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Postpartum Depression and Psychosis Information

  • Published: 2013-10-12 (Revised/Updated 2017-08-27) : Thomas C. Weiss (Disabled World).
  • Synopsis: Information and symptoms relating to postpartum depression and psychosis in mothers with new born babies
Postpartum

The postpartum period (or postnatal period) is the time beginning immediately after the birth of a child and extending for about six weeks. Less frequently used is the term puerperium. For postpartum depression early detection and adequate treatment is required. Approximately 25% - 85% of postpartum women will experience the "blues" for a few days. Between 7% and 17% may experience clinical depression, with a higher risk among those women with a history of clinical depression.

Main Document

Quote: "The most significant risk factors for postpartum psychosis include a personal or family history of bipolar disorder, or a prior psychotic episode."

Bringing a child into the world is supposed to be a happy time in a woman's life, yet for women who experience depression it may become difficult and stressful. Approximately 13% of new mothers experience depression after giving birth to a child referred to as, 'postpartum depression (PPD).' PPD is a treatable medical illness involving feelings of sadness, anxiety, and indifference.

Postpartum depression (PPD) is different from the, 'baby blues.' Up to 70% of new mothers experience the baby blues, which is a short-lasting condition that does not impair their functioning and does not require medical attention. Symptoms of the emotional letdown might involve irritability, crying for no particular reason, anxiety, and restlessness. Postpartum depression is different from the baby blues because it involves effects that are more debilitating and may continue for months. The symptoms of PPD can include the following:

  • Changes in appetite
  • Sluggishness and fatigue
  • A lack of interest in the baby
  • Crying for no particular reason
  • Difficulty concentrating or confusion
  • Fear of harming the baby or oneself
  • Difficulty sleeping or sleeping too much
  • Feeling hopeless, sad, helpless, or worthless

Chart showing symptoms of postpartum depression
About This Image: Chart showing symptoms of postpartum depression
Women who experience depression often have several of these symptoms and the symptoms and their severity might alternate. The symptoms may cause new mothers to feel guilty, ashamed, or isolated. Receiving treatment is important for both the child and the mother. It is important to contact a doctor if you are experiencing several of these symptoms for more than a two week period of time, if you have thoughts of harming your child or thoughts of suicide, if feelings of depression worsen, or if you are experiencing trouble performing daily tasks or providing care for your baby. Depression is a form of medical illness and not a sign of poor parenting or weakness. Depression can be treated.

Women at Risk and Treatment

Even though any woman might experience symptoms of depression, women are at an increased risk of depression during or after pregnancy if they have previously experienced depression or another form of mood disorder, if they have a family history of depression or mood disorders, if they are experiencing especially stressful life events, or if they do not have the support of their family members and friends. Research has suggested that rapid changes in thyroid and hormone levels after delivery have a strong effect on moods and might contribute to postpartum depression.

Women must be taken seriously when they experience these symptoms. Depression may be treated with medication, psychotherapy or both. A medical evaluation may rule out physical issues such as thyroid changes. Support from family members, friends, and support groups may be helpful as well. It is important for women who are being treated for PPD to continue treatment even after they feel better. If they stop treatment too soon, their symptoms may return.

Additional Postpartum Conditions

The potential exists for women to experience other conditions after giving birth to a child. Among these are, 'Postpartum Anxiety,' 'Post-traumatic Stress Disorder after Childbirth,' and, 'Postpartum Psychosis.'

Postpartum Anxiety: Some women do not experience depression after giving birth to a child, instead experiencing intense anxiety or irrational fears. The symptoms they experience can include a sense of impending doom, a rapid heart rate, and dizziness. There is another subset of women who may experience obsessive-compulsive disorder, a form of anxiety that involves persistent and recurring thoughts, impulses, or images. Some research has shown that postpartum anxiety affects more new mothers than postpartum depression does.

Post-traumatic Stress Disorder after Childbirth: Women may develop PTSD after a traumatic birth. PTSD many times involves reliving the experience through flashbacks or nightmares. They may feel detached or estranged, and have a hard time sleeping.

Postpartum Psychosis

Recently, a woman experiencing postpartum psychosis was shot and killed after attempting to use her vehicle to drive into government protected areas. Her one year old child was in the back seat, yet apparently the Secret Service and other law enforcement officers were unaware of this fact. Officers fired at her and the vehicle repeatedly, finally ending her life; fortunately, her child was not harmed.

Chart showing symptoms of postpartum psychosis
About This Image: Chart showing symptoms of postpartum psychosis
Postpartum psychosis is a very rare but serious condition. It happens in approximately 1-2 out of every 1,000 deliveries. The symptoms of postpartum psychosis are exaggerated and might include excessive energy, insomnia, hallucinations, agitation, suspiciousness, or paranoia. The symptoms of postpartum psychosis represent a serious medical emergency and demand immediate medical attention. The onset is usually sudden and occurs most often within the first 4 weeks after delivery. Once again, the symptoms of postpartum psychosis may include the following:

  • Hyperactivity
  • Severe irritation
  • Rapid mood swings
  • Suspiciousness or paranoia
  • Strange beliefs or delusions
  • Difficulty with communicating
  • Inability or decreased need to sleep
  • Seeing or hearing things that are not there

The most significant risk factors for postpartum psychosis include a personal or family history of bipolar disorder, or a prior psychotic episode. Of the women who develop postpartum psychosis there is a 5% infanticide or suicide rate associated with the illness. The reason is because the women who experience the psychosis experience a break from reality. In their psychotic state, the beliefs and delusions make sense to them and feel highly meaningful; many times they are religious. Receiving immediate treatment is imperative.

It is also important to be aware that many survivors of postpartum psychosis never experienced delusions containing violent commands. Delusions take a number of forms and not all of them are destructive. The majority of women who experience postpartum psychosis do not harm anyone or themselves. There is; however, always the risk of danger because psychosis involves delusional thinking as well as irrational judgment. For these reasons, women with postpartum psychosis must receive appropriate treatment and careful monitoring by trained health care providers.

Postpartum psychosis is a temporary condition that is treatable with professional help. It is also an emergency and it is vital for women with the condition to receive immediate help. If you or a person you know may be experiencing this condition be aware that it is not your fault and you are not to blame. It is important to contact a doctor or an emergency crisis hotline promptly so you can receive the assistance you need.

Related Information:

  1. JAMA and Archives Journals (Sep 06, 2010). Parents at Highest Risk for Depression in First Year After Childbirth
    https://www.disabled-world.com/health/neurology/depression/parents-childbirth.php
  2. Quest Diagnostics (Jan 04, 2012). 16% of Pregnant Women Test Positive for Hypothyroidism
    https://www.disabled-world.com/health/female/pregnancy/hypothyroidism.php


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