All about postpartum psychosis: Causes, symptoms and treatment strategies

Postpartum psychosis: High levels of stress, including the demands of caring for a new baby, can trigger the condition. (Image: Canva)

Postpartum psychosis is a severe mental health condition that can affect new mothers, typically within the first two weeks after childbirth. It is a medical emergency that requires immediate attention and intervention. This condition is characterised by sudden and extreme changes in mood, hallucinations, delusions, and disorganised thinking, making it distinct from the more common postpartum depression. Women experiencing postpartum psychosis may have thoughts of harming themselves or their baby and often require hospitalisation to ensure safety. Prompt treatment is essential for recovery.

Causes

The exact cause of postpartum psychosis is not well understood, but several factors may contribute to its development according to Delhi-based gynaecologist Radhika Netra.

Hormonal changes: The rapid drop in hormones after childbirth, particularly estrogen and progesterone, can affect brain chemistry and mood.

Genetics: Women with a family history of postpartum psychosis or bipolar disorder are at a higher risk.

Personal history: Women who have previously experienced postpartum psychosis or have a history of bipolar disorder or other psychiatric conditions are more susceptible.

Sleep deprivation: The physical and emotional stress of childbirth combined with the lack of sleep can contribute to the onset of postpartum psychosis.

Stress: High levels of stress, including the demands of caring for a new baby, can trigger the condition.

Symptoms

Postpartum psychosis is characterised by a sudden and severe onset of symptoms, says Netra and lists down major ones.

Hallucinations: Seeing or hearing things that are not there.

Delusions: Strong beliefs that are not based in reality, such as thinking the baby is evil or that one has special powers.

Extreme agitation: Restlessness and inability to sit still.

Confusion: Difficulty in thinking clearly or making decisions.

Mood swings: Rapid and severe changes in mood, from extreme euphoria to deep depression.

Insomnia: Inability to sleep or sleeping very little.

Paranoia: Distrust and suspicion of others, believing they pose a threat to oneself or the baby.

Thoughts of harming oneself or the baby: Suicidal thoughts or thoughts of harming the baby.

Treatment

Postpartum psychosis requires immediate medical attention and is often treated with a combination of the following.

Hospitalisation: In severe cases, hospitalisation in a psychiatric unit may be necessary to ensure the safety of the mother and baby.

Medications: Antipsychotic medications, mood stabilisers, and sometimes antidepressants are commonly prescribed to manage symptoms.

Electroconvulsive therapy (ECT): In some cases, ECT may be recommended, especially if medications are not effective or symptoms are severe.

Therapy: Psychotherapy, including cognitive-behavioural therapy (CBT), can help address underlying issues and provide support during recovery.

Support systems: Family support and participation in support groups can be crucial for recovery. It’s important for loved ones to be aware of the condition and understand how to help.

Recovery

With prompt treatment, many women recover fully from postpartum psychosis. The condition usually improves significantly within a few weeks of starting treatment, but full recovery can take several months. Ongoing psychiatric care may be necessary to monitor and manage any underlying mental health conditions.

Netra says that postpartum psychosis is a serious but treatable condition. Early intervention and comprehensive care are essential for the health and well-being of both the mother and her baby.