Postpartum Psychosis: Symptoms, Treatment, and Who's at Risk

It's important to be able to recognize the symptoms of this serious postpartum condition that requires immediate treatment.
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Most of us are familiar with postpartum depression, either from experiencing it after the birth of a baby, or from knowing a mom friend who has dealt with more than just the baby blues. While PPD is a serious condition you should seek help for, there is another, lesser-known, birth-related disorder that is even more serious: postpartum psychosis. Read on to learn about what this extremely emergent condition is, what the symptoms are, how it is diagnosed and treated, and how postpartum psychosis is different from postpartum depression.

What is postpartum psychosis?

Postpartum psychosis is a temporary and treatable illness that can cause delusions or strange beliefs and affects new moms after .1 -.2% of births, 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. 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 exactly what postpartum psychosis is, 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," 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 diagnosis of postpartum psychosis is made, a woman will require treatment that involves medications which work on the brain to 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

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 is rare, occurring in one to two out of 1,000 births.

According to Dr. Weinberger, another distinguishing characteristic is that 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, crying, experiencing mood swings, anger and irritability, sleeping and/or eating too much or too little, having difficulty concentrating and making decisions, and losing interest in activities that were previously enjoyable.

"A woman with postpartum depression can feel emotionally disconnected from the baby and other friends and family, can doubt her ability to care for the baby, and can even have thoughts about harming herself or the baby," she says. She typically won't suffer from delusions or hallucinations, however, and can still maintain her connection to reality.

If you think you or someone you love is suffering from postpartum psychosis, contact a doctor to get help right away.

The media often confuses postpartum depression and postpartum psychosis, but the two are quite different, since psychosis is considered a psychiatric emergency. Dr. Judy Greene explains the symptoms of postpartum psychosis, and what to do if you think you have it.

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