What is postpartum psychosis?

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

Postpartum mood disorders in general are common – including the “baby blues” – and it’s estimated that up to 85% of postpartum parents experience some form of mood disorder in the weeks or months after giving birth. Specific mood disorders, like postpartum obsessive compulsive disorder and postpartum psychosis, are much more rare. As a consequence, the people who experience them are likely to have never 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 it 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. While PPP is associated with bipolar disorder, it can also occur in people with no history of mental illness, and, 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 people who give birth.

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

  • Paranoid delusions: Delusions are false beliefs. In postpartum psychosis, delusions are often 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. Visual or auditory hallucinations also exist. Someone experiencing a hallucination is having a sensory experience that is not based in reality, but feels very real to them.
  • Rapid mood swings: In general, the symptoms of postpartum psychosis often mirror the symptoms of bipolar disorder. This includes moods changing from feeling very “up” (mania), to feeling very “down” (depression).
  • 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 often find themselves feeling confusion or having trouble with normal, routine activities, including self-care and infant care.

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 loss of touch with reality, and many with postpartum psychosis aren’t able to recognize that they’re experiencing it. Though it doesn’t always do so, postpartum psychosis can also interfere with bonding with the baby.

Postpartum psychosis is a medical emergency that requires immediate medical treatment. In rare cases, postpartum psychosis can result in suicide or infanticide. If you’re feeling off, it’s a good idea to contact your healthcare provider as soon as possible.

And if you are feeling like you are in urgent danger of hurting yourself or someone else, you should call 911 or the toll-free 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889).

Read more
  • Veerle Bergink. “Postpartum psychosis: madness, mania, and melancholia in motherhood.” The American Journal of Psychiatry. Published online. September 9 2016. Retrieved July 9 2018. https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2016.16040454.
  • MGH Center for Women’s Mental Health. “Can we identify women at high risk for postpartum psychosis?” Women’s Mental Health. MGH Center for Women’s Mental Health, August 3 2009. Retrieved July 9 2018. https://womensmentalhealth.org/posts/can-we-identify-women-at-high-risk-for-postpartum-psychosis/.
  • MGH Center for Women’s Mental Health. “Postpartum psychiatric disorders.” Women’s Mental Health. MGH Center for Women’s Mental Health. Retrieved July 9 2018. https://womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders/?doing_wp_cron=1525105923.4827690124511718750000.
  • Dorothy Sit, Anthony J. Rothschild, Katherine L. Wisner. “A review of postpartum psychosis.” Journal of Women’s Health. 15(4): 352-368. May 2006. Retrieved July 9 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109493/.
  • “Postpartum depression: not something you just get over.” Mayo Clinic Health System. Mayo Clinic, November 15 2017. Retrieved July 9 2018. https://mayoclinichealthsystem.org/hometown-health/patient-stories/postpartum-depression-not-something-you-just-get-over.
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