It's a storyline that has gripped EastEnders fans and thrust a little-talked about, or understood, condition into the limelight.
The birth of Stacey Branning's son, Arthur, sparked the onset of a devastating disorder, called postpartum psychosis. Viewers have been gripped as Stacey suddenly found herself experiencing extreme paranoia, delusions and hallucinations and was subsequently sectioned.
The storyline has shed light on a condition, which affects around 1 in 1000 pregnant women every year. But for women with bipolar disorder, like the character Stacey, that figure dramatically increases, to one in five.
Despite this, there is a lack of high-quality research exploring risk factors for postpartum psychosis in this high risk group.
Now, the UK's first prospective study, exploring these risk factors is being conducted.
Researchers at the University of Worcester, led by Professor Lisa Jones and colleagues at Cardiff University as part of the Bipolar Disorder Research Network, are working with women with bipolar disorder right from pregnancy, through birth, to the first three months after childbirth to identify factors that make some women more or less likely to experience postpartum psychosis. It is hoped the research will lead to better prediction and treatments.
Researcher, Amy Perry, said: "For a small number of women with no previous psychiatric history, childbirth itself can be a potent trigger for new onset bipolar disorder. However, for women who already have a history of bipolar disorder, the risk of experiencing an episode of mood illness during pregnancy or the postpartum is much higher. Though many women with bipolar disorder remain well during this time, it is estimated that approximately 50% will experience some form of mood illness across the perinatal period, with the majority of episodes occurring following childbirth."
While postnatal depression can occur months following delivery, the onset of postpartum psychosis is usually much more rapid. Symptoms usually appear within the first few weeks after delivery, but can appear within days or even hours after childbirth. An episode of postpartum psychosis is considered a severe psychiatric emergency and for the majority of women, treatment will involve medication and admission to hospital.
The symptoms of postpartum psychosis are varied but can include feeling very elated, anxious or confused. Usually women will also hold strange beliefs that aren't true or see or hear things that aren't really there. As we have seen with Stacey's character, for some women these delusions or hallucinations can also be related to their new baby.
Professor Ian Jones, Consultant Perinatal Psychiatrist at Cardiff University and Fellow of the University of Worcester, and Clare Dolman, Vice Chair of Bipolar UK, a national charity which supports individuals with bipolar disorder, were involved in consulting with the writers and researchers of EastEnders.
Clare said: "EastEnders asked me to consult on the storyline about Stacey having a baby because, like her, I have bipolar disorder and faced similar problems when I had my children. When I had my daughter Esther at the age of 28, I was advised to stop taking the mood stabilising medication lithium which had kept me completely well for the last five years. Unfortunately, when my little girl was born (a healthy weight and with no complications), the birth triggered a frightening episode of postpartum psychosis. Within days I found it impossible to sleep, was very excitable and agitated and began hallucinating and having paranoid thoughts. I spent five weeks in hospital - with Esther being cared for by my family - before I recovered enough to come home and start looking after her myself."
So far around 80 women have signed up to take part in the ongoing study, but the researchers would be delighted to hear from more women with bipolar disorder who are pregnant.
Professor Lisa Jones said: "The EastEnders storyline has been fantastic in raising awareness of postpartum psychosis. This is a very severe condition that has, until now, received very little attention and is still not widely understood. Though postpartum psychosis can be devastating for mothers and their families, the good news is that with treatment, most women are able to fully recover and are fantastic mothers to their children.
"We are hoping that our research will help us to understand the factors that may lead to an episode of postpartum psychosis, working prospectively with women, rather than asking them to reflect afterwards, when it is often difficult to fully recall all the things that were going on in the lead up to that time. Better understanding of these risk factors will allow better predictions about which women are likely to become unwell and hopefully improve treatments."
"If you have bipolar disorder and are pregnant, or if you have experienced postpartum psychosis in the past, we would love to hear from you on 01905 542 880 or firstname.lastname@example.org".
For more information about Professor Jones and colleagues' work visit the Mood Disorder Research Group pages.