Postpartum psychosis is rare, affecting only one in a thousand newly delivered women, blighting what should be those precious first few weeks of motherhood with insanity. So after I had written about it in “Starting Out” (Intima, Fall 2022) I was surprised, on flipping through the archives, to see another recent article on the same theme: Laura English’s “Cradle and All” (Intima, Fall 2019).

But what a difference perspective makes. Laura writes of her own struggles with postpartum illness, and with her difficulties in accessing and organising help. I write as a psychiatrist, full of professional detachment, and only beginning my involvement late in the day, once someone arrives in the emergency room.

I like to think that I have a good understanding of my patient’s experience. After all, I have spent decades of my life working with people in the depths of despair, or the heat of psychosis, and helping to guide them through to the calmer waters on the other side of their hospitalization. And as we journey together I listen, and empathize, and hence comes understanding.

Except of course it doesn’t. However much I learn about my patients, it can never be the same as spending even a day in the mind of someone whose life has been upended by madness and mania. Doctors’ attempts to fully comprehend their patients’ lives are always worthwhile, but should never be seen as anything more than partial. If you really want to understand mental illness, then read a patient narrative. Or better still, read and publish both patient and doctor.

JP Sutherland has come late to writing, after a long career as a psychiatrist. He is writing non-fiction to try and help demystify this most misunderstood branch of medicine. His first work was published in Ars Medica.