All About Postpartum Psychosis

In the world of mental health professionals, classification of postpartum disorders is an ongoing debate.

Some experts feel these conditions deserve their own classifications in diagnostic manuals. Others believe they represent core mental health conditions that happen to appear during the postpartum period.

Currently, the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) uses “postpartum” to define when a mental health condition has appeared.

For example, you may experience brief psychosis at any time in life, but when it occurs during the first 4 weeks after giving birth, it becomes “postpartum psychosis.”

Postpartum psychosis is not the same as postpartum depression, though both conditions can come with swift changes in mood, insomnia, and intense feelings of sadness.

Unlike postpartum depression, though, when you experience postpartum psychosis, you might have one or more psychotic symptoms, such as hallucinations.

This might mean that the things you think, see, feel, touch, taste, and smell feel real to you, but they’re not representative of what’s truly happening around you.

In other words, hallucinations can cause you to live out full events that feel very real to you, but that other people in the same place don’t experience.

Likewise, delusions can affect your thoughts, causing you to stand by beliefs that are known to be untrue.

For instance, you may be unwavering in the belief that your grandmother was a famous actress when, in reality, she never tried out for a role in her life.

When your mind cannot tell the difference between what’s real and what isn’t, it may lead to situations that put you and your baby’s safety in jeopardy.

For this reason, postpartum psychosis is a condition that requires immediate medical care.

The exact cause of postpartum psychosis is unclear, but a combination of factors may come into play, including:

• extreme hormone fluctuations
• genetics
• presence of other underlying mental health conditions
• family history of mental health conditions
• sleep disruptions
• thyroid dysfunction
• immune system dysregulation

There are also some contributing factors that might increase your chances of developing postpartum psychosis. For example:

• you or a close relative have bipolar disorder
• this is your first baby
• you experienced depression, psychosis, or another mental health condition during pregnancy

Experiencing brain fog, confusion, and disorientation might happen to everyone during life-changing events like starting a family.

However, if these symptoms become persistent and come with more severe symptoms like hallucinations, it might mean you have postpartum psychosis.

Postpartum psychosis isn’t included in the DSM-5 by itself. Instead, it’s classified under brief psychotic disorders. Mental health professionals usually add the specifier “with postpartum onset.”

This means that to reach a diagnosis, a mental health professional will look for symptoms of brief psychotic disorder that specifically appear during the first 4 weeks after giving birth.

One or more of these four symptoms must be present:

• delusions
• hallucinations
• disorganized and incoherent speech
• behavior that’s either severely disorganized or catatonic (unresponsive)

At least one of the first three symptoms must be present for a postpartum psychosis diagnosis to be reached.

Other common symptoms of postpartum psychosis may include:

• euphoria
• depressed mood
• overactive thoughts
• severe confusion
• restlessness or hyperactivity
• refusal to eat and rest
• paranoia
• anxiety
• supernatural beliefs related to your baby
• rapid mood changes
• insomnia
• unusual behaviors
• irritability
• secrecy about your symptoms
• suicidal thoughts
• thoughts of harming your baby

Anyone experiencing symptoms of postpartum psychosis is advised to seek immediate care.

Reaching out to a health professional as soon as you notice the first signs can help you manage your symptoms and find coping strategies and treatments that work for you and your family.

Postpartum psychosis is treatable and full recovery is possible.

Of course, every person is different, so a healthcare pro will be able to help you find the options that work best for you.

These may include:

• inpatient care for a few days
• medications like mood stabilizers and antipsychotics
• psychotherapy
• lifestyle changes like improving sleep habits and getting more nutrients in your diet

It is possible for someone who’s experienced depression or other mental health conditions before or during pregnancy to develop postpartum psychosis.

This doesn’t mean this is always the case, though. Nor does it mean that someone with postpartum depression will develop psychosis too.

Both conditions have overlapping symptoms, but they’re significantly different.

Symptoms of postpartum depression are very similar to those of major depression. The difference focuses on timing (during pregnancy or after giving birth) and on the baby being at the center of your preoccupation.

Postpartum psychosis may include symptoms of depression, but it’s mainly characterized by psychotic episodes that are not present in postpartum depression.

Another important difference is that postpartum psychosis usually requires emergency medical help.

Postpartum mental health conditions like psychosis and depression are treatable with the right tools and treatment options. There’s no shame in getting help, so reach out to your OB-GYN or another healthcare professional for support.

Postpartum psychosis is different from postpartum depression in a number of ways. The biggest difference is the presence of severe symptoms like delusions and hallucinations.

Because of the severity and effects of these symptoms, it’s recommended you seek immediate care when you first notice they appear.

Once you receive treatment for the symptoms of postpartum psychosis, full recovery is possible.

These resources might help you take the first step:

• American Psychiatric Association’s Find a Psychiatrist tool
• American Psychological Association’s Find a Psychologist tool
• National Alliance on Mental Illness Helplines and Support Tools
• National Institute of Mental Health’s Helpline Directory