The causes of postpartum psychosis are partly obscure

Essentially, anyone with a newborn baby can develop postpartum psychosis. Under the greatest risk are those mothers who are suffering from bipolar disorder and mothers who have already suffered from postpartum psychosis after a previous pregnancy. These groups have a 50% risk of developing postpartum psychosis. Mothers with bipolar disorder or psychosis in their family history are also at increased risk.

All postpartum psychoses have different backgrounds. It is strongly believed that the severe changes in hormonal balance linked with the pregnancy finishing play an important role in the onset of at least some postpartum psychoses.

Firstly, childbirth, C-section, and a previously experienced mental illness increase the risk of developing postpartum psychosis. The situation can be worsened by, for example, relationship problems with one’s partner and the difficulties of becoming a parent. Mothers with postpartum psychosis have themselves described that the causes of postpartum psychosis may include, e.g., experiencing a major lifestyle change, a lack of sleep, and/or a difficult or painful childbirth. Causes or factors may also include having a sick child, unrealistic goals for motherhood, or the death of a loved one.

Sometimes childhood psychosis is associated with a physical illness such as gestational poisoning or infection. Often the causes of the illness cannot be determined. However, the symptoms of postpartum psychosis are very similar regardless of the causes of the disease.

Symptoms of postpartum psychosis

– the mother is confused and delusional

The most severe postpartum syndrome is postpartum psychosis. It is estimated that only 0.1 to 0.2 percent of new mothers suffer from postpartum psychosis. The postpartum psychosis usually begins within two weeks of delivery.

The symptoms of psychosis are more pronounced than those of depression. Primary symptoms may include fatigue, exhaustion, insomnia, restlessness, feeling low and tearful, and having significant emotional instability. The mother may also lose her ability to function.

At a later stage, the mother may be hyperactive or, on the other hand, completely passive. A person with postpartum psychosis is confused and delusional. Their sense of reality is distorted. Their thoughts and speech can come out as a flood. They may be very irritated. The well-being of the baby can be obsessively important to the mother. Suicidal thoughts may even occur.

Postpartum psychosis is a severe illness that always requires professional attention.

A patient with psychosis must be hospitalised immediately. The treatment usually takes place in a hospital, sometimes in ambulatory care. Antipsychotics and antidepressants are used as treatment. Often, the psychosis is followed by a phase of depression that can be treated in a variety of ways. However, not everyone gets depression after the psychosis has been successfully treated.

The recovery prognosis for postpartum psychosis is good and the recovery is often rapid.

Follow-up after a hospital stay is vital. For example, the mother may need psychological visits, support from family workers, etc. The interaction between mother and the baby can benefit from professional help. Going through and structuring the experience is also important. Otherwise, a distressing or frightening memory may remain about the psychosis.  For instance, support from Äimä ry can be very important.

Treatment of postpartum psychosis

Postpartum psychosis is a severe disease, but recovery can be very rapid. A mother with postpartum psychosis must be immediately hospitalised where appropriate medication is planned for her. Most mothers recover well from postpartum psychosis and can function normally.

The duration of the psychosis phase varies from a few weeks to several months. Usually, the symptoms of psychosis are relieved soon after medication begins, but the feelings of being very confused may continue thereafter. Recovery from postpartum psychosis is always an individual process.

Postpartum psychosis is very commonly followed by a period of depression, and for some it may be very severe and deep. Normally, dealing with the illness itself also takes time. Conversational care and therapy are often helpful in recovery.

In primary health care, postpartum psychosis is often poorly understood. Midwives and nurses’ knowledge of an illness is often limited. For instance, postpartum psychosis and postpartum depression may not be distinguished.

Postpartum psychosis is a crisis for the whole family and severely affects the people close to the patient as well. The family usually needs support even after the acute crisis has subsided. For instance, family work professionals may support the family.

When a mother that has previously suffered from postpartum psychosis is expecting another baby, intensified monitoring of the mother’s health is necessary to reduce the risk of recurrence. However, treatment and monitoring cannot fully prevent the recurrence.

The support offered by Äimä

Äimä ry provides peer support for families who have experienced postpartum psychosis. For more information contact volunteering coordinator, heli.mikkola@aima.fi.