Because postpartum psychosis is so rare, we don't have as many opportunities to hear from women who have gone through it and get their perspective. I was happy to hear from aWarrior Mom who wanted to share some ofher experience as well asher thoughts on the ABC "Private Practice" episode that has caused such a ruckus this past week. I appreciate her willingness to share her point of view with us:
"Firstly, I agree it was irresponsible of ABC to request apublic service announcement (PSA)about postpartum depression (PPD) from PSI when the show was about postpartum psychosis (PPP). For those who viewed the PSA on the web, it clearly could have created confusion about what PPD is and what PPP is. The PSA should have been about PPP.
Additionally, the segment of the show where Violet [the therapist] tries to comfort the father by speaking about depression creeping up insidiously and then mentions psychosis as though it is something that naturally follows depression also muddles the picture. I can also appreciate how it could frighten mothers experiencing PPD, postpartum anxiety (PPA) or postpartum obsessive-compulsive disorder (PPOCD).
All that being said, as someone who suffered from postpartum psychosis (more specifically, severe postpartum depression with psychotic features) and who has since been able to get help for four PPP-afflicted women, I believe that the show was very accurate in depicting a postpartum psychosis crisis.
Anyone who has experience with PPP (either personally or perhaps through a spouse) would easily identify with the scene of the woman talking to herself or to people only she can see, being excessive in speech while making little to no real sense and laughing inappropriately. The scene where the woman stresses emphatically that she would never harm her baby and that she loves her baby is particularly poignant. In my experience, the afflicted women I dealt with behaved similarly in an effort to communicate that they did not wish or want to do what they felt compelled to do because of their hallucinations, delusions or disorganized thinking (as in the character's case).
Additionally, I saw Violet's behavior to be representative of the moronic attitude of some healthcare professionals. In one situation I was involved in, I personally witnessed a nurse trying to involve child services against a woman with postpartum psychosis after we had her admitted to the hospital for treatment. Why she would do this to someone in the process of getting help is beyond me. Imagine the afflicted woman's horror when, after my assuring her that getting help was the right thing to do, the healthcare professional reported her as unsafe to child protection services.
However, I appreciate that they ["Private Practice"]showed two balanced, level-headed doctors whose views prevailed in letting the mother be with her baby.
Ultimately I thought the show did a remarkably accurate job of presenting how a woman with PPP may behave, the ethical dilemmas healthcare workers face and the right thing for them to do in a situation where a women with PPP is seeking help — all in the 15 minutes they had dedicated to this storyline.
Reading some of the comments posted on Postpartum Progress, I can see that people would have preferred an episode about the more common PPD and I can appreciate that. However, the episode that did air was also necessary in that people need to know that PPP exists, what it may look like, that it can be treated and that even women with PPP are good mothers and can expect to be well again. All of that goes a long way in making women exhibiting the early symptoms of PPP and their families know that coming forward with such symptoms is the best thing to do toward getting help.
Connected to this is that too many people, include healthcare professionals, don't know enough about PPP. The perception that PPP is rare is often an excuse to stay ill-informed. This is a dangerous situation that not only led my family to not realize the seriousness of my symptoms, but also resulted in my being consistently sent home by doctors who repeatedly misdiagnosed me — first with PPD, then PPA and even PPOCD. Sadly, this was also an experience shared by most of the women with PPP I have been able to help.
It is bad enough not to be able to get help when you have PPD, but imagine how it feels to suffer from the symptoms of PPP and consistently be turned away by the very people you are counting on to help you through a dangerous condition. Perhaps this show will make that kind of behavior happen a little less."
Thanks HK for feeling comfortable enough to share your feelings. As someone who has not experienced postpartum psychosis, I appreciate hearing from someone who has a more personal view of what it's like and what may happen.
Dear Katherine,
Thanks for posting this letter. I find myself identifying with HK as a Severe PPMD survivor whose variety of PPMD symptoms, especially insomnia, led to near psychosis. While I think that these situations are too subjective to put labels on them (which is why I always refer to my experience as a severe postpartum mood disorder), I do think it is important to bring forth awareness about PPP. Even though 1 or 2 in 1000 is "rare" for those of us in the Perinatal Mood Disorder community who deal with the more common PPD, PPA, PPOCD, PTSD, and Postpartum Adjustment Disorder on a daily basis, it is SO important to educate the public about PPP for that very reason. We are out there advocating for the common and prevalent disorders and though that is necessary, PPP is even more severe and has fatal consequences occasionally.
For me, this brings to mind the successful non-profit Jenny's Light. While that organization strives to bring education, advocacy, and support to families, I think that it often blurs the lines for people between PPP and PPD. Jenny's Light refers to Jenny as having suffered from PPD and always uses that term when marketing the organization. Jenny could very well have had a similar case as mine in that her PPMD symptoms could have led her into psychotic behaviors. However, it seems to me that perhaps Jenny's Light, the media, and other Perinatal Mood Disorder related content should always be clear that infanticide, like in the case of Jenny and Graham, is not always an inevitable consequence of PPD, even if left untreated. Though it is horrible for mom and the whole family to leave a Postpartum Mood Disorder untreated, even then it is very unlikely or probably nearly impossible for a typical suffering mom to kill her child or herself unless she is having a psychotic episode.
That said, please be clear that I am a treatment advocate, almost to the point of preemptive treatment for those with high risk because of the possible results of not treating, which to me is a risk not worth taking. At any rate, bringing to light psychosis as it relates to the postpartum period is helpful to the public and supportive to those "warrior moms and families." Let's just be careful to talk about BOTH the early on-set PPP AND the PPMDs that often lead to psychosis if severe or untreated. In either case, harmful results are likely and therefore I commend those who speak out about PPP.
Sincerely, Amber Koter-Puline http://www.atlantappdmom.blogspot.com
Thank you HK for this…like Amber, I commend you for speaking up and shedding more light on PPP. I hope you continue bringing awareness to PPP; for it is only through such personal bravery that others suffering come forward to seek help and advocate for themselves – with the beginnings of bravery within themselves!
And thank you Katherine for your blog which has helped countless women and their families.
Private Practice has never claimed to be a "factual" program. It is a fictional program with fictional characters. If viewers don't know this than I suggest they watch programs that have been scientifically proven as accurate.
I am a "survivor", for lack of better word, of PPP. I was supported by wonderful family and friends and have gone on to lead a normal life. I take no offense to the program as I take it for what its worth: Entertainment. I know of no fictional show that claims to be 100% accurate or even has the desire to be so. Their story lines are used to pull in viewers. Thats the bottom line.
If it was a "news" program I can absolutely see people up in arms over it. But its not and you need to take a deeper look at your form of entertainment if you have a problem with it.
Karin- If Private practice wanted this episode to be pure fiction then they would not have consulted with PSI, posted a PSA or put a quiz about a real-life situation on their show's website. ABC continues to shock me with their $ hungry behavior…yesterday's ENTIRE episode of General Hospital (which I watch to follow Robin's PPD–or not so PPD storyline) was filled with commercials for V8 and Prego products- blatantly the actors were cheesily touting the "heart-healthy" benefits of these anti-oxidant rich foods during what they barely attempted to make regular scenes! ABC needs to choose whether they want to educate the public via their TV entertainment as a way to reach millions about important causes or whether it is pure fiction all together in their dramas. The problem is not that TV is fictional…it's that TV writers, producers, etc. try to delude the public into thinking they care and then misinform while "educating."
Amber
I disagree with your assertion. If that were true, then why do major organizations like the CDC and Bill & Melinda Gates Foundation financially support the Hollywood, Health & Society program at the USC Annenberg Norman Lear Center to provide entertainment industry professionals with accurate and timely information for health storylines. According to its website, the program recognizes the profound impact that entertainment media have on individual knowledge and behavior.
According to the 2005 Porter Novelli HealthStyles survey, over half of regular primetime drama/comedy viewers reported that they learned something about a disease or how to prevent it from a TV show. About one-third of regular viewers said they took some action after hearing about a health issue or disease on a TV show.
It's not as simple as saying "It's just TV."
I am a survivor of a mom with Postpartum Psychosis. It is really a miracle I survived. I almost died many times, and I claim I even died a couple of times, but she brought me back every time. When searching for help I find so many resources for moms having PPP etc, but nothing for someone like me. The problem is off course also that I don’t have good family relations, which I think is common after growing up like this. I am the oldest of 3 children, where the problems got worse by every sibling. I became the black sheep who always protected my siblings and looked for help wherever I could, but never really found it. Making my parents upset every time I talked to someone outside the family and getting severe punishments for that. My siblings do not have their memories back, though they sometimes have had glimpses. But my family have made sure they know they will not be welcome if they talk about it. So they forget because they are not strong enough to loose that relationship, and they are not well. My sister has tried to commit suicide so many times I don’t know how many. Neither of them are able to be out where there are many people and lock themselves in. Neither have worked for a long time and my sister has been on disability since she was 30. I have chosen another road and have my memories, have been able to work, but feel so alone. Is there really nothing for someone like me? I have gone to depression groups but make everyone cry and that is not helpful. I’ve gone to sexual abuse survivor groups but no one else in those groups had been violently sexually abused by their mom (yes I know this is even more unusual than PPP) and therefore they don’t want me there; my situation is different from theirs. I have gone in counseling for years and years but really would like a contact that can understand what Ive been through. I feel so alone. The older I get the more tired I get and the less I feel I can keep going. Is there anywhere for me?