Dr. Tina Tessina is a psychotherapist in Long Beach, California who specializes in marriage and family counseling. She spoke with TIME.com Thursday afternoon about postpartum depression and the Yates case.
TIME.com: Can you tell us a little bit about postpartum depression?
Tina Tessina: What postpartum depression means is that after the pain and tremendous exhaustion brought on by childbirth, and then through the fatigue of round-the-clock feedings, some women start to feel incredibly isolated, like no one understands what you're dealing with and that can't talk to anyone. Women sometimes also experience serious hormonal shifts, which can lead to radical mood swings. There is often a very serious disconnect between what women feel after they've given birth (depressed, tired, in pain) and what women are told they're supposed to feel as new mothers (elated, joyful, selfless).
Do you think it's conceivable that postpartum depression drove Andrea Yates to kill her children?
No one can say exactly what drove her to do this terrible thing and it's important to remember that psychological disorders don't necessarily have cut and dried definitions. We just look for names to call things by. We do know that it's an incredibly desperate act to kill your own children. And this is speculation, of course, but an act like that probably means Yates felt absolutely helpless and hopeless, and didnít feel she could get help.
I hate to speculate here, but it's possible she didn't feel she could talk to anyone. Or there may have been people trying to help her, and she could have been rejecting the help.
But this was a psychotic act, wasn't it? This doesn't seem like an act of simple depression.
In psychiatric terms, Yates definitely would have been psychotic when she killed her own children. To determine whether she's psychotic in legal terms, though, they have to decide whether she knows the difference between right and wrong. And we don't know yet if she'd be considered legally insane.
How likely is it that Yates never gave any indication that she was capable of doing this?
It's very likely. If anyone had known what she was capable of, they certainly would have stepped in.
This could have been building up for a long time. You'd think a woman who'd had post-partum depression would be watched after she'd given birth. But that's not the focus in the medical community these days. Instead they're interested in prescribing pills.
It's very complex, it's very hard to tell who's capable of what. One woman might be screaming "I'm going to kill my children," and she'd be the most stable of the bunch because she's actually venting. And then the quiet one who keeps things bottled up will commit some terrible crime. After someone does something like this, it's very standard to hear friends and neighbors of the accused say, "Oh, she was such a quiet person. I can't believe she did this." That's because everything was percolating inside.
In fact, isolation is a much better predictor of desperate acts than anything anyone would ever say out loud. If Yates didn't have much objectivity about herself, she wouldn't have had that voice inside saying, "Hey, shouldn't you talk to someone about this?" Instead, she'd become more and more desperate.
Dr. Tessina is the author of many books, most recently "The Ten Smartest Decisions a Woman Can Make After Forty." She encourages readers to visit her web site, where they can send her questions.