Maple Leaf Counseling

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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