Postpartum psychosis

Postpartum psychosis or (also sometimes referred to as puerperal psychosis or postnatal psychosis), is a mental illness, which involves the rapid onset of psychotic symptoms in a woman following childbirth. Although sometimes confused with postpartum depression, postpartum psychosis is a different disorder and is much less common. Postpartum psychosis is also known as "postnatal stress disorder", because the patient is under emotional stress and exhibits unusual behavioral patterns not seen before their pregnancy or postpartum event. In clinical psychology it may also be diagnosed as a form of Brief Psychotic Disorder.

The majority of cases occur within the first 2–4 weeks after childbirth with a classic 10–14 day "meltdown", likely caused by the radical hormonal changes combined with neurotransmitter overactivity. When correctly diagnosed at the earliest signs and immediately treated with anti-psychotic medication, the illness is recoverable within a few weeks. If undiagnosed, even for just a few days, it can take the woman months to recover. In cases of postpartum psychosis, the sufferer is often unaware that she is unwell.Fray, Kathy: "Oh Baby...Birth, Babies & Motherhood Uncensored", pages 364–381, Random House NZ, 2005]

ymptoms

Symptoms of postpartum psychosis can include:
* Feelings of being ordered by God or a power outside of oneself to do things one would not normally do, like harming oneself or the babyThe Boston Women's Health Book Collective: Our Bodies Ourselves, pages 489–491, New York: Touchstone Book, 2005]
* Feelings of intense confusion or agitation
* Seeing or hearing things that others don't
* Extreme highs or extreme lows of energy or mood
* Inability to take care of the baby
* Experiencing thoughts and feelings as being out of one's control
* Memory lapses (periods of confusion similar to amnesia)
* Random or uncontrollable anxiety attacks
* Unintelligible speech or communication

Treatment and prognosis

Postpartum psychosis is treated as a serious psychiatric disorder. Prompt treatment can shorten the duration of the illness.Fact|date=June 2008

Whilst postpartum/puerperal psychosis is a serious psychiatric illness, the risks of a mother suffering this illness harming her baby are low: infanticide rates are estimated at 4%, and suicide rates in postpartum/puerperal psychosis are estimated at 5%.

Epidemiology

Psychosis can also take place in combination with an underlying psychiatric disorder, such as bipolar affective disorder, schizophrenia, or undiagnosed depression. In some women, a postpartum psychosis is the only psychotic episode they will ever experience, but, for others, it is just the first indication of a psychiatric disorder.

Only 1 to 2 women per 1,000 births (.1% to .2% of births) develop postpartum psychosis. [ [http://www.bcrmh.com/disorders/psychosis.htm bcrmh.com] ]

Notable cases

Andrea Yates

Andrea Yates methodically drowned her 5 children in a bathtub in her Clear Lake City, Houston, Texas house on June 20, 2001.

After the National Organization for Women (NOW) noted on their website that Andrea Yates had postpartum depression, the Individualist Feminists of Ifeminist.com quickly pointed out that Yates suffered from postpartum psychosis, a more serious and much less common disorder, and that the clinical definition of postpartum depression does not list infantcide as a symptom.cite journal | last =McLellan | first =Faith | title =Mental health and justice: the case of Andrea Yates | journal =The Lancet| volume =368 | issue =9551 | pages =1951-1954 | publisher =Elsevier| location =Amsterdam | date =2 December 2006|url=http://www.thelancet.com/journals/lancet/article/PIIS0140673606697894/fulltext | doi =10.1016/S0140-6736(06)69789-4 | accessdate=2008-04-10] ["(Killing your baby is not listed as a symptom or outcome of the depression.)"; Wendy McElroy, Rallying around a Baby Killer, ifeminist.com, Aug. 28, 2001 [http://www.ifeminists.com/introduction/editorials/2001/0828.html Article] ] After Ifeminist.com pointed out that this misrepresentation of Yates' illness stigmatized a large number of mothers and made them less likely to seek professional help for fear of being seen as a threat to their children and consequently being committed, NOW promptly revised their statement to include postpartum psychosis. ["NOW is ringing an alarm bell about postpartum depression, which drives non-working mothers to infanticide....The increasing tendency to lump postpartum depression in with infanticide made them afraid to tell anyone about their depression. They didn't want to be viewed as threats to their children, they worried about being committed. Because postpartum depression had been demonized, they were less likely to risk being stigmatized by seeking help...NOW should be discussing postpartum psychosis -- a comparatively rare and much more serious disorder -- that includes psychotic reactions such as hallucinations and delusions."; Wendy McElroy, Rallying around a Baby Killer, ifeminist.com, Aug. 28, 2001 [http://www.ifeminists.com/introduction/editorials/2001/0828.html Article] ] [NOW President Kim Gandy, Tragedy Focuses Attention on Postpartum Psychosis, September 6, 2001 [http://www.now.org/press/04-01/09-06.html Statement] ;(Modified statement made about a week after ifeminist.com pointed out NOW's error identifying Yate's disorder as "postpartum depression" reflects update with focus on the more rare and child endangering disorder of postpartum psychosis.)] Numerous media outlets alleged that Yates' minister, Michael Peter Woroniecki, bears some responsibility for the deaths, reporting that he and his wife built a framework of homicidal and suicidal delusions in Yates' impressionably ill mind through "relentless gloom and doom sermonizing." [ [http://www.worldnetdaily.com/news/article.asp?ARTICLE_ID=26949 World Net Daily, Beware of Poisonous Preachers] Mar. 23, 2002] [Lost in the Message? Lisa Teachy, Houston Chronicle, April 5, 2002 [http://www.chron.com/disp/story.mpl/front/1346952.html Article] "Shortly after Satan's first appearance at Andrea Pia Yates' capital murder trial, many observers began blaming the tragedy on a traveling evangelist the Yates family once admired. Television networks flashed images of the proselytizing preacher in a devil costume to accompany their coverage of the trial -- linking Michael Woroniecki to Yates' confession that she killed her children to save their souls."] [In the aftermath of the 2006 retrial and insanity verdict of Andrea Yates, host Chris Cuomo reported on ABC Primetime that: " [Andrea Yates'] delusions were fueled by the extreme religious beliefs of a bizarre, itinerant street preacher named Michael Woroniecki ..."; Chris Cuomo, "Primetime, Insanity Verdict, Insanity Defense. Secrets and Lies: The American Imposter, The American Imposter Tells All", ABC Primetime, July 27, 2006 [http://www.transcripts.tv/primetime-live.cfm Order Transcript] See also: [http://a.abcnews.com/Primetime/Story?id=2244865&page=1 ABC Article of Telecast] ] [Doug Saunders, Globe and Mail, Toronto Canada, Mar. 14, 2002 [http://www.rickross.com/reference/woroniecki/woroniecki4.html Article] ] She had come to believe that she was a "bad mother" who was spiritually and behaviorally damaging her children, and that it was better to kill herself and her offspring rather than to allow them to continue "stumbling" and go to hell ["Andrea’s life was also distinguished by religious obsession and a steadfast devotion to tales of sin and Scripture, a 'repent-or-burn zeal' that led her to believe she was a bad mother with ruined offspring. According to Andrea, she killed her children to save them from Satan and her own evil maternal influences, delusions that did little to help Andrea’s defense because they fueled her own desire for punishment." Deborah W. Denno, WHO IS ANDREA YATES? A SHORT STORY ABOUT INSANITY, Duke Journal of Gender Law & Policy, Vol. 10, Summer, 2003 [http://www.law.duke.edu/shell/cite.pl?10+Duke+J.+Gender+L.+&+Pol'y+1+pdf Article] ] --a staple of her minister's teaching to parents found on his 1996 video, which the Yates both received from him and watched. [Suzanne O'Malley, Are You There Alone? The Unspeakable Crime of Andrea Yates, Simon and Schuster, c. 2004, p.229]

Melanie Blocker-Stokes

Melanie Blocker-Stokes, of Chicago, IL delivered a healthy baby girl in February 2001. In the weeks following the birth of her daughter, Ms. Blocker-Stokes developed postpartum psychosis and was in and out of Chicago area hospitals several times over period of a few months for medical assistance and care. Despite medical treatment and the support of her loving family and friends, Melanie Blocker-Stokes ended her life on June 11, 2001. Her death led to the proposal of the Melanie Blocker-Stokes Postpartum Depression Research and Care Act (H.R. 846 and S. 450), intended to expand research into the condition.Office of Legislative and Policy Analysis. 2007. "Melanie Blocker-Stokes Postpartum Depression Research and Care Act". http://olpa.od.nih.gov/legislation/108/pendinglegislation/postpartum.asp]

References