Postpartum Depression and Postpartum Psychosis
This week, instead of featuring photos and links, we’re using this page to clear up some of the most common myths about postpartum depression and postpartum psychosis.
“Postpartum depression and postpartum psychosis are basically the same thing.”
They’re very different. PPD is a depressive disorder. PPP involves loss of contact with reality, which can include delusions, hallucinations, severe confusion, paranoia, disorganized behavior, or profound mood disturbance.“Postpartum psychosis always looks obviously psychotic.”
It doesn’t. Symptoms can fluctuate, and someone may appear organized or relatively normal during portions of the day while still experiencing serious delusions or other psychotic symptoms.“If she knew enough to hide something, make a phone call, or carry out a complicated task, she couldn’t have been psychotic.”
Psychosis does not necessarily eliminate a person's ability to plan, speak coherently, drive, use a phone, or interact normally. Reality testing can be severely impaired in one area while other cognitive abilities remain intact.“Postpartum psychosis means a mother wants to hurt her baby.”
Most people experiencing PPP do not harm their children. When dangerous behavior does occur, it may arise from delusional beliefs, hallucinations, severe confusion, or distorted perceptions rather than ordinary hostility toward the child.“If a mother has thoughts about hurting her baby, she has postpartum psychosis.”
Not necessarily. Intrusive, unwanted thoughts can occur with postpartum depression, anxiety, and especially postpartum OCD. A person may be horrified by those thoughts and have no desire or intention to act on them. That's very different from believing a psychotic delusion.“Postpartum depression is just being sad after having a baby.”
PPD can involve profound anxiety, irritability, guilt, hopelessness, numbness, inability to experience pleasure, sleep and appetite disturbances, difficulty bonding, impaired concentration, and suicidal thoughts. Some people don't describe themselves as particularly “sad.”“Postpartum depression is just the baby blues.”
Baby blues are extremely common and generally resolve within about two weeks. PPD is more persistent and clinically significant.“Postpartum psychosis happens immediately after delivery, so if symptoms appear months later, it can't be postpartum psychosis.”
PPP most commonly begins very soon after childbirth, often within days to the first couple of weeks. However, later postpartum presentations can occur, and clinicians need to evaluate the entire course of symptoms rather than using an arbitrary calendar cutoff.“A good mother wouldn't become psychotic and hurt her child.”
Psychosis isn't a measure of someone's love, character, or parenting ability. Severe psychiatric illness can profoundly distort a person's perception of reality.“Women with postpartum psychosis know that their beliefs aren't real.”
Often, they don't. That's one of the crucial differences between a delusion and an intrusive thought. A delusion can feel completely real to the person experiencing it.“If she remembers what happened afterward, she couldn't have been psychotic.”
Memory and psychosis are separate issues. A person can remember actions that occurred during a psychotic episode.“If she wasn't diagnosed with postpartum psychosis at the time, she didn't have it.”
PPP can be missed or initially mistaken for severe depression, anxiety, insomnia, mania, or another condition, particularly early in its development.“Postpartum psychosis is just an extreme version of postpartum depression.”
This is an especially important one. PPP is generally considered a psychiatric emergency and is strongly associated with bipolar-spectrum illness. It isn't simply PPD that became really severe.“Postpartum psychosis is permanent.”
No. With prompt treatment, many women recover, although having an episode increases the risk of future episodes, particularly following subsequent pregnancies.“Postpartum mental illness happens because someone couldn't handle motherhood.”
These are medical and psychiatric conditions involving biological vulnerability, dramatic hormonal changes, sleep disruption, psychosocial factors, and, particularly with PPP, vulnerability to mood disorders. They aren't evidence that someone simply wasn't emotionally strong enough.
And here’s a link to an article about the medication we refer to in the episode, Zuranolone
EP. 18
Postpartum Depression and Postpartum Psychosis
Postpartum depression and postpartum psychosis are often talked about as though they're interchangeable, but they're very different conditions. In this episode, we break down PPD versus PPP, what psychosis actually looks like, what's happening in the brain and body after childbirth, and how a loving mother can become so disconnected from reality that she does something completely unimaginable. We also tackle the myths, the new treatments, and why understanding the difference can literally save lives.
Click HERE to listen to the full episode:
