Teach Me

Postpartum Psychosis: A Rare but Dangerous Condition

As a new mom, you might expect your baby’s earliest days to be tiring but also full of joy. Sometimes, though, welcoming a new baby can cause mental health challenges. 

You’re probably familiar with postpartum depression (PPD). It’s a condition with feelings of sadness, anxiety and exhaustion that goes beyond the “baby blues” that a lot of new moms can experience. PPD can seriously impact a woman’s well-being and her ability to care for her baby.

However, postpartum psychosis (PPP) is different. It is a rare but serious mental health condition. For every 1,000 new moms, only one or two will develop postpartum psychosis. But it puts you and your baby at serious risk, so if you think you may have PPP you need to get medical attention right away. Women who have experienced a stillbirth or infant loss are also at risk of PPP.

“With postpartum psychosis, you might see mood changes such as depressive symptoms and disrupted sleep that you also see in postpartum depression. But PPP also includes other severe symptoms such as loss of touch with reality, disorganized thinking or behavior, delusions, hallucinations, paranoia, extreme mood changes or agitation. It is most typically seen within the first six weeks after giving birth,” said Francia Day, PsyD, a psychologist with Banner Health.

Symptoms of postpartum psychosis

Postpartum depression tends to develop gradually. But with postpartum psychosis, alarming symptoms may come on quickly, often within two weeks after giving birth. 

You may have:

  • Hallucinations: You may see, hear or feel things that are not actually there. “The brain acts as if it’s getting input from the senses without the actual input,” Dr. Day said. These hallucinations can be extremely distressing, and it can be hard to tell the difference between a hallucination and what is real.
  • Delusions: You may have beliefs that are not based on reality. These beliefs can range from grandiosity (thinking you are unique or better than others) to paranoid thoughts, and they can impact your behavior and decision making. “You can’t change these beliefs, even in the face of evidence that contradicts them,” Dr. Day said.
  • Extreme mood swings: You may have rapid shifts in mood, from euphoria to agitation or confusion, within a short time.
  • Disorganized thinking: You may have difficulty organizing your thoughts, speaking coherently or making sense of reality.
  • Agitation, irritability or restlessness: You may feel constantly on edge or unable to relax.
  • Difficulty sleeping: You may have insomnia or disrupted sleep patterns, which can make your symptoms and your mental health worse. 

Severe and urgent warning signs include:

  • Thoughts of harming yourself or the baby.
  • Appearing confused, disoriented or out of touch with reality.
  • Erratic or bizarre behaviors that are out of character.
  • Withdrawing from social interactions.
  • Neglecting personal care and hygiene.
  • Acting impulsively or recklessly without considering the consequences.
  • Feeling detached or indifferent toward the baby.
  • Neglecting the baby.

Postpartum psychosis risk factors

It’s not clear exactly what causes postpartum psychosis. But some factors put you at higher risk:

  • A personal or family history of mood or mental health disorders, particularly postpartum psychosis, bipolar disorder or schizophrenia.
  • Postpartum psychosis in a previous pregnancy.
  • Sleep deprivation, disrupted sleep patterns and exhaustion following childbirth.
  • Fluctuations in hormone levels during and after pregnancy that can affect neurotransmitters in the brain.
  • Imbalances in serotonin, dopamine or gamma-aminobutyric acid (GABA) that disrupt normal brain function.
  • Significant life stressors, such as financial difficulties, relationship problems or traumatic childbirth experiences.
  • High levels of anxiety during or after pregnancy.
  • Little or no support from partners, family members or health care providers, which can cause feelings of isolation and stress.
  • Poverty, unemployment or housing instability, which can increase stress and reduce access to resources.
  • The stigma surrounding mental illness, which can discourage people from sharing their symptoms or seeking help.

Differences between postpartum depression and postpartum psychosis

With postpartum depression, you may feel sad, anxious and tired and have trouble bonding with your baby since you don’t have feelings of joy or pleasure. You may feel detached, indifferent or resentful. It may be hard for you to care for yourself or your baby. You may feel guilty, worthless or inadequate and struggle with daily activities.

Postpartum psychosis, on the other hand, may make you feel out of touch with reality. You may hallucinate, have delusions, disorganized thinking or extreme mood swings. These symptoms put the well-being of you and your baby at risk since you may behave in ways that are erratic, bizarre, impulsive, irrational or dangerous. In severe cases, you may harm yourself or your baby. You may feel as though your baby is a threat or is in danger.

Seek help right away for postpartum psychosis

If you or someone you know is showing symptoms of postpartum psychosis, contact a health care provider or mental health professional right away. You may want to call or text a crisis hotline such as 988 (the Suicide and Crisis Lifeline), call 911 or go to an emergency department. 

Postpartum psychosis is a medical emergency that needs to be addressed right away to keep the mother and baby safe. Taking steps early helps keep symptoms from getting worse and lowers the risk that the mother might harm herself or her baby.

“Because PPP affects a person’s sense of reality, it can put the woman at risk of harming herself or her baby,” Dr. Day said. “Do not leave the person unsupervised.”

Getting help quickly also makes it less likely that the mother will have long-term problems with functioning or with mental health issues. 

Encourage open communication with family members and health care providers so the new mom can get the support and treatment she needs. It’s important to speak honestly about mental health challenges, without shame or stigma. Truthful conversations help reduce feelings of isolation and provide validation and empathy.

What can help with postpartum psychosis?

Treatment usually includes medical interventions, therapy and other supports:

  • Prescription antipsychotic medications can manage symptoms and mood. Hospitalization may be needed to monitor symptoms and adjust the medications if needed.
  • Hormonal treatments, such as estrogen supplements or hormone replacement therapy, may help if hormonal imbalances are causing the condition.
  • Cognitive-behavioral therapy (CBT) can help mothers identify and challenge negative thought patterns, manage stress and learn ways to cope.
  • Electroconvulsive therapy (ECT) may be an option in cases where other treatments have been ineffective or if the mother’s condition is severe and life-threatening.
  • Education and support for the mother and her family members about postpartum psychosis symptoms and treatment can help reduce stigma and promote understanding. Including family members in therapy sessions can improve communication, support, understanding and recovery.
  • Local or online support groups can also provide guidance, validation, empathy, encouragement and a sense of community.

How families can cope

It can be incredibly difficult to deal with postpartum psychosis. It can help to:

  • Learn about postpartum psychosis and educate partners and family members, so they understand symptoms, treatment and what the new mom is going through.
  • Recognize the warning signs so you can connect with help if needed.
  • Promote open communication so people feel comfortable asking questions and sharing their concerns.
  • Set up routines and schedules to promote a secure, stable and low-stress environment.
  • Encourage the mother to take breaks and recharge. Ask family members if they can help with chores, childcare or other tasks. 
  • Provide emotional support and encouragement for the new mom so she knows she can share her feelings and she’s not alone. 
  • Encourage the mom to get professional help and have someone go with her to appointments if she wants support. 
  • If you’re a caregiver for the mom, ask for help to prevent burnout. Try to find time for exercise, meditation or relaxation. Maintain your connections with friends, family and support networks. And seek professional help if you’re struggling with the challenges of supporting your loved one.

The bottom line

Postpartum psychosis is a rare but serious mental health condition that may strike new mothers soon after they give birth. With it, a woman may lose touch with reality and be at risk of harming herself or her baby. It’s an emergency that requires medical attention immediately.

If you notice any signs of postpartum psychosis, call Banner Behavioral Health at 800-254-4357 or call 911—or go to an emergency room. If you would like to learn more about health-related conditions linked with pregnancy and the postpartum period, reach out to an expert at Banner Health.

Other useful articles

Behavioral Health Pregnancy Parenting Women's Health