"Pink flags" of postpartum psychosis — and more takeaways from "Healthful"

The "Healthful" podcast recently featured a discussion with perinatal psychiatrist Dr. Uruj Kamal Haider about the lesser-known but serious perinatal mood disorder known as postpartum psychosis. Dr. Haider explained that postpartum psychosis is a "break from reality" characterized by delusions, hallucinations, and confusion, where the brain cannot properly process information. She emphasized that it is a psychiatric emergency and requires immediate hospitalization and separation of the mother from her baby.

However, Dr. Haider also stressed that with prompt and adequate treatment, most women recover and go on to have wonderful lives with their families. She pointed out that the term "postpartum depression" is a misnomer and should be considered more broadly as perinatal depression or perinatal mood and anxiety disorders, which can present from conception up to a year after giving birth.

Postpartum psychosis is rare, occurring between one and two in every 1,000 cases, but it is more lethal due to the 4% risk of infanticide. Dr. Haider urged the community to look out for "pink flags," which are earlier signs of psychosis such as a mom not being able to sleep or being unusually high-energy and active. In contrast to the "red flags" of full-blown psychosis, a mom may still be high-functioning and attached to her baby.

Interestingly, Dr. Haider noted that two-thirds of perinatal mental health conditions actually start before the baby is born, which is why early detection and screening for risk factors during family planning and pre-pregnancy is crucial. Kriti Lodha, a mom who had a personal experience with postpartum psychosis in 2020, shared her story. She attributed her condition to a combination of sleep deprivation, being a new mom, and a traumatic birth experience.

Lodha described how her daughter had trouble latching and was losing weight, which triggered her first delusions about having postpartum depression and being unable to care for her child. She ultimately called 911, believing neither she nor her husband was fit to care for their child, leading to her being connected with an obstetrician and then transferred to an inpatient psychiatric unit. Now recovered, Lodha emphasized the importance of timely treatment, diagnosis, and compassionate care for mothers and babies.