Author Catherine Cho recounts how one of the happiest moments of her life turned ugly when she developed postpartum psychosis shortly after the birth of her first child. This is the story of how she and her family made it through.
Back From Broken is a show about how we are all broken sometimes, and how we need help from time to time. If you’re struggling, you can find a list of resources at BackFromBroken.org.
Host: Vic Vela
Lead producer: Jo Erickson
Editor: Dennis Funk
Producers: Luis Antonio Perez, Rebekah Romberg
Music: Daniel Mescher, Brad Turner
Executive producers: Brad Turner, Rachel Estabrook
Thanks also to Hart Van Denburg, Jodi Gersh, Clara Shelton, Matt Herz, Martin Skavish, Kim Nguyen, Francie Swidler.
On Twitter: @VicVela1
Transcript
Vic Vela:
In three, two, one
[indeterminate child sounds]
Catherine Cho holds her excited son while her husband assembles a toy horse.
Child:
Two, two foots.
Catherine Cho:
Four feet. They're on four legs, kiddo.
Vic Vela:
This happy family life seems a far cry from their lives three years ago.
James:
You traveled very far away on your horse.
Catherine Cho:
On your horse.
James:
You’re now in Virginia. [indeterminate child sounds]
Vic Vela:
Like most first-time moms, Catherine Cho was nervous about being a mother. It's such a life-changing experience, especially for a highly accomplished literary agent who is far more comfortable managing the egos of writers than changing diapers. Catherine was 30 years old when she found out she was pregnant.
Catherine Cho:
And so it seemed kind of destined, because my mother had been 30 when she had me. And so was my grandmother when she had my mother.
Vic Vela:
All the signs in her life were saying this was meant to happen. But when Cato was born, something inside of Catherine snapped. The stress and anxiety of being a new mom triggered postpartum psychosis, something that affects almost two out of a thousand new moms.
Catherine Cho:
It was such a surreal experience because I basically, I went into a complete, a mental break.
Vic Vela:
Catherine went from being a quiet self-assured brilliant woman into something else, something that's scared her.
I'm Vic Vela. I'm a journalist, a storyteller and a recovering drug addict. And this is “Back from Broken” from Colorado Public Radio, stories about the highest highs, the darkest moments, and what it takes to make a comeback.
Catherine Cho and I spoke recently on an international phone call.
Catherine, hi, how's it going?
Which, as you might notice, had a little bit of a delay.
What time is it there, by the way? [laughing]
Catherine Cho:
It’s 2:00 PM.
Vic Vela:
Catherine was born in Kentucky to academic parents who moved there from Korea. After spending a long time in New York and Hong Kong, she settled in London with her husband where she works as a literary agent and writer. Catherine's first book, “Inferno,” is a memoir about her journey into motherhood and madness. But before that descent, Catherine says she had the same positive feelings as a lot of other moms when she found out she was pregnant.
Catherine Cho:
You know, I felt really excited. I'd always wanted to be a parent. I hadn't really given much thought to it before, but for me it just felt just like a blessing and something that, you know, I'd always hoped for.
Vic Vela:
What were your feelings in the days leading up to the birth of your child?
Catherine Cho:
It was a lot of excitement, but also anxiety. I think that's, you know, it goes for any first time parent, you focus so much on birth and the whole experience of birth and it's such an unknown. We did all the classes, I read all the birth stories and yeah, you kind of try to prepare as much as you can, but I think you, at some point have to accept that actually it's not something you can really prepare for.
Vic Vela:
So he was born and you named him Cato.
Catherine Cho:
Yes.
Vic Vela:
Where does that name come from?
Catherine Cho:
So that was my husband's idea. I actually wasn't super keen on the name, but my husband really wanted a name that was a bit unique. And what's also nice about it is that it kind of sounds Asian actually, but it's also Western as well. So we liked that aspect.
Vic Vela:
So Cato is in your life now, your first child, you're 30. What was life like at the beginning? How were you feeling with Cato in the world?
Catherine Cho:
Everybody gets so excited when there's a new baby. And I remember, you know, we had friends come over and hold him and going for walks with him. Yeah. It was a really fun and beautiful time at the beginning.
Vic Vela:
Sounds like everyone's just really happy for you. And of course, you know, Cato's this beautiful boy. When did you notice that you were getting stressed out and anxious about the baby?
Catherine Cho:
So I didn't really notice it until we'd made the decision to go to the U.S. So I had this idea that because we had such a long period of time for our parental leave, that we could take this long trip, like a two-month trip to the U.S. Both my husband and my families they're all in the States. So we went from California to Virginia to New Jersey, and I suppose it was in the planning of it that I started noticing that I was feeling anxious just because everyone thought it was a terrible idea. They thought it was reckless. Cato was only two months old, so they just thought it was a very dangerous thing to do.
Vic Vela:
Yeah. So it's a different layer of stress. Talk to me about, Catherine, when the psychosis began.
Catherine Cho:
So the psychosis began at the very tail end of the trip. My son was three months old at that point. We were in New Jersey. And for me it culminated after many days of not sleeping, actually almost weeks, I suppose, of not sleeping and just, I was at my in-law's house at this point. And it was just a constant almost barrage of concern and worry and fear. And it all came from a place of love and it was nothing, you know, with bad intentions. But for me, I had this conversation with my father-in-law, where he was telling me about someone he knew who had shaken her baby and the baby had gone blind. And hearing that, I immediately just felt this fear or just, you know, like this thought. or kind of like, would I do that? Is that what he's afraid that I'm going to do? And when I went to go upstairs to feed my son, his face had changed at that point. So his face to me looked like the face of a devil.
Vic Vela:
It's such a heavy thing to, to have in your head. So when you saw Cato and it seemed like you were seeing something else or, or someone else's face, I mean, can you describe what you were seeing? Do you still remember that?
Catherine Cho:
Yeah, it was very clear to me. I mean, for me, it looked real. His face just did not look like his face. He was looking at me, I thought with fear. His eyes had changed. My brain was trying to understand that this was what was happening and I, I couldn't accept it, but I also couldn't disbelieve what I was seeing. It was a very strange experience
Vic Vela:
What happened next?
Catherine Cho:
So I immediately panicked. I really felt like something really bad was going to happen. And I just had this sense of everything was shaking. And, you know, I, I didn't know what was happening, but I just knew that if I stayed in that house, something bad was going to happen. And so I just told my husband that, you know, I needed him to trust me and to believe everything I was saying. I really just kind of clung to him in that sense. I just told him I needed to leave the house. So he packed everything up. We went to a hotel nearby, I suppose, but at that point, it, it just really escalated and got so much, so much worse.
At that point, I started losing sense of time. So time was no longer linear to me. I, I was, I thought we were stuck in this hotel room as almost like a simulation. And I kept seeing us trying to leave and not being able to leave. And I was hearing voices and seeing figures kind of running around the room and leaving. And my husband was trying to get me to sleep. So I slept, kind of, but didn't, and at that point I thought I was hearing the voice of God. And I thought God was basically telling me that my whole life was actually a simulation, that I was in hell, I had died, that my husband was Dante.
Vic Vela:
Wow.
Catherine Cho:
Yes. And that I was Beatrice, so I was the one who had to lead him through the circles of hell.
Vic Vela:
Oh my gosh.
Catherine Cho:
Yes. So at that point, in a way, it felt almost a relief because it kind of made sense. Like, to me, it, at least it seemed to me in my state that it made sense and all these kinds of patterns and stories fit together. And I was trying to think about, oh, that does make sense. So we are in hell and I kind of felt like, okay, I just have to get through this. And just to, to go through whatever it is that we are destined to go through.
Vic Vela:
The voice of God here, was it saying anything about Cato?
Catherine Cho:
Oh yes. So one of the things was the voice said that my husband would be responsible for killing Cato, or that Cato had to die, but that was his punishment, my husband's punishment. And yes, I would have to be the one to help my husband process his guilt.
Vic Vela:
Catherine, I just couldn't imagine having those thoughts. I mean, had you ever experienced thoughts like this before in your life?
Catherine Cho:
No, never. I mean, I guess that's the kind of shocking thing is I was very lucky in that I had never had any mental health—really, ever, so it was a completely foreign experience for me.
Vic Vela:
So how did you end up going to the hospital?
Catherine Cho:
My husband could tell, obviously that something was really wrong. I was, you know, I was calling my brother and talking to him about all these different things and I was just not acting myself. And at that point, my memories are a bit blurry, but he basically, he called his parents and asked them to pick up our son to take him home. And he, then he just immediately drove me to the emergency room because he didn't know what was going on.
Vic Vela:
Were you telling James what you were hearing at that time?
Catherine Cho:
So, no, I didn't. I didn't tell him anything about that just because I didn't want to scare him.
Vic Vela:
I understand.
Catherine Cho:
I didn't want to terrify him that we were in hell. So I was just like, he's going to figure this out. I'll just let him figure it out.
Vic Vela:
At the hospital, Catherine was diagnosed with postpartum psychosis, thought to be brought on by hormone shifts and sleep deprivation. She spent four days in the emergency ward, where she was clearly losing her mind rapidly. Her thoughts were chaotic. She was tearing at her clothes, and she was seeing demons. Her husband, James, didn't have a choice. He signed Catherine over to the care of the New Jersey psychiatric facility. Catherine was heavily medicated and she had become completely detached from reality.
Catherine Cho:
It's a very confused period. In my head, I thought I was in hell, obviously in a simulation. So I have memories of, you know, the different nurses and I have memories of different things. But then I also have memories of things that couldn't possibly have happened, because I had lost all sense of time. And, you know, the room kept shifting, you know, people's faces were changing. Sometimes I was me. Sometimes I thought I was my son or my husband or my mother, you know, I, I completely was unmoored from what was real.
Vic Vela:
What was it like being in that ward with other people who were struggling with their own mental health issues?
Catherine Cho:
It was such a surreal experience because I — basically, after they had moved me, I went into a complete mental break. So I, I thought I was being surrounded by animals. I had stripped off all my clothes. I was urinating on the floor. They sedated me. And I think it was basically two days later or something that I woke up in this room. And I, I genuinely had very little sense of who I was or what I was doing there. And it, you know, it's like a scene from a film in that it's a white room, it's blank, you know, and you have these fragmented memories, but you're not quite sure what's actually happened. And I remember just getting up and kind of falling in line with what was going on outside of the room, which was that in this ward, there were around maybe 20 of us, men and women, everybody going through their own thing. And we're all just kind of, have appeared in this place and are meant to follow the rules and wait until we're released.
Vic Vela:
After the break, Catherine talks about how holding on to memories of everyday things like a cup of tea helped give her some hope and belief that someday she would recover.
Catherine's deep spiral into madness landed her in psychiatric care. She spent three months trying to recover from postpartum psychosis. Life on a psychiatric ward takes a little getting used to, and for Catherine, time seemed slow and stretched. A day seemed like an eternity. In an attempt to hold onto the person she was before the breakdown, Catherine started to make a list of all the things she missed.
Catherine Cho:
I made lots of lists. So my husband had left a notebook for me and a pen. And he was very insistent to the nurses that I have it. I made a list of things that I knew were true. And then I also made a list of things that just reminded me that there was joy and stuff that was outside. So, you know, whether it was a cup of coffee or tea, being able to listen to the radio, the little things really were the things I desperately missed.
Vic Vela:
Was Cato on that list?
Catherine Cho:
So, he wasn't. I, at that point, you know, I did try to think about Cato just because I knew that I should. I guess, you know, we, at that point, I hadn't seen him, I guess it’d been almost a little over a week. But it was really difficult to think about him because I couldn't really remember him and I couldn't picture him either.
Vic Vela:
So everyone there is, is trying to get out of there, you know, and I'm sure in their way of doing that, they're trying to appear normal to the doctors. How did you impress your doctor that you were better?
Catherine Cho:
Yes, that's probably one of the strangest things is I started trying to think about how could I act sane to show that I was sane. I realized that we were monitored all the time. And so I tried to act as calmly as possible. There was one of the other patients and he told me, you know, the fastest way to get out of here is to act like you don't want to leave. And I was like, okay, that, that really makes sense.
Vic Vela:
The reverse psychology, right? Yeah.
Catherine Cho:
Yes, the reverse psychology. I just tried to act like I was completely okay and calm with the situation, and try to just seem like I was happy to be in the therapy and just as easy as possible, I suppose that was my goal.
Vic Vela:
And did it work?
Catherine Cho:
Actually, I think so because— so at one point the doctor met with me and with my husband at the same time and James had basically told her he didn't think I was well, and I was furious because I just was like, how come he can't see that if he says that I'm going to stay here longer? But I acted as calmly as possible. And I just said, I remember I told her specifically that, you know, my husband's a perfectionist and you know, of course, I have a way to go but I feel completely like myself. And I remember James told me later that the doctor kind of took my word for it over his. They, they listened to me in that sense, I suppose.
Vic Vela:
Knowing that he was telling the doctors his concerns, were you nervous about going back to the hotel?
Catherine Cho:
You know, I, I felt completely like myself and in retrospect I realized I was wrong. He was right. So, no, I didn't feel worried. I felt kind of like, okay, I felt stable. Yeah.
Vic Vela:
You said you felt stable — were the voices gone? Was the voice of God gone, the demons, that kind of stuff?
Catherine Cho:
Yeah, so I think that's the reason why is I no longer heard any voices. I didn't, you know, I was experiencing time as everyone else does in a linear way. There were moments where I would have like a moment where I was, I thought maybe like, I remember thinking the receptionist, her eyes looked a little weird, you know, like that kind of thing. And then I'd be concerned like, Oh gosh, you know, like, is it coming back? But I felt stable in the sense that I knew, or I felt I knew that I could differentiate between what was reality and what wasn’t.
Vic Vela:
After three weeks, Catherine was released into her husband's care. James now had to figure out how to safely move his wife and Cato back home to London. He had to assess how Catherine would react to living outside of the psychiatric ward. Despite doctor's reassurances, James was still worried.
When you held Cato for the first time after not seeing him for a while, how did that feel?
Catherine Cho:
So my parents brought Cato, I think it was my second day out of the ward and yeah, it felt really unfamiliar. And to be honest, physically painful. I had a really difficult time holding him. I just wanted to give him back straight away.
Vic Vela:
Physically painful. How does that, I mean, I guess describe what it's like. I couldn't imagine it feeling physically painful to hold a child.
Catherine Cho:
It really felt wrong to me. It felt like I shouldn't be touching him. I shouldn't be holding him. And I think it's probably a protection mechanism. That's how I have at least explained it to myself afterward, because I think a lot of women who go through postpartum psychosis feel this way. It just, it just felt like I shouldn't be holding him and I just couldn't do it. So I remember I held him for maybe a second and then I just, I handed him back to my father.
Vic Vela:
Did James, and your other family members, did they trust you caring for Cato?
Catherine Cho:
So, no. I mean, James never said it explicitly, but he never left me alone with Cato. And I think he partly did it out of a kindness as well, because he knew it was difficult for me. And I was really honest about that. I just said, I can't. So he never left me alone with Cato, I think for a very long time, for many months actually.
Vic Vela:
This kind of begs the question, how was James doing at this time? Because this is a lot for him to deal with.
Catherine Cho:
Yes. I think he went into a full, kind of, adrenaline fueled state where he had to drop everything in terms of work and kind of, you know, for him it was terrifying because he didn't know what was happening. He didn't know if I was going to get better. He didn't, you know, there was so much uncertainty. He felt really helpless. You know, he was just constantly trying to figure things out.
Vic Vela:
So recovery was very slow. At some point you fell into a depression. How did that affect you?
Catherine Cho:
We came back to London and I was starting to feel better. My anti-psychotic medication was lowered and that was a relief because I could, you know, I had trouble sitting still or looking at light. And this is apparently very common in the sense that most people who go through psychosis then go through a depression. But for me it was a complete shock. And I think it was three weeks after we came back. I just couldn't get out of bed. It was a very deep clinical depression.
Vic Vela:
A lot of people can relate to depression, but after everything you've gone through, how did that affect you?
Catherine Cho:
And in many ways I felt like the depression was the most difficult aspect, just because I'd never experienced anything like it. It was so physical. I physically couldn't lift my limbs. I couldn't sit up. I just felt darkness and it didn't feel like it would ever get better. And that's, I think the most dangerous and, you know, disturbing part of it is that feeling of this is never going to go away. And I was like that for over, I think it was almost three months where I just, I just couldn't function.
Vic Vela:
Wow, three months is a long time.
Catherine Cho:
Yeah. Yes. It felt unending for sure.
Vic Vela:
Did it bother you at that time that James was now the main caregiver for you and Cato?
Catherine Cho:
It did because I felt a lot of guilt. We were very lucky in that, you know, his workplace was very understanding. They let him cut back his hours. They actually, they even paid for a nanny to come to take care of Cato, but I could see it taking a toll on him where, you know, he's basically trying to take care of me, but then also trying to take care of, you know, a five-month-old baby by himself.
Vic Vela:
How did you start to pull yourself out of this dark hole?
Catherine Cho:
I think, you know, there are many things. So the medications, I was put on an antidepressant. The NHS here has something called the crisis team. So they came to our flat every day to check in on me and they would always give me a task. So I spent a lot of time writing lists again and they asked me to make a list of tasks that I could try to do every day, like very basic things. And I also kept a gratitude list. So just a list of things to be grateful for. And I think very, very slowly, all those things started to become easier and I could spend more time out of bed and I could kind of feel, I guess, awake again. I suppose that's the closest feeling. I felt awake, but then I knew that it would be temporary and that, you know, but eventually those stays were longer than the other days.
Vic Vela:
What did that list look like? What were you grateful for?
Catherine Cho:
It would be very basic things from, you know, grateful for being in my own bed, having my own sheets, to grateful that I have James, you know, grateful that it was sunny today, you know, grateful that I was able to have a cup of tea or brush my hair, things like that.
Vic Vela:
What did it take to make you feel more like your old self?
Catherine Cho:
To be honest, it just took time. So when I was finally able to kind of sit up in a chair without feeling physically in pain and actually noticed that there was light outside the window, then I realized, you know, I'm actually getting better. That I'm, I'm actually myself.
Vic Vela:
Can you remember the first time you could play with Cato and feel good and not feel anxious?
Catherine Cho:
I think that also happened gradually. So part, I guess part of the daily tasks were that I should try to spend at least 10 minutes a day playing with Cato, which sounds so short now. But at the time it just felt impossible. But I remember, you know, as it became summer, so I could have him on my, you know, I could play with him and, you know, I, I could touch him without feeling the sense that I shouldn't be touching him.
Vic Vela:
Were you scared at first, you know, when you were playing with him?
Catherine Cho:
It wasn't that I felt scared. It was just, I felt very distant. I felt so distant from him and just, you know, he could have been anybody's baby, but also it just didn't feel right. It was very gradual for me to feel a connection to him again. And I just had to make it almost a practice, like an intention that I would, you know, do this and that I would become more like a parent for him.
Vic Vela:
So how old is he now?
Catherine Cho:
He's three now.
Vic Vela:
Wow. What's he like?
Catherine Cho:
He’s very cute. He's very sweet. He's very stubborn. Yeah. We have an amazing relationship now. I would say, you know, he was really close to James before, but now it's more 50/50, but he's you know, obsessed with dinosaurs and trains and he's a very happy, happy kid.
Vic Vela:
So am I, by the way. Yeah. That's great. Now with all the struggles you had, you decided to have a second child.
Catherine Cho:
Yes.
Vic Vela:
Yeah. That's incredible. [laughing]
Catherine Cho:
[Laughing] It was a big decision to make, I'll be honest. Because the statistics aren't particularly in my favor. If you've had postpartum psychosis, you have a 50 percent chance of recurrence. And I think when James heard that, he just said, okay, there's no way. We talked about it a lot. And we analyzed, you know, the reasons why it had happened the first time. And I thought a lot about all that uncertainty, all that fear. And I, I don't think I would feel that way this time. And as much as I say Cato is such a joy for me and for James, I was just thinking, you know, if we're lucky enough to have another one, then you know, I would really want to accept that and, have another kid.
Vic Vela:
Aside from your own experience, what did you learn about postpartum psychosis that could help other listeners understand it?
Catherine Cho:
Yeah. I mean, I think, you know, those stories that you read in the media and particularly the famous ones are so sensationalized and horrifying. It usually is, you know, a mother has done something really terrible to her children or to herself. And I think psychosis in general is a very frightening thing for many people because it, it comes with such sort of violence and you know, that kind of connotation.
But I suppose something that I learned a lot about is that there are so many degrees to it. So it can be anything from postpartum anxiety — so there are a lot of women who have this fear that maybe something bad will happen to their child or that, you know, they might be responsible for something bad. And I think the thing that I would hope people would understand is that it's really not in your control. It's a combination of hormones, environment. It's a combination of that identity shift when you have a baby. And the best thing to do is to be honest, because I think there are so many people who do maybe feel those things, but then they hide it because they're afraid of it. Or they have a sense of shame about it. And I would say, you know, of course my case was very extreme, but I suppose if you have any feeling like that, then the best thing to do is, is to, to try to share it and try to, to get help.
Vic Vela:
What would you say to other women who are struggling with motherhood either with or without postpartum?
Catherine Cho:
I do say this to any of my friends who have babies is just to be kind to yourself, and no matter how many times it might seem someone else is having an easier time, everything looks picture perfect, it's difficult. Just because so many people have babies, doesn't make it less difficult. It's a really hard thing to do to have a baby. You also have to remember that you have a self too, and that you should be taking care of yourself. Because if you take care of yourself, then you can take care of a baby as well.
Vic Vela:
At the time of this interview, Catherine was nine months pregnant and about to give birth. But what she said about the possibilities of postpartum psychosis recurring worried me a little bit. And I wondered, could the same thing happen again? There was no way I could just leave it there. So we reached out to Catherine just to make sure mother and baby are well. She sent me this voice memo.
Catherine Cho:
[baby sneeze] Oh, bless you. Hi, Vic. It's Catherine. I'm doing very well. I had a baby girl. Her name is Cora. Everything went smoothly with the delivery and the recovery. And yeah, even though we've been in lockdown, it's been really lovely. James, Cato have been adjusting and yeah, it's, it's all been very positive.
Vic Vela:
“Back from Broken” is a show about how we are all broken sometimes and how we need help from time to time. If you think you're struggling with postpartum depression or postpartum psychosis, you can find a list of resources our website, backfrombroken.org.
Thanks for listening to “Back from Broken.” Please review the show on Apple Podcasts; it really helps other people find it. “Back from Broken” is hosted by me, Vic Vela. It's a production of Colorado Public Radio's Audio Innovations Studio and CPR News. Our lead producer today was Jo Erickson. This podcast is made possible by Colorado Public Radio members. Learn more about supporting “Back from Broken” at cpr.org.
