Fatal Maternity (part 3): Acutely Psychotic Filicide
Mental illnesses that can kill: A dive into postpartum depression, psychosis, and the often overlooked condition of postpartum rage.
A murder with no comprehensive motive is startling. It becomes especially jarring when a mother murders her children, and is horrified that she cannot fathom why in the aftermath. She snaps out of the voices and disturbing impulses that took control of her mind and body, suddenly alone in a room with the children she loved so much, except they’re dead. She can only ask herself one question:
What have I done?
This type of filicide sees lots of overlap with the Altruistic classification, but we are going to delve into psychosis and postpartum conditions more here. We will look at three things in specific that could lead to a mother committing this type of filicide: postpartum depression, psychosis, and postpartum rage — accompanied by a story a friend of mine agreed to share anonymously.
Psychosis – what is it?
“Psychosis is a condition that affects the way your brain processes information. It causes you to lose touch with reality. You might see, hear, or believe things that aren’t real. Psychosis is a symptom, not an illness.” - WebMD
Several things could trigger psychosis, such as mental illness, substance abuse, physical injury or illness, and extreme stress and trauma. Psychosis follows a pattern. Early signs include dropping grades or job performance, issues thinking with clarity or focusing, being suspicious of others, neglecting self-hygiene, self-isolating, being over emotional or not at all.
In the early psychosis stage, one may see, hear, or taste things others don’t. Maybe someone clings to unusual beliefs or thoughts, despite arguments disproving them. The neglect of self-hygiene may worsen, and one may isolate themselves further from family and friends. Thoughts and concentration become difficult and messy.
A psychotic episode is typically preceded by the above symptoms, accompanied by hallucinations and delusions. Hallucinations can be auditory (hearing things or voices), tactile (unexplained, strange feelings or sensations, or visual (seeing people or things that aren’t there, or misinterpreting shapes of things.) Delusions are beliefs that don’t fall in line with one’s culture and make no sense to others. One might believe they are being controlled by outside forces, that small events and comments have bigger meanings, or that they have special powers, are on a special mission, or they’re a god. A psychotic episode can last from a few hours up to a few days.
Common diagnoses for mothers who commit filicide are postpartum depression or psychosis, schizophrenia, major depressive disorder with psychotic features, or personality disorders. However, I must note, that just because one is diagnosed with any of the above, does not automatically make them a criminal or a killer. To assume so tags a dangerous stigma to these people that they don’t deserve.
Mentally Ill Mothers
As stated above, psychosis is a symptom of something more happening. Postpartum psychosis is an escalation from postpartum depression, which starts in the first weeks or months after a woman giving birth.
In a study called “Child Murder Committed by Severely Mentally Ill Mothers: An Examination of Mothers Found Not Guilty by Reason of Insanity” by Philip J. Resnick, Susan Hatters Friedman and others, acutely psychotic filicide is defined as “when a psychotic mother kills her child with no (non-psychotic) motive, or based on delusional deific decree.”
In this study, they looked at 39 mothers who had committed filicide and had been found not guilty by reason of insanity (NGRI). Their mean age was 28.9 years at the time of the crime. The majority of them were not married at the time (72 percent), 77 percent had completed high school, and about half were receiving government assistance or had no income at all.
The average age of the children they murdered was 3.7 years. Older children tended to be spared, with a mean age there of 9. Most of the mothers were the primary caregivers of the children. Only about half of the fathers were involved with the childrens’ lives.
About 72 percent of these mothers also had previous mental health care. Half of them had been hospitalized previously for psychiatric issues. The average age of onset for these issues was 25, and those who had been in treatment had been so for at least a year prior to the filicide and reported about 4.4 years of symptoms leading up to that. Some psychiatric emergency visits had been as recent as a month before the filicide occurred, with contact with a mental health provider being as recent as hours beforehand.
Half of the mothers reported being depressed at the time of the filicide, as well as planning suicide along with the crime. They often used the same method to kill themselves as they had used on their children.
At least 69 percent of the mothers experienced auditory hallucinations, with 78 percent of those describing those hallucinations as commands to kill their children. Roughly 26 percent reported visual hallucinations. With 74 percent of the mothers also being delusional at the time of the filicides, most of those delusions reportedly involved their children and beliefs that the children were either possessed by Satan or some sort of devil, or that the mother was God or a religious figure. Alternatively, these mothers also sometimes believed their children would be raped, abused, murdered, or forced into servitude if they were kept alive.
These statistics are a minuscule glimpse at what is happening within the mind of a psychotic mother, but reflects the importance isolation plays. In many cases, they are alone with their children at a time they shouldn’t be.
But how do you express to someone who believes you are a wonderful mother, a doting, nurturing parent, that you experience voices and visions trying to convince you to do the absolute worst thing you could ever fathom? How do you tell your spouse, your parents, or your best friend that something demented in your mind believes you and your kids would be better off dead, even if you logically don’t believe it?
How do you explain the moments you are so overwhelmed, so exhausted and sleep deprived, so frustrated and feeling like a failure, that you could snap and it end it all?
That’s what I’m attempting to do today — with the help of a friend.
Postpartum Depression
The Cleveland Clinic breaks postpartum depression down into three parts:
Postpartum blues or baby blues: This is a temporary depression that sets in within the first week of giving birth. A new mother might have prolonged bouts of frequent crying, sadness, and anxiety. This usually subsides within two weeks and passes and doesn’t require treatment.
Postpartum depression: About 1 in 7 new moms will find their depression lasts much longer than the baby blues does. If you have a history of postpartum depression, your risk of experiencing it again goes up 30 percent with each pregnancy. Symptoms include alternating highs and lows, frequent crying, irritability, fatigue, guilt, anxiety, and the inability to care for yourself or the baby. This can involve the inability to bond with your baby and a disinterest in caring for them. The symptoms can be mild to severe and show up within a week of delivery, up to a year after. This can be treated with psychotherapy and medications.
Postpartum psychosis: This is considered an emergency medical condition. Only about 1 in 1000 women experience this after delivery, making it relatively rare. Symptoms generally set in quickly after delivery and include severe agitation, confusion, feelings of hopelessness and shame, insomnia, paranoia, delusions, hallucinations, hyperactivity, rapid speech, or mania. An increased risk of suicide or harming the baby comes with this condition, which is why it is considered an emergency. It is treated with hospitalization, medication, and therapy.
While 75 percent of women experience baby blues, only about 15 percent go on to experience postpartum depression, and even fewer fall into postpartum psychosis.
Of course, someone who has a history of mental health issues in their family is more prone to getting one of these conditions, but the truth is it can happen to anyone. Hormonal, physical, emotional, financial, and social changes are all massive adjustments to go through when having a baby. Not to mention that giving birth on its own can be a traumatic experience, and the resulting PTSD of that can cause changes to your brain and your emotional state.
Postpartum PTSD
According to postpartumdepression.org, this condition occurs as a result of a traumatic incident before, during, or right after childbirth, which could have been real or perceived. It is similar to normal PTSD in that the person experiencing it can suffer from anxiety or panic-like symptoms, leading the person to believe they are in constant danger.
Women who suffer from this also experience flashbacks, or memories of the trauma. Postpartum PTSD and postpartum depression are separate conditions, but can exist together. Symptoms include:
Reliving the trauma repetitively in an intrusive and uncontrollable way;
Flashbacks, nightmares, or memories of the trauma;
Experiencing triggers from events that are reminders of the trauma;
Avoiding anything that will remind you of the trauma;
Constantly on the edge and hyper-vigilant of threats, real or perceived;
Reacting in an exaggerated way to said threats;
Feeling detached or disconnected;
Anxiety, panic attacks, depression;
Difficulty sleeping, concentrating, or with memory.
Postpartumdepression.org adds that about 30 percent of women experience PTSD after giving birth. Other studies have shown that between 3 and 7 percent of women experience postpartum PTSD in specific. It can be caused by long, painful, and difficult child labor; emergency C-sections; a heath crisis to mother or baby before or during labor or umbilical cord prolapse.
As with other conditions, a history of mental illness can contribute to getting postpartum PTSD.
Psychosis can also be a symptom of PTSD, but not in all cases. Sometimes, psychosis can be present with PTSD but a symptom of something else.
Postpartum Rage
In a corner of motherhood that is even less widely discussed than the above conditions, postpartum rage, according to the Cleveland Clinic, is “a mood disruption that causes intense anger, aggression, and agitation in the weeks and months after you give birth.” This can coincide with postpartum depression.
Postpartum rage isn’t something that is officially diagnosed, and experts don’t really understand why some mothers experience this sudden aggression after they have their baby. Nonetheless, it can be as dangerous as postpartum depression and its ominous escalations.
This condition differs from postpartum depression in that the anger and outbursts of rage are uncontrollable. A new mother can feel unfounded rage without depression, and another might feel the depression without ever boiling over with anger. It tends to show up within six weeks to the first year after a woman gives birth.
In a study called “Correlates of Canadian mothers' anger during the postpartum period: a cross-sectional survey” in 2022, the writers note that “it is unclear how many women experience postpartum anger.”
“For mothers, lack of sleep, fatigue, and carrying the majority of infant care responsibilities, mixed with the reduced capacity to meet their needs, can contribute to their experiences of anger,” the study says.
Beyond sleep deprivation, one also has to consider how an adverse childhood, abuse, trauma, and intimate partner violence could also contribute to postpartum anger. With trauma being a huge factor in other mental conditions where psychosis can be a symptom like schizophrenia, major depressive disorder with psychotic features, or personality disorders, it isn’t a huge leap to ruminate on how trauma could also be linked to postpartum rage.
In Lewis and Bunce’s study, about half of their sample came from single parent families and suffered sexual abuse as kids. In addition, a 2005 study by Phillip J. Resnick, Susan Friedman Hatters, and several others, stated:
“In sum, three-quarters of the mothers (72%) were noted to have experienced considerable stressors during their developmental years. - sexual or physical abuse, abandoned in some way by their mother (death, divorce, removal from custody), incest victims. One-quarter (23%) of the mothers reported that as adults, they were victims of domestic violence.”
We already know that an early separation from the mother causes trauma to a baby’s nervous system. This infantile trauma is also a common link with serial killers. The bond between mother and infant is the earliest human connection we know, and how we begin to learn empathy.
For now, though, in the early stages of research on this, sleep deprivation seems to be the culprit researchers want to blame for this condition, and it makes sense. Running on fumes with little to no sleep will make anyone on edge and unable to regulate emotions properly. To add a new born baby who constantly needs attention and care, with no time to care for yourself, would become incredibly overwhelming when in a state of fatigue.
“In a meta-analysis of 28 studies, Yang et al. found that the proportion of women with problematic sleep during the postpartum period was 67.2%,” this study notes.
And with problematic sleep being highly associated with postpartum depression, it stands to reason it could also cause sudden anger problems in new mothers. The study continues:
“Krizan and Hisler found that adults’ sleep restriction has been associated with anger. Anger may be the result of increased sensitivity to negative stimuli from restricted sleep and reduced capacity to regulate emotions.”
Socioeconomics are another factor. A new mother with a proper support system, a caring partner, who isn’t as concerned about finances, would naturally not be as stressed or prone to angry outbursts as another mother who is maybe a single parents, or has an unsupportive partner, and little to no support system, and has financial problems.
“Inadequate social support could also be associated with anger because anger has been linked to unfulfilled expectations of others. For example, mothers may have expectations of receiving support from partners or family members and, when
support does not materialize, women may feel distressed and angry,” the study says.
In 278 women who were surveyed for this study, all were new mothers between the ages of 23 and 44 with a high socioeconomic status and a household income over $90,000. Out of these women, 30.6 percent reported intense anger shortly after giving birth and 26 percent reported poor sleep quality.
A large portion of these women reported experiencing intense anger without depressive symptoms. In addition, 21 percent of them said they experienced both poor sleep quality and intense anger. Such women who were sleep deprived were 2.9 times more likely to show rage.
“Mothers’ anger has typically been explored in the context of depression, but our finding suggests that anger is a distinct mood disturbance that is not consistently associated with depressive symptoms,” the study notes.
So if what little research on postpartum rage which exists indicates that it isn’t directly correlated to postpartum depression, why is it not diagnosed as its own condition?
I usually end off with my own thoughts on a topic — but here’s the thing. I’m not a mother. I opted out of parenthood and it’s not something I ever wanted. It’s not in any realm of experience I have ever had, or ever will. So I wanted to end this with a real experience from a mother I know in my life.
The topic of postpartum rage came up spontaneously in a conversation I recently had with her. Despite all of my writing on true crime, filicides, and female killers, I had never heard of it. My friend will remain anonymous here for obvious privacy reasons. This is a woman who is not normally prone to sudden anger problems and was thrilled to welcome her baby into the world. She’s a wonderful mother and a wonderful human being. But after having her first born, she discovered the dark side of motherhood. She agreed to share her story, and I will her tell it in her words:
As a woman who has seen firsthand, the detrimental side effects of postpartum. I would like to share some of my experiences that unfortunately led me to discover what postpartum rage was. I feel as though postpartum rage isn’t talked about quite as frequently as postpartum depression, and I believe this is something that should be taken just as seriously, as it is just as harmful. Although they coincide in many aspects, they are also very different in the way that it can affect you! For myself, postpartum depression wasn’t something I experienced thankfully! For those reading, I would like to give some insight as to how scary postpartum rage can actually be and why I am forever grateful that I have such a strong support system that helped me overcome this because I could’ve never done this without them, even though they didn’t know the mental battles I had within myself due to my own fault of not speaking up!
I remember when it first started progressing, I was about 3 weeks postpartum! It was almost as if it was growing inside of me waiting for a weakness so that it could strike, and to this day I still can’t forgive myself for some of the inner thoughts and actions, many in which I had to snap myself out of. My baby didn’t deserve to be treated the way I was treating him. The constant yelling, me needing to distance myself and cry in the bathroom wondering what was wrong with me. But please do not get me wrong, I never once missed a night time feed, I changed diapers, my life was so much better with my child in it. To this day, I think about certain horror stories about people and how they can hurt their children and it honestly makes me sick to my stomach, but I look bad now and realize, yes my baby was healthy! But I find myself reliving those moments and asking myself if my baby was happy, was he wishing he had a different, kinder mother? I have come to realize that my trigger, was my baby crying.. as terrible as that sounds! I had been told by other moms that “as long as baby is in a safe space, it is okay to walk away and take a few minutes for myself to try and reset the tone”. Which I had to do on many occasions, but after my husband had to return to work, was when I felt like I really had no control over my emotions! I describe it as almost being in a trance, I could be perfectly fine one moment, then boom, I would explode, the smallest things would set me off and I wasn’t even sure why! For example: I’ll never forget the one night I could have seriously harmed my child, it was the closest I’ve ever been to an out of body experience. I had actually started to smother my baby as he was crying because I mentally couldn’t handle it anymore, and on top of sleep deprivation I was getting so frustrated. Thankfully I had realized what I was doing and I immediately stopped. I was so disgusted with myself so both me and my baby sat and cried together, while I rocked and kissed his head and reassured not only myself but my baby too, that I wouldn’t never hurt my child like that again. I know that my child didn’t ask to be here and that he didn’t know any better, he was just a baby, he couldn’t tell me what was wrong. But I was too overwhelmed. I will truly never forgive myself for what I did because I love my baby with every fibre of my being!
One thing I always ask myself is why I never asked for help while I was going through such a hard time, I think maybe now that I was just too embarrassed. Although my support system was great, I had such fear that telling someone how I was REALLY doing, would make them think differently of me. I didn’t want to be seen as an unfit mother, because I am a great mother, I was just going through something that I didn’t know how to deal with in a healthy way! Even now, almost 2 years later I still have anger issues. I do find that my fuse isn’t as short, and I have much better ways of handling the rage when it gets out of control. I just wish it didn’t take this long for me to find better solutions for my anger. My baby deserved to have the best mom he could, and I’m glad to have overcome the thick of it so that I can truly be the best for him! There has never been a timeline as to how long postpartum rage can last, but all I know is that it is very REAL. As a mom who went through it, I know just how much it needs to be talked about. Its needs to be taken more seriously, just like all other postpartum mental illnesses! Please, speak up, tell someone, talk to a doctor! That kind of rage can escalate into something ugly, I know firsthand. Don’t wait to get help, because you don’t want to end up regretting not acting sooner.
Thank you for reading,
A mom who understands
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Sources
Cleveland Clinic