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Postpartum Psychosis Is a Disabling Condition That Occurs After Childbirth

Kristie Leong M.D. is a family practitioner who believes in the power of nutrition and a healthy lifestyle to prevent and fight illness.

Postpartum Psychosis Is Common

Most women feel great joy and happiness after giving birth to a child, while others deal with the darker side of motherhood and have mental health issues that persist for weeks or months after birth. According to Cleveland Clinic, 1 in 7 women experiences postpartum depression after having a child, and a still smaller percentage of those women show even more disturbing signs and symptoms after giving birth. Not only do they feel irritable and restless, but they have psychotic symptoms such as disordered thinking and visual and auditory hallucinations.

This frightening condition, called postpartum psychosis, affects up to 1 in 500 women after childbirth. Postpartum psychosis is more common with a first pregnancy.

Signs and Symptoms of Postpartum Psychosis

The symptoms of postpartum psychosis usually appear soon after giving birth, most commonly within the first few days but almost always within the first two weeks.

  • Agitation and Sleeplessness. Women with this condition can become restless, agitated, and have difficulty sleeping.
  • Bizarre Behavior. The new mom’s mood can rapidly change from calm to agitated, and she may say and do bizarre things.
  • Talkativeness. Some women with postpartum psychosis become unusually talkative and social, but their thoughts, speech, and ideas are hard to follow.
  • Despondency. At the other end of the spectrum, some women become withdrawn and almost unresponsive to human contact, paying little attention to their new infant.
  • Hallucinations and/or Paranoia. (See more about this below.)

Women With Postpartum Psychosis May Experience Hallucinations and Paranoia

These early symptoms of postpartum psychosis usually progress to visual and auditory hallucinations, and the new mom may be suspicious of the motives of others. These symptoms are similar to schizophrenia, a mental disorder that affects a person’s ability to think, feel, and behave normally. They may seem like they have lost touch with reality. They may see or hear things that others don't and believe things that aren't true.

Postpartum Psychosis Eventually Resolves

Fortunately, the outlook for women with postpartum psychosis is better than that for schizophrenia, a chronic condition. With medical treatment, including antipsychotic medications, postpartum psychosis often resolves in a few weeks. Without treatment, it can linger for months. Some women with this condition are at high risk for suicide, so brief hospitalization may be necessary.

Postpartum Depression vs. Postpartum Psychosis

Do women with postpartum depression bever harm their children? Andrea Yates, the mother who murdered her five children by drowning them in a bathtub, was incorrectly labeled as having postpartum depression, but her diagnosis was later revised to postpartum psychosis.

Women with postpartum psychosis are more likely to harm themselves through suicide than to harm their children—but it does happen. According to the Encyclopedia of Domestic Violence, about 4% of women with postpartum psychosis display violence towards their children.

Another problem with postpartum psychosis is that women who have it may ignore the baby or be incapable of caring for it.

What Causes Postpartum Psychosis?

Women with a history of mental illness, such as bipolar disorder or schizophrenia, are at higher risk for postpartum psychosis. Bipolar disorder, also known as manic-depressive disorder, is a chronic mental illness that causes severe mood swings. People with bipolar disorder experience periods of high energy, known as mania, and low energy, known as depression.

Some experts believe the symptoms of postpartum psychosis are undiagnosed bipolar disorder caused by pregnancy's stress and hormonal changes. After pregnancy, estrogen levels rapidly drop, which may trigger conditions such as postpartum psychosis and postpartum depression. Women with a family history of bipolar disorder or schizophrenia are also at higher risk for postpartum psychosis.

Postpartum Psychosis Is Serious But Treatable

Postpartum psychosis is an uncommon but serious condition that occurs in women after giving birth. Fortunately, most women recover with treatment, although their risk of having another psychotic episode with future pregnancies is still higher than a woman who has never had this condition.. Fortunately, most women recover with treatment.

References:

  • Encyclopedia of Domestic Violence. “Postpartum Depression, Psychosis and Infanticide”
  • Sit D, Rothschild AJ, Wisner KL. A review of postpartum psychosis. J Womens Health (Larchmt). 2006 May;15(4):352-68. doi: 10.1089/jwh.2006.15.352. PMID: 16724884; PMCID: PMC3109493.
  • British Journal of Psychiatry 172: 521-526.
  • Medscape.com. “What is Postpartum Depression?”
  • "Postpartum Depression: Causes, Symptoms & Treatment - Cleveland Clinic." https://my.clevelandclinic.org/health/diseases/9312-postpartum-depression.
  • "Postpartum Psychosis: What It Is, Symptoms & Treatment." https://my.clevelandclinic.org/health/diseases/24152-postpartum-psychosis.
  • "Postpartum Psychosis: Symptoms, Treatment and More - Healthline." 20 Oct. 2016, https://www.healthline.com/health/parenting/postpartum-psychosis.

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.