Causes of Postpartum Psychosis
We don’t know for sure what exactly causes postpartum psychosis. Even though the causes of postpartum psychosis aren’t well understood, what we do know is that there are some si
- gnificant risk factors that might increase a postpartum woman’s chance of developing it. We’ll look more closely at some of the risks to be aware of later.
"Postpartum psychosis is when the new mother has a rapid decline in her mental facilities. The causes of postpartum psychosis are unknown, but there are some contributing factors such as a history of mental illness and family history of mental illness and/or postpartum psychosis that can increase the likelihood of postpartum psychosis."
— Minkyung Chung, MS, LMHC
Signs & Symptoms of Postpartum Psychosis
What is postpartum psychosis? Postpartum psychosis is one form of postpartum mood disorder. While other conditions such as postpartum anxiety and postpartum rage may occur, postpartum psychosis is the most severe. According to a group of research, postpartum psychosis is like an overt presentation of bipolar disorder that co-occurs with intense hormonal changes. Symptoms typically begin to appear suddenly and within the first couple of weeks after delivery.
Postpartum psychosis symptoms can be similar to manic episodes in bipolar disorder, but they can also present as very low moods or a depressive state. A mother might show signs of impaired cognition and severely disrupted behavior that’s vastly out of character.
Other postpartum psychosis symptoms can include:
- Suicidal ideation
- Being unsure of location, date, or time
- Delusions
- Inability to sleep
- Restlessness and irritability
- Extremely rapid mood swings, from energetic to sad
- Behaviors and mannerisms that are vastly out of character
- Experiencing repetitive and compulsive thoughts about harming the baby
- Hearing voices, possibly encouraging harm to self or baby
- Unfounded beliefs, typically related to the baby (like fearing someone is about to harm them)
Postpartum psychosis is frightening and dangerous for both mother and child. If you notice any symptom in yourself or in someone you know, get help and see a doctor as soon as possible. If symptoms are severe, call 911 immediately for a medical emergency.
Postpartum Depression vs Postpartum Psychosis
It’s common for new mothers to experience “postpartum blues.” They might have feelings of anxiety, irritability, tearfulness, or mood swings. However, these symptoms are normal reactions to hormone fluctuation, emotional rebalancing, and the stress of new motherhood.
If these symptoms persist for more than 2-3 weeks, or if they begin to impair daily functioning, it might be more than just a simple case of the baby blues. At that point, a postpartum woman may actually be experiencing what’s known as postpartum depression, and once diagnosed, postpartum depression treatment is the best route forward.
Postpartum depression is a more serious form of postpartum blues (although not as severe as postpartum psychosis). In fact, postpartum psychosis is a much rarer condition than postpartum depression and can lead to a sudden onset psychotic symptoms such as hallucinations and delusions, both of which can be harmful to the mother and baby. On the other hand, postpartum depression can last for quite some time if not treated.
Postpartum depression symptoms may include:
- Persistent feelings of sadness or guilt
- Feeling worthlessness or inadequacy
- Difficulty concentrating
- Persistent anxiousness
- Changes in appetite (eating more or less than normal)
- Disrupted sleep
- Chronic fatigue
In some cases, postpartum depression can cause a woman to experience suicidal thoughts. If the symptoms of postpartum depression persist, or if they intensify to the point that they’re dangerous, you need to seek professional help immediately.
"Most people are likely aware of what postpartum depression is and may end up confusing some symptoms of it with postpartum psychosis. The difference lies in the specific symptoms that are present. Both postpartum depression and postpartum psychosis have symptoms of irritability and mood fluctuations. With postpartum psychosis, delusions, hallucinations, and other severe symptoms can be present."
— Minkyung Chung, MS, LMHC
Postpartum Psychosis Risks and Complications
For some women, postpartum psychosis can develop even without known risk factors present. That said, we do know that some of the following factors might increase someone’s risk of developing this condition.
Risk factors of postpartum psychosis include:
- A family history of bipolar disorder or postpartum psychosis
- A history of postpartum psychosis after a former pregnancy
- A history of bipolar disorder
- A history of schizophrenia
- A history of schizoaffective disorder
- Prenatal depression during a current pregnancy
- First pregnancies
- Discontinuation of psychiatric medications
Additional factors that may play a role in a woman developing postpartum psychosis might include culture, environmental factors, genetics, or sleep deprivation.
"While most postpartum disorders are temporary, the risks of postpartum disorders like postpartum psychosis are: a family history of postpartum disorders, a history of bipolar or schizophrenia, or discontinuing any psychiatric medication. The risk of suicide is high in mothers diagnosed with postpartum psychosis. Through therapy and medication management, these symptoms can improve."
— Minkyung Chung, MS, LMHC
How to Get a Postpartum Psychosis Diagnosis
A psychiatrist or doctor will assess postpartum psychosis by first interviewing a new mom who’s exhibiting symptoms. They’ll ask how long symptoms have been present and inquire about symptom severity. They will also want to know about past medical conditions and history, including:
- History of chronic anxiety, bipolar disorder, or depression
- Thoughts of self-harm or suicide
- Family history of mental health conditions
- Alcohol or drug abuse
During diagnosis, it’s essential to be open and honest with the doctor. This will allow them to rule out other possible conditions that may have overlapping symptoms. It can also ensure a new mother gets the essential help she needs as soon as possible. Blood tests, thyroid hormone level tests, white blood cell counts, and depression screening may all be necessary to help a doctor determine the best course of treatment.
Treatment for Postpartum Psychosis
Postpartum psychosis is a critical condition that requires rapid medical intervention. The first line of treatment is usually medication in an effort to stabilize the mother’s mood, alleviate depression, and reduce any psychotic symptoms that are present.
Inpatient treatment
Most women with postpartum psychosis will spend at least some time in an inpatient treatment facility or center. This will allow time for treatment to begin to reduce the risk of her harming herself or her baby. The time spent there will also focus on stabilizing her mood, beginning to manage depression, and reducing psychotic episodes.
Medication
Types of medications that might be prescribed include, but aren’t limited to:
- Antipsychotic medications to manage and reduce hallucinations.
- Aripiprazole (Abilify)
- Olanzapine (Zyprexa)
- Risperidone (Risperdal)
- Ziprasidone (Geodon)
- Mood stabilizers to level out depressive and manic states.
- Carbamazepine (Tegretol)
- Divalproex sodium (Depakote)
- Lamotrigine (Lamictal)
- Lithium (Lithobid)
