"...it would be normal to respond in this way to a life threatening experience..."

Question: Why do women with HELLP develop acute and long-term psychosomatic disorders?
  
Answer:
There are a number of potential reasons.  We have recently learned that women who have had eclampsia have some deficits in mental functioning (Gerda Zeeman - Holland).  It is certainly possible that women who did not have seizures will have effects. 

I certainly see that women with severe preeclampsia and HELLP have memory problems around the time of delivery.  Many women complain that they are just "not right."  Most women with these diseases would qualify for an experience that would incite post traumatic stress disorder.

Question:
Why are the psychosomatic/mental health disorders in HELLP - acute phase and in the long-term-worse than preeclampsia? 
 
Answer:
I am not at all sure that they are worse with HELLP and severe preeclamspia.
 
Question:
Why do women develop severe psychosomatic/mental health symptoms with HELLP and not with preeclampsia? 
 
Answer:
We have some evidence from the survey of the Preeclampsia Foundation that the symptoms are present in that group.
 
Question:
Do we have treatment protocols/guidelines/care pathways for psychosomatics/mental health symptoms/disorders? 
 
Answer:
Not that I know of that are specific to the disease.  I do considerable counseling for women attempting a second pregnancy.   A successful second pregnancy really seems to help.
 
Question:
Do you have any resources or advice? 
 
Answer:
No specific resources.  The first step is to recognize that it would be normal to respond in this way to a life threatening experience.  Even more so when the outcome will challenge a core value that many women define as part of their essence - the ability to bear children.

Thomas R. Easterling, M.D.
Associate Professor
Department of Obstetrics and Gynecology
University of Washington Medical Center, Seattle