Everything you need to know about postpartum psychosis

When it comes to mental illness, it’s important that friends and family know what signs to look out for in their loved ones and learn about how they can support them, including where to turn to for help if needed. This is especially true of illnesses that include psychotic features, as often those struggling with the symptoms of psychosis are unable to recognise that they are unwell. 

Postpartum psychosis (PP) is a severe but treatable illness that affects around 1,400 women in the UK each year, or around 140,000 worldwide. It usually begins suddenly in the days and weeks after having a baby, however, in some cases it can have a more gradual onset—the signs of which are harder to detect. While women who have previously experienced illnesses such as bipolar disorder are more at risk, in around half of cases women have had no previous mental health diagnosis. 

Because it can occur completely out of the blue, national charity Action on Postpartum Psychosis is urging as many members of the public as possible to brush up on the basic facts to help spot the signs in a friend, partner, or family member—enabling them to get help more quickly and, ultimately, save lives.

Dr Jess Heron, CEO, Action on Postpartum Psychosis says, “Postpartum psychosis is a severe but eminently treatable illness that should always be considered a medical emergency. Often it can be confused with other more common perinatal mental illnesses such as postnatal depression, but, while some women can experience symptoms of depression following an episode of postpartum psychosis, postpartum psychosis itself is a very different illness with a distinct set of symptoms that requires specific treatment and support.”

If you are experiencing postpartum psychosis you will have one or more of the following symptoms of psychosis:

Early signs and symptoms to look out for include feeling:

Zebunisa Pathan experienced postpartum psychosis after having her baby boy. She says, “Having a baby is a significant, wonderful and stressful time of life. But when giving birth coincides with family weddings and various other things that life throws at you, that stress can be amplified tenfold. In the days after I gave birth, I remember feeling vulnerable, exhausted and highly emotional. So far so normal.

“However, by day five things for me and my family were definitely not normal. I became quite elated but I was also really confused and, I’m told, acting in quite a bizarre way. Running naked around the room was certainly not normal for me, and neither was telling anyone and everyone my personal problems. I was so sleep deprived and was struggling with breastfeeding big time. I sought out breastfeeding support on several occasions and after seeing the breastfeeding support team and speaking with them as if they were my counsellors, they suggested I see the crisis team. They could tell something simply wasn’t right.”

Dr Heron adds, “Women may appear far more talkative and stumble over their words, finding it difficult to keep their attention focused on one thing. They may lose their inhibitions and act completely out of character. Of course, having a baby is a huge moment and some behaviour change is expected, but if you’re worried that someone is behaving very differently, seems overly distressed or agitated and is struggling to cope, it’s always worth speaking to them without judgment and encouraging them to seek help from a healthcare provider. If you are concerned for the safety of a mother or baby, call their midwife, GP, mental health crisis team, or, in an emergency, call 999. If it is postpartum psychosis, it can get worse very quickly but, with the right treatment, most women make a full recovery.”

Treatment for postpartum psychosis usually involves admission into a Mother and Baby Unit (MBU) where women can remain with their babies to build that all important bond, while at the same time receiving specialist care and support. Dr Heron says, “Without the right care and support, we are hearing of too many women dying by suicide. This has to change. While we are campaigning for more MBU beds and improved awareness and training for health professionals and first responders, it’s also important for members of the public to have some basic awareness, to get women and their families urgent help and support. It’s no exaggeration to say that this can save lives.”