What is Postpartum Psychosis?

Postpartum psychosis is a very serious mental illness that begins suddenly in the first few days or weeks after having a baby. It should be treated with professional help. 

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Psychosis is when a person loses touch with reality. They may start to see, hear, and/or believe things that aren’t true. This effect can be very dangerous for a new mother and her baby.

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Of the women who develop postpartum psychosis, research has suggested that there are approximately a 5% suicide rate and a 4% infanticide rate associated with the illness. This is because the woman experiencing psychosis is experiencing a break from reality. In her psychotic state, the delusions and beliefs make sense to her; they feel very real to her and are often religious. Immediate treatment for a woman going through psychosis is imperative.

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It is also important to know that many survivors of postpartum psychosis never had delusions containing violent commands. Delusions take many forms, and not all of them are destructive. Most women who experience postpartum psychosis do not harm themselves or anyone else. However, there is always the risk of danger because psychosis includes delusional thinking and irrational judgment, and this is why women with this illness must be quickly assessed, treated, and carefully monitored by a trained healthcare perinatal mental health professional.

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What causes postpartum psychosis?

Postpartum psychosis is not your fault and isn’t caused by anything you have done. Some women develop postpartum psychosis even if they have never had a mental health problem before. However, you are at greater risk of getting postpartum psychosis if you have:

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• had postpartum psychosis before

• had a diagnosis of bipolar disorder or schizoaffective disorder

• had a diagnosis of schizophrenia or another psychotic illness

• a mom or sister who have had postpartum psychosis.

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How common is Postpartum Psychosis?

Postpartum Psychosis is a rare illness, compared to the rates of postpartum depression or anxiety. It occurs in approximately 1 to 2 out of every 1,000 deliveries. The onset is usually sudden, most often within the first 2 weeks postpartum.

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Psychosis symptoms

Postpartum psychosis symptoms are similar to those of a bipolar, manic episode. The episode usually starts with the inability to sleep and feeling restless or especially irritable. These symptoms give way to more severe ones. Examples include:

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• auditory hallucinations (hearing things that aren’t real, such as suggestions for a mother to harm herself or that the baby is trying to kill her)

• delusional beliefs that are usually related to the infant, such as that others are trying to harm her baby

• disoriented as to place and time

• erratic and unusual behavior

• rapidly changing moods from extreme sadness to very energetic

• suicidal thoughts

• violent thoughts, such as telling a mother to hurt her baby

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Postpartum psychosis can be severe for a mother and her little one(s). If these symptoms occur, it’s important that a woman receives medical help immediately.

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What are the risk factors?

While some women can have postpartum psychosis with no risk factors, there are some factors known to increase a woman’s risk for the condition. They include:

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• history of bipolar disorder

• history of postpartum psychosis in a previous pregnancy

• history of schizoaffective disorder or schizophrenia

• family history of postpartum psychosis or bipolar disorder

• first pregnancy

• discontinuation of psychiatric medications for pregnancy

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The exact causes of postpartum psychosis aren’t known. Doctors know that all women in the postpartum period are experiencing fluctuating hormone levels. However, some seem to be more sensitive to the mental health effects of changes in hormones like estrogen, progesterone, and/or thyroid hormones. Many other aspects of health can influence the causes of postpartum psychosis, including genetics, culture, and environmental and biological factors. Sleep deprivation may also play a role.

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When to get medical help

Postpartum psychosis is a medical emergency. Some women become very unwell very quickly. If you suspect that you (or someone you know) may have postpartum psychosis, contact your doctor (or your mental health team) and ask to be seen the same day, or go immediately to ER.

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If you have bipolar disorder or a schizoaffective disorder, which increases your risk of getting postpartum psychosis, make sure everyone in your healthcare team is aware of it.

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Where To Get Help

Don’t be afraid to reach out if you or someone you know needs help. Learning all you can about mental health is an important first step.

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Reach out to your health insurance, primary care doctor, or state/country mental health authority for more resources.

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Contact the PPSC SupportLine to find out what services and supports are available in your community. 

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If you or someone you know needs help now, you should immediately call the National Suicide Prevention Lifeline at 1-800-273-8255 or call 911.

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