What If We’d Known? Rich Baish on Postpartum Psychosis and Parenting Through Grief

0:00A quick note before we begin, this episode does include a conversation about suicide and maternal mental health. So if you're in a vulnerable place, please take good care of yourself while listening and take a look in the show notes for some links to places where you can get some support if and when you need it. So my guest today is Rich Baish, who I've known for almost 20 years, sharp intake of breath being able to say something like that since we were working together and living our best life at a cinema in our teens. Rich tragically lost his wife to postpartum psychosis just days after the birth of their second child.

0:30It's the kind of tragedy that is absolutely impossible to comprehend. And yet, Rich talks about it with an honesty, clarity and heart that I'm pretty sure will stay with you for a very long time. We're having this conversation today because postpartum psychosis is still so widely misunderstood and too many families just simply don't see it coming until it's too late. By sharing what happened to his wife, Rich is helping to raise awareness, break down the stigma and make sure that other families know exactly what to look for and what support is out there. This is a conversation about maternal mental health, yes, for sure, but it's also definitely a conversation about fatherhood, about friendship, about resilience and above all about love.

1:10It's absolutely heartbreaking but it's also strangely hopeful because what Rich shows us is that even in the darkest of times it is possible to keep going, to keep showing up, to hold space for what was, while also making space for what comes next. So grow yourself a cup of tea and let's dive into this amazing conversation with an old friend.

1:40Hello, it's Bill. I don't know what like, I want to say almost 20 years, which I think is Actually saying that is probably the oldest I've ever felt in my life. Like, it's been two years since we were living our best lives at the Odeon.

1:56Rich Baish:I reckon the Odeon was my favourite ever job, you know. It's a very exciting one. I loved it. I know. Well, you wouldn't now. It's closed. It's closed.

2:07Thank you so much for reaching out and for agreeing to do this today. How are you?

2:12Rich Baish:Yeah, thank you. Pleasure. I'm good. I'm good, thank you. Are you working from home right now? Yeah, it's fantastic. Love it. You know what? Because you've got a sort of map of the world behind you and it looks very classroomy. And I know that till very recently you've been teaching. So I was like, have you gone back into teaching alongside the other stuff that you're doing? But no, no. Yeah. I was going to say like an evil genius, but it's far too, you wouldn't have an evil genius. I'm in such a colourful environment. Showing the map of the world with some lovely animals all over it thriving.

2:44We need more of those. Tell me what's going on with you. What's your situation right now? How many kids have you got?

2:50Rich Baish:I have Freddie, who has been six in a couple of weeks' time. And we've had a countdown for the last 50 days or so. And he's just a delightful little boy. And I know every parent loves their kid, don't they, normally? But he's just an absolute joy to be with. Just so sweet. And he's got a little sister, Rosie, who is two and a half and is a delight. But it's very much second child syndrome, where when the third child seems fine. and the second one comes along and makes up for that in every way. She's a delight. But when she wants her away, she absolutely gets her away. And the relationship between Freddie and Rosie is just gorgeous.

3:26So you work for a charity right now that is all around spreading awareness around the highly important but highly unknown topic of postpartum psychosis. Can you sort of walk me through, firstly, what do you do there and what is the charity?

3:43Rich Baish:Yeah, so Action on Post-Pastalmine Psychosis is the only national charity which helps mums and families affected by post-pastalmine psychosis, which is mental illness, which is the most severe form of post-natal illness. And I work for them because that's something that my family have suffered with two and a half years ago. I joined them in January and I've got three main roles. One of them is, so my job is the development manager. Part of it is to form part of a bereavement project, and that's to support people who have been bereaved, whether it's partners, children, parents, family members or whatever, to help grieve or do something in their own way in that person's honour.

4:22Rich Baish:I also help with organised training for GPs and health professionals. And the other part of it, probably the more fun bit, is fundraising to help people in their weird and wacky ways and raise money frequently. Amazing. And I think kind of the natural next question is, how has postpartum psychosis touched you and your family? Well, it touched us in the worst. Touch is the wrong word, isn't it? It destroyed our family, I suppose you can say, permanently without us realising what it was. The worst and most frustrating thing is with postpartum psychosis, it's a treatable disease illness. If people knew about it at the time, they could nip it in the bud, they can act on it.

5:00Rich Baish:I didn't know anything about it until it was too late so I'd heard of what the baby blues were which is such a throwaway innocuous term to use isn't it the baby blues oh she's just a bit sad that's largely what kind of people view it to be I had no idea about it so I only started to find out about it after I lost Alex so my wife had suffered no mental health issues in the past whatsoever but there's something that triggers something in the brain to make people have delusions basically and it can come across in different ways it can be hallucinations it could be mania it could be being completely withdrawn there's such a range of ways that it can affect people but ultimately the mum is different to how they normally are now the charity i work for app they had a huge national campaign last year and the slogan was um new mums seem strange seek help and it's It should be as simple as that for family members, for partners, for friends, just to say, oh, someone just had a baby, they're not looking right, and I need to speak to them, I need to speak to the GP.

6:10Rich Baish:But actually, the best practice, the best form of help is taking them to A &E straight away because it should be treated like a medical emergency, and they should be treated within four hours. So talk me through the timeline of your own experience. so you had Rosie two and a half years ago how quickly did you start to realise that something was wrong? Yeah good question I run a good way because the birth was absolutely fine it was brilliant it was so quick for the first sort of two weeks everything was absolutely perfect and then Alex started to suffer with breastfeeding like a lot of new mums do with sleeping like a lot of new mums do and the decline was probably in about three days.

6:57Rich Baish:It was when I got back from, I'd just broken up for half term in the October on the Friday. Got back and she said, I need to speak to you, I'm not well. We had a low key weekend, not doing very much. She went to the GP on Monday. The GP had prescribed her some antidepressants to have, which don't kick in until about two weeks time. And had agreed for her to see a professional psychologist two or three days later but then she took her own life on that monday night so it really from from the friday to the monday yeah and there's there is some research that's being done in terms of how sleep deprivation or um you know anything frustrating to do with with breastfeeding can can affect people so i think they were they were contributing factors but i think ultimately this um this shift in hormones in brain function was was the thing that um that's a character and so when she first sort of pulled you aside and and had that chat with you and said i'm not i'm not well what was she experiencing at that time what did that look like for her that feeling of not being well it was a feeling of not being able to do anything kind of day to day um yeah and just like every everything was a huge effort was a chore even just you know there were questions about how we're going to hope as a family how am i going to be X, Y and Z.

8:19Rich Baish:So in that way, it was harder to spot than someone who has got a lot of rage and a lot of anger and is outwardly expressing lots of fear and frustration. There have been some storylines on things like Hollyoaks and Casualty, where the mum shows more of these outward signs. With Alex, it was very much a withdrawn sign and symptoms that she was showing. I always use the analogy of in a class obviously as a teacher if there's two children who are um you know they're not engaging in the lesson you've got one kid who's you know throwing chairs and some swearing and kicking off instinctively the teacher will go to that person because the signs are more obvious to see but you've got another child who's you know got the head on the table they're not wanting to talk to anyone they each need their um the teacher's attention but just in different ways and it's just harder to see with the latter one so yeah the signs were really really difficult to spot and again frustratingly there are so many people who suffer from postpartum psychosis who have had no history of mental illness yeah yeah and because you know background wise she's got a stable family supported loving people around her very good job no history of mental illness she was a mist and there was someone i spoke to recently where she'd suffered postpartum psychosis and the person who was dealing with her said oh if you have another child um you'll be okay because you'll be you'll be seen too straight away and people will keep an eye on you so well why is that okay because someone's had that issue before then they're giving more attention yeah i mean i i feel extremely passionately about this the whole field of maternal mental health because i have talked a lot about my own experience with maternal mental health which i think what frightens me i think about alex's story and your story is it's actually quite unusual that someone in say a three-day window is already seeking help so so every opportunity for intervention was there because she actually reached out for help to you and to the doctor and still was able to slip through the net.

10:14I think a lot of people, myself included, can go months before they actually even realise that they need help. It's frightening to think that somebody can fall so quickly and so hard, still try and get some support and still be missed. That to me is really scary.

10:31Rich Baish:Yeah, you're totally right. Actually, the earnest shouldn't have been on Alex, because it shouldn't have been on you to reach out. It's actually up to everyone else. And do you know the frustration as well? People say, oh, there's no funding in the NHS for this, for people to check in. I mean, we had the regular sort of checks every few days and everything seemed to be fine. And yet, as soon as we lost Alex, there were people coming in all the time and they were saying, what can we do for you X, Y, and Z? Well, if the support is there afterwards, why couldn't it have been there before? There's got to be more preloading.

11:04Rich Baish:just while i'm on this my my one of my biggest frustrations there are quite a few um things that i don't want to blame anyone specifically for um the way we we lost alex but now i just think there are holes in the system one thing that really frustrated me with them with our antenatal group is one area we would kind of put into this frame of mind where everything would be perfect is all the build-up to the perfect birth and we were told you both have so much oxytocin flowing through your body that everything's been great be the most amazing moment of your life with freddie i'll be completely honest it took a little while for me to like really sort of like fall in love with him because i was just so scared right yeah and and when something goes wrong is you're not given that those tools to um to understand how to deal with it i always use the analogy of like when i teach my children how to cross the road safely i'd rather they um knew what to do in case there's a danger and nothing happened then not realize that danger and something bad happened or needs in these antenatal groups is someone to say right look most of the time you're going to be fine but there is a chance that something will be wrong if this is the case you need to rush yourself or your partner to yeah you need to go and get this help because we're only talking with postpartum psychosis we're talking between um 0.1 and 0.2 percent of people um worldwide that suffer with it it doesn't sound very much does it but actually that's the same percentage roughly the same percentage of people that suffer with Down syndrome.

12:25Rich Baish:And everyone knows about Down syndrome and there's so much done for that, isn't there? And it's helping in the UK alone between three or four mums a day are still going to suffer with postpartum tichosis. It's a big enough thing for people to need to know about. And again, it's just a five-minute conversation just with a midwife or a GP or an antenatal group beforehand just to say, look, this might happen. If it does, this is what you do about it. So this feeling of everything's going to be great just really frustrates me because we're just forced into having to tell ourselves that everything is wonderful, when actually a lot of the time it's not as a new mum or dad.

13:01Rich Baish:It's pretty scary, isn't it? And it's just unrealistic expectations. And I think it's why so many people don't actually reach out for help because you're told the story that you're supposed to be flowing with oxytocin, you're supposed to be in this absolute bubble of joy and love and wonder. And for some women, I think a lot of not just women, men and women. The opposite is true. You're blown wide open, you're exhausted, you're sore, you don't know what's going on. And you're afraid to say that because what will that then mean about you as a parent? Will people judge you? Will people think you don't love your child?

13:37I know for me, that was a massive barrier to getting help is just this fear that people would think I was an unfit mother or that worse, they would take my, it was with my first son take him away from me so I really kept everything bottled up because it didn't feel safe to say I need help.

13:55Rich Baish:That's a big fear actually as well people who worry that the child's going to be taken away from them and therefore they don't want to reach out just in case. Yeah. Yeah. So what I mean it's hard I think for people to understand what it looks like when you're looking at somebody who's really struggling what's the difference between postpartum depression and postpartum psychosis like where where do you tip over into that really extreme end of the spectrum well yes good question it's a really fine line but i don't think it's that there's a straight continuum you might find people with um depression might show more extreme symptoms than psychosis it's just um the way they they answer i guess it's really tricky question to answer post-partum psychosis can um have so many different symptoms like i said it could be um calcitonia it could just be this this feeling like you're talking to someone who's just not in the room i just think it's the fact that they almost become like a different person and and yeah with my wife that i suppose i've got of her was where she looked you know really vacant and almost like she'd she'd made her mind up and um i just think it's difficult to answer i don't know there are so many different factors and so many different ways that people can react that um you can't really say this is depression this is psychosis i would say but i think the message is if somebody is changing and is struggling then it's really urgent that they get that support right away like you can't sit on it because it the line between being able to cope with it just about and not is a thin one and you can sort of fall into um that that horrible situation that alex found herself in where she just couldn't get her she couldn't get out there was no option for her in her mind than to then to take her own life the decision is just be taken out of her hands yeah so you know if i'd have known about it if um it happened to to someone else and i'd seen new signs, I would have taken her straight to A &E.

15:57Rich Baish:And then the idea is within four hours, they are meant to be assessed by a professional and should then, if they need to, be taken to a mother or baby unit. And I think really importantly here is the message that this can happen to literally anybody. Alex didn't experience any mental health concerns prior to having a baby. she didn't experience it with your first son it's it came from nowhere it came quickly it can happen to all of us and so i think you're completely right we all need to be looking out for those signs in that period where we're you know told the story or the myth that it's this wonderful magical experience we all need to be looking out for but when it's not we need to do something about it we need to do something about it right away yeah completely if let's say someone's sort of concerned about somebody who's just had a baby they seem a bit off and they want to make sure that they're getting the right support what's where should they go is it well that's the thing isn't it that the reason why i was really hesitant in terms of going to a gp is we didn't go to a gp and again without being personal this gp hadn't obviously heard of the uh the significance or severity of postpartum psychosis or maybe they had but hadn't seen the signs of it so if i told people i'll go to a gp and that specific gp wasn't aware of it or didn't act and maybe as as they should have done then the worst can happen so yeah my answer would be to save any doubt it's straight to any yeah yeah and but you know if you're with that person at the time then action on postpartum psychosis is probably the best site to go on because they've got signposting they've got support they've got stories they're just loads of information to to help people and partners i I'd probably suggest that the partner or the person responsible for that, for the new mum, the onus needs to be more on them because they're able to do it more objectively.

17:52Rich Baish:But yeah, what's the worst that can happen? You go to A &E and they turn you away. They're going to know about it a lot more than one individual is saying. So obviously the worst case scenario happened for you and your family. What did the aftermath of Alex's death do to you personally, but also like I'm trying to imagine how it must have been you've got a newborn baby an older child who you're trying to take care of and also deal with their grief and manage your own grief and just like trying to figure out what's gone on what did that first few months look like it's it's so weird like in some ways it's a blur but in other ways I've got just like such a sharp memory of everything that that happens I found out at four o 'clock in the morning and I even remember um like alex's family sort of being there and and telling me i think obviously like there's one part of me that was just you know completely devastated didn't know how to think emotionally and i've still not had any proper therapy so maybe there's still there's definitely still a part of me that needs to deal with that but the other side of it is like you just go straight into survival mode and i think i'm definitely still in that so i found at four o 'clock i knew that my son had a little grow clock in his room and as soon as that turned yellow at seven o 'clock he's going to be up and he's going to be normal so i remember like being at his door at like a minute to seven and then um as soon as it turned yellow you heard him say it's on yellow and he you open the door and like freddie i gave him like a big hug it needs to be normal and um obviously suddenly he's thinking over the practical stuff i'm like well yeah my daughter's exactly a month old today um she's gonna need some milk uh we were actually just starting to make that move from breast milk to formula anyway.

19:37Luckily, a midwife, I think the fourth or fifth midwife

19:41Rich Baish:we dealt with finally said, you know what, I'm listening to you. I understand it's tough. It's just moving on to formulas. We'd already started that journey. But I was straight onto Amazon. I bought a load of bottles and formula just to make sure that Rosie was going to be okay, nappies and stuff like that. So you just have to go into survival mode. And the first few hours I was on the phone to like life insurance people and i'd messaged uh school and i made sure that everyone you needed to know in the immediacy just just just knew about it straight away yeah um and in a way like you sort of think oh that that that's really tough having to do with all these things but in a way it really sharpened my mind because i just had to focus on making sure that my children still had a roof over their head that they still had had things stuff like that so in a way all those other things like all these emotions of losing my wife and and all this sort of stuff and having to then change my job and things they they were just secondary so it's easier for me to compartmentalize if you like it's quite amazing how even in the the i can't think of a worse experience actually that a person has to go through that phase of life you've got a tiny baby and and you've lost someone you've built you're building a life with that you just go straight into kind of caring mode for other people like your primary thoughts were about your children and how to make sure they're okay.

21:01And you mentioned to me in a previous conversation that you became last on the list when it came to the grief experience. Can you sort of talk a bit more about how you did handle your grief in this experience? What do you mean by it came last? I mean, beyond the obvious.

21:19Rich Baish:I know it's really crass to kind of think of a ranking system of people who you kind of feel sorry for. But I just think I had to look at the bigger picture. Like for Freddie and Rosie, I just thought how awful it is for them to have this situation growing up and what they have to deal with. We went to Gampo to Arsenal, actually. So Joe, my lovely partner, and her son, and Freddie came along as well. He was just talking to a guy in the underground, the bloke who does all the announcements. And he looked at Freddie and he looked at Joe and he said, he referred to Joe as his mum. And Freddie is four years old at the time.

21:58Rich Baish:and he said um my mummy's died and you sort of think oh for god's sake like he's gonna have to do this like for the rest of his life yeah yeah um and and even like now he still just just mentioned mummy and and i hate to say this but at some point there's going to be a horrible kid probably when he's 15 years old who will make a comment yeah that's something that i just know is going to happen but i've just got to brace myself for it so just for them i just feel so sorry just so sorry for them that they've missed out on that and normality and those expectations to make and stuff and just making sense of it and making my job as well is to make sure that they don't feel any resentment towards their their mum yeah yeah and it's i've got to explain really carefully so there's so much fun to do and out to parents as well i mean having to lose your your own daughter and and and your best friend as well i just i just couldn't imagine losing either of my children so again i'm just thinking from from my point of view how bad is it like how far down the the spectrum is it that's got to be worse losing your child but also i said above me is um in terms of people i feel more sorry for is alex herself just you know the most amazing um person wife mum um and this feeling that she's she's missing out on them but i'm not um i've never been a religious person um but actually i've become a lot more spiritual i think and i've seen signs in the last few months and you know biologically she is a big part of them and yes and i felt so much more comforted in the last few months just but just just feeling these signs occasionally i know i'm going off a tangent sorry so thanks for this um space to say i've been at mind um there was a time and i it blows my mind to think about it now but it was on the anniversary there's two year anniversary of losing alex and freddy at the time was was sleeping in my my bed next to me now he would go to sleep from like eight o 'clock till seven o 'clock like he'd just be a log he just wouldn't wake up for anything and um so it was yeah on the 25th october 2020 or this was so i found out at four o 'clock in the morning and on the four o 'clock in the morning two years as in to the to the minute he just sat up bolt right and you know bolt up right in bed and um he just tucked me on the shoulder and just said um i really love you daddy oh my god i'm like that hasn't happened before oh my goodness yeah well not some sort of sign that like yeah yeah yeah that was um like a heart breaking but heartwarming moment at the same Yeah, yeah.

24:37And I think that's, you've touched upon something there that I did want to talk to you about is the kind of like the duality of the grief that you experience, that it's both devastating, but also you do still, you've got your children who are going to constantly keep you bound to Alex and all of the beautiful things about her will continue to live in, you know, the ways that your children grow and show up in the world. And so there must be this really strange experience of both pain, a lot of pain, a lot of sadness, but also trying to balance that with the heartwarming moments, as you mentioned, that you can see that particular memory is a good example of how one scenario can be both of the things.

25:19And that must just be a really, I mean, no one gives you the tools of how to deal with grief. We don't know really how to grieve. No.

25:28Rich Baish:And there's no particular right way or wrong way. to grieve with her i think initially whenever we did anything as a group where i could see rosie smiling or giggling and freddie really happy and really enjoying what he's doing it felt amazing it just just anytime they have like a normal moment where they just feel yeah just makes me feel so so good but in the first few months especially it you said right it was just this this huge mix of happiness but but um devastation as well like a few months later we went to go and see um like a little circus show and freddie was just hooked he was just like for the whole hour and and he was loving it and and rosie she was like six months at the time but she was engaged she was enjoying it and i didn't really watch the show very much i was just like watching the two of them just and i just looked at them and i was like crying like for the yeah the whole hour like tears my eyes the whole time but now with two years on i'm starting to i'm able to move more towards just the enjoyment of things and that's not to say that i'm over what happens or that i'm starting to forget about it but i just think i'm able to to rationalize more and just just appreciate more that feeling of enjoyment that they're there and that alex is still in their hearts and she's you know hopefully watching on from from somewhere or she's you know still a part of them enjoying it together so yeah i just think as people say oh you know you never you never get over it but you get used to it yeah yeah you learn to live with it yeah yeah of course yeah that's right what about parenting child that's grieving obviously rosie was a baby a real tiny tiny weenie baby so this is her normal i suppose freddie on the other hand he i guess can remember life before and life now it looks different for him how have you navigated freddie's grief it is yeah it's a really good question initially you have to be really black and white by the way when when you first when i first had to tell him it's just like the worst thing with lots of people around that day obviously coming in um you know like from from family members to friends and the police having to like do swaps and stuff it's just the most surreal day like i've ever had in my life and so i just kept saying it could tell obviously something different you kept saying where's mummy gone and in the middle in the afternoon but by that point i just like right i've got to tell him so i picked him up took him to a room and just um sat down i said that mummy's died it's very sad but she loves you very much.

27:46Rich Baish:She's not coming back. She's really, really blunt like that. For a three-year-old, you don't really understand this very scene too. You're much, much older, do you? And it was nearly kind of Halloween time. He just, as he looked for his head, went, oh, like that. And then he saw this like little pumpkin light torch thing that under his head. What pumpkin torch can I play with it? Within a few seconds, like it's obviously not a slight on him, but I just suddenly opened my floodgates and he's back in the room. So I guess that kind of starts to answer the question in a way because what you'll get from like a three to five year old is little snippets of I miss mummy and you know I'll show him pictures and videos of them together.

28:32Rich Baish:I always try and you know do that because I never want him to forget mummy. I never want him to get too upset but it's always good for him to be upset. But as time's gone those conversations have gone like a little bit longer and it has become a little bit more emotional um yeah so i think it starts off with black and white short segments which is tricky for me because again every time he mentions like mummy like i just you know it goes to pieces but um there's a charity called seesaw which helps specifically um it works for children who have been bereaved but initially they said uh because he was only three they wouldn't go into work with him at that time because it's another adult and it's difficult for them to build that bond.

29:09Rich Baish:But as he gets older, they will start to come into school and work with him. And he has little nurture groups and stuff to talk about emotions and things like that. I mean, Freddie's a million because he is emotionally stable and he's just such a happy little boy. But that's not just come from me and our family. That's come from friends, wider society, school. They say, don't they, it takes a village to raise a child. but I think actually it takes a village to raise a family back up. I wouldn't be here today with all the extra support that we had from people. So I don't know what sometimes goes through his little mind.

29:42Even last night actually, bless him, he just, I don't know whether it's because I'd

29:45Rich Baish:had to tell him off. Like he was really tired and he pushed Rosie in the face, Rosie got upset, and I'd tell him off. And then just as he was going to bed, he just said, I just really miss mummy being a part of our family. Oh my gosh. So yeah, and I thought I'd have to have these moments of saying I'm a Mr. Anaha and he'd go to her mummy's garden as we call her where she's where she's buried and we visit there occasionally so in some ways i try and be proactive by showing videos and showing these lovely you know memories of him but other times i kind of just wait for him and i'll always be open to say um whenever he mentions it i'll happily stop everything and and talk about it but i do worry we worry about when he grows up and he he realizes the extent of what happened how it happened and i just worry that he'll get angry but then yeah i've just tried to tell myself over the next couple of years this will just happen you've got to take it day by day i can't worry too much about what's going to happen when he's like 10 and if he suddenly has his anger outburst and throws things around the room for now and for the last two and a half years he's been a really happy boy and yeah i'm just trying to appreciate that every day i think um one of the things i've found most moving about sort of seeing your your experiences from the sideline she's so much a part of the stories you tell the things that you share obviously you've got your life now you're you're moving forwards you've got a new partner and you're building a blended family and Alex is still there with you in the things that you share and the ways that you talk and I think that's so important for you know just thinking about what would what would make a child experiencing grief at different phases of their childhood angry, I would imagine a large part of it is just feeling like they weren't able to experience the emotions as they come.

31:29And it sounds so much like you're giving all of that space, even if sometimes it's uncomfortable or hard to talk about the feelings that arise in a little boy or eventually your daughter as well. You just stop what you're doing and you give them space and allow Alex to still be part of your life as you're moving forwards and and a really important part of the family that you're building so i think it's i've just been really inspired by how you've handled your grief oh that's really sweet thank you and i i think

31:58Rich Baish:initially i just spoke so much like i said i haven't had any professional therapy but actually um i've got by just by talking to people i do feel it's refreshing as a man to to be able to say you know talk about your feelings because uh yeah you do it a lot less than the women generally but But I think with Freddie and Rosie initially, it was to sort out so many practical things and make sure that day-to-day they were okay. But in the evenings when they were asleep, that's when I kind of had my downtime, my talking time with other people. So I think in some ways I've had to put them first practically.