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Capitol chase woman: postpartum depression or bipolar disorder?

Rumors are flying that the Connecticut woman—who was shot to death by the police on Thursday after slamming her car into a barrier near the White House—likely suffered from post-partum depression. The woman’s mother told ABC News that her daughter, 34-year-old Miriam Carey, began suffering from post-partum depression a few months after giving birth more than a year ago and had been hospitalized for her condition.

But the typical symptoms of post-partum depression—depressed mood, change in appetite, poor self esteem, concentration difficulties, and low energy—are unlikely to have resulted in the actions taken by Carey.

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In fact, some psychiatrists say the mayhem she caused is more typical of someone suffering from psychosis, which more commonly occurs with bipolar disorder. About 1 in 1,000 women who give birth get diagnosed with bipolar disorder (also called manic depression) for the first time during the postpartum period.

Postpartum depression can also have a psychosis component, but that’s far more rare, said psychiatrist Dr. Kimberly Yonkers at the Yale University School of Medicine. Even more rare: violent tendencies toward strangers.

“Women with this psychosis may do harm to themselves or their babies,” Yonkers said, “but we don’t typically see violence toward anyone else.”

Studies suggest that more than 90 percent of women who have postpartum depression along with psychosis develop symptoms during the first month of childbirth.

In fact, the latest diagnosis manual for psychiatry, called the DSM-V, defines postpartum depression as the onset of symptoms within the first month after childbirth.

“It’s a big stretch to say that one year after birth a woman [undergoing treatment for depression] is still postpartum and experiencing the effects” of giving birth or adjusting to motherhood, Yonkers said.

Dr. Leena Mittal, director of reproductive psychiatry at Brigham and Women’s Hospital, agreed but added that it’s tough to know for certain when Carey’s symptoms may have begun.

Law enforcement officials told NBC News that Carey believed President Obama was stalking her; such delusional thoughts, if they did exist, are a hallmark of psychosis.

If Carey had bipolar disorder with psychosis, she likely had symptoms before getting pregnant, Mittal said, though they may not have been properly diagnosed. Her symptoms may have also been mild enough to fall beneath her family’s radar until they manifested themselves in a more severe form following childbirth—or they may not have existed at all.

“The stressful events of pregnancy and birth, taking care of a newborn, and sleep deprivation can all cause the brain to go through changes,” Yonkers said, “causing an unmasking of bipolar disorder in a fraction of women.”

And it’s possible, she added, that someone with psychosis related to bipolar disorder would be organized enough to get in a car, strap her child in a car seat, fill her car with gas and drive for hours to Washington while still being delusional enough to think the President is after her.

But it’s probably wrong to blame these actions on garden variety postpartum depression, which affects 10 to 15 percent of women after delivery and rarely, if ever, leads to treasonous violence.

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