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Understanding Postpartum Psychosis – A Serious Issue Affecting New Mothers

Nmesoma Okwudili


April 1, 2023

Postpartum is a term given to the period after childbirth. There are various things a woman encounters during her postpartum., one of which is bleeding. The bleeding can be more in the morning and even more after breastfeeding. This experience results from the contraction of the uterus back to its standard size.

Uncontrolled bleeding after birth is extremely dangerous and can lead to death. This situation is called postpartum haemorrhage. The advice is to handle such a situation with immediate attention.

Also, breastfeeding can be equally painful. Women experience pain from the areola and nipple being tugged by the baby’s mouth. This is because the nipple is tender at the early stage of postpartum. The nipples get cracked or even sore during this stage. They are also prone to an infection in the milk duct called mastitis. This infection is accompanied by redness and hardness of the breast, fever and chills. This infection can be treated with the use of antibiotics prescribed by a medical doctor.

However, there are several other possible breast infections after pregnancy, such as yeast infection, lump development, etc. It is advised to keep in contact with doctors even after delivery.

The birth of a child, they say, is a blessing. Blessings can cause a mix of emotions ranging from happiness, fright, disquietude or anxiety. An unexpected feeling that comes with childbirth is a mental health condition called postpartum psychosis. Right after delivery, most women experience emotional disturbances such as mood swings and slight depression, but a few go through PTSD, major postpartum depression or total psychosis. No one expects to go through mental health struggles right after being blessed with a child, but unfortunately, some women are faced with this unpredicted mood disorder.

It is not unusual for most women, mainly first-time mothers, to feel a bit of anxiety or depression right after childbirth. Postpartum depression is a feeling of sadness, void, and tiredness that often kicks off within 1-3 weeks right after birth and last for about two weeks or longer. This feeling makes it difficult for mothers to look after themselves and their newborns properly.

Postpartum depression affects up to 1 in every seven women, and half of the women identified with PPD; it’s often their first experience with depression. Factors such as a family history of depression, changing hormone levels after childbirth, and a low quantity of thyroid hormones give rise to PPD.

However, postpartum psychosis is dissimilar from PPD. Postpartum psychosis is a mental illness experienced by some women after childbirth. The condition is characterised by an indifferent response to the newborn baby, which includes thoughts of inflicting harm on the newborn. This connotes a bipolar disorder and not just a depressive disorder.

It is a more critical case which constitutes a feeling of losing touch with reality right after giving birth. This mental condition intrudes on a person’s sense of reality, resulting in extreme confusion, intense paranoia, hallucination or other kinds of behavioural changes. Most women who experience this mental disorder have a history of Schizophrenia, bipolar or other mental illness, but some do not. Fortunately, when proper care and medical attention are given to the patient, this condition is reversible.

Postpartum psychosis is a rare condition. An estimate of about 1 to 2 of every 1,000 mothers experiences it, according to a report by psychiatric times in January 2014.

The causes of this illness are not entirely understood, but a possibility lies in the fundamental shift in hormones after birth. Some of the women who had experienced it were known to have a history of mental illness.

The symptoms kick off as early as two or three weeks after delivery. It starts with depression, hallucination, delusion, lack of emotional response towards the child or anyone, difficulty in sleeping, agitation, inability to bond with the baby, thoughts of suicide, confusion and even thoughts of killing the baby. It reported that as many as half of the total estimate of those suffering from such mental conditions experience features such as the thought of harming the child or committing suicide. However, the person should not be blamed for this thought because they genuinely do not consider the action to be harmful. Alternatively, they firmly believe it is in the best interest of the child.

If any of the visible symptoms are detected, they should be communicated to a medical doctor.

Hallucination is a significant symptom associated with this mental condition. The person begins to see, hear, feel or taste things primarily based on imagination. However, in the case of PPP, there is less auditory and more visual hallucination. The things the person senses make it challenging to differentiate hallucination from actual reality.

Delusion is another existing symptom of PPP. The patient develops a fixed false belief that contradicts reality. This is often triggered by constant misinterpretation of events.

Other symptoms may include:

  • Disconnection from baby
  • Paranoia
  • Anxiety
  • Suicidal thoughts
  • Incoherent speech
  • Euphoria

Most women are not as lucky to get out of it. Some remain mentally ill, and some remain under close medical supervision. These conditions intensify when not detected early by close relatives of the patient.

What can be done?

A timely discovery or identification of this illness is crucial as it is a mental disorder emergency that requires immediate psychiatric attention. This implies especially to mothers who are at high risk of harming themselves, others or their child. When symptoms are recognised and treatments are administered as early as possible, patients can return to resume bonding with their children as soon as they can.

For patients with a history of bipolar disorder or previous isolated episodes of PPP, Lithium treatment has been recommended right after delivery. The lithium blood level is advised to be obtained twice a week for the first few weeks after birth. However, lithium has a 2.8% risk of inducing major congenital malfunctions.

Electroconvulsive therapy (ECT) is another treatment recognised with practical benefits for patients with PPP. This treatment is recommended especially for patients with Schizophrenia related psychosis and with minimal risk of complications.

Several other treatments can be administered to women with postpartum disorder. However, it is left for close family members to conscientiously decide and weigh the risks and benefits of each treatment.

Medical Conditions and Support 

Women experience several other medical conditions during pregnancies which might lead to a sad state of health. There are some unknown and rare pregnancy symptoms other than the ones we know about. One of which is blurry vision or partial blindness. According to babaycenter.com, 15% of pregnant women worldwide have partial blindness or blurry vision during pregnancy. This exists due to changes in hormones, blood circulation, fluid retention, and metabolism. The fluid retention may increase the curvature and thickness of the cornea. Although this could be solved with medicated contacts or glasses, it is still incredibly challenging. Most of these symptoms reverse themselves weeks or months after the pregnancy.

Another condition is an eye disease called central serous chorioretinopathy. The fluid builds up beneath the retina. This leads to the detachment of the layers of the retina, creating blind spots. The cause of this disease is linked to stress hormones usually seen in late pregnancies but can also occur during the first or second trimester.

It is advised that women who experience these symptoms during pregnancy should apprise their midwife or doctor immediately. These symptoms, if not carefully considered, examined, or taken care of, could lead to more significant problems, such as prolonged damage to the eyesight or even permanent blindness.

Like several other illnesses, PPP does not only affect the mother but family members. It is crucial that the treatment team assigned to the patient understands the enormity of the emotional and physical pain the family are going through and addresses all concerns and questions.

Women should be screened for signs or possibilities of mental illness pre and post-pregnancy. Enlightenment of the illness, its causes, consequences and possible treatment options should be communicated to those who are planning on getting pregnant and are liable to developing postpartum psychosis.

Women should be under intensive care after delivery and extended occasional support. Having a human being growing inside you for nine months is not an easy task. I sincerely celebrate all mothers out there—those who have gone through all the stages and lost their babies on the way. A special tribute goes to women who fought but ended up 6 feet below with their babies or without them. Mothers are indeed unique treasures.

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