Early Symptoms of Postpartum Psychosis

Mother & babyTelling the difference between the normal emotions many women experience after having a baby and symptoms that indicate the start of a PP episode is difficult. 

We asked 127 women who suffered a PP episode to describe the symptoms they had before the full-blown onset of their PP. Symptoms are arranged in the table below in order of the frequency with which they were reported.
 
Many of the symptoms described are common in postnatal women and do not necessarily mean that a PP is beginning. If you are at high risk of PP, look out for these symptoms, and any other symptoms you have identified as an early sign of illness for you. Tell your partner and health professional if you experience any of them and ask them to help you monitor what is normal and unusual for you. 
 
Getting treatment for PP episodes early, means the illness will not have the chance to become as severe and you will recover more quickly.
 
It’s worth noting that symptoms of ‘high mood’ can be harder to identify than low mood or confusion. Most women in this study believed, at the time, that they were coping ‘ultra well’ with childbirth and a new baby – but in retrospect knew that these symptoms were unusual for them and believed they were early signs of the illness. 
 
Symptom number (%)  
Excited, elated, high, ‘over the moon’ giggly 66 (52)
Active, energetic, overactive 47 (37)
Chatty, sociable, talking more, always on the phone 45 (35)
Busy mind, racing thoughts, lots of ideas 40 (31)
Muddled thinking, mixed up, confused, not with it, disorientated 37 (29)
No need for sleep 32 (25)
Not able to sleep 29 (23)
Irritable, people getting on nerves, arguing, angry, impatient 29 (23)
Anxious 24 (19)
In a dream world, unreal, detached from world 21 (17)
Efficient, organising, lots of housework, making lists, lots of jobs 20 (16)
Distractible, getting nothing finished 19 (15)
Fearful, ‘paranoid’ 16 (13)
Disinhibited, saying/doing things would not normally say/do 14 (11)
Looking after baby easy, ‘super-mum’, capable, self-confident 13 (10)
Tearful, sad 13 (10)
Things beautiful, heightened perception, things more interesting 12 (9)
Alert, clear minded 12 (9)
Creative, writing more 10 (8)
Up and down, crying and laughing 9 (7)
Low mood, depressed 8 (6)
Tired, no energy 8 (6)
Agitated, stressed, tense 7 (6)
Overemotional, oversentimental 7 (6)
Increased libido 6 (5)
Excessive worries 6 (5)
Tearful but not sad 6 (5)
Spending more money 5 (4)
Not coping 5 (4)
Feeling more spiritual 4 (3)
Experiencing nightmares, vivid dreams 4 (3)
Disconnected from baby, baby does not feel like its mine 4 (3)

Heron J, McGuiness M, Blackmore Robertson E, Craddock N, Jones I. Early postpartum symptoms in puerperal psychosis. British Journal of Obstetrics and Gynaecology. 2008, Feb, 115 (3): 348-353.