Postpartum Psychosis

Only experienced by one or two women out of 1,000, postpartum psychosis (PPP) is a rare and extreme form of postpartum mood disorders and is seen in women who lose touch with reality shortly after birth. Usually occurring during the first three months after childbirth, women with PPP are often misdiagnosed with postpartum depression (PPD), a less severe form of PPP. The defense attorneys for Andrea Yates—in her highly publicized 2001 case about the drowning of her five young children in a bathtub—built a case around PPP. Yates was later found not guilty by reason of insanity and committed to a Texas state mental hospital.

The number of women with PPP has not changed since it was first recognized as a disorder in 1850. PPP is thought to be caused by a number of possible events, such as hormone changes after birth, low self-esteem due to postpartum appearance, lack of social and emotional support, financial strain, and a host of other factors. PPP has a 5 percent suicide rate and a 4 percent infanticide rate. Women who have a personal and/or family history of psychosis, bipolar disorder, or schizophrenia are at an increased risk of developing PPP. Those who have had past experience with PPP are between 20 and 50 percent more likely to develop the condition again.

There are a number of symptoms and signs that a woman is experiencing PPP, but the best course of action is to seek urgent help from a healthcare professional, since PPP can often be treated with immediate medical attention. Symptoms often develop during the first two to three weeks after birth, and can include guilt, delusions, hallucinations, illogical thoughts, refusal to eat or drink, insomnia, suicidal or homicidal thoughts, periods of mania, extreme feelings of anxiety and agitation, and the inability to distinguish reality from imagination.

Women with PPP are often misdiagnosed as having PPD and suffer from a lack of adequate treatment. Some women are unaware that anything is seriously wrong, misinterpreting their feelings as the “baby blues,” and thus find it difficult to consult a physician. PPP is typically treated with antipsychotic medications, which may be combined with antidepressants or antianxiety drugs, and also may benefit from individual psychotherapy or group therapy. With proper treatment, women with PPP usually recover. Without proper treatment, a woman can be hospitalized for failure to adequately care for herself and her child.