Postpartum Psychosis is a mental health condition that affects someone soon after they have given birth.
The condition involves the mother showing signs of psychosis. It is a medical emergency that requires quick and efficient treatment.
Postpartum psychosis should be treated quickly, and when it is, recovery is common. This is important for the health of both the mother and her child.
What are the symptoms of Postpartum Psychosis?
The symptoms of postpartum psychosis will normally manifest suddenly within 2 weeks of the mother giving birth. In some cases, it can be within days, or even hours.
In very rare cases, they can develop a few weeks after the mother has given birth. But this is incredibly rare.
Symptoms can include:
- Hallucinations – Where a person sees or hears something that doesn’t exist outside of their mind
- Delusions – Where a person has a belief that they steadfastly believe in, though isn’t true. It is associated with paranoia.
- Mania – Exhibiting over-excitable behaviour, talking a lot or having substantial energy
- Depressive episode – Feelings of low mood, sadness, lack of energy, anxiety, sleeping issues
- Thought disorder – Also called disturbed thoughts, this refers to someone whose thought process has become distorted due to losing touch with reality
What are the causes of Postpartum Psychosis?
Research suggests that postpartum psychosis affects around 1 in 1,000 mothers following birth [1].
While the causes of postpartum psychosis are not entirely known, there are clear risk factors at play.
Those with an existing diagnosis of mental health conditions are at a heightened risk. This is especially the case in those with Bipolar Disorder, Schizophrenic Spectrum conditions, and psychosis.
Similarly, anyone who has had postpartum psychosis in a previous pregnancy is at risk of developing the condition again. Additionally, a family history of postpartum psychosis is a risk factor.
Like with many mental health conditions, a history of trauma has also been attributed as a risk factor [2].
Diagnosis of Postpartum Psychosis
It is crucial that anyone exhibiting the signs or symptoms of postpartum psychosis receives medical help immediately.
This could be through seeing a GP (a same day appointment is highly recommended) or by calling 111 and seeking medical advice.
Postpartum psychosis is a medical emergency, and it should be treated as such. Going to the hospital is also a possibility.
In terms of the actual symptoms that need to be present for a diagnosis to be made, the following criteria should be seen:
At least two of the following:
- Hallucinations
- Delusions
- Mania
- Depressive episode
- Thought disorder
- Disorganised behaviour
- Disorganised speech
- Unusual motor behaviour
Postpartum psychosis is occasionally confused with Postpartum Depression, but includes psychotic symptoms, whereas postpartum depression does not.
How is Postpartum Psychosis treated?
Seeking treatment for postpartum psychosis is crucial. It is important to do so to protect the health of the mother, the child, and their wider family.
Treatment generally happens in a hospital. It is normally completed in a specialist psychiatric unit called a “Mother and Baby Unit”. Unfortunately, not all hospitals have facilities readily available, so a psychiatric ward may be needed.
The most severe symptoms usually last up to 2-3 months. Medication is often required for up until a year. By the end of this year, most people will have recovered.
Medication
Medication forms the main part of treatment. The exact type of medication that is prescribed will depend on the symptoms present.
For example, if the mother is exhibiting symptoms of mania, a mood stabiliser is recommended, whereas someone displaying delusions and hallucinations would be better suited to an antipsychotic. Antidepressants can be useful in cases where low mood is the primary symptom.
Antipsychotics: Antipsychotics (also known as neuroleptics) block the effect of dopamine – a chemical in the brain that is heavily linked to psychotic symptoms like hallucinations. They can also be useful for stabilising mood, and treating anxiety. They are not suitable for everyone however, and are often associated with many side effects like weight gain, dizziness and dry mouth.
Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.
Mood Stabilisers: Mood stabilisers can help level out moods, meaning fewer lows, and fewer euphoric highs are felt. Lithium Carbonate is the best-known mood stabiliser. Others include Lamotrigine and Sodium Valproate, which are anticonvulsant medicines that have mood stabilising properties. These medicines are generally taken on a long-term basis.
Talking Therapy
While medication can help alleviate the symptoms displayed, a longer term approach involves a form of talking therapy. The type of therapy that is normally used is Cognitive Behavioural Therapy:
Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.
There are multiple other types of talking therapy. For more information on this, please see our dedicated Therapy section.
Summary
Postpartum psychosis is a scary condition, and can cause many difficulties for anyone with the condition, as well as those around them.
The safety of everyone involved is of paramount importance. Therefore, cases of postpartum psychosis requires quick action. For more information on all things mental health, our website can assist you!
See Also
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If you are struggling with your mental health, help is available. With the right support and treatment, you can make a recovery. For information on helplines, or if you are in a state of crisis, please visit our crisis page by clicking on the relevant link for your geographical location (United Kingdom), (United States), (International). You can also see how to get mental health treatment and the process involved by clicking this link.
References
[1] Friedman, S. H., Reed, E., & Ross, N. E. (2023). Postpartum Psychosis. Current Psychiatry Reports. 25 (2): p65-72. DOI: https://doi.org/10.1007/s11920-022-01406-4.
[2] Perry, A., Gordon-Smith, K., Jones, L., & Jones, I. (2021). Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review. Brain Sciences. 11 (1). DOI: https://doi.org/10.3390/brainsci11010047.
