Postpartum Psychosis In the News (Again)

I wanted to take a moment to talk about postpartum psychosis, since I know so many of you have been following the tragic case of Lindsay Clancy. In the 90s, when I first learned about postpartum psychosis, it was Andrea Yates.

Side note: in undergrad, I wrote my persuasion piece for a public speaking class on why Andrea Yates needed psychiatric help, not prison. Ironically, here I am over two decades later, still preaching about why we need more education on this condition.

Cases like these are tragic, and my heart breaks for everyone involved. They also stir up intense anxiety for so many moms — the fear of "what if that happens to me," or the worry that an intrusive thought about harming their baby means something is seriously wrong. (That's usually a different condition — postpartum anxiety — and I wrote about the difference here.)

What I want everyone to know is this: postpartum psychosis is real, and it's very treatable.

For every tragic story that makes the news, there are countless others where someone got the right treatment and healed before tragedy struck.

Postpartum psychosis is often called "rare," but there are enough mothers living this reality that many of them find that word isolating, even dismissive. The numbers say it affects an estimated 1-2 out of every 1,000 births — high enough that this condition should be on the radar for everyone involved with a pregnancy or a new baby.

Postpartum psychosis typically shows up within the first two weeks postpartum, though it can emerge earlier, during pregnancy, or later into the postpartum period. And here's what makes it so dangerous: it doesn't always look like what people expect. It's not always a mother in obvious distress. Sometimes it looks eerily calm.

The affected person may be dealing with delusions, hallucinations, and paranoia, but she may appear quite normal to those on the outside. While a mother experiencing postpartum psychosis is completely detached from reality, things may seem very logical to her internally. She likely isn't talking about her distress. She may experience severe confusion, rapid mood swings, and disorganized thinking, but these symptoms can wax and wane — meaning a mother can seem fine one hour and be in crisis the next, making it difficult for others to catch or act on with urgency.

It's imperative that providers and loved ones have this condition on their radar in order to intervene when needed. If you want a deeper dive into the full list of symptoms, risk factors, and what recovery looks like, I break it all down in this post on perinatal psychosis.

For Providers

If you're working with a client or patient who may be experiencing postpartum psychosis, it's essential that you collaborate with her full treatment team. Get consent to be in touch with her OB/GYN, therapist, psychiatrist, and any other treating physicians. Get consent to consult her partner or family, both for a fuller risk assessment and to establish "eyes on her" — someone who isn't her, tracking how she's actually doing day to day. This is not a condition to manage in the isolation of a single weekly session or infrequent follow-up appointments. If you aren't well trained in postpartum psychosis, seek consultation.

For Families

Postpartum psychosis is a medical emergency. If you suspect something might be off — even if you can't quite name it — don't wait. Get in touch with someone who specializes in perinatal mental health: a reproductive psychiatrist, or a therapist with a PMH-C credential (Perinatal Mental Health Certification). This diagnosis is not always well understood by general practitioners or general therapists, and postpartum psychosis can be missed or misread as "just" postpartum depression or anxiety if the person evaluating her doesn't know what to listen for. Don't leave the mother alone with herself or her children until you can confirm she is not in crisis.

If you are a mother experiencing any of these symptoms, or you're worried about someone who is, please don't sit with it alone. Call the National Maternal Mental Health Hotline at 1-833-9-HELP4U (available 24/7), or 988 if there is any immediate danger.

This is a treatable illness. Women get better. With the right kind of help — often brief hospitalization and medication — tragedy can be prevented.

I also want to name something that keeps families from reaching out in the first place: fear. Moms suffering from postpartum psychosis are not bad people. They are women experiencing a serious medical condition that includes a temporary break from reality. Treatment sometimes means a brief hospitalization, and a brief period of separation from baby while she stabilizes — but that separation is short, and it's part of getting her well, not a verdict on her fitness as a mother. It is not a reason for anyone to call CPS, question her as a parent, or fear that her children will be taken away. So many moms and families hesitate to get help because of exactly this fear — and that hesitation is what turns a treatable illness into a tragedy. Reaching out for help is not a risk to your family. It's what protects it.

If you're following the Lindsay Clancy case and feeling distressed or worried about your own risk, get in touch. My team and I at Be Well Wellness love meeting with pregnant families to provide education, assess risk, and establish a relationship should support be needed at any point.