Today, I'm honored to feature a guest post from my friend and fellow writer, Janet Cincotta, MD. A family physician for 30 years, Jan retired to pursue her other passion -- writing. Click here to follow her blog, begin...begin again.
Jan wanted to write in response to a current news story that has shocked and appalled many of us. She has a different perspective and I'm so glad she's willing to share it with all of you. I believe it's THAT important, especially if you know anyone who has a new baby or is due to have one soon. I ask you read this, and to pay attention.
If
you’re anything like me, you were horrified by reports of a newborn baby who
died last week after her mother intentionally set her on fire, an
unconscionable act of cruelty. This unleashed an outpouring of comments on
social media demonizing the infant’s mother, labeling her “pure evil,” and “a
monster,” some calling for her to suffer a slow, painful death by fire, too.
Wait
a minute. Let’s not be so quick to judge.
This
case shouts “postpartum psychosis” to me, and although I’m not an expert on the
condition, as a family physician I am painfully aware of its existence and the
devastating impact it can have on a new mother. You should be, too. If you recognize
the symptoms in someone you know, you might be able to prevent a similar
tragedy.
In
fact, there exists a continuum of depressive disorders that are unique to the
postpartum period, the days and weeks after the birth of a baby. They coincide
with the dramatic shift in hormone levels that follows delivery. In most cases,
the onset of these disorders can’t be anticipated or predicted. Every pregnant
woman is vulnerable.
These disorders
include:
· The Baby Blues: This is a commonly occurring
but temporary disorder that develops within a few days of birth, usually lasting
1-2 weeks, characterized by unexpected mood swings, anxiety, crying spells,
poor concentration, and insomnia.
· Postpartum Depression: More intense than “the
blues,” this condition sometimes lasts for months if left untreated. Symptoms
include sleep disturbance, extreme fatigue, loss of appetite, irritability, dramatic
mood swings, lack of joy, withdrawal from family and friends, difficulty
bonding with the infant (often leading to feelings of guilt or shame), and intrusive
thoughts of harming oneself or the baby.
These thoughts may be frightening but are not acted upon.
· Postpartum Psychosis: This is the rarest of these
conditions, occurring at a rate of 1-2 cases per 1000 births. It is more likely
to occur in women with a prior history of depression or Bipolar Disorder. The changes
in the woman’s behavior mark an abrupt and extreme departure from her usual
mental, physical, and emotional state. In addition to the above symptoms, she
may appear to be confused or disoriented. Auditory or visual hallucinations can
occur. She may display paranoia, becoming suspicious and accusatory toward
previously trusted individuals. But the defining symptom is the
intention/attempt to harm herself or, to harm or kill her baby.
Bingo.
In
cases like this, reporters do not have the authority to speculate about motive,
nor to guess at pre-existing mental health issues. Their job is to present an
attention seeking story line—in this instance, an episode out of the life of a
cruel, sadistic monster. Perhaps the rest of us should exercise caution about embracing
it. Instead, we should be aware that postpartum depressive disorders are a grim
fact of life, and that they are treatable. First, though, they must be
recognized. With proper diagnosis and management, tragedies like this one can
be averted.
I
wonder how this story will turn out. If, in fact, postpartum psychosis did play
a role in it, how was it missed by the people who were closest to this woman?
Did anyone try to get help for her? Did the system fail to provide it?
Unfortunately we may never know. Next week the media will report on the next
gut-punching news story so as to stir up more knee-jerk outrage and merciless commentary,
while this case slips out of awareness.
This
post is not intended to excuse or justify what happened in this case. My hope is
to raise awareness of this disorder, to urge women to get help at the first
sign of postpartum depression, and to urge responsible and compassionate media coverage
when the news is enough to break one’s heart.
Many
thanks go out to Hana for inviting me to weigh in on this issue, and to share
it with you.