Postpartum Psychosis Clarification

From now on when I write about my postpartum experience, I am going to use the term Postpartum Psychosis instead of Postpartum Depression. I was using PPD because it was easier and to be honest, postpartum psychosis brings to my mind lunacy. PPS is a level of PPD anyway and I thought PPD was an encompassing there. However, I now think I should be very clear about what I had because it was significantly different from standard PPD.

I think I wrote before about the three levels of PPD. There's the baby blues that hit 3 or so days after birth. This is caused by hormones leaving the mother's body. Moms become weepy and a little blue, but it passes within a week or two. Up to 80% of moms experience this.

Standard PPD is what most people think of when they think of PPD. If you read Brooke Shield's book, Down Came the Rain, it's what she had. PPD is a clinical depression that affects between 10%-20% of new moms. It can strike at anytime up to a year postpartum. Women who have PPD experience the usual depression symptoms of fatigue, sadness, hopelessness, insomnia, and appetite changes. They also may have feelings of guilt and worthlessness. They might think they are terrible mothers. They may worry about their babies more than normal. They often worry that their babies will get sick or injured. They may withdraw from their babies and feel detached. They may avoid their babies. They may isolate themselves and spend a good deal of time crying. In more serious cases, they may be suicidal. Some mothers may have intrusive thoughts and worry about hurting their babies.

Risk factors for PPD include having one or more episodes of clinical depression, having a difficult or disappointing pregnancy or delivery, lack of emotional support, major life changes prior to giving birth, marital problems, unplanned pregnancies, and a history of severe premenstrual syndrome.

PPD is a serious condition and can impair a mother's ability to care for her children. Families may have to use secondary caregivers because the mother is unable to care for the children. The good news is is that it is extremely treatable. Antidepressants and sometimes therapy are used to lift the mother out of depression.

The third level is Postpartum Psychosis. It is very rare and very serious. It affects only 1 out of 1000 mothers. This is what I had. PPS is what causes mothers to kill their babies and sometimes themselves. Mothers with PPS may experience the symptoms of PPD but also may have hallucinations, delusions, irrational thoughts, episodes of mania and delirium, obsessive thinking, paranoia and suicidal thoughts.


I went through all three stages on the spectrum, really. I had the baby blues, but they ended very quickly, within a few days. At around 3 weeks, I began feeling depressed. I felt a general sadness at first. It progressed to feeling hopeless about my situation. I cried most of the time and I fantasized about leaving. I isolated myself somewhat (not hard to do with a newborn anyway) and very early on began feeling very detached from Ladybug.

Very quickly though, within two weeks at the most, the symptoms of psychosis began. I basically lost touch with reality in a way. I become irrationally obsessive about taking detailed notes about Ladybug's eating and sleeping habits. If my husband did not cooperate with this, I would become raging mad, hysterical. I became paranoid about other people; I was convinced that my mother-in-law wanted to take my children from me. During one episode, I was convinced that my husband locked me out of the house at night and I became hysterical. I attributed thoughts and deeds to people that never occurred. I seriously thought that Ladybug was crying just to anger me, that she wanted to irritate me and that she hated me. I felt like everyday was a roller coaster. I would feel OK one minute and hysterical or raging mad the next. I felt absolutely out of control.

The scariest symptoms for me were the hate and anger I felt toward Ladybug and the secret desire to hurt her. I felt much more likely to kill Ladybug than myself, though I did attempt suicide at one point. As I said before, I was deemed homicidal and suicidal by medical professional. I hated having to see or touch my baby and I would think about all the ways she might die. Women with PPD often fear that their babies will die or become injured. I actually wanted Ladybug to die and I would think about ways I could do it. I would see pictures in my head, flashes of me doing something to her and I would often feel a strong urge to follow through with these actions. I never heard voices, but I would feel compulsions. I also would become hysterically angry at her and rage at her until my husband removed me from the room. And a handful of times I came extremely close to hurting her. I actually squeezed her very hard several times and shook her and I remember very roughly dropping her in to her crib in anger, almost throwing her in.

I have never before experienced psychosis before the birth of Ladybug. I do have a personal and family history of depression. I have been clinically depressed and suicidal twice before and was hospitalized in my twenties. But I am not bipolar or psychotic. This was a definite postpartum experience.

In reading all this now, I look like a total lunatic, I know. But I am fine now. I was put on anti-psychotics for a while and have been on antidepressants for months. Once stabilized, I never had another episode of psychosis.

I will never have another child though. The risk of the psychosis returning if I gave birth again is high and I have been advised by my psychiatrist not to get pregnant again. I am fine with this and I think for us, it is the right decision. I would never want to go through that again and I would never want my family to have to go through it again either. It almost destroyed my marriage and we'll never know what it did to my children.

Yesterday, we had a day of Christmas activity--baking cookies, listening to carols, getting ready to go to the grandparents' house. As we were doing all this, I looked around me at my children and was so deeply happy and felt so much love for them that it made me cry. I try now to give extra attention and love to Ladybug to make up for the hate I showed her as a baby. I try everyday to hold her in my arms a few minutes and rub my cheek against her head, nibble her cheeks and tell her how much Mommy loves her. My fear is that she will have lasting emotional scars from her early months and I want to do everything I can to heal them.