Postpartum psychosis

Postpartum psychosis is a serious mental illness that can develop in mothers soon after childbirth, causing major changes in mood and behaviour. If you think you (or someone you know) could have postpartum psychosis, it’s important to see a doctor without delay.

What is postpartum psychosis?

Postpartum psychosis (also called postnatal psychosis, or puerperal psychosis) is a mental illness that can affect any mother, including those without any history of mental illness. The condition can come on very suddenly – sometimes within hours of giving birth.

The word ‘psychosis’ refers to a loss of sense of reality. If you have postpartum psychosis, you may be seeing or hearing things that are not there (hallucinations), feeling everyone is against you (paranoia) and powerful delusions (beliefs that clearly conflict with reality). Women with postpartum psychosis need specialised psychiatric treatment to get better.

Postpartum psychosis is not the same as postnatal depression, which begins after giving birth. While postnatal depression affects more than 1 in 7 new mothers each year in Australia, postpartum psychosis is rare, affecting only about 1 or 2 women in every 1,000 mothers.

Signs and symptoms of postpartum psychosis

Signs of postpartum psychosis usually start to show in the first week or 2 after childbirth, although they may take up to 12 weeks to appear.

Postpartum psychosis causes significant changes to mood and behaviour. They can be manic (lots of energy and racing thoughts), psychotic (an altered sense of reality) and/or depressed (low energy and mood).

Symptoms may include:

  • extreme sudden mood swings
  • being aggressive or violent
  • being very agitated
  • speaking in a disordered or nonsensical way
  • having irrational or delusional thoughts or beliefs
  • having hallucinations and changes in sense perception (like smelling, hearing or seeing things that are not there)
  • feeling paranoid
  • finding it hard to concentrate
  • not being able to sleep, sometimes for day
  • responding in an unusual or inappropriate way towards the baby
  • thinking of or planning to harm yourself or your baby

If you notice these kinds of changes in yourself, or someone close to you, you should seek professional help. See your GP, local hospital emergency department, or call one of the support services listed at the end of this article.

How is postpartum psychosis diagnosed?

Postpartum psychosis is a very serious mental health illness, and diagnosis is made by a psychiatrist. Most women with postnatal psychosis need to be admitted to hospital for psychiatric assessment and treatment.

How is postpartum psychosis treated?

Postpartum psychosis is treatable. After getting the necessary treatment, most women make a full recovery.

To begin with, you will most likely need to be admitted to hospital, where you will be safe and doctors can monitor you closely. This first phase of treatment can take weeks or months, depending on your symptoms and how well you respond to treatment.

It will take more time and further treatment for you to recover fully.

Treatment options for postpartum psychosis include:

  • medications such as antidepressants, mood stabilisers, and antipsychotics (drugs that help with psychotic symptoms such as hallucinations)
  • electroconvulsive therapy (a process that stimulates brain neurons with an electric current to treat mania, psychosis and severe depression)
  • psychological therapies, such as cognitive behaviour therapy (CBT)

Advice for a partner, family and friends

If you suspect your partner or loved one is showing signs of postpartum psychosis, you may need to help her seek treatment urgently. While this may be difficult, it is necessary. Both the mother and the baby could be at risk, and delaying treatment may mean it becomes more complex and recovery takes longer.

Where to go for help

It’s important to act if you are concerned that you, or someone you know, could have postpartum psychosis. Call one of these services for advice:

  • PANDA (Perinatal Anxiety &Depression Australia) — 1300 726 306
  • Beyond Blue — 1300 22 4636
  • Pregnancy, Birth and Baby — 1800 882 436

You can also get help from your GP or hospital emergency department.

Need to talk to someone?

Pregnancy, Birth and Baby offers non-judgemental emotional support during pregnancy and parenting for when you're feeling anxious or overwhelmed.

Call us on 1800 882 436 or video call seven days a week.

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