About postnatal psychosis
Myths about postnatal psychosis
Myth: People who have had an episode of postnatal psychosis are dangerous to others.
Fact: NOT TRUE. The main myth about psychotic illnesses is the image of the dangerous psychotic continually portrayed by the media. People who have had an episode of postnatal psychosis are not necessarily dangerous to their baby or others. However, the presence of certain psychotic symptoms and unusual behaviour can increase the risk of neglect and or harm to the baby. Postnatal psychosis is therefore considered an emergency, as the parent’s symptoms can worsen very quickly, especially if they don’t receive prompt assessment and treatment, together with adequate support to monitor risk through the time of their illness.
Outside these brief periods of increased risk, people with this condition are no more likely to pose any risk than anyone else.
What causes postnatal psychosis?
As with many mental health conditions, the exact cause of postnatal psychosis remains unknown, although it is known that it is not the fault of you or your partner.
Childbirth is considered a significantly challenging time for everyone. There are many adjustments to be made, and you will find yourself in stressful situations, including the birth itself. While anyone who gives birth is vulnerable, there are certain factors that increase the chances of developing postnatal psychosis. The strongest risk factor is a past history of a bipolar disorder and/or other psychotic disorders.
If you have had a mental illness in the past, and are worried about postnatal psychosis, talk to your midwife or doctor. With early recognition and treatment, and the right support, you will be able to reduce the risk and make a good recovery if you do experience postnatal psychosis.
If you are concerned, or suspect you (or a loved one) has postnatal psychosis, it’s important to talk to your midwife, doctor or Well Child Tamariki Ora nurse (through Plunket or another provider) immediately. In an emergency, dial 111.
Please remember unattended and untreated postnatal psychosis places both you and your baby at an increased risk of harm and/or neglect.
None of these feelings are your fault. Please don’t hesitate to reach out and get the necessary help for your or your loved one’s treatment and recovery.
Close monitoring of risk by a skilled health professional is critical during this period. When risk is present, high levels of support, or separation of parent and baby until the risk has passed, may sometimes be necessary.
Treating postnatal psychosis can involve a number of options, each of which will be tailored to your individual situation.
Your doctor will recommend a mix of treatment options that best suit you. This will usually include medication as well as talking therapy.
If you are considering stopping treatment, please always talk to your doctor or health professional about your concerns. It’s important to work together to find some compromise that will ensure continuing wellness but address your concerns about the treatment.
If you are on medication, it is very important that the decision to stop taking it is made with the input of your doctor and anyone else involved in your treatment.
Postnatal psychosis often requires treatment with antipsychotic drugs, mood stabilisers and/or antidepressants. These are usually prescribed by a specialist psychiatrist. The actual medication you are prescribed will depend on how severe your condition is and how you are feeding your baby.
Research regarding which medications are safe in pregnancy or while breastfeeding and which are useful for treating postnatal psychosis is ongoing. When looking at medication during pregnancy or while breastfeeding, the risks relating to becoming mentally unwell for both you and your baby need to be weighed against the risks of treatment with medication. It is therefore most important that you check with your doctor about the latest information on which medications are considered safe and effective.
The medication you are prescribed may make you quite sleepy. Although this will help you sleep at night, which can really be very helpful, it is important that you and those supporting you know this, so you can ensure there is someone else around to help you with your baby.
If you are prescribed medication, you should receive clear instructions about how you should take it and what precautions are necessary.
- the names of the medicines
- what symptoms they are supposed to treat
- how long it will be before they take effect
- how long you will have to take them for and what their side effects (short- and long-term) are
- whether the medication could interact with any other medication you might be prescribed or taking
It’s important the doctor knows all the medications (including any herbal medicines) you are taking, as some taken together can be dangerous. You should not mix different types of antidepressants unless instructed by your doctor.
Alcohol and other drugs may make your symptoms more intense and are not good for the baby.
Thanks to Mark Huthwaite, consultant psychiatrist, and members of the Thriving Madly peer support network in Christchurch for reviewing this content. Date last reviewed: September, 2022.
Thanks also to Sutherland Self-Help Trust for making the 2022 updates possible.