Postpartum Psychosis: Symptoms, Treatment, and Who's at Risk
It's important to recognize the symptoms of postpartum psychosis, a serious condition that requires immediate treatment.
Most of us are familiar with postpartum depression, which is characterized by intense feelings of sadness that stretch past the baby blues. While PPD is a serious condition, there is another lesser-known postpartum disorder that's perhaps even more worrisome: postpartum psychosis. Read on to learn about what this extremely emergent condition is, what the symptoms are, how it's diagnosed and treated, and how postpartum psychosis differs from postpartum depression.
What is Postpartum Psychosis?
Postpartum psychosis is a temporary and treatable illness that can cause delusions or strange beliefs. It affects new moms in 0.1 -0.2% of births—or one to two of every 1,000 deliveries, according to Postpartum Support International. "[It'] a psychiatric emergency usually necessitating rapid intervention or hospitalization because of the potential risk of suicide and harm to the newborn," says Bushra Mubashshir Shah, M.D., assistant professor of psychiatry at the Virginia Commonwealth University. "It can present in a dramatic fashion, with onset of symptoms as early as the first 48 to 72 hours after delivery."
According to Dr. Shah, risk factors of postpartum psychosis include a prior history of postpartum psychosis, a personal history of bipolar disorder, and a family history of schizophrenia or bipolar disorder."
Symptoms of Postpartum Psychosis
To understand postpartum psychosis, it helps to look at the symptoms. According to Tal E. Weinberger, M.D., director of adult outpatient services and clinical assistant professor at Sidney Kimmel Medical College at Thomas Jefferson University and Hospital, "Symptoms can include hallucinations, delusions, bizarre behavior, and disorganized thinking."
Other common symptoms include obsessive thoughts regarding the infant, and in some cases, delusions of suicide or infanticide, adds Kristina M. Deligiannidis, M.D., associate professor, Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research.
"For approximately 50 percent of women with postpartum psychosis, the postpartum episode is the first manifestation of mental illness," Dr. Weinberger explained to Parents.com. And that is why the experience can be so scary. Consider too that, as Weinberger notes, "Women with postpartum psychosis will often lack insight into the fact that she is manifesting symptoms of a mental illness." She adds, "In this case, it is crucial for friends or family members to seek treatment on her behalf, even when she is resistant to their efforts or angry with them for intervening."
Diagnosing Postpartum Psychosis
Dr. Deligiannidis emphasizes that postpartum psychosis is a psychiatric emergency. "Women are significantly impaired by their symptoms as the brain disorder interferes with their ability to determine what is real or not real," she says. To make a proper diagnosis, it's important to first rule out other potential causes of symptoms. "Inpatient hospitalization is recommended for evaluation and treatment as it provides a safe setting for the medical workup and reduces the risk of harm to mother or infant," she says.
Treatment for Postpartum Psychosis
If a new mother is diagnosed with postpartum psychosis, she'll require treatment involving medications that reduce symptoms and restore function, according to Dr. Deligiannidis. These medications include antipsychotics, lithium, and benzodiazepines. Sometimes electroconvulsive therapy (ECT) is recommended. "Psychotherapy may be used to encourage treatment adherence and to provide support," adds Dr. Shah.
Postpartum Psychosis vs. Postpartum Depression: What's the Difference?
It's crucial to note that postpartum depression, which can affect up to 20 percent of women, is far more common than postpartum psychosis, which only occurs in one to two out of 1,000 births. According to Dr. Weinberger, PPD "typically develops more slowly than postpartum psychosis, and commonly begins between one to two weeks, to a month after delivery."
PPD symptoms are similar to depression and include feeling sad, empty, overwhelmed, angry, and irritable. Mood swings are common, and so is sleeping and/or eating too much or too little, having difficulty concentrating and making decisions, and losing interest in activities that were previously enjoyable. However, women with PPD typically won't suffer from delusions or hallucinations (the telltale sign of psychosis), and they can still maintain a connection to reality.
If you think you or someone you love is suffering from postpartum psychosis, contact a doctor right away.