Postpartum psychosis affects women who have recently given birth, with symptoms starting in the first four weeks. It can occur in stages, with insomnia, excitement, and agitation leading to a manic phase, followed by depression. Treatment involves medication and supportive care, and hospitalization may be necessary. Women with a history of mental illness are at higher risk.
Puerperal psychosis, also known as postpartum psychosis, is a psychiatric condition that affects women who have recently given birth. Puerperal psychosis usually strikes in the first few days after birth, but symptoms can begin anytime in the first four weeks after birth. Typically, the condition occurs in stages, starting with symptoms of insomnia, excitement, and agitation. Subsequently, patients usually go into a manic phase, followed by a depressive phase. While postpartum psychosis is treatable, it is generally considered a medical emergency, and women who develop it are more likely to experience it again after subsequent births.
The average woman’s chances of developing postpartum psychosis are generally much lower than her chances of developing postpartum depression, a much more common psychiatric disorder associated with childbirth. Postpartum psychosis affects about one in 500 women who have given birth in the past four weeks. Experts believe that postpartum psychosis may be linked to heredity, as women are more likely to develop it if their mothers or other close relatives have suffered from it.
Women who have suffered from puerperal psychosis in the past may have up to a 50% chance of developing it again in the future. Women who suffer from bipolar disorder or schizoaffective disorder may be more likely to suffer from postpartum psychosis. These cases are often attributed to a relapse triggered by the stresses and hormonal changes of pregnancy and childbirth.
Insomnia is often the first symptom of postpartum psychosis. While it’s considered normal for women to experience insomnia the first night after giving birth, insomnia generally resolves by the second night, due to the physical stress of labor and the demands of meeting a newborn’s needs. Insomnia symptoms are typically followed by increased energy levels or feelings of restlessness and irritability. Women may or may not care about baby care, but even if a woman is very concerned about caring for her new baby, she typically lacks the mental acuity to do it properly. Feelings of paranoia, even directed at family members, or fear that something is wrong with the child are often common.
Between four and 14 days after birth, the mother suffering from puerperal psychosis generally experiences a manic phase, during which hallucinations, delusions and mental confusion can occur. Women in this stage often have no understanding of their own mental condition and can become unusually aggressive or angry when loved ones or professionals attempt to intercede. After the manic phase, most women will experience a phase of depression. Women in this stage can become so severely depressed that they think about harming themselves or their babies.
Treatment of puerperal psychosis usually involves a combination of psychiatric medications and supportive care. Many health professionals prefer to hospitalize women with their babies, so that staff can support the mother-child bond and help the new mother learn to care for her baby after release. Treatment may need to be continued for several months, but the prognosis is often good, especially in women with no history of mental illness.
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