Postpartum Psychosis Case Study

Postpartum depression, which is the most prevalent of all maternal depressive disorders, is said to be the hidden epidemic of the 21st century. (1) Despite its high prevalence rate of 10-15% and increased incidence, postpartum depression often goes undetected, and thus untreated. (2) Nearly 50% of postpartum depression cases are untreated. As a result, these cases are put at a high risk of being exposed to the severe and progressive nature of their depressive disorder. (3) In other words, the health conditions of untreated postpartum depression cases worsen and progress to one of their utmost stages, and they are: postpartum obsessive compulsive disorder, postpartum panic disorder, postpartum post traumatic stress, and postpartum psychosis.

Postpartum Depression also referred to as “the baby blues” is depression that is suffered by a mother following the birth of her child that typically arises from the combination of hormonal changes and fatigue, as well as the psychological adjustment to becoming a mother. Most mothers will feel depressed or anxious after the birth of their child, however it turns into postpartum depression when is lasts longer than two weeks, and if treatment is not sought after a month, it could continue to worsen severely.

“Postpartum psychosis is a severe psychotic syndrome that is estimated to occur after 1.1 to 4 of every 1000 deliveries. More than half of the affected women meet diagnostic criteria for major depression” (Weissman and Olfson 800). Postpartum depression is a further common mental illness than postpartum psychosis, however Margery Kempe displays serious symptoms. Several readers believe that Margery Kempe was a woman who devoted her life to God, however, after her first child was born Margery Kempe was recognizably sick due to the feelings that she should not live. In The Book of Margery Kempe, the first autobiography in the English Language, Margery Kempe displays the symptoms of hallucinations, crying episodes, and depression to show that she has postpartum psychosis.

Ongoing sleep deprivation, the intense experience of birth, radical role shifts, and hormonal fluctuations all collide to produce mood swings, irritability, and feelings of being overwhelmed in the majority of mothers. While as many as 80% experience some form of the “baby blues,” a smaller percentage experience Postpartum Depression, with even fewer moms that experience Postpartum Psychosis. Treatments vary depending degree and intensity of symptoms, and can include talk therapy/psychotherapy (individually or group), antidepressants, electroconvulsive therapy, and other modalities. Awareness encompasses knowing and recognizing signs and symptoms. In order to minimize the harmful effects of this disorder, we should know our risk factors, conduct regular screenings, engage recent moms in expressing feelings, and sustain postpartum support groups.

According to Dupey “postpartum depression and postpartum psychosis are two separate conditions. Postpartum depression the mom knows that she is struggling but does not lose touch with reality. With postpartum psychosis the mom is dealing with anxiety, depression, and a complete break from reality. Knowing the difference between the two is important that family and providers recognize the difference (2014, para.12)”. When doctors do not recognize the difference and is treating the new mom for postpartum depression instead of psychosis, the end results can be harmful for the mother. The rate of mothers harming their children or commit suicide has increased over time. More states would benefit to have more faculties that deal with women

The birthing process generally leaves women with overwhelming joy and happiness. However, some women do experience a period of postpartum blues lasting for a few days or at most a couple of weeks but goes away with the adjustment of having a baby (Postpartum Depression, 2013). A condition called Postpartum Depression Disorder (PPD) leaves a dark gray cloud over 10-20% of woman after birth that is recognized in individuals 3 weeks to a year after the delivery of their baby (Bobo & Yawn, 2014). PPD leaves new mothers feeling lonely, anxious, and hopeless (Bobo at el, 2014). Postpartum Depression is a cross cutting disorder that can affect any woman after the delivery of a baby regardless of race, socioeconomic status, age, or education level (Postpartum Depression, 2013). Although this disorder affects more than 10% of women the article Concise Review for Physicians and Other Clinicians: Postpartum Depression reports that less than half of women with PPD are actually diagnosed with this condition (Bobo at el, 2014). It is important that postpartum women and their support systems receive education on what PPD consist of and ways to recognize the signs and symptoms of PPD so that a diagnosis is not overlooked. Early diagnosis is important because early recognition and treatment of the disorder yields for better results when treating individuals with PPD. In this paper I will deliver information about PPD based on recent literature,

Elated one minute, depressed the next is one common scenario observable in mothers who recently delivered a baby. Women manifest mood swings or “baby blues” in the few days after childbirth. It is an identified psychological postpartum complication in new mothers. According to BC Reproductive Mental Health Program (2011), eighty percent (80 %) of women report to be experiencing postpartum blues within 3-5 days after giving birth. During this time frame, rapid mood swings, feeling of helplessness, disturbed sleep pattern or difficulty to sleep, and crying for no reason are common signs which are considered normal on women having the postpartum blues. This is a transient phenomenon which self-resolves within 10-14 days with no medical intervention required (Rai, S., Pathak, A., & Sharma, I., 2015). Although its etiology remains unidentified to date, biochemical, psychological, social and, cultural factors are not excluded as contributors to this condition.

“Postpartum psychosis is a severe psychotic syndrome that is estimated to occur after 1.1 to 4 of every 1000 deliveries. More than half of the affected women meet diagnostic criteria for major depression” (Weissman and Olfson 800). Postpartum depression is a more common and less threatening mental illness than postpartum psychosis, however, Margery Kempe displays the more fatal symptoms. Several readers believe that Margery Kempe was a woman who devoted her life to God, however, after her first child was born Margery Kempe was recognizably sick and continued these symptoms throughout the entire book. In The Book of Margery Kempe, the first autobiography in the English Language, Margery Kempe displays the symptoms of hallucinations, crying

The Center for Disease Control estimates that 1 in 20 people suffer from depression (2014). Although widely recognized and somewhat easy to diagnose, depression is an ignored and almost hidden, disease. In women, the statistics are especially grim for those who are pregnant or were recently pregnant. A great number of women suffer from postpartum depression; an illness which is often overlooked, misdiagnosed and untreated. Postpartum depression (PPD) has been defined as an emotional disorder that occurs in an estimated 10-15% of all women after childbirth (Liberto, 2010). Postpartum depression not only impacts the mother, but can cause long-term psychological challenges for the baby and create emotional turmoil for all family members.

Postpartum psychiatric disorders are generally divided into 3 different categories: postpartum blues, postpartum psychosis and postpartum depression. Postpartum blues are very common. Symptoms are characterized by crying, confusion, mood swings, and anxiety. These symptoms manifest early after birth but don’t last very long. Another one is postpartum psychosis which is more severe. Symptoms appear within four weeks and include delusions, hallucinations and gross impairment in functioning. Postpartum depression begins in or extends into the postpartum period (Ohara, 2004). According to Health Facty, there are 10 symptoms of postpartum depression; sadness, mood swings, feeling overwhelmed, crying spells, problems with memory and concentration, change in sleep cycle, altered patterns of eating, loss of libido, social withdrawal, and an enduring sense of exhaustion. Symptoms must last longer than one moth to be diagnosed as postpartum depression.

Mothers who have brought into this world a blessing have been preparing themselves for a big change in their life. They have been learning and educating themselves about how to be a good mother. Many mothers find it really hard to transition from being an independent woman without children to becoming a mother (Corrigan, Kwasky, & Groh, 2015). Adapting to motherhood can be a drastic change, and usually creates challenges that lead to feeling overwhelmed (Leger & Letourneau, 2015). When a newly mother begins experiencing stress or becomes emotional then there can be a possibility that they can encounter Postpartum Depression (Leger et al., 2015). Postpartum depression can be seen and experienced in many different ways, it all varies on every mother (Corrigan et al., 2015). Many different mental health issues can be seen including baby blues, postpartum depression, postpartum obsessive-compulsive disorder, and the most serious, postpartum psychosis (Tam & Leslie, 2001).

Postnatal depression (PND) is an isolating and debilitating mental health disorder that effects an estimated 13-15% of new mothers within one year post-delivery (CDC, 2008; Gaynes et al., 2005). PND can be experienced as a vast array of symptoms such as anhedonia, excessive crying, mixed anxious mood, sleep disturbance, and even suicidality (Kantrowitz-Gordon, 2013). Further, mothers with PND typically report difficulty bonding with their infant and a reduced ability to express love and warmth (Letourneau et al., 2012; Paulson, Dauber & Leiferman, 2006). Occasionally, the mother has thoughts and images associated with hurting herself or her baby (NEED REFERENCE).

Davidson stated in her 2012 book A Nurse’s Guide to Women’s Mental Health that “It is estimated that 50-80 percent of women suffers from some form of baby blues after birth”. (pg.175)

Feeling moody or blue after child birth is a common issue that many new mothers work to overcome but it is widely acknowledged that postpartum depression can be dangerous to a new mother and her baby. Mothers can experience symptoms such as losing interest in the baby or self, lack of motivation, insomnia, worrying about hurting their baby, irritability, and even have thoughts of death or suicide (Smith & Segal, 2014). These sings tend to set in after childbirth and continue to develop over several months. (Tharner, 2012). While this makes it difficult for the mother to take care of herself, it makes it increasingly difficult, if not impossible, to take care of all her baby’s needs.

Postpartum mood disorders is defined as a spectrum of illness including postpartum blues, postpartum depression and postpartum psychosis. The postpartum blues are extremely common and no specific treatment is usually needed. Postpartum depression is less common and may significantly impact both the health of the mother and baby. Postpartum psychosis is extremely rare with clinical features including mania, psychotic thoughts, severe depression, and other thought disorders, and requires hospitalization. This paper will focus on reviewing and discussing postpartum depression.