Postpartum Depression is common. Postpartum Psychosis is rare. Thankfully.
Andrea Yates drowned her five children in a bathtub. Horrible. Unfathomable. She was ultimately diagnosed with postpartum psychosis and was found not guilty by reason of insanity.
Otty Sanchez did something worse. Much worse. But for likely the same reason. She murdered her 3 1/2-week-old son because the devil told her to do it. Unfortunately she did more than that. Much more. Though the official autopsy and police reports are not yet available, the media reports paint an extremely disturbing picture. Neither Stephen King nor Dean Koontz could make up this horror.
She apparently used a sword, a machete, and a kitchen knife to stab, gut, skin, decapitate, and dismember the infant. She bit off three toes and consumed parts of his brain and other body parts. She screamed that the devil had told her, made her, do this and slashed her own chest, abdomen, and throat. She survived. So did her other two children, ages five and seven, who were in the house at the time but were not targets of her devil-directed actions.
When I read the initial news report, I knew what the diagnosis would be: Postpartum Psychosis. Not only was the timing right, but what else could drive a mother to do this?
A family member reported that Otty had had psychiatric treatment in the past so her problems, though now much more acute and severe, were not new.
Postpartum Depression and Postpartum Psychosis are poorly understand psychiatric entities that come in many forms. If recognized and treated early, they tend to resolve quickly and without long-term problems in most sufferers. If not, they can linger and progress to full-blown psychosis. Many victims of these disorders have underlying schizophrenia, depression, and/or bipolar disorder.
First recognized in 1850, the classic presentation is for the psychiatric symptoms to appear just before or just after the delivery, usually after, and typically within 3-4 weeks after delivery. The person might become moody, withdrawn, sad, cry a lot, exhibit anxiety and agitation, suffer insomnia, ignore their new infant, ignore themselves in that they don’t bath or eat consistently, exhibit periods of mania or delirium, and experience hallucinations, such as visions or voices.
This should be considered a psychiatric emergency and the victim should be hospitalized and treated with antidepressant or antipsychotic drugs. If so, recovery and return to full normalcy is likely. Untreated you get an Andrea Yeats or an Otty Sanchez.