Postpartum psychosis

Postpartum psychosis is a rare but serious mental illness that can develop soon after you give birth. It can come on very suddenly — within hours of giving birth. It may also happen up to 12 weeks after birth.

Postpartum psychosis is also called postnatal psychosis or puerperal psychosis.

'Psychosis' means a loss of a sense of reality. If you have postpartum psychosis, you may:

• see or hear things that are not there (hallucinations)
• feel that everyone is against you (paranoia)
• experience delusions (beliefs that do not match reality)

If you or someone you know may have postpartum psychosis, it is important to see a doctor urgently. This is important for the safety of you and your baby. If you have postpartum psychosis, you will need specialised psychiatric treatment to recover.

Hormonal changes that happen during birth and the physical stress of birth are thought to contribute to postpartum psychosis.

Postpartum psychosis can affect anyone who gives birth, even if you do not have a history of mental illness.

Factors that increase your risk of developing postpartum psychosis include:

• a personal or family history of bipolar disorder
• a personal or family history of postpartum psychosis
• severe sleep deprivation
• a physically stressful or complicated birth

Postpartum psychosis can cause serious changes to your mood, behaviour, thoughts, perception and sleep.

Symptoms usually include a combination of the following:

• mood changes
  • sudden mood swings
  • excessive happiness
  • irritation
  • depression

• behaviour changes
  • speaking quickly and not finishing sentences
  • being disorganised, confused or forgetful
  • making unrealistic plans
  • being unable to care for your baby

• thought changes
  • false beliefs (delusions) that may be paranoid
  • being unable to concentrate
  • considering or planning to harm yourself or your baby

• changes to perception
  • hearing or seeing things that are not there (hallucinations)

• sleep changes
  • being unable to sleep, sometimes for days

If you notice these changes in yourself, or someone you know, it's important to get professional help. See your GP, local hospital emergency department, or call one of the support service helplines listed at the end of this article.

Postpartum psychosis is diagnosed by a psychiatrist. If your doctor thinks you may have postnatal psychosis, they will admit you to hospital for psychiatric assessment and care.

Postpartum psychosis is treatable. After getting the right treatment, you are likely to make a full recovery.

When you are first diagnosed with postpartum psychosis, you will need to stay in hospital for your own safety. In hospital, you will be closely monitored by your medical team. You may be able to go to a mother and baby unit, so you can continue to care for your baby in a safe place.

This first phase of treatment may take weeks or months, depending on your symptoms and how well they respond to treatment. Recovery will take time and ongoing care.

Your doctor will recommend treatment depending on your symptoms and condition. 
There is a wide range of treatment options for postpartum psychosis. These include:

• Medicines such as antidepressants, mood stabilisers, and antipsychotic medicines. These treat symptoms and reduce the chance of symptoms coming back.
• Electroconvulsive therapy (ECT) sends a small electric current to the nerve cells in your brain. It helps to treat severe symptoms of mania (extremely high mood), psychosis and severe depression. Your doctor might recommend this if your symptoms are severe.
• Psychological therapies, such as cognitive behaviour therapy (CBT) can help you to develop coping strategies as you recover.

Recovery can take time. Try to reduce stress and sleep well. You may consider limiting the number of visitors you have, especially at the beginning. Too many visitors can feel overwhelming.

Counselling and support for your partner and support people is also important.

Postpartum psychosis cannot always be prevented. 

If you have certain risk factors, your doctor may work with you to reduce the risk of postpartum psychosis. This may involve planning your care during pregnancy and after birth with a psychiatrist or specialist perinatal mental health team. Your doctor may recommend close monitoring after your baby is born. In some cases, your doctor may prescribe medicines as a preventive treatment.

Getting enough sleep and having support from family, friends or healthcare professionals after birth can also support your recovery and wellbeing.

If you are worried that your partner or loved one is showing signs of postpartum psychosis, it is important to arrange a doctor or mental health professional to see them urgently. 

Both the birth parent and the baby could be at risk. Delaying treatment can make things more complex and make recovery time longer.

Experiencing or caring for someone during a mental health crisis can be frightening, but help is available 24 hours a day. Ask your GP, maternal health nurse or the hospital where your baby was born for advice.

To find a maternal, child and family health service near you, use the Pregnancy, Birth and Baby tool.

COPE has a fact sheet about postpartum psychosis, as well as a comprehensive list of helplines, resources and services.

You can also call one of these mental health support services:

• PANDA (Perinatal Anxiety & Depression Australia) supports the mental health of parents and families during pregnancy and in their first year of parenthood — call 1300 726 306.
• ForWhen (Perinatal Depression & Anxiety Helpline) provides perinatal mental health support for new and expecting parents — call 1300 24 23 22.
• Gidget Foundation online and telehealth support for perinatal mental health issues — call 1300 851 758.
• Beyond Blue for mental health information and support — call 1300 22 4636.

Languages other than English

PANDA has a checklist available in many languages to help you understand how you are feeling and if you might need support.

Information for Aboriginal and/or Torres Strait Islander peoples

ForWhen provides mental health and wellbeing support for Aboriginal and/or Torres Strait Islander people during pregnancy and afterwards.

Call 13YARN on 13 92 76 to talk with an Aboriginal or Torres Strait Islander crisis supporter.

Information for sexually and gender-diverse families

COPE (Centre of Perinatal Excellence) has resources and tips for LGBTIQ+ parents and rainbow families.