What is Postpartum Psychosis?

Many women feel great joy and happiness after giving birth to a child, while others deal with the darker side of motherhood - postpartum depression. A still smaller percentage of women have more disturbing symptoms after giving birth. Not only do they feel irritable and restless, they have psychotic symptoms such as disordered thinking and visual and auditory hallucinations. This frightening condition called postpartum psychosis affects up to 1 in 500 women after childbirth.

Other Symptoms of Postpartum Psychosis

The symptoms of postpartum psychosis usually appear soon after birth, most commonly within the first few days but almost always within the first two weeks. Women suffering from this condition may appear restless and agitated and have difficulty sleeping. The new mom's mood can rapidly change from calm to agitated, and she may say and do bizarre things.

Some women with postpartum psychosis become very talkative and social, but their thoughts and ideas are frequently hard to follow. At the other end of the spectrum, some women become withdrawn, almost unresponsive to human contact and pay little attention to their new baby.

These early symptoms of postpartum psychosis usually progress to visual and auditory hallucinations and the new mom may be suspicious of the motives of others. These symptoms are very similar to what people with schizophrenia experience.

Postpartum Psychosis: When Does It Go Away?

Fortunately, the outlook for women with postpartum psychosis is better than that of schizophrenia. With medical treatment using antipsychotic medications, postpartum psychosis usually resolves in a few weeks. Without treatment it can linger for months. Some women with this condition are at high risk for suicide, so a brief hospitalization may be safest.

Do women with postpartum depression ever harm their children? Andrea Yates, the mother who murdered her five children by drowning them in a bathtub, was incorrectly labeled as having postpartum depression, but her diagnosis was later revised to postpartum psychosis.

Women with postpartum psychosis are more likely to harm themselves through suicide than harm their children - but it does happen. According to the Encyclopedia of Domestic Violence, about 4% of women with postpartum psychosis show signs of violence towards their children - but this is still too many.

What Causes Postpartum Psychosis?

Women who have a history of mental illness such as bipolar disorder or schizophrenia are at higher risk for this disorder. In fact, some experts believe the symptoms of postpartum psychosis may be a manifestation of undiagnosed bipolar disorder brought on by the stress and hormonal changes of pregnancy. After pregnancy, estrogen levels rapidly drop, which may trigger conditions such as postpartum psychosis and postpartum depression. Women with a family history of bipolar disorder or schizophrenia are also at higher risk for postpartum psychosis.

The Bottom Line?

Postpartum psychosis is an uncommon but serious condition that occurs after childbirth. Fortunately, most women can be successfully treated, although their risk of having another psychotic episode with future pregnancies is still higher.

References:

Encyclopedia of Domestic Violence. "Postpartum Depression, Psychosis and Infanticide"

British Journal of Psychiatry 172: 521-526.

Medscape.com. "What is Postpartum Depression?"