Postpartum Psychosis

Postpartum Psychosis

Postpartum psychosis is a MEDICAL EMERGENCY and requires immediate medical attention!

If you or a loved one is experiencing these symptoms and has recently given birth, contact a health care provider immediately or present to the emergency department at a hospital.

What is postpartum psychosis?

Postpartum psychosis (also called postnatal psychosis, or puerperal psychosis) is a mental illness that can affect any mother, including those that have no prior history of mental health issues. Postpartum differs from postnatal depression, characterised by mania, depression, confusion, hallucinations and delusions. Postpartum psychosis effects about 0.1% of women and postnatal depression effects about 10-15% of women. Postpartum psychosis starts suddenly in the days or weeks following birth

Why does postpartum psychosis happen?

As postpartum psychosis is rare, there is not a huge amount of research produced, but it is believed to be linked to genetics and hormone levels. It is important to remember postpartum psychosis is not your fault and it is not caused by stress.

What are the risk factors?

  • bipolar type 1 or schizoaffective disorder (20-50% more likely)

  • bipolar type 2 and schizophrenia (5-15% more likely)

  • postpartum psychosis in a previous pregnancy (50% more likely)

  • family history

Signs & Symptoms:

  • inability to eat or sleep

  • feeling full of energy or restlessness

  • agitation

  • feeling invincible

  • auditory and/or visual hallucinations

  • delusions (she or her baby have superpowers, someone is trying to hurt her baby, she should be punished for being a bad person/mother)

  • mania

  • suicidal ideology

  • self-harm or harming the baby

  • difficulty concentrating or severe confusion

  • making unrealistic plans

  • paranoia

  • overspending

  • difficulty coping with regular activities

  • feeling hopeless, helpless and worthless

  • extreme sudden mood swings

  • aggressive or violent behaviour

How is it diagnosed?

Postpartum psychosis can only be given a definitive diagnosis by a psychiatrist. Majority of women with postpartum psychosis need to be admitted to hospital for assessment and treatment.

How is it treated?

Most states in Australia have a mother and baby unit (MBU) where you can receive treatment for mental health conditions (including postpartum psychosis) while still being able to care for your infant safely with constant support and guidance. If there is not a bed available on a mother and baby unit, you will need to be admitted to a general psychiatric ward and have someone else look after your baby until you are able to transfer to a mother and baby unit.

In Western Australia, our public mother and baby unit is at King Edward Memorial Hospital.

Once released from a psychiatric unit of any kind, you will require a community perinatal mental health service until you fully recover.

Postpartum psychosis does require medication. You will likely be given an antipsychotic, mood stabiliser or both. If you are breastfeeding, you do need to notify your care provider as there are some medication options that are more breastfeeding friendly than others. Your psychiatrist will weigh up the risks and benefits of medicating while breastfeeding.

In rare cases, it may be suggested to try electroconvulsive therapy.

How can you support your partner or a loved one who suffers from postpartum psychosis?

  • be calm and supportive

  • take time to listen

  • help with housework and cooking

  • help with looking after the baby

  • assist in ensuring the mother is getting enough sleep

  • help with night time feeds

  • attend appointments to ensure you have a full understanding of the condition and the warning signs that mental health is regressing

Will I recover and how long will it take?

Most women fully recover from postpartum psychosis, however it is a long process. The first phase of treatment, generally while hospitalised, can take weeks to months to complete. The most severe symptoms are felt in the first 12 weeks and can take up to 12 months to fully recover. Most women who have experienced postpartum psychosis can take a long time to rebuild the confidence in friendships and relationships.

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