SCOTT SIMON, HOST:
The Lindsay Clancy case ended in mistrial yesterday. There have been weeks of live TV coverage, rallies outside the courthouse and days of tense jury deliberation. It's all sparked discussion too, about maternal mental health, specifically postpartum psychosis. Clancy's defense team argued that's what she was suffering from when she killed her three children and attempted suicide. NPR's Rhitu Chatterjee reports that the condition is often missed or misdiagnosed.
RHITU CHATTERJEE, BYLINE: Psychiatrist Dr. Jennifer Payne at the University of Virginia specializes in women's mood disorders. She says there's a big reason why healthcare providers don't know much about postpartum psychosis.
JENNIFER PAYNE: Postpartum psychosis is a rare psychiatric condition that occurs in about 0.1% to 0.2% of all pregnancies.
CHATTERJEE: Payne has only seen a handful of cases during her decades-long career. She says an OB-GYN or a general psychiatrist might only see one or two.
PAYNE: That is part of the problem. And that is also part of the problem of why we cannot amass a large number of cases quickly to understand the biology.
CHATTERJEE: One major symptom of postpartum psychosis is mania, which is relatively easy to diagnose.
PAYNE: The mood is elevated, and energy is elevated. So thoughts typically go really fast. Speech is fast. They may engage in really unusual behaviors for themselves. And it's pretty obvious when someone is presenting with mania. They typically end up in the emergency room.
CHATTERJEE: She says depression is also a symptom. When that's the case, women often get diagnosed with postpartum depression because it's much more common. But Payne says...
PAYNE: Typically, the cases I've seen are not responding to classic treatment for postpartum depression.
CHATTERJEE: Such as Prozac or Zoloft. Another prominent set of symptoms include delusions and hallucinations, but Payne says women are often reluctant to reveal that to their provider because of stigma. Another group of symptoms are milder, cognitive ones.
PAYNE: Patients will complain of brain fog or not being able to get organized. And again, these are subtle symptoms.
CHATTERJEE: Symptoms that physicians can easily miss. She says most providers simply aren't aware of postpartum psychosis or how to treat it. Payne and some psychiatrists specializing in maternal mental health want to have the condition listed in the Diagnostic and Statistical Manual, or the DSM, which doctors use to diagnose mental and behavioral health conditions. Dr. Nancy Byatt is a perinatal psychiatrist at UMass Chan Medical School.
NANCY BYATT: Having postpartum psychosis recognized in the DSM, I think, is an absolute important step.
CHATTERJEE: In fact, she says the DSM should list all maternal mental health conditions.
BYATT: Currently, there is no chapter on women's mental health in the DSM. And there is very little recognizing that women's physiology is different.
CHATTERJEE: And women are at a higher risk of mental health disorders during pregnancy and postpartum - disorders that put women and, in rare cases, even their infants' lives at risk. Byatt says these conditions are treatable.
BYATT: In pregnancy and postpartum, we have effective treatment options for postpartum psychosis, for depression, for anxiety, for bipolar disorder.
CHATTERJEE: Postpartum psychosis is treated with two drugs, says Dr. Jennifer Payne.
PAYNE: Lithium, which is a mood-stabilizing medication, plus an antipsychotic medication.
CHATTERJEE: Patients respond well to those drugs, she adds, often within days.
Rhitu Chatterjee, NPR News.
SIMON: And if you or a loved one is experiencing a mental health crisis, please call or text the national Suicide & Crisis Lifeline - 988.
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