After CT-based teacher Sarah Madden’s first daughter spent a week in the NICU, Sarah developed postpartum depression (PPD). She worried about the baby getting sick, but the increasing anxiety meant she began to withdraw from friends and family. “My symptoms didn’t start until two months after birth,” says Sarah. “It started with intense anxiety and OCD tendencies.”
Lifestyle blogger Caitlin Houston, also based in CT, experienced postpartum depression as well, but unlike Sarah, her battle started well after her daughter was a newborn, 16 months postpartum. “I remember the waves of sadness came rolling in out of nowhere,” she says. “I would cry over the silliest things like finding a pile of crumbs my husband missed while cleaning the counter. Then the sadness would turn into sporadic bursts of rage or even periods of overwhelming anxiety,” recalls Caitlin, who got help from her doctor after confiding in her mother.
“My OB-GYN told me the delayed PPD was due to the sudden hormonal changes I was experiencing while weaning my daughter from breastfeeding,” she says. Generally, symptoms start within the first few weeks after birth, but as Caitlin and Sarah, experiences vary from mom to mom.
Recently, postpartum mood disorders have been newsworthy with the story of Lindsay Clancy, the Duxbury, MA mom who killed her three children before attempting suicide. In a statement shared with GoFundMe, her husband Patrick detailed how their family was happy, their marriage strong, but that his wife was suffering from an (as yet unnamed) condition (some have speculated it was postpartum psychosis, aka PPP) and that he forgave her.
Experts note that while postpartum depression and postpartum anxiety (PPA) affect between 20 to 25 percent of women, postpartum psychosis is relatively rare, affecting only .2 percent of women. “PPD often manifests as sadness, inability to sleep, and PPA often manifests as excessive worry,” says Natasha K. Sriraman MD, author of Return to You: A Postpartum Plan for New Moms.
Postpartum psychosis (PPP), on the other hand, is an emergency. “PPP affects a person’s sense of reality, and can cause hallucinations, delusions and paranoia,” says Dr. Sriraman. “In severe cases, a women experiencing PPP can harm herself and/or baby.”
Primarily people with bipolar disorder, as well as major depression disorder and schizophrenia, appear to be at a greater risk for developing PPP. But normally, having even severe PPD or PPA will not turn into psychosis. “I, along with my medical colleagues who do this work, don’t want these rare incidences, while heart breaking, of PPP to prevent anyone from asking for help. I want moms (and their partners) to remember that you are not alone and with help you will get better,” says Dr. Sriraman.
It’s crucial in the rare case of psychosis for partners or other loved ones to recognize what is happening and get help, says Karen Kleiman, MSW, LCSW, founder of The Postpartum Stress Center. “Clear signs that help is needed ASAP are: sleepless nights associated with manic or elevated mood, paranoid or disorganized thinking, and confusion, such as if mom states she is hearing voices that are not her own or seeing things that others do not see,” says Kleiman.
KLEIMAN’S CHECKLIST FOR HELPING TO RECOGNIZE POST PARTUM PSYCHOSIS:
- Does she or anyone in her family have a history of bipolar illness or previous psychosis?
- Is she talking or acting in a strange manner that is not characteristic for her?
- Is she unusually quiet and withdrawn, or speaking rapidly with little concentration?
- Does she claim to hear things or see things that others do not?
- Is she suspicious of others or expressing concern that others are out to get her or trying to harm her in some way?
- Does she have a decreased need for sleep or food and/or exhibit a high degree of confidence or an exaggerated sense of her capabilities or self-worth?
- Does she feel abnormally hyperactive with racing thoughts and/or behaviors?
Like so many mothers, the news of the Clancy tragedy hit Caitlin hard. “I am angry that the mental health system failed her – and I can’t help but wonder how things would have been different if she received the inpatient medical treatment she needed so badly,” says Caitlin.
Sarah went on to give birth to another daughter without experiencing any PPD or PPA. She was inspired to get her Master’s degree in Public Health which gave her a unique perspective to the Lindsay Clancy headlines. “When I read the news, I asked myself, Why is there not more funding and research when it comes to prenatal/postpartum physical and mental health in this country? How many more mothers have to silently suffer before we start acknowledging that there is a maternal mental health crisis in America?”