Meghan Cliffel
“It’s a deeply scary experience to go from a rational brain one day to a totally irrational brain the next. The process of regaining wellness was a long one. There's getting out [of the hospital], and then there’s trying to make your way back to a new version of yourself. I really think what we need to teach people the most is how to manage their minds and their emotions, this art of being human.”
Meghan has worked in public education for the length of her career: first as a teacher, then at the district level in New York City, and then as the Chief Strategy Officer founding a nonprofit education consulting firm. Since her experience with postpartum psychosis, Meghan has worked for herself as a consultant in public education and spends increasingly more of her time teaching about things she learned from postpartum psychosis and finding her way back to herself. She teaches yoga, mindfulness meditation, and coaches—all grounded in people learning to see their conditioning, harness their minds, and tune into their deepest wisdom: to get better at the art of being human. She writes to share her experience in doing the same with the world.
She’s working on getting her memoir about her experience with postpartum psychosis out into the world and writes regular notes about mindfulness that you can sign up for here. She lives in Cleveland, Ohio with her husband and three wonderful (and needy) small children.
This blog is made possible by a sponsorship from Sage Therapeutics. All content on this page has been curated by the Mass. PPD Fund without input from Sage Therapeutics, Inc.
February 2023 | Interviewed and edited by Jessie Colbert, Executive Director, Mass. PPD Fund
Seven years ago, Meghan Cliffel was living in New York City and working as the Chief Strategy Officer for an education consulting firm when she had her second child. At eight months postpartum, gnawing stress and anxiety spiraled into a terrifying episode of postpartum psychosis. Unlike most survivors, Meghan remembers every detail of the illness taking over her mind. She shares that story in this interview, along with her path to healing.
The recovery process was long but life-changing for Meghan. She came out of the experience with a new vision not only for her own life, but for how our society treats new parents, and mothers in particular, the priorities of our education system, and more.
Let’s start with what was going on in your life before this happened. Can you set the stage for us?
When I had my second baby, I was living in a tiny little apartment in New York City, working a big job. Neither my husband or I had any family in the city. Most of our friends who had had babies at that time had left, so we didn't have a lot of camaraderie.
I went back to work after kind of a blissful maternity leave – you know, the perspective that comes with the second where you’re more relaxed as a parent. But when I went back to work, I was put on managing this giant contract, which was a disaster. At first I didn't realize the scope of it, and once I realized what a mess things were, I kind of went all out trying to fix them. That was about a month after I got back from maternity leave.
Around that time, I started not feeling like myself. I couldn't really articulate it in any other way. I had never been to therapy before. It wasn't really part of my Midwestern upbringing. I had a really strong work ethic, and I am — and was — an achiever. So I just kept going. And my husband and I would talk about it and say, Two weeks. If you don't feel well in two weeks, let's go see somebody. I got kind of lost in the disaster and started to feel like not feeling like myself was the new normal. Lots of “two weeks” passed.
Can you share how the episode started?
My husband had just gotten back from a couple of nights out of town. I'd been working lots of hours, still awake in the night for breastfeeding. I was sleep deprived, hormones all over the place. Seemingly out of the blue – but of course in retrospect not out of the blue – I woke up one morning and my mind was so hard to harness that I had to say an action in order to do it. I was more distracted than I'd ever been. It felt like my mind was just somewhere else. And still I kept going, in forward motion. I got on the subway, took three trains to get to work.
I remember the first weird thought. I was in the elevator with this woman, and she said, I’ve been in this building for 50 years. Which is true, because she went to early childhood education there, and she worked there. But I had this thought cross my mind, I wonder if something’s keeping her in the building. And I was like, Oh, that's a weird thought.
How did things start to escalate?
When I sat down at my desk, I was supposed to review a document. I opened it up and I was staring at it, but I couldn’t read it. It was like I was reading a dense text in a foreign language. I put in headphones and tried blaring music, and that still wouldn't work.
Then I was pulled into an interview for a data analyst. As soon as I walked in the room, I had this weird thought that [the applicant] seemed like a younger version of my boss and I just couldn’t stop giggling. I tried to think sad thoughts, or kind of wait for little funny moments in the conversation that allow for a laugh to happen. I was just starting to get super giddy.
Another moment I remember that day was as if I could hear the words everybody was saying but also almost see everybody's background interest and why they were advocating for what they were saying. It was really weird. And then I had this overwhelming thought that my colleagues were passing bad contracts but not ever doing any work, and they were trying to assess whether I would be able to be brought in [to the scheme]. But my behavior that day was normal enough that nobody said anything.
That was probably about five o'clock, and over the next few hours things started to escalate really quickly. I got into the subway to head downtown and just brush off all the weird thoughts. I was heading to meet a friend for a happy hour she’d arranged for all of our old colleagues from New York City Department of Ed. I suddenly realized – or thought I realized – that everybody in the subway was staring at me. I began to think they were surveilling me, and that the thing that was going on with my colleagues had materialized into this cult running the entire city. I thought people were following me, so I took off my hat and switched lines, hoping to lose anybody that was behind me.
I walked in and saw my friend, and I was so relieved to see her. But then she kind of stepped aside and fear was, like, coursing through my body. People I’d spent years with kept coming to this happy hour, but instead of feeling excited to see them I felt like it was a sign that I was being recruited. At one point my friend was like, Hey, where are your kids? I thought that it was a threat that if I didn't join this thing, they were going to be killed. I had to get out of there as soon as possible. I walked home – again, quickly trying to lose anyone who was following me – back to our apartment.
What happened when you got home?
I walked in and my husband was like, What are you doing here? Because from his perspective, I had my best friend in town – why did I come home? But what I heard was, Why didn't you agree to join [the cult]? You’ve put our family in danger. So then I started to fear that he was part of it. I grabbed my baby and tried to nurse her, and she wouldn’t – I’m sure she could sense my nervous system.
Eventually the kids go to bed and all the distractions are kind of absent, so it’s harder to play cool and not reveal anything to my husband. We’re watching television and he places sushi and a beer by me, but I don't touch it because I'm convinced it’s poisoned. The TV starts to change into, like, a visual hallucination. I tell my husband, I don’t feel well, I'm gonna go to bed. Because on the inside I'm alone and everybody's trying to get me. I go to bed, and our fridge was rattling and that became part of the storyline – I thought a gas was being released into our apartment. I keep on waking up in the night to open the window a little bit and check my kids to prevent the gas from poisoning us. And this continues to happen throughout the night, just the scariest thing you could imagine. And I believed it all.
And then in the middle of the night I had this epiphany, and it suddenly turned into euphoria. I thought that my husband was actually in the CIA, and that he was going to finally tell me tomorrow. So I wake him up, like, Just tell me now! I wanted everything to stop. But he’s like, Meghan, go back to bed. And then for a few moments joy gets generated by my brain. I think [the happy hour] wasn’t a recruitment event, but I won this competition for this app I’ve been talking about, and they were all there to celebrate. But then that cycles back quickly to fear.
I didn’t sleep at all but eventually morning comes. I'm visibly shaken, but my husband still doesn't know what's going on. I start thinking maybe I need to comply [with the cult]. I want to go to the roof so that I can jump off and prove that I'd be willing to die for the cult. My husband won't let me. He’s racing from keeping me away from the kids to keeping me from leaving the apartment because he’s sure I'll jump off the roof. I'm trying to get to the kids, who I think are dying in the closet. We get involved in a physical altercation. It becomes this all-out battle in our 750 square foot apartment for hours. Until eventually my husband decides to call the police. They hold me down and arrest me and take me to Bellevue psychiatric hospital.
What is your memory of what happened next?
I was strapped to a gurney and put into an ambulance. I was begging the paramedics to go back to my house, my kids are dying. And then I got to the hospital and people's eyes were, like, glowing, and there were characters from my work, and everything was moving really fast. Then I have this weird moment. It sounds super cliche, but I just saw a really bright light. And I have this rational thought that I didn’t want to die, that I wanted to make it to teach my girls. That’s the last thing I remember. Then I got a shot in the arm and it knocked me out.
I woke up and I was in the psych ward, but I was still psychotic. So I thought the cult had captured me and I was trying to prove my loyalty. The first few days I didn’t take any medicine, I tried to escape from the psych ward. I just was lost in my head. Time didn’t make sense to me because I wasn’t living in any sense of reality.
And then eventually, it must have been Tuesday or Wednesday – and I got there on Saturday morning – my husband somehow convinces me to take medicine. And then I start to ground myself in my body. I start to notice my breasts were swollen to bricks because I had suddenly stopped breastfeeding. I was in a ton of pain. Coming back to reality wasn't like a light switch. It's not like, Oh, now everything's real and you get it. It was like this sort of slipperiness of dealing with the delusions and then the PTSD from the delusions. Every time I had a thought, it was like, Am I believing this now, or did I believe this before?
Alongside that, I realized I was locked up away from my two little babies, and time started to crawl slower than you could ever imagine. The psychiatrist tells me if I take my medicine and stop trying to escape, my kids could come visit me on Friday. I tell her I need it written down. Nobody ever said to me, Hey, our goal is to get you out of here. And I think that really would have helped me, because it would have kind of poked holes in my delusions. I felt like I was being trapped forever in this timeless dimension.
So anyway, once that's written down, I started really working towards it, and trying to follow all the rules and take advantage of some of the supports they provide there. There's “group,” which could be anything from talking about addiction, to playing ping pong, to engaging in art. At one point I go to a writing class, and instead of writing, People were trying to kill me, my hand writes, I thought people were trying to kill me. And I started to realize that this was in my head. And I'm like, Okay, now I have to deal with that.
I met with this wonderful psychologist who was like, super pregnant. Everybody who I knew in my life – my parents, my husband – were trying to say to me, No, it’s not happening. There’s no cult, nobody is trying to recruit you. This psychologist was the first person to say, Wow, that must have been so scary. She was the first person to sit in my shoes. And that was, like, a big moment.
I played a lot of Crazy Eights, I missed my kids, I cried on the payphone to my husband. There were all these little moments that started to plant the seeds of reckoning with what had happened, and starting to create ways to get better. And eventually I was able to get out, after 12 nights.
What was it like after you got out?
When I got out, my husband met me at the ward door. I was used to this world where everything was dulled and quiet. There was no technology [in the hospital]. We were on First Avenue in Manhattan, and he dialed up an Uber and I was like, Holy crap, there's technology! It was like I was a time traveler from another place. And New York just seemed so fast.
The night I got home, I started to contend with the fact that my world was a barrage of triggers. Like, the sound of the elevator dinging reminded me of when I thought the elevator meant that they were almost there to kill me. The fridge in my apartment was still rattling and it reminded me that I thought there was poison gas. My body is like it's reentering a battlefield. For a while, I was more comfortable in the psych ward than I was in my apartment.
They didn't give me anything to sleep, and sleep is the most critical thing. The first night, I couldn't sleep and I actually got up in the middle of night and walked to Duane Reade [pharmacy] by myself. I was terrified, but more terrified of not being able to sleep because you're more susceptible to relapse in the first six weeks. I ended up getting a little sleep after I got something.
For six weeks Bellevue sort of monitors you, and I was seen by a regular psychiatrist. It was only when that time was up that I was able to request – or knew enough to request – somebody who had been a mom, and they ended up assigning me a perinatal psychiatrist. And that was when it started to feel like I was seen as a complex human and my identity was honored. She was the first person to say, Well, I think you had postpartum psychosis. All people were telling me up until then was maybe you’re bipolar, we don’t know if this is going to keep happening. And you know, postpartum psychosis is not a diagnosis in the United States. I still don't have a diagnosis. But her ability to put a label on it was really, really helpful.
The process of regaining wellness was a long one. There's getting out, and then there’s, like, trying to make your way back to a new version of yourself. And that would take a very long time.
Can you share more about what was helpful to you in the healing process?
Getting a therapist was immensely helpful. I couldn't really go through the day without being triggered multiple times. So I would just kind of madly write everything down that made me think a certain way, and logged my sleep, to have questions to bring to my psychiatrist or my therapist to try to figure out if I was going to lose it again. It’s a deeply scary experience to go from a rational brain one day to a totally irrational brain the next. Getting well was sort of about being able to share my thoughts and feelings so that other people could help me arbitrate and make sense of them. Because I had really no trust in myself at that point.
And then meditation was really critical. Before that point in my life, I feel like I sort of was my thinking mind. I’m a very analytical person, and my default is to be in my head. But my head was such an unfriendly place to be, because it had betrayed me. So I had to practice being in my body, and seeing my thoughts, and watching my breath. And that was critical to being able to do very basic things like going on the subway to get to work.
Over time, through the process of watching my thoughts, I realized there’s so much conditioning to do, and prove, and excel. That was a contributing factor in all of this for sure. And a real lack of being able to honor my feelings – like being overwhelmed [wasn’t allowed]. That was certainly a lot from my own upbringing, and from my conditioning societally as a woman trying to prove herself in the workplace. Once I saw [those thoughts and beliefs], I got to a place where I could choose whether I wanted to believe them anymore. And that was really the gateway to freedom.
What are your reflections on your experience now? How do you understand why this happened?
When I had my third kid, I did it from a place of knowing how vulnerable I was. When I was postpartum with him I was scared, I was watching for the delusions to come and nab me again. I woke up one night, and from my subconscious I was like, Maybe it was the cult of the White patriarchy. And I was like, Oh god, I’ve got to tell my perinatal psych about that, maybe I’m losing it! But I brought it to her with my rationale, which is, like, this society where women haven’t been in mental health trials, women are not supported in terms of going back to work and having guaranteed paid maternity leave, not enough supports around breastfeeding, not enough understanding around what are the physical and identity shifts of motherhood. For all parents, too, but I think there’s such a unique thing that happens with women and our own biochemistry.
And then alongside that, I feel like there's this culture of “having it all” and – at least for me – of being a woman and having to work harder and prove yourself more. I would also argue that our culture and our education system values achievement over really teaching people about thoughts, feelings, and how to manage this unique art of being human. When I think about what contributed to my psychosis, I sort of see it from two pieces: one, my own personal tendency to push myself, and certainly the hormones and lack of sleep; and the other, sort of the context or culture that values productivity over humanity.
Although this was the most terrifying experience of my life, it became such a great gift. If this hadn’t happened, I probably would have kept going just not feeling like myself and continuing to try and do it all. It was just this giant clarifier of what was really important. It allowed me to realize that I wanted to build a life outside the confines of what our society expects. And I have been able to do that. I work for myself, I have time to myself without my kids and I don’t feel guilty about it. I realized that I have to get good at mothering myself first to mother them well. And that my job is to kind of model what it is to be human - not solve their problems or have everything for them. I really think what we need to teach people the most is how to manage their minds and their emotions, this art of being human.
Postpartum psychosis (PPP) is a medical emergency. If you witness the signs of PPP in a loved one, contact your local emergency services immediately.
Additional resources:
Maternal Mental Health Leadership Alliance Fact Sheet on PPP
National Maternal Mental Health Hotline