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POSTPARTUM PSYCHOSIS
POSTPARTUM PSYCHOSIS occurs in approximately 1
in 1,000 births.
Since this disorder
is unique to women and relatively rare, there is a lack of understanding of the disorder and failure to identify
it, which has led to tragic endings including the mishandling of these cases in our legal system.
Postpartum psychosis is characterized by disorganized and bizarre thinking, delusions, paranoia, and hallucinations
(usually voices telling her to harm herself or her baby) resulting in homicidal and suicidal impulses and actions.
Most often, a woman with postpartum psychosis
does not share her thoughts or recognize the need for help even though this is considered a psychiatric emergency. The
symptoms of the depression might be the only thing noticed by family members or health care providers, but treating depression
will not help the psychosis and in some cases may make it worse.
Postpartum Psychosis is a Psychiatric Emergency and a Medical Emergency All
psychosis is medical in nature, caused by a "physical" problem. That includes the illnesses
of schizophrenia, bipolar disorder, depression etc. I actually think characterizing it as just a medical condition
minimizes the severity and difficulties of the condition.
Mental illness has always been difficult to understand because you can't see
it. You can't do a test or even an MRI of the head to tell if someone is hallucinating or planning suicide.
Post-partum psychosis is called a "psychiatric emergency"
because this particular illness usually results in uncontrollable impulses to attempt suicide and/or murder. ( The nature
of the emergency would be more comparable to a trauma/motor vehicle accident you don't see coming, because urgency
in care is the most important factor in order to save lives.)
I think
society in general understands that a person with mental illness does not have the ability to control the illness. Antipsychotic medication, antidepressants, etc. are prescribed more now than ever before. The stigma
is being lifted slowly.
A person
who is psychotic has had a break with reality. The person does not even recognize the need for treatment, or that what
she may be experiencing isn't "real" at all. Since the psychotic person doesn't recognize the experience as
abnormal, she will not recognize the need to tell someone about it, or seek treatment on her own.
With bipolar disorder and
schizoaffective disorder there is no conscious or active participation in the illness.
Unfortunately laws don't recognize that someone
can be mentally ill, maintain a notion of what is right and wrong, and still have psychosis which prevents the ability
to control wrong impulses. The only reason Andrea Yates was convicted was because the jury had to follow the instructions
of the law. The jurors all believed that she was insane at the time she killed her children, Texas law said a person
is criminally liable if she knew right from wrong when she committed the crime; they had no choice but to convict, and unfortunately
people found guilty but mentally ill are sentenced the same as people just found guilty.
It is the temporary nature of post-partum psychosis that makes it difficult for people to understand, but
some psychosis that is triggered by pregnancy may never go away without lifelong treatment.
Shontelle's situation is even more unique. Her post partum psychosis triggered a latent bipolar and
schizoaffective disorder. Approximately 25% of all women with bipolar disorder present with their first episode
right after childbirth.
TO LEARN MORE
ABOUT POSTPARTUM PSYCHOSIS VISIT THE SITES LISTED BELOW
"The Female Patient: Postpartum Depression" Grand Rounds at the University of Michigan
Attorney George Parnham explains why defending a woman with postpartum psychosis is difficult
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