Back to Maternal mental health

Postpartum psychosis

Postpartum psychosis (or puerperal psychosis) is a severe mental illness. It starts suddenly in the days, or weeks, after having a baby. Symptoms vary, and can change rapidly. They can include high mood (mania), depression, confusion, hallucinations and delusions. It is a psychiatric emergency - you should seek help as quickly as possible. It can happen to any woman and often occurs ‘out of the blue’, even if you have not been ill before. It can be a frightening experience for a mother, her partner, friends and family. It can last several weeks or longer – but you will usually recover fully. 

It is much less common than baby blues or postnatal depression. About 1 in every 1000 women (0.1%) who have a baby will have a postpartum psychosis. Recognising symptoms and seeking urgent professional advice is essential.


Watch a video from Best Beginnings on Postpartum Psychosis.

If you’re worried that yourself, or someone close to you may be suffering with postpartum psychosis, initially start by looking out for some of the symptoms listed below:

  • Mania: feeling over-excited, elated or 'high', active, energetic, not needing to sleep, feeling agitated, restlessness, and irritable, with a busy mind or racing thoughts, being more talkative, active and sociable than usual.
  • Depressed or low mood or alternating rapidly between mood states.
  • Hallucinations - hearing voices, seeing things or smelling smells that other people cannot perceive.
  • Delusions - false beliefs that are firmly held, sometimes related to the baby, such as it is 'sent from God', or 'evil' in some way. Delusions, such as that the mother has won the lottery, that the TV or radio are referring to her, or that she has special healing powers, are not uncommon.
  • Confusion, rapid or muddled thinking.
  • A lack of insight - a woman experiencing this condition may be unaware that her behaviour is off in any way. Very often it will be other people who notice that she is behaving oddly and is not well.
  • Delusions can frequently be paranoid in nature. Mums may believe that everyone (especially hospital staff and/or loved ones) are trying to harm her and/or her baby.
  • Additional symptoms - losing your inhibitions, doing things you usually would not do.
  • Behaviour that is out of character
  • Feeling as if you are in a dream world
  • Being restless and agitated.
  • Being very withdrawn and not talking to people.
  • Finding it hard to sleep, or not wanting to sleep.

​​​

We know that talking about how you are feeling can often be very difficult, however, there is help out there. You do not have to feel like this. We hear that women often worry that they will be judged or seen to be ‘not coping’ - this is a common misconception. Health professionals are aware of how much bipolar can affect people can be during the perinatal period, and are able to support you and your family. There will be a range of treatment open to you.

Medication is an important part of the treatment for postpartum psychosis. It needs to be discussed with your GP and Specialist Perinatal Mental Health Team. Click here for further advice.

If you start to have symptoms of postpartum psychosis, you need to be seen urgently. If you have been told, during pregnancy, that you have a high risk of postpartum psychosis, look at your care plan. This should have emergency contact numbers for your mental health team or local crisis service.


If you don’t have this type of plan, or have not had a mental illness before, see your GP urgently (the same day) or go to your local A&E department. If you are told you do not have postpartum psychosis but your symptoms then get worse, go back to be re-assessed.


Most women with postpartum psychosis need to be treated in hospital. Ideally you should be offered a bed in a Parent and Baby Unit (PBU). This is a specialist psychiatric unit where mothers with mental illness are admitted with their babies. You will be supported in caring for your baby whilst you have the care and treatment you need. 
 

Postpartum psychosis is not your fault, and is not caused by anything you or your partner have done.