On January 24, 2023, the town of Duxbury, Massachusetts and the perinatal community at large were shocked by the news of tragedy: Lindsay Clancy, a labor and delivery nurse and a mother to three children- Cora, age 5, Dawson, age 3, and Callan, age 8 months- was found severely injured outside of her home after an attempted suicide; her children, inside, were lifeless. Immediately, speculation spread like wildfire about the cause of this, while investigators named postpartum depression as a factor. Those who are trained in perinatal mental health have since advocated for awareness of and education about postpartum psychosis in the wake of this tragedy.
Misinformation continues to be rife among media and news outlets. The quick spread of inaccuracies about what Lindsay was going through as well as about perinatal mood and anxiety disorders has likely caused undue fear, blame, and judgment among those who are experiencing postpartum depression, anxiety, and OCD. We at The Life Workshop feel strongly about ensuring our community is aware of the signs and symptoms of all perinatal mood and anxiety disorders, so we have outlined them here.
Postpartum depression (PPD) emerges at least two weeks and up to one year after birth. Symptoms include persistent feelings of sadness, hopelessness, and fatigue (unrelated to lack of sleep in the newborn period). New mothers may experience changes in appetite, sleep disturbances, and difficulty bonding with their newborns. Other signs include irritability, anxiety, and a sense of worthlessness. There is often significant shame attached to these symptoms, making it hard for some people to reach out for support.
The onset of PPD can be influenced by various factors, including hormonal fluctuations, lack of social support, and pre-existing mental health conditions. While the exact frequency of PPD varies, it is estimated that around 10-15% of new mothers may experience it. Recognizing and addressing PPD is crucial for the well-being of both the mother and the child. Supportive interventions, such as therapy and medication, can significantly alleviate symptoms, promoting a healthier postpartum experience.
Postpartum anxiety (PPA) is characterized by excessive worry and fear related to the new baby's well-being. Onset typically occurs within the first year after childbirth, with symptoms manifesting as restlessness, racing thoughts, and heightened sensitivity to potential dangers. Mothers experiencing PPA may struggle with constant feelings of unease, muscle tension, and difficulties concentrating, impacting their daily functioning. It may impact a new mom’s ability to leave the house with their baby or allow anyone else to care for them due to the intensity of the anxiety.
The frequency of postpartum anxiety is notable, with estimates suggesting that up to 15% of new mothers may grapple with its effects. PPA often coexists with postpartum depression, emphasizing the interconnected nature of maternal mental health. Early identification and intervention, including therapy and support groups, play a vital role in managing postpartum anxiety, promoting the well-being of both the mother and the newborn.
Postpartum Obsessive-Compulsive Disorder (OCD) is characterized by intrusive, distressing thoughts and repetitive behaviors. Onset typically occurs in the early postpartum period, within the first few weeks to months after childbirth. Those with postpartum OCD may experience obsessive thoughts related to harm coming to their baby, accompanied by compulsions or rituals performed to alleviate the anxiety- for example, fearing germs or contamination, so obsessively washing hands, or being afraid of the baby passing away while sleeping, or checking repeatedly in a short time span to ensure baby is still breathing.
The frequency of postpartum OCD is estimated to be around 3-5% of those in the perinatal period, though it often goes underreported. The condition can be isolating and distressing, impacting maternal well-being. Recognition and understanding of postpartum OCD are essential for timely intervention. Cognitive-behavioral therapy, support groups, and medication can be effective treatments, offering relief to those grappling with the challenges of postpartum OCD.
Postpartum psychosis is a severe and rare mental health condition that can occur in the postpartum period, typically within the first few weeks after childbirth. It is a psychiatric emergency requiring immediate attention. The illness is characterized by a rapid onset and is marked by severe mood disturbances, hallucinations, delusions, and disorganized thinking. Some of those experiencing postpartum psychosis may display extreme agitation, paranoia, and a significant impairment in reality perception (for example, thinking they are receiving messages from a spiritual higher power or demon, or thinking they can see the future). The symptoms of postpartum psychosis necessitate immediate and urgent medical intervention. Treatment often involves hospitalization to ensure the safety of both the mother and the infant. Medications such as antipsychotics and mood stabilizers are commonly prescribed to stabilize the mother's mental state. The onset of postpartum psychosis is unpredictable, and risk factors include a personal or family history of bipolar disorder or psychosis. Sleep deprivation and hormonal fluctuations may also contribute to its occurrence.
Postpartum psychosis requires a comprehensive approach involving psychiatric care, therapy, and support for the affected mother and her family. In some cases, long-term management and support may be necessary to prevent recurrence. Early detection and intervention are critical in ensuring the best possible outcomes for both the mother and her child. Education and awareness about postpartum psychosis are essential to promote understanding and reduce stigma surrounding this serious mental health condition.
It is our hope that continued awareness, education, and training about perinatal mood and anxiety disorders can better support new parents. The tragedy faced by the Clancy family, as well as all families who have experienced postpartum psychosis, is one too many. It is imperative that we prioritize the mental health of new parents and reduce the stigma in order to ensure a more positive future for families in our country.
If you or someone you know is experiencing a mental health crisis, including thoughts of suicide, harm to yourself, or harm to your baby or family, please know you are not alone and there are resources available to you. Please utilize your local emergency room, crisis hotline, or the National Maternal Mental Health Hotline at 1-833-852-6262.