Postpartum psychosis

Postpartum psychosis is a very serious mental illness that usually starts in the days or weeks after birth.

You may not be able to look after yourself or your baby very well. There are many different symptoms, which include:

  • being severely depressed
  • being manic – excessively energetic and talkative
  • quick changes of mood from high to low to high to low
  • being restless and agitated
  • being very withdrawn
  • being very confused
  • not sleeping
  • racing thoughts
  • hearing voices or seeing things that aren’t there (hallucinations)
  • developing odd thoughts or beliefs (delusions)
  • feeling things aren’t real (like you’re in a dream world)
  • feeling paranoid and suspicious of other people
  • behaviour that is out of character
  • feeling suicidal
  • thinking about harming yourself or your baby.

If you have postpartum psychosis you won’t necessarily experience all of these symptoms. Postpartum psychosis is a psychiatric emergency. You should get help as soon as you suspect you might have it. It can happen to any woman, even those who have not been ill before, but women who have existing bipolar disorder or schizophrenia are at higher risk.

With treatment the vast majority of women recover fully from postpartum psychosis.

“A few days after my first child was born, I developed classic symptoms of postpartum psychosis. I was very excited and soon became extremely tired and anxious. I had to leave my baby with her father and spend some time in a psychiatric unit to recover."Clare, mum of two

How common is it?

Around one in every thousand women develops postpartum psychosis after giving birth.

What should I do?

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

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

“When my twins were babies, I developed psychosis. I was hearing them crying when they weren’t even in the house. The twins’ dad made me go and see a doctor and I was given antipsychotic medication.”Shamim, mum of two

Risk factors for postpartum psychosis

Postpartum psychosis is not caused by anything you have done. Some women who have never had a mental health problem before develop postpartum psychosis ‘out of the blue’. However, you are at greater risk of getting postpartum psychosis if:

  • you have had bipolar disorder
  • you have had schizoaffective disorder
  • you have had a diagnosis of schizophrenia or another psychotic illness
  • a close relative has had postpartum psychosis.

Can anything be done to prevent postpartum psychosis?

If you have one of the mental health problems mentioned above in 'Risk factors' (such as bipolar disorder), you can have help and treatment which may prevent you getting postpartum psychosis.

You should tell your midwife early in pregnancy that you have had one of these mental health problems (even if you have been well for some time).

The midwife can refer you to a mental health service (ideally a specialist perinatal mental health service) so that you can discuss what can be done to prevent you becoming unwell. They will also make a plan with you to make sure you stay as well as possible, and that you get help quickly if you do become unwell.

You should be visited regularly in the weeks after the birth so that if you get unwell it can be picked up quickly.

Treatment for postpartum psychosis

It’s essential to get treatment as soon as possible. If you get treated quickly you will usually recover well. You will normally be treated with medication and you may need to be admitted to a specialist hospital ward. Some hospitals have psychiatric mother and baby units so your baby can stay with you. If you are breastfeeding, talk to the doctor treating you about the risks and benefits of take medication while breastfeeding.

Will I need to be referred to Children & Families Social Services?

You may be referred to Children & Families Social Services in pregnancy if you have a high risk of developing postpartum psychosis, or after birth if you actually develop it. The referral will be discussed with you (unless you are too unwell).

Sometimes women worry that this means that people think they cannot care for their baby, but this isn’t usually the case. It is very rare for babies to be removed from women with postpartum psychosis.

The reasons for Social Services assessment are:

  • to check the support you have from family, friends and professionals
  • to make sure there is safe plan for your baby if you are too unwell to care for him or her.

You may need extra help from family members during illness and recovery. If you have no support from family or friends, social services may be able to help. Social workers can find a temporary carer for your baby if you need to go into hospital and there is no place available in a Mother and Baby Unit.

More information and support

Action on Postpartum Psychosis: Information and support, online chatroom, peer support network.

Other resources

Read more

Sources

  1.  RCP (2014) Postpartum psychosis, London: RCP, 2014. Royal College of Psychiatrists. Available at:http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/postpartumpsychosis.aspx
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Last reviewed on February 1st, 2015. Next review date February 1st, 2018.

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