What I Want You to Know About Postpartum Psychosis

If you've been following the news lately, you've probably heard about the Lindsay Clancy trial. It ended in a mistrial this month, after the jury couldn't agree on a verdict. The case has put a spotlight on something I think about every single day in my work: postpartum psychosis.

As a perinatal mental health counselor, I've sat with a lot of new moms in a lot of hard moments. And when a case like this makes headlines, it becomes even more clear how much misinformation is out there, which is why I thought this post was needed to keep educating and breaking down the stigma.

So let's talk about it, gently and honestly. 

I want to say up front: I'm not weighing in on this specific case, what happened in that courtroom, or what was in anyone's mind that day. That's not mine to judge, and frankly, no blog post could do it justice. What I can do is help you understand the illness itself, because there's so much fear and misinformation swirling around it right now, and fear helps no one, least of all the moms who are suffering in silence.

What Postpartum Psychosis Actually Is

Postpartum psychosis is a rare but serious psychiatric emergency. It affects roughly 1 to 2 out of every 1,000 births.  It's not just "really bad baby blues." It's not "postpartum depression, but worse." It is its own distinct condition, and it involves a break from reality. That can look like:

• Delusions (fixed, false beliefs, like believing the baby is in danger, possessed, or not really hers)

• Hallucinations (seeing or hearing things that aren't there)

• Severe confusion or disorientation

• Rapid mood swings, from euphoria to despair

• Paranoia

• Not sleeping for days, even when exhausted

• Behavior that feels completely out of character

This is a medical emergency, like a stroke or a severe allergic reaction. It requires immediate psychiatric treatment, usually hospitalization, because a person experiencing psychosis is, by definition, not able to reliably tell what's real from what isn't.

What It Is Not

Here's where I want to slow down, because this is the part that gets muddled in headlines, comment sections, and maybe even with your friends and family. 

It's not the baby blues. The baby blues are incredibly common (up to 80% of new moms experience them); they're mild, and they resolve on their own within a couple of weeks.

It's not the same as postpartum depression. PPD involves sadness, hopelessness, exhaustion, and difficulty bonding, but it does not involve a loss of touch with reality. Someone with PPD knows a scary thought is scary. Someone with psychosis may not.

It's not the same as postpartum OCD, which involves unwanted, intrusive, distressing thoughts about harm coming to the baby. These thoughts are ego-dystonic, meaning the person is horrified by them and actively avoids anything related to them. This is one of the most misunderstood distinctions in perinatal mental health, and it matters: a mom with postpartum OCD is not a danger to her baby. She is suffering, and she needs support, not shame.

And it is not a character flaw, a parenting failure, or something a person can "snap out of." It is a biological and treatable medical condition.

Why This Matters So Much to Me

Every time a case like this becomes national news, I worry about two things. First, that moms who are quietly struggling will be too afraid or ashamed to say anything, because they're terrified of being seen as dangerous, or fear that they will lose custody of their baby if they say they are struggling.

Second, that nuance gets lost, and whatever the mental health diagnosis being spoken of becomes a scary label thrown around loosely, when what it actually needs is compassion, awareness, and access to care. 

If there is one thing I hope you take from this: postpartum psychosis is treatable, and with fast intervention, the outlook for full recovery is genuinely good. This is not a life sentence. It is an emergency that, when caught, can be met with real, effective help.

CBS Sunday Morning ran a piece on this on September 6th — a woman sharing her own experience with postpartum psychosis, how she got help, went through treatment, and went on to have another baby. It's a powerful reminder that recovery is possible, and I'd encourage you to watch it. 

If You're Worried About Yourself or Someone You Love

Trust your gut. If something feels seriously "off", if a new mom seems disconnected from reality, is saying things that don't make sense, isn't sleeping at all, or is expressing beliefs that feel delusional, please don't wait it out. Call her OB, call a psychiatric provider, or go to the nearest emergency room. This is not the time for a wait-and-see approach. And if you're a mom reading this and something in your own mind feels off, frightening, or not like you, please reach out to your provider, to a trusted person, to me. You are not the first person to feel this way, and you will not be judged for asking for help. You deserve support. Your family deserves support. And no one should have to navigate this alone.

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If you are experiencing a mental health crisis, please call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room. 

Postpartum Support International also has a free helpline: 1-800-944-4773.

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https://www.cbsnews.com/sunday-morning/full-episodes/  (16mins in) 

Caitlin Hart LCPC NCC PMH-C

Managing Mom Guilt: Setting Boundaries Without the Shame

From a counseling perspective, mom guilt is one of the most common themes that shows up in my office. It often presents quietly—through anxiety, burnout, irritability, or a persistent feeling of never doing enough. While it can feel deeply personal, mom guilt is not a personal failure. More often, it is a learned response shaped by cultural expectations, relational patterns, and internalized beliefs about worth and caregiving. And yes, social media certainly doesn't help.

This blog explores mom guilt through a therapeutic lens, with a focus on how to set healthy boundaries without attaching shame.

Understanding Mom Guilt Clinically

Clinically, guilt is meant to signal that we may have violated a value. However, for many mothers, guilt becomes overgeneralized. It activates not because a true harm has occurred, but because a boundary has been set or a role expectation has been disrupted.

Many clients report guilt when they rest, say no, prioritize work, or attend to their own emotional needs. In these cases, guilt is less about ethics and more about conditioning—particularly for individuals socialized to equate self-worth with self-sacrifice.

Why Boundaries Activate Shame Responses

Boundaries often trigger shame because they challenge long-standing attachment patterns and people-pleasing behaviors. Many of us were raised with messages like "children should be seen and not heard" or that good mothers are always available, never tired, and endlessly giving.

When we set a boundary, we may unconsciously fear we are being selfish, unkind, or failing in our role. But shame thrives in silence and isolation. Naming it and understanding where it comes from, begins to diminish its power.

Reframing Boundaries as Regulation, Not Rejection

From a nervous system standpoint, boundaries are a form of self-regulation. They reduce overwhelm, prevent emotional flooding, and allow for more consistent presence.

Boundaries are not about pushing others away; they are about creating conditions in which connection can be sustained. As I often tell clients: boundaries involve short-term discomfort for long-term relational health.

Cognitive Reframing: Separating Guilt from Values

A core therapeutic intervention I've been using since attending the 2023 PSI Conference is the concept of your "Best Yes"—committing to what supports your well-being.

This includes asking yourself a few questions:

1. Will this add to my stress?

2. Is this where I want to put my "extra energy"?

3. Will I find joy in this obligation?

4. Does this support my mental health?

5. Or is this a time for a boundary—without guilt or shame?

These questions help separate true values-based decisions from obligatory yeses driven by fear or conditioning.

When Boundary Work Feels Especially Difficult

Boundary-setting is often more challenging during periods of transition or vulnerability—postpartum, during a child's diagnosis, after a loss, or when external support is limited.

Clinically, this is not viewed as regression, but as a signal that additional support and compassion are needed. You are not failing when boundaries feel hard. You are navigating complex emotional terrain, and that deserves acknowledgment.

A Therapeutic Reframe

From a counseling perspective, guilt does not always mean something is wrong. Often, it means something is changing.

Boundaries are a clinical tool for sustainability—not a moral failing. When mothers are supported in setting limits without shame, they are better able to engage authentically with themselves, their children, and their relationships.

You are allowed to have needs.
You are allowed to protect your energy.
And you are allowed to do so without earning permission.

Caitlin Hart LCPC NCC PMH-C

Providing Care and Support in a Time That Can Hold Such Polarizing Emotions

Antepartum, pregnancy, and postpartum are seasons often painted with society’s rose-colored glasses. We see images of glowing mothers and perfectly swaddled babies, but for many women, this season is far more complex.

As a mom of nearly two under two and a survivor of both traumatic pregnancy and birth, I know firsthand how challenging this journey can be. I am passionate about opening conversations around the real, often unspoken experiences of pregnancy and postpartum.

The Realities Many Women Face

Many women face infertility struggles, unwanted pregnancies, prenatal depression, medical trauma, or life circumstances that overshadow what is often expected to be a joyful season. The reality is, your experience is uniquely yours, and it doesn’t have to feel positive all the time.

You might feel:

• Excitement and fear at the same time

• Joy mixed with guilt

• Peace followed by waves of sadness or frustration

• Loneliness, even when surrounded by others

Some women have prayed, manifested, or deeply hoped for this season, while others find themselves mourning the life they had or the identity they have known. All of these feelings are valid.

Why Talking About It Matters

There is so much pressure on mothers to be grateful and happy, which can silence the real struggles happening underneath. Open, judgment-free conversation is essential during this season.

As a mental health provider, I am committed to creating a space where you can show up exactly as you are. Whether you are ready to process your birth story, explore your fears, grieve your old identity, or simply say out loud, “This is really hard,” you deserve a space to be seen and heard.

Support Is Available

While medication can be a valuable tool for some, many women benefit from non-pharmacological support, education, and consistent resources throughout their pregnancy and postpartum journey. Therapy, somatic practices, mindfulness, and community connection can help you feel supported while honoring the complexity of this season.

Holland Stidham Counseling Intern

Breaking the Silence: Navigating Maternal Mental Health Wellbeing

Maternal Mental Health is a topic not talked about enough and often misunderstood, yet it's a reality that countless women face every day. I have the honor of helping women by understanding, supporting, and empowering them as they navigate the complexities of motherhood. 

I wanted to take this opportunity during Maternal Mental Health Month to discuss this topic further, educate people, and break the stigma. 

First, let me define Maternal Mental Health(MMH): the emotional well-being of women during pregnancy, childbirth, and the postpartum period. It encompasses a range of mental health symptoms that affect mothers. The range under that MMH umbrella are postpartum depression, anxiety, psychosis, OCD, and PTSD. And Baby Blues, which is commonly used for what a mother is experiencing but tends to minimize it.  

 Here are some common signs to watch for and an excellent time to seek help: 

• Persistent Sadness

• Excessive Worry 

• Difficulty Bonding with the Baby 

• Changes in Sleep or Appetite

• Fatigue or Exhaustion

•  Irritability or Anger

• Intrusive Thoughts or Fears

• Social Withdrawal

• Loss of Interest or Pleasure

Maternal mental health is essential for mothers' and babies' well-being. Untreated issues can affect maternal bonding, infant development, and family dynamics, but seeking help from a healthcare provider specializing in perinatal mental health to get support can help. 

As a therapist, my foremost goal when working with my clients who are mothers is to create a safe and supportive space where they feel understood and validated. I want them to know that they are not alone. Throughout our therapy journey, I help them navigate their thoughts and emotions, teaching techniques to manage intrusive thoughts and regulate their emotions. Grounding exercises and other behavioral strategies become tools they can use daily to cope with challenges. I aim to destigmatize the use of medication for mental health issues, especially during the perinatal and postpartum periods. Drawing from my own experience as a mother who used medication during pregnancy and beyond, I emphasize the importance of informed decision-making. I am very grateful to my healthcare providers, who approach these decisions with empathy and understanding. Thank You! 

I hope we can continue to advocate for breaking the stigma surrounding maternal mental health, encouraging open conversations and acceptance of mental health challenges as a normal part of the motherhood journey with less guilt and shame!

Resources:

• Call or text Postpartum Support International Helpline at 800-944-4773

• Download the Connect App by PSI

• Call or Text 988

• Call or text the Maternal Mental Health Alliance Hotline 833-852-6262

Caitlin Hart LCPC NCC

Don’t let COVID-19 be your Grinch

Holidays are already a time of high stress, then sprinkle in Coronavirus, and we have ourselves a Bad Moms Christmas Special. Christmas 2020 is filled with so much: concerns about family gatherings, stress of package arrivals, financial struggles, family health, and the “normal” high expectations of delivering a perfect Christmas. So with that, this blog is speaking to all parents whose mental health check engine light is on. Here are some tips for enjoying this holiday season no matter what it looks like: 

• Set Boundaries- It is essential to be aware of your limitations and what you are comfortable doing this year. Just because you have done something in the past does not mean you must keep doing it. Let go of guilt because it is a paralyzing emotion. It blocks out the joy you deserve to feel celebrating in your home with your household family the way you feel most comfortable.  

• Be Flexible -  No holiday celebration is perfect and certainly not during COVID. View all the changes as opportunities to be flexible and resilient, create some new traditions. If the package doesn’t arrive in time, breathe in the frustration but let it go. It’s paramount to keep everything in perspective. 

• Ask for Help- You are not alone. These are not ordinary times, how many commercials have played that line. But it is true. Your mental health can only process so much at a time so call a friend and vent. 

• Do Something for You- As always, It is not selfish to take care of yourself first. With a little one glued to your side or breaking up a sibling conflict while having racing thoughts on the stress of the holidays, you need to take some time to relax and be kind to yourself. 

During this holiday season, remember to be present and find happiness in the moments, as different as they may look. Find time to relax, reflect, and recharge. I wish all a happy healthy holiday season. Goodbye 2020 and cheers to 2021 and may it bring good mental health..insert Frasier voice there.

Caitlin Hart LCPC, NCC