Post partum depression and psychosis
The case of Lindsay Clancy recently ended in mistrial, so today Asif and Ali discuss post partrum depression and psychosis. The guys start off by discussing discuss postpartum depression/perinatal depression (3:58), a common and treatable medical condition that can affect parents during pregnancy or after childbirth. They explore how postpartum depression differs from the “baby blues,” how to recognize symptoms beyond simply feeling tired or overwhelmed, and why depression may begin during pregnancy rather than after delivery. They then discuss risk factors, screening questions, the effects of untreated depression on parents, babies, and families, and the fact that fathers and non-birthing partners can also experience perinatal depression. Finally, Asif goes over evidence-based treatments, including psychotherapy and antidepressant medications, and emphasizes the importance of recognizing symptoms early, reducing stigma, and ensuring that parents have access to appropriate care.
Then they discuss postpartum psychosis (17:26), a rare but serious psychiatric emergency that typically develops within days after childbirth. Asif and Ali explore what postpartum psychosis looks like—including hallucinations, delusions, confusion, severe agitation, extreme insomnia, mania, and dramatic changes in behavior—and how it differs from postpartum depression and the “baby blues.” Asif then discusses the strong association with bipolar disorder, why postpartum psychosis can be the first presentation of a major psychiatric illness, and the risk factors and warning signs that families should recognize. They also examine the potential risks to both parent and baby, why immediate medical and psychiatric evaluation is essential, how clinicians investigate possible medical causes, and treatments including antipsychotic medications, lithium, and electroconvulsive therapy (ECT). Most importantly, he discusses why postpartum psychosis should be treated as an emergency—and why, with prompt recognition and appropriate treatment, most people recover.
Music courtesy of Wataboi and 8er41 from Pixabay
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Show Notes:
- Key moments in the Lindsay Clancy case: the 911 call, mental health care, mistrial: https://apnews.com/article/lindsay-clancy-massachusetts-trial-key-moments-3347cdc3f6c0c27c9d388d9696844771
- Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice: https://publications.aap.org/pediatrics/article/143/1/e20183260/37306/Incorporating-Recognition-and-Management-of?autologincheck=redirected
- Postpartum Depression - URL https://www.nejm.org/doi/full/10.1056/nejmcp1607649?utm_source=openevidence (New England Journal of Medicine)
- Postpartum psychiatric disorders - URL https://www.nature.com/articles/nrdp201822 (Nature)
- Establishment of the MGH Postpartum Psychosis Project: MGHP3 - URL https://pmc.ncbi.nlm.nih.gov/articles/PMC9910633/ (PubMed)
- Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum: ACOG Clinical Practice Guideline No. 4 - URL https://journals.lww.com/greenjournal/abstract/10.1097/aog.0000000000005200~screening-and-diagnosis-of-mental-health-conditions-during?redirectionsource=fulltextview (PubMed)
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