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Understanding Postpartum Psychosis

Postpartum psychosis is a rare and very serious type of depression that can occur after pregnancy. It mainly affects women who have a personal or family history of bipolar disorder, or who had a past psychotic disorder. Postpartum psychosis is a medical emergency. It’s vital to call your healthcare provider and get help right away.

What is postpartum psychosis?

Postpartum psychosis is a very rare mood disorder that affects some new mothers. It occurs in only 1 or 2 out of every 1,000 births. It's much less common than the “baby blues” (postpartum blues) and postpartum depression. And the symptoms are much more severe.

Psychosis is a serious mental disorder. It makes you lose touch with reality. A woman with postpartum psychosis may start to see, hear, or believe things that are not real. She may think that other people are trying to harm her. She may try to hurt herself or her baby. Symptoms often occur in the first 2 weeks after birth.

This condition is a medical emergency. If you or a family member feel you may have this condition, call your healthcare provider right away. Treatment is available.

What causes postpartum psychosis?

Experts don’t know the exact cause. It’s likely caused by a mix of things, including:

  • Inherited (genetic) factors

  • Drops in hormone levels after birth

  • Immune system issues

Severe lack of sleep may also play a role.

Symptoms of postpartum psychosis

Symptoms can appear suddenly, in the first 2 weeks after a baby is born. They may include 1 or more of these main symptoms:

  • Having strange thoughts and beliefs that are not true (delusions)

  • Seeing, hearing, feeling, or smelling things that are not there (hallucinations)

  • Not able to think clearly

  • Acting inappropriately

Other symptoms can include:

  • Depression

  • Trouble sleeping

  • Anxiety

  • Feeling that other people want to hurt you

  • Feeling hopeless or upset

  • Trouble functioning

  • Mood changes

  • Having a lot of extra energy

  • Thinking about hurting yourself, your baby, or others

Are you at risk for postpartum psychosis?

Some women may have this condition without having any risk factors. But you are most at risk for this condition if you:

  • Have a personal or family history of mental illness, such as bipolar disorder

  • Had a psychotic disorder before your pregnancy. This includes schizophrenia or schizoaffective disorder.

Diagnosing postpartum psychosis

Getting a diagnosis right away is vital. Your healthcare provider will give you a physical exam. He or she will ask about your health history, including your symptoms and any past or current psychiatric conditions.

You may be asked to fill out a form that can identify depression. You may also need lab tests to rule out other conditions that could cause behavior changes.

Treatment for postpartum psychosis

It’s important to start treatment right away, for the safety of the mother and her baby. A woman with this condition may need to be hospitalized until she is stable. She should not be left alone with her baby.

Antipsychotic medicines are the main type of treatment. These medicines can reduce the delusions and hallucinations. They may be used for about a year. This is to reduce the risk of relapse. But some women may need to take these for the rest of their lives. Other medicines may also be needed, depending on the full diagnosis and other symptoms. Tell the healthcare provider if you are breastfeeding. He or she will choose medicines that are safe.

Talk therapy (counseling or psychotherapy) may also be used once symptoms are under control.

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