Postpartum psychosis affects approximately one to two per 1,000 births, begins abruptly within days of delivery, and is in most cases an episode of bipolar-spectrum illness rather than a schizophrenia-spectrum disorder. It is missed with striking regularity, partly because most affected women have no prior psychiatric history and bear no resemblance to the public image of a person with chronic psychosis, and partly because postpartum psychosis is a thought disorder in which insight is characteristically impaired, so that the failure to disclose symptoms is something the illness produces rather than something the patient chooses. This article, prompted by renewed public attention following the Lindsay Clancy trial but making no claim about that case, describes how postpartum psychosis actually presents; how it differs from chronic schizophrenia, from the ordinary intrusive thoughts of new parenthood, and from perinatal obsessive-compulsive disorder; and what the evidence supports for assessment, emergency treatment, prevention in high-risk pregnancies, and safety planning for mothers, infants, and families. A free relapse-prevention plan template is included.

Important Safety Note: This post is for educational purposes. If you or a loved one are experiencing severe distress, postpartum warning signs, or suicidal thoughts, please call or text 988 to reach the 988 Suicide & Crisis Lifeline, or access specialized care through Postpartum Support International’s helpline and resources.

Weaning from breastfeeding is one of the most significant hormonal transitions a woman will experience in the postpartum period — and one of the least clinically supported. This post explores why the 3–6 month postpartum window, when most American mothers are weaning, is a period of compounding vulnerability: shifting reproductive hormones, the return of estrogen cycling and menstruation, postpartum thyroiditis (which affects 5–10% of postpartum women and often goes undetected), cumulative sleep deprivation, and the withdrawal of oxytocin and prolactin can converge into a perfect storm of mood disruption that is often more destabilizing than the early postpartum period itself. While breastfeeding is consistently associated with lower rates of postpartum depression, the direction of that relationship is complex — and the medical literature on post-weaning psychiatric symptoms remains startlingly thin, with only thirteen documented syndromes across six published case reports, even as thousands of women describe the same experience in online communities. Drawing from both personal experience and clinical practice, this post examines the neuroendocrine landscape of lactation and weaning, the emotional weight of ending a breastfeeding relationship, and what evidence-based treatment actually looks like — including interpersonal and cognitive behavioral therapy, SSRIs and other medications, psychosocial breastfeeding support, and the kind of compassionate, unhurried care this transition deserves. If you are experiencing mood changes, insomnia, or anxiety during or after weaning, this post is for you.