Aaisha (00:08)

She admitted herself into psych wards. Why? Because she knew. And I tried to get myself admitted to it because I knew the worst thing that could happen in my life.

the worst thing that I could ever do in my life, is to kill my daughter.

Pauline (00:41)

Hello everyone and welcome back. I am Pauline Walfisch, and I am here with my faithful co-host, Megan Nelson. And we have a special episode for you today, which will be far less cheeky than we often try to be. Today is a serious topic, and we want to make sure that we give it all of the attention it deserves.

Aaisha (00:50)

you you

Pauline (01:05)

So I am going to allow

Megan to share with you our topic and our special guest speaker today. So Megan, take us away.

Megan (01:17)

Hi everyone. Have you been hearing about pregnancy and postpartum psychosis in the media lately? And struggling to make sense of it all. Do some of the things that you hear sound familiar, but you've never talked about it? Today we have Aaisha Alvi here to share what no one warned her about.

Aaisha lived through the experience of postpartum psychosis twice and came out on the other side. She's an advocate for the treatment and prevention of pregnancy and postpartum psychosis and the author of a book, "A Mom Like That, A Memoir of Psychosis." Aaisha, welcome. Thank you for being here today.

Aaisha (01:54)

Thank you so much for giving me the opportunity to spread awareness about postpartum psychosis, and especially right now in light of what's going on in the media.

Megan (02:04)

So for our listeners, can we can you tell us a little bit about the decision to never appear on camera while talking about this?

Aaisha (02:12)

Yes, yes for sure because I want to address that like you know the elephant in the room of why my face is is not visible to anybody essentially The reason I don't appear on camera is because my experience of postpartum psychosis particularly my second

episode of postpartum psychosis was very severe and I was dismissed multiple times and that's why it became so severe and

That's why I wrote a book

and I didn't want to sugarcoat any aspect of my experience with postpartum psychosis and I wanted to be completely open. But at the same time, when I submitted my draft to my psychiatrist, who was the one that encouraged me to write it, she was like, you may want to take measures to protect your identity because of how full and comprehensive my disclosure is on aspects of my homicidal and suicidal urges and how severe it got.

and you know, subsequent to writing my book, I'm so grateful that she said that to me because I have received a lot of vitriolic comments. I have received a lot of hate and I was not expecting that. I mean, 95 % of the feedback that I've gotten has been extremely good, but there are people that have reached out to me and said, you know, you were clearly possessed. You just needed to find Jesus and all that kind of ignorant stuff. And I'm like, thank you for your comments.

You can move along now. I also wanted to mention that my story intersects with the story of another person that I was able to help. And that's actually how my book begins. And

although our stories intersect, I really wanted to ensure that I'm taking measures to also protect her privacy, because our although our stories intersect, it is for story. You know what I mean? What I what I relay

Pauline (03:54)

Yeah.

Aaisha (03:54)

in my book. So that's why I

I don't show my face. want it to be complete in my disclosure so that people could fully understand this illness and it

shed perspectives on things like the Lindsay Clancy case, but at the same time, I didn't want it to harm me. so that's why I take those measures. But I hope

Pauline (04:13)

Yeah.

Aaisha (04:13)

that the extent of the disclosure that I engage in will make up for the fact that nobody sees my face, you know?

Megan (04:20)

Yeah.

Pauline (04:20)

Yes.

And it's completely understandable, if you're on social media, if you're reading the comment section, there are a lot of people that are villainizing Lindsay and other

moms who have gone through this because they just don't understand. Maybe they don't

Aaisha (04:35)

Mm-hmm.

Pauline (04:36)

have the capacity to understand. Maybe they don't have the knowledge. Maybe they're

trolls or bots that are just trying to, you know, make a presence known. And it's it's not fair. What you've done to share your story has been so brave.

And I'm I'm happy to be able to protect the peace that you have cultivated in your life so that you don't have to live with monsters.

Aaisha (05:00)

Yeah, thank you. Thank you so much. And that's why podcasts like this are so important because I have to be honest, after I came out of the illness, it was really difficult for me I kept wondering

if it was some type of character flaw I had within me, you know what I mean? And then it was helping other people and stuff and seeing how the symptoms kind of mimic each other that made me really realize like, no, this has nothing to do with the type of person you are.

Pauline (05:25)

Yeah.

Aaisha (05:25)

Right?

and awareness is what's going to help people to understand that. So, thank you again.

Pauline (05:30)

Yeah.

No, thank you. I you know, at listening to your book, you like you mentioned, you do talk about another another mom who was going through a scenario that was very similar to yours and it was kind of uncanny. I I think you even said that in the book, how odd that these two stories are so similar. And I have worked in,

In psychiatry and behavioral health for almost 20 years, and I've seen a lot of postpartum psychosis. And what I read in your book just sounded so familiar and like the culmination of so many people's stories over the years. You

Aaisha (06:10)

Mm-hmm.

Pauline (06:11)

know, different. Some people hear voices, some people see things, some people are paranoid, some people are referential, meaning like

Aaisha (06:13)

Mm-hmm.

Pauline (06:22)

They they hear or see things that they interpret to to be about them, but the agony and the suffering and the questioning, like am I a good person? What's happening to me? is just so accurate for for the experience that so many people live through.

Aaisha (06:46)

Yeah, and thank you. And yes, exactly. Like even with my two experiences with postpartum psychosis, they're very different from each other. You know what I mean? They were extremely different. And that's why I thought like my psychiatrist thought it important that I write that book so that people can see like, it doesn't look the same, even in the same person sometimes,

And yet it's the same condition, because I know that some people will be I have met survivors of postpartum psychosis that have said to me like,

I wasn't the homicidal type as if like, okay, wait, there's this difference. And I was like, I wasn't the homicidal type either. The first time I became that because I didn't get help consistently. You know

Pauline (07:27)

Yeah.

Aaisha (07:28)

what I mean? And it got worse.

Megan (07:30)

do you mind sharing a little bit of your story so that our listeners can understand really what those differences were?

Aaisha (07:38)

Yes, for sure, for sure. So for me,

was happily married for about five years and I had no pre-existing mental health conditions. was physically and mentally healthy and very much looking forward to having my first child. And so after five years of marriage, we decided to get pregnant. Well, it was me that got pregnant, but we decided together.

Pauline (08:00)

It takes two

usually.

Aaisha (08:01)

Exactly for sure. And so, I was eagerly anticipating the birth of my child. I was very happy when she was born, you know, for that day and a half. And then slowly the mood issue started, coming. And I was just starting to feel depressed and anxious. And I didn't really think much of it because, I had heard of the baby blues, right. But then the anxiety started to really ramp up and I became

kind of like obsessively anxious about was my daughter getting enough to drink? Was she peeing and pooping? And that's not like normally my baseline to be so obsessively worried. And so was like, what's going on? But not really like maybe this is the baby lose type of thing. And very soon after that, I started developing intrusive thoughts. If I may define what those are just for, yeah, so intrusive thoughts are just like random

unwanted thoughts that can pop up into your head. They can be disturbing, violent, sexual, religiously blasphemous in nature. And 90 % of parents actually experience these thoughts. So they're very normal. But I had never experienced intrusive thoughts before having a baby. So I was very shocked by these violent images that would present like my daughter's head bashed in, her drowning. And I was like,

What is this? I've never experienced this before.

Pauline (09:16)

Yeah, doesn't feel normal.

Aaisha (09:18)

Exactly, and it feels very terrifying, you know? And so I was scared. so because I was scared, I actually suggested to my husband that maybe we should give our daughter up for adoption because I was like, I don't know. Like, does this mean I'm going to do something bad? And I want to really stress that intrusive thoughts are very normal. It is not psychosis, right? But I think

Where my story started to hit psychosis was when I started to think that my family was at risk of acting on the intrusive thoughts that were in my head. Now that is not a normal thought, right? nobody knows what your thoughts are and nobody can act on the thoughts. But I truly believe this. And because

Pauline (09:58)

Yeah.

Aaisha (09:58)

of that, I started, you know, not wanting my family to be around my daughter because I was scared that they would act on.

thoughts in my head. I developed other strange beliefs and when you have strange beliefs that are not grounded in reality they're called delusions. I obviously did not know they were delusions. I just believed these these thoughts right?

Megan (10:19)

Were you communicating these thoughts to your loved ones when they were happening?

Aaisha (10:23)

No I didn't say initially I never said you know you're gonna harm her or anything. I was just acting on the thoughts. I was like I know this is true.

so it started off with that thought. I then started thinking that my baby wasn't really a baby and she was like a grown adult pretending to be a baby, which made me react to her with frustration and anger because I was like, why are you pretending when we both know you're an adult? You know? I had multiple delusions, but for me, the worst one at that time was the belief that my husband wanted to sexually molest our daughter.

I

Pauline (10:55)

Mm-hmm.

Aaisha (10:55)

believe that he was a risk to her and he wanted to do this. And actually at one point, because I believed so viscerally, I started punching him in the head while he was driving because I was like so disgusted. And the thing that I really want people to understand is that this is very different from an intrusive thought. Intrusive thoughts are random. They just pop up. A delusion is something you so viscerally believe. It's there, fixed. It's not just like comes and goes or anything like that. It's fixed. And you...

Literally act on it because you believe it so, so much. That's why I was punching him in the head. I think any mother that thought that their partner wanted to sexually molest their child would react like that. So my behaviors were normal for what I believed. They were bizarre to everybody else, but completely normal to me.

And

Pauline (11:44)

Yeah.

Aaisha (11:45)

so what happened is that my family noticed that my behavior was bizarre. They knew something was off with me.

And they tried to take me twice to the doctor. My husband says more, but I have to be honest with my memory and I remember only going twice. So they took me to the doctors. I communicated that I was not feeling like myself. My husband communicated that I was not acting like myself. There was no follow-up questions. Nothing was asked to me. I was just basically told, you know what? Motherhood is hard isn't it? And pat it on the back and sent home.

And I was like, my God, motherhood is really hard. Because, you know, I was like, this is wild.

Megan (12:25)

Yeah.

Aaisha (12:26)

Anyways, I never got help. And then I was believing all these things, acting strangely. And I remember one time my family staged an intervention. And it was at that time that I kind of disclosed I know what you want to do to her. And they laughed in my face because they were like, why would you even think that? And that made me angry. And I ran off and

Pretty soon after that, I kind of just really felt like I wanted to die because I was so confused by everything. Fortunately,

Pauline (12:55)

Yeah.

Aaisha (12:58)

four months later, I just remember one day just like waking up and being like, what the heck was that whole time about? Why did I even think those things? I was very embarrassed by things that I recalled that I had done and said to people, but I just, with the snap of a finger, I just seemed to have

come out of it miraculously on my own.

Pauline (13:22)

Right. And so lucky 'cause

that that doesn't always happen.

Aaisha (13:25)

No, and that's what I want to say. Like nobody should ever be like, maybe she'll snap out of it because

Megan (13:31)

Right.

Aaisha (13:31)

what my psychiatrist explained to me was that my second episode was probably so much worse because I was fully left untreated with pretty severe postpartum psychosis the first time. And she said, that's why even though you had it after a four month miscarriage, that's why it was so bad.

You know how we talk about how our brain is plastic and we have pathways. So she said it was that back route to that proverbial land of psychosis was so strong that your mind immediately ran there.

Pauline (14:04)

we use an analogy

often in trauma of like the fuel in the gas tank, if there's no

fuel in the gas tank, nothing catches fire. But if there's a little something there

Aaisha (14:14)

Mm-hmm. You know what can happen exactly. So

Pauline (14:17)

Yeah.

Aaisha (14:18)

I don't want anybody to listen to this part of my story and be like, well, it just spontaneously went away for her because

that is the worst thing that happened to me because it set me up for the complete worst experience of my life, which could have resulted in me

harming my daughter. And I was very close to it.

Pauline (14:35)

And could have

been completely prevented.

Aaisha (14:39)

Exactly.

Pauline (14:40)

Because when we

know that somebody had a psychotic episode in the past,

there are things that you can do to prevent it from happening, not just treat it when it happens.

Aaisha (14:50)

Exactly because the people that had postpartum psychosis one experience of it are at a 50 % increased risk of experiencing at the second time so I could have totally been prevented from having like the worst

nightmare experience of my life, right

Pauline (15:05)

Yeah.

Aaisha (15:09)

No, no, no, no,

Megan (15:06)

You didn't even know at that time that you had that it was called postpartum psychosis.

Pauline (15:12)

You just knew

like this weird, like, what was that?

Aaisha (15:15)

Exactly. Not only what was that, even though I had always wanted three children, I was like, I don't want any more children. What

Megan (15:21)

Mm-hmm.

Aaisha (15:22)

the heck was that about? But

Pauline (15:23)

Yeah.

Aaisha (15:23)

I did do my own research into trying to figure out why I had these kinds of experiences. And I came across postpartum depression. And so then I was like, maybe that's what I had. Even though all my symptoms did not line up. It was like something that I said, well, maybe that's what it was.

And so even though initially I did not want to have children, when all my friends were going on to second and third children, I was like, I want to have children. you memories fade. And that's why you do some things that you have sworn off doing, right?

Pauline (15:53)

Yes. Yes.

Megan (15:54)

It's

most of the reason why people have second children because every say yours

Aaisha (15:57)

Exactly!

Megan (15:58)

were just a little, yeah. Yeah.

Pauline (15:59)

Yeah. That amnesia that happens.

Aaisha (16:02)

Yeah.

Pauline (16:02)

Before you talk about your second episode, I just wanna

Aaisha (16:02)

Exactly.

Pauline (16:05)

I wanna just reflect for a second for the people who are listening. Cause you said, you know, your family knew that you weren't yourself, you weren't acting right. And I think you used the word bizarre, but the things

Aaisha (16:18)

Mm-hmm.

Pauline (16:18)

that you were doing externally weren't that bizarre, right? Like

Aaisha (16:22)

Oh no, they were bizarre.

Pauline (16:25)

well, I mean like not wanting your family to come see the baby.

happens sometimes moms are like worried about germs and they don't want other people to come see

Aaisha (16:34)

Yes, yes.

Pauline (16:35)

the baby but a lot of the stuff that was happening in your head you hadn't shared the the real

Aaisha (16:41)

No.

Pauline (16:41)

details about so

Aaisha (16:43)

Yes.

Pauline (16:44)

that that was they they they knew you you were not quite yourself but they didn't really understand just how distorted

Aaisha (16:51)

Yes.

Pauline (16:52)

or your your thinking was.

Aaisha (16:55)

100%. And the thing is that I really

tell them because it was about them. You know what I mean? It was

Pauline (17:02)

Right. Yeah.

Aaisha (17:03)

about them. I would say, yeah, you're 100 % right in the sense that in my second experience, my behaviors were really bizarre, but

the first experience,

my family would probably be like she and that's what they said she is not behaving like herself at all like you know what i mean

Megan (17:18)

Mm. Yep.

Pauline (17:21)

Yeah, and that's that's

the thing I I tell families, if you're like, what is going on here? Like that furrow brow, like you're like, something's not right. ask more questions, get curious.

Aaisha (17:34)

Yeah,

that's right. Definitely get curious. 100 %

Pauline (17:40)

Yeah. But it's that trusting, very often we hear people like like this isn't how I thought she'd be postpartum or like that's strange. she doesn't usually fill in the blank, right? So get get

Aaisha (17:52)

Yes. Yeah, yeah, exactly.

Pauline (17:56)

curious and ask ask questions.

Aaisha (17:59)

And I think my husband has kind of made a digital story that's now used by organizations and stuff like that. And in it he just says it just didn't feel like she was my wife. Like

Megan (18:09)

Mm-hmm.

Aaisha (18:09)

the woman that I had married, you know?

Pauline (18:11)

Yeah.

Your your brain was taken over.

Megan (18:14)

Hijacked

Yeah.

Pauline (18:15)

And then your second episode, which I I I'm sure you're gonna talk about, but I I just wanna say happened without a baby being born.

And so I think just that in and of itself, people don't think that it's possible to have any kind of postpartum mental health when you didn't bring home a baby.

Aaisha (18:32)

Exactly, exactly. then after I got pregnant, and I was super excited and looking forward to that baby, I experienced a miscarriage at four months, which was sad in and of itself. But after, I had made peace about it, because I'm a religious person, so I made peace about it in my own way.

And so I was kind of surprised when after being fine for a little while, I suddenly plummeted down into depression and anxiety again. But this time I was like, wait a second. I've never felt like this except for that time that after I had my daughter. So I clued in pretty quickly that this there's something wrong with me. Whereas before I didn't clue in on the fact that something was wrong with me. I clued in pretty quickly.

Pauline (19:17)

Right. But other people

didn't. I listened to your story, right? So other

Aaisha (19:20)

Mm-hmm.

Pauline (19:21)

people didn't. They were like, you're grieving. You're a grieving mom. Like and and then

Aaisha (19:23)

Yes, yes, 100%.

Pauline (19:26)

eventually like, why are you still grieving? Which

Aaisha (19:28)

That's right, yeah.

Pauline (19:29)

whole other complicated

Aaisha (19:32)

Yeah. So when I went in to get help, that's exactly what I was told that, you know, you're grieving, it's fine, like blah, blah. But my symptoms kept worsening. And this time around, my symptoms were like repetitive thoughts, mundane repetitive thoughts over and over again. And I was concerned by that too. So I went in and it increased up to like having disturbing thoughts. And by disturbing bizarre thoughts, I mean

I literally felt like my mind was trying to convince me that my daughter needed to die, I was like, where is this coming from? I don't agree. But it was like an argument was unfolding. Like, this is why she needs to die so she can go to heaven. And I was like, no, no, I don't agree with this. So like, I was really confused and terrified as to why I went again. And I was saying, hearing

disturbing like thoughts in my head and that I don't agree with and stuff like that and basically I was kind of told that I'm having intrusive thoughts. I told them that I was felt like I was hearing a voice and still I was told that I seem to be coping well and dismissed. So I went through four providers and these were all people that were like GPs, PhDs in psychology, obstetricians, gynecologists.

person that would have delivered my baby, all of these kinds of people. And then my symptoms kept worsening. And it got to the point where I started to believe that I was in this apocalyptic battle between God and the devil for control of my thoughts and my actions. And I was hearing voices and stuff. So I went back for a fifth time. And while I was at this appointment, I specifically was freaking out because I was hearing

a

voice in my

that was a command hallucination. This was the first time I heard a command hallucination before it was just like voices commenting on me and telling me awful stuff about myself and things like that.

Megan (21:27)

It sounded

like another voice, not like yourself saying this about yourself.

Aaisha (21:34)

no, so, initially when I was asked if it was like a voice and if it was, you know, like my own thoughts or whatever, I was kind of like, maybe it is my own thoughts, but I felt not my own thoughts, like in my own voice initially, but they did not come, the source is not me. And that's why the types of questions you ask are so important because I was feeling like,

Yeah, initially, maybe it's in my own voice, but somebody else is responsible for putting it there, which is a delusion, right?

Pauline (22:02)

Right.

Aaisha (22:03)

So that's why the questions you asked are so important. Anyways, at the fifth appointment, I was

Pauline (22:06)

Yeah.

Aaisha (22:08)

now like hearing a command hallucination, which was not in my own voice, which I felt was from the devil. And he was telling me to stab my daughter to death. And it was terrifying. And so I became hysterical and started begging the doctors.

to like stick an IV into me, to medicate me, to stop whatever was going on. Even though I believed 100 % I was in this apocalyptic battle, I also was so aware of the fact that I did not want to be a part of this battle, which is why I was desperately seeking medication because I was very disturbed by what was happening to me. And

Pauline (22:45)

Yeah.

Aaisha (22:45)

so believe it or not, I know, Pauline, you know, but the doctors looked at me and they were kind of like,

you need to calm down, go take a walk outside and get a prescription for an anti-anxiety medication. And they literally sent a woman in psychosis onto the street. And at that point, my command hallucinations started telling me to shove people into the street, to literally go and harm people in front of me. And I felt I had a symptom called delusion of control, which means that I felt like my actions were in the control of somebody else.

So I literally felt like, I don't know if you can understand it, but I literally felt like a force was shoving me and making me shove people into traffic, which therefore made me want to throw myself into traffic so that I wouldn't comply. And

Pauline (23:34)

Yeah.

Aaisha (23:35)

it was absolutely horrific. I was crying. was begging my husband to hold me back, like pulled my hand tighter because I felt like...

I was gonna push people, I felt like I was gonna throw myself and I didn't want to do any of these things.

Pauline (23:50)

Right. You were scared.

Aaisha (23:52)

yeah, I was terrified. I scared I even be like, touch it.

Pauline (23:56)

Yeah, and we we hear that,

Aaisha, I just I know that you know this, right? But

we hear that over and over, That the thoughts about hurting somebody else or the thoughts about hurting yourself are not about causing harm to somebody else. They are to protect somebody else, right?

Aaisha (24:14)

no, no, no, I wouldn't agree with that because, in some cases they're altruistic, motivations. When you have delusion of control, I did not feel like I was protecting anybody when, when it was telling me to shove, you know what I mean? So altruistic

Pauline (24:28)

Yes,

Aaisha (24:29)

delusions, but there's also the ones that stem from delusions of control have no altruistic basis in it. Right? Yeah.

Pauline (24:37)

Yes, but the

your thought of like maybe I should kill myself so that I don't do these things.

Aaisha (24:43)

That's right, that one was like an altruistic one. one thing that I'm big on in the lived experience webinars that I teach is that, yes, it's important to talk about the altruisticly motivated infanticides that occur, but sometimes there are women that commit infanticide and they literally will say, the devil told me to do it. And it's not because the devil told them, it was more like the devil, they felt like the devil was forcing them.

So those women should also be entitled to a proper defense because they were also under a delusion. Even if it wasn't an altruistic delusion, they felt like they were not in control of themselves, right?

Pauline (25:19)

Yes, yes, and there are

so many different types of delusions,

right? They they show up in all sorts of ways.

Aaisha (25:24)

Exactly. 100%.

Yes. But Meg Spinelli, who is actually the forensic psychiatrist that is testifying in Lindsay Clancy's case, I've spoken to her extensively and worked with her and she blurbed my book and endorsed it and everything. And she said, I actually believe this symptom that you're describing, delusion of control is what is the most significant determiner of violence.

you need to be assessing for delusion of control because if you feel like you're not acting on your own, that's when bad, really bad things can happen. and so the continuation of my story is my best friend went and ran and filled the prescription while my husband was walking with me. And I took that anxiety pill, went back to the doctor, told them specifically.

I feel like I'm being forced to do bad, evil things. I don't want to, which is making me feel like doing bad things to myself, which I also don't want to do. So I want to be hospitalized. And I was told, I think you're fine. You're having a panic attack. and they prescribed me the smallest dose of an antidepressant and a pretty huge dose of an anti-anxiety medication and sent me.

home. And so a week later, only God helped me because that antidepressant and those anti anxiety medications did not stop the urges did not do anything. Only God helped me to prevent myself from acting on those urges, the voices, all of that. So I seriously still don't know how I did because I knew how strong it felt.

Pauline (27:06)

Yeah.

Aaisha (27:07)

have to say, I had the opposite reaction to what I've heard many women with postpartum psychosis have to anxiety medications, which is that I felt heavy. And I think that was because I'm a small person. My doctor gave me a huge dose. So that weighted me down, which kind of made me feel like, okay, even if I grab a knife, anybody can wrestle it out of me because I'm in slow motion.

Megan (27:28)

Yeah.

Pauline (27:29)

Like a weighted security blanket.

Aaisha (27:32)

Exactly. I literally asked my family, I told them,

Please hide the knives and they were like why and I didn't want to tell them You know, like I think the devil's gonna force me to kill you all in your sleep I couldn't say that because

Megan (27:46)

Mm-hmm.

Aaisha (27:46)

I didn't want

Pauline (27:47)

Yeah.

Aaisha (27:47)

to do it and I thought that everybody would be terrified of me and and hate me but my family I can't even remember if they hit the knives. I just fell asleep because of how drowsy the Anti-anxiety medication at such a high dose made me

But the only thing that helped me was being referred to a perinatal psychiatrist who diagnosed me properly and put me on antipsychotics. That in and of itself was a bit of a process because she wasn't 100 % confident I was psychotic because by the time I got to her, I was so far gone that I had a new delusion that I shouldn't be telling her everything or she would think I was crazy because she wasn't of my faith. And so

Pauline (28:26)

Right. Right.

Aaisha (28:28)

I was...

kind of catatonic-ish, but she was so astute and smart enough and spent enough time that she was like, I think that you are on the border of psychosis. She gave me the tiniest dose, amped it up 10 times because I kept obsessively calling her. And at 10 times the initial dose of my antipsychotic, the psychosis broke. Within one week, I was stabilized, came off of my meds within three months and I've never had a

return.

And that's why Lindsay Clancy's story is so, so saddening because

Pauline (29:02)

Yeah.

Aaisha (29:04)

it's like all she needed was a one person that fully listened to her, gave her time and treated her for what she actually probably had.

Pauline (29:12)

Yeah. I'm glad that you mentioned the delusions of believing that you being controlled but also that that the psychiatrist couldn't understand you because so often I have sat with women who want to tell you and and the th and the feelings are so filled with guilt and shame sometimes of like how could this

Aaisha (29:33)

Mm-hmm.

Pauline (29:34)

happen?

I I mean of course we don't wanna tell somebody our our deepest, darkest secrets, but then

Aaisha (29:39)

Mm-hmm.

Pauline (29:40)

in addition, sometimes there's a voice that says, Don't tell them. Don't don't let

Aaisha (29:44)

Mm-hmm. Mm-hmm. 100%

Pauline (29:46)

don't let them know. Keep it keep it to yourself. They they are gonna they're gonna hurt you, they're not gonna help you, they're gonna lock

Aaisha (29:53)

Yes. Yes.

Pauline (29:54)

you up, they're gonna take away your baby,

Right. And so it's the very

illness that is causing the symptoms that gets in the way of getting help for many people.

Aaisha (30:04)

And yeah, and that's true 100 % at one level, but like my psychiatrist pointed out, it's ignorance by the providers too, she said, sure, when you came to me, you were at the point of having a delusion that was making you hide your symptoms, right? But

Pauline (30:20)

Right.

Aaisha (30:21)

you literally told the other providers you were hearing voices, which is a hallucination. You told them that you felt like you were being forced to harm, which is a delusion.

So...

Why were they so ignorant that they could not read the hallmark symptoms of this condition?

Megan (30:37)

looking back, what is your guess on w why they didn't do that?

Aaisha (30:41)

I have three reasons. And if you're okay with me sharing those three reasons. So firstly, I think that too many providers, too many organizations still want and insist on calling this condition rare. And what they do not understand is that when you call something rare, you are giving permission to society and healthcare providers.

to not know about it because you're basically saying you're never gonna see this. Why commit any brain space to this condition that you will never see? the first provider, she actually, that one that dismissed me the first time when I went, she apologized and she said to me, I'm so sorry, but you were the first case of postpartum psychosis that ever came into my office. And I was like, maybe not. Maybe you just never knew to recognize it. You know what I mean?

Pauline (31:29)

Right.

Yep.

Aaisha (31:31)

So that's

the first issue that when we call it rare, we give permission for people to not know about it, to not keep the hallmark symptoms of it top of mind. Okay. we do this and I've been told we do this calling it rare so that we don't frighten women. But you know what? You can't be frightened in developing postpartum psychosis. It's a medical condition. Like if I tell you, my God, did you know people could have strokes? You're not going to suddenly develop one just because you heard about it.

Pauline (31:58)

Right.

Megan (31:58)

Right.

Pauline (31:58)

And yet

we warn people about preeclampsia, gestational diabetes.

Megan (32:03)

There's other ways

to reassure people by s instead of saying it's rare.

Aaisha (32:07)

Yeah, yeah, and I, in my education, I tell everybody, but I tell them the actual incidents and tell them it's fully treatable so that you don't need to be scared, okay? Second issue is that there is this popular, hugely popular misconception, it's driving me nuts right now because in people's efforts to want to now educate about postpartum psychosis, they keep putting out this.

information which is completely wrong and which is completely why Lindsay Clancy was dismissed and why I was dismissed and this information is hey if you're disturbed by your thoughts you can't be psychotic this is completely untrue there's a New Yorker article from 2025 where Patrick Clancy specifically says that we were told that because Lindsay was disturbed by her thoughts they're just thoughts

Implying that there's no risk of harm now typically in an OCD context that is true

Megan (33:03)

Mm-hmm. Mm-hmm.

Aaisha (33:04)

OCD people have obsessive intrusive thoughts and Just because you have obsessive intrusive thoughts that are very disturbing there is a very good chance that Nothing is going to come out of it because they are just thoughts but psychosis is different

You could have disturbing thoughts that you're feeling compelled to act on. That's why it's not enough just to be like, are you disturbed by your thoughts? You need to be asking questions to see, is this just a thought? Is it part of a delusion?

Pauline (33:35)

And that takes

time. It takes time for

Aaisha (33:37)

That exactly.

Pauline (33:38)

the provider. It takes time and expertise. Right.

Aaisha (33:42)

Yes.

Pauline (33:43)

To know what questions to ask, how to ask

Aaisha (33:45)

That's correct.

Pauline (33:46)

them, being patient to allow you to be able to answer the question.

Aaisha (33:52)

100%, 100. And the other thing too is that, so in Lindsay Clancy's case, that's what Patrick Clancy said, and that resonated so much for me because when I went back, because I'm an advocate, like this is not what made me an advocate. I've always been an advocating type of person. So I was like, I'm gonna take those doctors through the ringer for what they did to me. And I looked at my notes. Now what I found in my notes was shocking. So what I found in them was that they just kept writing.

Patient is articulate. Patient is insightful. Patient is extremely disturbed by her thoughts. They did not write that I said I was hearing voices. They did not write that I was saying that I was feeling forced to harm. Because you know why? Probably because they didn't want to write things down that could get them in trouble. But also because of the misconception that if you are disturbed by your thoughts, it means you are sane. So that trumped any other things that I was saying. And this

big misconception. And if you go on Instagram or anywhere, you'll keep seeing providers that are putting out this nonsense and I have been messaging each of them and saying, please, this is the very reason why what happened to Lindsay happened and why it happened to me,

Pauline (35:04)

in your

book you say, anxiety about thoughts does not prove sanity.

Aaisha (35:10)

That's right. They're not mutually exclusive, right?

Megan (35:12)

Yeah.

Aaisha (35:13)

you can be made anxious by your thoughts. And a lot of times people are like, but then doesn't that show insight? No, it shows the fact that I'm terrified of what's happening to me.

Megan (35:23)

Yeah.

Aaisha (35:23)

That's what it shows.

Megan (35:25)

In

researching for this, I saw that there was some provider and I don't have her name, sorry. Whoever you are, I'll look for you and shout you out.

Aaisha (35:33)

Robin Kowalewski?

Megan (35:34)

Yes.

she had interviewed you, I guess on a podcast that hasn't been released yet. And she described this as an example would be like taking your child to the doctor and having to give them a shot or an IV or something.

she

was saying that it feels very distressing and that and yet you're doing it, maybe holding your child down because the doctor is telling you to do this. And so you feel like it's in the best interest or what you have to do.

Aaisha (36:04)

Yeah, and so I agree fully with that example, but a lot of times people will be like, okay, so the woman did it because she felt like God was telling her to it. And that's one good example, but also you can do it because you feel like you're being forced by the devil to do it. And in that case, maybe when you think that God is telling you to do it, you might not feel distressed because you feel like you're doing something for a good reason. But because I felt like a...

devil was forcing me to do it, I was very disturbed and upset because I didn't want to listen to the devil and I felt like he was forcing me to. And that distress kept being interpreted as, wow, you have insight. You are disturbed and not going to do anything.

Pauline (36:51)

which I have to say, from reading your book and and interviewing many people over the years who had postpartum psychosis, I think you you did have more insight than some people.

Aaisha (37:01)

Mm-hmm.

Pauline (37:02)

And the thing about postpartum psychosis or perinatal psychosis is that it's that waxing and waning. you can one minute be like these these thoughts are upsetting. I don't want to do that. And then another minute lose that.

Grasp of reality.

Aaisha (37:17)

That's also very, very true, but I think that I wouldn't exactly say that I had insight because I had insight that I did not want to do this, but I

fully believed the devil was making me do it.

Megan (37:28)

Mm-hmm.

Aaisha (37:29)

I had insight and that's why I say

People shouldn't say there's no insight. There's poor insight. I had a sense like, don't want to do this. I was insightful enough to know this is not something that I agree with.

Pauline (37:39)

Right and help me do something, give me medication, put me in the hospital.

Megan (37:44)

Yeah.

Aaisha (37:45)

you said like, why are you feeling like you have to do it? I was gonna be like, because the devil's controlling me, which shows that I don't have insight, right?

Pauline (37:52)

Right. Well it shows that you had a delusion.

Aaisha (37:54)

That's right, exactly.

and so the third issue that I think that why providers dismiss me was because of number one, people keep calling it rare, so nobody even bothers to learn about it. Number two, providers have this misunderstanding of the symptoms of postpartum psychosis. I think we create these little infographics to simplify things because people don't want to spend the time that it's going to take to tease out these symptoms.

So people try to be like, hey, here's this quick litmus test. Check if the woman is disturbed and that tells you if she's psychotic. And you could fit in four psychiatric patients into an hour. But my psychiatrist, the reason that I know she helped me she's so humble that she always says, I didn't save your life. I just did my job. And I say, no, you saved my life. And you know why I say that? Because

she doesn't have to give all her patients one hour per appointment. I always had one hour and that's what she gives every patient She could have said I do 15 minute appointments and I first initially thought every psychiatrist has to give their patient an hour and then I started helping people and I would take them be with them at their Appointments and I'd be like wise why are we being rushed out after five minutes? Why are we being rushed out after 15 minutes? So I actually call my psychiatrist

And I said, hey, should I report these doctors? Because this is what they're doing. She laughed and she said, no, nobody, nobody makes me spend an hour. I do it because I think that that's what you truly need to do to provide proper care. And

Pauline (39:22)

Yeah.

Aaisha (39:22)

I was like, what? Like, so that's, that's

Pauline (39:26)

Right.

Aaisha (39:26)

where Lindsay Clancy was lost is what I believe.

Pauline (39:30)

Yeah. I mean there's a lot of systemic issues that that went wrong, right? but I think that and you mentioned this in one of your myths and misconceptions, that I think obs, pediatricians, non-perinatal specialists, non-psychiatrists think

Being in a psych hospital is the worst thing that you could do to somebody.

Aaisha (39:51)

yes. I've definitely heard that from a lot of psychiatrists have reached out to me and said, I am so glad that you wrote this book and you showed how horrible the experience can be when you're not put in a psychiatric hospital because a lot of times I've

thought a woman needed to be hospitalized, but I'm like, I don't want to traumatize her. But you really showed how actually traumatizing it is when you're not admitted. not trying to say that a stay at a psychiatric hospital is your dream vacation destination. No way. There are problems and you need to fix those problems. But you are going to

100 % not kill your child while you are in a psychiatric hospital. And for me, killing your child or killing another person is the worst thing that can happen. And I almost, I almost did it. I remember when I went back to my psychiatrist, I called her Dr. Baker in my book. I said, Dr. Baker, how much worse could it have been? And she literally looked at me because she does forensics.

And she looks at me and she said, are you serious? And I was like, what? And she was like, you are hair's breath from causing tragedy. Like it's

Pauline (41:03)

Mm-hmm.

Aaisha (41:03)

a miracle you I've had survivors like reach out to me that haven't read my book and say, that's so rude that, you know, you go on and you say, that's not the worst experience. You don't know what happened to me in the psych ward. Well, I do know that you're not on trial for killing your child.

Megan (41:18)

Right.

Pauline (41:18)

Yeah. And and you

know, sometimes things are going to be traumatic and we do

them anyway because they're necessary.

Aaisha (41:27)

And not only that, when people sometimes talk about my experience in the psych ward is so bad, nobody should go there. I've had people that went in for heart surgery that had very bad care. So are we going to tell everybody don't go in for heart surgery, deal with it at home? No, we're not going to say that

Megan (41:43)

It's a medical emergency

Yeah.

Aaisha (41:45)

Yeah, exactly. And so that's the place that I come from. again, I'm not trying to undermine anybody's terrible experience in a psych ward. But what I'm saying is be grateful. You did not kill your child. Look at Lindsay. She admitted herself into psych wards. Why? Because she knew. And I tried to get myself admitted to it because I knew the worst thing that could happen in my life.

the worst thing that I could ever do in my life, is to kill my daughter.

Pauline (42:16)

Yeah. It's it's a tragedy that so many moms are listening and can't wrap their head around, right? Because fortunately they've never had psychosis. They can't imagine being in that position. And you

Aaisha (42:27)

Mm-hmm.

Pauline (42:29)

sharing your story really just, you know, Lindsay can't share her story, right? And you can, and thank you.

Aaisha (42:34)

Yeah,

I always write my own pieces in terms of articles I've been in Huff Post and I've never ever agreed to have my story shared by a reporter like media because I'm always afraid that they'll sensationalize it and do the wrong thing but I did it for Lindsey. So I'm in New York Post which is like a sensational tabloid but

I agreed to do it because I said, This is the type of audience that reads this is the one, is the type that's the most vitriolic. And if hearing my story can humanize Lindsay for them, I'm gonna do it for Lindsay. And that's the only reason I put myself out there in the context of Lindsay Clancy, because Lindsay Clancy could have been me. I could have been Lindsay Clancy.

Pauline (43:19)

We all could.

Aaisha (43:21)

no, but like when we say we all could have been,

It's more like tangential because, maybe people say that when they had a similar diagnosis, but I literally was hearing command hallucinations and feeling forced harm and couldn't get help. So not tangentially, but actually, you know?

Pauline (43:40)

Yeah, your story

is powerful, right? Because

because it's real.

Aaisha (43:45)

thank you. that's why the story of Lindsay Clancy has just been so disturbing. truthfully and honestly, she should not even be in a mental hospital. She should not. She is as much a danger to society as I am. And I am no danger to society. do know what I mean? I have not

Pauline (44:04)

Yeah.

Aaisha (44:04)

done anything.

since my two experiences have not had any such urges.

So she should not be in jail.

Pauline (44:11)

Right. These are this is

a treatable illness that does not

last forever.

Aaisha (44:18)

temporary and fully treatable.

Megan (44:17)

It can be yeah.

Aaisha (44:20)

That's what everybody needs to know about this. Nobody needs to fear having it. Nobody needs to fear anything about it because nobody wakes up one day suddenly with postpartum psychosis picks up and they can kill somebody. I know that because I

kept having to go back to my psychiatrist to say, what if this just happens to me? if

Megan (44:40)

Mm, mm-hmm.

Aaisha (44:41)

my psychiatrist was like, no.

You were so seriously ill this doesn't just suddenly happen. Even though it's a rapid onset developing illness, you experienced so many symptoms that you were trying to get help for. And even the first time you had it, it never got that bad. It was only because it was left for so long that it developed like that. So if you're having early symptoms, go get help. If you're having late symptoms, go get help.

Pauline (45:08)

I wanna

just emphasize what you said. Thinking about it, talking about it doesn't make it happen.

Aaisha (45:16)

100 %

Pauline (45:17)

Right. And we are hearing a lot

from women right now who have OCD and postpartum OCD, which is very different than postpartum psychosis, who are replaying the stories, thinking about it all of the time, worrying that they're going to become psychotic.

Megan (45:37)

Terrified they're gonna wake up one day and kill their child and that's

Pauline (45:40)

That

is a very different illness that requires very different treatment.

Aaisha (45:46)

100 % and I have a lot of those OCD women contact me

and obsessively ask me is this what I'm having so I know that it triggers anxiety and women with anxiety with OCD and they become obsessive about it and they fill up my message box and I'm comfortable with that I respond to each of them and reassure each of them but in reality we cannot stop

talking about postpartum psychosis just because we fear those with OCD and anxiety worsening. No, all they need, they don't have psychosis, they need different type of help. But for too long, we've refrained from talking about postpartum psychosis because we're scared that we'll make them suicidal. But their rights do not trump the rights of women that have this condition that are at risk of killing their children and themselves, right?

Pauline (46:35)

Yes.

Aaisha (46:36)

and I want to emphasize too, just because you have postpartum psychosis, it's not always associated with violent or homicidal and suicidal urges. The first time I had it, I had none of those, absolutely none. But it's especially because it can that we need to spread accurate awareness about it and treat every case like that might be a possibility because even one child dying is one child too

Megan (47:02)

Right.

Aaisha (47:03)

many.

Megan (47:03)

It's preventable. Yeah.

Pauline (47:05)

That's right.

Aaisha thank you so much for sharing your story and your what no mom told you. I know that you think your doctor saved your life, and I just want to make sure that you know that you are saving lives.

Aaisha (47:18)

Aww thank you so much. That is really nice of you to say and my hope is just that we never have to hear and read about these kinds of tragedies. I truly hope that you also know that they're doing the work that you guys are doing. You guys are also saving lives. Thank

you.

Megan (47:37)

Thank you.

Pauline (47:38)

We'll keep going until this stops.

Aaisha (47:41)

For sure, for sure. And it won't stop until every mom and baby and child is free from the risk of being dismissed by professionals that don't understand and by a public that doesn't want to hear about this.

Megan (47:57)

Yeah.

Yeah.

Pauline (47:58)

Yeah. So thank you and to all of the advocates out there for postpartum perinatal pregnancy related psychosis.

Aaisha (48:07)

Thank you again so much.

Pauline (48:09)

Your work is meaningful and valuable.

Aaisha (48:12)

And I will send you a link that anybody can read the forward and first five chapters of my book for free. And I think even with those first five chapters, you'll get enough information to really make you question some of the misconceptions you have about this book. So I hope you'll include that in

Pauline (48:29)

Yeah. And and

Megan (48:30)

Absolutely.

Pauline (48:31)

and I I I read the book and I agree with that. So

Megan (48:34)

Yeah.

Aaisha (48:35)

perfect. Thank you so much.

Megan (48:36)

Thank you again

Pauline (48:37)

Thank you, everybody.