You probably know about postpartum depression, a mood disorder that can develop after a baby’s birth and leave new mothers struggling with feelings of intense sadness, hopelessness, and irritability.[1] But you may not have heard of postpartum psychosis, another type of postpartum illness that is rare but also very serious.
Postpartum psychosis is the kind of mental break that requires immediate attention, which is why it’s so important to become familiar with what it looks like so you can act right away.
Read on for more about this condition, including causes, signs, and how it’s diagnosed, so you or someone you know can get necessary treatment as soon as possible.
What is postpartum psychosis?
Postpartum psychosis is a very severe form of mental illness that develops in up to 4 new mothers out of every 1,000 births.
This condition usually begins within the first two weeks of a newborn's arrival — though signs may be noticed in as little as two days — or it can develop weeks to months after delivery.
It’s an emergency situation, and the dramatic symptoms typical of this condition may result in harm to the mother or baby.[2]
What causes postpartum psychosis?
The causes of postpartum psychosis are difficult to pin down, but both physical and emotional changes likely play a role:
- Postpartum hormonal changes. After giving birth, a woman's body experiences a huge drop in two hormones, estrogen and progesterone. These major changes can contribute to feelings of fatigue, tension and depression.
- Family history. If you or a family member has a history of depression or bipolar disorder, or you’re currently being treated for it, your risk of postpartum psychosis increases.
- History of other serious mental health conditions. Another condition known as schizoaffective disorder — marked by a combination of symptoms including hallucinations or delusions and mood disorder symptoms like depression or mania — also puts women at higher risk.
- Major life changes on top of giving birth. Women who lack support from family and friends, have troubled relationships, or experience sudden life changes (a death in the family, a move to a new state, illness, job loss, money woes) can also be more at risk for postpartum depression or psychosis.
- Complicated pregnancy, delivery, and other factors. Having a multiples birth, a baby born with health problems, or a lot of difficulty breastfeeding can also factor in, as can severe sleep deprivation, anxiety, restlessness, or feeling extremely overwhelmed by baby care.
What are the symptoms of postpartum psychosis?
In the majority of women, postpartum psychosis is related to bipolar illness, so symptoms may mimic the extreme mood swings (mania, depression) of this condition. Signs of postpartum psychosis also include:
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- Insomnia
- Confusion
- Irritability
- Erratic behavior
- Agitation
- Paranoia
A woman with postpartum psychosis may also have obsessive thoughts about her baby and experience hallucinations (hearing or seeing imaginary things).
Although not all women have the same symptoms — and some people with this condition never experience thoughts of violence — life-threatening behavior may be the result of a mother acting on postpartum psychosis delusions. That's why it's critical to seek help right away.[3]
How does postpartum psychosis differ from other postpartum mental health conditions?
Postpartum psychosis is much less common and much more concerning than other postpartum mental health conditions. This illness is considered a medical emergency.
It’s very different from a case of the baby blues, for example, which can come and go in the early days after childbirth and then subside in a week or so without treatment.[4]
Because of the rapid onset of severe symptoms (extreme paranoia, mood swings, hallucinations) and the fact that postpartum psychosis could lead to devastating outcomes, this condition requires immediate diagnosis and treatment.
How is postpartum psychosis diagnosed?
The first step toward diagnosing a postpartum mental health issue is an evaluation by a medical professional. Your physician may order a blood test to see whether you have a thyroid condition or other health issue that’s worsening your symptoms.
Talking with a doctor can help determine whether you have a condition such as postpartum depression, postpartum anxiety or a more serious case of psychosis. As part of this discussion, you may be asked a set of questions called the Edinburgh Postnatal Depression Scale (EPDS)[5] to help screen and diagnose the severity of your condition.
How is postpartum psychosis treated and is it possible to recover?
Immediate admission to a hospital or other in-patient facility is often an important part of treating postpartum psychosis. Once there, antipsychotic medications or mood stabilizers may be prescribed to control symptoms. Unfortunately, some of these medications aren’t compatible with breastfeeding.
Very severe cases of postpartum psychosis may require electroconvulsive therapy (ECT) if medication doesn’t help. With ECT treatment, small electrical currents pass through the brain to cause a short seizure, alter the brain’s chemistry, and alleviate symptoms.
As scary as postpartum psychosis sounds, keep in mind that this condition is treatable. With rapid intervention and the right medications, symptoms can be relieved. Keep in mind that in the most severe cases, symptoms tend to last two to 12 weeks.
Recovery is possible, but it can take time to get back to feeling like yourself. While you heal, being under the care of medical professionals and getting plenty of help are essential.
The following resources offer more information and support if you or someone you know may be suffering from postpartum psychosis:
- Office on Women's Health (800-994-9662)
- Postpartum Support International (800-944-4PPD)
- National Alliance on Mental Illness (800-950-NAMI)
Remember that postpartum psychosis is an urgent condition. Help should be sought right away.
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