Hey guys, welcome back to pre podcast. This is Sarah and Whitney. All right guys. So we're going to close out this month with um a postpartum psychosis. And let's preference this episode that this is one that is a true medical emergency. It is and very rare. Um But it's something that we need to definitely make you aware of and your friends and family need to be aware of and we need to know what to do. So let's start with what is it? OK. So postpartum psychosis is when a mom who is, I'm gonna say maybe about two or three weeks. 

Postpartum is when it onsets, it is not likely to onset later on in your postpartum journey. So it's usually, it's pretty immediate, I would say within the first two months and I feel like two months is pretty generous. So it can even, I would say probably first weeks. Absolutely. Um You're not as likely to see it in the hospital setting when you get home. 

Yeah, I would say probably maybe postpartum day four up until I would say again, I'll give it up to eight weeks even though I feel like that's pretty generous. So I would say that if you are six months or more or postpartum, you're probably not gonna experience this definitely nine months and more postpartum. You're not gonna deal with postpartum psychosis. We're looking at a different diagnosis. So this is not like postpartum, depression, anxiety where it can occur up to a year after childbirth. This is a more think of fresh newborn period, probably even before. Honestly, the baby turns one month old. Um Yes, I would agree with that. And we do know specifically with this main factors, bipolar schizo schizoaffective disorder, they have higher risk, they do of this. Um But it still can happen, it can happen without any risk factors. And I know I, I know someone who personally experienced this and um I've heard several O B si have worked with, speak of this. And so yes, it is rare but if you've experienced it once or heard someone like talk about it, it's, it's going to stick with you. Oh for sure. Um So when someone experiences postpartum psychosis, they experience thoughts of I should harm my baby, not that they're scared of it. Ok. Different story there that they should harm their baby in a certain way because they are being told to do that either by radio television, God Jesus, a higher being, a higher deity. 

They are being sent these messages that they are supposed to kill their baby because their baby is out to get them, their baby is going to harm them. There is a paranoia at play here. So we are having auditory hallucinations or in even visual hallucinations where you see things and hear things that are not there and they're telling you to do things or I know a story was that the baby to this mob was an alien and that she was being told to kill the alien and she was OK with that because it was an alien. It was an alien, not her child. And you may be like what? 

That is wild, but it was truly this mom was not herself. This is a true medical emergency. So when we say psychosis, someone is not in their right mind. Ok. So this is more severe than postpartum, anxiety, depression O CD rage. Anything that falls into that maternal mental illness umbrella, this is going to be more severe. 

This is we need to be at an emergency department. Stat they will separate baby from mom and I don't say that to scare you. It is for the protection of the mom and the baby. It is not permanent. Hear me saying that it would not be permanent but we need to get mom stabilized on some medicine. Medicine is going to be your the first round of treatment. And and the reason for that we have a chemical imbalance happening in the brain. 

This is not they're causing this, this is not something they can control this is not something that is going to go away and this is something just like you would treat a heart attack, you call 911, you go to the, er, you do the same thing for this mom and this baby, um, and it's, she cannot control it and it will not stop. So that is, this is why you have to recognize it early on and you know, paranoia is a huge thing. It is because you think that the baby is out to get you or that it is an enemy of some sort. I actually have heard of someone thinking that their baby was the devil. I've heard that and I think there's a lot silly if you're thinking of religious context of God, a deity. Um speaking, we're hearing from voices being command upon us or my baby is, needs to be in heaven. Yeah. So let's take a little time out. 

I and do a discussion of what is the difference between an intrusive thought and a psychosis thought because they are not the same. So again, intrusive thoughts, they come from a place of protection. Ok. You're having that thought of, I don't want to fall down the stairs with my baby or when we're dealing with postpartum depression and we think my baby deserves better than me. Ok? So that being said again, we think we want good for the baby ultimately, right? 

That is our motivation with those things even though they can be very challenging. That is our motivation with that. When we're talking about a psychosis, it is one of those where you think the baby is not a baby, it is definitely not your baby. Again. You think that it is a weird creature. 

You are having these voices in your head. So, auditory hallucinations, not your own thinking of an intrusive thought, you can audibly hear these voices saying I need you to kill the this because it's out to get you because it's going to harm you or see something, saying it or doing it. And so it's command. So just think like you're under command. So like you can hear us audibly telling you these things. That is what it's like to have an auditory hallucination. And in truth of that is your own thinking. And I've, I remember hearing this person describe their friend and they were talking about the energy levels that she had like extreme burst of energy. So that is where bipolar kind of plays a role in this being a higher risk factor. 

As you think about the manic face of someone in bipolar. Because when someone is in the manic phase of bipolar, they can get two or three hours of sleep at night and feel great. They are not tired, they are not exhausted, they thrive in it. They're cleaning their house at two o'clock in the morning, which hey, come on over to my place, I'll let you clean. 

I'm not against that. I am not above that. I'm here for it. But I will say you have those people that thrive in that manic stage on very, very little sleep. Same thing with psychosis. 

We have this burst of energy where all of a sudden we're getting all the things done and it's not a rapid mom clean. OK. Those are two different things because we all know as moms, we try to maximize babies nap time. So we do try to rush and get a bunch of things done. This is different. This is like you are scrubbing your baseboards all of a sudden when that wasn't a priority 10 minutes ago. And here's another part of that psychosis. 

We're gonna have very rapid mood swings. Now, this is different than bipolar because bipolar is cyclical in nature. So you're not gonna see 20 mood changes in a day. But this one you will this, you're gonna, and it's all over the place. It's gonna be. I have this burst of energy. 

Let me go do something and then we're sobbing and then we're happy and it's a weird type of happy. It's not like a oh, thank you for telling me that I'm happy now or like, hey, you comforted me. I feel a little bit better. It is this weird, almost euphoric happy. It's different. It's, it's going to be um and I, I keep going back to just, and I've read about people who are saying this is what my wife experiences, what my sister experienced. And they're like, they were telling them this is not like you. And um there is such a distrust that the psychosis put on them that then they think that the people, their loved ones, they can't trust they're out to get them. 

Um, paranoia is a big deal with psychosis and, or they said that they felt like they, that they saw this person feel like I understand everything that's going on in my life now. I like they had this clarity of this is why I'm on this. Uh-huh. And so it was very much just like everything made sense that never had made since the paranoia, the um auditory and visual hallucinations, the commands and to piggy back off something you said earlier. It's almost like they have that spiritual awakening in the sense. Uh-huh. And that they were destined to do this. 

They were purposed to do this and it's OK because God Jesus, a higher deity, a higher power said do this. It's OK. Uh And it could be like you're listening to music and you hear those voices or I remember um I forgot her name. She did a TED talk about it and she said the ceiling fan would command her at night and was commanding her to burn down the house with her for because the child didn't need to be on um the planet anymore. And I, I wish I can remember that, Ted talk. If I remember I'll link it. But it was her saying that she experienced it and she got help and clearly now she's given TED talks, right? So like she's an advocate, she's recovered. But I think what part of it is, is in the beginning of it just like anything. 

They are like scared to death. What is happening to them? Well, and that's fair because if you've never experienced a mental illness at all and all of a sudden we have this sudden onset of psychosis and I'm hearing voices and I'm seeing what is going on and admittedly, a lot of people would think, ok, maybe I do just need some sleep because again, sleep deprivation can make things so much worse for us. 100%. So you think, ok, let me just go get some sleep and you get that sleep and it's still happening and you're like, oh my God, what is wrong with me? What is wrong with me? And again, we do have that fear of our Children being taken from us. 

Let me say with postpartum psychosis, when you go to the er, they will separate you and baby in the immediate, I'm just going to be honest and that is for the safety of everybody. Now, does that mean that C P S or D hr that is in your state is going to permanently remove the baby from you? Absolutely not chances are, what they will do is have a safety plan put in place. They need to ensure that mom is regularly consistently taking her medications that she is going to therapy and they're going to be involved in your life for a few months, which means they're gonna be doing some home visits. Yeah, that's ok. That's fine. That is perfectly fine. It is there for your protection. 

I'm one of those people I loved doing family preservation services when I was a baby social worker because the whole goal is to keep the family together. And that is what D hr or C P S would want to do is to keep you all together. But they need to make sure that we actually see recovery taking place to keep you and your baby and the rest of your family because, and I could be misspeaking. But years ago there was a mom that buckled her four kids in the car, drove them in the lake like she put like a um a cinderblock or a brick on the gas pedal, drove the car into like a lake or river and she was out there and watched it and that was postpartum psychosis. And that, I mean, and you, and this is the stories that you hear in the news and you hear that and you're like, I can never imagine. And well, because you've never, you've never experienced and this is not to say postpartum psychosis is the only reason people do unimaginable, unspeakable things. But this is something that is unique to post partum. But now that I'm a therapist and now that I have this clinical knowledge, I look back at that story and I think, I wonder if that was postpartum psychosis because I want to say one of the kids was a very, very young child. And so what if now does that mean that it was right for her to do that? Absolutely not. However, had she gotten help and gotten treatment, if the signs had been picked up on, would those Children still be here? Yes. And that's, and that's something. So if you are seeing this and your mom, friends and your sister and your family and your wife, whoever that just had this baby, ok, we're talking immediate post part of I am always the person that says I would rather ask, I would rather seek than never do it. And that, and that is if you are concerned about someone and then you speak up, talk to them and if they confide in you this, you need to take them to the er, and you need to make sure them and the baby are safe and that is like, like when he said, separating them in that time. And so moms that are listening to this, it may feel uncomfortable to do this, but share this episode with your immediate support system. So they have the knowledge because when you are in the depths of that psychosis, how can you advocate? You can? Well, because again, your thought process is not normal, you may not realize that you're in a psychosis because in that moment you believe it to be the truth and to be reality or you think that they're out to get you because it's already taking over so much of the paranoia, correct? So as uncomfortable as it may seem, share this podcast episode with your immediate support system so that they can be aware of these symptoms so that they can be on the lookout for these things. And just because you're sharing this episode or listening to this episode is not an inevitable that you will deal with psychosis, but it's being prepared, I guess what, like, I know it's uncomfortable but like what would you not rather deal with this uncomfortable listener right now than what would happen and does happen when psychosis is not talked about? 

It's not prepared for, it's not awareness. Yes. So like with anything, we have to be ok with uncomfortable conversations. And again, that's kind of what we do here at Previa is we have these uncomfortable conversations. We shine a light on this stuff, not to force awkwardness or uncomfortableness on people, but to raise that awareness and say it's ok to speak up because we want to save mom's life. 

We want to save babies' lives and we want to say we want to again, post prime psychosis is recovered 100% of the time as long as it is treatment, intervention and treatment. So this is not something that I mean, I think it's one of those things that it's quicker, like recognized and treated instantly, like some of our postpartum depression, anxiety stuff where you have to constantly like fight for therapy or fight for intervention or someone to recognize. This is something that medical professionals know they have to act immediately. Absolutely. And that's why I say medicine is going to be your first intervention because we've got to get mood stabilizers on board. 

We've got to get some medicines on board. So you could be looking at staying at the hospital for a few days, not to scare anybody but be prepared. It's probably not gonna be an in and out in your visit. And I don't say that to scare you. I say that to prepare you that they're gonna be working with medications. It is trial and error with medications, but that's not saying that you couldn't potentially have a visitation with your baby during that time. 

Just like what I had experienced in the hospital where we had a mom who had suicidal ideas, had a gun available to her, had a plan, told us what she was going to do when she left the hospital. Well, you know what, we're going to go take baby to the well, baby nursery while you're here in the er, we're gonna let them get you stabilized. We'll figure out a time for you all to meet up. Now, granted were those visit, you know, supervised visitations? Yes, they were. But at the same time, you know, I wanna say she was in the hospital for maybe three or four days doing much better, much, much better and got to go home with her baby and support system because that was one of those D hr we did get D hr involved because of the threat of it because we didn't know if we, we're just dealing with a very severe case of postpartum depression or psychosis. So D hr was on board and we had it set up to where basically one set of the grandparents was more or less living in for a bit. Yeah. And, and that's something we can figure out the, the discharge, we can figure out the continued support. 

We can figure all that out. The biggest thing is to get that immediate early help and get in and get seen. Absolutely. You know, there are so many, if you are like, ok, this sounds like something I've heard. I want to know more. There is so much like Survivor stories out there and the more we talk about it, the more awareness, the more prevention. So thank you guys. We know it's kind of a hard, heavy episode. Um But again, it is something that is in a medical emergency. We I'll let you know, but we're always here for you. That's right till next time.