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- [00:00]
A
You know, it was a perfect storm of sleep deprivation, being a new mom, a traumatic birth experience. And it was really the postpartum period where the journey turned really dark for me.
- [00:10]
B
The country has been gripped by the horrific Lindsey Clancy murder trial. Her lawyers argue that she was suffering with undiagnosed postpartum psychosis.
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C
It is a medical illness, therefore it's a psychiatric emergency. The mom needs to be sent to the hospital. The baby needs to be put into a safe place to.
- [00:29]
B
This is a public health crisis that few people are talking about.
- [00:34]
A
I was not of sound mind. You know, I lost my mind. I was unfit to parent. I didn't know, frankly, if I'd ever come out of it.
- [00:42]
C
It affects some women more than others. And that's why identifying those risk factors early on, that's where we can sa.
- [00:57]
B
Hi, it's Nora and welcome to Healthful. Today's episode is a bit different. That's right, the country has been gripped by the horrific Lindsey clancy murder trial. That is the 35 year old mother and former nurse who is accused of killing her three children and then trying to take her own life. Her lawyers argue that she was suffering with undiagnosed postpartum psychosis. And that has raised long larger questions about maternal mental health and something called postpartum psychosis. I feel like that's something new in the conversation. So we wanted to get you some answers. I'm joined by Dr. Arooj Kamal. Heather. She's a perinatal psychiatrist and she treats patients with postpartum psychosis. Krithi Lotha was diagnosed with postpartum psychosis during the pandemic. And she has bravely decided to share her story with us in hopes of helping other mothers and families. And so thank you so much for being here for what I think is a very important discussion. And before we start, I do want to note to people and give you a warning that we are about to have a conversation about severe mental illness, violence, suicide and potential infanticide. So if you or someone that you know is in a mental health crisis, remember there is help out there for you. Please call the National Mental health hotline. And that is nine, eight, eight. Welcome to both of you. Dr. Heather, I feel like this is a public health crisis that few people are talking about.
- [02:36]
C
Yeah, I agree. Thank you, Nora, for having me. So you know, 23% of maternal deaths in the United States are secondary to maternal mental health conditions. And that can include substance use and unintentional overdose as well. And when they looked back on that data, almost 100% of that data was shown to be preventable. So, you know, that's really important data that we have here. So I'm just so excited we're talking about this today.
- [03:04]
B
I mean, I just, to me, I mean, I just learned this, that the leading cause of maternal mortality is a mental health issue.
- [03:13]
C
Yeah.
- [03:14]
B
How is this not talked about?
- [03:16]
C
Yeah, well, I do think stigma has a lot to do with it. You know, I think that in, in general there can be stigma around mental health conditions and psychiatry in general. And you know, I get it. I understand, I'm a perinatal psychiatrist. I understand topics like postpartum psychosis can be scary, you know, and it's potentially lethal as well. So I truly do understand that. And I also think the stigma of talking about mental health and psychiatry has reduced significantly over the past few years as more data like this has come out. And you know, the way that my 26 year old sister and my 30 year old sister and their friends talk about mental health is way different from how I was talking about it with my mom when I was in my, you know, late 20s and how I will talk about it with my three little girls when they're older. And I think social media has a lot to do that with that. And I think the prevalence of mental health conditions in itself is also increasing. And I think people are realizing that and I think it's good we have to talk about it.
- [04:12]
B
We know that having a baby is difficult and brings about a lot of changes, not only having to care for a young infant, but certainly many of the hormonal changes that happen, the lack of sleep, all of that. So, doctor, maybe describe, since you treat so many patients, hundreds of patients, what is the difference between postpartum depression and postpartum psychosis?
- [04:35]
C
Yeah, that's a really good question. So when we talk about depression, I think it's important to take a moment and talk about perinatal mood and anxiety disorders as a whole. So they're referred to as pmads. And you know, perinatal mood and anxiety disorders, pmads. And so pmads can include depression, anxiety, ocd, bipolar disorder during the perinatal time period. And the perinatal time period, it's defined as the time from conception throughout pregnancy to about a year after the baby is born. So it's almost like a two year time period. That's pretty big. And the reality is postpartum depression or perinatal depression or OCD or anxiety can occur at any point during this two year time period.
- [05:18]
B
That's a Pretty long term. That's new. I just learned that that's important. Yeah.
- [05:21]
C
And a lot of people don't know that. And you know, Nora, misnomer is, is I think the word postpartum depression. I would encourage others to consider or to start calling it perinatal depression, because the reality is the postpartum period is just one. It's one glimpse of time in that entire almost two year time period. And the reality is postpartum or perinatal depression, anxiety, ocd, can occur at any point during that time period. Now, I talk about PMADs because perinatal depression is different from postpartum psychosis in that it's more rare. It occurs in about one to two in a thousand individuals. And perinatal depression is more common. It's about one in seven individuals. And PMADs as a whole are about one in five individuals. So while postpartum psychosis is far less common, it far less common compared to other PMADs, it's potentially more lethal because there is a 4% risk of.
- [06:24]
B
And, doctor, just to talk about that, psychosis is a break from reality, correct?
- [06:29]
C
Yes. Yes.
- [06:29]
B
Describe what that is.
- [06:30]
C
Yeah. So what exactly is psychosis? That's a great question. It, as you said, it is a break from reality and the brain cannot properly process information. So postpartum psychosis are the onset of psychotic features that occur in the postpartum period. 70% of the time they occur in the context of bipolar disorder and it's characterized by delusions. So fix false beliefs that tend to revolve around the baby. Hallucinations, auditory, visual hallucinations, confusion, disorganization.
- [07:04]
B
This is. We've heard about this in the Lindsay Clancy trial where she has reported hearing voices. Right. That can be a symptom of that.
- [07:12]
C
Yes. So voices in general can definitely be a symptom of postpartum psychosis. And it is a true. It is a medical illness. Therefore, it's a psychiatric emergency. The mom needs to be sent to the hospital. The baby needs to be put into a safe place as soon as possible. And I want to emphasize, with adequate and prompt treatment, most of these women go on to recover and have wonderful, beautiful lives with their families.
- [07:40]
B
And Krithi, this happened with you.
- [07:42]
A
It did. It did. And one thing I want to add is, you know, the maternal mental health crisis, as you mentioned, Nora, it's a silent crisis. But these conditions, all conditions across the spectrum, whether it's something as severe as a psychiatric emergency, that is postpartum psychosis, which is what I had, or the spectrum of disorders that Dr. Heather mentioned, they're all temporary and treatable. And while the stats you mentioned of the prevalence, we know that 75% of moms won't actually seek out help. And so there are temporary, you know, this, this condition is temporary and there are ways to treat this in adequate time.
- [08:20]
B
You're providing some hope out there. Look, yeah, this can be treated.
- [08:23]
A
Yes. Like, I think I'm living proof of that. Right. It's why I'm here today. And so I think often people focus on sort of one side of the coin, sort of this, this fear mongering and this silent crisis because it, it can feel hopeless. It can feel really scary for listeners that are here, you know, whether they're mothers, whether they're clinicians treating these patients, whether they're family members, whether they're on the other side, maybe they're survivors that are listening to this conversation. And I think it's important to note that this is temporary. This is treatable. We know the pathways to care. And so timely treatment and diagnosis and treating mothers and babies with care and compassion really matters and makes a difference.
- [09:02]
B
Can you talk about what happened with you?
- [09:04]
A
Yeah, absolutely. So, you know, I've always dreamed of being a mom. It's something I thought about even when I was an adolescent. And I wasn't always sure if it'd be in the cards for me. I don't have a history of mental illness or psychiatric history prior to becoming pregnant. And so almost half people who experience postpartum psychosis actually do not have prior psychiatric history. But I did have a host of hormonal issues. So I had pcos, or I think it's now called pmos. And, you know, aspects that I thought would make it really challenging to become a mom. And so when I did become pregnant in 2020, in the peak of the pandemic, frankly, I had so much gratitude despite the isolation that, like, my body didn't fail me that I was able to, you know, become a mom. And so, you know, I didn't have any mental health complications that were clinically diagnosed in my pregnancy. In fact, I had never seen a therapist, a psychiatrist, or taken medication. And it was really the postpartum period where the journey turned really dark for me. And so, you know, a variety of things happened. So first of all, I had to labor and deliver in a mask because it was the pandemic. And I had what I now know is medically a traumatic birth experience. So my labor experience lasted 46 hours and 16 minutes. Oh my goodness. That was A combination of factors. We weren't sure whether my water had been broken. And there were some challenges there. And so what people may not realize is birth trauma is what we call a psychosocial factor that also can trigger maternal mental health challenges. So that happened. I also had all intentions of breastfeeding. And so my partner and I were hoping that we could provide breast milk and do pumping, but my daughter had a really hard time latching. And so that's where really the sleep deprivation started. So didn't sleep much during labor, lost a lot of sleep in just arduous breastfeeding. And because my daughter wasn't able to latch, she lost a third of her body weight. And so I actually went to the pediatrician the morning I was hospitalized and was told that we had to wean her to formula right away for her safety.
- [11:24]
B
Krithi, I feel like so many women are listening to this and like saying, oh, my gosh, this is so similar to my story.
- [11:29]
A
Absolutely, absolutely. And so, you know, it was a perfect storm of sleep deprivation, being a new mom, a traumatic birth experience. You know, my partner had to go to work because of short paternity leave in this country. You know, he had to go back to work. And all these things coincided. And, you know, I didn't sleep for four days straight through a combination of factors. And really, that's when I started behaving a little differently. And I think people have these perceptions around postpartum depression, and there's either a lack of information or misinformation. But with postpartum psychosis, you can experience highs. It's not necessarily just lows. And so I felt on top of the world. I felt really confident, and I wasn't sleeping, but my partner and family thought I was just being like a high achieving mom who is trying to do the best for her child. And ultimately, one of my first delusions was that I believed I had severe postpartum depression. So that was actually my delusion. And so I was very concerned about my ability to parent my daughter. I thought I was an unfit mother. And so I also.
- [12:35]
B
And did you express that to a doctor? Were you able to express that to a doctor?
- [12:39]
A
You know, it's interesting, as Dr. Heather mentioned, postpartum psychosis is truly a break from reality. And what I want to emphasize is that this is not an intrusive thought that I am aware of being in a separate reality. Like, to me, this was very real. And so, interestingly, it wasn't necessarily my doctor. It was actually my partner, my mom, and direct family members that I was saying, I think I have the baby blues. I think I have postpartum depression. In fact, I wrote emails to them in my mania about, I'm going to find a therapist, I'm going to find support groups. And the other piece that I haven't shared publicly is I actually posted on Instagram six days before I was hospitalized with postpartum psychosis. And it was a long post talking about how being a mom is hard and how I think I have medically what's known as the baby blues, and basically listing out for my Instagram friends all the things I would do to take care of my mental health. And so Dr. Heather often says postpartum psychosis can hide in plain sight. And so I was hiding in plain sight.
- [13:45]
B
Right? Because if you were my friend, if you were my daughter, I would be thinking, oh, she's aware that there's something going on, she's seeking treatment. Or those all seem rational to some degree. Am I wrong? You know, like, that's. So what then led to the psychosis?
- [14:03]
A
Absolutely. So again, I think sleep deprivation and all these combination of factors, cessation of feeding and all these things led to it. But ultimately it was a variety of things. So I actually, believe it or not, in my delusions, I thought both my husband and I were having a panic attack and that we were both unfit to parent. I called 911. I am the one who called 911, believing that I was experiencing some form of an emergency, that my partner and I were not fit to parent our child. It was really just me. It wasn't him. But in my delusion, I thought it was both of us. And admittedly, through that 911 call, getting connected with an object who was an incredible OB who was available to my partner 24 7. In chatting with her, in chatting with my partner, my mom, who was there and then one of my cousins was a psychologist who actually called to be like, I think I need help. They made the brave decision to send me to the emergency room. And I was in the emergency room for about 48 hours and then transferred to a general population inpatient psychiatric unit.
- [15:12]
B
Without your baby?
- [15:13]
A
Not only without my baby, Nora. Without my partner, and frankly, no visitation. So I was fully and entirely separated from my partner, my baby, for 10 days. I was in a mask. I was in a unit where there was no other mothers. I'm a vegetarian person. I didn't have access to vegetarian food. I didn't have access to fresh air for more than. For more than an hour a day through a barbed wire in a high rise building. And I got my phone for about an hour a day where my partner or my mom would send me photos of my daughter, my dog Simba. And that sort of got me through it. I didn't know frankly if I'd ever come out of it.
- [16:11]
B
And Dr. Heather, is that common? What happened with Krithi?
- [16:18]
C
Yeah, it's a good question. So I think this is a really good opportunity to talk about the spectrum of postpartum psychosis. There's a big myth that postpartum psychosis means that a mom is suddenly hallucinating that aliens are taking away her baby. Or a voice is telling to, you know, her baby has turned into a puppet and that's what you need to hear. And it happens suddenly and dramatically. That is not always the case. And in fact that is a smaller percentage. So postpartum psychosis actually occurs up on a spectrum. I refer to them as pink flags and red flags. And I think it is so important for the community, for everyone connected to the mom, which is honestly a countless amount of people. It's the dad, it's the husband, it's the siblings, the kids, the, the parents at the kids school, the list goes on. Right. So as the sooner the community is aware that this occurs on a spectrum, the better. So for example, what are pink flags? I refer to pink flags as quieter signs of postpartum psychosis. And that's where lives can be saved.
- [17:23]
B
What would be some pink flags?
- [17:25]
C
Exactly. So example of a pink flag would be, I had a mom who told me that, you know, the baby was sleeping all night, but she couldn't sleep because she was looking out the window of her nursery because she was so afraid someone was going to come and take her baby in the middle of the night. Or she was very productive and expressing early hypomanic features and she was nursing the baby all night, but she was up at the crack of dawn and her hair and makeup was perfectly done and she just had a baby three weeks ago and she was cleaning and she was in her, you know, her designer suit with her Birkin, 25, ready to go out the door as if it was, this was just normal life.
- [18:01]
B
And so that's a manic behavior, right?
- [18:03]
C
Hypomanic, manic type behaviors. So when it be so those. So the confusion, the paranoia, the suspiciousness, the early onset confusion, the mood changes, those are pink flag symptoms. If we can tell something is off the community, the village of the mom, that's where we can save lives.
- [18:25]
B
What becomes a red flag?
- [18:26]
C
Exactly. And so, for example, a red flag would be an example of a red flag. Delusions, hallucinations, confusion waxing and weakening features. I had a mom who had just had a baby, and she told me she heard a voice to give her prescribed Xana next to her dog, a tablet of the Xanax. And so she did cause the voice told her to. And the pink flags weren't detected early enough. I had another mom, actually, several months after having the baby. She had a very traumatic delivery, unfortunately. She started planting flowers in the cabinets of her kitchen sink. She took soil from outside while her husband was at work. She filled it with the kitchen cabinets, put in seeds, watered it. She watered the kitchen cabinet so much, the kitchen flooded while the babies was crawling around on the floor. So those. So the pink flags have now turned to red flags. So my message, I think it's simple and I hope that we look for the pink before we ever see the red.
- [19:21]
B
Wow, Dr. Heather, I think that's an excellent way to describe things. Does that make sense to you, the pink and the red flags? Do you feel like you had that spectrum? I mean, it's different for everybody.
- [19:32]
A
It fully resonates, you know, Something I haven't openly talked about is prior to the cessation of feeding, I had a lot of ruminative writing. And so I had one of those apps. Like the feeding apps, right? Like, what is it? Like, I don't even remember now, but it's like every three hours you feed. And I was manically writing on whiteboards and scheduling when my husband would do the bottle and I would do the bottle and my mom would do the bottle. And I think I had so much anxiety around the fact it was terrifying that my daughter had lost so much body weight. And so I think in terms of pink flags, I remember my husband calling me back to bed and being like, hey, you got to sleep. And I would set alarms, set alarms to do it, and just sort of be manically writing the other thing that I've never talked about. But when I was in the er, I had a lot of confidence. I was very proud of myself for being in the er. I actually thought that the frontline providers were actors, that they were actors. You know, I grew up acting on stage and sort of they were telling me what an amazing mom I am and how amazing performance I had, you know, made. And, you know, I did start thinking about, you know, you know, what would people talk about with me and my eulogy one day? I don't like to think about why I had that thought. Frankly, Nora never shared that delusion, and I'm sharing that today for the first time because, you know, sometimes these delusions can be really scary. And I think it's important to name that. While the majority of folks don't have thoughts of harm or self harm, and I didn't actively have it, I do wonder why was I thinking about the wonderful things that different people would talk about at my funeral? There was so much of that. The other piece, to her point of confusion, in case you can't tell, I'm a pretty talkative person. And I remember prior to being hospitalized, going to a coffee shop across from our apartment and not being able to order. Like, I lost the ability to speak. It was, like, very low. And not knowing where I was and having to call my husband and have him come back with our dog and my daughter's stroller to, like, come and get me to help cross the street. And so I think for someone who's never had a history of mental illness, who's high functioning, you know, I think it was very confusing to him, like, why. Why does my wife need help even walking my dog, letting go of the leash and not really knowing how to walk him? So there's these, you know, going back to pink flags. I think there are so many things that slowly built up.
- [22:06]
B
Sure.
- [22:06]
A
But because no one had ever educated me on postpartum psychosis, in fact, I didn't get a firm diagnosis till eight weeks postpartum, which we can talk about. I didn't even know, and neither did my partner, that these were warning signs to look for. All we knew to look for was, you know, is she feeling depressed and does she feel attached to her baby? And the reality is, even as a postpartum psychosis, I felt very attached to my baby, and I felt really confident. Like, I got up and showered that morning. I took my daughter to the doctor.
- [22:35]
B
Yeah. And this is a really interesting thing, doctor, because I think so many women and people across this country are following the Lindsay Clancy case so closely is because they maybe perhaps have felt somewhere on that spectrum between depression and psychosis or have friends or family members. And also just the gruesome nature of that trial. And one of the things, too, is her husband in this trial said that of the day that she murdered her children, she. He said her husband that it was one of her best days. I mean, how. How can that be possible?
- [23:16]
C
Yeah. So, you know, I can't speak to the case, but postpartum psychosis in General, like I had said, it's a spectrum. And a mom can be. Can be functioning. She can do pickup, drop off. She can be. Appear to be a normal functioning member of society, but she may have these delusions inside her head. Her brain architecture is just, it's interpreting signals in reality differently from us. And she doesn't have that insight. It can wax and wean, which is why, you know, there's that dangerous misconception that, you know, a mom has to be floridly psychotic in order to have it. But that's why I keep going back to the spectrum and early detection, early detection saves lives. And I also think it's an opportunity to talk about the fact that 2/3 of perinatal mental health conditions start before the baby is born. So one third is preconception, so family planning, ivf, you know, before you even get pregnant, and then approximately another third during pregnancy. And so that's 2/3 before the baby is born. Only one third occur after the baby. So I'm a big advocate of preventative health care, and I think it's mental health care, and I think it's a big white space. But the sooner we screen, the sooner we connect at risk individuals to mental health providers and psychiatrists and clinicians, the sooner we can identify those women at risk and get them treatment as early as possible before the risk of developing new disease increases.
- [24:44]
B
How do you screen for these things?
- [24:45]
C
Yeah, so it's a great question. There is no screening for postpartum psychosis. I think there's a myth that there is. There is not. It's not like heart disease, where you can lower your cholesterol levels and modify your exercise and prevent a cardiac event from occurring. But what we can do with postpartum psychosis, we have to connect at risk individuals to mental health clinicians and providers as early as possible. So when we identify those with risk factors for postpartum psychosis, we are going to decrease the risk of new cases happening. And again, do it during ivf, you know, do it during couples therapy. When you're talking about having. Do it as early as possible, even before the baby is born. I firmly do believe that.
- [25:29]
B
And I have not, you know, I'm not specifically covering the Lindsay Clancy trial, but, you know, I have read about it and certainly. And one of the things too, I think that jumps out is she was seeking care and help. She wrote about it in her journal. She also had been prescribed 13 different psychiatric medications. So I think in that too, people are asking what happened? You know, it wasn't like, she was totally off the radar. Right. Like what. When you look at something like that, what are some of the signs about? And I know you talked about pink and red flags that people can be in the community, and I talk about the community inside the home, outside the home can be helpful and know when hospitalization is needed.
- [26:14]
C
Yeah. You know, I think it's important to acknowledge our healthcare system is fractured. And the first thing I'll say, if you are a loved one or you are the patient, you're not satisfied with the care that you're getting, or you're not satisfied with the amount of time. And I'm saying this generally, I'm not speaking to anyone in particular. If you're not satisfied with the amount of time your psychiatrist or your psychiatric clinician is giving you, ask for more time or find a second opinion. It takes me minimum 45 to 60 minutes to do a proper psychiatric assessment. In my clinical opinion, it cannot take less than 45 to 40 to 40 minutes to really get all the risk factors.
- [26:54]
B
And that's what they are scheduled for, is usually about 50 minutes. Right?
- [26:57]
A
Yeah.
- [26:58]
C
And the healthcare system, it's. It's fractured, and I don't have a solution. But I think we have to acknowledge that, and we have to. You know, I don't want to scare families away about postpartum psychosis. I want to empower them, and I want them to know that we can identify risk factors. And, you know, you are allowed to seek the best care for you and your loved ones.
- [27:20]
B
What symptoms should perhaps family members be looking for?
- [27:25]
C
I'm gonna talk about sleep. I think sleep is, you know, sleep is not a luxury. Sleep is health care. There is a reason that militaries and intelligence agencies worldwide have historically used sleep deprivation as a form of psychological torture. And I really think the culture has to prioritize the sleep of moms and dads. Let's not forget about our dads here, too. Right. Because a lot of the time they're supporting the mom. But dads can get perinatal depression, too. And we know that 70% of the time postpartum psychosis occurs in the context of bipolar disorder and a risk factor for mood destabilization, mania, hypomania. It's in fact, disrupted sleep. It's poor sleep in the postpartum phase that can be a big risk factor. And there are public figures that recognize this. From Anne Hathaway to Prince Harry to Cardi B to Ivanka Trump, they have emphasized the importance of maternity and paternity protection. And leave in the postpartum period because they recognize that maternal mental health is really the most bipartisan issue out there. And I think we have to start prioritizing the sleep of our parents and the babies. You know, I wish I could give some magic script where moms and babies slept all night and everything was wonderful, but it's not like that. So let's start shifting that culture and talking about caregiving and sleep more supportively.
- [28:45]
B
Yeah. And, Krithi, I mean, with your own experience, you just described, because you had become so focused on the feeding, when you hear that, does that resonate with you?
- [28:55]
A
It fully resonates. You know, something I think is really important for anyone listening to hear is that I believe the healthcare system failed my family as much as it failed me. And the reality is, when you're having a break from reality, you know, it might be stigmatizing to say, but I'm gonna say it out loud because it's important. I was not of sound mind. You know, I lost my mind. I was unfit to parent. And so I think it resonates in the sense of, I think we put so much onus and burden on mom or the birthing person to be the one to see the signs. Whether it's pink flags or red flags. I couldn't. It needed to be someone I loved or it needed to be my provider. And so I think it fully resonates in that I wish sleep is a really important one. But the other piece I'd add is that how do we empower folks to make a mental health plan early, just like a birth plan? And so, to me, I think what troubles me is why was the first time my husband and I even heard about the potentiality of postpartum psychosis only when I was seeing a psychiatrist who specializes in maternal mental health Outpatient.
- [30:03]
B
After you'd given birth?
- [30:04]
A
Yeah. Like, why didn't people tell me about this? They told me about gestational diabetes. They told me about postpartum hemorrhage. They told me about, you know, preclampsia. They told me about, you know, what would I need for an emergency C section. And I get that I don't fit into the profile, right? Like, if a doctor saw me, they wouldn't necessarily think that I fit into the risk profile for postpartum psychosis because I don't have a bipolar disorder and I didn't have a mental health history. But I wish they had empowered me early because to Dr. Heather's point, we could have been proactive about safeguards to Sleep. So as an example, even when I got out of my hospitalization, I'm so privileged. My mother was my night nurse. So for four months, my mother is the one who actually provided my daughter the bottle. And really, it was about protecting my sleep. She was the one, my partner and I. And so even thinking about the fact that there was so much shame around me not breastfeeding internally for myself, but knowing that actually protecting my sleep, having that night coverage, I wish people had both told us really early in the journey so we could proactively prepare for those hormonal changes for all the safeguards that Dr. Heather mentioned. But I also wonder, like, why was it brought up so late? And how could have I empowered my OB and my husband to recognize those signs far sooner? Which is why I think this conversation is so important. I mean, I'm gonna be honest, it's terrifying for me to be having this conversation with you. Yeah, I don't like reliving my trauma on a platform like this. But I also know that if someone can hear this story, if someone can see the power of an incredible physician like you, an incredible physician, Dr. Heather, and someone like me, if you saw where I was and where I'm at now, it's a medical marvel. I mean, I want people to talk about how incredible is it that I was as ill as I was, but I got that timely treatment, that I had a village to support me, that I had my mom protecting my sleep, that I had an incredible prescriber who actually was able to name this diagnosis and help me recover, and then ultimately that I had resources in a community to help me heal even beyond this lifelong trauma.
- [32:20]
B
So that's a powerful testimonial, and it really is important that you are sharing your story. It will resonate with so many people. And one thing, for me, as someone who has had three children and gone through this and now who has gone through perimenopause and menopause, and something that there's so little science around is the issue of hormones and the great hormonal change that is happening to your body not only through childbirth, but breastfeeding or non breastfeeding that we don't talk about, that this is completely a normal, biological thing that happens to you with your hormones, and we're not treating it or understanding how much the body is going through after the birth. And as you point out, it's not just after the birth while you're getting pregnant and pregnant.
- [33:06]
C
There's a reason the postpartum period, I think, affects some women with postpartum psychosis more than others. As you had said, it's that sudden withdrawal of hormones. You know, it's not the absolute levels. It's that crash. And for some reason, it affects some women more than others. And that's why identifying those risk factors early on, I keep going back to it. Let's look for the pink before we ever look for red. Pink before Red.
- [33:34]
B
Well, Dr. Heather Krithy, thank you. You really will help so many women and their families by sharing your stories and sharing this expert medical advice. Thank you so much.
- [33:46]
C
Thank you.
- [33:47]
B
And I do want to remind our audience that if you or someone you know is experiencing a mental health crisis, please call the National Mental Health hotline. That number is 988. Thanks for joining.