Understanding Postpartum Psychosis: A Temporary Madness
by Theresa Twomey
Threaded with in-depth stories from women who experienced postpartum psychosis – including one who committed infanticide – this unique and absorbing work offers psychological, medical, legal, and historical perspectives on this potentially deadly mental illness.
Back to You
by Natalie Dombrowski
A Recollection of one woman’s postpartum survival back to herself, her baby, and her husband.
Touched by Suicide
by Michael F. Myers, M.D. and Carla Fine
No Time To Say Goodbye
by Carla Fine
Beyond the Blues
by Shoshana Bennett & Pec Indman
A Guide to Understanding and Treating Prenatal and Postpartum Depressino
Down Came the Rain
by Brooke Shields
A Deeper Shade of Blue: A Woman’s Guide to Recognizing and Treating Depression in her childbearing years. (Hardcover) by Ruta Nonacs 2006
A Daughter’s Touch
by Sylvia Lasalandra Frodella
She’s Had a Baby and Now I’m Having a Meltdown: What Every New Father Needs to Know About Marriage, Sex & Diapers
by James Douglas Barron
Postpartum Husband: Practical Solutions for Living with Postpartum Depression
by Karen Kleinman, MSW
The following is from the book “Touch by Suicide” by Michael F. Myers, M.D. and Carla Fine, author of “No Time To Say Goodbye.” Both of these books can be purchased at thepenguin.com website.
“Woman Suffocates Baby Daughter and Herself.”
“Mother Throws Children From Building, Then Jumps To Her Death.”
“Mom Drives Car Into Lake Drowning Her Three Kids and Herself.”
“Mom Kills Kids and Self, Dad Hospitalized For Shock.”
How do we begin to understand something that is so incomprehensible? How can a mother do something so unfathomable to the child or children she loves? You may even understand a beleaguered mother killing herself, but ask why she had to take her kids with her. To make any sense of these actions, you must first understand severe mental illness.
Each year in the United States alone, between 10 and 15 percent of all new mothers- or approximately half a million women- suffer from postpartum depression following the births of their children. This depression is NOT the same as the “baby blues” that affect 70 to 80 percent of all new mothers and involve much milder symptoms that usually disappear around 10 days after delivery.
According to the Office on Women’s Health of the U.S. Department of Health and Human Services, new mothers should seek help or be encouraged to seek help if they experience more than a couple of the following signs, especially during the first 90 days following delivery:
- Strong feelings of sadness, anxiety, or irritability.
- Emotional stress that interferes with taking care of self or family.
- Trouble doing normal, everyday tasks.
- Diminished interest in food or compulsive overeating.
- Diminished interest in self-grooming (dressing, bathing, fixing hair).
- Inability to sleep when tired or sleeping too much.
- Trouble concentrating, making decisions, remembering things.
- Loss of pleasure or interest in things that used to be fun or interesting.
- Overly intense worries about the baby.
- Lack of interest in the new baby.
- Fear of harming the baby.
- Thoughts of self-harm or suicide.
If any of these symptoms lasts most of the day, every day, for at least two weeks, immediate medical attention is recommended. Often, new mothers are embarrassed to ask for help because they are ashamed that they aren’t feeling the expected joys of motherhood. The good news is that postpartum depression is treatable, the sooner the better.
What happens after a diagnosis of postpartum depression? To begin, your doctor will conduct a very thorough examination and start treatment immediately. Antidepressant medication plus supportive counseling will be very effective. You can continue to breastfeed with most of the newer medications. Your physician will also want to interview your husband or partner: Explaining the disease of postpartum depression to people who support you will enable them to understand what you’re struggling with.
Postpartum depression is very different from postpartum psychosis, which is extremely rare, affecting less than one of every 1,000 new mothers. The potential effects of postpartum psychosis are devastating, real, and considered a medical emergency: The risk for suicide is 5 percent and the risk for infanticide is 4 percent.
Postpartum psychosis usually begins within the first month after delivery, but can occur as early as three to four days after giving birth. Symptoms evolve rapidly and include intense restlessness, irritability, sleep disturbances, confusion, and disorganized behavior. There may be rapid mood swings from depression to elation, false and suspicious ideas (delusions), voices (hallucinations), and obsessive thoughts about the infant. Hospitalization is essential and can be lifesaving for the mother and the baby. Treatment includes close observation for safety, nursing assistance with grooming and diet, medications, rest, and supportive counseling. Follow-up care by a psychiatrist, primary care physician, community nurse, or other support person is recommended to help make sure that both the mother and her child are doing well.
“How could this have happened?” asks Brian, whose 28-year-old wife threw herself under a train with her infant son strapped to her chest, killing them both instantly. “I feel as if I’m living someone else’s life. My family has been wiped out; people are saying horrible things about my wife; my baby is dead; and I did nothing to stop this nightmare.”
There is no formula for mourning two simultaneous and sudden deaths of loved ones and the total annihilation of one’s family.
What follows are some suggestions:
- Attend to your basic needs. Force yourself to eat, to sleep as best you can, and to avoid isolation. Accept food and other gestures of help from your neighbors and friends.
- Remind yourself that you can survive this with support and time. You may feel suicidal. You may ask yourself, why bother to continue living now that you no longer have your family? You will feel all alone, and may have fantasies of joining your departed family in an afterlife. If you don’t want to put your extended family through what you’re living through right now, hold on to those thoughts. They will protect you from harming yourself.
- Educate yourself about mental illness in new mothers. Women who kill their infants and then themselves are usually psychotic or out of touch with reality. They often believe that this world is evil or dangerous, that by dying with their children they are escaping to a better place. These women see their children as an extension of themselves, and consider it an altruistic, protective, and caring act to take their children with them when they die.
- Try to find out additional information about your wife’s condition from her gynecologist, the family physician, or the baby’s pediatrician. If she was seeing a psychiatrist or therapist, make an appointment with that individual to get some insight into what she was battling. Trying too understand why she didn’t simply kill herself and leave your child for you to raise will be tough. Psychotic individuals are not rational.
- If your wife wasn’t undergoing treatment, try to get as much information as you can about postpartum disorders and mental illnesses at your library or online.
- Accept your rage as normal. You may derive some small comfort from knowing that your wife was very sick and probably frantic before her tragic actions. However, you may still have intense anger at her for her terrible deed. This is both normal and appropriate.
- Understand that this horror is not your fault. Don’t use 20/20 hindsight and blame yourself for ignoring warning signs that your wife was desperate. You are human. Who thinks that this nightmare would ever happen to them? No one.
As with so many illnesses, the best treatment is prevention. Research over the past 20 years has shown that you can reduce the risk of developing and postpartum illness if you pay close attention to these red flags in new mothers:
- A depressive episode in the past or prior diagnosis of bipolar (manic-depressive) illness.
- A family history of depression or bipolar illness
- A history of premenstrual depression- not just premenstrual “tension,” but major mood swings with menstruation.
- Isolation and lack of friends and/or family nearby for support.
- Marital problems.
- Stressful life events such as unemployment, money troubles, physical illness, and so on.
- Unplanned or unwanted pregnancy.
- Increased anxiety and depressed feelings during pregnancy with no treatment.
- Medical problems with the infant.
- Brief bout of the “baby blues.”
Increasingly obstetricians, pediatricians, and family physicians are watching for signs if postpartum illness. You can help by openly discussing any of the preceding signals with them regarding yourself or the woman you are concerned about.
How can I help a new mother at risk for postpartum depression?
- Advise expectant mothers to avoid life changes during pregnancy. A change in career path or a move is stressful by itself, and adding a new baby to the picture could be more than she can handle.
- Ask her to go to the gym or take a walk with you. Exercise will not only enhance her health and physical well-being, but also serve as a way to get her out of the house.
- Help her cook nutritious and balanced meals. Prepare them in advance and store them in the freezer. This will save precious time, and maintain or improve her and her baby’s overall health.
- Make an appointment with a doctor or mental health professional for a new mother if you think she is showing signs of postpartum depression. Most women who have postpartum depression are ashamed to seek treatment and unlikely to do so. In most cases, however, treatment is effective.
Used with written permission.