Postpartum Psychosis: An Internal Battle 

Danielle LaSusa, a 42-year-old mom with a 9-year-old daughter, experienced manic PPP shortly after giving birth in 2016. After moving to Portland from New York, LaSusa decided to stay home and take care of her baby while attempting to turn her philosophy dissertation into a book.  

LaSusa became severely sleep-deprived a couple of months after giving birth, slowly becoming fearful of being home alone. Her sleep deprivation caused minor hallucinations, such as hearing small things that weren’t there or seeing strange colors.  

LaSusa checked herself into an inpatient program, where she was put on medication to help with depression and anxiety after her family expressed concerns about her well-being. She was able to sleep for more than four hours each night and even made a friend in the program. A 60-year-old veteran, who got his masters in philosophy, was particularly close with LaSusa. “We hit it off like really old buddies,” LaSusa said. 

After five days in the hospital, LaSusa went home. She started to have delusions about her child and people around her shortly after she was released from the hospital. At one point, she thought her cousin was going to start a female-led religion and that she was going to help write the sacred text. She began to think that her baby and her cousin were fully enlightened beings. She felt like she was going crazy.

“I couldn’t bear the idea of just being,” LaSusa said. She studied philosophy during her undergrad and was well-versed in theories of the universe and how things are connected. When she had her baby, she wanted to be and feel more connected to everything, even if that meant concocting theories, such as her cousin being connected to Jesus. 

“[My cousin] had a traumatic brain injury and she was 33, which is the same year that Jesus had started teaching and the Buddhist church taught the same year. I had this whole story. It was so bizarre to be thinking, oh, we’re going to change the world,” LaSusa said.

LaSusa then joined an outpatient program for a month and a half, where she changed medications, because she knew things weren’t right. She believes that the medication she was on, Zoloft, exacerbated her symptoms, which led her to want to change her prescription. 

After the change, she slowly began to sleep better than before. She had extensive support from her family and decided to pump instead of nursing her child. Things began to get better. It took LaSusa a few months to get back to herself.

“I think the psychosis was sort of fueled by my worries about being a bad mom,” LaSusa said. Her relationship with her daughter is strong and is something she has always wanted. 

She has been working on a memoir about her experience with PPP for the last six years. It’s called “You’re Not Real.” LaSusa, her husband and her daughter live in the greater Portland area, where she is successfully off the medication she had to take for a year after her daughter’s birth and is now looking for a publisher for her memoir.

Childhood and general trauma are major contributing factors to PPP, according to Kelly Mach, a perinatal mental health therapist based in Portland, Oregon. Working through that trauma early on can help prevent PPP, among other things, like Post Traumatic Stress Disorder or depression and anxiety.

Mach explains that people who have a history of bipolar disorder are more likely to have PPP and that bipolar disorder can be a defining factor in whether someone has PPP.  

Although resources are available, mothers may not have access due to affordability, location and the stigma around getting medical support. Typically, postpartum is available in local hospitals, birthing clinics, doula centers and sometimes through support groups. All resources vary in price depending on the place the mother chooses. 

According to the National Institutes of Health, PPP is one of the severest forms of mental illness, as it presents itself through delusions, hallucinations, mania, extreme confusion, a loss of touch with reality and a severe reduced need for sleep. 

Without proper treatment, PPP can manifest into serious consequences such as suicide and filicide. Substance abuse, medical history and family history are important things to take into consideration as they can create a greater risk of a mother developing PPP. 

Caring for a newborn is both physically and emotionally demanding, which is why most mothers need extensive postpartum care, either from their family and friends or from medical professionals. 

A sleep schedule, strong support system, a followed medication regimen, and asking for help is what Mach suggests mothers should stick to when going through PPP. Every episode of PPP differs from person to person.  

Crissy Shaffer, a mom of two boys, 16 and 12, in Portland, Oregon, had PPP after both of her pregnancies.  

Shaffer experienced mania, with symptoms including a reduced need for sleep, unusually high levels of energy, euphoria, increased talkativeness and hyperactivity, as well as depression for several years.  

She suffered from Premenstrual Dysphoric Disorder, a more severe case of premenstrual syndrome, all her life. PMDD is characterized by severe mood swings, intense depression and anxiety. PMS affects up to 75% of women, while PMDD affects 3-8% of women. Shaffer thinks this could have contributed to her PPP and eventually her postpartum depression.  

Her first birth was not what she expected. Shaffer wanted an at-home birth with her midwife, but ended up needing to give birth in a hospital. Shortly after, Shaffer experienced PPP symptoms for about two weeks after giving birth.  

“I stopped eating, and stopped sleeping and started talking a lot,” Shaffer said. Her husband and mother knew something wasn’t right. She felt like she was on top of a mountain, but this was the mania speaking.

She was immediately put on medication to help with these symptoms, as well as prednisone, an oral steroid, to help with an intense full-body rash she developed, which eventually went away. After a couple of weeks, her mania subsided. 

For her second birth, Shaffer had a plan in place, with a large support system of family, friends and doctors who knew what to do if she slipped back into a manic episode. Careful monitoring of Shaffer was the first step in this plan, with a potential medical regimen in place.

Although her PPP symptoms were short-lived, Shaffer is still on mood stabilizers to help with her depression. There is no specific time frame of how long postpartum symptoms last. The duration can be anywhere from weeks to years, depending on the person.

She now volunteers at Baby Blues, a support group for mothers going through postpartum difficulties, based in Portland.  

Doula Love, a postpartum resource based in Portland, provides mothers with in-home doulas. A doula is a non-medical professional who provides support pre-birth, during birth, post-birth and even during death. Postpartum doulas offer support from processing emotions to cleaning up around the house. The doulas at Doula Love are trained in postpartum work, including noticing signs or symptoms of PPP. 

Most doula agencies are available through doctors’ offices, according to Angel McGinn, a doula at Doula Love. “Even if you don’t want professional help or don’t have the funds to hire a doula, there are a ton of places you can go to for free,” McGinn said. She specifically mentioned Baby Blues, the support group that Shaffer and LaSusa attended.  

“Nobody is ever meant to go through postpartum alone,” McGinn said.