Warning: MAJOR spoilers for the movie Tully lie ahead.
In recent years, our society has begun to start a much-needed and long-overdue conversation about postpartum depression. While movies and TV shows have usually glamorized motherhood in the past, the new movie Tully, which stars Charlize Theron as Marlo, shows the throes of motherhood in a really honest and raw way. While this is a huge step in the right direction and an important issue for every new mom to know about, there's also another postbirth issue that's still rarely discussed, but one that is addressed in Tully: postpartum psychosis. In the movie, Marlo hires a night nurse named Tully, who — spoiler alert — ends up being a figment of her imagination.
This is a form of postpartum psychosis, which is the most severe postpartum psychiatric disorder. Think of it this way: the "baby blues," which are unpleasant but common, don't impact a new mother's day-to-day life. More concerning is postpartum depression, which has symptoms indistinguishable from general depression and affects mothers deeply, causing them feelings of hopelessness, worthlessness, guilt, and severe fatigue. The most severe form of postpartum psychiatric disorder is postpartum psychosis. According to the Massachusetts General Hospital Center for Women's Health, postpartum psychosis affects one to two women per 1,000 and is an extremely severe disorder that requires quick diagnosis and treatment.
Postpartum psychosis is often an episode of an underlying bipolar disorder, triggered by the complex and intense hormonal changes caused by childbirth (it usually begins within the first two weeks after giving birth). It's linked with manic or erratic thoughts and behaviors. These kinds of episodes involve feeling extreme highs followed by periods of deep depression. In postpartum psychosis, these episodes are often correlated with obsessive thoughts about the new baby, and many mothers with the condition report thoughts about harming their baby or themselves. One report describes a case study in which a mother with postpartum psychosis experienced hallucinations of taking her newborn baby into her arms and stepping in front of a subway train.
Suffice it to say: postpartum psychosis is an extremely serious condition. Mothers who experience the disorder need help, and quickly. Knowing what to look for is the first step to getting treatment. Some of the symptoms to look out for include hallucinations (like in Tully), long periods of staring into space or being otherwise detached, feelings of believing she's a horrible mother to the point that suicide becomes a "solution," erratic or manic highs and lows, and obsessive religious feelings (some women with postpartum psychosis believe that a deity is instructing them to harm their baby).
Postpartum psychosis is nothing to mess around with and is thought to be a contributing factor in many of the cases of infanticide we hear about on the news. But it's also temporary and treatable, so if you, your partner, or a family member or friend is experiencing these kinds of symptoms, it's important to seek help immediately by talking to your doctor or calling an emergency crisis hotline.