Postnatal, or Postpartum Psychosis is an uncommon disorder that occurs in 1 - 2 per 1,000 women and has a sudden onset with severe symptoms - usually within 2 - 3 weeks of childbirth. Symptoms can also begin during pregnancy especially where there has been a prior episode of psychosis or bipolar disorder. (Factsheet: What is Postnatal (Puerperal) Psychosis?, The Black Dog Institute) This is a medical emergency and a doctor should be contacted immediately. (Emotional Health During Pregnancy and Early Parenthood booklet, Beyond Blue)
It involves having difficulties thinking clearly (thought disturbance), seeing or hearing things that are not there (hallucinations), feeling everyone is against you (paranoia) and powerful delusions. (Emotional Health During Pregnancy and Early Parenthood booklet, Beyond Blue)
Most puerperal psychoses have their onset within the first month of delivery and are manic in nature. An inability to sleep for several nights, agitation, expansive or irritable mood and avoidance of the infant are early warning signs heralding the onset of puerperal psychosis. When delusions or hallucinations are present, they often involve the infant. A woman may have thoughts that the baby is possessed by a demon and should die. She may even experience auditory hallucinations "telling" her to kill her infant. Because the woman is at risk of harming herself or her baby (or both), postpartum psychosis is a medical emergency. (Epperson, American Academy of Family Physicians, April, 15, 1999)
When your partner has postpartum psychosis
This is an extremely uncommon and difficult illness for you and your partner to experience. Communication with your partner will be affected if her thoughts are confused, if she is saying things that don’t make sense, or if she is experiencing delusional thinking or hallucinations. Once your partner is receiving care it can be a good idea to seek counselling yourself as you will be greatly affected and may have many questions. Try to find a trusted health professional for yourself. Some of the things your partner says may seem highly distressing or inappropriate, but try to remember that this is the illness talking. (Factsheet: Caring for someone with PND, PANDA)
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- Urgent assessment by a medical specialist is essential.
- Treatment by a psychiatrist, with antipsychotic medication is necessary in most cases.
- Hospitalisation may be required during the acute stages.
- The safety of the mother and the baby needs to be assessed carefully by a health professional because the mother can be disoriented and delusional and unable to adequately care for herself or for her infant. After treatment has started careful monitoring of mother and baby is required on an ongoing basis.
- Once the acute symptoms have settled psychological therapies can be used alongside medication to assist with adjustment to the illness and to provide ongoing care and support with the adjustment to parenthood.
- Family counselling may also be needed to assist family members to understand more about the illness and the required care. (Factsheet: What is Postnatal (Puerperal) Psychosis?, The Black Dog Institute)
- With appropriate treatment and support, the rate of full recovery is high. (Factsheet: Caring for someone with PND, PANDA)