What is Postpartum Psychosis?

mumbabysleepPostpartum Psychosis (PP) is a severe, but treatable, form of mental illness that occurs after having a baby. It can happen ‘out of the blue’ to women without previous experience of mental illness. There are some groups of women, women with a history of bipolar disorder for example, who are at much higher risk. PP normally begins in the first few days to weeks after childbirth. It can get worse very quickly and should always be treated as a medical emergency. Most women need to be treated with medication and admitted to hospital.

With the right treatment, women with PP do make a full recovery. Recovery takes time and the journey may be tough. The illness can be frightening and shocking for both the woman experiencing it and her family. Women do return to their normal selves, and are able to regain the mothering role they expected. There is no evidence that the baby’s long term development is affected by Postpartum Psychosis.

The period after childbirth can be a devastating time to experience a severe mental illness. For women who experience PP, their partners, friends and family, it can be hard to find high quality information about the symptoms, causes and treatment.

Symptoms

There are a large variety of symptoms that women with PP can experience. Women may be:
• Excited, elated, or ‘high’.
• Depressed, anxious, or confused.
• Excessively irritable or changeable in mood.

Postpartum Psychosis includes one or more of the following:
• Strange beliefs that could not be true (delusions).
• Hearing, seeing, feeling or smelling things that are not there (hallucinations).
• High mood with loss of touch with reality (mania).
• Severe confusion.

These are also common symptoms:
• Being more talkative, sociable, on the phone an excessive amount.
• Having a very busy mind or racing thoughts.
• Feeling very energetic and like ‘super-mum’ or agitated and restless.
• Having trouble sleeping, or not feeling the need to sleep.
• Behaving in a way that is out of character or out of control.
• Feeling paranoid or suspicious of people’s motives.
• Feeling that things are connected in special ways or that stories on the TV or radio have special personal meaning.
• Feeling that the baby is connected to God or the Devil in some way.

There are a great many other symptoms that can be experienced. For more information see mums’ and dads’ personal descriptions of PP.

Diagnosis

Postpartum Psychosis is the label used by most professionals for an episode of mania or psychosis with onset soon after childbirth. However, other names can be used and this can be confusing. You might hear the terms: Puerperal Psychosis; Postnatal Psychosis; Mania or Bipolar Disorder triggered by childbirth (this doesn’t necessarily mean that your partner will develop ongoing Bipolar Disorder); Schizoaffective Disorder with onset following childbirth (this doesn’t necessarily mean that your partner will develop ongoing Schizoaffective Disorder); Postnatal Depression with psychotic features.

There are many other mental health conditions that occur following childbirth, including Postnatal Depression (PND), severe anxiety, and Obsessive Compulsive Disorder. It is important that these conditions are not grouped under the term ‘Postnatal Depression’. PND is much more common than PP, but tends to require different treatments and has different causes and outcomes. 

Causes

Unfortunately we know little about the causes of PP. Research points to biological, probably hormonal, factors related to pregnancy and childbirth but many other factors are likely to be involved.

For further information about PP take a look at our Frequently Asked Questions, read our Insider Guides, see the Royal College of Psychiatrists PP patient information leaflet which we have helped to develop, read the personal stories of APP members, and find out about the research we are conducting to help understand more about the condition.