What is postpartum psychosis?
Postpartum psychosis is a serious but rare mental health problem which develops after you give birth. It is sometimes called puerperal psychosis.
Postpartum psychosis can be an overwhelming and frightening experience, and it is important to seek help as soon as possible if you experience symptoms. But with the right support, most people fully recover.
This page covers:
- Signs and symptoms of postpartum psychosis
- Causes of postpartum psychosis
- Treatments for postpartum psychosis
- Self-care for postpartum psychosis
- Planning another pregnancy
Signs and symptoms of postpartum psychosis
The symptoms of postpartum psychosis usually start quite suddenly, within a few weeks after you give birth. ‘Postpartum’ means after childbirth.
If you have postpartum psychosis, you are likely to experience a mix of psychosis, depression and mania. This means you may experience these common symptoms:
How you might feel
You may feel:
- excited or elated
- severely depressed
- rapid mood changes
- confused or disoriented.
How you might behave
You may be:
- restless
- unable to sleep, even when you have the chance
- unable to concentrate
- experiencing psychotic symptoms, like delusions or hallucinations.
What are delusions and hallucinations?
Delusions and hallucinations are aspects of psychosis which you may experience.
Delusions are strong beliefs that other people don’t share. For example, you might think that:
- you are being followed
- your thoughts are being read
- you are very powerful and able to influence things outside of your control
- you have special insight or divine experiences.
Some delusions can be very frightening, such as believing that someone is trying to control you or kill you. These sorts of delusions are often called paranoid thinking or paranoia. See our information on delusions and paranoia to find out more.
Hallucinations are when you experience things that others around you don’t. For example hearing voices, seeing visual hallucinations and other unexplained sensations. See our information on hallucinations and hearing voices to find out more.
Causes of postpartum psychosis
There is no clear evidence on what causes postpartum psychosis. But there are some factors which mean you may be more likely to develop it. For example, if you have:
- a family history of mental health problems, particularly a family history of postpartum psychosis
- a diagnosis of bipolar disorder or schizophrenia
- a traumatic birth or pregnancy
- experienced postpartum psychosis before.
But you can develop postpartum psychosis even if you have no history of mental health problems.
If you are at a higher risk of developing postpartum psychosis, it’s important to discuss your mental health with your doctor or midwife. They can help you think about how you can plan ahead.
Action on Postpartum Psychosis (APP), based in the UK, has a series of guides about postpartum psychosis. This includes a guide to planning pregnancy if you are at high risk of developing postpartum psychosis.
Treatments for postpartum psychosis
Postpartum psychosis is a psychiatric emergency. If you experience symptoms listed above, it is important to present to your family doctor for timely assessment and referral for treatment. There are various treatments that you may be offered for postpartum psychosis. Your doctor should discuss these options with you, so you can make a decision together about the best treatment for you:
Medication
Your doctor is most likely to offer you an antipsychotic drug to manage your mood and psychotic symptoms. They may also offer you an antidepressant.
See our pages on medication for more information.
ECT
If your symptoms are very severe and other treatments don’t work, your doctor may offer you electroconvulsive therapy (ECT).
Will I have to go to the hospital?
Your doctor may decide that treating you in hospital is the best way to get the help you need. If it’s possible, you should be admitted to a mother and baby unit (MBU), where you can stay with your baby while getting treatment.
See our page on support and services for more information.
Self-care for postpartum psychosis
If you are experiencing postpartum psychosis, the most important thing to do is get help. Speak to a health professional if you feel able, such as your doctor or a psychiatrist.
If you don’t feel able to speak to a health professional, you could talk to someone who you trust about how you’re feeling, and ask for their support in getting help.
Once you’re receiving professional help, there are things you can also do to look after yourself while you recover:
Join a peer support group
You might feel really alone or as if nobody understands, but talking to other people can help. Peer support is a way to share your feelings and experiences with other people who’ve had similar experiences.
Recognise your triggers
Try keeping a diary of your moods and what’s going on in your life. This might help you recognise patterns or notice what affects your mental health. It can also help you become aware of the sort of experiences or feelings that might make you feel worse.
This gives you the chance in future to notice what’s going on before you become more unwell, and ask for help.
Contact specialist organisations
Action on Postpartum Psychosis (based in the UK) has a guide to recovering from postpartum psychosis. This includes lots of tips and ideas about how to cope in the days and months after being diagnosed.
For more ideas, see our page on ways to look after your mental health when becoming a parent.
Planning another pregnancy
If you have experienced postpartum psychosis before, you may worry about becoming pregnant again.
Experiencing postpartum psychosis does mean you are more likely to develop it again with future pregnancies. But with the right support, you can plan ahead in case it does happen again.
So if you want to have another baby, or if you find out that you’re pregnant, you should talk to your doctor and make a plan as soon as possible.
Your doctor can also refer you to a perinatal psychiatrist. This is a specialist doctor who can support you if you are pregnant or recently gave birth, and have experience of mental health problems.
Action on Postpartum Psychosis (APP) has a series of guides about postpartum psychosis. This includes a guide to planning pregnancy if you are at high risk of developing postpartum psychosis.
