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Postpartum psychosis: A guide for partners

25 July 2019 in Health

Contents

Postpartum psychosis is a serious mental health condition that can occur in the days or weeks following childbirth. Postpartum psychosis is not common but it can progress very quickly, and may be devastating if left untreated.

Postpartum psychosis can also be an overwhelming experience for family members and loved ones. If your partner is suffering from postpartum psychosis, you may feel frustrated, confused, or isolated. You may feel overwhelmed at the prospect of raising a new baby while caring for your partner, or frightened for your partner’s health.

These feelings are normal, but it’s important to remember that your partner is not responsible for what they are going through. Postpartum psychosis is normally temporary. With the right treatment and support, most women recover from postpartum psychosis.

In this article, you’ll find information that will help you to identify the signs of postpartum psychosis, details of the most common treatment options, and advice on helping your partner to manage the recovery process.

You will also find advice that is designed to help you cope during this difficult time, and links to third-party resources that may be able to provide additional support.

What is postpartum psychosis?

Postpartum psychosis (sometimes known as puerperal psychosis) is a serious mental illness that affects approximately one in every 1,000 women. The condition usually starts suddenly in the first few days or weeks after childbirth, and often causes people to feel:

  • irritable or angry
  • anxious, suspicious, or paranoid
  • confused or disoriented
  • excited, elated or ‘high’
  • overactive and energetic
  • like their thoughts are racing a lot
  • like their thoughts are muddled or confused
  • like they don’t need to sleep
  • unusually tired or lethargic
  • like their senses are heightened

People with postpartum psychosis may also experience delusions and hallucinations as the condition develops. They may claim to hear voices, develop irrational fears, or feel like actors on TV are trying to communicate with them.

Note: It is important to distinguish between postpartum psychosis and postpartum depression. Both conditions occur in the days or weeks following childbirth, but postpartum depression is a more common illness that causes low mood, negative thoughts, and low energy levels.

If your partner is exhibiting symptoms of low mood or depression without showing signs of mania, anxiety or excitability, you should contact your doctor, and tell them that you’re worried about your partner’s mental health. They will be able to screen for postpartum depression and provide treatment options for your partner.

What causes postpartum psychosis?

The exact causes of postpartum psychosis are unknown, but research suggests that people who have previously been diagnosed with bipolar disorder or another serious psychiatric illness have an increased risk of developing the condition. Research also suggests a genetic link, with studies showing that people with mothers or sisters who have previously suffered from postpartum psychosis are up to six times more likely to develop the condition.

If your partner fits into one of these categories, you should pay close attention to their behaviour, and watch for symptoms of postpartum psychosis.

The onset of postpartum psychosis may be linked to severe sleep deprivation and your partner’s hormone levels, but there is no suggestion that postpartum depression is you or your partner’s fault. It is not caused by anything you or your partner have thought or done, and it is important to remember that relationship problems, family income, or the baby being unwanted do not cause postpartum psychosis.

Spotting postpartum psychosis

Spotting the symptoms of postpartum psychosis can be challenging. The early signs normally start to show two to three days after giving birth, but the condition can sometimes take two or more weeks to manifest. The early signs of postpartum psychosis are also quite common in postnatal women, which can be confusing.

Initially, you may notice that your partner seems unusually restless, excitable or elated. You may also notice that they seem uncharacteristically chatty, or have trouble sleeping at night. It may be difficult to tell whether this high mood is natural, or the symptom of a serious mental illness.

It is perfectly normal to wonder whether or not your partner needs help at this point, particularly if you are not sure what counts as ‘normal’ behaviour, and don’t know what to expect during the days that follow the birth of your new baby.

Most cases of postpartum psychosis progress very quickly. Early signs of restlessness or high energy may become more pronounced, and you may notice that your partner shows signs of:

  • irritability or anger
  • sudden and dramatic mood changes
  • anxiety, fear or paranoia
  • racing thoughts and an overactive mind
  • confusion or disorientation
  • lacking energy
  • lack of appetite
  • being withdrawn or tearful
  • extreme and uncharacteristic sociability (eg. talking on the phone all the time)

You may also feel that your partner is acting out of character for prolonged periods of time. They might display lowered inhibitions and engage in reckless behaviour, like giving away their valued possessions or going on a sudden, excessive shopping spree. They may also stop sleeping properly and spend a lot of time worrying about things that wouldn’t normally upset them.

In some cases, women suffering from postpartum psychosis also experience delusions. For example, they may believe that actors on the TV are trying to send them a message, that they have special powers, or that the new baby needs to be protected from something. People suffering from postpartum psychosis can also experience hallucinations where they see or hear things that aren’t really there.

IMPORTANT

Postpartum psychosis is a serious medical emergency. If you have noticed a significant change in your partner’s behaviour and feel like they might be struggling with postpartum psychosis, contact emergency services or take them to hospital straight away.

Postpartum psychosis can be treated and many women make a full recovery, but the condition can also be dangerous. According to Postpartum Support International, there is a 5% suicide rate and a 4% infanticide rate associated with the illness, so it’s important to involve medical professionals as soon as possible.

If you feel that your partner has postpartum psychosis, it is normal to feel frightened or confused by your partner’s behaviour. However it is also important to remember that they could be suffering with a severe mental illness, and they may not be able to control their thoughts, emotions, or actions at this time.

The best thing you can do is to reach out and get them the medical attention they need. You can do this by calling a crisis hotline or contacting a midwife, health visitor, mental health crisis team, or local hospital straight away.

Your partner is unlikely to share any concerns about their behaviour. According to Action on Postpartum Psychosis, it’s common for women suffering from postpartum psychosis to feel as if they are coping well with childbirth and the new baby, despite exhibiting symptoms they would later identify as the early signs of a serious mental illness.

Try to keep an eye out for any sudden changes in your partner’s behaviour, and listen carefully if close friends or family express any concern. With the correct support, most women can make a full recovery, but timely intervention is the key to proper treatment, so if you are worried about your partner’s behaviour, contact a health professional as soon as you can.

Treating postpartum psychosis

If your partner is suffering from postpartum psychosis, they need immediate medical attention. In most cases, women suffering from postpartum psychosis need to be admitted to a psychiatric unit so they can be treated properly. In some countries, healthcare professionals will need to request a psychiatric hold or a mental health section so that your partner can be admitted to hospital and treated.

If you live in the UK, France, Germany, Belgium or Australia, your partner may be admitted to a specialist mother and baby unit (MBU) instead. These units are dedicated to the treatment of postnatal mental health conditions, and employ doctors who specialise in conditions like postpartum psychosis.

Being admitted to a specialist mother and baby unit means that your partner will be able to care for your baby while they are being treated. They will be closely supervised at all times, but will still be able to bond with your child.

Treatment for postpartum psychosis normally involves round the clock care, regular meetings with a psychiatrist, and monitoring by specialist mental health practitioners. Medications, such as antipsychotics, mood stabilizers, and benzodiazepines are used to treat postpartum psychosis. In some cases, electroshock therapy (ECT) may be recommended.

The thought of involving medical health professionals can be frightening, and you may be reluctant to have your partner sectioned. It is also common to feel guilty about having your partner committed to a psychiatric unit, but your partner is more likely to get the care and support they need in a specialist mental health facility.

If the condition is treated properly, most women do recover from postpartum psychosis. Recovery times can vary depending on the individual, and it can take several months before they feel completely ‘back to normal’, but the general outlook is positive.

What about caring for my partner after they’ve been discharged?

Once home from the hospital, your partner will usually be supported by the community mental health team or a specialist perinatal mental health team.

You may be able to help her recover by doing some practical tasks like cooking meals, or taking care of housework and shopping. People recovering from mental health conditions often struggle to take care of basic self-care tasks and need to dedicate time to the recovery process, so doing small jobs around the house can be helpful.

You can also encourage your partner to become more confident in looking after her baby by:

  • giving her space to establish a bond with your child
  • allowing her to take small steps towards independent baby care

It may be helpful to let her know that you are unsure about some things too. People recovering from postpartum psychosis have often lost confidence in their parenting abilities and it can be reassuring to know that they’re not behind as a parent.

Above all, try to be supportive and calm. It can be difficult to support someone who is recovering from postpartum psychosis and you may feel overwhelmed in the days (or weeks) following your partner’s discharge, but most people do make a full recovery and go on to lead perfectly normal lives.

It also helps to have a plan in place should your partner’s symptoms reappear. If you are worried about your partner’s behaviour after they’ve been released from the hospital, you should contact your doctor or mental health crisis team straight away.

Coping with postpartum psychosis

It can be difficult to learn that your partner is suffering from postpartum psychosis. You may feel confused, frightened or overwhelmed by the sudden change in their behaviour. You may also be worried about agreeing to have them hospitalised, frustrated by their behaviour or exhausted as a consequence of your partner’s illness.

All of these feelings are normal, and there’s no reason to feel guilty about your emotions. However, remember that your partner isn’t responsible for what is happening to them, and cannot help the way that they are behaving. It may be helpful to remind yourself that recovery is the most likely outcome.

Try to make sure that you’re supporting your own mental health. The weeks and months surrounding the onset of your partner’s symptoms are likely to be stressful. Your expectations of new parenthood will have been turned upside down, and you may feel that you are struggling to stay abreast of the sudden change in your circumstances. You may feel as if you cannot cope with the responsibility of raising your child without your partner’s support, and it’s normal to feel anxious or overwhelmed during this difficult time.

If you’re worried about your emotions and feel like you need support, you should contact your doctor immediately. They will be able to talk through your issues and help you.

You could also try talking to a close friend or family member about your concerns. They may be able to offer you some additional support, and take care of any practical tasks, like making meals or keeping people updated on your partner and baby. Your friends and family may also be able to look after your baby while you rest, which can be invaluable if you are feeling fatigued by your ordeal.

If you are struggling to take care of your baby - or you feel like the situation is causing you too much strain - try reaching out to your midwife, doctor, or a support group.

Support groups may be able to provide additional help, so we have collected a list of relevant organisations below, organised by country:

UK

Action on Postpartum Psychosis (APP) - Peer Support Network - a project that provides specialised support for women, their partners, and their family during an episode of postpartum psychosis

Family Lives - a charitable organisation that provides help and support to struggling families

Home Start - a network of community-based volunteers that aims to help struggling families

PANDAS - a dedicated support service for families suffering prenatal, antenatal and postnatal illnesses

US

Postpartum Support International (PSI) - a charity that specialises in helping families struggling with postpartum illnesses

France

Maman Blue - an organisation dedicated to supporting families that are struggling with maternal difficulties

Germany

Schatten & Licht - an organisation that aims to help mothers and their families during difficult pregnancies

Australia

PANDAS - an organisation that aims to help mothers and families suffering from perinatal medical conditions like postpartum psychosis

The rest of the world

If your country of residence isn’t mentioned here, visit the PSI website for a list of international support groups.

References

Patient.info. Postpartum Psychosis. Postnatal depression information. 2019. Cited 25 July 2019.

Rcpsych.ac.uk. Postpartum Psychosis in Carers. 2019. Cited 25 July 2019.

Panda.org.au. Postnatal Psychosis. Perinatal Anxiety & Depression Australia. 2019. Cited 25 July 2019.

App-network.org. What is Postpartum Psychosis?. 2019. Cited 25 July 2019.

Mind.org.uk. Postpartum psychosis. 2019. Cited 25 July 2019.

App-network.org. Postpartum Psychosis: a guide for partners. 2019. Cited 25 July 2019.

Nhs.uk. Postpartum psychosis. 2019. Cited 25 July 2019.

Bmcpsychiatry.biomedcentral.com. The global prevalence of postpartum psychosis: a systematic review. 2017. Cited 25 July 2019.

Rcpsych.ac.uk. Postpartum psychosis. 2019. Cited 25 July 2019.

App-network.org. Early Symptoms of Postpartum Psychosis. 2019. Cited 25 July 2019.

Womensmentalhealth.org. Postpartum Psychiatric Disorders. 2019. Cited 25 July 2019.

Sign.ac.uk. Management of perinatal mood disorders : A national clinical guideline. 2012. Cited 25 July 2019.

App-network.org. Resources for Partners. 2019. Cited 25 July 2019.

Mghp3.org. MGH Postpartum Psychosis Project (MGHP3). 2019. Cited 25 July 2019.

Postpartum.net. Postpartum Psychosi. 2019. Cited 25 July 2019.

England.nhs.uk. Service Specifications: Specialised Perinatal Mental Health Services. 2016. Cited 25 July 2019.

Cochranelibrary.com. Antipsychotic drugs for non‐affective psychosis during pregnancy and postpartum. 2004. Cited 25 July 2019.

Panda.org.au. Information for Partners. 2019. Cited 25 July 2019.

Postpartum.net. Tips for Postpartum Dads and Partners. 2019. Cited 25 July 2019.

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Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.