postpartum psychosis

The human mind can play some nasty tricks sometimes, and postpartum psychosis is one of them.

This rare disorder, which affects only one or two mothers for every thousand, can be very dangerous and needs to be treated. It’s important to raise awareness, because even if there are risk factors, it can actually affect anybody.

Nowadays, we’re finally getting some attention towards postnatal depression, another condition that affects new mums and that has remained sort of hidden for a long time. It’s important to speak about this sort of conditions, since due to the pressure felt by the new mother – who thinks of herself as less of a mother due to these contradictory feelings-, they sometimes decide not to speak up and to deal with this themselves. That is the most dangerous part: If women who suffer from postpartum depression need professional help, women who suffer from postpartum psychosis need it even more, and with more urgency.

But what is postpartum psychosis, exactly? Don’t miss the following lines to find out more about this rare disorder.


What is postpartum psychosis? 

Postpartum psychosis, also called puerperal psychosis or postnatal psychosis, is a mental illness that affects some women (1 or 2 every 1.000) after having a baby. It usually appears early after birth, as soon as hours after the baby is born or during the first four weeks.

Theresa Twomey, author of Understanding Postpartum Psychosis: A Temporary Madness, and a victim of the disorder as well, defines it as:

A different reality superimposed onto this reality. It’s like watching a TV show and believing that it’s perfectly normal for the actors to be speaking to you. 

It is different from postnatal depression, even if they have some things in common: whereas the clinical profile of postpartum depression is mostly apathy and a deep sadness, together with feelings of guilt and rejection for the baby, postpartum psychosis symptoms are more related to paranoia and hallucinations. 

And why does it happen? Well, that is hard to say, since doctors aren’t really sure. There are certain risks factors, and some blame the hormonal disorders and fluctuations, as well as sleep deprivation. However there seems to be a genetic cause, since women who have a family history of postpartum psychosis are more likely to develop it.

These are the risk factors of postpartum psychosis:

  • Having had postpartum psychosis before: in fact, this is the most important risk factor, since women who have suffered it are likely to suffer another episode in subsequent pregnancies.

  • Having a history of mental illness: women who suffer from schizophrenia or bipolar disorder are more likely to suffer it.

  • Having a family history of postpartum psychosis or just psychosis.

Finally, it is important to highlight what doesn’t cause postpartum psychosis: Doctors may have not been able to find a clear cause, but what does not cause it is indeed very clear. Postpartum psychosis isn’t caused by anything the mother has done wrong. It’s not due to stress, or due to having problems at home. If you suffer from postpartum psychosis, do not feel guilty: you did nothing to trigger it.


The symptoms of postpartum psychosis

This disorder needs treatment as soon as possible, so it’s important to be aware of the signs that indicate it. These are the most frequent symptoms of puerperal psychosis:

  • Lots of unnatural energy: if you feel you have more energy that you’ve ever had before, and feel especially great – no sign of exhaustion even if you just had a baby. In fact, you are all the time doing things that need to be done, and talk and think very fast. You also feel unique and special, like nobody else in the world.

  • But also a lack of energy: signs of depression can also be a symptom – of course, if they are accompanied by others in this list. Anxiety, loss of appetite and a deep sadness are symptoms to watch out for.

  • Hallucinations: seeing and hearing things that don’t actually exist. Hearing voices is a common one.

  • Delusions: You believe things that are just not possible or very unlikely.

  • You have paranoia: You suddenly don’t trust your loved ones or hear voices that tell you they will want to hurt you or the baby. The voices could also tell you that you should hurt them – or even the baby.

  • Lack of sleep or restlessness.

  • Confusion.

Yes, it sounds quite unbelievable – but the signs of postpartum psychosis are similar to any other kind of psychosis, which means, in other words, losing your mind. Psychosis is a serious mental illness, however temporary, and it needs to be considered as a medical emergency.

However, with treatment, most women who suffer an episode of postpartum psychosis recover just fine. Yes, they may suffer another one in a future pregnancy, but the prognosis is especially good and the treatment response is fast. However, it needs to be caught on time, or else it could get worse or have awful consequences. The new mother who is suffering from postpartum psychosis may not be aware of it, and it could end up hurting herself or even the baby.

If you think someone you know may be having an episode, contact your GP immediately: they will know what to do. You can also call NHS 111, or 999 if you think there is an immediate danger. If you or your partner are at risk of suffering postpartum psychosis because you identify with the risk factors, talk to your doctor during pregnancy. You can design a care plan so you have a crisis team available if an episode takes place.


How is postpartum psychosis treated?

Fortunately, the response to the treatment is usually very good. Hospitalisation may be necessary, but it will be the doctor who will assess it depending on the case and the risks. However, the ideal situation is that the new mother is admitted to a psychiatric mother and baby unit, so they can keep bonding with their baby. It is also useful for them to understand that what is happening to them is in no way related to their value or their capability as a mother.

They will also be treated with medication, which will include one or more of the following:

  • Antipsychotics: They block the effects of dopamine, which is the chemical responsible of giving information to the brain.

  • Antidepressants: They will balance the moods and help with depression, irritability and confusion.

  • Mood stabilisers.

Of course, the doctors will test how these different drugs are working in case they have to change the course of treatment, and will also consider breastfeeding and other conditions the mother with postpartum psychosis will be suffering. 

Now that you know that this is a possibility, try to consider your options without panicking. First of all, remember that the disorder is rare; second, remember that the treatment is usually very effective, and with the help and support of your loved ones, you wouldn’t have any problem bonding with your baby after an episode. If you suffer an episode of postpartum psychosis, you may need a while to recover your self-confidence and to feel secure with yourself – that is completely normal.

You can get support at several charities and forums, like the Action Postpartum Psychosis, PANDAS and the Association for Post Natal Illness.


Postpartum psychosis is a form of mental illness and, unfortunately, in our society there is still a taboo about mental illness. But, as any other disorder, it can be cured and you 


Need help? Ask other mummies in CaptainMums' forum!


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