What is postpartum psychosis?

In recent years, postpartum depression has become more commonly discussed than ever before – although there’s still a wealth of misinformation surrounding it. Other postpartum mood disorders, on the other hand, still remain mysterious, which means that, for the women who experience them, they can be completely unexpected.

Postpartum mood disorders in general are common. Specific mood disorders, like postpartum obsessive compulsive disorder and postpartum psychosis, are much more rare. As a consequence, the women who experience them are likely never to have heard of them before they seek treatment.

Postpartum psychosis

Postpartum psychosis is a rare but serious mood disorder that can begin as early as 48 hours after delivery, and usually sets in within the first two weeks after delivery. Women who have experienced bipolar episodes in the past are at a much higher risk for postpartum psychosis, which closely resembles bipolar disorder, but it can also occur in women with no history of mental illness; in fact, half of the women who experience postpartum psychosis have no previous history of mental illness. Postpartum psychosis is thought to affect just one or two in every 1000 women who give birth. Other risk factors for postpartum psychosis include a personal or family history of postpartum psychosis, and stopping taking medication for bipolar disorder during pregnancy.

The first warning signs of postpartum psychosis are restlessness, irritability, insomnia, and quick shifts between intensely depressed and elated moods. More definitive and advanced signs of postpartum psychosis include:

  • Paranoid delusions: These can include visual or auditory hallucinations, and are usually centered around the baby, and may include the conviction that the baby is in danger, or has been switched at birth. These also may focus on the postpartum person’s partner.
  • Rapid mood swings: In general, the symptoms of postpartum psychosis often mirror the symptoms of bipolar disorder.
  • Depression: Postpartum psychosis does share features with postpartum depression, but in conjunction with symptoms like delusions, irrationality, and a disconnect from reality.
  • Confusion: People experiencing postpartum psychosis over find themselves feeling confused or having trouble with normal, routine activities, including self-care and infant care. They may feel extra disorganized, or disoriented about the time or where they are.

Postpartum psychosis patients can have an even longer and harder time getting the treatment they need than they might with other postpartum mood disorders because symptoms of postpartum psychosis include delusions and loss of touch with reality, and many with postpartum psychosis aren’t able to recognize that they’re experiencing it.

Postpartum psychosis is a serious condition that often requires hospitalization. Though not true in all cases, postpartum psychosis can interfere with bonding with the baby. In rare cases, postpartum psychosis can result in suicide or infanticide.

Read more
  • Veerle Bengink, Natalie Rasgon, Katherine L. Wisner. “Postpartum psychosis: madness, mania, and melancholia in motherhood.” American Journal of Psychiatry. 9 September 2016. Retrieved 21 June 2018. https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2016.16040454.
  • MGH Center for Women’s Mental Health. “What is postpartum depression and anxiety?” American Psychological Association. American Psychological Association. Retrieved 21 June 2018. http://www.apa.org/pi/women/resources/reports/postpartum-depression.aspx.
  • MGH Center for Women’s Mental Health. “Can we identify women at a high risk for postpartum psychosis?” American Psychological Association. American Psychological Association. 3 August 2009.  Retrieved 21 June 2018. https://womensmentalhealth.org/posts/can-we-identify-women-at-high-risk-for-postpartum-psychosis/.
  • Mayo Clinic Staff “Postpartum depression: not something you just get over.” Mayo Clinic Health System. Mayo Clinic Health System, 15 November 2017. Retrieved 21 June 2018. https://mayoclinichealthsystem.org/hometown-health/patient-stories/postpartum-depression-not-something-you-just-get-over.
  • Dorothy Sit, Anthony J. Rothschild, Katherine L. Wisner. “A Review of Postpartum Psychosis.” Journal of Women’s Health. 15(4): 325-368. 7 June 2011. Retrieved 21 June 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109493/.
  • “Postpartum psychiatric disorders.” MGH Center for Women’s Mental Health. MGH Center for Women’s Mental Health. Retrieved 21 June 2018. https://womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders/?doing_wp_cron=1525105923.4827690124511718750000.
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