One day I was reading how Andrea Yates, a wife and mother of five, drowned her five children in a bathtub after recently giving birth to her baby girl. She was convicted of first degree murder after pleading innocent by reason of insanity, which was rejected by the jury. Four years later her conviction was appealed and reversed on the basis of insanity leaving Andrea committed to a state institutional hospital. The overturn of her conviction is how Yates became the “poster child” for postpartum depression. Her tragic story allowed me to understand the true depth of postpartum depression and postpartum psychosis for the very first time. You may have heard this condition also being described as having the “Baby Blues”.
According to the American Journal of Obstetrics and Gynecology, postpartum depression (PPD) is the leading cause of murder in children under the age of one. In this county 20% of women experience PPD. In fact, “50% of women who experience PPD have reoccurrences in subsequent pregnancies” says Kim Pearson, MD from the Department of Psychiatry at Harvard Medical School. PPD is now a clinical diagnosis that falls under the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders 5th Edition). The classification is Depressive Disorder with Peripartum Onset. This onset can actually start anytime during the pregnancy up to one year after giving birth or longer if left untreated.
Here is a snapshot of PPD. Women are at a higher risk if they:
- lost the baby either through a miscarriage or during labor and delivery
- are a mother multiple children like twins or triplets
- are a teen mom
- experienced a difficult pregnancy or delivery
- have and unwanted pregnancy
- have low social support or outside help
- low self esteem
- low socioeconomic status or financial stress
- have a baby born with a birth defect
The root cause of PPD still remains unknown at this point. There is some speculation that the dramatic drop in hormones, which occur after the pregnancy has ended, causes mood shifts in the brain. This leads to symptoms of feeling sad, empty, guilty, hopeless, exhausted, withdrawn, easily frustrated, frequent anxiety, along with having low energy levels and a depleted sex drive.
Mothers who murder their children often believe they are delivering their children to a much better life than the life they were given at birth. They feel trapped themselves as if they were at the bottom of a giant bowl and can’t climb up the sides to get out. This is the psychosis part of PPD. It leads to hallucinations that may or may not be communicated by the mother. (Flashback: remember when Oprah’s character killed her children in the movie Beloved) It’s important to know that PPD requires immediate treatment. Current treatment options for mother who suffer from PPD include antidepressants and antipsychotic medication. ECT (electroconvulsive therapy) is recommended when the condition does not respond to medication.
What can you do? If you have a friend or a loved one that you feel may be at risk or shows signs of PPD for two consecutive weeks or more, here are a few helpful tips for you to consider:
- Call the National Suicide Prevention Lifeline’s Help for Someone Else Hotline and find out what resources like counseling services are available in her area. Dial 1-800-273- TALK (8255)
- Be willing to listen without judgement or over reacting. Your friend or loved one will more than likely withdraw from you if you do.
- Don’t lecture or debate with her about how valuable life is or anything else. Remember you are dealing with the condition not the person.
- Make the appointment to seek help from a healthcare professional and go with her to that appointment if it fits into your schedule.
- Remove anything that could be used cause harm to the baby or herself (guns, stockpiled pills, knives, maintenance tools, ropes, etc)
The main thing is to show love, support, and compassion. Even new moms without help who simply feel overwhemled without having PPD may appreciate a weekend of rest and spa treatments so offer to pick the baby up or go over and spend a significant amount of time with the baby to free her temporarily.