Postpartum psychosis is a severe mental health condition that can affect mothers after giving birth. Learn why immediate diagnosis and treatment is essential.

Giving birth is accompanied by many natural physical and emotional changes. However, if a woman experiences disturbing thoughts or extreme mood swings soon after her baby is born, she may have postpartum psychosis.  

What Is Postpartum Psychosis?

Postpartum psychosis, also known as puerperal psychosis, is a rare but severe mental health condition that can affect new mothers. Postpartum psychosis commonly begins within the first two-three days after childbirth and can make caring for a newborn very difficult. 

However, postpartum psychosis can appear up to three months after giving birth. If left untreated, postpartum psychosis can lead to suicide or harm to the baby. Due to the severity of symptoms, quick diagnosis and treatment are needed to protect the safety and well-being of the mother and baby. Although postpartum psychosis symptoms are severe, episodes generally last only one to two and a half months with proper treatment.

Feelings of depression can lead to suicidal thinking. If you or a loved one is experiencing suicidal thoughts or tendencies, call the National Suicide Prevention Hotline at 1-800-273-8255.

Postpartum Psychosis vs. Postpartum Depression

Postpartum psychosis is far less common than postpartum depression, which affects 10%–13% of new mothers. Postpartum psychosis also has different and more severe symptoms that are not present during postpartum depression, including hallucinations and delusions. Due to these symptoms, treatment for postpartum psychosis is more intense and can include hospitalization.

Symptoms of Postpartum Psychosis

Symptoms of postpartum psychosis include:

  • Hallucinations (seeing or hearing things that are not there)
  • Delusions (unusual beliefs that are not true)
  • Paranoia
  • Confusion
  • Mood swings
  • Difficulty sleeping
  • Extreme excitement
  • Feeling unsettled
  • Racing, disorganized thoughts
  • Feeling disconnected from the world
  • Thoughts of harming yourself or your baby

Causes of Postpartum Psychosis

Although the exact causes of postpartum psychosis are unknown, medical professionals believe that several factors are involved, including:

Risk Factors

Some identified risk factors for postpartum psychosis include:

However, more than half of women who develop postpartum psychosis have no history of mental health conditions.

Diagnosing Postpartum Psychosis

Postpartum psychosis is considered a medical emergency that requires rapid diagnosis and treatment due to the risk of suicide or infant harm. 

Several screening methods are used to diagnose postpartum psychosis. The “Edinburgh Postnatal Depression Scale” and “Mood Disorder Questionnaire,” lists of questions administered during postnatal visits, can be used by doctors to diagnose postpartum psychosis. 

Women with a personal or family history of mental health conditions should discuss the risk of postpartum psychosis with their doctors and should be closely monitored after giving birth. Rare medical conditions can also mimic postpartum psychosis, so blood tests, urine tests and brain scans are also needed to ensure another disease is not causing the symptoms.

Postpartum psychosis is currently not recognized as a distinct mental health condition in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Instead, doctors add the wording “with postpartum onset” to “brief psychotic disorder,” or to another mental health condition if symptoms occur within four weeks of childbirth.

Statistics on Postpartum Psychosis

The rate of postpartum psychosis is between 0.89 and 2.6 per 1000 births when measured across several countries, including the United States, Nigeria, Denmark, India and Sweden.  

The average age of women with postpartum psychosis is 26.3 years when many women are having their first child. Suicide is observed in 5% of women with postpartum psychosis, highlighting the importance of proper diagnosis and treatment.

Postpartum Psychosis and Co-Occurring Disorders

According to the DSM-5, postpartum psychosis may be classified as a severe form of major depression or the beginning of another mental health condition, such as schizophrenia.  

However, researchers now believe that postpartum psychosis is linked to bipolar disorder.  Despite these complications, women who experience postpartum psychosis along with a co-occurring disorder have a good prognosis.

For women with bipolar disorder, 75%–86% remained symptom-free after a single episode of postpartum psychosis.  For women with schizophrenia, 50% remain symptom-free after a single episode of postpartum psychosis.

Postpartum Psychosis Treatment

After diagnosis, postpartum psychosis treatment should begin immediately to protect the mother and baby. Initial hospitalization is common while creating a treatment plan. Once symptoms are under control, postpartum psychosis can be mitigated with a combination of therapy and medication.

Treatment for postpartum psychosis can include:

  • Talk therapy
  • Antipsychotic medications
  • Antidepressant medications
  • Antiepileptic medications
  • Electroconvulsive therapy

Although postpartum psychosis is a serious condition, with treatment, mothers usually have a favorable prognosis, recover quickly and do not experience long-term problems.

If you or a loved one is struggling with drug or alcohol addiction and co-occurring postpartum psychosis, The Recovery Village can help. You can receive comprehensive treatment for these co-occurring disorders from one of our facilities located throughout the country. To learn more about treatment programs, call The Recovery Village to speak with a representative today.

Camille Renzoni
Editor – Camille Renzoni
Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more
Candace Crowley
Medically Reviewed By – Dr. Candace Crowley, PhD
Dr. Candace Crowley received her B.S. in Biochemistry from Cal Poly, San Luis Obispo, and her Ph.D. in Immunology from UC Davis, where her thesis focused on immune modulation in childhood asthma. Read more
Sources

Rai, S.; Pathak, A; Sharma, I. “Postpartum psychiatric disorders: Early diagnosis and management.” Indian Journal of Psychiatry, July 2015. Accessed May 29, 2019.

Sit, Dorothy; Rothschild, Anthony; Wisner, Katherine. “A Review of Postpartum Psychosis.” Journal of Women’s Health (Larchmt), May 2006. Accessed May 29, 2019.

Tinkelman, Amanda; Hill, Emily; Deligiannidis, Kristina. “Management of New Onset Psychosis in the Postpartum Period.” Journal of Clinical Psychiatry, 2018. Accessed May 29, 2019.

VanderKruik, R; Barreix, M; Chou, D; Allen, T; Say, L; Cohen, L. “The global prevalence of postpartum psychosis: a systematic review.” BMC Psychiatry, 2017. Accessed May 29, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.