Not the Normal BABY BLUES

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Many people are familiar with the term “postpartum depression”. It is a very common form of depression that occurs in many women after the birth of a baby. 85% of women will report some type of mood disturbance after the birth of a baby. For most women, it is short lived; yet for others it can be very dangerous. Postpartum psychosis or PPP is the more dangerous form of a psychiatric illness. It is rare compared to postpartum depression, occurring in about 1% of mothers who give birth. Unlike the more common depressive symptoms that mothers experience with postpartum

depression, postpartum psychosis include symptoms of hallucinations, delusions, paranoia and rapid mood swings. It is estimated that about 5% of women with postpartum psychosis commit suicide and about 4% will commit infanticide (the practice of killing an infant). Christine Miracle, killed her six year old son by suffocation as she thought she was resurrecting her deceased brother by baptizing her son. Andrea Yates, in 2001 drowned all of her five children because she said Satan had ordered her to kill them so they could be saved from hell. Dena Schlosser in 2004 amputated the arms of her 11 month old daughter because she heard the voice of God telling her to remove her daughter’s arms. All of these women suffered from postpartum psychosis that was left unrecognized and untreated. Postpartum psychosis is a very serious mental health condition. Unlike the common “baby blues”, postpartum psychosis is very sudden with the onset usually appearing within the first 2 weeks. Women who suffer from postpartum psychosis experience a break from reality meaning that the delusions and beliefs make sense to her. This is very similar to people who suffer from schizophrenia and other psychotic disorders. In the case of Dena Schlosser, she indicated that she had heard a news story about a boy being mauled by a lion which she interpreted as a sign of the apocalypse. She later indicated that the voice of God commanded her to amputate her daughter’s arm as well as her own. Why does it happen and how can it be treated? As we know, there is a hormonal shift after the birth of a baby. Typically estrogen and progesterone levels fall within 48 hours after delivery. So there is a direct correlation between hormonal levels and changes in mood. Another factor is that some women are sensitive to these changes which place them at extreme risks for developing post depressive and psychotic symptoms. Other factors include women who have a history of depression or bipolar disorder, stressful life events, poor social supports, and marital problems such as domestic abuse. Treatment for postpartum depression includes therapy such cognitive behavior therapy (CBT) and interpersonal therapy (IPT) have both been shown to be effective for women with mild and severe cases of PPP. Many hospitals and outpatient programs offer supportive groups for women suffering from PPP. Pharmacological treatments include the use of antidepressant medication such as Prozac, Zoloft, and Luvox which has also been shown to be effective in treating women with PPP. It is often difficult to prevent the onset of PPP because most women do experience some postpartum mood disturbance. However, it is possible to identify women who are more vulnerable to PPP by identifying risk factors such as history of depression or bipolar disorder. With early prevention, treatment can be successful which will help the mother care for and nurture her baby.

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