Last week’s tragedy in Duxbury put postpartum mental health in the spotlight. Charged with numerous crimes. Clancy remains hospitalized with injuries sustained in an apparent suicide attempt. Authorities have not clarified whether they believe mental illness was involved in Clancy’s alleged behavior, but similar cases in the past have been linked to postpartum mental health conditions, including postpartum psychosis. Dr. Nancy Byatt, a perinatal psychiatrist at the University of Massachusetts Chang School of Medicine, attended his GBH. all things considered Host Arun Rath explains the differences in pregnancy-related mental health conditions and how they manifest themselves. This transcript has been lightly edited for clarity and length.
Arun Lass: Before we get into the conversation, I want to make sure I’m using the terminology responsibly here. Because we’re talking about mental health and we’re talking about tragic situations. How broadly do you understand postpartum depression and postpartum psychosis?
Nancy Byatt: One thing we hear a lot about is, like you said, postpartum depression. I actually like to think of it as perinatal depression, depression that occurs during pregnancy or within the first year after giving birth. Postpartum psychosis is very different. Because depression doesn’t include psychotic symptoms. Another illness that is becoming increasingly common during this time is anxiety. Recently, the term “perinatal mood and anxiety disorders” is often used in this field. This refers to depression, anxiety disorders, and bipolar disorder during this time.
I would also like to clarify that postpartum psychosis is very different from mood disorders and that this is extremely rare. To do. Postpartum depression or perinatal depression usually occurs in 1 in 7 women. [and] Postpartum psychosis, on the other hand, occurs in 1 to 2 per 1,000 births. Therefore, it is much less common and much rarer than other mood and anxiety disorders seen during this time.
When looking at postpartum psychosis, it often occurs in the context of mood disorders. People have depressive episodes with bipolar disorder, but manic episodes are also seen. Or we see something called hypomania. [of] depression. Depression tends to make you feel depressed, hopeless, and helpless. They may think about death or wish to die. With mania, it’s quite the opposite. What we are seeing is an elevated mood, an increase in energy, and a significant reduction in sleep, but still a lot of energy and increased thinking and irritability.
In bipolar disorder, people may present with psychotic symptoms in that context. What is seen there are symptoms of psychosis, which may include hallucinations. So, for example, you may hear a voice commanding you. Also, when we see infanticide or suicide, it can be a voice telling people to hurt their babies.
Another thing we see in postpartum psychosis is that people have delusions that are altruistic in nature. For example, people may believe the world is better off without their babies. They may believe that something is wrong with their baby or that there is something wrong with them. Or maybe you believe something bad is happening because something bad is happening. I live I think one of the most common misconceptions about postpartum psychosis is that people often ask, “How can you do this?” What is overlooked is that people often come from a place of love and actually do this to do what they think is best for themselves, their babies, and even the larger world and society. That’s it.
Russ: It seems to be expected by many mothers. And would one of the effects be that it makes it harder for people going through this to seek help? We expect mothers to be able to handle everything.
Byat: I believe it is a contributing factor. You know, when we think of childbirth, when we think of parallel periods, it’s historically been celebrated that this period is so wonderful and that mom and baby are so happy. The reality is that there is no limit. In fact, it is often very difficult. … I think the persistence of that fantasy and myth makes it even harder for people to talk about this and ask for help.
I would also like to add that even though people are comfortable talking about this and seeking help, it is difficult to get help. I have. If people are asking for help, or if someone is screened in the setting and it is detected, they may not always be responsive and capable of providing an appropriate response.
Russ: I know we’ve had a lot of conversations over the last few years about how the pandemic is impacting the mental health baselines of nearly everyone. environmental issues to give. To what extent has the pandemic affected the prevalence of perinatal and postnatal psychiatric disorders?
Byat: I have. Indeed, we have seen an increase in the prevalence of these diseases. I think some things happened. One is that the prevalence itself seems to be increasing. For example, we talked about depression being more common than anxiety. However, more recent research shows that 1 in 5 people can actually feel anxious. depression. So we are certainly seeing an increase in anxiety likely related to COVID. Secondly, we are also seeing an increase in awareness and detection. This is great. There have been recommendations from the American College of Obstetricians and Gynecologists and many other professional groups and policy makers to screen for depression and, more recently, peripheral disorders during this time. Obstetric practices and providers are screening individuals. So we detect this and are aware of it more often than before.
Russ: Dr. Byatt, it was great talking to you about this. Thank you very much.
Byat: you’re welcome. I am honored to be here.