Can postpartum depression become so invasive as to cause a mother to kill her children? Since this very rarely happens, many scoff at the prospect. Interestingly enough, postpartum psychosis was first recognized as a disorder as far back as 1850. According to Pregnancy Infonet, (2007), studies on the rates of the disorder have shown that the number of women experiencing postpartum psychosis hasn't changed since the mid 1800s. Expert psychologists, psychiatrists, and behavioral scientists are discovering that postpartum depression can, if not treated promptly and properly over an extended period of time most definitely can escalate to psychosis. Doctor statements and evaluations, insufficient treatment, and failed suicides are things that must be considered in determining Andrea Yates mental defect at the time of her crime.
It has been argued that due to some of Yates' logical and thought out actions that these prove she was sane at the time of the incident. The fact that, on two occasions she refused medication and on another occasion she stopped taking her medication. The fact that she had done a "practice run" of filling up the bathtub and, individually tracked her children down and drug them to their death are all arguments that are being touted as evidence that she had full knowledge of what she was doing.
To understand the concept of Postpartum depression and Postpartum psychosis, one must first realize that the two illnesses are not synonymous. Postpartum depression is described as something that can start at anytime within one year of birth. There is usually sadness, common after such an ordeal as birth, and of course a loss of energy, also a common thing after giving birth. Sometimes there will be a bout with the inability to concentrate, especially for first time mothers and along with that, anxiety about motherhood. All these are symptoms of postpartum depression. Not every woman experiences these and some may experience only a few of them. However, these symptoms are quite different than those of postpartum psychosis. Catherine Roca, (April, 2005)
Dr. Dan Williams, Psy.D., PA-C, "Peace and Healing", (2006), describes post partum psychosis as "very rare". He goes on to say that "It is characterized by homicidal and suicidal impulses, hallucinations, delusions, disorganized and bizarre thinking." Dr. Williams goes on to further describe some of the consistent characteristics of one who suffers postpartum psychosis.
"The dilemma is that these individuals usually refuse treatment. This is a medical emergency situation. If post-partum psychosis is suspected, families need to call 911 as emergency intervention is necessary. Medication most likely will be prescribed. The ultimate goal is to keep the baby and mother safe." "Peace and Healing", (2006)
Yates was first diagnosed July 21, 1999 as having severe major depression by Eileen Starbranch, MD. This diagnoses, came after her attempted suicides. During her week stay at Methodist Hospital Psychiatric Unit, she was diagnosed as having severe major depressive disorder, recurrent with psychotic features. Additional problems diagnosed were social withdrawal and minimal verbal communications. It was during this psychological evaluation that Andrea Yates admitted to having thoughts of hurting herself or someone else.
Eileen Starbranch, MD, Court TV, Psychiatric Evaluation July (1999) On August 5, 1999, Dr. Starbranch along with Dr. Arturo Rics, M.D., had a consultation regarding continued care of Andrea. The findings of this consultation revealed that the onset of her depression began about six week prior along with symptoms of psychosis. Much of the documentation that was reviewed by both physicians indicated that Andrea remained reclusive, guarded and still had a persistent, depressed mood. Eventually Andrea did respond to some degree to her medication but was warned by Dr. Starbranch not to have another child as this could bring on another psychotic episode.
Dr. Arturo Rics, M.D., Dr. Starbranch, MD, Methodist Hospital Psychiatric Center July (1999) Another psychiatrist, Dr. Melissa R. Ferguson, former medical director of psychiatric services at the Harris County Jail, gave testimony that in her opinion, Yates was suffering from psychosis. According to Dr. Ferguson, Yates told her she believed that the cartoon characters on television were telling her how bad she was for giving her children "too much candy and cereal". Ferguson also testified that she believed that Andrea was incapable of understanding the consequences of what she did. Dr. Milissa, Former Director, Harris County Jail.
Andrea Yates had all the classic symptoms of post partum psychosis. Even though medication was administered, there was little supervision to ensure that she followed doctor's orders. Her hospital stays were short and therefore not effective in a medically supervised environment assuring that at best the possibility of her harming herself or others was sufficiently minimized.
There is absolutely do doubt in anyone's mind that Andrea Yates did in fact drown her children in a bathtub. There is no doubt that the "how" was too horrible to fathom. Because of the rarity of this condition and its horrendous results if not treated, many Americans, particular women, will judge women like Andrea Yates without compassion for the suffer or the effort to learn and understand the illness. What those individuals should realize is that by understanding this catastrophic illness, it in no way condones the actions done as a result of that illness.
In conclusion, the state of Texas is to be applauded in its efforts to recognize this rare, yet debilitating and extremely dangerous illness. The Andrea Yates bill became affective September 3, 2003 and it states the following:
"Postpartum depression (PPD) is a serious disorder, each year affecting 10% to 15% of women who have delivered children. This disorder, despite its high prevalence, often goes undetected and untreated. In an attempt to address this public health problem, the State of Texas has enacted legislation, House Bill 341 (also known as the "Andrea Yates Bill"), which went into effect on September 1, 2003. This law requires healthcare providers who treat pregnant women to provide them with resource information regarding counseling for postpartum depression and other emotional traumas associated with pregnancy and parenting."
Blue Corss/Blue Shield of TexasPostpartum Depression and House Bill 341
References:
BlueCross BlueShield of Texas; Postpartum Depression and House Bill 341
(2007) Retrieved on September 9, 2007 from the World Wide Web:
http://www.bcbstx.com/provider/postpartum.htm
Ferguson, Dr. Melissa R. Former
Medical Director of Psychiatric Services at the Harris County Jail. Retrieved on September 8, 2007
from the World Wide Web: http://crime.about.com/b/a/257021.htm
Roca, Catherine , Chief, Women's Programs, (2005) Depression During and After Pregnancy
National Institute of Mental Health, (April 2005). Retrieved on September 7, 2007 from the World
Wide Web: [http://www.4woman.gov/faq/postpartum.htm#5]
The Pregnancy-Info Team, Postpartum Psychosis (2007) Retrieved on September 7, 2007 from the World Wide Web:
http://www.pregnancy-info.net/postpartum_psychosis.html
Starbranch, Eileen, M.D. Court TV
Retrieved on September 9, 2007 from the World Wide Web:
http://www.courttv.com/trials/yates/docs/gifs/psychiatric6.gif
Williams, Dan Psy.D., PA-C, (2006) Peace and Healing.
Retrieved on September 7, 2007 from the World Wide Web:
http://www.peaceandhealing.com/psychosis/postpartum.asp
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