Postpartum Mood Disorders: Common, Complex, Distinct and Treatable
California Congresswoman Lois Capps noted in a May 1999 Mother’s Day press conference announcing sponsorship of a bipartisan resolution on postpartum depression that hundreds of thousands of American women experience these issues every year and many “don’t even know they need help. This condition can put a tremendous strain on family relationships, at a time when families should be experiencing the joy of the birth of a child.”
Postpartum psychosis is a different entity altogether from postpartum depression, although the two are often inappropriately linked in the public’s understanding of the mood disorders following pregnancy. Liz’s beliefs, thought processes and reactions to her infant are unfortunately typical.
As Margaret Spinelli, M.D., assistant professor of clinical psychiatry at Columbia University’s College of Physicians and Surgeons in New York City, N.Y., explains, postpartum psychotic behavior usually occurs with little warning and “is associated with hallucinations and delusional beliefs about the infant.”
As Spinelli points out in an article in the November 1998 Journal of Gender-Specific Medicine, this condition constitutes a “psychiatric emergency requiring hospitalization” and, because new mothers suffering from the condition frequently believe they must kill the new baby, “the infant must be protected from the psychotic mother and her infanticidal tendencies.”
Postpartum psychosis fortunately is the least common of the three conditions, occurring about once or twice in every 1,000 births. Like other psychotic conditions, the symptoms are very exaggerated and may include insomnia, religious preoccupations, agitation and bizarre feelings or behavior in addition to the delusional thoughts and sensory hallucinations, typically auditory or visual in character.
As Karen Kleiman, M.S.W., director of the Postpartum Stress Center in Rosemont, Pa., explains, “Postpartum psychosis is not simply a worsening case of postpartum depression. It’s a totally distinct psychological disorder. In the most severe cases of postpartum depression, the concern is that a woman may harm herself. In postpartum psychosis, the woman must be regarded as a threat to her infant.”
Women who have experienced a postpartum psychosis following one pregnancy have 100 times the risk of experiencing such a psychosis after subsequent births.
Real, Treatable Illnesses
In her practice in suburban Philadelphia, Kleiman has helped thousands of women navigate the sometimes troubled waters between giving birth and a return to emotional health. Like Beck and Spinelli, she believes appropriate treatment for postpartum psychosis is immediate psychiatric hospitalization at the onset of symptoms, while the best approach to postpartum depression is early detection linked to the appropriate type and amount of antidepressant medication and psychological counseling and support.
In the case of the “baby blues,” Kleiman notes that even though the mood disorder may be brief and self-limited — in other words, that the woman will recover with little or no outside intervention — such professional support can be reassuring and useful.
“I believe women should trust their instincts when it comes to being concerned about how they feel emotionally after delivery,” Kleiman says. “If they feel something is wrong with them, there probably is. Even if they tell their mothers or friends, their husbands or their doctors and are given reassurance that everything is fine and normal, they should persist in seeking help with feelings that are troubling. Whether their postpartum mood disorder is mild, moderate or severe, it’s a real illness that can be treated.”
For information about the postpartum mood disorders, access the national support group Depression After Delivery.
VanScoy, H. (2013). Postpartum Mood Disorders: Common, Complex, Distinct and Treatable. Psych Central. Retrieved on July 3, 2015, from http://psychcentral.com/lib/postpartum-mood-disorders-common-complex-distinct-and-treatable/