Post-partum psychosis is a serious mental illness that starts soon after childbirth. Fortunately it is very rare and there are very effective treatments.
Psychosis essentially means a loss of reality. It usually comes on in a very quick and spectacular manner within the first few weeks after giving birth, but the onset can be within hours of deliveriy. It can be extremely scary, especially if you’ve never had it before, because you find it difficult to differentiate between reality and the illness playing tricks on your brain.
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Things that are thought to contribute to post-partum psychosis include:
- a genetic predisposition (there is an increased risk in women with a family history of post-partum psychosis or bipolar disorder)
- severe sleep deprivation that can happen in the first little while after a baby is born
- the rapid hormonal changes around the birth
- physical stress of delivery – particularly if there are other medical problems.
There is also a relationship between post-partum psychosis and bipolar disorder. Women with bipolar disorder are at greatest risk of a relapse with psychotic symptoms soon after delivery. Conversely for some women, post-partum psychosis marks the first episode of a bipolar illness. However, this is not always the case. Some women will have only a single episode of post-partum psychosis, while others will have an episode of illness after each time they have a baby.
Women who have post-partum psychosis may have a range of the following symptoms:
- confusion and disorientation, about the day and time and who people are
- concentration can be affected and your mind may feel foggy or that it is overloaded with too many thoughts
- severe physical anxiety or agitation, such that you cannot stay still
- variable mood, either on a high, irritable or depressed
- insomnia, feeling like you need less sleep and perhaps going days without sleeping
- delusions or thoughts that are not true and that are often paranoid – that the hospital staff are spies, that your partner is an imposter in disguise. These thoughts may seem bizarre or silly when you are well, but in the middle of the illness they can seem real
- hallucinations or impaired sensations where you either hear, see or smell things that are not present
- strange sensations that you are not really yourself and there are others controlling your actions and thoughts
- thoughts of and/or plans to harm yourself and your baby.
Post-partum psychosis is a psychiatric emergency and you need immediate treatment for your safety and the safety of your baby.
Treatment will be provided in a hospital, in either a:
psychiatric mother–baby unit, where your baby will stay with you
general adult psychiatric unit, where your baby will need to be cared for by your partner, family or friends until you are well enough to go home.
Treatment usually involves medication, but sometimes, if the episode is very severe, electroconvulsive therapy (ECT) is the fastest and most effective treatment to get you on the path to recovery.
It may also be worthwhile to have counselling. The experience of psychosis can be very traumatic. You may be left grieving, scared or confused about the entire event. Talking through your experience can help you process and make sense of it.
Depending on how unwell you are, it may be up to your partner or another family member to organise medical help for you. It can be very hard for family members to support a woman who has post-partum psychosis because she may resist help or think that people are intending to harm her. Partners can get advice and support through Beyond Blue, the hospital where your baby was born, your local hospital emergency department or GP. A Crisis Assessment or Acute Treatment team (sometimes called a CAT team) can also be accessed in a mental health crisis. Your local hospital or community health centre can help you to access the right service.
The Women’s does not accept any liability to any person for the information or advice (or use of such information or advice) which is provided on the Website or incorporated into it by reference. The Women’s provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance and accuracy. Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest Emergency Dept.