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Friday, July 31, 2009

PSI’s response the Otty Sanchez case


Postpartum Support International is aware of the tragic Otty Sanchez infanticide case in San Antonio.  While we are unable to comment on the specifics of this particular case because we don’t have the details,  we would like to respond to some errors we have seen in the media with regard to this case:

· Postpartum depression and postpartum psychosis are very different illnesses and are not interchangeable.  With postpartum psychosis there is a real break from reality, whereas with postpartum depression or anxiety, the woman is in distress but in touch with reality. An informed medical professional can and should assess whether a woman is depressed, anxious, or psychotic.

· When the subject of postpartum depression (PPD) comes up in the media, it is often accompanied by misinformation and erroneously linked to mothers who commit infanticide, abuse or neglect their children.  There is NO direct correlation between infanticide, abuse or neglect and postpartum depression.  Making these incorrect connections only serves to unnecessarily stigmatize women with PPD and make them more afraid to reach out for professional help.  Women with postpartum depression do not harm their children.

· Most women who experience postpartum psychosis do not harm themselves or anyone else. However, there is always the risk of danger because psychosis includes delusional thinking and irrational judgment.   It is, therefore, considered a psychiatric emergency when a woman is suffering symptoms of postpartum psychosis, and she is often committed to a hospital for careful monitoring and treatment.

· Postpartum psychosis always includes delusions, disordered thinking, and sometimes includes auditory or visual hallucinations. In her psychotic state, the delusions and beliefs make sense to her; they feel very meaningful and are often religious. As opposed to non-psychotic religious states, women often mix spiritual beliefs with paranoia and a very personal identification with the divine. Before any psychosis is evident, there are often fluctuating states of mania, depression, and significant detachment. The first symptoms of Postpartum Psychosis might start within the first 3 or 4 months postpartum, but most often symptoms start within the first four weeks postpartum.

· From the few details available, it does not appear that Otty Sanchez was suffering from postpartum depression.  Women with postpartum depression do not suffer from delusions or command hallucinations.

· It must be understood that a woman in a postpartum psychosis might understand the concept of right and wrong according to the law of the land, but at the same time might be hearing commands that she fully believes to arise from a higher and more powerful authority. These delusions are extremely powerful and she may feel compelled to follow instructions as if everything depended on her actions.

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