Postpartum Psychosis Symptoms and Treatment

There are many symptoms that occur in postpartum psychosis. These may include: ·

• feeling ‘high’, ‘manic’ or ‘on top of the world’
• low mood and tearfulness
• anxiety or irritability 
• rapid changes in mood
• severe confusion
• being restless and agitated
• racing thoughts
• behaviour that is out of character
• being more talkative, active and sociable than usual
• being very withdrawn and not talking to people
• finding it hard to sleep, or not wanting to sleep
• losing your inhibitions
• feeling paranoid, suspicious, fearful
• feeling as if you’re in a dream world

delusions: these are odd thoughts or beliefs that are unlikely to be true. For example, you might believe you have won the lottery. You may think your baby is possessed by the devil. You might think people are out to get you.

hallucinations: this means you see, hear, feel or smell things that aren’t really there.

If you, your partner or family think that you 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, you may have a care plan. This should include emergency contact numbers for your mental health team or local crisis service.

You may not have this type of plan, or you may not have had any mental illness before. In that case you should see your GP urgently (the same day) or attend your local A&E department. If you are told you do not have postpartum psychosis but your symptoms worsen, you should make sure you are seen again.

Most women with postpartum psychosis need to be treated in hospital. Ideally you should be offered a bed in a Mother & Baby Unit (MBU). 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.

There are many parts of the country with no Mother and Baby Unit. Even where there are MBUs, there may not be a bed available. You may be admitted to a general psychiatric ward. If that happens, your partner or family will need to care for your baby. If you have nobody else who can look after your baby, social workers can find a temporary carer. This will only be until an MBU bed is available, or until you are well enough to care for your baby yourself. You may choose to be admitted to a general ward if the nearest specialist MBU is far from your home.

·                  Medication and breastfeeding

Most women with postpartum psychosis need treatment with medication. This is usually an antipsychotic, a mood stabilizer or both.

It is possible to breastfeed whilst taking some medications. Your psychiatrist can discuss the risks and benefits of medications in breastfeeding with you. You may be unable to breastfeed. There are several reasons for this. You may be too unwell, or you may be admitted to hospital without your baby. You may need a medication which is not safe in breastfeeding. Some women feel guilty about being unable to breastfeed, but you should not feel this way. If you have postpartum psychosis, it is not your fault. It is important for your baby that you have the treatment you need so that you get better.

·                  Help in caring for my baby

During the severe part of the illness you will probably need help caring for your baby. You are likely to need practical help. You may also need help to bond with your baby. Mother and Baby Unit (MBU) staff are trained to support you with all aspects of caring for your baby. If you do not go to an MBU, there are people who can help and support you once you go home. These include health visitors and mental health professionals. There may be a local perinatal or parent-infant mental health service. In some areas, Children’s Centre staff and/or voluntary organizations can also help.

It is normal to lack confidence with mothering after postpartum psychosis. Remember that most new mothers, who have not had an illness, also feel like this. You may find it hard to attend mother and baby groups when recovering from postpartum psychosis. Health visitors and community psychiatric nurses can give you one-to-one advice until you feel up to attending groups with other mothers.

Some mothers have difficulty bonding with their babies after an episode of postpartum psychosis. This can be very distressing. Usually these problems don’t last long. Most women who have had postpartum psychosis go on to have very good relationships with their babies. Talk to your health visitor or other professionals involved in your care. They can tell you what help is available in your area. Health professionals can support you in learning how to interact with and respond to your baby. You may find baby massage and other groups for new parents helpful.

·                  Care and support for you during recovery

Allow your partner, family or friends to help and support you while you get better (see section on partners below).

Usually you will need to have care from a mental health service until you fully recover. This team can advise you about treatment. They can support you and your family. You may have care from a perinatal or parent-infant mental health service.

These specialist teams do not exist in all areas. In that case your local community mental health team, health visitor and GP will continue to support you whilst you recover.

It is important to ask for advice about contraception. It is a good idea to avoid getting pregnant again too soon after an episode of postpartum psychosis.