Postpartum Psychosis
Rounding out our series on postpartum mental health, we’re going to get into the rarest of the three postpartum mental health issues mentioned in this series, impacting only about 0.01-0.02% of birthing parents- postpartum psychosis. Unlike postpartum depression or anxiety, the hallmark of postpartum psychosis is the presence of psychotic symptoms like hallucinations or delusions. Also unlike postpartum depression and postpartum anxiety, postpartum psychosis is considered and treated like a medical emergency.
The minute people hear the word “psychosis” it seems to raise hackles. Psychosis is a scary thought for a lot of people and suggests a break from reality. (It is also scary for a lot of people due to mental health stigma, but that’s a different conversation). To demystify this a bit, let’s dive right in. What does postpartum psychosis look like?:
· Onset of symptoms is typically within hours or days and come on rapidly
· Delusions (thoughts or beliefs that are not likely to be true)
· Hallucinations (seeing or hearing things that aren’t there)
Feeling very irritable
Hyperactivity
Decreased need for or inability to sleep
Paranoia and suspiciousness (This can also be experienced as fearfulness)
Rapid and extreme mood swings
Difficulty communicating at times
Loss of inhibitions
Confusion
While there isn’t a clear cut cause for postpartum psychosis, several risk factors and correlative relationships have been identified. A family history of psychosis or a personal history of bipolar disorder or schizophrenia are the strongest risk factors for postpartum psychosis. If you’ve had a previous experience with postpartum psychosis you have a 1 in 2 chance of experiencing it again and are at higher risk. Some doctors believe that additional risk factors include: this being your first birth, your pregnancy being unplanned, and having stopped psychotropic medication during your pregnancy.
These are pretty wide sweeping risk factors, so how might you prepare if you find that you have one or several of these? First, build your team. You want to be working with a specialist and you want to have a care plan in place before you give birth. Your team might include: your partner, a perinatal psychiatrist and other mental health professionals, your OB, doula, midwife, members of your personal support network (family or friends), and your regular doctor. Meeting to create your care plan helps to ensure that everyone involved in your care is well apprised of the symptoms of postpartum psychosis and can put into action all of the steps needed to get you the care that you need as fast as possible. It also creates an additional level of monitoring to ensure that you can nip the symptoms in the bud as soon as they seem to present (if they present), rather than having to experience the onset, then go to the ER, THEN get connected to care. It cuts out the middlemen.
Postpartum psychosis can impact birthing parents who have no risk factors. If you or your loved one is experiencing symptoms of postpartum psychosis, you’re going to want to go to your closest ER. This is a medical emergency. While some advice suggests that you can call your GP, in the United States it can be incredibly challenging to get same day appointments and this cannot wait. Typical treatment includes a combination of medication, therapy, and support services. The initial stages of this may require you to be admitted to the hospital to ensure you can be monitored and that any medication can be adjusted to help you feel more like yourself.
If your partner or loved one is experiencing postpartum psychosis, one of the best things that you can do is provide support. Support can look like:
taking time to listen
helping with housework and cooking
helping with childcare and night-time feeds
letting them get as much sleep as possible
helping with shopping and household chores
keeping the home as calm and quiet as possible
not having too many visitors
getting support for your own feelings and experiences around this