Hormonal changes and the demanding physical requirements of caring for a newborn make it likely that up to 80 percent of new mothers experience some feelings of sadness, irritability and anxiety, known as “baby blues,” within a few days after giving birth. These feelings can last anywhere from a few days to a few weeks, although in some cases they may be harder to shake. If symptoms last more than two weeks, they should be reported to a doctor.
Depression is also one of the symptoms associated with the condition known as postpartum psychosis, a rare psychiatric emergency that affects about one in 1,000 pregnancies. Unlike the commonly experienced baby blues, postpartum psychosis is a severe mental illness, which makes it difficult for a new mother to emotionally respond to her child and may even result in her harming the child. The symptoms of this serious condition, which include rapid mood swings, paranoia, confusion, and thoughts of harming the baby or committing suicide, may begin without warning, within days or weeks of the birth.
Here is how some of the symptoms might manifest:
Manic Mood Swings:
Women with postpartum psychosis can have rapid mood swings, alternating between feeling energetic, upbeat, and competent to feeling sad and anxious. Such mood swings may even happen a few times in the same day. The manic period can involve feeling so exhilarated that sleep is impossible or feeling exhausted but not being able to sleep because the mind won’t stop racing.
Postpartum psychosis often results in paranoid delusions in which the new mother thinks people are trying to harm her or the baby. A woman might believe people are trying to steal her baby or that someone already has and the baby was switched at birth. A woman suffering from postpartum psychosis may not be able to trust family and friends because she is deluded into believing they are plotting against her.
Only one in ten women with postpartum psychosis has delusions that compel her to harm the baby, her other children, or herself, but those rare and often highly publicized incidents underline the need to take the condition seriously.
Some women only experience the depression part of postpartum psychosis. They lose interest in daily life and feel sad, but the depression associated with postpartum psychosis is different from postpartum depression, as it will likely be accompanied by delusions or hallucinations. The new mother might hear voices that criticize her and prompt her to act in an irrational way. When the voices talk, she may feel compelled to do what they tell her, even if the messages have no logical connection to reality.
The confusion experienced during postpartum psychosis can be so extreme that it makes it impossible for a new mother to perform daily activities. When suffering from hallucinations, she might realize something is wrong and that is terrifying. She may know she is acting irrationally but may be afraid to get help.
Thoughts of harm:
Only one in ten women with postpartum psychosis has delusions that compel her to harm the baby, her other children, or herself, but those rare and often highly publicized incidents underline the need to take the condition seriously. Under the influence of postpartum psychosis, she may feel compelled to act on powerful urges, which at the time seem like perfectly logical solutions to real or imagined problems. Possibly, she may resist getting help because of the stigma or the fear that she will be locked up and never get better.
Some of the women who experience postpartum psychosis do not have any previous risk factors but a history of mental illness, especially bipolar disorder, seem to raise the likelihood of developing this severe condition. It has been suggested that postpartum psychosis may be a form of bipolar disorder triggered for the first time by hormonal changes or a case of bipolar disorder that has not previously been diagnosed. It’s estimated that 37 percent of women who have bipolar disorder may have postpartum psychosis.
Women who are already taking medication for psychiatric disorders such as bipolar disorder or schizophrenia may stop taking prescribed medication during the pregnancy. There’s no evidence that taking such medication during pregnancy will prevent postpartum psychosis, but the hormonal disruptions that accompany giving birth may trigger new symptoms or a recurrence of previous symptoms. Women who have been diagnosed with bipolar disorder or another mental illness need to be closely monitored during pregnancy and immediately thereafter.
The symptoms can last for a few days or a few months and usually require hospitalization. Symptoms usually start when the new mother is home from the hospital and may progress rapidly. While she may suspect something is wrong, it’s usually a family member or friend who notices the unusual behavior and takes her to get help.
Treatment can include counseling, antipsychotic medication, mood stabilizers, and even electroshock therapy. Once a woman has had an episode of postpartum psychosis, there is a 50 percent chance she will experience a second episode after a subsequent delivery.
Women who are treated for postpartum psychosis may still suffer from feelings of low self-esteem, mistakenly believing they are somehow at fault for being sick and unable to adequately respond to their child.
However, with prompt and adequate treatment, many women fully recover and can end up having a healthy relationship with their baby. Getting help quickly is essential.