Last Updated on April 28, 2023

You’ve learned of postpartum depression and the baby blues. But one in every 1,000 new moms faces something much more acute during the first few weeks after delivery: Postpartum psychosis.

Postpartum psychosis is characterized by problems responding emotionally to the infant — even ideas of harming the child. “It typically represents a bipolar disorder, not only a depressive disorder,” says shrink Charlotte Ladd, MD, PhD, assistant professor of psychiatry in the University of Wisconsin in Madison. The truth is, Dr. Ladd qualifies postpartum psychosis as a “psychiatric emergency.”

Who Gets Postpartum Psychosis?

About half of mothers with postpartum psychosis have a history of mental illness — and that means another half don’t have any reason to suppose it. The causes of postpartum psychosis are not well understood. It’s not impossible that the problem could be triggered by the sudden shift in hormones after delivery. And recent research indicates that being an older mother may raise danger, but that a mother who has diabetes or gave birth to a sizable baby may be protected.

While postpartum depression is probably to emerge in the three months after delivery (but can appear within the very first year of the infant’s life), among the hallmarks of postpartum psychosis is its early start — most commonly in the initial two or three weeks after the baby’s arrival.

Most mothers will soon be home from the hospital and from the watchful eyes of their medical team when it hits, but these depression symptoms are really so worrisome, says Dr. Ladd, that a partner or other caregiver nearly constantly notices that something’s wrong and calls a physician or a family member to express concern.

The Warning Signals of Postpartum Psychosis

Symptoms go beyond those connected with postpartum depression. Here’s what to watch for:

• Surprising thoughts of throwing the baby or harming it in some other way
• Delusions — or beliefs about yourself or current events that don’t have any basis in reality
• Hallucinations — seeing or hearing things that aren’t there
• “Flat affect,” or a lack of mental reaction
• Difficulty responding emotionally to the child
• Difficulty sleeping past the standard interrupted sleep of new motherhood
• Changes in appetite or eating
• Irritability
• Confusion
• Agitation
• An inability to bond with baby
• Thoughts of suicide as well as the belief that the baby or your family would be better off without you

In extreme scenarios, a woman with postpartum psychosis may exhibit behaviors such as making statements that are apparently irrational, muttering to herself, refusing to eat, or staring off into space.

“It’s generally fairly remarkable in the sense the husband might call up and say she is not reacting to the baby, she’s not sleeping. It can not typically go undetected,” says Ladd, including that any mother being seen by a doctor for a mood interference in the first days or weeks after delivery should be inquired whether they’ve had any thoughts about harming themselves, their baby, or other individuals.

While the mother herself is likely to know she has a problem, she might not need to find help. “Intrusive thoughts of throwing a baby out the window or across the area usually appear to come out of nowhere, and women are frightened to talk about them,” Ladd says. These thoughts might actually be because of a “snuggling instinct gone awry,” she notes, describing that these mothers occasionally feel almost fanatical in their baby-focus.

Because they are afraid that doctors or family members will take their baby away, women may keep these thoughts to themselves, and this unwillingness to discuss leaves women with postpartum psychosis feeling quite alone. When treating girls is let them understand the thoughts are a regular part of the sickness actually, among the initial matters Ladd does.

An immediate response is required — or if you imagine it in yourself — if caregivers or other family members guess psychosis. “If someone has psychosis, it is important to get them to your psychiatric facility right away and also to divide mother from infant throughout that appraisal period,” she says. This separation doesn’t mean the infant is going to be forever taken from the mom’s care. The aim will be to transfer both baby and mother into a secure situation and then evaluate the mom so she is able to get the appropriate medical treatment, for example hospitalization, antipsychotic drugs, antidepressants, or counselling.