Postpartum Psychosis

Postpartum psychosis is a severe episode of mental disorder which can begin suddenly after having a baby. It is a rare and serious mental disorder that can affect new mothers. Postpartum psychosis is different from postpartum depression. While postpartum depression largely encompasses feelings of hopelessness and worry, postpartum psychosis includes episodes of euphoria (often mistaken as the joy of motherhood) as well. Postpartum psychosis is said be an overt presentation of bipolar disorder.

It usually starts within a few days or weeks of giving birth, or can develop suddenly, within just a few hours. Symptoms vary and can change rapidly, including elevated mood (mania), depression, confusion, hallucinations and delusions. Postpartum psychosis is a psychiatric emergency for which you should seek help as quickly as possible.

Postpartum psychosis often occurs unexpectedly and can be a frightening experience for you, your partner, friends and family. However, you can usually recover fully after an episode of postpartum psychosis. Often, mothers who have postpartum psychosis also have manic depression (bipolar affective disorder) or schizophrenia. If you have had postpartum psychosis before, or had a severe mental illness while you were pregnant, you are at particular risk. You're also more likely to develop postpartum psychosis if you have a family history of severe mental illness, especially bipolar disorder. ​

Postpartum psychosis is different from postpartum depression, as it is more severe. There are many symptoms that occur in postpartum psychosis. These may include: 

  • Feeling manic

  • Low mood and tearfulness

  • Anxiety or irritability 

  • Rapid changes in mood

  • Severe confusion

  • Being restless and agitated

  • Feelings of incompetence

  • Being unable to bond with or take care of your baby

  • Racing thoughts

  • Out of character behaviour

  • Problems sleeping

  • Feeling paranoid and suspicious

  • Delusions or odd thoughts or beliefs that are unlikely to be true

  • Hallucinations, meaning you see, hear, feel or smell things that aren’t really there​​

If you are a new mother facing alarming symptoms including hallucinations and extreme highs and lows, seek help from your doctor at Mind and Brain Service Line at The Aga Khan University Hospital.

You can also consult your gynaecologist working with the Women's Health Care Service Line to guide you during this phase of life. ​
Your time with your doctor may be limited, so makes sure to prepare for your visit beforehand. Here are some tips to help get you started.​​

Your doctor will usually talk with you about your feelings, thoughts and mental health to distinguish between postpartum depression and a more severe form of psychosis. It is important not to be embarrassed and share your symptoms with your doctor so that a useful treatment plan can be created for you.

As part of your evaluation, your doctor will also ask you to complete a depression-screening questionnaire and order blood and others tests to determine whether an underactive thyroid is contributing to your signs and symptoms​​

Postpartum psychosis is a psychiatric emergency for which you may need to be hospitalized. Your doctor will prescribe medication, including the following types of drugs:

  • Antidepressants, which work by balancing mood-altering chemicals in the brain. These can help ease symptoms such as low mood, irritability, lack of concentration and sleeplessness, allowing the mother to function normally and cope better with her new baby.

  • Antipsychotic medications, which work by blocking the effect of dopamine (a chemical that transmits messages in the brain).

  • Mood stabilizing drugs (such as lithium).

Your doctor will have to ensure that the benefits from these drugs outweigh the risks and side effects. Along with prescribed medications, psychological therapies can also help in the development of effective on-going coping strategies. Cognitive-behavioural Therapy (CBT) and Interpersonal Therapy (IPT) are often used for the treatment of postpartum psychosis. These are effective for treating the symptoms of depression and mania, and can make significant improvements in the quality of your interpersonal relationships.​​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.​

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​​
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​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.