Key takeaways: Postpartum psychosis is a rare but serious condition that usually begins within the first few weeks after birth, often in the first 2 weeks. Signs include confusion, hallucinations, delusions, severe agitation, and very little sleep. A history of bipolar disorder is a major risk factor. It’s a medical emergency; call 911 or go to the ER. With treatment, most people recover fully.
Postpartum psychosis is uncommon, but recognizing it quickly can save lives.
How Common Is It?
It’s estimated to affect about 1 to 2 of every 1,000 people who give birth.
When It Starts
Usually within the first few weeks after birth, often in the first 2 weeks, and sometimes within days.
Warning Signs
- Confusion or disorientation.
- Hallucinations: seeing or hearing things that aren’t there.
- Delusions: strong false beliefs, such as believing the baby is possessed or that someone is trying to harm them.
- Severe mood swings, mania (very high energy, racing thoughts), or depression.
- Extreme agitation or restlessness.
- Not sleeping, or not feeling a need to sleep.
- Paranoia or suspiciousness.
- Unusual behavior that’s out of character.
The person may not realize anything is wrong.
Who’s at Higher Risk
- Bipolar disorder, personal or in the family.
- A previous episode of postpartum psychosis.
- First-time parents.
- Stopping mood-stabilizing medications during pregnancy.
Many cases occur in people with no prior history.
Treatment
- Emergency evaluation and usually hospital care.
- Medications such as mood stabilizers and antipsychotics.
- Mother-baby psychiatric units in some places.
- Most people recover with treatment.
Planning Ahead if You’re at Risk
If you have bipolar disorder or a past episode, work with your psychiatrist and OB on a plan before birth, including medications, sleep protection, and close follow-up.
For Family and Friends
- Don’t leave the person alone with the baby if you notice warning signs.
- Call 911 or go to the nearest emergency room.
- Stay calm and supportive.
This is an emergency. Call 911 or go to the ER if a new parent shows confusion, hallucinations, delusions, or talks about harming themselves or the baby.
The Bottom Line
Postpartum psychosis is rare but dangerous. Know the signs, act fast, and know that recovery is likely with treatment.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Sources
- Bergink V, Rasgon N, Wisner KL. Postpartum psychosis: madness, mania, and melancholia in motherhood. Am J Psychiatry. 2016;173(12):1179-1188.
- American College of Obstetricians and Gynecologists. Clinical Practice Guideline No. 5: Treatment and management of mental health conditions during pregnancy and postpartum. Obstet Gynecol. 2023;141(6):1262-1288.
- Postpartum Support International. Postpartum psychosis. https://www.postpartum.net
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
