May is Maternal Mental Health awareness month, and of course, this coming Sunday is Mother’s Day, a day to stop, and practice gratitude for our mothers. The topic I want to write about today is a difficult one, but it is not talked about enough and there is much confusion about it. So, in the spirit of raising awareness about maternal mental health, I wanted to write about the rare and devastating illness of postpartum psychosis.
Postpartum psychosis has been called a “temporary madness” and that is a good description. Women who are struggling with psychosis after they deliver a baby may also be struggling with more common postpartum mental health issues like depressed mood and/or panic and worry but added to these is a layer of disturbance where a woman feels like she is losing control of her mind, and often having delusional thoughts. Sometimes she knows the thoughts are delusional and other times she cannot tell the difference between what is real and what is not real. As you might imagine, this is a horrifying experience – like a nightmare that you cannot wake up from or being stuck in an episode of the Twilight Zone.
Unfortunately, since most of these symptoms are happening inside the woman’s mind, no one knows what she is going through, and she often has just enough insight to know that something is really wrong with her and becomes afraid to tell other people what is happening to her or what she is thinking. She may also be paranoid and not sure who she can trust. Sometimes she may tell people that she feels like she is “going crazy” or “losing her mind” but unless she has a history of mental illness, her family and friends may rush to reassure her that she is fine in an attempt to be helpful, but the result may be a sense of isolation and hopelessness that she will ever get help or feel better.
Imagine the fear and hopelessness for a minute. In this context, women have killed themselves or killed their infants/children or both. It is horrible. The scientific community is researching this illness, but we still do not know why some women become psychotic after delivering a baby. It occurs in approximately 1 to 2 out of every 1,000 deliveries, or approximately .1% of births. Some women get help and recover before anything tragic happens, while others do not. For women who kill their children while psychotic, our legal system is conflicted and disjointed and generally charges the mother with murder and her sentence will vary widely depending on what state she is in and what type of defense is used.
Generally, postpartum psychosis and its symptoms respond well to treatment (usually with antipsychotic medication) which is positive, but also confusing. How could someone be psychotic and very, very sick, and then recover and be sane again? It is extremely traumatic to go through this for both the woman and her family, and in the case of infanticide, the mother must now also find a way to deal with having killed her own son or daughter – a thing that now that she has regained control of her mind seems unfathomable.
There are so many questions that people ask me about postpartum psychosis. I, myself, have a lot of questions. However, as I’ve mentioned before on this blog, my teachers are my clients. I know what I know about perinatal mental health from listening to the women who have had the courage to come to me for help. So, during this month of building awareness of Maternal Mental Health, I want to encourage you all to think about fostering curiosity. Building awareness is really about the willingness and openness to learn new things, to ask questions, to talk about things we typically do not discuss. In Buddhist psychology, they talk about the concept of “beginner’s mind” – the type of openness that comes from a sense of seeing something for the first time. Postpartum psychosis is such a disturbing idea, that we tend to turn away from it, or make snap judgements about it or the women we hear about in the media who have suffered from it. Instead of doing this, let’s try to stay open and not shut down aroun