My wife had postpartum psychosis. Why was it so hard to get help?

Oath editorial note: Postpartum psychosis has received increased attention in the wake of the tragedy of Lindsay Clancy, a Duxbury, Massachusetts mother who allegedly killed her three children before attempting to take her own life. 

She may have been suffering from postpartum psychosis, which occurs in approximately 1 to 2 out of every 1000 births, or 0.1%. We don’t usually hear about it except for the rare cases when the worst happens (about 4% of PPP cases result in infanticide and 5% in suicide). But even when everyone comes out of the experience alive, there can be immense suffering and trauma involved. 

Many parents who experience postpartum mood disorders say that they are not getting the support they need. What follows is the anonymous account of a new dad whose wife experienced postpartum psychosis shortly after giving birth to their first child, followed by reflections from Oath therapist Brittany Williams.

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It began two and a half months after she gave birth to our first child. She started having some deep realizations about her childhood and upbringing. She went deep into her thoughts, making connections to everything—some connections were valid, others were quite out there. 

For four days leading up to the actual psychosis, things were very up, then very down. She started reaching out to long lost cousins and oversharing with them. I tried talking with her about it but she kept telling me that she understands now and that I needed to trust her. Though she was acting very manic and not like herself at all, she always seemed so sure of herself, and kept telling me that everything was okay. 

The psychosis came completely out of the blue. She had never experienced anything like this before outside of a couple of panic attacks after smoking too much marijuana. 

We went to the emergency room and she was forced to be hospitalized due to the nature of her episode. They sent her to a facility that focused on substance abuse patients. She was the only one there who had suffered from a postpartum incident. Her doctors were not specialized in postpartum issues. We tried getting her transferred to a better facility but we were told of all the insurance obstacles that we would have to deal with. 

Now we’re in month five of recovery and still trying to figure it out. My wife still struggles with depression and the effects of an ever changing medication plan so I have no choice but to take all of this on and try to get her the right help. I don't know what I’m doing.

The Lindsay Clancy story hit me hard. They were doing all the right things. They’re doing more than we are. I am trying to do everything right but I’m not a medical professional and I don’t know, and even the medical professionals we’re working with don’t seem to know. They often group her with other mental illnesses like bipolar, but I feel like that ignores the true nature of this stemming from her being postpartum. 

Once things felt more stable and we had established relationships with doctors I started feeling more comfortable leaving her alone. But after the Lindsay Clancy story, I worry that I am not supposed to be leaving her alone for even a minute. It consumes my mind when I’m not with her. 

But it’s also hard on her to feel like she needs to be babysat—it destroys her confidence. Such a delicate balance. 

I am certain that if it was not for the postpartum psychosis, Lindsay Clancy would never have dreamed of doing what she did. Connecting it to my wife’s experience, I think Lindsay thought she was saving her children from some perceived imminent threat. The only positive to the tragedy in Duxbury is that it brought an incredible awareness to this and so many people have been reaching out offering to help. Going forward, we will have someone with my wife at all times. 

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Reflections from Brittany Williams, LMFT:

This dad is doing everything he can to support his wife. His account of what it’s been like to witness and support his wife through her postpartum psychosis is a beautiful representation of how to support someone experiencing this difficult diagnosis. Although we are able to define, diagnose, and treat postpartum psychosis it still remains very ambiguous in character for the individuals and families that experience it. 

This father was attuned to his wife, noticing her behavior, trying to talk to her about her thought processes and ultimately took her to an emergency room when he knew something wasn’t right and got his wife the help she needed. 

What we can also see in this dad’s account is how postpartum psychosis infiltrates a family system. The increased anxiety for the supporting partner. The erosion of self confidence for the birthing parent. The relational block and strain between the parents and extended family because they don’t fully understand the diagnosis or how to support. 

Postpartum psychosis demands more attention from the parental hierarchy, subsequently leaving less for the children of the family and can negatively impact the mother’s ability to bond with her child. The individuals and families facing postpartum psychosis need more support and for longer periods of time than families who are not facing postpartum psychosis. These families need friends, family, & individuals who are willing to help with daily tasks, providers who are informed and compassionate, and researchers dedicated to learning all that we can about this disorder and its prognosis. 

‍Postpartum psychosis (PPP) is a severe, temporary, treatable emergency that warrants professional help. The greatest risk period for PPP is the two weeks following delivery. Initial symptoms of PPP include depression, mania, or a mixture of the two before progressing to psychosis. More specifically: delusions or strange beliefs, hallucinations, severe irritation, hyperactivity, decreased need and/or inability to sleep, and paranoia. It is important to note that symptoms vary widely and can change rapidly, even over the course of hours. 

Although each woman’s recovery follows a unique timeline, it is believed that the most severe symptoms of postpartum psychosis last anywhere from 2 – 12 weeks. With an adequate treatment regimen and comprehensive psychosocial support nearly all individuals who experience postpartum psychosis achieve full remission within 6 – 12 months. 

When to seek help

There’s no such thing as reaching out too early. If you think you or someone you know may be experiencing postpartum psychosis the best thing to do is seek same day medical help and request a thorough assessment. If unable to be seen same-day by your primary care physician go to your nearest emergency room and/or crisis center. 

Is it possible to identify it in yourself or do you need someone else to notice?

Because two main symptoms of psychosis include delusions and hallucinations it is not likely that a mother will be able to identify postpartum psychosis in herself. This is because delusions and hallucinations severely disrupt thinking, perceptions, behavior, and emotion. It is more likely that someone close to the mother will notice symptoms first.

How to ask for help from your community should your family be experiencing it

There is a lot of stigma and fear surrounding postpartum psychosis. It is important to know that this is not your/your partner’s fault, and there is no one to blame. Ask your community for help with meals, laundry, household chores, childcare (specifically nighttime care), help with monitoring the treatment plan adherence, and to be a calm presence and safe confidant. 

Actionable things that partners should do when they notice early warning signs that mom seems not herself

Schedule a same-day visit with the mother’s OB and/or PCP. If that is not feasible, take the mother to the nearest emergency room or crisis center. If you are unable to leave the mother, dial 9-1-1. 

Postpartum mental health resources

1. Free Consultations for Medical Providers caring for patients with Postpartum psychosis: https://www.mghp3.org/consult-line
2. Action on Postpartum Psychosis: https://www.app-network.org/what-is-pp/
3. Postpartum Support International: https://www.postpartum.net/get-help/postpartum-psychosis-help/

1. Emergency Hotline available 24/7: 1-800-273-8255 

1. Virtual Community to connect with others who have experienced postpartum psychosis: https://healthunlocked.com/app-network/about

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