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.

Jigyna shares her powerful personal journey through perinatal mental health challenges. She is a South Asian mom of three, maternal mental health advocate, and support group facilitator with PSI, Group Peer Support, and The Policy Center for Maternal Mental Health.

From fertility struggles and PCOS to a traumatic first birth, and from postpartum depression and anxiety to undiagnosed postpartum psychosis marked by violent visions, dancing knives, and seeing in black and white, Jigyna’s story is both harrowing and inspiring. She also reflects on a later surprise twin pregnancy and the impact of cultural stigma within her South Asian community.

In this conversation, Jigyna highlights the importance of sleep, advocating for yourself, and leaning on community - even when recovery isn’t linear. She shares wisdom on postpartum planning, giving space for ups and downs, and the power of connection in supporting moms through their journeys.

Trigger warning: We discuss symptoms of depression and postpartum psychosis, including violent delusions and suicidal thoughts. Please take care as you listen.

Resources:

• PSI Postpartum Plan
• Postpartum Plan - Postpartum Virginia
• Postpartum Wellness Workbook - The Nesting Place
• PSI Support Groups
• Group Peer Support Groups

Citations:

1. Bergink, V., Akbarian, S., Byatt, N., Chandra, P., Cirino, N., Dazzan, P., & De Witte, L. (2025a, October 22). Postpartum psychosis and bipolar disorder: Review of Neurobiology and expert consensus statement on classification. - sciencedirect. Biological Psychiatry.
2. Bergink, V., Akbarian, S., Byatt, N., Chandra, P., Cirino, N., Dazzan, P., & De Witte, L. (2025b, October 22). Postpartum psychosis and bipolar disorder: Review of Neurobiology and expert consensus statement on classification. - sciencedirect. Biological Psychiatry.
3. Gaskell, C., Simmonds-Buckley, M., Kellett, S., Stockton, C., Somerville, E., Rogerson, E., & Delgadillo, J. (2022, October 6). The effectiveness of psychological interventions delivered in routine practice: Systematic review and meta-analysis. Administration and policy in mental health.
4. Schoretsanitis, G., Gastaldon, C., Kalaitzopoulos, D., Ochsenbein-Koelble, N., Barbui, C., & Seifritz, E. (2021, December 23).Polycystic ovary syndrome and postpartum depression: A systematic review and meta-analysis of observational studies. Journal of affective disorders.

In this episode, Sarah - a nurse, mom, and mental health advocate - takes us inside her whirlwind journey through postpartum psychosis. From a premature birth and NICU stay to walking into her own workplace in the grips of psychosis and professing her love to her once boss, Sarah shares the moments that shocked her and those around her.

She uses a tornado as a metaphor for the chaos of postpartum psychosis, reflects on her bipolar diagnosis, and wonders about the connection between thyroid health and mental health. Most importantly, Sarah shows how recovery is possible and why whole-family support, sleep, and community matter.

Trigger warning: we discuss some death related delusions, and suicidal thoughts. Take care as you listen.

Resources:

• Sarah’s instagram
• PSI Online Support Groups
• PSI Peer Mentor Program

Citations:

1. Bergink, V., Kushner, S. A., Pop, V., Kuijpens, H., Berg, M. P. L. den, Drexhage, R. C., Wiersinga, W., Nolen, W. A., & Drexhage, H. A. (2018, January 2). Prevalence of autoimmune thyroid dysfunction in postpartum psychosis: The British Journal of Psychiatry. Cambridge Core.
2. Caropreso, L., de Azevedo Cardoso, T., Eltayebani, M., & Frey, B. N. (2019, December 4). Preeclampsia as a risk factor for postpartum depression and psychosis: A systematic review and meta-analysis. Archives of women’s mental health.
3. Cohen, L. S., Arakelian, M., Church, T. R., Dunk, M. M., Gaw, M. L., Yoon, H. E., Kobylski, L. A., Vanderkruik, R., & Freeman, M. P. (2024, December 6). The phenomenology of postpartum psychosis: Preliminary findings from the Massachusetts General Hospital postpartum psychosis project. Nature News.
4. Soh, X. C., Majeed, N. M., Sim, L., Reyes, M., Ling, N., & Hartanto, A. (2025, August 18). Prevalence of depression, anxiety, burden, Burnout, and stress in informal caregivers: An umbrella review of meta-analyses. ScienceDirect.

In this episode, we meet Katrina — a twin mum, former teacher, and maternal mental health advocate from Sydney, Australia. Her twins were born prematurely at 33 weeks and spent time in the NICU. After delivery, Katrina experienced postpartum psychosis, leading to a month-long hospital stay.

We talk about her experience navigating hospital and legal systems, and how factors like twin pregnancies, ADHD, bipolar disorder, and sleep deprivation can influence perinatal mental health. Katrina reflects on recovery beyond hospitalization — parenting twins, rediscovering herself, and finding purpose through advocacy and community work. She now facilitates support groups, organizes fundraising events, and shares her story to raise awareness. Read more about her experience here.

Tune in for Katrina’s insights on healing from psychosis and moving from surviving to thriving.

Resources in Australia:

• Centre of Perinatal Excellence (COPE) - Perinatal mental health information and tools
• Perinatal Anxiety & Depression Australia (PANDA) - Direct emotional support for parents
• Gidget Foundation - Free perinatal psychology sessions
• Beyond Blue - Mental health support across the lifespan

Citations:

1. Cohen, L. et al (2024, December 6). The phenomenology of postpartum psychosis: Preliminary findings from the Massachusetts General Hospital postpartum psychosis project. Molecular psychiatry.
2. Egsgaard, S., & Bliddal, M. (2024, October 25). Risk and timing of postpartum depression in parents of twins. Acta Psychiatrica Scandinavica.
3. Huberman, A. (2023, November 20). A science-supported journaling protocol to improve mental & physical health. Apple Podcasts.
4. Involuntary treatment - mental health - AIHW. Australian Institute of Health and Welfare.
5. Madsen, K. (2021, September 30). Pregnancy and postpartum psychiatric episodes in fathers: A population-based study on treatment incidence and prevalence. Journal of affective disorders.
6. Shahani, L. (2012, May 8). A father with postpartum psychosis. BMJ case reports.

Megan, a mom of two from northeast England, experienced postpartum psychosis after the birth of her first baby. She navigated pregnancy during the pandemic, had a long labor followed by an emergency procedure, and experienced a gradual curve of psychosis over eight weeks. Despite raising concerns with her care team, her symptoms weren’t treated properly until she was quite unwell.

Megan describes her experience in a mother-baby unit and a general psychiatric ward, and how those different environments shaped her recovery. We reflect on how COVID may have influenced her journey, why religion surfaced in her delusions, and what it was like to approach pregnancy again after psychosis.

Trigger warning: This episode includes discussion of suicide, delusional experiences involving death, and mentions of self-harm in a psychiatric setting.

Resources:

• Kelly Rickard’s Free as a Bird Bit

Citations:

• Burtle, A., & Bezruchka, S. (2016, June 1). Population Health and Paid Parental Leave: What the United States can learn from two decades of research. MDPI.
• Gilden , J. (2020, March 10). Long-term outcomes of postpartum psychosis: A systematic review and meta-analysis. The Journal of clinical psychiatry.
• Heshmati, A., & Honkaniemi, H. (2023, January). The effect of parental leave on parents’ mental health: A systematic review. The Lancet. Public health.
• Kovess-Masfety V et al (2018, February 16). Psychotic experiences and religiosity: Data from the WHO World Mental Health Surveys. Acta psychiatrica Scandinavica.
• Liu, J., & Lai, H. (2025, October 9). Association between COVID-19 infection and risk of mental disorders: a systematic review and meta-analysis. ScienceDirect.
• Savić, A. et al. (2022, November). Changes in psychiatric services dynamics during the COVID-19 pandemic: Recognizing the need for resources shift. Elsevier.
• Severance, E. G. et al (2009, June 2). Coronavirus immunoreactivity in individuals with a recent onset of psychotic symptoms. Schizophrenia bulletin.
• Wesseloo, R. et al. (2015, October 30). Risk of postpartum relapse in bipolar disorder and postpartum psychosis: A systematic review and meta-analysis. The American journal of psychiatry.
• Westhead, M., & Georgiades, A. (2025, July 3). The role of spirituality and religiosity in the maintenance and recovery of psychosis: A systematic review. Early intervention in psychiatry.

In this episode, we hear from Kendra, a patient care technician, first-time mom, and psychosis survivor. Kendra shares her experience with a psychotic break during her pregnancy in 2022 - involving a cross-country drive, psychiatric hospitalization, and the challenges of navigating motherhood with limited support. She also offers advice for other survivors - your psychosis is one moment in your life, and it doesn’t define you.

We discuss:

• The role of social support during pregnancy, postpartum, and psychiatric crises
• Voluntary vs. involuntary psychiatric admission
• Mandatory reporting and CPS involvement in perinatal mental health situations
• How childhood adversity can influence mental health outcomes
• The need for clearer definitions of perinatal psychosis

Trigger Warning: This episode contains descriptions of a suicide attempt and references to cases of infanticide (Casey Anthony and Lindsay Clancy). Listener discretion is advised.

Resources:

• Postpartum Support International
• Action on Postpartum Psychosis
• MGHP3

Citations:

1. Fekih-Romdhane, F., El Hadathy, D., 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. https://pmc.ncbi.nlm.nih.gov/articles/PMC11360526/
2. Hutchens, B., & Kearney, J. (2020, January 22). Risk Factors for Postpartum Depression: An Umbrella Review. Wiley. https://onlinelibrary.wiley.com/doi/10.1111/jmwh.13067
3. Involuntary commitment in Texas. Texas Law Help. (2025, October 9). https://texaslawhelp.org/article/involuntary-commitment-in-texas
4. Kendell, R. E., Chalmers, J. C., & Platz, C. (2018, January 2). Epidemiology of puerperal psychoses: The British Journal of Psychiatry. Cambridge Core. https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/abs/epidemiology-of-puerperal-psychoses/F2861FD5151AE5B8FB9949F1638436FB
5. Nonacs Center for Women’s Mental Health, R. (2022, January 11). Essential reads – postpartum psychosis: A diagnosis for the DSMV - MGH center for women’s mental health. MGH Center for Women’s Mental Health - Perinatal & Reproductive Psychiatry at Mass General Hospital. https://womensmentalhealth.org/posts/postpartum-psychosis-dsmv/