176: Postpartum Psychosis, Depression & Intrusive Thoughts: What Women Need to Know with Dr. Kristin Lasseter

When does the "baby blues" become postpartum depression? What separates an intrusive thought from an intention to cause harm? And what does postpartum psychosis actually look like?

In this episode of Confessions of a Male Gynecologist, Dr. Shawn Tassone sits down with psychiatrist Dr. Kristin Lasseter for an important conversation about the mental health conditions women can experience during pregnancy, postpartum, and throughout their reproductive lives.

They break down the differences between postpartum blues, postpartum depression, postpartum anxiety, and postpartum psychosis — including why these conditions can sometimes be misunderstood, overlooked, or misdiagnosed.

Dr. Lasseter explains the relationship between postpartum psychosis and bipolar disorder, why a person experiencing psychosis may still have periods of lucidity, and why intrusive thoughts, although frightening, are not the same thing as wanting to act on those thoughts.

The conversation also tackles one of the most complicated parts of psychiatric care: medication. Dr. Tassone and Dr. Lasseter discuss psychiatric medication management, polypharmacy, changing diagnoses, and the importance of understanding the complete clinical picture instead of treating individual symptoms in isolation.

But postpartum mental health is only part of the discussion.

Dr. Lasseter also shares how the field of reproductive psychiatry has evolved, why there still aren't enough specialists to meet the demand, and why mental health screening should be a more routine part of women's healthcare — not something addressed only after a woman reaches a crisis.

They also explore the difference between psychiatrists and psychologists, the role of therapy alongside medication, the connection between mental health and libido, and the stigma that still prevents many women—especially during pregnancy and postpartum — from admitting that they are struggling.

Women are routinely monitored physically throughout pregnancy and after delivery. This episode asks an equally important question:

Are we paying enough attention to what is happening mentally and emotionally?

In This Episode, Dr. Tassone and Dr. Lasseter discuss:

• The difference between baby blues, postpartum depression, and postpartum psychosis

• Why postpartum mental health disorders can be difficult to recognize

• Whether current diagnostic definitions adequately reflect the postpartum experience

• How bipolar disorder can intersect with postpartum psychosis

• What intrusive thoughts actually mean and why they should not automatically be confused with intent

• Why someone experiencing psychosis may still appear completely lucid at times

• Psychiatric medications during the reproductive and postpartum periods

• How polypharmacy can complicate symptoms, diagnoses, and treatment

• Why communication between patients and psychiatrists matters

• The growing field of reproductive psychiatry and why access still falls short

• How women are typically referred for reproductive mental health care

• The difference between a psychiatrist and a psychologist

• Why psychiatrists may use both medication and psychotherapy

• How women's mental healthcare has changed over the past several decades

• The connection between mental health, sexual health, and libido

• Why better mental health screening is needed during reproductive transitions

• The stigma that still keeps pregnant and postpartum women from asking for help

Key Takeaways

Postpartum mental health exists on a spectrum.
Temporary emotional changes after delivery are common, but persistent or worsening symptoms deserve evaluation rather than being dismissed as part of becoming a mother.

Postpartum depression and postpartum psychosis are not the same condition.
Understanding the distinction matters because the symptoms, risks, and level of intervention can be dramatically different.

Intrusive thoughts do not automatically equal intent.
Unwanted, disturbing thoughts can occur in postpartum mental health disorders and can be terrifying for the person experiencing them. The clinical context matters.

Postpartum psychosis can be associated with bipolar disorder.
A woman's psychiatric history, symptoms, sleep, behavior, and changes over time can all be important pieces of the diagnostic picture.

Psychosis does not always look the way people imagine it does.
Someone experiencing severe psychiatric symptoms may still have periods where they appear lucid, organized, or completely like themselves.

Medication management requires context.
Adding medication after medication without continually reassessing the diagnosis and full clinical picture can make psychiatric care more complicated.

Reproductive psychiatry remains an underserved field.
Interest and training have grown, but access to clinicians specifically trained in women's reproductive mental health still does not meet the need.

Mental healthcare should be part of reproductive healthcare.
Pregnancy, postpartum, fertility changes, PMDD, perimenopause, menopause, sexual health, and libido can all intersect with mental wellbeing.

Screening needs to happen before a crisis.
Mental health should be discussed routinely throughout reproductive transitions instead of waiting until symptoms become severe enough that a woman is forced to ask for help.

Stigma still keeps women silent.
Fear of judgment—particularly during pregnancy and postpartum—can prevent women from admitting what they are experiencing and seeking appropriate care.

Postpartum mental health deserves the same seriousness, attention, and follow-up we give physical recovery after pregnancy. Whether the issue is depression, anxiety, intrusive thoughts, psychosis, medication, libido, or simply feeling unlike yourself, women should not have to reach a breaking point before someone starts asking the right questions.

A note from Dr. Lasseter

I'm Dr. Kristin Lasseter, a board-certified psychiatrist and the founder of Reproductive Psychiatry & Counseling (RPC). Since starting RPC in 2018, it has grown to be a practice devoted to expert, compassionate care for individuals navigating mental health concerns across the reproductive lifespan—including pregnancy, postpartum, infertility, pregnancy loss, premenstrual mood disorders, and perimenopause.

My interest in reproductive mental health began in college, when I took a course in reproductive endocrinology and became fascinated by the powerful influence of sex hormones on both physical and mental well-being. That curiosity—paired with my love of medicine and commitment to improving mental health care—led me to the field of reproductive psychiatry.

When I moved to Austin in 2014, I was surprised and disheartened to find a lack of local services for patients experiencing hormone-related psychiatric symptoms. That gap inspired me to build RPC—now one of the leading reproductive psychiatry clinics in Texas. Since founding RPC, I've been committed to increasing access, awareness, and education around reproductive mental health through clinical care, professional training, and community advocacy.

My clinical work focuses on helping patients find clarity, relief, and confidence through personalized, evidence-based care. Whether you're navigating perinatal anxiety, postpartum depression, PMDD, pregnancy loss, or medication decisions during pregnancy or lactation, I take time to understand your values, your goals, and your story. My approach is collaborative and nonjudgmental—centered on helping you make informed decisions that feel right for you.

I believe the mental health needs of women and birthing people—especially during reproductive transitions—have been historically overlooked. At RPC, we're working to change that.

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Please help break the stigma: Share a resource, start a conversation, and join us in raising awareness about maternal and reproductive mental health.

Connect with Dr Lasseter

Instagram | @the.reproductive.psychiatrist

Work with Dr Lasseter | rpcaustin.com

Episode Resources:

Work with Dr. Tassone | Tassone Advanced Gynecology

Please contact the clinic directly at (512) 956- 0296 with all scheduling inquiries.

Purchase Dr. Tassone's Best-Selling Book | The Hormone Balance Bible

Dr. Tassone's Integrative Hormonal Archetype Quiz | Discover Your Hormonal Archetype

Medical Disclaimer
This podcast and website represent the opinions of Dr. Shawn Tassone and his guests. The content here should not be taken as medical advice and is for informational purposes only. Because each person is so unique, please consult your health care professional for any medical questions.