Mom Breaks: Science and Stories of Postpartum Psychosis

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What exactly is postpartum psychosis? How is it classified in the ICD and DSM, and what do we know about why it happens? In this episode, Julia and I – with our shared love of neuroscience and empirical research – talk through the “basics” of postpartum psychosis after digging into the literature together.

We discuss genetics, sleep, hormones, brain imaging, and other factors researchers are investigating – plus what we know about risk, proactive treatment for people who are at risk, and ways to support people without a prior history of mental illness.

And then there’s recovery: What does the research tell us about treatment and timelines? What helps people rebuild and make sense of what happened? And where are the biggest gaps in what we know?

We are two survivors of postpartum psychosis sharing what we’ve learned from the research and our own experiences. This episode is for informational purposes and is not medical advice; please discuss medical questions with a qualified healthcare provider.

Resources:

• Mom Breaks Substack

Citations

1. Bergink et al (2026, May 1). Postpartum psychosis and bipolar disorder: Review of Neurobiology and Expert Consensus Statement on Classification. Biological psychiatry.
2. Borghare, P. T., Methwani, D. A., & Pathade, A. G. (2024, August 5). A comprehensive review on harnessing wearable technology for enhanced depression treatment. Cureus.
3. Engqvist, I., & Nilsson, K. (2014, February 21). The recovery process of postpartum psychosis from both the woman’s and next of Kin’s perspective - an interview study in Sweden. The open nursing journal.
4. McKenna et al (2026, April 15). Postpartum psychosis is associated with elevated neuromelanin-MRI signal in the midbrain. Nature News.
5. Sambataro, F., Cattarinussi, G., Lawrence, A., Biaggi, A., & Fuste, M. (2021, May 12). Altered dynamics of the prefrontal networks are associated with the risk for postpartum psychosis: A functional magnetic resonance imaging study | translational psychiatry. Translational Psychiatry.

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Kara is a special education teacher, runner, and survivor of postpartum psychosis. She lives in Pennsylvania with her partner and daughters in a blended family — she and her partner each had a child from previous relationships, then together they welcomed twins. She shares how she went from never expecting to be a mom to a mom of four, as well as her experience with C-sections, twin pregnancy, the NICU, and navigating flu season with two newborns.

We discuss how her postpartum psychosis began after her babies were born last year, as worries about repeat hospitalizations and a series of scares along the way developed into a delusional narrative that her babies had died. We also talk about breastfeeding and medication, self-compassion, making space to care for yourself through early parenthood, and what recovery looked like for Kara as she worked to make sense of her experience — including listening to Mom Breaks and recording voice memos to herself along the way.

Resources:

• 988 Suicide & Crisis Lifeline (US) — Call or text 988
• U.S. Maternal Mental Health Hotline — Call or text 1-833-TLC-MAMA

Citations:

1. Bornand, D., Toovey, S., Jick, S., & Meier, C. (2016, March 3). The risk of new onset depression in association with influenza – a population-based observational study - sciencedirect. ScienceDirect.
2. Cimino, S., & Cerniglia, L. (2023, September 27). Breastfeeding apps: A descriptive report. Behavioral sciences.

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Shelby joins us to share her experience with postpartum psychosis. A mental health counselor in Kentucky and mom of two, Shelby reflects on what first drew her to become a therapist, her experience with a miscarriage and depression, and navigating medication during a subsequent pregnancy and postpartum period. Despite trying different meds after giving birth, Shelby became manic and then psychotic. During her psychosis, she believed she was jumping between timelines—and, because of her professional background, was able to mask some of her symptoms even as they intensified.

Shelby also reflects on how her experience has shaped her as a mental health counselor, deepening her empathy and compassion for others in similar situations. We talk about healing after postpartum psychosis, the role of medication in her experience, navigating a narcolepsy diagnosis, and more.

Resources:

• Shelby’s Practice - Central Kentucky Counseling Associates

Citations:

1. Anderson, I. (1998, December 7). Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability. ScienceDirect.
2. Carr, C., Borges, D., Lewis, K., Heron, J., Wilson, S., Broome, M. R., Jones, I., Di Florio, A., & Morales-Muñoz, I. (2023, December 7). Sleep and postpartum psychosis: A narrative review of the existing literature. Journal of clinical medicine.
3. Evans, C., Kreppner, J., & Lawrence, P. J. (2022, June 28). The association between maternal Perinatal Mental Health and Perfectionism: A systematic review and meta-analysis. The British journal of clinical psychology.
4. Ross, L. E., Murray, B. J., & Steiner, M. (2005, July). Sleep and perinatal mood disorders: A critical review. Journal of psychiatry & neuroscience : JPN.
5. Verstraete, L. (2025, January 30). Narcolepsy and psychiatric comorbidity: A review of the literature - sciencedirect. Elsevier.

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Dr. Bobbie Decker is a neurologist, mom of two, and survivor of postpartum psychosis. Her work focuses on the ways reproductive hormonal changes intersect with neurological health, and her own experience with postpartum mental health has given her a personal perspective on the gaps in how we care for women.

After the birth of her second child, Bobbie experienced postpartum OCD, depression, and psychosis. In this conversation, she shares what it was like to experience postpartum mental illness as a physician who specializes in the brain—and how surprisingly little she understood about postpartum disorders from her own medical training. Her story is a powerful reminder that postpartum psychosis can happen to anyone, including someone whose career is devoted to understanding the brain. We discuss what we understand—and don’t understand—about the postpartum brain, and how Bobbie’s experience has shaped the way she thinks about caring for women through pregnancy and postpartum.

Resources:

• Bobbie’s Oped in USAToday
• Brain on Fire Movie

Citations:

1. Kate, S., Holt, R., & Puryear, L. (2023). Mental Health and placenta accreta spectrum : American Journal of Perinatology. Ovid. https://www.ovid.com/journals/ajper/abstract/10.1055/s-0043-1761913~mental-health-and-placenta-accreta-spectrum?redirectionsource=fulltextview
2. Nonacs, R. (2022, January 19). Is preeclampsia a risk factor for postpartum psychiatric illness?. MGH Center for Women’s Mental Health. https://womensmentalhealth.org/posts/is-preeclampsia-a-risk-factor-for-postpartum-psychiatric-illness/

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In this episode, Julia shares her experience with postpartum psychosis after the birth of her son in 2021. She takes us through her journey navigating care in the Netherlands—from early attempts to support her at home, to a general psychiatric unit, and ultimately to a Mother and Baby Unit. We discuss what it feels like to not grasp your own illness, navigate treatment and recovery, and make sense of life after the acute episode.

Julia has a background in neuroscience and is currently completing her PhD in neuroimaging. She lives in Dubai, where she serves as an International Coordinator for Postpartum Support International. She is also a member of the PSI Postpartum Psychosis Task Force. Shortly after launching this podcast, Julia generously offered to help organize and review the growing body of relevant literature I've been gathering—a collaboration we plan to share more about in a future episode.

Resources:

• Netherlands Crisis Resources:
  • Emergency services: 112
  • Suicide prevention line: 0800-0113
  • Crisis hotline: 088 0767 000
• Postpartum Support International

Citations:

1. Bahji, A., Sepehry, A., & Cabrera, C. (2019, March). ECT beyond unipolar major depression: Systematic review and meta-analysis of electroconvulsive therapy in Bipolar Depression. PubMed.
2. Quevedo, J. (2024, July). The misrepresentation of electroconvulsive therapy in movies - Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences. McGovern Medical School.

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Dr. Diana Barnes is a psychotherapist, educator, and forensic expert who has spent more than 30 years advancing the field of maternal mental health. After her own experience with postpartum anxiety, she dedicated her career to supporting women and families through the reproductive years as they navigate a wide range of perinatal mental health conditions, including postpartum psychosis.

In this episode, Dr. Barnes reflects on the evolution of maternal mental health care and discusses her work as an expert witness in legal cases involving postpartum mental illness. She shares why specialized expertise is essential as these cases navigate the legal system and reflects on a motto of "making lemonade out of lemons"—finding purpose through life's most difficult experiences.

Trigger warning: This episode includes discussion of several cases involving infanticide in the context of severe perinatal mental illness.

Resources

• Center for Postpartum Health - Dr. Barnes Practice
• Baby Doe Film
• PSI Postpartum Psychosis Taskforce
• PSI Legal Toolkit
• PSI Legal Advocacy

Citations:

1. The Mcnaughton Rules. Forensic Psychiatry Experts. (n.d.).
2. PTSD and DSM-5 - PTSD: National Center for PTSD. US Department of Veterans Affairs. (2025).
3. Wessel, J., Endrikat, J., & Buscher, U. (2002, November 1). Frequency of denial of pregnancy: Results and epidemiological significance of a 1‐year prospective study in Berlin - wessel - 2002 - Acta obstetricia et Gynecologica Scandinavica - Wiley Online Library. Wiley.

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In this episode, Laura reflects on her experience as both a survivor of postpartum psychosis and perinatal mental health provider. Following a painful birth, breastfeeding challenges, and a cycle of sleeplessness, her reality began to blur. She became convinced she was uncovering hidden abusers, predicting the future, and protecting her hospital from an active shooter—delusions that felt entirely real in the moment.

Laura shares what postpartum psychosis felt like from the inside, how she and her family navigated hospitalization and recovery, and how this experience has shaped her work in private practice. We discuss how postpartum psychosis does not discriminate, the role of therapy, and the importance of not minimizing our experiences and instead using them to highlight the serious nature of postpartum psychosis.

Resources

• Laura's Private Practice – Movemeant for Change
• PSI Helpline: 1-800-944-4773
• PSI Provider Directory

Citations

1. Bergink, V., & Burgerhout, K. (2015, February). Treatment of psychosis and mania in the postpartum period. Treatment in Psychiatry.
2. Toor, R., & Wiese, M. (2024). Postpartum psychosis: A preventable psychiatric emergency. Psychiatry Online.

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Bridget is a health coach, mother of two, and maternal mental health advocate. In this conversation, she shares her experience with undiagnosed postpartum psychosis following the birth of her second child in 2013, which unfolded during the early postpartum period while she was on maternity leave. Although she sought support and received treatment for postpartum anxiety and depression, the more severe symptoms—including paranoia, delusional thinking, and a disconnect from reality—were not recognized at the time as postpartum psychosis. Her experience eventually resolved without hospitalization, but left her with many questions.

It wasn’t until years later that Bridget learned there was a name for what she had experienced. Together, we discuss how difficult it can be to recognize postpartum psychosis with waxing and waning symptoms, the fear and uncertainty that can surround seeking higher levels of care, and the importance of talking openly about mental health and suicide prevention.

Resources:

• 988 Suicide & Crisis Lifeline (US) — Call or text 988
• International suicide hotline directory
• U.S. Maternal Mental Health Hotline — Call or text 1-833-TLC-MAMA

Citations:

1. Gould, M., & Marrocco, F. (2005, April 6). Evaluating iatrogenic risk of youth suicide screening programs: A randomized controlled trial. JAMA.
2. U.S. Department of Health and Human Services. (2024). 5 action steps to help someone having thoughts of suicide. National Institute of Mental Health.

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After six conversations with spouses and family members affected by postpartum psychosis, I wanted to pause and reflect on the patterns that emerged across these stories—from sleeplessness and behavioral changes to the uncertainty families face in recognizing when something is wrong and figuring out how to get help.

In this solo episode, I reflect on what happens after the crisis: the challenges of navigating care, the transition home from hospitalization, and the role family members play in recovery. Along the way, I discuss research on family dynamics in psychosis, evidence supporting counseling after traumatic births, and a few ideas for how we can build better systems of support for postpartum families moving forward.

If you find value in these conversations, please follow the show wherever you're listening. I'd also love to have you join me on Substack, to hear episode updates, resources, and reflections between releases.

Citations

1. Dekel, S., Papadakis, J. E., Quagliarini, B., Pham, C. T., Pacheco-Barrios, K., Hughes, F., Jagodnik, K. M., & Nandru, R. (2023, December 18). Preventing posttraumatic stress disorder following childbirth: A systematic review and meta-analysis. American journal of obstetrics and gynecology.
2. Verma, M., Bagul, K. R., Gangwal, R., Rastogi, P., Mudgal, V., & Singh, A. (2025, April 23). Expressed emotions in families of patients with bipolar disorder. Cureus.
3. Williamson, E., & Pipeva, A. (2021, November). The Birth Trauma Psychological Therapy Service: An audit of outcomes - sciencedirect. ScienceDirect.

Resources:

• National Maternal Mental Health Hotline - Call or text 1-833-TLC-MAMA
• 988 Suicide & Crisis Lifeline - Call or text 988
• National Crisis Text Line - Text HOME to 741741
• Postpartum Support International HelpLine (non emergencies) - Call or text 1-800-944-4773

Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode!

Clint shares his family’s experience with postpartum psychosis after the birth of their first child. Following a long and difficult labor that ended in a hospital transfer and NICU stay for their newborn, Clint found himself trying to make sense of rapidly escalating symptoms in his wife, Courtney — a chiropractor with a solid understanding of the human body and no psychiatric history.

In this conversation, Clint reflects on the confusion of navigating a psychiatric emergency with little guidance, what it was like bringing home a wife still actively psychotic after hospital discharge, and the lasting impact the experience had on their family. He also shares how faith, advocacy, and the birth of their second child became part of a deeply healing chapter in their lives.

You can follow Courtney’s advocacy and educational work around postpartum mental health on Instagram at @drcourtneywinter.

Trigger warning: this episode includes discussion of suicide attempt and a family story involving schizophrenia and homicide shared in the context of recognizing delusional behavior.

Resources:

• Courtney’s PP Resource Guide
• Postpartum Psychosis: a guide for partners
• PSI Support Group - Family Members

Citations:

1. Bruce, M. J., & Weaver, T. L. (2021, December 27). Testing cognitive models to characterize trauma anniversary reactions marked by stress and growth. PubMed.
2. Chaney, L. (2024, October 1). Treatment of postpartum psychosis in breastfeeding females. The mental health clinician.
3. Xia, M., Wang, J., & Liang, Y. (2022, July 1). Association between breastfeeding and postpartum depression: A meta-analysis. Journal of affective disorders.