Postpartum Psychosis

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 a chronic mental illness. Being aware of the signs of this mental health condition is vital so treatment can be sought early enough to achieve a full recovery.

What is Postpartum Psychosis?

Postpartum psychosis is a condition that affects women in the weeks and months after giving birth. It has similar effects as a bipolar episode (manic-depressive episode). Postpartum psychosis is also occasionally 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. These cause bizarre and horrifying behaviors as they care for the baby. During these “psychotic episodes,” the woman is completely detached from reality. By the nature of the condition, women aren’t aware of their bizarre behaviors and rather think that they are rational.

For this reason, postpartum psychosis is a very dangerous condition that can have tragic outcomes. An estimated 10 percent of postpartum psychosis cases result in suicide or infanticide. Because of these risks, 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, the rest of the family feels the effects as well. The condition prevents proper bonding between mother and child. Additionally, when a woman is hospitalized, the primary responsibility of child care falls to the father or other family members like the mother’s 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 may set in due to the dramatic drop in hormone levels after the birth. This drop creates mood and behavioral instabilities.

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

Postpartum Psychosis Risk Factors

In addition to the biological factors and the stressful responsibilities of child care, postpartum psychosis has other risk factors that can make women more vulnerable to developing it,

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

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

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 appear in as little as 48 to 72 hours. Most symptoms of postpartum psychosis will present themselves in 2 weeks to 3 months following childbirth.

Here are some common signs and symptoms of postpartum psychosis:

  • Sudden onset of symptoms (seemingly coming out of nowhere)
  • Delusions and hallucinations that the woman thinks are real
  • Serious agitation and anxiousness
  • Inability to sleep or 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 on 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, so she is not aware of her own actions or 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 her and her child.

During hospitalization, the child is 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 with a psychiatrist or another 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, go on to live normal lives and develop healthy maternal bonds with their children.

Jenna Carberg

Jenna Carberg was diagnosed with postpartum depression following the birth of her daughter in 2016. It was a healthy birth but in following days, Jenna's mood changed quickly. Doctors suggested that it might be the "baby blues", but her husband Chris suggested she seek a second opinion. Jenna was diagnosed with postpartum depression and began a journey that lasted 9 long months with significant ups and downs. Jenna's mental health care and her experiences became a passion for her to share with the world. She and her husband Chris founded as a support website designed to help women suffering in silence and their loved ones.

Last modified: May 3, 2019

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