Postpartum Psychosis: What It Is, Symptoms & Treatment
Postpartum psychosis (PPP) is a reversible — but severe — mental health condition that affects people after they give birth. This condition is rare, but it's also dangerous.
Postpartum Psychosis: What It Is, Symptoms & Treatment
Source: Cleveland Clinic
URL: https://my.clevelandclinic.org/health/diseases/24152-postpartum-psychosis
Date: Last updated 09/13/2022
Overview
What is postpartum psychosis?
Postpartum psychosis (PPP) is a reversible — but severe — mental health condition that affects people after they give birth. This condition is rare, but it's also dangerous.
IMPORTANT: People with postpartum psychosis have a much higher risk of harming themselves, dying by suicide or harming their children. Because of this, PPP is a mental health emergency. If you have the symptoms of PPP or are near someone who shows signs of it, it's important to seek immediate help. If you believe someone is a danger to themselves or others, you should immediately dial 911 (or your local emergency services number).
Who does postpartum psychosis affect?
Postpartum psychosis can affect anyone who recently gave birth. While it usually happens within several days of giving birth, it can happen up to six weeks after.
It can happen to anyone who gives birth, but the odds of having it are higher for people with certain mental health conditions. While experts don't know if these conditions contribute to or cause PPP, they do know that there's a link.
How common is postpartum psychosis?
Postpartum psychosis is a rare condition. Experts estimate that it affects between 0.089 and 2.6 out of every 1,000 births. In the United States, that means it happens in between 320 and 9,400 births each year.
Symptoms and Causes
What are the symptoms of postpartum psychosis?
The two main symptoms of psychosis affect a person's sense of reality and how they understand the world around them:
Other symptoms that are common with postpartum psychosis include:
Organizing the symptoms into types
Depressive symptoms (most common, ~41% of cases):
The depressive subtype is the most dangerous. Research shows that depressive symptoms and psychosis are almost always a factor in cases that involve self-harm or harm to a child, especially hallucinations or delusions that command a person to harm their child or themselves. The rate of harm to a child is about 4.5% with this subtype, about four or five times greater than with the other subtypes. The rate of dying by suicide is about 5%.
Manic symptoms (~34% of cases):
The risk of self-harm or harm to children is lower but still possible, happening in about 1% of cases.
Atypical/mixed symptoms (~25% of cases):
What causes postpartum psychosis?
Experts don't know why postpartum psychosis happens but suspect it involves a combination of factors, including:
Diagnosis and Tests
How is postpartum psychosis diagnosed?
A mental health provider can diagnose postpartum psychosis based on your symptoms (either by observation or what you describe) and a physical and neurological exam. Other tests are possible, but these are to rule out other conditions or underlying causes of psychosis. These tests can't diagnose PPP itself.
Some of the most common tests include:
Your healthcare provider may also use specialized screening tools or questionnaires.
Management and Treatment
How is postpartum psychosis treated?
Because PPP is a mental health emergency, people with this condition need inpatient mental healthcare. This kind of care means trained medical professionals are with them at all times to make sure they're safe and as comfortable as possible.
Involuntary hospitalization
Because PPP disrupts a person's sense of reality, many people who have it are completely unaware that they have a mental health or medical issue. Further complicating this is the fact that delusions and hallucinations may actually make them afraid to seek help. For those reasons, inpatient mental healthcare for PPP is almost always involuntary.
Treatment methods
Medications:
Electroconvulsive therapy (ECT):
ECT is a safe and highly effective method for treating conditions that involve psychosis. This treatment uses a mild electrical current, passed through your brain, to induce a mild seizure. The effects of that seizure cause changes in brain activity that reduce or resolve the effects of PPP. ECT happens under general anesthesia, so the person receiving it is asleep and won't feel any pain or discomfort during the procedure.
How soon after treatment will I feel better?
PPP is a temporary condition. With treatment, people who have it can recover relatively quickly within a few weeks. Without treatment, PPP can last for weeks or even months. This condition also becomes more severe and more dangerous the longer it goes untreated.
Outlook / Prognosis
Prevention
For people with a previous instance of PPP, a history of PPP, bipolar disorder, schizophrenia or a family history of any of these conditions, some treatments may reduce the risk of developing it. Lithium, which also treats PPP, is the most common medication used to lower the risk of another occurrence later in life.