What You Should Know About Postpartum Psychosis

Having a baby is often one of life’s most joyful experiences, but the postpartum period can also bring unexpected and overwhelming challenges. If you’re here, you may be worried about yourself or someone you love. If you are experiencing unusual thoughts, feelings, or behaviors after childbirth, know this: you are not alone, this is not your fault, and treatment is available.

What Is Postpartum Psychosis?

Postpartum psychosis is a rare but serious mental health emergency.  It occurs in 1-2 birthing parents per 1,000 births. It most commonly presents within the first few weeks after childbirth, but can occur up to several months postpartum. It is very different from the more common baby blues or postpartum depression/anxiety because of its severity. The  affected individuals lose  touch with reality and experience fluctuating symptoms that can include hallucinations, delusions (developing strong but false beliefs that feel real but are not), severe confusion and insomnia. Because it is a psychiatric emergency, immediate medical intervention is necessary. While it may seem insurmountable, postpartum psychosis is treatable, and most affected fully recover with the right care and support.

If You're in Crisis

If you or someone you know is experiencing thoughts of harming themselves or their baby, or is experiencing hallucinations, delusions, or severe confusion, seek emergency medical attention immediately. Call 911, go to the emergency room, or contact the National Suicide Prevention Lifeline at 988. There is support available. 

Mental health is an essential component of overall wellness for both parents and their babies, and you can learn more in our guide to mental health during pregnancy and postpartum. Understanding conditions like postpartum psychosis can help families understand the various range of postpartum mental health  conditions and when they require immediate medical intervention.

Signs to Watch Out For

Understanding and recognizing the warning signs of postpartum psychosis have a significant impact on recovery, facilitating early intervention and treatment. The symptoms can be grouped into several categories, and they often develop rapidly over a period of days or weeks. 

Psychotic Symptoms

• Hallucinations: Seeing, hearing, or feeling things that aren't there. This could include voices telling the parent to harm themselves or their baby

• Delusions: Strong beliefs about the baby that are not true, such as believing the baby is possessed, has special powers, or needs to be harmed

• Severe confusion: Disorientation about time, place, or identity; inability to think clearly

• Paranoia: Unfounded suspicions about others' intentions or actions

Mood and Behavioral Changes

• Extreme mood swings, from euphoria to severe depression

• Agitation, restlessness, or hyperactivity

• Rapid or pressured speech

• Difficulty sleeping or staying awake. Insomnia

• Loss of inhibitions or inappropriate behavior

• Difficulty concentrating or making decisions

Concerning Thoughts and Behaviors

• Thoughts of harming the baby or oneself

• Refusal to eat or drink

• Inability to care for the baby

• Bizarre or irrational behavior

• Statements that don't make sense or seem disconnected from reality

Recognizing Symptoms in Loved Ones

If you notice any of these symptoms in a new parent, don't wait! Postpartum psychosis is a medical emergency that requires immediate professional intervention. Trust your instincts and seek help right away.

What Causes Postpartum Psychosis?

While the exact cause of postpartum psychosis isn't fully understood, researchers have identified several risk factors that may increase the likelihood of developing this condition. Understanding these risk factors can help healthcare providers and families make a plan to navigate the postpartum period together.

Primary Risk Factors

• Previous history of postpartum psychosis: Women who have experienced postpartum psychosis before have a 30-50% chance of recurrence with subsequent pregnancies

• Bipolar disorder: Women with a diagnosis of bipolar disorder have a significantly higher risk, particularly during the postpartum period when mood disturbances are more likely

• Family history: Having a family history of bipolar disorder or postpartum psychosis increases one's risk

Contributing Factors

• Hormonal changes following childbirth

• Sleep deprivation and exhaustion

• Complications during pregnancy or delivery

• Discontinuing psychiatric medications during pregnancy

• Extreme stress or trauma

Postpartum Psychosis and Other Postpartum Mental Health Conditions

While all of these conditions require attention and care, postpartum psychosis is unique in its severity and need for immediate intervention.

Treatment and Recovery

Treating postpartum psychosis typically involves an immediate evaluation, often in the Emergency Room, medication management, and ongoing mental health support. The specific treatment plan will depend on the individual's symptoms, medical history, and personal circumstances.

Immediate Treatment

Treatment for postpartum psychosis typically begins with a hospitalization, preferably in a facility that specializes in perinatal mental health. This allows for close monitoring, medication initiation, adjustment and management, and ensuring the safety of both the parent and the infant. 

Medication Management

Medications are often a crucial component of successful treatment and may include medications to manage psychosis, stabilize mood, and improve sleep, chosen carefully and taking into account if the parent is breastfeeding.

Ongoing Support and Therapy

• Individual therapy to process the experience and develop coping strategies

• Family therapy to help loved ones understand and support recovery

• Support groups with others who have experienced similar conditions

• Gradual reintroduction to parenting responsibilities with support

Support Resources and Getting Help

Recovery from postpartum psychosis is not a journey that should be traveled alone. Getting the right support and care, and building a strong support network is essential for successful recovery and preventing future episodes.

Crisis Resources

• National Suicide Prevention Lifeline: 988

• Crisis Text Line: Text HOME to 741741

• Emergency Services: 911

• National Postpartum Support International Helpline: 1-800-944-4773
  
  

Long-term Support Resources

• Postpartum Support International: Provides education, support groups, and resources for perinatal mental health

• National Alliance on Mental Illness (NAMI): Offers support groups and educational programs

• Local mental health centers: Many communities have specialized perinatal mental health programs

• Online support communities: Moderated forums and support groups for women with similar experiences

Preventive Strategies

While it's not always possible to prevent postpartum psychosis, there are steps that can reduce risk and improve outcomes. This is particularly important for people who have experienced postpartum psychosis before or have other risk factors.

• Prenatal planning: Work with healthcare providers familiar with maternal mental health to develop a postpartum mental health plan during pregnancy

• Medication management: Carefully plan any medication changes with psychiatric and obstetric providers familiar with the safety of medications during pregnancy and breastfeeding.

• Support system: Arrange for additional help and support during the first few weeks postpartum

• Sleep support: Prioritize rest and sleep, with help from family and friends

• Stress reduction: Minimize additional major life changes and stressors during the postpartum period

• Future Pregnancies: Work closely with healthcare providers to develop a comprehensive plan that addresses medication management, monitoring, and support systems if you have a history of postpartum mood and anxiety or psychosis.

Supporting Your Recovery Journey

Recovery from postpartum psychosis is a process that takes time, patience, and support. It's important to remember that seeking help is a sign of strength, not weakness, and that with proper treatment and support, you can recover fully and enjoy a healthy and bonded relationship with your baby.

The journey may feel overwhelming at times, but you're not alone. Healthcare providers, family, friends, and support groups are all part of your recovery team. Focus on taking things one day at a time, celebrating small victories, and being patient with yourself as you heal.

Remember that your experience with postpartum psychosis doesn't reflect your worth as a parent or a person. With time, treatment, and support, you can move forward and create the positive parenting experience you've always envisioned.