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Did Murderer Mom Suffer from Postpartum Psychosis?

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Dr. Michelle Golland: Stephanie Rochester, who was charged with the June 1 suffocation death of her 6-month-old son, Rylan (whom she feared was autistic), may have been suffering from postpartum psychosis. This is a horrible tragedy, whether or not she was psychotic at the time of her son's death.

Stephanie Rochester

I am sure Stephanie Rochester is going through an extensive battery of tests to find out if in fact she is experiencing postpartum depression or postpartum psychosis. We should leave it in the hands of the professionals to make that determination. But I must say, what appears to be a "delusional" belief about her child having autism does seem to point in that direction. Her emotional reaction after she discovered Rylan dead in his crib seems to point to it as well.

It appears that she was also experiencing suicidal thoughts, but didn't want to leave her husband with the "burden" of an autistic child. To some, this sounds callous, selfish and premeditated, which I can understand, but it also sounds like desperate and irrational thinking -- especially if it's out of character.

Postpartum psychosis is a stealthy illness, and it is possible that a new mom -- even one trained in mental health, as Stephanie Rochester is -- would not recognize her own confused thinking as "delusional." Neighbors have said that Stephanie told them she was experiencing postpartum depression and was not sleeping well.

The fact that her "delusional" thoughts were focused on issues of autism and the mental health of her child (if in fact that is the case) is not surprising, because often delusions can be rooted in things we know or are involved with in our daily lives. Stephanie Rochester was obtaining her master's in mental health and had worked with children with autism, which would prime her for that delusion. The delusions of Andrea Yates, the woman with postpartum psychosis who drowned her five children, focused on religion and the "souls" of her kids, because her life was centered on the church.

The severity of depression after childbirth varies widely. As many as 19 percent of women will experience some depression in the first three months after giving birth, while about 7 percent will suffer severe depression. Psychosis is rare, affecting just .2 percent of new mothers. These mental illnesses are caused by dramatic hormonal changes after childbirth. They are physical illnesses and are very treatable.

Although postpartum psychosis is extremely rare, it is a serious disorder. It is characterized by a loss of contact with reality and should be considered a medical emergency. Because of the extremely high risk for suicide or infanticide, hospitalization is usually required to keep the baby and mother safe.

Symptoms of postpartum psychosis include:

  • Hallucinations (hearing voices or seeing things that aren't real)
  • Delusions (paranoid or irrational beliefs)
  • Extreme agitation and anxiety
  • Confusion and disorientation
  • Rapid mood swings
  • Bizarre behavior
  • Inability or refusal to sleep or eat
  • Suicidal thoughts
  • Thoughts of harming or killing the baby

Postpartum psychosis is treated with medication, psychotherapy and marriage counseling. If you think that someone you know may be experiencing any of the symptoms listed above, you should discuss your concerns with her and her partner, and contact her doctor immediately. Postpartum psychosis can be deadly for the mother, her baby -- or both.

111 comments so far | Post a comment now
Anonymous June 10, 2010, 10:28 PM

Sad that a poor diet probably contributed to such a tragic situation.

Equally sad is how many mothers of new children have no idea that their imbalance of omega-6 to omega-3 fatty acids can affect their brain function.

been there June 11, 2010, 6:27 AM

Wow super article! Finally, some reasoned thinking prevails. I had postpartum psychosis and know first hand how difficult it is to see your delusion as delusion. The delusions feel like they make perfect sense and just like the good doc. said they are often around things that are important/familiar with. Thanks doc. with your insight and understanding of the condition, your female patients should know they are in good hands!

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