What Is Postpartum Psychosis, And How Can You Find Support?
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Psychosis can be seen as a severe emotional state involving a cluster of symptoms that can lead to a mental health crisis. When in psychosis, an individual might experience hallucinations, delusions, and disorganized thoughts that indicate a disconnect from reality.
There can be various causes for psychosis, and each person may have a different experience. Some gestational parents experience psychosis during or after pregnancy, and this is typically referred to as postpartum psychosis. Understanding the unique symptoms of this condition may help individuals identify psychosis in themselves and others and promptly seek professional support.
What is postpartum psychosis?
In a study published in StatPearls, postpartum psychosis is defined as “extreme confusion, loss of touch with reality, paranoia, delusions, disorganized thought process, and hallucinations.” The study reports that psychosis impacts approximately one to two women of childbearing age per 1000. Anyone with a gynecological reproductive system who has become pregnant may be at risk of this condition, so being educated on symptoms and presentations may be helpful.
The most common symptoms of postpartum psychosis include the following:
- Confusion
- A significant increase or decrease in energy
- Difficulty falling or staying asleep
- Obsessive thoughts about one’s baby
- Paranoia
- Delusions
- Hallucinations
- Disorganized speech and behavior
- Attempts to harm oneself or their child
Postnatal psychosis most frequently arises while caring for a newborn after childbirth, often within days or weeks of birth. This condition is considered an emergency and can be life-threatening or lead to harmful actions.
Is postpartum psychosis a symptom of postpartum depression?
Postpartum psychosis is not listed as a standalone diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). This condition is considered a subtype of “short psychotic disorder” in the Schizophrenia Spectrum and Other Psychotic Disorders category.
However, postpartum depression (PPD) is listed in the DSM-5 as a diagnosable depressive disorder. In rare cases, psychotic symptoms can accompany any type of depression. For this reason, people living with PPD may be at risk of postpartum psychosis.
Depressive symptoms of postpartum depression can include the following:
- Extreme fatigue
- A lack of emotional connection with the newborn
- Numbness or emotional distance
- Difficulty falling or staying asleep
- Increased or decreased appetite
- Anxiety
- A lack of interest in previously enjoyed activities
- A lack of motivation
- Social withdrawal
- Difficulty practicing self-care and hygiene habits
- Hopelessness or thoughts of worthlessness
- Believing one is a “bad parent”
- Desires to no longer be a parent
- Thoughts of suicide and self-harm
If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.
Causes and risk factors for postpartum psychosis
Postpartum psychosis (sometimes called puerperal psychosis, which refers to psychosis that develops in the six-week period following childbirth) has not been found to have one single cause. Experts believe a combination of factors may impact its development, including, but not limited to, those listed below:
- A family history of serious mental illness, especially schizophrenia spectrum or psychotic disorders
- A diagnosis of schizophrenia, a psychotic disorder, delusional disorder, or bipolar disorder
- Birth trauma
- The cessation of psychiatric medication during pregnancy
- A postpartum depression diagnosis
- Previous psychotic episodes
- Younger age (under 25)
- Medical conditions, such as an autoimmune disorder
- Having mood swings while pregnant
- Having a higher weight
- Having an unplanned pregnancy
If you are at high risk for postpartum depression or psychosis, reaching out to a doctor after you give birth may be helpful to be screened for both conditions. However, note that some people may develop this condition even without any risk factors, and some people with the risk factors may not experience postpartum psychosis.
Can postpartum psychosis occur while still pregnant?
Postpartum psychosis is sometimes referred to as “perinatal psychosis” when a psychotic episode is experienced while one is still pregnant, usually a few weeks before giving birth. Fewer studies have been done on psychosis during pregnancy. However, psychotic episodes should always be taken seriously. Reach out to your OBGYN or doctor if you experience new or unusual mental health symptoms while pregnant.
How is postpartum psychosis diagnosed?
Postpartum psychosis is often diagnosed by a medical doctor like a psychiatrist or a licensed mental health provider like a therapist. They may use a psychosis screening tool and interviews to learn more about your symptoms. Other tests might include blood tests and imaging scans, such as magnetic resonance imaging (MRI) or computerized tomography (CT) scans.
If you are still pregnant, the doctor might examine your baby to see how it is developing and if there are any complications.
How is postpartum psychosis treated?
If you believe you or a loved one could be experiencing psychosis, seek support immediately. Treating psychosis in the early stages may improve one’s chances of a quick recovery. Below are a few options for support.
Call a hotline or go to the hospital
If you are in active psychosis, do not wait to get help. Call one of the hotlines listed above to ask for support. You can also go to your local hospital emergency department to talk to them about your symptoms. Hospital staff are typically trained to screen for psychosis and other mental health emergencies.
If you’re unsure how to care for your children while seeking help, it might be helpful to talk to the Postpartum Support International HelpLine at 1-800-4773. They may be able to help you find childcare support in your area. Caring for your mental health and your child’s well-being is a priority, and you’re not weak for seeking help.
Consider a support group
Postpartum Support International lists two online support groups that may be helpful for people experiencing the aftereffects of psychosis:
You can also search for local support groups to meet with other parents who may have experienced similar symptoms or challenges. If you are in active psychosis, consider seeking crisis resources before attending support groups, which generally cannot provide the necessary support for acute symptoms.
Talk to a doctor or psychiatrist about medication
Medication can is often a firstline treatment for psychosis and can effectively reduce psychotic symptoms. By speaking to a doctor, like a psychiatrist, a client can discuss the possibility of antipsychotics or antidepressants to regulate their mood. Typical and atypical antipsychotic medications are often prescribed. Because postpartum psychosis is normally a temporary condition, your doctor might monitor your symptoms and guide you to gradually decrease the dosage and discontinue the medication. In rare cases, doctors may use medical interventions like electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) to manage symptoms.
Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.
Practice self-care
Self-care can be helpful when recovering from a psychotic episode. Caring for yourself may prevent further difficulties and help you regulate your mood throughout the day. When you care for yourself, you may be better able to care for your child. Below are a few self-care activities to try:
- Engaging in physical movement, such as walking, taking a swim class, or going to a dance class that allows you to take your baby with you
- Eating nutritious meals that nourish your body
- Asking family members and other support individuals to care for your baby during difficult moments after giving birth
- Reaching out to a crisis line if you notice symptoms starting to appear again
- Journaling about your experiences with psychosis and birth
- Practicing daily hygiene
- Partaking in your hobbies, such as art, cooking, or sewing
- Listening to music
- Spending time in groups, such as a parenting group or support group
Talk to a therapist
Although therapy may not be an immediate crisis resource, talking to a therapist can be helpful before or after a psychotic episode has occurred to help you make a safety plan, develop coping mechanisms, and move forward. However, new parents are often busy and may struggle to find an in-person therapist to meet their scheduling needs. In these cases, online therapy platforms like BetterHelp may be a more convenient option.
With an online platform, you can be matched with a therapist who meets your needs and has experience treating individuals struggling with postpartum mental health challenges. In addition, you can choose between phone, video, or live chat sessions at a time that fits your schedule.
Online therapy has been extensively studied in the context of depression, which can commonly occur alongside postpartum psychosis or after a psychotic episode. In one study, online therapy tended to be more effective than in-person options at reducing depression symptom severity and increasing quality of life.
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