Help for mothers with postpartum psychosis

Babies: Each year hundreds of women suffer the perplexing condition but with quick intervention the outlook is good

Each year, up to 1,200 new mothers suffer from postpartum psychosis, a new study suggests. According to data from the Royal College of Psychiatrists, based on births registered in 2022, the condition affects between 600 and 1,200 women annually.

So, what exactly is postpartum psychosis, and how can you spot the signs that someone has it?

SUDDEN AND SEVERE ONSET

Sometimes referred to as puerperal psychosis or postnatal psychosis, postpartum psychosis is a mental illness that happens right after giving birth.

“(It) is a sudden onset, serious mental health illness that presents in the immediate postnatal period, usually within two weeks after giving birth,” says Sarah Oliver, a therapeutic practitioner at the For Baby’s Sake Trust.

“However, there are cases where it can go undetected for several weeks.”

WHAT ARE THE SYMPTOMS?

Oliver says symptoms can vary from mother to mother but can generally be defined by sudden onset severe depression, often accompanied by elevated mood, hypomania and manic episodes.

“This differs from postnatal depression as the mood ‘swings’ and there can be rapid changes in mood,” she explains. “The mother can present as being in a very high mood, feeling great and on top of the world and very excitable.

“It may present as having brilliant and exciting thoughts, rapid speech and lots of energy and zest for life, and then within the next hour the mother could present as tearful, with low mood, and withdrawing, isolating and not talking at all. Tearfulness and inconsolable sadness may feature in the periods of low mood.”

DELUSIONS AND HALLUCINATIONS

Delusions and hallucinations are a feature of postpartum psychosis, and someone affected may have unusual beliefs that are unlikely to be true – such as believing they are a celebrity, that they’ve won the lottery, or that supernatural things are happening, Oliver adds.

“This can sometimes involve the baby, such as believing an evil spirit possesses the baby, that they have harmed the baby in some way, or believe the baby is not theirs,” she continues.

“They may also hear voices, see apparitions and visions, smell weird things that aren’t there, have strange bodily sensations and feel things that are not there. Paranoia can feature and mothers can become very suspicious and fearful of people they normally trust, and conversely place their trust in inappropriate people or strangers.”

LACK OF SLEEP

Sleep is also affected by postpartum psychosis, possibly causing someone to struggle to sleep even when tired, or feeling like they don’t need any sleep at all.

“Sleep deprivation adds to the inevitable confusion and the struggle the mother feels when trying to focus and concentrate,” says Oliver.

PERSONALITY CHANGES

According to Oliver, personality changes are also a symptom. A new mother with postpartum psychosis may come across as a completely different person to the person their loved ones know and recognise, inhibitions may be lowered, and they may do things they’d never usually do.

HOW CAN MOTHERS WITH POSTPARTUM PSYCHOSIS BE SUPPORTED?

For anyone affected, this is undoubtedly a perplexing and fearful experience. However, with rapid emergency care, postpartum psychosis can have a good prognosis with the worst symptoms being resolved within weeks.

“Mothers are usually admitted to specialist mother and baby units, where they can receive the expert care they need whilst remaining with their babies,” says Oliver.

“They can be supported with continuing to breastfeed and can receive guidance on which medications to resolve the psychosis are compatible with continued breastfeeding.

“If they cannot breastfeed in this period, they can be supported to return to breastfeeding when appropriate.

“Charities such as Mind and Tommy’s have information for mothers, families and friends, and specific support services exist: Action on Postpartum Psychosis, PANDAS Foundation, Postpartum Progress and The Association for Postnatal Illness.”

Sleep deprivation adds to the inevitable confusion

Often-dramatic swings in mood mark the condition apart from postnatal depression.