Postpartum Psychosis: What It Is and What to Do About It

Reviewed by Shelley A. Borgia, CCCA on December 09, 2022

It’s not uncommon for women to get the “baby blues” after giving birth. You might feel down, sad, anxious, overwhelmed, or depressed. Half or more of new mothers might go through it.

But in very rare cases, changes surrounding giving birth can bring on a very serious mental disorder called postpartum psychosis. Postpartum means after childbirth. Psychosis means you’ve lost touch with reality.

Some women who get postpartum psychosis had been diagnosed with bipolar disorder, schizophrenia, and other mental illnesses before. But most have no previous psychiatric problems.

Postpartum psychosis can come within a couple of weeks after you give birth. Usually, it happens suddenly. Different mothers may have different symptoms. But they might include:

  • Delusions (belief in something that’s not real)
  • Hallucinations (seeing, hearing, or experiencing imaginary things)
  • Agitation
  • Heightened energy or sex drive
  • Depression, anxiety, or confusion
  • Severe insomnia (You may not even feel the need to sleep.)
  • Paranoia and suspicious feelings
  • Constant mood swings
  • Feeling disconnected from your baby

It can be tricky to tell if your symptoms are a normal part of recovering from childbirth, or something more serious. This is why it’s important to have a loved one or a friend keep an eye on you in the early days and weeks.

Your chances for postpartum psychosis are higher if you or a close family member has bipolar disorder, or if you’ve had previous episodes of psychosis.

Doctors believe that the big hormonal changes before and after childbirth may help trigger postpartum psychosis. Your risks go up if:

  • This is your first baby.
  • Your pregnancy was unplanned.
  • You have big mood swings while pregnant.
  • You stopped your psychiatric medications during your pregnancy.

 

Postpartum psychosis is a very serious illness. About one in 20 women may try to harm themselves or their baby. Your risk for suicide can rise greatly for a year or longer after your delivery.

Fortunately, the psychotic state is only temporary. It is important to know what to do if it happens, both before and after your delivery.

Before delivery:

  • Talk to your doctor about your risks. They might send you to a specialist called a perinatal psychiatrist.
  • Tell your doctor and other members of your care team about any family history of bipolar disorder or postpartum psychosis.
  • Educate your partner or other loved ones about the symptoms, because you may not be able to recognize them in yourself.
  • Keep track of your moods during pregnancy.
  • Connect with an online support community for postpartum psychosis, such as “PPTalk.”
  • Arrange care for any children you might already have (for instance, a place for them to stay in case you’re unable to manage on your own after the baby is born).

After delivery:

  • Ask your partner or another loved one to help you keep a close eye on your behavior.
  • Get enoughsleep.
  • Don’t feel guilty or pressured if it’s hard for you to breastfeed.
  • Minimize visitors, especially for the first few days.
  • See your doctor regularly for checkups.
  • Keep a mood diary.
  • Lean on friends and family for help around the house.

 

If you or your loved ones think you have delusions, paranoia, or other signs of postpartum psychosis, call 911 right away. You may need to be hospitalized for your safety. You also may need medication, such as lithium, to stabilize your mood.

With the right care, you can recover fully. It takes time, but you will gradually feel like yourself again, and you will be able to provide plenty of love and support for your new little one.

Show Sources

SOURCES:

Action on Postpartum Psychosis (APP): “Early Symptoms of Postpartum Psychosis,” “PP Insider Guides,” “What is Postpartum Psychosis?”

Cleveland Clinic: “Depression after the Birth of a Child or Pregnancy Loss.”

Journal of Women’s Health: “A Review of Postpartum Psychosis.”

Mayo Clinic: “Postpartum Depression.”

Postpartum International Support: “Postpartum Psychosis.”

UpToDate: “Postpartum psychosis: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis.”

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