Postpartum psychosis

Postpartum or puerperal psychosis is a rare perinatal mood disorder about which most new mothers know very little or nothing at all. Although it only affects a small number of women (between 1 in 1000 and 2 in 1000 of new mothers) the impact it has on these women and their families makes it an illness that expecting parents and the general public must be educated about. The time of onset is variable but is generally within the first six weeks after the baby is born.

The list of symptoms which characterise this illness is extensive and variable, but may include:

  • hallucinations
  • delusional thinking
  • paranoia
  • grandiose ideas
  • sudden strong religious beliefs
  • insomnia and a reduced need for sleep
  • erratic behaviour
  • rapid/pressured thoughts and speech

Some, if not all, of these symptoms may mean little to the average person. Practically, the most important things for close family members to look out for are sudden, dramatic changes in an affected woman’s mood, personality, and/or thought processes. She may look and sound as though she has lost touch with reality. She may be convinced there is nothing wrong with her, which means the decision to seek treatment must lie with a close family member or friend.

Postpartum psychosis is a psychiatric emergency. Rapid medical assessment, preferably with a psychiatrist, or a GP who will recommend referral to a psychiatrist, is essential. Treatment includes antipsychotic medication and close monitoring. Hospitalisation is almost always necessary, and ideally should be in a mother/baby unit to preserve mother-baby bonding.

In Brisbane, the Brisbane Centre for Postnatal Disorders offers a specialised mother/baby unit at Belmont Private Hospital. The direct line phone number for the centre is (07) 3398 0238. Unfortunately, the public hospital system in Brisbane has only one mother/baby bed available. If hospitalisation is required, your psychiatrist will discuss the options available to you.

Thanks to the media’s tendency to only ever publish information about postnatal psychosis when it has ended in suicide and/or infanticide, many people’s perception of this illness is that it is incurable and almost invariably fatal for the mother and baby. This is false. Suicide is rare in cases of postpartum psychosis and infanticide is even rarer, especially if the illness is diagnosed and treated quickly, appropriately, and compassionately. With treatment and appropriate support, a psychotic episode can resolve within days or weeks and most patients return to normal functioning with the bond to their baby intact.

After a psychotic episode, the woman and her family may need psychological counselling to come to terms with what has happened to them. As with all mental illnesses, people often find that connecting with others who have had a similar experience is supportive, affirming and helpful in the process of recovery.

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The content on this page has been kindly provided by Anita Link, who experienced postnatal psychosis with both her children.