A new baby comes with a rush of emotions, and they aren’t always the happy kind.
Sure, we love our precious little ones, and after spending most of a year in anticipation, collecting baby clothes, cooing over tiny socks, and setting up a bassinet, finally getting to hold that tiny bundle in our arms and count those tiny toes is a blessing.
However, hormones and other physical changes have a strong effect on emotions, and sometimes, after giving birth, those effects can go quite wrong.
Postpartum Depression, Or Postpartum Psychosis?
You should know that several mental health conditions can arise in the weeks before and after birth. These may be referred to with the word ‘postpartum,’ meaning after your baby is born, or ‘perinatal,’ meaning around the time of birth and often referring to the last half of pregnancy and a few weeks after.
Throughout these periods, rushes of hormonal changes can cause you to feel, think, and even believe things that you would not usually feel, think, or believe.
Postpartum depression and postpartum anxiety can affect as many as one in eight and one in five new moms, respectively. They can leave you drained and unable to manage basic care tasks for yourself and your baby, or cause you to be so anxious about your baby’s wellbeing that you are unable to meet your own needs.
They can be debilitating.
Postpartum psychosis, however, is rarer (1-2 cases in 1,000 births) and more urgent — according to Postpartum Support International, an active case is considered an emergency.
How Serious Is Postpartum Psychosis?
Postpartum psychosis can be extremely serious.
It can cause the sufferer to hallucinate sights or sounds that aren’t there, and develop delusions and paranoia. Sometimes, people suffering from postpartum psychosis may become convinced that their partner is a danger to their child, or that their partner or another family member is trying to take the baby away.
In extreme cases, a person suffering from postpartum psychosis may hurt herself or the baby. This is less common, and treatment may be available that does not separate the mother from her newborn, even if inpatient care is required. Forcible separation of the mother from her baby can exacerbate symptoms and make the illness harder to treat.
More often, though, sufferers can be seen to show manic symptoms, along with hallucinations or delusions. For instance, a Maternal Mental Health Alliance pamphlet describes one new mom whose husband said:
“She started coming up with bizarre schemes to make our fortune and was starting to arrange all our possessions by colour. She spoke about how colours appeared particularly vibrant, sounds were amplified and smells were overwhelming.”
He knew the situation was serious when the new mom began having conversations with a deceased relative as though the person was present.
The Genetic Link And Postpartum Psychosis
There are risk factors that indicate a higher likelihood of an individual being diagnosed with postpartum psychosis.
One of the most significant factors is a personal or family history of bipolar disorder. If you or a close family member has been diagnosed with bipolar, then there is a high risk of postpartum psychosis, especially if you have a history of manic episodes that rob you of sleep.
There’s also a strong familial link.
One study found that if you have a cousin who suffered postpartum psychosis, there may be a slight increase in likelihood, but short of statistical significance in a sample group of more than 1.5 million women.
Having a sister who suffered it, though, is a more significant risk factor.
The Good News
If your sister suffered postpartum psychosis, you are more likely than a random individual to also suffer it — around ten times as likely.
However, it’s important to note that it’s still relatively uncommon — it raises your risk from 1-2 in a thousand to 1-2 in a hundred. So, you won’t necessarily need to rethink your family planning based on your sister’s experience.
However, if you know that you have an elevated risk, you can take advantage of that advanced knowledge. Tell your care team now!
There may even be treatment options that will reduce your risk levels.
For women who have previously been diagnosed with postpartum psychosis or with bipolar disorder, there is some evidence for starting treatment with lithium during pregnancy. However, lithium is also associated with some negative birth outcomes, and other studies found evidence in favor of starting lithium and other mood stabilizers immediately after delivery.
What Else Should You Know?
Lithium and some other medications may be contraindicated for breastfeeding, so make sure you discuss your feeding plans with your medical team when considering treatment.
You should also talk to your partner and others who are close to you and likely to be near you after delivery about symptoms of postpartum psychosis. They may be the first to recognize any concerning symptoms.
Make sure your loved ones are aware that a woman suffering postpartum psychosis may resist help and care, and discuss plans for encouraging you to make the safe choice for yourself and your little one.
Keep all postpartum medical appointments, and be honest with your doctor about your feelings, fears, and concerns.