When a new baby is born most people think of the new mom as glowing with radiance upon taking their child home, basking in motherhood.
However, for millions of women, the joys of childbirth are overwhelmed by the emergence of postpartum depression.
In this article, we shall explore postpartum depression and psychosis to see how it impacts the lives of new mothers, their newborns, and their families.
Although the article would seem to refer only to new mothers in the United States, postpartum depression and psychosis are not found only there.
Any woman of any country, religion, economic status or any other demographic one can think of is vulnerable to this disorder.
What is Postpartum Depression?
Every year 950,000 women develop postpartum depression a sinister condition can creep in and steal their joy. Postpartum depression is a mood disorder that can cause problems for a new mother after childbirth.
Postpartum depression usually starts shortly after childbirth from one week to a month after birth but may begin any time after delivery. The reason is that as the hormone levels of estrogen and progesterone drop, the mother’s body struggles to adjust, and these changes affect her brain and trigger symptoms.
New mothers who develop postpartum depression experience feelings of extreme sadness, anxiety and a lack of interest in their child. There are many other signs that someone may be living in the abyss of this type of depression, these include:
- Feelings of sadness, hopelessness, emptiness or of being overwhelmed
- Crying often, and for no apparent reason
- Worrying excessively
- Moodiness, irritability, restlessness
- Trouble concentrating and making decisions
- Anger or rage
- Losing interest in things that once were found enjoyable
- Physical aches and pains, headaches, stomach problems
- Withdrawal from friends and family
- Difficulty in bonding or attaching to her new baby
Postpartum depression is not the baby blues. The feelings of sadness and anxiety much worse and significantly interfere with the new mom’s ability to give adequate care to herself or her child.
Where the baby blues do not require professional treatment, postpartum depression must be handled with medications or other treatment options.
Who Experiences Postpartum Depression?
Postpartum depression is an equal opportunity disorder. It can affect any woman regardless of age, race, ethnicity or economic status. However, some women are at a higher risk of experiencing the disorder, especially if they have one or more of the following risk factors:
- Previous history of depression or bipolar disorder
- Postpartum depression after a previous birth
- A family member who lives with a mental health diagnosis and depression
- Have experienced a stressful life experience during the pregnancy such as a death in the family or the loss of a job
- Have experienced complications during childbirth
- Delivering a baby with health problems
- Mixed feelings about the pregnancy
- Lack of support from her spouse, partner, family or friends
- Prior alcohol or other substance abuse
If you have been reading this piece and found that the descriptions given thus far describes yourself or someone you know, don’t hesitate, get help right now.
How is Postpartum Depression Treated?
Postpartum depression, like most mental health issues, can be successfully treated.
The first step in eliminating the risks of postpartum depression is for the doctors, loved ones and the new mother herself to be aware of the possibility that it might occur.
The new mother’s health care provider is the first line of defense, so seeing your doctor or gynecologist is imperative. If they suspect you or your loved one is suffering from postpartum depression, he or she will decide what course of treatment that is needed.
These treatment options may include sending you to a counselor or a psychiatrist to prescribe you medication, or both.
My Personal Experience with Postpartum Depression
This author has had postpartum depression intrude on her personal life. My friend Margo had a child in 2015, and up until he was born she had been excited at the prospect of becoming a new mom.
However, two weeks after giving birth I noticed changes in Margo’s behavior. She wept continually and seemed to be distancing herself from the baby. She also spent significant amounts of time in bed sleeping and was gaining weight instead of losing it due to overeating.
I grew very concerned upon seeing the state of her mental health and accompanied her to her next appointment with her gynecologist. When I told her what I had observed she sent me out of the room to talk with Margo.
When at last Margo emerged, she had a broad smile on her face. Her doctor had explained to her that the emotional turmoil Margo had been experiencing was in no way her fault and that she was not a bad mother.
She told Margo all about postpartum depression and suggested she see a specialist who could prescribe her the medications she needed to overcome it.
Margo explained to me that she had been feeling so depressed that she could not function the way Margo wanted and had carried extreme guilt because she had thought herself to be lazy and a rotten mother.
I hugged her and told her that I was there for her.
Margo saw a Psychiatrist the next day, and after a few weeks of being on a medication regimen, she was right as rain again.
Postpartum psychosis is a rare form of postpartum depression that occurs after around 1%-2% of births in the United States. The onset is usually quite sudden and occurs within the first two weeks after the baby is born.
The symptoms of postpartum psychosis are very severe and include delusions (strange beliefs), hallucinations (seeing or hearing things that aren’t there), hyperactivity, decreased the need for or the inability to sleep, and paranoia (being unnaturally suspicious).
Research states that approximately 5% of women affected by postpartum psychosis commit suicide and 4% commit infanticide due to the psychosis causing a break with reality. In her psychotic state, the new mother believes her delusions and these odd beliefs make sense to her.
Mental health professionals know that this severe side-effect of giving birth can have fatal consequences.
The unrealistic thoughts and behaviors of a new mother with untreated postpartum psychosis can lead to the death of the mother and her baby. This happens when the new mom l believes her child to be ill, evil or some other delusion. This can lead to mom thinking that she, her newborn, and other children under her care would be better off dead.
Postpartum depression can begin a week after birth or up to six months later and possibly continue well past one year if there is no treatment given for it. The extreme emotions that accompany postpartum depression mixed with delusions and unstable beliefs can drive a new mother to take the lives of herself and her children.
A Case of Postpartum Depression with Tragic Results
The tragic case of Andrea Yates who lived in Texas, USA, is a case and point.
Mrs. Yates had experienced postpartum depression so severe after her fourth child had been born that her doctors strongly advised her not to get pregnant again.
She had, after her fourth child, experienced suicidal ideations and tried to die by suicide twice with subsequent hospitalizations in a psychiatric facility.
Unfortunately, Mrs. Yates became pregnant with her fifth child after leaving her Psychiatrist, and a series of events after the birth of her baby turned deadly.
When her fifth child was only seven months old, Mrs. Yates took all of her five children and drowned them one by one in a bathtub in their home. She then lay their bodies side by side on a bed.
While this story may seem to be an extreme case, it is not, and it illustrates just the seriousness of postpartum psychosis.
My Personal Experience with Postpartum Psychosis
I have also had personal experience regarding postpartum psychosis.
My relative Sarah gave birth to her first child in the 1980s and soon after began acting very strangely.
Sarah began to believe that her husband was cheating on her and that people could see and hear her through their television. At first, Sarah’s husband thought she was joking and pushed it off to her being goofy, but later he too became very concerned as her paranoia deepened.
Finally, one evening Sarah told her husband that if he left for work she was going to kill the baby and herself. Upon hearing this, Margo’s husband bundled her into the car and took her to the hospital where she remained for a week before being transferred to a psychiatric facility where she lived for a month.
After returning home, Margo was kept on a drug regimen for two years to prevent the kind of tragedy that happened to the family of Andrea Yates.
It is imperative that a new mother who exhibits any of the symptoms of postpartum psychosis receive treatment immediately. If you see a new mother behaving strangely, call her physician and take her to the emergency room.
The life of a child and a new mother depend upon your fast action.
Current Treatment Options for Both Types of Postpartum Depression
While postpartum depression and psychosis are severe illnesses, there are treatments available to help. In choosing which course to follow, it is important to remember two things.
One, a mixture of treatments may be required and two, treatment for postpartum depression will not be necessary forever.
Seeing a counselor involves speaking one-on-one with a mental health provider. The best type of therapies that have been found to be the most effective is cognitive behavioral therapy (CBT) and interpersonal therapy (IPT).
Cognitive behavioral therapy helps the new mother to understand and recognize the changes that have happened to her body and mind.
This type of therapy focuses on identifying helpful thoughts, feelings, and behaviors to replace the anxiety and negativity they had been experiencing. Cognitive behavioral therapy for postpartum depression is short-term, only lasting from 12-16 sessions.
Interpersonal therapy helps the new mom to understand and work better with problematic relationships with partners, friends, and family. It also usually lasts for 12-16 weeks.
Antidepressant medications are an effective method to treat postpartum depression and are often given to enhance talk therapy. These drugs act on the chemistry of the brain that is involved in regulating mood. However, the new mom must tell their prescriber if they are going to breastfeed. Most antidepressants are considered safe to use while breastfeeding, but for the safety of the baby, the new mom needs to ask.
The most common type of antidepressant medication used involves selective serotonin reuptake inhibitors (SSRIs). These drugs affect the levels of serotonin in the brain and are considered the first choice because they are relatively safe. Some of the most commonly prescribed of these drugs include; Prozac, Zoloft, Paxil, Luvox, and Celexa.
Doctors have found that around two-thirds of the new mothers who are treated with antidepressants improve. However, these drugs may take anywhere from one to six weeks to be effective, so it is important not to stop taking them but to hang on until they do.
In the most severe cases of postpartum psychosis, drastic measures may need to be taken to safeguard the life of a new mother. Remember, this type of treatment is a last resort, and you should not be afraid to take this option if it becomes necessary. These treatments are called electro-convulsant therapy.
For many, ECT brings recollections of scary images such as those from One Flew Over the Cuckoo’s Nest. However, the ECT of the 1950s is no longer what happens during these treatments; things have become much more humane.
Electro-convulsant therapy is generally administered before breakfast. Before the client is given the treatment, they are given general anesthesia and a muscle relaxant to make them comfortable.
Electrodes are attached to the person’s scalp, and an electric current is applied to cause a brief convulsion that the patient never feels as they are asleep.
A few minutes later the person awakens and feels confused and does not remember anything about the treatments administration.
ECT treatments occur in repeated sets of usually three times a week for a month, and some people need more lasting from six to twelve treatments.
Electroconvulsive Therapy Helps with Severe Cases of Postpartum Psychosis
When judging the effectiveness of ECT for women who are under the influence of a severe and resistant case of postpartum psychosis, one need only turn to the research.
A paper that appeared first in Arch Women’s Mental Health in 2013, states:
“Presence of catatonia (abnormality of movement and behavior arising from a disturbed mental state), augmentation of medications, and suicidality were common indications for ECT. Catatonic symptoms were significantly higher among women who received ECT. There was no significant difference in duration of hospitalization or severity of psychopathology between women who did and did not receive ECT. Transient side effects to ECT were observed in few women, with no adverse effects noted in infants who were breastfed. The current study supports the use of ECT as an effective and safe treatment for women with severe PPP.” (Babu, et al. 2013).
Translated, they found that ECT is highly effective for women who are experiencing the worst of the symptoms of postpartum psychosis.
There is Very Good News
The good news is that with the proper medical help, the treatments used to treat postpartum depression work very well allowing the new mom can soon move forward with her life.
Happily, the procedures for both postpartum depression and psychosis are covered by most insurance policies.
Postpartum depression does not need to cost a new mother the time they have with their precious bundle of joy. With lots of support from her partner, family, friends and medical provider she can recover quickly and enjoy her growing family.
Below are some helpful numbers and sites to help you if you or someone you know is experiencing postpartum depression or psychosis.
To Find Postpartum Help Hotline Numbers by Your State in the U.S.
For Help Outside the United States
Post-Partum Support International
Suicide Prevention in the United States
If you or someone you knows is in danger of dying by suicide, please don’t hesitate. Reach out for help.
National Suicide Prevention Hotline
Don’t forget to download and utilize our free Patient Next Door app onto your smartphone. With it, you can share the healthcare journey of you and your child with people who are facing similar conditions.
The app isn’t just free, it is ads free!
As always, we here at Patient Next Door love serving you and hope you will join us in aiding others in finding resources and hope.
We care about you.
Disclaimer: The opinions expressed in this post are the personal views of the author. They do not necessarily reflect the views of PatientNextDoor. Any omissions or errors are the author’s and PatientNextDoor does not assume any liability or responsibility for them.