Dr. Veerle Bergink, MD, PhD, a leading expert in perinatal psychiatry, shares how she began studying postpartum psychosis. She shares insights from her landmark cohort study and other work, discussing sleep disruption, immune and hormonal changes, and thyroid dysfunction as factors in postpartum psychosis. She also shares unanswered questions about psychosis and bipolar, including risk factors, biological triggers, and long-term outcomes including risks around menopause.

We discuss ideal care scenarios, the importance of specialized perinatal psychiatric care, and how supporting a parent’s mental health is central to caring for the baby. Dr. Bergink emphasizes the need to GET LOUD about awareness, research, and advocacy for mothers and families.

Resources:

• Make Postpartum Psychosis a Distinct Disorder in the DSM, Expert Panel Says
• Fussy Baby Network - 888-431-BABY
• MotherToBaby - 866-626-6847
• National Pregnancy Registry for Psychiatric Drugs

Citations:

1. Bergink, V., Akbarian, S., Byatt, N., Thippeswamy, H., Vigod, S., & Payne, J. (2025, October 2). Postpartum psychosis and bipolar disorder: Review of Neurobiology and expert consensus statement on classification. - biological psychiatry. Biological Psychiatry.
2. Gordon-Smith, K., Perry, A., Florio, A. D., Craddock, N., Jones, I., & Jones, L. (2024, November 14). Associations between lifetime reproductive events among postmenopausal women with bipolar disorder - archives of Women’s Mental Health. SpringerLink.
3. Johnson, K. (2025, October 31). Make postpartum psychosis a distinct disorder, experts say. Medscape.
4. Valdimarsdóttir, U., Hultman, C. M., Harlow, B., Cnattingius, S., & Sparén, P. (2009, February 10). Psychotic illness in first-time mothers with no previous psychiatric hospitalizations: A population-based study. PLOS Medicine.

Writer and advocate Aaisha Alvi, a postpartum psychosis survivor based in Canada, shares her two experiences with PPP — first completely missed after the birth of her daughter, and later only diagnosed after seeing six different providers following a miscarriage.

Her memoir, A Mom Like That: A Memoir of Postpartum Psychosis, offers a raw look into her delusions and the barriers that often delay diagnosis and treatment, especially for women of color. She volunteers and speaks widely about why PPP must be treated as the medical emergency it is - and never be referred to as ‘rare.’

Trigger warning: We discuss intrusive thoughts of harm to herself and her baby.

Resources:

• A Mom Like That: A Memoir on Postpartum Psychosis
  • Google Books Preview
• Instagram - @aaishaalviwrites

Citations:

1. Accortt, E. et al (2023, March 19). Association between diagnosed perinatal mood and anxiety disorders and adverse perinatal outcomes. The journal of maternal-fetal & neonatal medicine
2. Bonham, V. L. (2021, January 1). Race, ethnicity, and pain treatment: Striving to understand the causes and solutions to the disparities in pain treatment: Journal of Law, Medicine & Ethics. Cambridge Core.
3. Farr, S. L et al (2020, September 3). Postpartum anxiety and comorbid depression in a population-based sample of women. Journal of women’s health.
4. Fekih-Romdhane, F. et al (2024, August 29). Relationship between childhood trauma and postpartum psychotic experiences: The role of postnatal anxiety and depression as mediators. BMC psychiatry.
5. McGuire, D. et al (2019, June 14). Prevalence of cerebral palsy, intellectual disability, hearing loss, and Blindness 2009-2016. Disability and health journal.
6. Yilanli, M. (2018, September 1). Muhammad ibn Zakariya al-Razi and the first psychiatric ward | American Journal of Psychiatry. Psychiatry Online.

In this episode, we talk with Dr. Catherine Birndorf, reproductive psychiatrist and Founder & Medical Director of The Motherhood Center of New York, to talk about postpartum psychosis, the challenges in perinatal mental health care, and what it takes to build meaningful support for women and families.

Dr. Birndorf shares:

• The clinical realities of postpartum psychosis — how it presents, how it’s distinguished from mood and anxiety disorders, and why rapid treatment matters
• The relationship between postpartum psychosis and bipolar disorder
• The default treatment approaches, including hospitalization and medication
• Why developing a partial hospitalization program in the U.S. is so difficult — from insurance barriers to legal limitations
• Her mission-driven commitment to women’s mental health, including advocating for informed choices, supporting women in a still-paternalistic medical system, and honoring the feminist values that shaped her
• How The Motherhood Center offers a level of support that many outpatient women’s programs don’t — especially for those who need structured, intensive care

We touch briefly on my own experience with postpartum psychosis; I’ll share more of that conversation in an upcoming personal reflections episode.

Trigger warning: we mention as an aside the importance of treatment for postpartum psychosis considering realities of potential infanticide or suicide.

Resources:

• The Motherhood Center of New York - Dr. Catherine Birndorf
• Dialectical Behavior Therapy (DBT) Psychotherapy Interventions in the Perinatal Period
• The Center for Women's Mental Health at Mass General - Dr. Lee Cohen
• Telepsychiatry offerings (California) - Dr. Vivien Burt
• Women’s Mental Health Program at University of Wisconsin - Madison - Dr. Zachary Stowe
• Psychiatry offerings at Columbia University - Dr. Meg Spinelli

Citations:

1. Fekih-Romdhane, F., Hadathy, D. E., Malaeb, D., Barakat, H., & Hallit, S. (2024, August 29). Relationship between childhood trauma and postpartum psychotic experiences: The role of postnatal anxiety and depression as mediators - BMC psychiatry. BioMed Central.
2. Gemmill, A., Franks, A. M., Anjur-Dietrich, S., Ozinsky, A., Arbour, D., Stuart, E. A., Ben-Michael, E., Feller, A., & Bell, S. O. (2025, April 15). US abortion bans and infant mortality. JAMA.