Estimated reading time: 7 minutes
Women are often judged for suffering from poor mental health after giving birth. The CDC reports, "about 1 in 8 women experience postpartum depression (PPD) after pregnancy. However, estimates vary widely depending on the study and population. This is due to a number of factors, including cultural differences, reporting practices, and stigma." The realties of postpartum psychosis and bad mental health stigma after pregnancy impact women in significant ways. In this article we explore postpartum stigma, signs of postpartum psychosis, and risk factors.
Postpartum Stigma
You might have heard the term "baby blues." According to Johns Hopkins Medicine, baby blues is "a mild, temporary form of depression that usually improves within a few weeks. It's very common, affecting up to 85% of new mothers. Symptoms include crying, anxiety, and restlessness." Postpartum Depression or PPD is a more serious condition that can last months or even years when left untreated. Symptoms can include:
- Persistent sadness
- Lack of interest in normal activities
- Lack of energy or fatigue
- Insomnia
- Difficulty caring for yourself and your baby
- Withdrawing from others
- Problems concentrating
- Thoughts of harming yourself or your baby
The stigma surrounding postpartum mental health issues is associated with the last bullet point above. Horror stories of women harming their children after giving birth has been seen in movies, television and beyond. Postpartum psychosis is much more rare than postpartum depression, and involves symptoms that include delusions or hallucinations and can put both the mother and her child in danger, health experts say. But because of how rare it is, the stigma can prove more dangerous than the actual condition.
Societal Misconceptions
Postpartum psychosis (PP) and postpartum depression are often confused and lumped together. PP causes both auditory and visual hallucinations that can make reality seem both threatening and terrifying. Postpartum depression (PPD) is much more common and can affect many people after giving birth. Telling the difference between postpartum depression and postpartum psychosis is important. The psychosis can strike immediately after birth, and get worse very quickly. It is an emergency. The risk to yourself and your baby may be greater. Postpartum psychosis is more closely related to bipolar disorder than depression in terms of treatment requirements.
Lack of Knowledge
People fail to understand the intricacies of PPD and postpartum psychosis which leads to a lack of empathy. Many assume women with poor mental health after pregnancy do not actually want to be parents. They find psychosis to be scary. And many assume that women with postpartum psychosis need the same interventions as anyone with severe mental health issues. People need specialist care for PP. As PP often starts days, or even hours, after giving birth, you are physically, as well as mentally, vulnerable and you simultaneously have a newborn to take care of.
Perceived Stigma
According to the National Institute of Health, "perceived stigma of postpartum psychosis refers to the negative beliefs and attitudes individuals with postpartum psychosis may believe others hold about their condition." This often leads to feelings of shame, isolation, and reluctance to seek help due to the fear of judgment or being seen as an unfit mother. This stigma can stem from a lack of understanding about the illness, associating it with extreme behaviors, and the societal expectation of perfect motherhood after childbirth. This stigma can also cause mothers to avoid seeking treatment or hiding their condition to avoid said stigmas.
Signs of Postpartum Psychosis and Bad Mental Health After Pregnancy
Postpartum psychosis and bad mental health after pregnancy is considered rare, but impacts thousands of women each year. Symptoms usually begin suddenly, immediately or soon after giving birth. According to the National Health Society, these signs can include:
- Hallucinations: Seeing, hearing, smelling, or feeling things that aren't there
- Delusions: Having unshakeable beliefs in things that aren't true
- Mania: Feeling very "high" or overactive, such as talking and thinking too much or too quickly
- Low mood: Showing signs of depression, such as being withdrawn, tearful, lacking energy, or having a loss of appetite
- Confusion: Feeling disoriented or confused
- Difficulty concentrating: Having trouble concentrating
- Anxiety or agitation: Feeling severe physical anxiety or agitation
- Thoughts of harming yourself or your baby: Having thoughts of or plans to harm yourself or your baby
Risk Factors for Postpartum Psychosis
Although postpartum psychosis is rare, there are a few risk factors involved in increasing the likelihood of it appearing. These can include:
- Mental Health History: Those who have suffered from bipolar disorder, schizophrenia, schizoaffective disorder or a previous instance of postpartum psychosis are at increased risk.
- Family History: A family history of either mental health disorders as listed above as well as others in your family who have suffered from PP increases your risk of experiencing the same.
- Lack of Sleep: Insomnia or a severe lack of sleep due to the newborns needs can increase risk of psychosis.
- Hormonal Changes: According to the National Institute of Health, "the rapid drop in estrogen levels after birth can contribute to postpartum psychosis."
- Physical Stress: The stress of a delivery or traumatic pregnancy can increase your risk of PP.
Road to Recovery
It is critical that moms and families get the support they need when suffering from mental health issues after pregnancy. Whether a woman is suffering from postpartum psychosis, postpartum depression, or just generally struggling, having a supportive network of family and friends to help them through this time is critical. Instead of judging women for "not being the perfect mother," offer to provide supports to those who are suffering. Some ways that you can show up include:
- Reassurance that they are not alone.
- Listening and lending a helpful ear.
- Offering to help with tasks or other responsibilities that come with being a new parent.
- Encouraging and enforcing self-care for the birthing parent as well as those around them.
- Helping them to find mental health or other supports.
Conclusion
It should be noted that those that did not give birth can also experience both postpartum depression as well as postpartum psychosis. Though often attributed to the birthing parent, in rare instances the concern for the child's wellbeing or an extreme lack of sleep can affect the other parent as well and take a toll on their mental well-being.
No one is exempt from the possibility of having a mental health issue and that includes those who are giving birth. For all of us, it is critical that we learn about and understand these conditions before casting judgement on others. We are all at risk. Create a supportive and loving environment for those you care about and even for people you don't know. When we hold one another up, we all win.
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