Postpartum Psychosis

Postpartum Psychosis

Many believe that pregnancy is a time of happiness, excitement and quirky food cravings. On the contrary, the hormonal changes that occur during pregnancy can create severely disruptive mood shifts for some mothers. This can cause anxiety, depression, or even psychosis- sometimes in women who have never dealt with mood symptoms before. Given how this may be unanticipated, and can be severe- and that both the mother and baby may be at risk of harm, pregnancy-related mood shifts should always warrant a rapid and supportive response to get the mother the help she needs.

After giving birth, up to 50% of women experience a couple days (or up to two weeks) of “baby blues,” or mild mood changes. This is completely normal and expected after giving birth. What is not expected is the development of postpartum psychosis; also sometimes referred to as postnatal psychosis or puerperal psychosis. Postpartum psychosis is a severe, but treatable form of mental illness; it is psychosis after giving birth. It is crucial for the health and wellbeing of the mother and baby to seek immediate medical attention if you or someone you know may be experiencing postpartum psychosis.

Symptoms of postpartum psychosis

As mentioned earlier, it is normal for a mother to experience “baby blues” after a recent pregnancy which only lasts a couple days. However, if the mother’s mood changes persist and worsen to include severe symptoms, there is a chance that the mother may be experiencing postpartum psychosis. There are multiple mood symptoms that a mother may experience such as feeling excited, elated, or “high,” or she could feel depressed, anxious or confused, lastly, she may feel excessively irritable. Postpartum psychosis specifically involves experiencing one or more of the following:

• Delusions
• Hallucinations
• Mania
• Severe confusion
• Violent thoughts

There are also several common symptoms of postpartum psychosis such as:

• Restlessness 
• Feeling suspicious/paranoid or fearful of others motives
• Loss of inhibitions
• Unable to sleep or not feeling the need to sleep at all 
• Behaving out of character
• Having racing thoughts
• Being more talkative or sociable than usual 

Postpartum psychosis is a very serious condition and needs to be treated as a medical emergency. If not treated right away, it can result in the mother getting worse and potentially harming themselves or the baby. It is also common for the mother not to realize she is experiencing postpartum psychosis, so it is imperative that family members or friends take immediate action after observing behavior that is not normal for the mother.

Postpartum psychosis versus postpartum depression

There are several types of postpartum mood disorders identified by doctors. Some common terms may include postpartum anxiety, postpartum OCD, postpartum depression, and postpartum psychosis.

Postpartum blues are estimated to affect 50 to 85 percent of women post delivery. Symptoms commonly experienced are crying for no apparent reason, anxiety, irritability, or insomnia. Though this is the least severe form of postpartum depression, it is still important to pay attention to the changes happening in your body and seek professional help if symptoms persist longer than 14 days after delivery.

Postpartum depression occurs when symptoms of “baby blues” last more than two to three weeks and impair daily functioning. Symptoms associated with postpartum depression include feelings of guilty, appetite changes, worthlessness, consistently sad mood, and in more severe cases, suicidal thoughts.

Postpartum psychosis is a rare, but severe form of mental illness that affects approximately .1 to .2% of births (1 to 2 out of every 1,000 deliveries). It is known to have the most detrimental effects on mental health and it is vital to seek immediate medical attention.

Causes

Unfortunately, little is known about the underlying cause of postpartum psychosis after giving birth. However, research indicates that biological factors (hormones related to pregnancy and childbirth) as being the probable cause of postpartum psychosis, but several factors are likely to be the culprit as well. Additionally, you are more likely to develop postpartum psychosis if:

• There is a family history of mental illness
• There is a prior diagnosis of bipolar disorder of schizophrenia
• It is a traumatic birth or pregnancy 
• Postpartum psychosis was experienced in a previous pregnancy

In order to reduce the risk of postpartum psychosis, you should have a pre-birth planning meeting with everyone involved in your care to discuss a plan of care during and after your pregnancy. Additionally, it is advised to have regular home visits from a midwife or a trained healthcare perinatal mental health professional after the baby is born to ensure safety and the mental wellbeing of the mother. 

Treatment for postpartum psychosis

Postpartum psychosis is deemed as a medical emergency and a person should call 911 and seek treatment at a local hospital or crisis center if one is experiencing symptoms of postpartum psychosis. It is common for a mother to be admitted to an inpatient center to receive treatment until her mood is stabilized and there is no apparent risk of harm to herself or her baby. While receiving treatment, a woman suffering from postpartum psychosis may receive a medication or a combination of medication such as:

• Antipsychotics to reduce hallucinations and delusions
• Mood stabilizers to reduce manic episodes 
• Antidepressants to reduce symptoms of depression
• Antianxiety to reduce symptoms of anxiety

Additionally, if the mother is not responding to the medication or needs further treatment, electroconvulsive shock therapy (ECT) is sometimes used in cases where medication or therapy has failed. Cognitive behavioural therapy (CBT) is also used in the treatment for postpartum psychosis, it is a type of talk therapy that helps change the way you think and behave. It is also recommended to continue CBT during recovery. 

As long as the right treatment is utilized, most mother’s will make a full recovery. Researchers suggest that the most acute symptoms of postpartum psychosis can last from two to 12 weeks or in severe cases, anywhere from six to 12 months. It is common to experience depression or anxiety even after the major psychosis symptoms dissipate.

References:

Nall, R. (2016, October 20). Postpartum Psychosis: Symptoms, Treatment and More. Retrieved January 14, 2021, from https://www.healthline.com/health/parenting/postpartum-psychosis

Postpartum psychosis. (2020). Retrieved January 14, 2021, from
https://www.nhs.uk/conditions/post-partum-psychosis/

What is Postpartum Psychosis? (n.d.). Retrieved January 14, 2021, from
https://www.app-network.org/what-is-pp/