Postnatal depression and perinatal mental health

Explains postnatal depression and other perinatal mental health issues, including possible causes, sources of treatment and support, and advice for friends and family.

What is postpartum psychosis?

Postpartum psychosis (PP) is a serious, but rare, diagnosis occurring in around one in 1,000 births. You're likely to experience a mix of:

Symptoms usually start quite suddenly within a few weeks after giving birth. PP is sometimes called puerperal psychosis.

Postpartum psychosis can be an overwhelming and frightening experience for you and your loved ones, and it's important to seek help as soon as possible. With the right support, most women fully recover.

This page covers:

Postpartum psychosis

Watch Kathryn talk about her experience of postpartum psychosis.

What are the common signs and symptoms?

How you might feel

  • excited or elated
  • severely depressed
  • rapid mood changes
  • confused or disorientated

How you might behave

What are delusions and hallucinations?

Delusions and hallucinations are aspects of psychosis.

A delusion is a significantly unusual belief that other people don't share. For example, you might believe that you are related to someone famous, although you don't share any relatives, or you may believe you are able to control the weather. Some delusions can be very frightening – for example, if you believe that someone is trying to control you or kill you. These sorts of delusions are often called paranoid thinking or paranoia. See our pages on paranoia for more information.

Hallucinations are when you see or hear things, or experience tastes, smells and sensations, that people around you don't. For example, you might see objects move in ways they normally wouldn't, or hear voices that other people don't. See our pages on hearing voices for more information.

For more general information, see our pages on psychosis.

What causes postpartum psychosis?

There is no clear evidence on what causes postpartum psychosis, but there are some risk factors. You are more likely to develop postpartum psychosis if:

  • You have a family history of mental health problems, particularly a family history of postpartum psychosis.
  • You have a diagnosis of bipolar disorder. Although postpartum psychosis occurs in around 1 in 1,000 births, for women with a diagnosis of bipolar disorder this rises to around 1 in 4 births.
  • You have a traumatic birth or pregnancy.

However, you can also develop postpartum psychosis if you have no history of mental health problems at all.

It is slightly more common in first rather than later pregnancies.

If you are at a higher risk of developing postpartum psychosis, it's important to discuss your mental health with your midwife or doctor, and think about how you can plan ahead. Action Postpartum Psychosis has a guide on planning pregnancy for women at high risk of developing postpartum psychosis.

What are the treatments?

You are most likely to be offered an antipsychotic drug to manage your mood and psychotic symptoms. See our pages on antipsychotics and our antipsychotics A-Z for more information about these drugs. You may also be offered an antidepressant.

If your symptoms are very severe, and don't respond to other treatments, your doctor may offer you electroconvulsive therapy (ECT). See our pages on ECT for more information and your rights around treatment.

Will I have to go into hospital?

Your doctor may decide that treating you in hospital is the best way to get you the help you need. If it's possible, you should be admitted to a mother and baby unit (MBU), where you can stay with your baby while getting treatment. See our page on support and services for more information.

Eve smiling and holding baby

My experience of postpartum psychosis

"I became ill almost as soon as Joe was born."

How can I help myself cope?

If you are experiencing postpartum psychosis, the most important thing to do is get help. Speak to your doctor if you feel able to, or talk to someone you trust about what's going on and ask for their support in getting help.

Once you're receiving professional help, there are things you can do to help look after yourself while you recover:

  • Join a support group. You might be feeling really alone or feeling as if no-one understands, but talking to other people can help. APP runs a peer support network for women who have experienced postpartum psychosis. Alternatively, you might want to try a support group around psychosis more generally.
  • Recognise your triggers. Try keeping a diary of your moods and what's going on in your life. This might help you recognise patterns or notice what affects your mental health. If you can become aware of the sort of experiences or feelings that can trigger you, it gives you the chance in future to notice what's going on before you become more unwell, and ask for help.
  • Contact specialist organisations. Action Postpartum Psychosis has a guide to recovering from PP here. It has lots of tips and ideas from women who've experienced PP about how to cope in the days and months after being diagnosed.

Planning another pregnancy

If you've experienced postpartum psychosis, it's understandable to feel anxious about becoming pregnant again. Unfortunately, experiencing PP does put you at higher risk of developing it again with future pregnancies.

If you want to have another baby, or find out that you're pregnant, it's important to talk to your health care professional and make a plan in case you do become unwell again. See Action Postpartum Psychosis's website for more information about planning your pregnancy if you are at high risk of developing PP.

This information was published in July 2016. We will revise it in 2019.

References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.

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