In the Danish movie “Sorrow and Joy” directed by Niels Malmros (2013), a woman becomes depressed after giving birth to a daughter. In the depression (psychosis) she kills her baby. Even though her action is not shown, the horrible occurrence takes place in the beginning of the movie and is the main theme throughout. The true tragedy however is, that the movie is auto fictional. This really happened for the director in the winter of 1984, as his wife was home alone with their nine-month-old baby.
In the movie we see the protagonist - a director named Johannes - fall in love with Signe, we see her scars on the wrist, and she talks about her mood swings. Since her latest affective episode was ten years ago, Johannes encourages her to give up Lithium. She becomes pregnant, and after delivery, she loses her joy.
Her irrevocable deed takes place during a leave a week after she has been hospitalized. In his heart Johannes knows that she is too unpredictable to take care of their daughter, but in the moment, he considers his work obligation to be more important. He persuades his mother-in-law to look in on his wife.
We do not get a thorough psychiatric explanation of why Signe acted, as she did. It is only told by the psychiatrist, that Signe has a psychosis, and that her deed was a result of obsessions (?), but the content of the delusions is not explicit: She had no intentions of killing herself afterwards, as she had no recollection of fear of or aggression towards the baby.
The depiction of a depressed, partly agitated woman is done impeccably. Her face turns expressionless, as if her spirit has disappeared from her eyes. She has a few angry outbursts and is incapable of crying. Her action indicates a psychosis, but since most post-partum psychoses begin only a few weeks after delivery, it is likely that the psychosis is a result of a long lasting not treated affective episode. On the other hand, she had a predisposition of postpartum psychosis, since the probability in a bipolar woman ranges from one-fourth to two-thirds, her father was bipolar and her mother’s brother killed himself. She herself thinks that the deed partly is a result of the husband's constant depreciation of her social background. That too is a risk factor according to research.
The theme of the movie however is on how the husband handles his self-examinations and his triple guilt. He suggested her to stop medication, he left her that fatal day, and he devaluated her cultural ideals. He copes by blaming the mother-in-law, and later he increases his own workload - directing movies.
In 1984 Niels Malmros (not Johannes) had studied medicine for 20 years. He finally succeeded, and got his diploma as a doctor in 1987. It is tempting to think that Niels Malmros increased his commitment to the medical studies as a consequence of his recognition of his wife’s chronic disorder – and to soothe the guilt.
Niels Malmros himself has said that he could never blame his wife, since she was psychotic at the time, and that their mutual love has conquered the sorrow. Whether his guilt also has played a role, in why they still are married, and why he always presents his wife with great pride, remains unknown. □