Postpartum psychosis
Postpartum psychosis is a rare and severe mental health condition that affects approximately one in every one thousand women after childbirth. Distinct from the more common postpartum depression and the transient "baby blues," postpartum psychosis can manifest with symptoms such as hallucinations and delusions, where a mother may perceive things that are not there or hold false beliefs about her or her child's safety. These symptoms can fluctuate dramatically, leading to potential risks for both the mother and her child. Women with a history of bipolar disorder or other serious mental health issues are at heightened risk for developing postpartum psychosis, and the condition often surfaces within the first two weeks following delivery.
While treatment is available and may include medications such as antipsychotics and antidepressants, close monitoring is essential, especially for mothers with known risk factors. Inpatient care may be required to ensure safety and facilitate recovery, which sometimes includes support for maintaining maternal bonds. Given its seriousness, women exhibiting signs of postpartum psychosis should seek immediate medical evaluation to ensure the well-being of themselves and their children. Awareness and understanding of this condition are crucial, as it can recur in future pregnancies, necessitating a coordinated approach to prenatal and postnatal care.
Postpartum psychosis
Postpartum psychosis is a rare mental health condition that happens to about one in every one thousand women who give birth. This disorder is different from and rarer than postpartum depression or another condition often referred to as the "baby blues." It is also potentially more serious than these conditions. Some women suffering from postpartum psychosis feel compelled to harm themselves or their child/children. Although postpartum psychosis can be treated, it is likely to recur with subsequent pregnancies.
Overview
A significant number of women experience altered moods after the birth of a child. Medical professionals generally recognize three specific conditions that affect new mothers: the baby blues, postpartum depression, and postpartum psychosis. Of these, postpartum psychosis is the rarest and most severe.
The additional hormones released as part of the pregnancy and birth process combined with the lack of sleep and additional stress that often accompanies the early days of caring for a newborn can cause episodes of sadness commonly referred to as the baby blues. This condition generally clears on its own as the hormones dissipate and the new mother adjusts to caring for the child. The baby blues often subside within ten days of the birth. As many as eight out of every ten women will experience some level of the baby blues in the weeks following childbirth. This is sometimes considered to be a mild form of postpartum depression.
As many as one in seven mothers may develop feelings of sadness, anger, and anxiety and experience a lack of connection with their newborns. In some cases, the mother may present a threat to herself or to her child. This is a more serious condition known as postpartum depression. It generally requires treatment with medication or therapy for the mother to recover fully.
Following about one in every one thousand births, the mother develops a more severe condition known as postpartum psychosis. Symptoms are similar to those of postpartum depression but also include hallucinations—seeing, hearing, and even smelling things that are not really there—and delusions, or beliefs that are not true, such as thinking the newborn is possessed or that someone is trying to hurt the child. The condition frequently occurs in women who have bipolar disorder or other serious mental health concerns. Although it does not happen in every case, the hallucinations and delusions can cause the mother to harm herself, her child, or others.
Symptoms, Risk Factors, and Treatment
Women suffering from postpartum psychosis can exhibit a range of symptoms, which can change rapidly. The woman could feel exuberant and happy one moment and feel very low and tearful the next. She may be anxious, irritable, and restless. She may seem very talkative and outgoing or very withdrawn and quiet. The new mother might have lowered inhibitions or behave in uncharacteristic ways, or she may exhibit signs of paranoia and be fearful or suspicious of those around her.
Many of these symptoms are also typical of postpartum depression. What differentiates postpartum psychosis is the presence of delusions and hallucinations. A psychosis is a mental health condition in which the person is disconnected from reality in some way. The woman sees, hears, or smells things that are not really there—such as hearing a deceased relative yelling at her—or believes something that is not based in fact, such as thinking her spouse is trying to harm her or the baby when the spouse has no such intention. These things seem very real to the person experiencing them. In some cases, a mother experiencing postpartum psychosis may be driven by these imagined experiences or events to harm herself or her child. While it is possible for a woman to have postpartum psychosis without taking harmful actions, the suddenness with which the symptoms change mean that any new mother who exhibits signs of postpartum psychosis should be evaluated by a medical professional for her own safety and the safety of those around her.
Postpartum psychosis is most likely to occur in women who have bipolar disorder or who have a family history of the condition. It is also more likely to reoccur in women who have experienced postpartum psychosis after previous pregnancies. Women with known risk factors should be seen during pregnancy or as soon after delivery as possible—even if they are not exhibiting any symptoms—for evaluation to ensure their safety and the safety of their children.
The condition generally becomes evident within the first two weeks after the child's birth, but it can occur weeks later as well. If a psychotic episode begins, the woman will likely require inpatient care in a facility equipped to deal with postpartum psychosis. Some have facilities for caring for the child as well, which can help restore the maternal bond. Most women will need medication to deal with the condition. Medical treatment may include an antipsychotic drug, an antidepressant, or possibly both. Part of the treatment includes helping the woman and her family understand that the condition is not the result of anything she or anyone else did wrong. Self-care is also emphasized since patients experiencing mental health issues often forget or ignore mealtimes and basic hygiene.
Recurrence and Precautions
Patients who have had postpartum psychosis or who have been treated for another condition such as bipolar disorder are more likely to develop problems after pregnancy. This is especially true when the woman must discontinue any mood stabilizing drugs or antipsychotic medications during pregnancy to protect the health of the child. In these cases, it is important for the woman to have a mental health professional on her prenatal care team and to make sure her obstetrician and the other medical professionals who treat her are aware of her past mental health issues. They will then be able to take the appropriate steps to safeguard the woman and her child after birth through monitoring and medication adjustments if necessary.
Bibliography
Chan, Melissa. "The Difference between Postpartum Depression and Postpartum Psychosis." Time, 22 June 2016, time.com/4377455/postpartum-depression-postpartum-psychosis-symptoms/. Accessed 3 Dec. 2016.
"Postpartum Depression." Mayo Clinic, www.mayoclinic.org/diseases-conditions/postpartum-depression/basics/symptoms/con-20029130. Accessed 3 Dec. 2016.
"Postpartum Disorders." Mental Health America, www.mentalhealthamerica.net/conditions/postpartum-disorders. Accessed 3 Dec. 2016.
"Postpartum Psychiatric Disorders." Massachusetts General Hospital Center for Women's Mental Health, womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders/?doing‗wp‗cron=1480736079.2811329364776611328125. Accessed 3 Dec. 2016.
"Postpartum Psychosis." Patient, patient.info/health/postpartum-psychosis-leaflet. Accessed 3 Dec. 2016.
"Postpartum Psychosis." Postpartum Support International, www.postpartum.net/learn-more/postpartum-psychosis/. Accessed 3 Dec. 2016.
Silberner, Joanne. "One Mother's Story: Postpartum Psychosis: Rare, Frightening and Treatable." NPR, 18 Feb. 2002, www.npr.org/programs/morning/features/2002/feb/postpartum/020218.postpartum.html. Accessed 3 Dec. 2016.
Sit, Dorothy, et al. "A Review of Postpartum Psychosis." Journal of Women's Health, vol. 15, no. 4, May 2006, www.ncbi.nlm.nih.gov/pmc/articles/PMC3109493/. Accessed 3 Dec. 2016.