Understanding Postpartum Psychosis

Postpartum psychosis is a devastating and horrifying mental health condition that occurs in women after childbirth. Though rare, it can have serious consequences for the mother, her child and her family.

Postpartum psychosis is highly treatable and doesn’t necessarily result in the long-term development of a mental illness. Being aware of the signs of this mental health condition is vital so that treatment can be sought early enough to achieve a full recovery.

What is Postpartum Psychosis?

Postpartum psychosis is a serious mental health condition that affects women in the weeks and months following giving birth. It is considered to be close or similar to the same effects as a bipolar episode (manic-depressive). Sometimes postpartum psychosis will also be referred to as puerperal psychosis, postnatal psychosis, bipolar disorder triggered by childbirth, mania or schizoaffective disorder.

Women suffering from postpartum psychosis experience severe hallucinations, paranoia and delusions which cause bizarre and horrifying behaviors surrounding the care for the baby. These are referred to as “psychotic episodes” during which the women is completely detached from reality. By the nature of the condition, women aren’t aware of their bizarre behaviors and rather think that it is rational given their paranoid state.

For this reason, postpartum psychosis is a very dangerous condition that can have tragic outcomes. An estimated 10% of postpartum psychosis cases result in suicide or infanticide.  Because of the risk of death, many women with postpartum psychosis are hospitalized for an extended period of time while they wait for medications to take effect.

Who Does Postpartum Psychosis Affect?

Postpartum psychosis is a condition that affects between 1 and 2 women out of every 1,000 births. It is considered a rare condition when compared to the prevalence of other postpartum conditions such as depression and anxiety.

While postpartum psychosis directly affects the mother, there are also potential devastating consequences for the child. The condition prevents proper bonding between mother and child. Often, when a woman becomes hospitalized, the primary responsibility of childcare falls to the father or other family members such as the parents or in-laws.

Postpartum Psychosis Causes and Risk Factors

Because postpartum psychosis is so rare, its causes aren’t totally understood. Like most postpartum conditions, psychosis can form as the result of the dramatic drop in hormone levels that creates mood and behavioral instability.

These biological changes, combined with the pressure of new responsibilities can trigger psychotic symptoms in women.

Postpartum Psychosis Risk Factors

In addition to the biological factors as well as the stressful responsibilities of childcare, postpartum psychosis has other risk factors that can make women more vulnerable to developing this mental health condition.

Here are some of the known risk factors of postpartum psychosis in women:

  • A personal history of postpartum psychosis
  • Being previously diagnosed with and treated for bipolar disorder (manic-depressive)
  • A history of depression and/or anxiety
  • A history of obsessive-compulsive disorder (OCD)
  • Having obsessive personality traits
  • A family medical history of bipolar or other mood disorders
  • Current or past life stressors such as lack of social supports, divorce, financial troubles, etc.
  • Low socioeconomic status

Postpartum Psychosis Symptoms

Symptoms of postpartum psychosis come on very suddenly and manifest themselves in ways similar to bipolar disorder. These manic-depressive states create “psychotic episodes” characterized by paranoia and delusions.

Postpartum psychosis symptoms typically come on suddenly in as little as 48-72 hours. Most symptoms of postpartum psychosis will present themselves in 2 weeks to 3 months following childbirth.

Here are some of the top signs and symptoms of postpartum psychosis:

  • Sudden onset of symptoms (seemingly coming out of nowhere)
  • States of delusions and hallucinations that the women thinks are real
  • Serious agitation and anxiousness
  • Inability to sleep or full insomnia
  • Being hyperactive or purposely trying to stay busy
  • Behaving irrationally
  • Becoming confused or making poor decisions
  • Trouble concentrating and remembering things
  • Sudden angry outbursts
  • Emotional dysregulation (mood swings)
  • Aggression towards others
  • Suicidal or infanticidal threats/attempts

When postpartum psychosis first develops, some of the earliest signs you may notice are an increase in restlessness, insomnia and irritability. These can quickly morph into intense mood swings, eventually leading to full on psychotic episodes.

Women may move quickly from “highs” such as elation to “lows” such as disorientation and confusion. Women with postpartum psychosis may also seem to be disorganized or scattered in their thoughts and behaviors.

When postpartum psychosis becomes severe, women will have delusional beliefs that center around their child. In some cases, women may hear voices that don’t exist. These voices may be instructing the woman to harm herself or the baby.

It’s important to understand that in these situations, the woman cannot distinguish between hallucination and reality and so she are not aware of her own actions and thoughts. This puts her at serious risk to her own health and her baby’s health.

Postpartum Psychosis Treatment

Postpartum psychosis requires immediate attention. Women experiencing psychotic episodes during the postpartum period almost always need to be hospitalized to protect the health and safety of both the woman and her child.

During hospitalization, the child becomes temporarily removed from the mother’s care. Women are then placed on antipsychotic medications, sedatives or other mood altering medications to control the psychosis.

In addition to hospitalization and medication, women with postpartum psychosis also undergo psychotherapy from the help of a psychiatrist or other mental health professional. Electroconvulsive therapy is sometimes used to treat women with postpartum psychosis.

If your loved one is exhibiting any signs of postpartum psychosis, it is critical to seek treatment immediately. She is likely not aware of her symptoms and so it is up to her support circle to help her obtain the necessary treatments.

With immediate and appropriate treatment, women with postpartum psychosis can make a full recovery and go on to live normal lives and develop healthy maternal bonds with their children.


  1. http://psychotherapy.com/mom.html
  2. https://womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders/?doing_wp_cron=1476573771.0558168888092041015625
  3. http://www.app-network.org/what-is-pp/
  4. http://www.postpartum.net/learn-more/postpartum-psychosis/