Temporary Sabbatical from Blogging

Back in July, I knew I was taking a break from blogging.  Though, I didn’t realize that I wouldn’t be blogging for THREE MONTHS–the longest break I’ve ever taken from blogging!  Had I known that was going to be the case, I would’ve blogged about “Going on a Temporary Sabbatical from Blogging” back then.  It’s the fastest three months I can ever recall!   And it’s not because I was having fun during this time either.  I had to sacrifice many a night and weekend during my favorite season to study for an exam, which required weeks of reading and 1,560 practice questions–all of which was dry as all heck.

To ensure no distractions, I decided to step back from Facebook.  I follow some 550 or so Facebook pages, so what I did was set up a special feed that would enable me to see my friends’ updates and exclude all the posts of those 550 or so Facebook pages, which quite honestly used to take 2-3 hours a day of my time to scroll through (and read some of the articles that I found interesting).  I needed to ensure I  devoted ALL my energy and time after work and on weekends to study.

I wasn’t required to take this exam but I had to do this for myself.  I figured it could only bolster my credentials.   I set the exam date for October 18 ( to ensure I wasn’t tempted to postpone for an indefinite period of time), which was a week ago.

Good news is I PASSED!

It has taken me a week to unwind from both my anxiety levels and the study mode I forced myself to be in.  And now I am about to begin studying for yet another exam, which I hope to take in the next couple of months.  So, I am not returning to blogging just yet.

My passing this exam is proof positive that…..

You’re NEVER too old/ it’s NEVER too late to accomplish something if you put your mind to it….and along the same veins, it’s never too late to go back to school and/or change career direction!

Happy Mother’s Day – 2013

spring2013I’ve written a Mother’s Day blog post each year since I started up this blog in 2009.  After a while, my posts from one year to the next start sounding the same.  I’ve blogged in the past about mompetitions, just as I have blogged about the fact that all too many mothers (i.e., one out of eight) are suffering from postpartum depression (PPD) but you wouldn’t necessarily know that because they can hide their suffering so well, feeling too ashamed to talk about it.  Or like me, they don’t even realize they are suffering from a postpartum mood disorder because the vast majority of our population is lacking in knowledge when it comes to mental health awareness–especially as it pertains to motherhood.  As I’ve mentioned countless times before, the public seems to keep on thinking that the birth of a baby can only be one way–i.e., a beautiful and joyful experience.

May is Maternal Mental Health Awareness Month, as most if not all of you know from reading my last post which is part of Postpartum Support International’s very first blog hop.  If you haven’t visited some of the blog hops posts from PSI’s 2013 blog hop, I recommend that you do so.  If you are experiencing PPD and feel alone…please know that you are far from it.  Take celebrity moms speaking up as an example.  These brave women have gone public with their experiences so that others would not follow in their footsteps in terms of feeling alone.  Now, if only these celebrities can get more involved with PPD advocacy.  We need more moms with a public platform speaking up and helping to combat stigma and spread awareness!

Now, for my Mother’s Day message:

For all the moms out there, remember self care
Is the single most important piece of advice I can give you.
If you are a brand new mom, just remember that
Without adequate rest and nutrition after childbirth
And with exhaustion and physical changes–
Not to mention sleep deprivation and getting up every couple of hours for feedings–
You are opening the door wider for PPD to sneak up on you.

If you are a mom with older children like me,
You may feel the way I now do about this Hallmark occasion.
No more do I need to eat at a fancy restaurant and receive a nice gift from the hubs.
Instead, I look forward to the simple pleasures of
Spending time with family and extended family.
Maybe even visiting a garden or two and take in the spring  flowers
Blooming all around us….nature can have a very calming effect.
I also look forward to just chilling because–
If you are a working mom like me–
You just want to do nothing, really, but relax and
Do something just for you and don’t normally have time for,
Like getting a pedicure or going shopping.

For all those who have a mom (or two) you care about
And will be celebrating Mother’s Day with her today,
Please remember (especially if this is a new mom) that the greatest gift
You can give her is emotional and practical support.
Don’t provide advice unless she asks you for it.
Do provide a shoulder to cry on if she’s having a rough day.
Do provide help so she can get the rest she needs
And/or time to do something just for herself.

Happy Mother’s Day to all the moms out there!

Here’s a wish from one mother to another!

xx

Sydney_me

Please Join: Webinar on Overcoming Anxiety While Trying to Get Pregnant – September 27, 2012

Last night, I saw information come up in my Facebook news feed from my friend and Executive Director of  Postpartum Support International, Wendy Davis about this free webinar at 10:00 AM PST (or 1:00 PM EST) this  Thursday, September 27th, on the relationship between infertility and anxiety.  The subject of the webinar immediately grabbed my attention and I knew right away I needed to try to spread the word about it.

Please visit the website of perinatal specialist and mental health therapist, Robin C. Gibler, MA, to find out how you can join what I expect to be a very informative webinar.  Even if you can’t make it to the live call, you can get a copy of the recording as long as you register.  When you register, you will receive instructions on how to access the webinar (via phone with web simulcast).

Aside from the relationship between infertility and anxiety, Ms. Gibler will be talking about the symptoms of perinatal anxiety, who is vulnerable to it, how to seek help to address perinatal anxiety before it worsens, and how it typically continues on into the postpartum period, especially if you don’t seek any help to address your perinatal anxiety before baby’s arrival…..pretty much the major touch points of one of my most popular blog posts: “Unresolved Grief & Anxiety from Multiple IVF Cycles and Years of Trying to Have a Baby: Risk Factors for Perinatal Depression.”  If you haven’t already read this blog post, please do so now, especially if you are currently experiencing anxiety while trying to get pregnant with or without IVF.

The topic of this webinar is very near and dear to my heart.  If you are experiencing anxiety while trying to get pregnant with or without IVF, please, please, please do yourself a HUGE favor and join this webinar.  Knowledge is power.  Don’t follow the path that I took…in the dark, ignorant, blindsided, fearful, and suffering–rather than enjoying–your first few weeks/months of motherhood.  Because anxiety that goes unchecked during pregnancy can have a devastating impact postpartum.  Believe me.

Introducing Regroup Therapy, a New Online PPD Support Group Led by Licensed Professionals!

Looking for a non-judgmental forum through which new moms can come together for support, learn ways to cope with the stress of first-time motherhood, and share difficulties in adjusting to motherhood…..all while participating in the comfort and privacy of your own home?

Regroup Therapy offers video support groups for new moms experiencing postpartum depression (PPD) and/or difficulties adjusting to motherhood.  Each group is moderated by a licensed therapist who has experience treating PPD.

Have privacy concerns? The only information about you that will be shared with anyone is your first name.

Worried about your appearance?  No one’s going to know whether you’ve brushed your teeth, taken a shower or even changed out of your pajamas.  In fact, PJs are welcome!

Want to know that you’re not alone in your experience?  You can see the faces of the other participants and of the moderator, as if you were in the same room with them.

Not sure if you have the right equipment to join?   Accessing the video support groups are easy.  No special equipment other than a PC with broadband Internet connectivity and webcam is needed. Before joining a session, be sure to click here for instructions and click here

When’s the next session and how much is it going to cost me?  The next FREE session moderated by Dr. Pec Indman, co-author of “Beyond the Blues” will take place on April 13, 2012 from 1:00-2:15 PM EST (or 12:00-1:15 PM CST). Yes, you heard right.  FREE! During its beta (or launch) period, Regroup Therapy is offering FREE sessions.  All that they ask of you is to provide a minute of your time to provide feedback after the session.

If Only There’s Such a Thing as a Real-Time Bleeper for Ignorant Words Used in Media Re: PPD

Okay, so much for the 6 blog posts I still have yet to post.  This one now takes precedence!

The purpose of tonight’s post is to provide a wonderful example of PPD moms/survivors speaking up when they see something misleading (to put it nicely) about postpartum depression (PPD) in the media.  This time it was an article over at babycenter.com titled “Can color cure PPD?”  What?  Whoa!  Hold on to your horses.  <record scratch>  I had to do a double take, and then when I did, I realized with dismay “Oh, great! Here we go again. Another false claim to an easy way out of PPD.  A reliable cure for PPD. And yes, this time it’s in the form of….hold onto your seat….COLOR THERAPY!  All you need to do is purchase these beautifully-colored tank tops and bras, and voila, NO MORE PPD!”

Seems like all the reactions to this article in the form of tweets and blog posts occurred during work hours for me, so by the time I realized what was going on, the damage control had already been done.  The title was changed to a much more realistic and acceptable one “Can color help postpartum blues?”  Much, much better and thank you babycenter.com!  And thank you to all the individuals who tweeted, posted on Facebook, and wrote blog posts!  Look at the good that comes out of speaking up!

I feel so encouraged by this, because such concern and diligence for public awareness is of utmost importance in combating the plague that refuses to be cured….otherwise known as STIGMA.  Kudos to all the fellow stigma/myth busters and maternal mental health champions (a/k/a #PPDArmy)!  I am so, so glad to see how the growing number of PPD moms are on the alert and addressing ridiculousness like this.

This is one of my favorite tweets I spotted.  It’s by @SocraticMrMeth: “seriously. #PPD kills and @Babycenter has whipped back to the 50′s to suggest women try prettying up some, not ‘SEE A DOCTOR RIGHT AWAY’.”

I’d like to highlight the efforts of the following #PPDArmy, all of whom I know from Twitter:

  1. Amanda’s tweet: “I am disgusted that you would use #PPD to market tank tops! Way to make #PPDmoms feel no support!”
  2. Kimberly’s tweet: “I’m actually wearing neon bra and matching undies. Last time I checked I was still depressed.”
  3. Esther Dale’s comment on the babycenter.com Facebook page.
  4. Comment to the article by Lexy: “As a two-time sufferer of PPD, I opened this with genuine interest. I was then met with a somewhat bland description of postpartum depression which quickly transferred into a sales pitch for a tank top. Granted, I love clothes too, and I’d probably be very interested in this shirt otherwise. PPD is a bigger, uglier beast than that – clothes and bright colors won’t ‘cure’ it. It almost makes PPD sound like a malady a new mom can quickly overcome or ‘snap out of.’ I’m normally not one to be argumentative, but this subject hit close to home.”
  5. Comment to the article by Amanda: “As a mom currently suffering from PPD that required hospitalization, continued therapy, and meds I find it offensive that you would use PPD as a way to market tank tops…I have been an avid user of your site but will no longer be visiting. I find this as inappropriate as if the headline read Can Color Cure Cancer? No it can’t.”
  6. Comment to the article by Stephanie: “That title is offensive. PPD is not just being sad after having a baby. It’s not about the stress of the adjustment. It’s not about feeling frumpy and different. It is a medical condition that makes some women want to harm themselves or their babies. It can literally ruin the bonding between mother and child.”
  7. Comment to the article by Andrea: “I find this pretty offensive that you could even suggest that color could help postpartum blues!!! As someone who has been through ppd, I know that seeing brighter colors didn’t cure me. This makes me sad that there are women out there really struggling & may find hope when seeing a title like this then just to be disappointed. There is obviously still a lot for you to learn about postpartum mood disorders.”
  8. And of course there was Lauren, author of the My Postpartum Voice blog and #PPDChat moderator on Twitter, armed with her wit, came up with this tweet: “So we should have been prescribed a colour wheel instead of meds and therapy?”  Speaking of Lauren if you haven’t been over to her awesome post in response to this article, then please hop on over there now!  Here’s an excerpt:  “Postpartum Depression is a diagnosis. It’s not a marketing tool, people…….Dear marketers, please, do not use the term “cure for PPD” in your materials. It’s highly offensive and ultimately disingenuous to vulnerable mothers and desperate family members truly searching for successful treatment options.”

I so wish there was such a mechanism as a real-time bleep for every ignorant word used in conjunction with perinatal mood disorders.  But we are much better-equipped for handling such situations than we were just a few years ago, thanks to the #PPDArmy!

You ladies give me hope.  You ladies rock!

Postpartum Psychosis – Know the Facts and Stop Judging Based on Ignorance

Yesterday, I stumbled across a disturbing article that shows just how mired in stigma postpartum mood disorders (PPMDs) are, particularly postpartum psychosis (PPP), and how people just cannot understand why it is necessary to have a separate category of infanticide in cases where it is proven that an infant < 1 year of age dies by the hands of his/her mother who is suffering from postpartum psychosis.  I am not going to post a link to that article because it is completely ludicrous and not deserving of any further attention than it may already be getting.   Nor am I going to quote any portions of the article or any of the biased comments.  Instead, I’m getting my thoughts out via my own blog.  I wasn’t about to post a comment and be eaten alive by people who haven’t a freakin’ clue and who insist on voicing their self righteous opinions, going off on anti-women and anti-abortion tangents.  Not worth my effort whatsoever.   

All I will say is this.  As long as society doesn’t educate people on the truth behind the various PPMDs, they are going to continue to be stigmatized and mothers suffering from a PPMD will be afraid to get the help they need.   In my opinion, the medical and mental health care communities are largely responsible for not educating the public about PPMDs.   Keeping quiet about PPMDs isn’t going to make them go away. Most people are not aware that the rate of PPD in new moms is ONE IN EIGHT.  I just blogged about that in my last post.   Per the Postpartum Support International website, PPP occurs at a rate of  approximately 1-2 of every 1,000 deliveries (or approximately .01% of births) , with a 5% risk of infanticide/suicide.  And we don’t even know just how many mothers out there fall through the cracks as far as proper diagnosis and treatment for PPMDs are concerned.  

In the United Kingdom, because PPP is recognized as an illness rather than a crime, infanticide by a woman diagnosed with PPP is treated rather than put in jail for murder.  There are about two dozen other countries that have put infanticide laws in place, which they have basically modeled after the British one.  Australia, Austria, Brazil, Canada, Colombia, Finland, Germany, Greece, Hong Kong, India, Italy, Japan, Korea, New Zealand, Norway, Philippines, Sweden, Switzerland, and Turkey. 

How many times do you hear about mothers killing their children via drowning, suffocation or some other terrible means?  Yes, these stories reflect the unthinkable, the unimaginable.  But who knows what condition these mothers were in?  Did these women try to warn anyone that they weren’t feeling themselves?  Did they show signs of severe depression that went ignored by loved ones and even doctors?   Did they get help but were prescribed the wrong course of treatment? 

People ignorant about PPMDs don’t understand why a mother who isn’t feeling well after childbirth doesn’t just get help.  These people prefer to stay in the rut of ignorance they’ve fallen into and can’t (or refuse to) climb out of.  These people would prefer to blame the new mom for their actions without considering what the woman’s situation may have been like.   In my humble opinion, if a new mom is diagnosed with PPP by an expert in that field, that determination MUST be factored in during the trial for sentencing purposes.

Barriers to progress include, but are not limited to, the following…..as I’ve said time and time again:

  • All too many mothers are still afraid of speaking up and getting help today.  Look at the stigma and the awful things that get written in the media and on blogs.  Due to lack of public awareness campaigns, all too many mothers still don’t know enough about PPMDs to know when they are suffering from one, let alone how to get help.  
  • Not all mothers who need help have access to doctors, therapists and support services within their communities that are adequately equipped and trained to help moms suffering from PPMDs. 
  • Not all mothers have family members that can help care for the new baby and the new mom.   There are all too many moms out there fending for themselves and their babies on their own, including single moms and moms whose husbands don’t help at all, either because they’re always at work or are unwilling to help (yes, there are men like this).

The main keys behind reducing the occurrence of PPMDs among new moms include:

  • SUPPORT:  Ensuring moms get the emotional and practical support they need after childbirth
  • EDUCATION:  Ensuring an increase in public awareness about PPMDs, including what they are, why they occur, how to minimize risk of occurrence, and how to recognize when someone has a PPMD and how they can get help (medical/therapy)
  • EARLY DETECTION AND PROPER TREATMENT:  Ensuring all medical/mental healthcare practitioners are trained to detect, diagnose, and treat PPMDs properly

Until these 3 points are satisfied, women will continue to fall through the cracks with sometimes tragic consequences, and they are victims of a society that all too often focuses its priorities in the wrong places. 

I’ve blogged about these 3 points before, but I haven’t really ever blogged about PPP or postpartum OCD (which is all too often confused with PPP).   Both Postpartum Progress and Beyond Postpartum contain many helpful posts–too many to list here–on both these PPMDs.   Just visit these blogs and do a search of those two terms.

What is PPP?

PPP can occur anywhere from 24 hours to 2-3 weeks postpartum.  PPP is always considered a medical emergency that requires the mother to be hospitalized so she can be monitored and treated.  A woman with PPP typically alternates between reality and losing touch with reality, with episodes characterized by command hallucinations to kill the baby or delusions that the infant is possessed.  You may think that the one case you hear about that involves delusions relating to the devil—think Andrea Yates—is a purely isolated case.  Unfortunately, it’s not.

The leading risk factor for PPP is a personal and/or family history of bipolar disorder, schizophrenia, psychosis, or mental illness.   Bipolar disorder (more commonly known as manic depression) is characterized by extreme mood swings (thus, bipolar) alternating between highs (mania)—where they may experience elevated moods and increased energy levels, confidence, productivity, sociability and creativity—and lows (depression).  

There is risk that some woman suffering from PPP—who experience symptoms of both mania and depression—can mistakenly be misdiagnosed with and treated for PPD.  The danger of this is that some medications used to treat PPD can actually aggravate the symptoms and lead to disastrous consequences, as in the case of Andrea Yates, which I will talk about later in this post. 

PPP can be hard to diagnose because the woman can have periods of high energy, which can be mistaken for happiness.  This period is characterized by so much energy to the point of never feeling tired and no need for sleep.  During the first couple of weeks after her baby is born, a woman in the hypomanic phase feels energized and on top of the world, thinking to herself: “Gee, this is how those supermoms out there feel.  Motherhood is just as easy as those moms make it look.”  After leaving the hospital and without ever needing to rest, she goes straight into taking care of the baby along with doing all the housework, cooking and shopping without any help whatsoever.    

Symptoms of hypomania/mania may include some or all of the following:

  • Increased energy; hyperactivity; restlessness
  • Decreased need for sleep
  • Feeling elated
  • Racing/disorganized thoughts
  • Increased energy, productivity, creativity
  • Feeling overly confident
  • More talkative, rapid speech
  • More outgoing
  • Impulsive behavior

Because the symptoms of hypomania have the tendency to create the impression that the new mother is merely excited about the baby and motherhood, PPP has the tendency to be missed until after the hypomanic phase is over and a mother sinks into a deep depression, after which the following symptoms may develop and become dangerous if she doesn’t get help quickly.  

  • Hallucinations (visual/auditory)—hearing, seeing, feeling and even smelling things that aren’t really there—often characterized by voices or a vision of someone instructing the mother to kill the baby.  Inability to distinguish between reality and hallucinations; when hallucinating, fully believing what she is thinking, hearing and/or seeing represents reality.
  • Paranoia and irrational/delusional thoughts/fears, such as denial of the baby’s birth or other random feelings of suspicion that can cause violent behavior.  In the midst of a violently psychotic episode, some even seem to gain superhuman powers, such as being able to rip a radiator out of the hospital wall.
  • Feeling like your thoughts are no longer your own and you can no longer control them.
  • Rambling and incoherent speech
  • Confusion, incoherence and poor judgment
  • Extreme and rapid mood swings
  • Extreme agitation
  • Belief that she must kill herself and/or the baby

A woman in the delusional state of PPP should never be taken lightly by those around her, as there is a high incidence of suicide and/or infanticide when PPP goes undiagnosed and untreated.  It’s during the extreme lows that new mothers with psychosis may try to commit suicide and/or hurt/kill her baby.  It’s really sad when you hear about those who succeed. 

What Loved Ones Should Be Aware Of:

Firstly, at the slightest hint of suicidal or infanticidal thoughts by a new mother, medical help should be sought immediately and the baby should not be left alone with her—not even for a minute.  All it takes is a minute for disastrous consequences to occur.  Do not wait to see if things get any better.  I’ve read of many instances where the behavior was ignored until it was too late. The mother should be hospitalized to protect her life and that of her baby’s.  The hospital is a place where the mother and baby can be safe, cared for and monitored until the mother is able to provide adequate care for herself and her baby. Going to an ER is the best way to guarantee medical attention immediately, since most doctors will not likely be able to see her right away without an appointment made in advance.

In any of these situations, call 911 or the national suicide hotline (National Hopeline Network) at 800-784-2433.

You should seek help for her immediately when any of the following occurs—don’t wait:

  • At the first sign of a change in personality or bizarre behavior.
  • If she insists she does not need rest and seems highly energized.  If she doesn’t seem to be in keeping with the fact that she’s just given birth and should take it easy.  For example, planting flowers is not typically unusual behavior but should be questioned if a new mom is doing it upon arriving home after a c-section.
  • When you can’t seem to get through to her.
  • She seems confused or on a different wavelength or lost touch with reality.
  • Where there is weird/paranoid/delusional behavior (says/thinks illogical things about things/people).
  • If she complains of imagining or hearing things.

 

Andrea Yates

Pretty much everyone in this country has heard about the Andrea Yates case.  After each of her children were born, she suffered PPD but never sought treatment until her 5th child was born and she developed PPP.  She still didn’t seek any help because she did not realize the dangers of her PPP.  On June 20, 2001, she decided she had to drown her children in order to save them from Satan.  Instead of receiving treatment for her PPP, she was sentenced to life in prison.  On January 6, 2005 the Texas Court of Appeals reversed the convictions due to the determination that the psychiatrist who served as a prosecution witness had given materially false testimony during the trial.  On July 26, 2006, with an expert testifying in her defense, she was found not guilty by reason of insanity, as defined by the state of Texas.  She is now staying at a low security state mental hospital in Texas. 

Had she and those in her life known that her symptoms indicated she needed immediate hospitalization, her children would still be alive today.   Not heeding her psychiatrist’s warning never to leave her alone with the children, her husband Rusty did just that.  Between the time he left to go to work and the time his mother came to help with the children—a span of an hour—Andrea drowned all 5 of her children.  In fact, without consulting the doctor and against medical advice, Rusty began to leave his wife alone with the children for several weeks prior to the drownings.  It appears that Rusty is in large part responsible for what happened, not only for ignoring the psychiatrist’s warning but also to persuade Andrea they should continue to have children despite warnings from Andrea’s psychiatrist against doing so. 

Additionally, Dr. Lucy Puryear, the expert witness for the defense regarding PPP, indicated she did not think Andrea would have ever drowned her children if it hadn’t been for the religious influences of her minister, Michael Woroniecki.  Per Wikipedia, it was because of him that Rusty and Andrea “built a framework of homicidal and suicidal delusions in [Andrea’s] ill mind through ‘relentless gloom and doom sermonizing’….and [Andrea] had come to believe [through his sermons and a 1996 video they had received from the minister] that she was a ‘bad mother’ who was spiritually and behaviorally damaging her children, and that it was better to kill herself and her offspring rather than to allow them to continue ‘stumbling’ and go to hell.”

This tragedy would not have happened if everyone with whom the Yates came into contact during those years in which Andrea was obviously not well were educated about her risk for and dangers of PPP, advised them on what to do and actually tried to do something along the lines of helping to provide adequate social support and even intervention.  In terms of Andrea’s risk for PPP, Andrea’s father and brother both had bipolar disorder and her mother, sister and other brother had a history of major depression.  Her story is a prime example of how our healthcare system and society overall fail mothers.  Even today, most people know about the Andrea Yates case but very few individuals realize that she had suffered from PPP.  Only those educated about PPD and PPP or have experienced either one firsthand can truly emphathize with her.  The general public thinks such a monster deserves to be put away for life or have her own life taken away for snuffing out the lives of all 5 of her children.  Her story shows how desperately in need we are of putting public awareness of perinatal mood disorders up at the top of the priorities in this country.

Difference between Postpartum OCD and PPP

It is unfortunate and quite scary that these distinctions still elude many doctors, which does nothing to motivate mothers to reveal their experiences.  Unfortunately, because not all healthcare professionals are adequately trained about postpartum mood disorders, they are unable to successfully distinguish between postpartum OCD symptoms and PPP.  If you are experiencing postpartum OCD symptoms, share them as soon as possible with someone you trust and who is nonjudgmental and sympathetic, most preferably a therapist who can help treat your condition. If you do not know any therapists or don’t know anyone that can recommend one to you, you can contact Postpartum Support International for names of therapists in your area.    

The mother with postpartum OCD experiences recurring, obsessive, sickening, frightening and mostly violent thoughts/mental images. The postpartum OCD mother, realizing these uncontrollable, unwelcome thoughts are repulsive, irrational and not normal, would never let any harm come to her baby—even taking specific steps to protect the baby, like making sure she is never left alone with the baby and letting someone else take care of the baby until she is herself again.  Deep inside she knows she loves and would never hurt her baby, but her thoughts are terrifying enough to make her doubt herself and feel anxious about being left alone with the baby. 

The mother with PPP, on the other hand, has delusional beliefs about the baby (e.g., baby is a demon or Satan said she had to kill the baby in order to save the baby’s soul), and is capable of acting on her thoughts of harming the baby.  Women with PPP are unable to tell right from wrong, fully believing the delusion they are experiencing is real.  The PPP mother may—thinking that she is doing something difficult but morally right—hurt and possibly even kill her baby and/or herself as a consequence of her delusions.

In short, a woman with postpartum OCD realizes that these thoughts are disturbing, not normal and not real, while a woman with PPP isn’t disturbed by these thoughts because she thinks they are real, rational and in some cases are coming from someone else, like God or Satan (unfortunately there is something to the saying “the devil made me do it”) telling her that the baby is possessed or destined for a terrible fate, and she must follow his instructions if she hopes to set things straight.