Symptoms and Treatment of Postpartum Psychosis

clinical_manifestation_of_postpartum_psychosis

Postpartum psychosis is an affective disorder that occurs or worsens in the first months after childbirth.

Out of thousands of women giving birth, this mental disorder occurs in 1-2 ones. After the first pregnancy postpartum psychosis occurs 35 times more often than after giving birth to the second child. If a woman’s had a bipolar personality disorder in the past or a postpartum psychosis after a previous birth it significantly increases the possibility that a future mother will suffer from a similar disorder again

What is a postpartum psychosis?

It is a collective term. Schizophrenia, schizoaffective psychosis, bipolar disorder, a recurrent depressive disorder as well as a variety of diseases caused by infections in the birth canal (symptomatic psychosis) – all these mental disorders may be hidden behind the symptoms of postpartum psychosis.

The causes of postpartum psychosis

  • The causes of postpartum psychosis include the following somatic and psychogenic factors:
  • Burdened heredity (when one of the woman’s close relatives suffered from a mental illness). It is a severe predisposing factor for the development of this disorder;
  • During labor, the woman undergoes intense physical stress. In addition to this, there are significant hormonal changes that can also lead to postpartum psychosis;
  • Prolonged and severe labor, blood loss, protein shifts, dehydration, chronic diseases, changes in blood pressure may also affect a woman’s mental state;
  • Fatigue, insomnia, the psycho-traumatic situation in the family observed during the postpartum period;
  • The unpreparedness of a woman to fulfill her maternal duties;
  • Some personal qualities (increased suspiciousness and anxiety, characteristic of psychoasthenia);
  • Severe mental traumas or traumatic brain injuries in medical history.

postpartum psychosis - angry mother holding the baby

Postpartum psychosis and its clinical manifestations

The first symptoms of postpartum psychosis usually manifest themselves a few days after giving birth. The woman begins to complain about fatigue, weakness, and insomnia. She has irrational fears that she might have lost breast milk, that the child is hungry, that the newborn has an upset stomach, and so on.

Anxiety becomes more pronounced. There can be excitement, euphoria, hyperactivity, strange statements, etc. The woman may become paranoid: “Is this my child? Maybe they were replaced in the hospital? What if I will be taken away from my baby?”

Mood swings and paranoid delusion can be followed by a sharp decline in strength or total apathy. Some women lose interest in the newborn, refuse to look after the child.

If you don’t seek medical help on time, then the condition of a woman can become much worse: obsessive fears and confusion will arise. Delusional ideas appear: a young mother thinks she has given birth to a dead child or considers her baby a god or a devil who should be killed. Sometimes a woman starts imagining she have never been pregnant, and people around her want to make her look after someone else’s newborn.

Auditory hallucinations (“voices”) may occur. It is also possible for a woman to develop involuntary obscuration of consciousness, during which she becomes confused and simultaneously nervous. A young mother is disoriented, her speech and thoughts are incoherent at the time.

In some cases, postpartum psychosis is accompanied by catatonic manifestations.

Sometimes the oneiroid syndrome can develop. Its characteristic signs are the influx of visual hallucinations of fantastic dream-delusional content.

All these symptoms indicate a severe mental disorder requiring immediate medical attention. In this state, it is necessary for the young mother to be under the vigilant control of a loved one because she can harm herself or her baby.

Sometimes relatives don’t pay proper attention to the change in the mental state of the mother. They think this is postpartum depression but, in fact, everything is much more complicated.

symptoms of postpartum psychosis

The aftermath of postpartum psychosis

A mother can harm her baby and (or) herself. That is the most dangerous consequence of postpartum psychosis

“I came across a patient suffering from schizophrenia who had tried to drown herself and her newborn baby in the well under the influence of hallucinations. She had been rescued but, unfortunately, the child had died. It had been her second birth. After this, the forensic psychiatric examination was carried out and the woman had to undergo compulsory psychiatric treatment. But how to fix the fatal consequences of her morbid condition?”

Postpartum psychosis: treatment

The choice of drugs for treatment depends on the dominant symptoms of the mental disorder present. A therapist can prescribe one of the following medications:

  • They eliminate delirium, hallucinations, catatonic manifestations;
  • Antidepressants which help to overcome the symptoms of depression;
  • Membrane stabilizers. These drugs stabilize the mood.

In rare cases, electroconvulsive therapy is used.

If there are any other diseases (postpartum complications, infections, exacerbations of existing somatic diseases) they will also need treatment because they can make the postpartum psychosis worse.

Prognosis

postpartum psychosis therapy

As a rule, the postnatal psychiatric disorder is well-treatable if one notices it and consults a doctor in time. In 75% of cases, postpartum psychosis ends in complete recovery.

However, don’t forget that some women have a hereditary burden when some of the signs of a mental disorder (schizophrenia, bipolar affective disorder) have been noted before. In this case, childbirth becomes a factor aggravating the existing disease. In such women, the risk of exacerbation of the underlying mental disorder in future is quite high. If that’s the issue you’ll need to consult a psychiatrist about the further treatment as well as preventive measures against exacerbation.

References
1. https://en.wikipedia.org/wiki/Postpartum_psychosis

2. http://www.nhs.uk/conditions/postpartum-psychosis/Pages/Introduction.aspx

3. http://postpartum.org/defining-postpartum-psychosis/

4. https://womensmentalhealth.org/posts/postpartum-psychosis-ten-things-need-know/

5. https://parentingpod.com/postpartum-psychosis-symptoms-risk-factors/

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