Postpartum Psychosis

What it is, how to recognize it, what causes it, how it’s treated, and resources to seek help

Postpartum what?

You’ve probably heard the term Postpartum Psychosis before. If you haven’t, you might have seen the recent tragic news involving Lindsay Clancy. Lindsay – a new mom – was accused of murdering her three children and then attempting to take her own life in February of 2023. A seemingly “normal” mom, Lindsay was assessed after this tragedy and thought to have Postpartum Psychosis.

According to the National Institutes of Health (NIH), postpartum psychosis is classified as the

severest form of (postpartum) mental illness…characterized by extreme confusion, loss of touch with reality, paranoia, delusions, disorganized thought process, and hallucinations. It usually happens immediately within days to the first six weeks after birth.

Though postpartum psychosis is a rare phenomenon, affecting around 1 in 500 mothers after giving birth, it has historically resulted in postpartum psychosis sufferers committing infanticide, and 5% dying by suicide. Though these numbers seem small, they are life changing, horrible statistics. If you ask me, that number should be zero, which is why this is an extremely important issue that new moms and their families should be able to recognize and seek help for immediately.

Though I don’t know anyone who has had postpartum psychosis and haven’t personally experienced it myself, I  have been very open about the fact that postpartum anxiety and postpartum depression have been very, very real issues for me throughout my journey as a new mom. Recognizing the differences between postpartum baby blues, anxiety, depression, and psychosis can be extremely tricky.

So what makes postpartum psychosis different?

Symptoms to look out for

According to the NHS, the most prominent symptoms of postpartum psychosis include:

• hallucinations – hearing, seeing, smelling or feeling things that are not there
• delusions – thoughts or beliefs that are unlikely to be true
• a manic mood – talking and thinking too much or too quickly, feeling “high” or “on top of the world”
• a low mood – showing signs of depression, being withdrawn or tearful, lacking energy, having a loss of appetite, anxiety, agitation or trouble sleeping
• sometimes a mixture of both a manic mood and a low mood – or rapidly changing moods
• loss of inhibitions
• feeling suspicious or fearful
• restlessness
• feeling very confused
• behaving in a way that’s out of character

If you or a loved one is experiencing these symptoms and have even the slightest inkling that it may be postpartum psychosis, seek medical attention immediately. While you might feel down or depressed with the baby blues or postpartum depression, hallucinations, delusions, paranoia, and mania are not common in those conditions. Postpartum psychosis is considered a medical emergency and can be deadly for all involved if left untreated.

So what exactly causes it?

Though the causes of postpartum psychosis aren’t very well known, there are some common risk factors. According to this amazing article by Postpartum Support International, “the most significant risk factors for postpartum psychosis are a personal or family history of bipolar disorder, or a previous psychotic episode.” Other risk factors include a family history of mental illness (even if you yourself don’t have a history of mental illness), a history of postpartum psychosis in a previous pregnancy, a history of schizophrenia or schizoaffective disorder, and/or abrupt discontinuation of psychiatric medications during pregnancy. Unfortunately, this means that prevention isn’t always possible, but help is always available.

How is it treated?

According to the Cleveland Clinic,  treatment is usually preceded by a full medical evaluation including labs and imaging, and usually includes medication therapy, talk therapy, or a combination of the two. Some sufferers also elect to undergo Electroconvulsive Therapy or ECT, which sounds terrifying but can actually be a very effective treament for many mental health disorders.

Depending on the severity of symptoms, your treatment course might also include a short stay in an inpatient (in the hospital) or outpatient (out of the hospital) setting.

Treatment options should always be considered with you (the patient) in mind, so make sure to discuss all of your concerns with your provider. The Mayo Clinic has a great list of questions to discuss with your provider when you do decide to seek care.

Resources

If you or a loved one are suffering from these symptoms, please know there is absolutely NO shame and you are definitely not alone. Here’s what you can do to get help. 

• If symptoms are scaring you and causing thoughts of harm to yourself or to your baby, call 911 or report to an emergency room for treatment immediately.
  
• Action on Postpartum Psychosis is an incredible website detailing what postpartum psychosis is, how to get help, and how to care for someone who is suffering from it. 
• As always, I love Postpartum Support International for informational resources on postpartum psychosis as well as support services including support groups for moms.
• 988 Suicide & Crisis Lifeline can be accessed by calling or texting 988. Lifeline Chat is also available 24/7 and provides support from a crisis counselor to anyone in emotional distress. 
• The National Alliance on Mental Illness also has a helpline, 1-800-960-NAMI that is available from 10AM – 10PM ET. You can also text “helpline” to 62640.

There are countless other resources on the web, but these are just a few of my favorites. Please remember that postpartum psychosis is considered a medical emergency. Don’t wait to seek care! 

If you know of any other resources, please leave them in the comments for our readers below.

*Disclaimer: I am not a physician and this is for informational purposes only. If you are concerned you or a loved one has postpartum psychosis, please seek the appropriate medical attention*