Postpartum Psychosis

By | June 10, 2022

For many women, giving birth is associated with great physical exertion and an emotional experience. A whole new situation awaits the woman now that she is a mother, with all the demands that the baby brings with it. Many women who have recently given birth react to this with sad moods. This usually subsides after a few days, but in rare cases it can also develop into postpartum psychosis.

What is postpartum psychosis?

Around three percent of women who have recently given birth are affected by postpartum psychosis. The reason for this is, for example, the hormonal changes that occur after birth. Traumatic birth experiences, the sudden mother role and a large sleep deficit also promote the disease. For definitions of cat eye syndrome, please visit

Postpartum psychosis is the most severe form of mental crises that occur after pregnancy. This can lead to a loss of reference to reality. The women affected need immediate help. Postpartum psychosis is divided into three forms, which occur individually but also as mixed forms:

  • mania

Mania is a form of postpartum psychosis. It is manifested by motor restlessness, a sudden strong increase in drive, brief euphoria, megalomania, confusion, a reduced need for sleep, and a lack of judgment. Disinhibition can also occur, which can be dangerous for the child.

  • depression

Another form is depression, which manifests itself in apathy, disinterest and states of anxiety. Feelings of guilt and hopelessness can also occur.

  • schizophrenia

Schizophrenia is also a form of postpartum psychosis. This is shown by strong disturbances of emotions, perception and thinking. The mothers suffer from hallucinations. They think they hear strange voices and see things that don’t exist.


Why postpartum psychosis occurs is still controversial. According to assumptions, hormonal changes in particular are possible triggers, for example the drop in the concentration of estrogen and progesterone in the maternal bloodstream. Social and psychological factors are also likely to play a role, such as attitudes towards the child and towards the partner.

If mental illnesses have already occurred in the past, the risk of developing postpartum psychosis is greatly increased. A family history is also a risk factor for the disease. If relatives have already gone through psychotic or manic-depressive episodes, there is also an increased risk for the mother that postpartum psychosis will occur after the birth.

In addition, trauma that some women experience during childbirth, a caesarean section, stress, and social hardship can increase the risk of developing the disease.

Symptoms, Ailments & Signs

Postpartum psychosis is quite difficult to recognize, since hallucinations, delusions or unreal fears are usually not seen by those affected. In addition, it is often kept secret by those affected. This is out of fear that they will be thought insane.

The symptoms also often change very quickly, because the person affected can appear completely healthy in between and at the other moment decompensate psychotically. The psychotic symptoms in particular are particularly difficult to recognize and classify as such. This applies to those affected themselves as well as to their families, especially when the psychosis occurs for the first time.

Concentration disorders, memory disorders, thought interruptions or racing can be observed in postpartum psychosis, as well as confused thinking, which is often noticeable when speaking. In addition, there can be a reduced or increased drive, and social withdrawal of those affected is not uncommon. In addition, they are plagued by restlessness or rigidity as well as states of excitement.

The mood can be euphoric, irritable to aggressive, depressed or very anxious, desperate and hopeless. The atmosphere changes very strongly between the different extreme states. Obsessive- compulsive thoughts, impulses or actions occur rarely within the psychosis and problems falling asleep or staying asleep very often.

In addition, there is either a lack of energy or excessive energy. Many sufferers suffer from pain without an organic cause or physical discomfort. Postpartum psychosis usually has productive psychotic symptoms, such as delusions, hallucinations and experiences of being influenced. In connection with the psychotic symptoms, suicidal thoughts and, in the worst case, even suicidal acts often occur.

Diagnosis & course of disease

In the case of postpartum psychosis, the diagnostic measures are the same as those for psychotic disorders. Since it often has to be ruled out first of all that the psychosis is not the result of drug use, blood is usually taken to check for drug residues, but also for inflammatory markers and increased liver values.

Otherwise, the doctor asks the affected mother about the symptoms and how long they have existed in order to diagnose postpartum psychosis based on the typical symptoms.


Women with postpartum psychosis can sometimes become suicidal. Suicidal tendencies can come on gradually or suddenly. Psychologists distinguish between latent and acute suicidality. In the case of latent suicidality, for example, the person concerned thinks of death or feels a vague wish to die.

On the other hand, acute suicidality is characterized by intentions, plans and active actions up to and including attempting suicide. Some women with postpartum psychosis are not only endangering themselves, but also endangering others. Postpartum psychosis can lead to aggression. In addition, it is possible for the affected woman to harm or even kill her child.

Deliberate killings, which happen in madness, are also possible. Four percent are affected. In the event of severe complications, voluntary treatment or accommodation in a psychiatric clinic is possible. During the inpatient stay, the postpartum psychosis can be treated on the one hand and the safety of those affected and their child can be ensured on the other.

Some clinics have mother-child rooms so that the newborn does not have to be separated from the mother as long as there is no danger to the child. Other complications that can also occur in postpartum psychosis are less severe than suicidal tendencies and infanticide. For example, depressive symptoms, mood swings or psychosomatic complaints can also occur.

When should you go to the doctor?

Many women go through numerous emotional states immediately after giving birth. In most cases, the emotional state is regulated within the first few weeks or months after birth. Immediately after the birth there are strong hormonal changes in the body of the woman who has given birth. This leads to mood swings, sadness or euphoric states. In many cases, the mother’s personality has temporarily changed significantly.

Normally, the state of health improves within a few days and a doctor is not needed. However, if the psychological abnormalities persist or increase significantly in intensity, a doctor must be consulted. If you have delusions, sudden changes in behavior, or hallucinations, you need medical help. If the mother-to-be cannot take sufficient care of the baby, a doctor should be consulted.

In the event of complaints such as voice prompts or states of confusion, a doctor must be called immediately. Severe hopelessness, feelings of guilt, and sudden changes in drive should be evaluated and treated. If the sufferer experiences a state of apathy followed immediately by intense euphoria, these are worrying developments. A diagnosis is necessary so that a treatment plan can be drawn up as quickly as possible. The observations must be discussed with a doctor so that help can be initiated.

Treatment & Therapy

Depending on the disease and its severity, postpartum psychosis is usually treated with drugs such as neuroleptics and antidepressants. This is often done in combination with psychotherapy. In the case of postpartum psychosis, inpatient treatment is recommended, since the psychotic mother can usually no longer look after her child and herself.

In addition, many psychoses carry the risk of suicide. A mother-child ward in a psychiatric clinic is advantageous so that the mother and child are not separated. This also gives the mother the security in dealing with the child, which is often lost due to the acute illness.

If postpartum psychosis occurs for the first time and is recognized and treated early, there is a good chance that it will resolve completely. However, the risk of further episodes remains increased throughout life.


It is suspected that stress during pregnancy could be partly responsible for postpartum psychosis. Therefore, it is important to pay attention to an even balance and a mental equilibrium.


In contrast to the so-called “baby blues”, postpartum psychosis can have serious consequences, which is why it absolutely must be treated. Most of the treatment is inpatient, in some cases the mother is partially or completely separated from the newborn. This can be useful so that the mother can regain her strength and overcome the psychosis without distraction. However, the relationship between her and the child suffers significantly.

In aftercare, it is therefore important to reestablish the relationship with the child. This must be done gently and very slowly so as not to overwhelm the mother. She often feels guilty because she thinks that she did not take sufficient care of the child from the start. She might feel like she missed her chance. Acknowledging and speaking out about these feelings is important in overcoming them.

The mother should therefore have a trustworthy contact person who will not judge her for her feelings. The relationship with the child can be established by establishing a breastfeeding relationship, but this can also be too stressful for the mother, especially when breastfeeding problems arise. Then it is sufficient if the relationship is built through other physical proximity, be it through bathing together, baby massage or the exchange with other parents in a toddler group.

You can do that yourself

In many cases, postpartum psychosis resolves on its own. In the case of severe psychoses with depressive moods and delusions, a doctor should be consulted. Not only the patients, but also the relatives often need support from professional therapists.

The most important self-help measure is to stay active and accept the doctor’s advice. Contact with others affected can also be very important. Individual problems can be discussed well in a self-help group and patients often receive valuable tips on how to deal with postpartum psychosis themselves when talking to other sufferers. Together with the doctor, the causes of the postpartum psychosis must also be explored. Sometimes the symptoms are simply due to a hormonal imbalance, in other cases serious health problems or deep mental disorders are responsible for the symptoms.

In any case, the triggers must be identified before effective treatment of postpartum psychosis is possible. Sick people should speak to the gynecologist and use psychotherapeutic support. In most cases, therapy is needed far beyond the acute phase of the disease. Due to the high risk of recurrence, the mother must be closely monitored after giving birth again.

Postpartum Psychosis