Postpartum Psychosis: An Unknown Affliction

I had originally intended to write about postpartum depression, which had afflicted my grandmother, a mother of ten children, one of whom died at an early age, during the 1950's and 1960's, as well as my aunt, who suffered from it during the late 1970's; however, while researching this topic, I discovered another, and far rarer disorder that debilitates new mothers, entitled postpartum psychosis. While postpartum depression affects one in ten new mothers, postpartum psychosis only affects one in five hundred to one thousand new mothers during the first few months after childbirth (1). What interested me the most was the striking difference between the two disorders; at first observation, postpartum psychosis appears to simply be a more intense version of postpartum depression, but upon a closer look, it becomes clear that it is its own unique disorder, with its own unique problems and solutions.

Postpartum psychosis can be described as a “‘condition in which the person loses touch with reality,’” according to Dr. Ralph Wittenberg, who studies postpartum disorders. It is characterized by hallucinations, delusions, manic-depressed episodes, and the desire to harm oneself or others, including one’s baby. In one case, a mother saw people dropping things off of high buildings, but could only think about dropping her infant son and watching him splatter on the ground; overcome with secret guilt, she tried to commit suicide by overdosing on painkillers (1). Other women see their children as embodiments of the devil, things that need to be destroyed. A woman is at higher risk of this disorder if there is a “personal or family history of psychosis, bipolar disorder, or schizophrenia,” as well as if she has had a “previous postpartum psychotic or bipolar episode” (4). If caught in time, it can be overcome using medication and therapy.

The uncontrollable, horrifying images that haunt women suffering from postpartum psychosis are not just images that simply happen without reason or cause; they are the result of a change in the way the mind thinks about issues such as the self and the way it interacts with others, which is thought to be from a decrease of dopamine levels in the brain. According to Dr. Shaila Misri, a doctor at the University of British Columbia, “A lot of psychotic thinking is thought to be due to changes in the neuro-transmitters in the brain. In this specific instance, it appears that dopamine is the one that is often thought to be responsible;” she later states that, “When she has hallucinations or disturbances of her perception, it's again a very severe form of illness where we think that neuro-transmitters are involved. Often times, the psychotic depression is superimposed psychosis on top of the depression, in which case we think there might be more than just dopamine -- there may be other neuro-transmitters such as serotonin involved” (2). The I-factor that exists in the mind, one of the boxes within the innumerable other boxes that controls the realization of the self, becomes distorted; the wires that connect the boxes get crossed and warped, causing whatever the mind projects to meld with reality in a startling fashion.

Postpartum psychosis is on the opposite side of the spectrum from “baby blues,” a condition that occurs in about eighty percent of women who have recently given birth, in which a woman becomes depressed and anxious about her abilities as a mother. Those suffering from baby blues normally bounce back within weeks; those who do not recover begin to suffer from postpartum depression, which has an onset time of one month to a year after the birth of a child. Postpartum depression can be very mild, or it can lead to suicidal episodes, in which the mother becomes so grief stricken, feels so worthless, that she attempts to take her own life (3). While this appears to be similar to the effects of postpartum psychosis, it has the marked difference that it is mainly influenced by the mother’s anxieties and altered sense of self-worth, not by hallucinations, delusions, and homicidal urges directed at one’s baby. Some who suffer from postpartum psychosis believe that what they are experiencing within their minds is reality, and that what their disorder induces them to see and hear is the truth.

Postpartum psychosis is the result of a rift in what is actually occurring and what the mind perceives the occurrence to be, a discrepancy in the real and the surreal; it is something that twists the way the mind works so much, that, in the worst outcome of the disease, a child becomes an embodiment of evil and a mother becomes a killer, riddled with unknown guilt and shame. The signs are often overlooked by outsiders, who think that the mother is just experiencing the baby blues and will recover in a few days; however, the sad reality is that the woman is fighting a secret struggle, one where she and those close to her are unaware of the power and identity of the hidden adversary.

1. http://www.npr.org/programs/morning/features/2002/feb/postpartum/020218.postpartum.html
2. http://www.cbc.ca/disclosure/archives/0111_postpartum/interview.html
3. http://en.wikipedia.org/wiki/Postpartum_psychosis#Post-partum_psychosis
4. http://www.postpartum.net/brief.html