What is postpartum psychosis? Experts explain condition at the center of the Lindsay Clancy trial
The intensely watched trial of Lindsay Clancy, who is accused of murdering her three children before attempting to take her own life, is shedding light on maternal mental health. Lindsay's defense team argues that she took the lives of her children while suffering from postpartum psychosis because she was overmedicated.
Dr. Julia Riddle, a psychiatrist and clinical researcher at the UNC Center for Women's Mood Disorders, says new moms experience an array of mental health issues.
"If you have a pre-existing mental health condition, the postpartum is like no other time in any human's life," Riddle said.
Roughly eight in 10 women experience "baby blues" or a general struggle with life changes, according to Riddle. Two in 10 new moms experience postpartum depression and up to three in 10 experience postpartum anxiety.
Postpartum psychosis is far rarer, impacting roughly two in 1,000 new moms, according to the National Institutes of Health.
"It's a psychiatric emergency, so it can happen rapidly," Riddle said.
According to Riddle, experts generally agree that postpartum psychosis can happen within the first 12 weeks after birth, many times associated with underlying bipolar disorder. It presents with symptoms like hallucinations, delusions, and insomnia.
"Irritability, agitation, becomes psychotic, thinks something is wrong, thinks something is wrong," Riddle said, "Until what we'll say, mom loses insight. She doesn't realize that these thoughts are not real."
Postpartum psychosis has a different treatment than postpartum depression or anxiety. It can be treated with antipsychotics and electroconvulsive therapy, which runs an electric current through the brain.
Riddle says misdiagnosing and mistreating postpartum psychosis can have adverse effects on patients.
"If someone is given a treatment like an SSRI and they do have an underlying bipolar disorder, we know this in bipolar disorder across the board, not only in postpartum psychosis, it triggers mania," Riddle said.
Dr. Uruj Haider, the Medical Director of MCPAP for Moms and Assistant Professor of Psychiatry and Obstetrics & Gynecology at UMass Chan Medical School, says screening for all perinatal mood disorders has improved in recent years, but it can still get better.
"I think we really need to provide education on all the perinatal mood and anxiety disorders as a whole, in case they encounter a mother who is potentially struggling," Haider said.
Haider argues that each mom needs a village of support but that obstetricians, doulas, and pediatricians are the front line of defense.
