Latest news with #postpartumpsychosis
Daily Mail
13 hours ago
- Health
- Daily Mail
Mum found dead in bed at Travelodge 'after being discharged by hospital where doctors irreversibly damaged her brain'
A mother-of-one took her own life after being discharged from specialist mental health services despite still struggling with postpartum psychosis, an inquest has heard. Roisin Harron, from south London, had been suffering from the debilitating illness following the birth of her son in 2017. The 41-year-old, who had a history of depression, started treatment at Bethlem Royal Hospital, Bromley in 2018 following a week of hypermania—periods of abnormally elevated mood and energy levels. As part of her treatment Ms Harron underwent several rounds of electroconvulsive therapy (ECT)—which involves sending an electric current through a patient's brain. Under NHS guidelines, ECT should only be used as a short-term treatment if a patients, with repeated ECT only recommended if a patient has previously responded well to the treatment. But, an inquest in her death, found it was 'impossible to underestimate the impact psychiatric medication had in Roisin's life'. It also heard that Ms Harron felt 'her brain was in some was irreversibly damaged', following the treatment. Her parents, Margaret McMahon and Henry Harron told the South London Coroner's Court in Croydon: 'Roisin had been so unwell and such a risk to herself. But there had been much progress over the years. 'She tried to help herself and seemed to want to do her best at the things that mattered to her—being a good mother, being good at her job and working hard on her relationships with family and friends. 'Prior to he illness, Roisin had an incredibly good memory but during her hospitalisation her memory became quite impaired.' Ms Harron was then diagnosed with bipolar disorder—a mental health condition characterised by extreme mood changes from manic highs to depressive lows. She was prescribed a number of different medications to try and manage her symptoms, including antipsychotics and lithium—a long-term treatment typically prescribed for at least six months. But, the trial and error nature of finding an effective treatment whilst managing Ms Harron's symptoms proved incredibly difficult, causing her stress and anxiety, the inquest heard. In April 2023, Ms Harron was discharged from the specialist mental health services at South London and Maudsley NHS Foundation Trust and put back into the care of her GP at Paxton Green Group Practice, London. But her family told the inquest they were skeptical and did not feel that their daughter was well enough to be discharged and navigate her illness without the support of mental health professionals. They said: 'It was clear that beneath the smiling and friendly face that Roisin presented to the world, there were very difficult struggles going on. What is postpartum psychosis Postpartum psychosis is a serious mental health illness that can cause new mothers to experience hallucinations and delusions. It affects around one-to-two in every 1,000 births, according to Postpartum Support International. PP is different from the 'baby blues', which many mothers experience while they struggle to cope with the stress and hormonal changes that come with having children. It is also different from postnatal depression, which affects one in 10 women to some extent. This can cause feelings of helplessness, as well as a loss of interest in the baby and crying frequently. PP's symptoms usually start within the first two weeks. Some include: Manic mood Depression Loss of inhibitions Feeling paranoid or afraid Restlessness Confusion Acting out of character Its cause is unclear. Women are thought to be more at risk if they have: A family history of mental illness, particularly PP Bipolar disorder or schizophrenia A traumatic birth or pregnancy Suffered from PP in the past Ideally, patients should be put on a specialist psychiatric unit, called a mother and baby unit (MBU), where they can still be with their child. They may be admitted to a general psychiatric ward until a MBU becomes available. Antidepressants may be prescribed to ease symptoms, as well as anti-psychotics and mood stabilisers, like lithium. Psychological therapy, like cognitive behavioural therapy (CBT), may help patients manage how they think and act. In rare cases, electroconvulsive therapy can help with severe depression or mania. Most women with PP make a full recovery if treated correctly. Severe symptoms tend to last between two and 12 weeks. However, it can take a year or more for women to recover. A PP episode can be followed by a period of depression, anxiety and low confidence. Some women then struggle to bond with their baby or feel like they missed out. These feelings can usually be overcome with the help of a mental health support team. Around half of women who have PP suffer again in future pregnancies. Those who are at high risk should receive specialist care from a psychiatrist while they are expecting. Source: NHS 'There was still a deep and enduring depression and so many anxieties.' They added: 'She put on a brave face, but she clearly missed having regular contacts that she had built up a good relationship with.' Having been discharged from the services, Ms Harron had to use local pharmacies to access her medication—many of which had issues with supply and distribution. Her family told the inquest that this caused her a lot of anxiety and played a role in the tragic spiral that lead to her death. In response, Dr Aneesa Peer, a consultant psychiatrist based at the South London and Maudsley trust said when Ms Harron was discharged she was in remission. 'When patients are dealing well and are stable for at least a year and they are on a good treatment regime they are considered for discharge,' she said. Following this period, they can return back to the specialist services under a scheme that ensures they will be seen within four weeks, rather than being added to longer waiting lists. 'She didn't refer herself back after being discharged,' Dr Peer told the inquest. 'Roisin was very astute around her medication and would advocate for herself very clearly and concisely. 'This is not someone who is waiting on support,' Dr Peer told the court. 'Patients come back to us all the time. The door is open. I am not sure how we could have intervened.' Mr Harron, a retired social worker, also told the could he felt this attitude towards his daughter's treatment was 'too blase' and it was 'impossible to underestimate the impact' it had in his daughters life. Ms Harron was found dead at the London Crystal Palace Travelodge on June 17, 2024, just over a year after being discharged from specialist services. A postmortem examination revealed that she had overdosed and a number of prescription drugs were found in her system. Dr Mihir Khan, who carried out the examination, concluded she died of cardiac arrest triggered by an overdose. Assistant coroner Victoria Webb confirmed death by suicide, adding that Ms Haron had suffered with postpartum psychosis. Postpartum Psychosis affects roughly one in 1,000 women every year. It is different from the 'baby blues', which many mothers experience while they struggle to cope with the stress and hormonal changes that come with having children. It is also different from postnatal depression, which affects one in 10 women to some extent. This can cause feelings of helplessness, as well as a loss of interest in the baby and crying frequently. Postpartum Psychosis symptoms usually start within the first two weeks. Common signs include manic moods, feeling paranoid or afraid, acting out of character, confusion and restlessness. Little is known about exactly how or what triggers the illness and so far little evidence to suggest it can be linked to a traumatic birth. Antidepressants may be prescribed to ease symptoms, as well as anti-psychotics and mood stabilisers, like lithium, according to the NHS. Psychological therapy, like cognitive behavioural therapy (CBT), may help patients manage how they think and act. In rare cases, electroconvulsive therapy can help with severe depression or mania. Most women with PP make a full recovery if treated correctly. If you, or someone close to you, is experiencing postpartum psychosis, talk to a midwife, GP, health visitor or dial 111 - if there is an immediate threat to life, call 999. You can also call the Samaritans on 116123.
The Sun
a day ago
- Health
- The Sun
Mum found dead in bed at Travelodge ‘after being discharged by hospital where doctors irreversibly damaged her brain'
A MUM who was struck down with a rare and debilitating condition took her own life seven years after she failed to recover, an inquest heard. Her family said 'her brain was irreversibly damaged' by the treatment she underwent. 1 Roisin Harron had been suffering with postpartum psychosis following the birth of her much-loved son Dominic in 2017. She was so seriously ill she needed 12 electro convulsive therapy (ECT) sessions but felt the treatment had affected her memory and cognitive abilities and 'became very upset at forgetting things', her family said. A diagnosis of bipolar disorder was given, which her family was sceptical of, and she was stabilised with the use of drugs including lithium. But after she was discharged from specialist mental health services and returned to the care of her GP, the civil servant took her own life. Her family said they felt she had been left with no access to familiar experts to talk to. The inquest at South London Coroner's Court in Croydon, south London, heard about Ms Harron's tragic spiral after she became a mum. Her family, including her dad Henry Harron, mum Margaret McMahon and husband Robin Miskovic, said it was 'impossible to underestimate the impact psychiatric medication had in Roisin's life.' They said: 'Roisin had been so unwell and such a risk to herself she was under the care of the psychiatric hospital. However there had been much progress over the years to 2024. 'She tried hard to help herself and seemed to want to do her best at the things that mattered to her - being a good mother, being good at her job and working hard on her relationships with family and friends. 'She worked on her appearance as she felt change might make her feel better, having her teeth straightened and also significantly losing weight as she had gained a lot of weight from medication use. The 15 signs a loved one is struggling with their mental health - and how to help 'It was clear to close family that beneath the smiling and friendly face that Roisin presented to the world there were very difficult struggles going on. 'There was still a deep and enduring depression and so many anxieties.' 'Roisin felt her brain was in some way irreparably damaged' The court heard Ms Harron had suffered bouts of depression from her teenage years which may have left her susceptible to postpartum psychosis. After the birth in October 2017 she suffered a week of "hypermania" - a severe form of mania - and was admitted to the mother and baby unit at Bethlem Royal Hospital in Bromley, which specialises in the treatment of antenatal and postnatal illnesses, remaining there until March 2018. As part of her treatment she was given the ECT sessions, with her family saying Ms Harron felt 'her brain was irreversibly damaged', leaving her unable to remember things. 'Roisin prior to her illness had an incredibly good memory. During her hospitalisation her memory became quite impaired,' the statement went on. 'This was partly down to the effect of her medication but also part of her treatment in Bethlem Hospital was an on-going course of 12 ECT sessions. 'Margaret and Henry were both shocked at the obvious damage to her memory and cognitive abilities at the time. 'The recovery from this appeared to be very slow and although her memory did improve greatly Roisin felt her brain was in some way irreparably damaged. 'She talked about having brain fog and became very upset at forgetting things.' Changes to medication When Roisin was given the diagnosis of bipolar disorder - a mental health condition characterised by episodes of extreme highs and lows, which can last for weeks - her parents contested this as there were no further manic or psychotic episodes following the one straight after the birth. She was given many drugs to try and stabilise her mood, but the trial and error nature of trying to medicate someone in her position left her feeling terribly anxious, the court heard. 'Over the next few years there appeared to be a lot of uncertainty from mental health services over Roisin's treatment,' her family said. 'Different medications were tried and doses often changed. Roisin was highly sensitive to even minor changes. 'Each time Roisin experienced anxiety planning the changeover and sometimes severe withdrawal symptoms. 'Robin believes that continual worry about medication and changes had a significant detrimental impact on Roisin's mental health.' 'Roisin put a brave face on' After a year of mood stability, Ms Harron was discharged from experts at the South London and Maudsley NHS Foundation Trust (SLAM) back into the care of her GP at the Paxton Green Group Practice in Gipsy Hill, south London. But her family said this often meant her having to traipse from pharmacy to pharmacy to get her drug prescriptions if they were unavailable, something which added greatly to her upset. 'Roisin put a brave face on (her discharge) but she clearly missed having some regular contacts that she had built up a good relationship with,' her family said. 'She had people to confide thoughts and feelings to that she was not able to do with her family and friends. She clearly felt she still needed mental health support. 'Instead of picking up her prescriptions from Lambeth Hospital she had to use local pharmacies. 'A new anxiety for her was not being able to access her medication. There were difficulties in the distribution and availability of many drugs. 'Roisin would have to track around various pharmacies hoping to find her prescribed medication. 'The negative impact of these changes in routines around her medication was significant.' Sarah Bourne, an occupational therapist at South London and Maudsley, said Ms Harron was referred to the OPTIMA mood disorders service, an outpatient programme for adults with bipolar disorder who have recently had hospital admissions, in August 2019. She 'engaged proactively' with sessions and was on five drugs as well as folic acid and B12, Ms Bourne said. 'She had a history of depression from 15 years and an episode at 21 at university when she took an overdose,' she added. 'She demonstrated resilience, courage and determination,' Ms Bourne said of her treatment, adding that Ms Harron didn't always recognise her own strengths. 'She had great family support and continued to work four days a week. I was very shocked to hear of her death,' she said. What is postpartum psychosis? Postpartum psychosis is a serious mental health illness that can affect someone after having a baby. It affects around one in 1,000 mothers after giving birth. Many people who give birth will experience mild mood changes after having a baby, known as the 'baby blues', which usually only lasts a few days. But postpartum psychosis is different and should be treated as a medical emergency. Symptoms usually start suddenly within the first two weeks after giving birth and include: hallucinations - hearing, seeing, smelling or feeling things that are not there delusions - suspicions, fears, thoughts or beliefs that are unlikely to be true mania - feeling very 'high' or overactive, for example, talking and thinking too much or too quickly, restlessness or losing normal inhibitions a low mood - showing signs of depression, being withdrawn or tearful, lacking energy, having loss of appetite, anxiety, agitation or trouble sleeping sometimes a mixture of both a manic mood and a low mood - or rapidly changing moods feeling very confused If you think you, or someone you know, may have developed postpartum psychosis, see a GP immediately. You can all 111 if you cannot speak to a GP or don't know what to do next. Go to A&E or call 999 if you think you, or someone you know, may be in danger of imminent harm. Source: NHS Dr Aneesa Peer, consultant psychiatrist based at SLAM, said Ms Harron was discharged in April 2023 with her Bipolar Disorder in remission. 'When patients are dealing well and are stable for a year at least and they are on a good treatment regime they are considered for discharge,' she said. She added there was a one-year rule for discharged mental health patients that means they can be seen by an expert within four weeks rather than being added to a potentially longer waiting list. 'She herself didn't refer back after her discharge,' Dr Peer added. 'She was in communication with her GP, there was dialogue with her GP around her treatment and her treatment options.' Ms Harron's father Henry, a retired social worker, told the inquest he found the attitude towards his daughter's medication too 'blase.' 'It was one of the most anxiety-promoting things for Roisin,' he said to the court. 'Every time there was a medication change for Roisin since her son was born it caused a lot of anxiety and these were the trigger points. 'In the past she would have had support with these changes in medication and she didn't have that support.' Dr Peer replied, saying: 'Roisin was very astute around her medication. She would advocate for herself very clearly and concisely. 'This is not someone who is waiting on support, but I do appreciate that support is helpful when people have it and I do hear what you are saying. 'Patients come back to us all the time. The door is open. 'I'm not sure how we could have intervened.' Ms Harron's stepmother Siobhan Hier queried the number of deaths due to postpartum psychosis more than 12 months after birth and said she felt her stepdaughter's death was directly attributable to the condition, even though it occurred years later. 'The trigger was the birth,' she stressed. Ms Harron's GP, Dr Saif-Ur-Rehman Najeeb, said Ms Harron had not requested a referral back to mental health services, but said she had good insight into her condition. 'She didn't have any risk indicators,' he said. Cardiac arrest and overdose Ms Harron was reported missing and was found fully clothed in a bed at the London Crystal Palace Travelodge on June 17, 2024. She had taken a huge overdose of at least nine prescription drugs alongside ibuprofen. Dr Mihir Khan conducted a post mortem and found Ms Harron to have died of cardiac arrest and an overdose. The Royal College of Psychiatrists estimates that between 600 and 1,200 mothers experience psychosis each year in England and Wales. It is a medical emergency that causes high mood, depression, confusion, hallucinations and delusions and usually occurs within two weeks of birth. If left untreated, it can increase the risk of suicide and in rare cases put the baby's life at risk too. Suicide continues to be the leading cause of direct maternal death between six weeks and 12 months after birth, accounting for 39 per cent of deaths in this period. Assistant coroner Victoria Webb recorded a verdict of suicide and noted her having suffered postpartum psychosis.
BBC News
02-06-2025
- General
- BBC News
Maternal mental health: Calls for specialist unit in Northern Ireland
A new mother who was detained in a psychiatric hospital for five weeks says she "felt like a prisoner" because she was separated from her Browne, who had postpartum psychosis, was admitted under a mental health order after giving birth three years Great Britain mothers are cared for in specialist mother and baby units, but women in Northern Ireland are admitted to general psychiatric wards, separated from their business case for a mother and baby unit is months overdue, but the Department of Health (DoH) said it was well developed. However, it has also warned any future unit is dependent on funding being told BBC Spotlight she felt "lonely" and "pathetic" after being dropped off at the door of the Ulster Hospital psychiatric ward without her daughter, but said staff tried their best."I went in voluntarily and it was just the loneliest feeling in the world getting dropped off at a mental health ward with a bag and no baby," the 35-year-old year, about 100 women in Northern Ireland are admitted to adult psychiatric wards for similar care, without their babies. What is postpartum psychosis? A rare but serious mental health illness that can affect any motherSymptoms can include hallucinations, delusions, manic and low moods, loss of inhibitions, restlessness, out-of-character behaviour and confusionIf left untreated the condition can get rapidly worse and lead to mothers harming the baby, themselves or othersThe most severe symptoms usually last between two and 12 weeks but recovery can take several monthsSOURCE: NHS "I was a mother without her child and I felt like a prisoner," said Shelley."She wasn't with me, and I was in a mental facility. And it just broke me every morning."Seven health ministers have supported the idea of a mother and baby unit in Northern Ireland, but funding has never been found. Danielle Sands refused hospital treatment to stay with her first son, Joe, in she relied on specialist community teams."They had made it very clear that when I would go in there, I wouldn't have my Joe with me.""There was voices in my head 24/7, and they were negative," she said."Telling me everything I couldn't do, I wasn't good enough." Danielle and her partner, Nial, were supported by a community specialist perinatal mental health term perinatal covers the period of time from when a woman becomes pregnant, and up to a year after giving birth. Each of Northern Ireland's five health trusts receive more than 250 referrals for the community services each year, but because of staffing pressures they can only accept about 70 patients at a Julie Anderson, chair of the Royal College of Psychiatrists in Northern Ireland, estimates the number of women admitted to hospital could double or triple if a mother and baby unit was established."It's really, really frustrating knowing that there's much better care that our mums should be getting here in Northern Ireland," she said."And frankly, to be honest, somewhat embarrassing that we've been talking about this for almost 20 years and we're still not there yet." In 2018, Orlaith Quinn died at the Royal Jubilee Maternity Hospital in 33-year-old had given birth to her third child, a daughter, less than 48 hours Graham said her daughter began showing signs of postpartum psychosis shortly after giving birth."To go in and have a baby and come back out in a coffin, and you've three children left without their mother, it's just not a position you think you'll ever find yourself in a million years," she body was found in a part of the hospital that is unused at night. She had taken her own life. A 2022 inquest concluded Orlaith's death had been "foreseeable and preventable" and that there were a number of missed opportunities in her care and a statement, the Belfast Health Trust said it would like to extend a sincere and unreserved apology to Orlaith's added its maternity team would like the opportunity to meet Orlaith's family to offer an apology in trust said it was committed to learning from Orlaith's death and had put in place a training programme to help staff recognise the wider spectrum of perinatal mental health disorders, and the risk of maternal Maria Dougan tied the death to the absence of a mother and baby unit, finding that one should be established in Northern Ireland. Consultant perinatal psychiatrist, Dr Jo Black, who is originally from Cookstown, was instrumental in setting up a mother and baby unit in eight-bed unit, the layout and decor of Jasmine Lodge means it does not feel has areas for families to visit, and a team of said it was "extraordinary" there is not a similar unit on the island of Ireland."All of our evidence shows us that maternal suicide remains a major killer in the maternity period," she said."We can't shy away from that, and so these units save lives." 'Poor data collection' Between 2021 and 2023, 34% of late maternal deaths have been linked to mental health, according to a report by MBRRACE-UK, which includes Northern Ireland. A late maternal death is when a woman died between six weeks and one year after is currently thought more than 3,500 women develop perinatal mental illness in Northern Ireland each poor data collection could mean the need for perinatal mental health services is being underestimated, according to Dr Julie has confirmed the Department of Health has yet to implement a 2017 recommendation from the health regulator to improve data the time, the Regulation and Quality Improvement Authority (RQIA) said patient coding should be Department of Health said a review of coding practices for perinatal mental health conditions, and related hospital admissions, was planned. If you have been affected by any of the issues in this story you can find information and support on the BBC Actionline website.
Medscape
22-05-2025
- Health
- Medscape
Postpartum Psychosis Risk Linked to Sister's Medical History
LOS ANGELES — Risk for postpartum psychosis is significantly higher in women who have a sister who has experienced the condition and/or has bipolar disorder (BD), a new study showed. In a population-based cohort study of nearly 1.7 million women, those with a full sister who had had the disorder were 10 times more likely to have postpartum psychosis than those whose sister did not have it. Odds of developing the condition were doubled when a sister had BD and about 14-fold higher if a sister had both BD and postpartum psychosis. Although rare, postpartum psychosis is considered 'one of the most severe psychiatric conditions,' co-investigator Veerle Bergink, MD, PhD, professor in the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and director of Mount Sinai's Women's Mental Health Center, New York City, and colleagues noted. If not addressed and treated, the condition has been linked to increased risk for suicide and infanticide. But findings such as these can help clinicians identify those at potentially greater risk and make a plan, Bergink told Medscape Medical News. 'You don't have to start medication right away, but we do need to be aware' of the risk, she said. The findings were presented on May 19 at the American Psychiatric Association (APA) 2025 Annual Meeting and were simultaneously published online in the American Journal of Psychiatry. Relative Risks Postpartum psychosis typically occurs in the first 3 months after childbirth, with onset most likely in the first month. It can also occur in women who have no history of psychiatric illness and is the leading cause of maternal deaths, the researchers noted. If a woman shows symptoms of the condition — which include excessive energy, agitation, paranoia, confusion, and sleep problems — it should be addressed as a medical emergency, they added. Although previous research has shown that genetic factors can contribute to increased postpartum psychosis risk, the magnitude of that contribution has been unclear. In the current analysis, Bergink and colleagues examined data from Swedish national registers for 1,648,759 women who gave birth between January 1980 and September 2017. The primary outcome was a diagnosis of postpartum psychosis. Results showed that 2514 of the total participants — only 0.15% — had postpartum psychosis within the first 3 months of the birth of their first child. However, after adjusting for year and age at childbirth, the relative recurrence risk (RRR) was 10.69 for the condition in mothers with a full sister who had experienced the condition compared with mothers with a sister who had not experienced it (95% CI, 6.6-16.3; P < .001). Still, the absolute risk for those with an affected sister was estimated at just 1.6%. In the women diagnosed with postpartum psychosis, 49% had a history of BD, and 24% had a history of other mental health diagnoses. Prevalence of BD was 1.4% for the entire participant population. The odds ratio (OR) for postpartum psychosis when a sister had BD was 2.1 (95% CI, 1.0-4.0; P = .04). In addition, the combined OR was approximately 14.3 when a sister had experienced postpartum psychosis while also having BD. The RRR was also increased when a woman had a full woman cousin with postpartum psychosis, but it was not statistically significant when adjusted for birth year and age at childbirth or when adjusted for those factors plus history of BD. 'Our results provide guidance for clinicians working with pregnant women with personal or family histories of postpartum psychosis,' the investigators wrote. Diagnostic and Statistical Manual of Mental Disorders (DSM) Inclusion? Bergink noted that the condition is not currently listed as a stand-alone disorder in any version of the DSM. However, numerous research groups are collaborating to develop criteria for its inclusion in future iterations of the manual. They propose that criteria should include experiencing at least one of the following within 3 months of childbirth, with a duration of at least 1 week or of any duration if hospitalization is necessary: Mania/mixed state, delusions, hallucinations, disorganized speech or thoughts, and disorganized or confused behavior. Asked during a question-and-answer session if family history screenings are currently being done among women who are pregnant, Bergink answered, 'In general, no, but it should be.' 'Because of the potential negative impacts, sometimes severe, on mother and baby, this disorder needs to be identified and effectively treated,' Ned H. Kalin, MD, editor-in-chief of the American Journal of Psychiatry and professor and chair of the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, said in a press release. The current study is important because it highlighted the increased risk when the condition runs in families, he told Medscape Medical News . 'It also underscores the importance of understanding that risk and of working with your OB-GYN [obstetrician-gynecologist] doctor or psychiatrist to help reduce and mitigate the risk with treatment and close observation,' Kalin said. Bringing 'Stigma Out of the Darkness' Although postpartum psychosis is considered quite rare, tragic aftereffects in some undiagnosed and untreated women have been widely reported in the media. At the press briefing, Bergink shared that a medical colleague with the condition recently shot and killed herself and her baby girl. 'Unfortunately, not all cases are detected in time. At Sinai, we lost a colleague who had no psychiatric history and her baby,' she said. 'That happens. And it can occur in anyone.' Michael F. Myers, MD, chair of the APA meeting's Scientific Program Committee, shared that he was involved with two situations where patients had extreme forms of the condition, including one where a woman psychiatrist killed herself and her child. 'You hear about postpartum depression and postpartum blues. But then there's this subset that is not only dangerous to themselves but also to their baby,' Myers told Medscape Medical News. 'Talking about these situations is how we bring the stigma [about the condition] out of the darkness.' Psychiatric History Not Always a Factor 'There's a theme that having a psychiatric history is the main predictor for postpartum psychosis. But sometimes we miss it,' Misty C. Richards, MD, associate professor at the University of California, Los Angeles, and medical director of perinatal psychiatry for the university's Maternal Outpatient Mental Health Services Clinic, said at the briefing. She added that, as a clinician, 'you do the best that you can to try to catch this early because things can become wildly out of control in the postpartum period. Infanticide should just never happen.' She later told Medscape Medical News that the symptoms of postpartum psychosis differ from those of schizophrenia because they wax and wane and almost present as delirium. 'So you can be lucid one minute and the next be wildly delusional. It's usually in the setting of poor sleep and severe anxiety and becomes an emergency very quickly,' Richards said. She added that this is much more extreme than a normal response to the chaos that often occurs during the first week after delivery. 'People may think, 'Oh, she'll shake it off and be okay.' But no. If you miss it, that's when it can be catastrophic,' she concluded.
BBC News
17-05-2025
- Health
- BBC News
'I bin think say I don kill my baby' - di reality of postpartum psychosis
At first, Ellie say she bin dey veri happy. She born pikin for house without pain relief and she dey overjoyed to be new mama. Although she try sleep for few hours ova three days, she later decide say she no even need sleep at all. "Di best way I fit describe am na like waking from a nightmare wia you no fit tok weda na dream and reality. But [dat feeling] just continue dey go on," she tok. "Den I tink say I don kill my son for bed. I remember say I see my partner and I just dey reason say, dis dey real?" Ellie bin dey experience postpartum psychosis (PPP), one unbearable illness wey fit temporarily turn life upside down for new parents. Wetin be postpartum psychosis? Among di early warning signs for PPP na if new mothers no just dey feel like themselves or e be like say dem don lost touch wit reality. Although sleep-deprivation dey common wit new parents afta birth, one woman wey get PPP fit stop to dey sleep entirely. According to UK National Health Service, symptoms include: PPP na medical emergency, where in most cases, go need hospital admission for specialist care and treatment. But experts say di most important thing to remember na as severe as an episode of psychosis sound, wit treatment most women fit recover within months. Wetin dey cause postpartum psychosis? Despite years of research, e neva still dey clear wetin dey cause PPP. Doctors suggest say sudden change in hormones wey dey happun during childbirth fit get something to do wit am. Dis shift fit trigger extreme confusion and fear. But no reliable way dey to predict who go dey affected, for instance – blood test no dey. At least half of new mothers wey dey diagnosed wit PPP neva experience psychosis bifor, so for dem to begin hallucinate na sometin wey dey new and terrifying for dem. For Ellie, di beginning of PPP bin dey very fast. "I dey wonder now if e start as I dey active labour for hours overnight for house, for some reason, I bin decide not to wake my husband up until 6am," she tok. PPP dey affect one to two women wey give birth in every 1000. E no too common like post-natal depression wey dey affect around one in 10 new mums. Experts believe say more women dey affected pass bifor. For years, dem don dismiss severe post-natal depression as 'baby blues' but doctors warn dis attitude to mental health fit make am really hard for parents to access adequate support. Anecdotal research from UK charity Action on Postpartum Psychosis (APP) suggest say e still common for women to dey misdiagnosed, maybe by community midwife or doctor, who fit suggest sleeping tablets. Charities like APP, COPE: Centre of Perinatal Excellence and Perinatal Anxiety and Depression Aotearoa (PADA) dey work on campaigns wey dey raise awareness of PPP among di general public and frontline healthcare workers. For Ellie, wey dey work now for one charity wey dey support mothers' wit PPP, na few factors dey lead up to crisis point, wey include lack of sleep and di huge pressure to be perfect new mum. However, she also now know say she dey at much higher risk as she get bipolar disorder, type 1. Around 25% of women wey get dis disorder go get severe episode wey go make dem need hospital care afta dia first baby, according to Cardiff University research dem publish for The Lancet. For UK, Australia and New Zealand, dem dey encourage women for dis group to continue dia medication – Women for dis situation go need to see specialist perinatal psychiatrist for advice according to APP and multiple oda organisations. Research by Dr Ian Jones, one leading perinatal psychiatrist for Cardiff suggest say increased risk of postpartum psychosis no dey for pipo wit history of childhood trauma. E say dis add weight to im idea say biological element dey involved in PPP and surge in hormones be like one of di biggest driving factors. Wetin fit help? Risk dey say without treatment mothers wey get PPP fit try to harm themselves according to multiple pieces of research. For UK, Australia, and New Zealand clinical studies don establish say e dey beta to treat mums wit PPP by keeping dem wit dia babies in mother and baby psychiatric units under very close observation. "For me, e feel more like 'a switch' bin go off for my brain and e dey very obvious," Ellie tok. She get memory gaps but she remember say she stand for di top of di stairs for house dey listen to her husband phone di local maternity ward. "I dey very scared. I need help and bicos dem hear say I dey shout, di head midwife bin fight for me to go to MBU (mother and baby psychiatric unit)," Ellie tok. "Di most important thing e dey do na to keep you well, dat na di primary focus." Ariane Beeston, tok-tok pesin for di non-profit Centre of Perinatal Excellence for Australia wey don experience PPP, describe di need for these beds as crucial. For Ariane wey bin work for child protection, PPP come completely out of di blue. For her book I no be myself you see, she describe she hallucinate say she dey see dragons next to her baby son and government drones dey fly overhead. Afta dem finally admit her to a mother and baby psychiatric unit, she dey supported to get enough sleep, bond wit her new son and take part for 'parentcraft' lessons and recover. She say di experience don change her. One of di hardest moments for women wey dey transition out of these MBU na deciding wit dia care team, wen be di right time to return home. Weda or not to breastfeed na anoda major decision for women at higher risk, as you gatz understand how e go work with taking any ongoing medication, according to Dr Clare Dolman, one researcher for Kings College London. Accessing dis kain support fit dey extremely limited for oda kontris. Serious sociocultural differences dey for first time mums around di world. Some cultures still dey compulsory 40 days of confinement post-birth for new mums. For some parts of India, dem dey explain PPP as a religious fate — devva hididide, or being possessed by a ghost. Whereas for oda cultures, dem dey see postpartum mental health disorders as a personal deficit or failure as a mother. Researchers see say mothers for Hong Kong dey under pressure to play traditional maternal role and any failure to do dat go dey experienced as a shameful loss of face. So, wetin dey happun if you want anoda baby? For one in two mothers wey experience PPP, unfortunately dem dey go on to experience am again wit subsequent births according to Manchester and Cardiff University research. For mums wey get more children dem describe detailed pre-planning to ensure say dem get extra support in place - weda dis na additional family or friends on hand to help, prioritising sleep and essentially trying to "put yourself first, in order to be a good parent," Ellie tok.
