ABSTRACT
This chapter shows how analytic insights help to address the question of why the puerperium is such a vulnerable time for a depressive psychotic breakdown, and the aftermath for both mother and child. In general psychiatric outpatient departments, there are many cases where a prescription for antidepressant medication and the provision of dynamic understanding both prove appropriate and helpful. The general psychiatric treatment for puerperal psychosis is as for all depressive illnesses: drugs and electroconvulsive therapy (ECT). Early use of ECT is advocated to help the mother recover more quickly, so that she can sooner look after her baby. Analytic contributions in the literature tend to address general issues of mothering, rather than to focus specifically on puerperal psychosis. The chapter presents three case studies, each one highlighting different issues relating to the dynamics underlying puerperal psychosis. E. V. Welldon has described how female psychopathology can be looked at in three-generational terms: grandmother, mother, daughter.
