What is postpartum psychosis?

Postpartum psychosis is a mental health emergency, affecting a person’s sense of reality, causing hallucinations, delusions, paranoia, etc. 

Who does it affect:

• Affects anyone who gave birth recently

• Usually happens within several days to six weeks of giving birth

• Those who have certain mental health conditions prior are at higher odds
  

Statistics:

• This affects between 0.089 and 2.6 out of 1,000 births

• In the US, it is between 320 to 9,400 births per year

• Globally, it happens between 12 million to 352.3 million births per year
  

Symptoms:

• Two main symptoms that affect a person’s sense of reality:

• Hallucinations: Brain acts as if it’s getting input from senses such as eyes and ears, without any input. 

• Delusions: False beliefs that you hold onto very strongly, no matter if there is evidence against

• Other symptoms:

• Mood changes such as mania (increase in activity and mood) and hypomania/depression (decrease in mood)

• Depersonalization (an out of body experience)

• Disorganized thinking or behavior

• Insomnia and lack of sleep

• Irritability or agitation

• Thoughts of self harm or harming others
  

Three types of PPP:

• Depressive

• Manic

• Atypical/mixed
  

Depressive Symptoms:

• Most common, making up 41% of cases

• Most dangerous

• Research shows that depressive symptoms and psychosis almost always have cases that involve self-harm or harm to child

• The rate of self harm to a child is 4.5% in this subtype, which is about 4 or 5 times greater than with any other subtypes

• The rate of dying by suicide is 5%

• Symptoms:

• Anxiety or panic

• Delusions and hallucinations

• Depression

• Feelings of guilt

• Loss of appetite

• Anhedonia (loss of enjoyment to things usually enjoy)

• Thoughts of self harm, suicide, or harming their child
  

Manic symptoms:

• Second most common, affecting 34% of cases

• Risk of self harm or harm to child is lower, but possible with 1% of cases

• Symptoms:

• Agitation or irritability

• Disruptive or aggressive behavior

• Talking more or faster than usual 

• Needing less sleep

• Delusions of greatness or importance (ex: believing child is to be holy or religious figure)
  

Atypical/mixed symptoms:

• Makes about 25% of cases

• Can mix the symptoms of manic and depressive subtypes

• Also involve symptoms where a person seems much less aware (or vice versa) of the world around them

• Symptoms:

• Disorganized speaking or behavior

• Disorientation or confusion

• Disturbance of consciousness (person doesn't appear to be awake or isn’t aware of activities taking place nearby)

• Hallucinations or delusions

• Inappropriate comments, behaviors, or emotional displays

• Catatonia or mutism- being completely silent
  

Causes of PPP:

• Number of pregnancies: PPP is more common for people who gave birth to their first child

• There is a 30-50% chance it will happen again for future childbirths

• Family history of mental health conditions (such as PPP): People with PPP often have family members who have had PPP or history of mental health conditions

• Sleep deprivation: Not getting enough sleep can trigger mania in people with bipolar disorder, also suspecting that is a reason to developing PPP

• History of mental health conditions: 1/3rd of people with PPP have previously had a diagnosed mental health condition

• Most common is bipolar disorder

• Others include major depressive disorder and schizophrenia spectrum conditions

• Other medical conditions: Some examples are autoimmune and inflammatory diseases, electrolyte imbalances, vitamin deficiencies, thyroid disorders, stroke, etc

Treatment and Cure:

• PPP is treatable

• Due to the rarity, there is limited research on how to treat it

• PPP is a mental health emergency, people need inpatient mental healthcare

• Hospitalization

• Medications: 

• Antipsychotic medications

• Mood stabilizers

• Antiseizure drugs

• Lithium 

Outlook:

• PPP is a temporary condition

• With treatment people have been able to recover within a few weeks

• Without treatment, PPP can last for weeks or months, can get more severe and dangerous if left untreated

• PPP can develop into bipolar disorder, which is a better understood condition that has multiple methods and approaches for treatment