Motherhood, Mental Health, and the Courtroom: Dr. Diana Barnes on Expert Witness Work and Postpartum Psychosis

Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! What exactly is postpartum psychosis? How is it classified in the ICD and DSM, and what do we know about why it happens? In this episode, Julia and I – with our shared love of neuroscience and empirical research – talk through the “basics” of postpartum psychosis after digging into the literature together. We discuss genetics, sleep, hormones, brain imaging, and other factors researchers are investigating – plus what we know about risk, proactive treatment for people who are at risk, and ways to support people without a prior history of mental illness. And then there’s recovery: What does the research tell us about treatment and timelines? What helps people rebuild and make sense of what happened? And where are the biggest gaps in what we know? We are two survivors of postpartum psychosis sharing what we’ve learned from the research and our own experiences. This episode is for informational purposes and is not medical advice; please discuss medical questions with a qualified healthcare provider. Resources: Mom Breaks Substack Citations Bergink et al (2026, May 1). Postpartum psychosis and bipolar disorder: Review of Neurobiology and Expert Consensus Statement on Classification. Biological psychiatry. Borghare, P. T., Methwani, D. A., & Pathade, A. G. (2024, August 5). A comprehensive review on harnessing wearable technology for enhanced depression treatment. Cureus. Engqvist, I., & Nilsson, K. (2014, February 21). The recovery process of postpartum psychosis from both the woman’s and next of Kin’s perspective - an interview study in Sweden. The open nursing journal. McKenna et al (2026, April 15). Postpartum psychosis is associated with elevated neuromelanin-MRI signal in the midbrain. Nature News. Sambataro, F., Cattarinussi, G., Lawrence, A., Biaggi, A., & Fuste, M. (2021, May 12). Altered dynamics of the prefrontal networks are associated with the risk for postpartum psychosis: A functional magnetic resonance imaging study | translational psychiatry. Translational Psychiatry.

Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! Kara is a special education teacher, runner, and survivor of postpartum psychosis. She lives in Pennsylvania with her partner and daughters in a blended family — she and her partner each had a child from previous relationships, then together they welcomed twins. She shares how she went from never expecting to be a mom to a mom of four, as well as her experience with C-sections, twin pregnancy, the NICU, and navigating flu season with two newborns. We discuss how her postpartum psychosis began after her babies were born last year, as worries about repeat hospitalizations and a series of scares along the way developed into a delusional narrative that her babies had died. We also talk about breastfeeding and medication, self-compassion, making space to care for yourself through early parenthood, and what recovery looked like for Kara as she worked to make sense of her experience — including listening to Mom Breaks and recording voice memos to herself along the way. Resources: 988 Suicide & Crisis Lifeline (US) — Call or text 988 U.S. Maternal Mental Health Hotline — Call or text 1-833-TLC-MAMA Citations: Bornand, D., Toovey, S., Jick, S., & Meier, C. (2016, March 3). The risk of new onset depression in association with influenza – a population-based observational study - sciencedirect. ScienceDirect. Cimino, S., & Cerniglia, L. (2023, September 27). Breastfeeding apps: A descriptive report. Behavioral sciences.

Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! Shelby joins us to share her experience with postpartum psychosis. A mental health counselor in Kentucky and mom of two, Shelby reflects on what first drew her to become a therapist, her experience with a miscarriage and depression, and navigating medication during a subsequent pregnancy and postpartum period. Despite trying different meds after giving birth, Shelby became manic and then psychotic. During her psychosis, she believed she was jumping between timelines—and, because of her professional background, was able to mask some of her symptoms even as they intensified. Shelby also reflects on how her experience has shaped her as a mental health counselor, deepening her empathy and compassion for others in similar situations. We talk about healing after postpartum psychosis, the role of medication in her experience, navigating a narcolepsy diagnosis, and more. Resources: Shelby’s Practice - Central Kentucky Counseling Associates Citations: Anderson, I. (1998, December 7). Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability. ScienceDirect. Carr, C., Borges, D., Lewis, K., Heron, J., Wilson, S., Broome, M. R., Jones, I., Di Florio, A., & Morales-Muñoz, I. (2023, December 7). Sleep and postpartum psychosis: A narrative review of the existing literature. Journal of clinical medicine. Evans, C., Kreppner, J., & Lawrence, P. J. (2022, June 28). The association between maternal Perinatal Mental Health and Perfectionism: A systematic review and meta-analysis. The British journal of clinical psychology. Ross, L. E., Murray, B. J., & Steiner, M. (2005, July). Sleep and perinatal mood disorders: A critical review. Journal of psychiatry & neuroscience : JPN. Verstraete, L. (2025, January 30). Narcolepsy and psychiatric comorbidity: A review of the literature - sciencedirect. Elsevier.

Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! Dr. Bobbie Decker is a neurologist, mom of two, and survivor of postpartum psychosis. Her work focuses on the ways reproductive hormonal changes intersect with neurological health, and her own experience with postpartum mental health has given her a personal perspective on the gaps in how we care for women. After the birth of her second child, Bobbie experienced postpartum OCD, depression, and psychosis. In this conversation, she shares what it was like to experience postpartum mental illness as a physician who specializes in the brain—and how surprisingly little she understood about postpartum disorders from her own medical training. Her story is a powerful reminder that postpartum psychosis can happen to anyone, including someone whose career is devoted to understanding the brain. We discuss what we understand—and don’t understand—about the postpartum brain, and how Bobbie’s experience has shaped the way she thinks about caring for women through pregnancy and postpartum. Resources: Bobbie’s Oped in USAToday Brain on Fire Movie Citations: Kate, S., Holt, R., & Puryear, L. (2023). Mental Health and placenta accreta spectrum : American Journal of Perinatology. Ovid. https://www.ovid.com/journals/ajper/abstract/10.1055/s-0043-1761913~mental-health-and-placenta-accreta-spectrum?redirectionsource=fulltextview Nonacs, R. (2022, January 19). Is preeclampsia a risk factor for postpartum psychiatric illness?. MGH Center for Women’s Mental Health. https://womensmentalhealth.org/posts/is-preeclampsia-a-risk-factor-for-postpartum-psychiatric-illness/

Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! In this episode, Julia shares her experience with postpartum psychosis after the birth of her son in 2021. She takes us through her journey navigating care in the Netherlands—from early attempts to support her at home, to a general psychiatric unit, and ultimately to a Mother and Baby Unit. We discuss what it feels like to not grasp your own illness, navigate treatment and recovery, and make sense of life after the acute episode. Julia has a background in neuroscience and is currently completing her PhD in neuroimaging. She lives in Dubai, where she serves as an International Coordinator for Postpartum Support International. She is also a member of the PSI Postpartum Psychosis Task Force. Shortly after launching this podcast, Julia generously offered to help organize and review the growing body of relevant literature I've been gathering—a collaboration we plan to share more about in a future episode. Resources: Netherlands Crisis Resources:Emergency services: 112 Suicide prevention line: 0800-0113 Crisis hotline: 088 0767 000