What Is Postpartum Psychosis?

Giving birth is an emotionally intense experience — but for many women, those intense emotions stay with them even after they leave the delivery room. In the first few weeks after delivery, over half of mothers experience heightened sadness, anxiety, irritability, and general emotional unpredictability. 

Sometimes, these feelings last a few weeks and go away — known as the “baby blues.” Other times, they can develop into severe depression, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), or — most rarely and severely — postpartum psychosis.

What Is Postpartum Psychosis?

Psychosis is a mental illness in which you lose your typical sense of reality. This shifting of reality can include:

  • False beliefs 
  • Hallucinations 
  • Feeling like you’re in a dream 
  • Word salad (speaking random words or phrases that don’t make sense together) 
  • Sleep deprivation

Postpartum psychosis, which affects about one in every 1,000 people who have given birth, is when you experience psychosis in the first few days or weeks after birth. It a medical emergency which can potentially lead to suicide or infanticide (killing your baby). It is not your fault if you develop the condition, and most people fully recover with the right treatment.

Symptoms of Postpartum Psychosis

The first symptoms of postpartum psychosis usually appear anywhere from 48 hours to a few weeks after birth. You or others may notice that you’re experiencing:

  • Noticeably high mood and energy (mania)
  • Depression
  • Frequent switching between high and low moods
  • Trouble taking care of yourself or your child
  • Racing, repetitive thoughts
  • Memory loss
  • Confusion
  • Intense anger
  • Low self-esteem
  • Suicidal thoughts
  • Delusions or false beliefs
  • Trouble sleeping

Often, delusions can be about your new baby — that they have special powers, others are trying to take them from you, or they’re about to die, for example. Other times, delusions can include thinking people in your life are evil, you’re being closely watched by an evil organization, that you are a god or have other powers, or many other unrealistic thoughts.

Causes of Postpartum Psychosis

Experts aren’t sure what causes postpartum psychosis. Research suggests that: 

  • It runs in families
  • It has to do with changing hormone levels in your body during and after pregnancy
  • You’re more likely to experience it if you have bipolar or schizoaffective disorder
  • It has to do with disturbed sleeping patterns
  • If you’ve already had it, you may experience it again in later births
  • Your risk level rises as you get older 
  • Low birth weight can increase your risk level

Continued

Treatment for Postpartum Psychosis

It’s important to get medical attention for postpartum psychosis as soon as possible. Call your doctor or obstetrician as soon as you notice symptoms. If you think you or a loved one might be in danger, visit the emergency room.

After asking some questions and evaluating your symptoms, a doctor might recommend you visit a psychiatric hospital. Your partner or someone else will likely need to take care of your baby while you’re in treatment. A doctor may also prescribe you antipsychotic, antidepressant, mood-stabilizing, hormonal, or other types of medications.

Therapy and social support are also helpful in recovering from postpartum psychosis. Ask your doctor about support groups for people who have similar experiences, or look for a support group online. An individual therapist can help with one-on-one talk therapy, cognitive behavioral therapy, and other strategies.

Preventing Postpartum Psychosis

Though we don’t know the exact causes of postpartum psychosis, you can take steps to help prevent it. 

Get adequate sleep. Make sure you get enough sleep after you give birth. Lack of sleep affects your emotional state and can even lead to suicidal thoughts in new parents.

Plan ahead. Contact a mental health professional to make a plan before you give birth. They may prescribe you medication to start taking soon after birth.

Talk with your friends, family, doctor, and support network to discuss your risks and what to do if you start showing symptoms.

Risks of Postpartum Psychosis

One in every 20 people who has postpartum psychosis commits suicide, and one in every 25 commits infanticide. Without treatment and monitoring, delusional thoughts and behaviors can lead people with postpartum psychosis to hurt themselves or their children. That’s why early medical treatment is so important.

Postpartum psychosis can be a traumatic experience for new parents. Being in a hospital away from your new baby can impact your initial bonding process. Many people who have experienced postpartum psychosis feel that they’ve missed out on an exciting stage of parenthood. 

WebMD Medical Reference Reviewed by Dan Brennan, MD on March 10, 2021

Sources

SOURCES:

American Journal of Psychiatry: “Prevention of Postpartum Psychosis and Mania in Women at High Risk.”

GoodTherapy: “Postpartum Psychosis.”

Journal of Psychiatric Research: “Suicidal ideation in depressed postpartum women: Associations with childhood trauma, sleep disturbance and anxiety.”

KHN: “Postpartum Psychosis is Real, Rare, and Dangerous.”

Massachusetts General Hospital Postpartum Psychosis Project (MGHP3): “About Postpartum Psychosis.”

MGH Center for Women’s Mental Health: “Can We Identify Women at High Risk for Postpartum Psychosis?”

Mind: “What is postpartum psychosis?”

National Institute of Mental Health: “What is Psychosis?”

NHS: “Psychosis Symptoms.”

Obstetrics and Gynecology Clinics of North America: “Recognizing and Managing Postpartum

Psychosis: A Clinical Guide for Obstetric Providers.”

Royal College of Psychiatrists: “Postpartum psychosis.”

Seleni Institute: “The Truth About Postpartum Psychosis.”

Tommy’s: “Postpartum Psychosis.”

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