Postpartum Psychosis

Postpartum psychosis is a rare condition in which an individual who has just given birth experiences sudden, severe psychiatric symptoms.

This condition usually starts between a few days and four weeks after the baby is born. People experiencing postpartum psychosis generally experience delusions and/or hallucinations, sometimes without having ever had a psychotic episode in the past.

It’s very common for new parents to experience mental health challenges after the birth of a child, but postpartum psychosis is an especially acute condition that requires immediate, intensive treatment.

How common is postpartum psychosis?

Compared to other conditions that occur after the birth of a child (such as postpartum depression), postpartum psychosis is very rare.

According to Postpartum Support International, postpartum psychosis occurs after only about .1-.2% of all births. Put differently, 1 or 2 out of every 1,000 pregnancies might lead to postpartum psychosis.

Postpartum psychosis is also somewhat more common among women who have previously been diagnosed with bipolar disorder or schizophrenia.

What are some symptoms of postpartum psychosis?

Symptoms of postpartum psychosis can vary, but they are often sudden and quite noticeable. Common symptoms include:

• Delusions: Delusions refer to believing things that aren’t true. In postpartum psychosis, these beliefs may relate to the baby (such as believing it is evil) or oneself (such as feeling certain that one is doomed to be a bad parent).
• Hallucinations: Hallucinations refer to hearing, seeing, or otherwise sensing things that aren’t present.
• Mania: People with postpartum psychosis may experience enormous amounts of energy, as well as restlessness and/or a decreased need for sleep.
• Sudden or frequent changes in mood or energy level: As in bipolar disorder, postpartum psychosis can involve quick, extreme mood swings or changing in energy level.
• Thoughts of self-harm or harming others: Thinking about hurting oneself or other people (especially one’s baby) can be part of postpartum psychosis, though not everyone experiences this symptom.
• Paranoia: A common feature of postpartum psychosis is feeling like others are out to harm oneself (or one’s baby).

It’s important to note that these symptoms start within the first few weeks after the baby’s birth, and that they often require immediate treatment.

How is postpartum psychosis different from related conditions?

Postpartum psychosis is generally unique in that it includes delusions and/or hallucinations.

However, it can also overlap to some extent with these other conditions that can stem from pregnancy and/or childbirth:

• Postpartum depression: Postpartum depression may come with or without anxiety symptoms. Anxiety symptoms can also appear on their own in the postpartum period. These conditions often persist for months or more.
• “Baby Blues:” Many mothers and fathers feel some symptoms of anxiety and depression immediately after a child’s birth, but they may go away on their own in a matter of weeks, unlike postpartum depression and anxiety.
• Antenatal anxiety or depression: It’s common for both mothers and fathers to experience mental health challenges during the mother’s pregnancy.
• Postpartum OCD: New parents sometimes experience symptoms of obsessive-compulsive disorder (OCD).
• Challenges associated with high-risk pregnancies and births: Parents dealing with high-risks pregnancies and births—such as premature births or multiple births—may experience especially high levels of stress and be more prone to perinatal mental health challenges.

What to do if you or a loved one is experiencing postpartum psychosis

Postpartum psychosis should generally be viewed as a psychiatric crisis.

Postpartum psychosis is treatable and usually temporary, but in most cases, it is necessary to seek medical treatment immediately, starting with a visit to the emergency room.

Some of the following treatment options may be effective for postpartum psychosis:

• Therapy. Once your condition is stable, a therapist can work with you to process your experiences and reduce any remaining symptoms. (See more tips on finding a therapist below.)
• Check-ups: Because postpartum psychosis can be linked to the hormonal changes of pregnancy and childbirth, it’s especially important to stay up-to-date with your medical appointments. Your medical doctor can help you rule out physical conditions that may contribute to your symptoms and make sure that you and your baby stay well.
• Medication: Medication is often necessary for treating postpartum psychosis. Medication management can be especially challenging if you are breastfeeding, so a psychiatric professional can help you assess your options and decide if medication is the right choice for you.
• Support groups. Once your symptoms are under control, a support group can give you perspective, understanding, and solidarity from other parents who have also experienced postpartum psychosis. You can search for a support groups and resources in your area through Postpartum Support International.
• Hotlines: If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at 1-800-273-8255.

What should I look for in a therapist for postpartum psychosis?

The most important thing is to seek treatment immediately from a hospital or other medical provider. Postpartum psychosis usually involves hospitalization and/or medication in the short term.

In the long term, you may also want to work with a therapist to process your experience and work through any symptoms that remain. In this case, you’ll want to make sure that your therapist is qualified to treat people who have experienced postpartum psychosis. This will usually involve:

• Advanced education in a field related to mental health, such as psychiatry, psychology, or social work;
• Licensure to practice in the state where you live;
• Additional training and/or experience in treating perinatal mental health concerns, and postpartum psychosis specifically, which will usually also mean experience collaborating with your medical team.

Finally, as with any therapy, it’s important to make sure that your therapist is a good fit for your unique needs. Be sure to evaluate the following in your initial calls with therapists:

• How will you pay for therapy? Does the therapist take your insurance or otherwise offer rates that will work with your budget?
• When and where will you attend sessions? Does the therapist offer treatment at a location that is convenient for you and at times that work with your schedule?
• Most importantly, do you feel comfortable talking to this therapist and sense that you have the potential to develop a therapeutic alliance?