if you can't follow recipe or if you can no longer do math if you can't do a skill that you used to be able to do that is a huge red flag and family members are in a perfect opportunity to to do that. There are other things that I particularly advise families about who know that they're at risk that can help to surface if something is going on. So, I would tell families that them being educated is one of the most important things that they could do to avoid tragedy. What I would love to be able to do is then point them to a reliable source of education, but I don't feel that really I don't feel like that really exists yet that I know of. Oh, no. Well, now I got to redo that whole module in my child birth class cuz I'm I mean to be honest, I'm thinking about the bundle birth class. So, we have like the most comprehensive child birth class and it's like it's my soul incarnate for families that align with what I teach nurses in the physiology side and but mind you, it's a birth class. So, like the postpartum section is one I think it's like a 45minute module. So, it's like it's long enough. But I I I'm like, "All right, well, we're going to go do that after this and we're going to go like do better," you know, because I give like a chart in the workbook of signs and symptoms between the different like how like categorizing what it could look like. But I I mean I'm telling you I told you my my thoughts around it and what I was told and I'm like, "Oh boy, we got to do better." And then you'll have a source that you can you feel like you can recommend. So well then what would be the signs that you would educate? So now I am wife to some person that just gave birth and I'm saying you know we've been talking about the Lindsay Clancy case and I've noticed like there's something she's definitely different. What should I be looking for? Well, if you've noticed that she's definitely different in a way that concerns you, what you should be looking for is a professional to evaluate her. Okay. qualified professional to evaluate her. Yeah. Um so I mean because that's the reality. If you if you really hopefully that knows how to actually evaluate. Yeah. Yes. Um if you really notice something is off uh then something is probably off. It might not be psychosis, but it doesn't need to be psychosis for her to deserve proper care or for the family to benefit from proper care. Love it. I feel like that's a great stopping point for us. I'm looking at the time and going, well, it looks like we're at a two-part, which is amazing and fabulous. And so, we are going to come back for part two. And in part two, we're going to revisit the Lindsay Clancy case and to get your insights on the Lindsay Clancy case and especially related to your experience of your delusion, maybe hallucination that you had as it relates to Lindsay Clancy. And then we're going to talk recovery and what it looks like to get treatment and what we can as medical professionals do to encourage that forward. And so, thank you so much for being here for now, but we are literally going to pick up this conversation where we left off when we come back for episode two. And so, thanks for spending your time with us during this episode of Happy Hour with Bundle Birth Nurses. If you like what you heard, it helps us both if you subscribe, rate, leave a raving review, and share this episode with a friend. If you want more from us, head to bundle nurses.com, subscribe to our email list, or follow us on Instagram. So now it's your turn to go and do your own one step of research to pursue more education, more knowledge surrounding perinatal mood and anxiety disorders, particularly centering postpartum psychosis. We'll see you next time.