'Check on your mom friends, family and wives': What everyone needs to know about postpartum psychosis
Having a newborn is never easy. It’s common for new mothers to struggle with sleepless nights, feeding challenges and babies who never want to be put down. Most mothers make it through, even if they’re a little worse for wear. However, this isn’t the case for everyone.
Although rare, some mothers develop a condition called postpartum psychosis. According to Dr. Carla Sandy, an ob-gyn at Kaiser Permanente in Silver Spring, Md., this condition differs significantly from postpartum depression or the “baby blues,” which affects many women after delivery. When a woman develops postpartum psychosis, she “may experience hallucinations, delusions, confusion, paranoia, hearing voices in their head, bizarre behavior and delirium,” Sandy tells Yahoo Life.
What is it like to have postpartum psychosis?
After the birth of her daughter Brooklyn, Jerrica Wrate “was feeling quite on top of the world,” she tells Yahoo Life. She was full of energy and stayed up all night cleaning and shopping online. But then she started acting erratically. Wrate’s husband and friends became concerned, but the new mom wondered how “could anything be wrong when I was so happy, full of energy and enjoying life with my newborn?”
Eventually, Wrate’s husband connected with her obstetrician, who suspected postpartum psychosis. Wrate was taken to a psychiatric hospital by ambulance, where she spent the next 24 days. While there, Wrate recalls thinking that her husband admitted her to the psychiatric hospital because she was spending too much money shopping. She also started having hallucinations, believing that the hospital was on fire and that people were coming after her and trying to poison her.
Wrate also believed that “there were babies in other patients’ rooms in their showers” that were clones of her newborn daughter. She says she “thought the staff and other patients were all related” to her.
Although hospitalization was hard for Wrate, she is grateful that her husband and doctor recognized the signs of postpartum psychosis and that both she and her daughter were kept safe while she received treatment.
With therapy, medication and support, Wrate eventually recovered, but she still meets with a psychiatrist monthly and continues to receive support online from other women who have experienced postpartum psychosis.
Jessica O., who asked that her last name be withheld to protect her privacy, tells Yahoo Life that her experience with postpartum psychosis was “absolutely horrific.” Before she even left the hospital after giving birth, Jessica started believing that threats to her son’s safety were everywhere. She would not carry her son on stairs or bathe him, because she was afraid she would drop him. Jessica was also afraid the fumes from her car would asphyxiate her son.
Within a few days, Jessica stopped dressing her son because she thought the dyes in clothing would harm him. She stopped sleeping because she thought her son would stop breathing during the night. At one point, she shares, “The hallucinations were convincing me my son was inhuman, that I was a zombie and I needed to get rid of my child to protect myself.”
Eventually, her son’s pediatrician diagnosed her with postpartum psychosis. Jessica was permitted to stay at home to receive treatment, as long as there was always another adult in the home and Jessica was never left alone with her son. With treatment, Jessica’s postpartum psychosis subsided, although she still experiences anxiety.
What are the signs of postpartum psychosis?
Postpartum psychosis can manifest in several ways, with symptoms typically developing between three to 10 days after giving birth, Dr. Ariadna Forray, a Yale Medicine postpartum psychiatry specialist, tells Yahoo Life — although women can develop postpartum psychosis within hours to weeks after delivery.
Sabrina Romanoff, a clinical psychologist, tells Yahoo Life that some women who experience the mental health condition may attempt to harm themselves or their child. However, this isn’t true of all women suffering from the disorder, and other signs can be more subtle.
Women can have symptoms such as disorientation and confusion, notes Forray. “Disorganized, bizarre behaviors and obsessive thoughts regarding the newborn are typical,” she says. “Delusions often focus on the newborn, such as developing a delusion that something is wrong with the baby or the baby is in danger.”
Sandy adds that “family members may first notice that a mom’s thoughts are increasingly disorganized, and they are having trouble communicating coherently. Family members may also notice that a mom’s behavior is not appropriate for the setting they are in, for example, shouting or using insulting language.”
Dr. Brian Choi, a psychiatrist with Providence Mission Hospital’s maternal health program, tells Yahoo Life that “postpartum psychosis can be incredibly scary for new moms and their families. That’s why it’s important for partners and other family members to know the signs and symptoms of postpartum mental health disorders to get new moms the help that they need.”
What to do if you suspect postpartum depression
If a spouse or family member notices signs that a new mother may be suffering from postpartum psychosis, “it’s important to communicate them to the mom and encourage her to reach out to her ob-gyn, midwife or therapist, if she has one,” says Sandy. She adds that it’s crucial to “take action quickly if there are warning signs” so that the mother’s care team can determine the best treatment options for her.
If the new mom won’t call her care provider herself, experts say a spouse, family member or friend should make the call on her behalf. Choi says that this is important because most new mothers experiencing postpartum psychosis won’t recognize symptoms in themselves, as was the case for Wrate and Jessica — both of whom thought their thoughts and actions were reasonable. Wrate says that her mind had her “in such delusion” that she “was oblivious to anything happening.”
Even if mothers do recognize that something is wrong, they “may have a difficult time admitting that they are having abnormal thoughts or feelings after giving birth” and may feel “guilty, ashamed and inadequate,” which can put both mother and baby at risk, notes Choi.
Along with acting quickly, experts say that keeping an eye on both mother and baby is paramount. “Because postpartum psychosis can rapidly become dangerous, it’s extremely important that parents experiencing the disorder aren’t left alone individually or with their kids,” Choi says.
For women experiencing postpartum psychosis, “the risk of infanticide is estimated at 4%, and the risk of suicide is 5%,” says Forray. Getting help quickly may help save both the mother’s and baby’s life, even if the mother is not having thoughts of harming herself or her child.
If the mother does express that she’s thinking of harming herself or her baby, “This is a medical emergency,” says Sandy. In this situation, friends and family should immediately call 911 or take her to the nearest emergency room.
Who is most likely to develop it?
Although postpartum psychosis can strike anyone, says Choi, it’s more prevalent in those with a family history of the disorder or similar conditions, such as bipolar disorder. He says that sleep deprivation, inflammatory disease, electrolyte imbalances, B1 and B12 vitamin deficiencies, thyroid disorders, eclampsia and preeclampsia may also lead to postpartum psychosis, but more research is needed to definitively establish a link.
Wrate says she wishes “other women knew that postpartum psychosis doesn't discriminate. As an MBA and working woman with no prior mental health issues, it happened to me. Know the signs and check on your mom friends, family and wives,” she says.
How common is postpartum psychosis?
Sandy says that postpartum psychosis is “relatively rare,” adding: “It only impacts 1 or 2 out of every 1,000 births. In the United States, it occurs in between 320 and 9,400 births each year.”
As rare as postpartum psychosis is, Wrate says that “1 to 2 in every 1,000 is still a scary number.” Before her diagnosis, Wrate says that she had never heard of postpartum psychosis. She shares that her obstetrician never discussed the signs of the disorder with her or even told her that it existed.
Jessica says there’s a need for more screening, support and education. “I wish more women were counseled about the psychological risks of pregnancy,” she says. “A mental health care provider should be part of all prenatal care to provide pre-screening and education to moms and all support persons.”
Will postpartum psychosis recur?
Although there’s a chance of experiencing postpartum psychosis in a subsequent pregnancy, there are steps women can take to help mitigate it. According to Forray, the risk of a recurrence is 29%, but the risk can be managed. “Preventive strategies for future pregnancies include close symptom monitoring by a mental health professional, prophylactic treatment with medications following delivery, stress management, prioritizing sleep, education for partner and family and increasing social supports,” she says.
However, after an initial episode of postpartum psychosis, “a woman has a 50% to 80% chance of developing another serious psychiatric episode, usually within the bipolar disorder spectrum,” says Forray, so continued follow-up is important.
Wrate originally wanted to have two biological children but after her experience with postpartum psychosis, she says now she “isn’t so sure.” While she hasn’t completely ruled out another pregnancy, she doesn’t want to risk another episode, so she and her husband are also considering adoption.
Is postpartum psychosis treatable?
According to Forray, postpartum psychosis is a treatable condition. “Most people with postpartum psychosis make a full recovery with appropriate treatment,” she says.
Choi says that, in many cases, a mother experiencing postpartum psychosis requires an “inpatient treatment program where the environment is controlled and there is around-the-clock supervision.”
However, this isn’t necessary for everyone experiencing the disorder. “A rigorous outpatient program that focuses on a person's overall mental health, through psychotherapy appointments three to four days [a week], weekly family therapy sessions, bonding exercises between parent and baby and more, is also an option,” he says. Some people will also need medications, such as mood stabilizers or antipsychotics, notes Choi.
Although postpartum psychosis is dangerous and scary, the good news is that most women “will recover and return to their normal selves with treatment,” Choi says.
If you or someone you know is experiencing suicidal thoughts, call 911 or the National Suicide Prevention Lifeline at 988 or 1-800-273-8255, or text HOME to the Crisis Text Line at 741741.
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