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Dr. Michael
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience:  Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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My Paternal grandmother had postpartum psychosis. Is this

Resolved Question:

My Paternal grandmother had postpartum psychosis. Is this inherited?
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Michael replied 2 years ago.
Hello. I believe I can be of help to you with this issue.

It is not inherited per se but there is a very weak biological risk factor that can apparently be transmitted. The primary risk factor, the #1 predictor of having post partum depression is already having bipolar disorder. About 1/4 to 1/3 of women with bipolar disorders, schizophrenia have post partum psychosis.

But there are roughly 4 clusters of risk factors for post partum depression, and almost no clearly known risk factors for post partum psychosis---this is much more rare than post partum clinical depression. I teach this stuff so here goes: The first group of factors with the largest numbers have the greatest correlation with PPD: The last group, the weakest relationship. Post partum psychosis actually occurs at rates that are just a little higher among persons with serious history of mental disorders in one's family e.g., bipolar disorder, schizophrenia. The VAST majority of cases have no such family risk factors driving them. That is, the psychosis is for the most part, quite unpredictable and is related to hormonal imbalances that are extreme and atypical. The psychosis tends to resolve itself over time, but it can be resolved more quickly with medication. If a person has the psychosis reaction with one child, they are at high risk for having it again with subsequent children. But female siblings are not known to be at much higher risk than anyone else in the general population. So even the strongest risk factors are still very weak. Now, post partum depression is quite common---about 7 in 10 women have some mild post partum blues and about 1 in 8 have more pronounced depression. As I said, these depressions will resolve themselves over the course of a couple of months, but they can be helped along more quickly with medication. Mothers are typically advised to not take antidepressants if they are breast feeding---but you get all sorts of opinions about whether it is o.k. or not. I think it is not worth a risk.

All in all, if you are wondering if you are at risk for post partum psychosis, you are not at much higher risk than anyone else in the general population which is about 1 or 2 per 1000 women!!! Very low risk, even if you have family history, the odds don't increase much. They may increase to between 1 in 500 or 1 in 100 if your MOTHER had the problem, but they drop to close to 1/1000 if your grandmother had the problem---about the same risk as anyone in the population.

Other Risk Factors for post partum depression:

prenatal depression (.44 to .46)
low self esteem (.45 to. 47)
childcare stress (.45 to 46)
prenatal anxiety (.41 to .45)

high life stress (.38 to .40)
low social support (.36 to .41)
marital relationship problems (.38 to .39)
history of previous depression (.38 to .39)
difficult infant temperament (.33 to .34)

maternity blues (.25 to .31)
marital status (.21 to .35)

low socioeconomic status (.19 to .22)
unplanned/unwanted pregnancy (.14 to .17)

I hope this answered your question. Let me know if it has nor if I overlooked anything, Please click on the green Accept button at the bottom of the screen. Thanks.
Customer: replied 2 years ago.
Thank you. My paternal grandmother has since passed away, but I am 29 and expecting my first son. Through the years I have heard about my grandfather raising my father and his sister because of Postpartum depression. I was told that she was very outgoing before her babies and the afterwards
she went to live with her mother for years and on meds. She had electric shock therapy and hospitalized for periods of time until she had a heart attack and passed away. My father really never knew much other than postpartum, so i looked up on the internet if there was anything more severe than just depression after a baby. I know she was violent towards my father and she had to go away to have help. I just wanted to know
if I would be high risk. I am in my 8th month and I consider myself an introvert.
Expert:  Dr. Michael replied 2 years ago.
O.K., what obviously happened was that your grandmother did indeed, carry a biological predisposition for a more serious, long term mental disorder, such as a severe form of major depressive disorder, or bipolar disorder. After having children, the biological/hormonal changes and stress prompted the emergence of the disorder. This wasn't an post par tum psychosis, but rather, the formal emergence of one of the disorders I mentioned above. Post par tum psychosis and post partum depression by themselves, remit after a time. However, it is common for first episodes of serious mental disorders to be triggered or started up by things such as childbirth, use of illicit drugs such as amphetamines or marijuana, in persons who are predisposed. It seems doubtful that at the time your grandmother was living out her adult life, that many good drug or psychotherapy treatments were available that might have helped her. Based on your information in the posts, the best hypothesis is that your paternal grandmother had what we call severe Bipolar I disorder.

If this is true, you have a somewhat higher risk of developing this disorder yourself than the rest of the population (where the prevalence rate is around 1%; and if you were younger, your risk may be around 5-7%. But, you are 29, and the average age of onset for bipolar occurs in teens and then another 'peak' is hit in early 20s (20-24). People can develop this disorder later in life, but at 29, you are increasingly and rapidly moving out of the risk age period i.e., the odds are good you would have developed it before now, if you were going to develop it; so your age drops the odds perhaps 1-2 % points at this time. The paternal grandmother's genetic risk has been 'diluted' a great deal by the fact that half of your genes were contributed by your mom of course, your dad apparently did not have significant problems with clinical depression (I'm assuming ?); and we assume no one on your mom's side of the family had a serious mental disorder. All in all, I would say your risk is only slightly higher than I mentioned in my first post--maybe 2-4%, which is very low. This means of course that there is a 96% chance you'll not develop the disorder. All of the above is based on my speculation that your grandma actually suffered from bipolar I disorder---which of course, I cannot tell since I never evaluated her.

Hope this information is useful. Please let me know if i have overlooked anything. Please click on the green Accept button at the bottom of the screen. Thanks.
Customer: replied 2 years ago.
Hi Just saw your reply! Thank you. I showed this to my dad and said that this happened in the 40"s and that Post partum depression wasn't really known back then and that's the way they treated patients at that time.
Was there something else that made you feel like she had it worse?
Customer: replied 2 years ago.
Could my children be at risk one day? I believe my father's sister had a milder form of this , but had no children.
Expert:  Dr. Michael replied 2 years ago.
O.K., so this info about your father would probably increase the risk numbers I cited above by about 1/4 or 1/3---i.e., add in a couple more percentage points of risk.

The heritability risk drops off with successive generations. So your kids would have half of their gene structure from your husband, whom we'll assume has no evidence of serious mental disorder in his family; which will reduce risk for your kids far below the risk you face (and I'd consider you to be low risk as it is). They are close to having no more risk for say, bipolar disorder, than anyone else in the general population. They are at somewhat higher risk (maybe 4-5%) for mild variants of mood and anxiety problems; what is interesting about the heritability risk for bipolar disorder or any other serious mental illness is the fact that what is actually most commonly 'transmitted' is not the disorder per se, cut various mild risk for a range of mild problems e.g., being somewhat anxious or anxiety prone. The risk is slight however, and we know that healthy families (psychologically), healthy parenting and stable home environments help keep risk for the expression of these mild variants low.

Let me know if I can be of further help. Please click on the green Accept button at the bottom of the screen. Thanks.
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience: Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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