Post-partum psychosis. Introduktion
Post-partum psychosis, also known as postnatal psychosis or puerperal psychosis, is considered the most severe form of postpartum crisis. It occurs significantly less frequently than postpartum depression, affecting about one to three out of every 1000 mothers. Postpartum psychosis emerges suddenly, within the first three days to approximately four weeks after childbirth.
This condition involves a severe depression where additional features of psychosis accompany the symptoms of postpartum depression. These include changes in personality and behaviour that can pose an acute danger to both mother and child. Therefore, post-partum psychosis is always a medical emergency that should be promptly and preferably treated in a hospital setting.
Symptoms of Post-partum Psychosis
The initial signs of postpartum psychosis usually appear within the first six weeks after giving birth. In addition to the typical characteristics of postpartum depression, such as profound sadness, apathy, lack of motivation, anxiety, and so on, symptoms of psychosis also emerge. These symptoms include: delusions, hallucinations, disorientation, restlessness, obsessive thoughts of harming the child, and often suicidal thoughts.
Personality changes, loss of reality: Altered behaviour and personality are characteristic of postpartum psychosis. Affected individuals often experience extreme restlessness and anxiety, appearing confused and disoriented. Their thoughts, feelings, and actions are perceived as irrational by those around them, but they themselves consider them as completely logical because they perceive reality differently. This state can be interrupted by moments when the mother is completely clear and rational. Moments of complete clarity can abruptly shift to confusion and vice versa.
Depressive features
Increased drive, motor agitation (manic phase): Some mothers experience extreme restlessness and heightened drive. They may feel exaggerated feelings of happiness, energized, almost euphoric, and be cheerful and exuberant. Some may suffer from megalomania and make plans for grand projects, but their actions are often unproductive.
Lack of motivation (depressive phase): Some individuals become completely apathetic, lacking drive and interest. They appear paralyzed, mask-like, and frozen.
Mood swings fluctuate greatly, shifting from euphoric to hopeless, from desperate to irritable and aggressive. Sleep disturbances: There can be a significant decrease in the need for sleep, and affected women often suffer from insomnia and sleep disruption.
Suicidal thoughts are another common symptom of postpartum psychosis.
Psychotic features
Delusions: A mother may be convinced, for example, that her baby has been switched or that someone wants to take the baby away from her. Sometimes the child is believed to be a demon or a saviour, or the mother may believe herself to be a saint.
Hallucinations: delusions can be accompanied by hallucinations. Affected individuals may hear, see, smell, or taste things, people, or animals that do not exist.
Obsessive believes and actions: the mother may feel compelled to perform ritualistic actions and develop an obsessive behaviour accompanied with thoughts and fantasies of harming the child.
Treatment of post-partum psychosis
Post-partum psychosis is a very serious and dangerous condition. Especially the acute phase leads to self-doubt, and anxiety, both for the affected mothers and their loved ones. To protect the mother and child, it is crucial that the mother is not left alone with the baby and receives immediate medical care. To process the experiences and gain security in the relationship and care of the child, staying in a mother and baby unit within a clinic is extremely helpful, and ongoing psychotherapy is crucial.
Postpartum psychosis typically requires inpatient treatment with antipsychotic medications. Symptoms usually improve within a short period of time.
The recovery from post-partum psychosis
can be lengthy and challenging. Psychosis is a tremendous strain on the body and mind, leaving affected mothers exhausted and empty. Even after the psychosis symptoms have disappeared, the processing of the experience continues. If postpartum psychosis is properly recognized and receives adequate treatment in a timely manner, the prognosis is favorable. Unfortunately, it cannot be ruled out that the illness may recur at a later stage in life. This can particularly occur with subsequent births, but it is not guaranteed. Any future pregnancy, childbirth, and postpartum period should be carefully planned and professionally supported. Taking preventive medications, establishing an emergency plan, and taking precautionary measures for the time after childbirth can be helpful.