Postpartum psychosis or puerperal psychosis affects quite a number of women. It is an episode of mental illness which begins suddenly in the days or weeks after having a baby. It can happen to any woman and it is a frightening experience for women, their partners, family, and friends. But women usually recover fully after an episode of postpartum psychosis. It could begin within the first few days to weeks of having a baby. Some of the risk factors for postpartum psychosis include genetic predisposition.

Personal or family history of a major psychiatric disorder such as schizophrenia and bipolar disorder, having a sister or a mother who has had postpartum psychosis, and also a history of postpartum psychosis before are all risk factors. Other risk factors are lack of social support and single parenthood. Symptoms in postpartum psychosis can change quickly from hour to hour or from day to day.

These symptoms are: feeling elated or unduly happy and on top of the world, unhappiness, fearfulness, irritability, fluctuating mood, confusion, restlessness, anxiety, agitation, excessive speech, and disorganized thoughts. Other symptoms are withdrawal from people and not talking to anyone, difficulty falling asleep, paranoid thoughts, undue suspicions, delusions (beliefs in ideas that are unlikely to be true), hallucinations (hearing, seeing, feeling, or smelling things that are not really there). A woman in this condition is unable to care for herself or for her baby.

Postpartum psychosis is a psychiatric emergency and help should be sought as soon as possible. When it is already known that there are risk factors for developing postpartum psychosis or when it has occurred before in a woman, it is important to reduce stressors at the period surrounding delivery.

Education and support of the woman are essential, trying to get enough sleep and help with caring for the baby may all help. Also for women already on medication for a psychiatric illness, continuing with some or all of the medication or switching to other safer options are decisions to be decided by her doctor for the best interest of mother and baby.

In the treatment of postpartum psychosis, inpatient care is advised, and where possible mother and baby unit is preferable so as to be able to provide care for the woman while supporting her in caring for the baby. But where this is not available then the spouse or other family members will have to care for the baby while the woman recovers.

Most women with postpartum psychosis need treatment with medication and this is often a source of worry due to breastfeeding. But it is possible to breastfeed while taking some medications after weighing the risks and benefits (by the psychiatrist). It may take weeks to months to fully recover from postpartum psychosis but the vast majority of women will recover fully.

After the illness most women tend to feel sad or anxious about the time missed out on early motherhood and whether they will be able to care for their baby. This feeling eventually passes and they get back to their usual selves.

Many women who have had postpartum psychosis go on to have more children. There is a high risk of having another episode, about 50 percent of women who have had postpartum psychosis will have it again after the birth of another baby but with proper disclosure of previous experience to one’s doctor and proper care it shouldn’t be as alarming as the initial time.