What is postpartum psychosis?

Postpartum psychosis is a serious but rare mental health problem. It can develop after you give birth. It's sometimes called puerperal or postnatal psychosis.

My husband came into the kitchen to find me on my hands and knees scrubbing the oven rambling incoherent sentences, writing long lists. And then I went to the window and tried to climb out of it to get nearer to the outside world, away from the walls of the house I felt trapped in.

Postpartum psychosis can be an overwhelming and frightening experience. But with the right support, most people fully recover. It's important to seek help as soon as possible if you experience symptoms. 

Signs and symptoms of postpartum psychosis

The symptoms of postpartum psychosis usually start quite suddenly, within a few weeks after you give birth.

If you experience postpartum psychosis, you're likely to have a mix of psychosis, depression and mania. 

This means you might feel:

• Excited or elated (manic)
• Restless
• Severely depressed
• Anxious or irritable
• Like your thoughts are racing
• Paranoid or suspicious of other people
• Like your mood is changing rapidly
• Confused or disorientated

You may also feel a mixture of moods at once. This can be scary to experience.

And your behaviour might include:

• Being more social or reserved than usual
• Doing things you wouldn't normally do
• Struggling to sleep or feeling like you don’t need to sleep, even when you have the chance
• Struggling to concentrate
• Experiencing psychotic symptoms, like delusions or hallucinations

What are delusions and hallucinations?

Delusions and hallucinations are aspects of psychosis which you may experience.

Delusions are strong beliefs that other people don't share. For example, you might think that:

• You're being followed
• Your thoughts are being read
• You're very powerful and able to influence things outside your control
• You have special insight or divine experiences

Some delusions can be very frightening and can make you feel unsafe. For example, you may believe that someone is trying to control you or kill you. These sorts of delusions are often called paranoid thinking or paranoid delusions. See our information on paranoia to find out more.

Hallucinations are when you experience things that others around you don't. For example, hearing voices, seeing visual hallucinations and other unexplained sensations. See our information on hearing voices to find out more.

Living through postpartum psychosis

Watch Kathryn talk about her experience of postpartum psychosis.

Causes of postpartum psychosis

There's no clear evidence on what causes postpartum psychosis. You can develop it even if you have no history of mental health problems. But you may be more likely to develop it if you have:

• A family history of mental health problems, particularly a family history of postpartum psychosis or bipolar disorder
• A diagnosis of bipolar disorder or schizophrenia
• A traumatic birth or pregnancy
• Stopped taking psychiatric medication during your pregnancy
• Experienced postpartum psychosis before

If you're at a higher risk of developing postpartum psychosis and are pregnant or thinking of becoming pregnant, it's important to talk to your doctor or midwife. You should do this even if you currently feel well. They can help you to plan ahead for if you do become unwell.

You could also show our information to friends or family members, so they can look out for any symptoms.

Action on Postpartum Psychosis (APP) has a series of guides about postpartum psychosis. This includes a guide to planning a pregnancy if you're at high risk of developing postpartum psychosis.

Getting support for postpartum psychosis

If you have symptoms of postpartum psychosis, you may not recognise that you're unwell at first.

But if you or someone close to you is worried that you're experiencing postpartum psychosis, speak to your GP, midwife or health visitor straight away.

Postpartum psychosis is a mental health emergency and you should be seen urgently. You may be referred to a specialist perinatal mental health service for immediate assessment and support.

Treatments for postpartum psychosis

There are various treatments that you may be offered for postpartum psychosis. Your doctor should discuss these options with you, so you can make a decision together about the best treatment for you.

In some circumstances, your doctor may decide that treating you in hospital is the best way to get the help you need. If it's possible, you might be admitted to a mother and baby unit (MBU). You can stay there with your baby while getting treatment. See our page on perinatal mental health support and services for more information about MBUs.

Medication

Your doctor is most likely to offer you an antipsychotic drug to manage your mood and psychotic symptoms quickly. They may also offer you an antidepressant.

See our pages on medication for more information.

CBT and family intervention

If you have psychosis and become pregnant, you may be at risk of developing psychosis symptoms again during your pregnancy. You may be offered cognitive behavioural therapy (CBT) or family intervention to help prevent these symptoms.

Family intervention is a service that helps family members talk to each other about what helps, solve problems and plan for a crisis. Your GP will be able to find out if this is available in your area.