Postnatal (puerperal) psychosis

This is an uncommon disorder that occurs in 1 - 2 per 1,000 women and has a sudden onset with severe symptoms - usually within 2 - 3 weeks of childbirth. Symptoms can also begin during pregnancy especially where there has been a prior episode of psychosis or bipolar disorder. Medical review and treatment is necessary in the case of psychosis. Contact your GP if you have any concerns about symptoms of a possible psychosis.

Symptoms

• Confusion of thinking, may start to imagine things
• Restless, sometimes agitated behaviour, or strange movements
• Fearfulness and worrying (often about the baby)
• Mood swings sometimes with inappropriate emotions. Mood can sometimes be elevated and energy levels heightened to an extreme degree leading to manic patterns of behaviour.
• Inability to sleep
• Behaviour may appear out of touch with reality (psychotic), suspicious, or inappropriate.

Treatments

• Urgent assessment by a medical specialist is essential.
• Treatment by a psychiatrist, with antipsychotic medication is necessary in most cases.
• Hospitalisation may be required during the acute stages.
• The safety of the mother and the baby needs to be assessed carefully by a health professional because the mother can be disoriented and delusional and unable to adequately care for herself or for her infant.
• After treatment has started careful monitoring of mother and baby is required on an ongoing basis.
• Once the acute symptoms have settled psychological therapies can be used alongside medication to assist with adjustment to the illness and to provide ongoing care and support with the adjustment to parenthood.
• Family counselling may also be needed to assist family members to understand more about the illness and the required care.

For Further Information

Getting help for depression

Resources: Pregnancy and postnatal