Now this is a pretty scary topic, but luckily, it’s pretty rare, affecting 1 or 2 in every 1000 woman who have given birth. Other good news is that it is also highly treatable, over 90%, and most woman recover quickly, within a few weeks.
So, what is psychosis? It’s a loss of reality where there is a feeling of confusion, disorientation, and delusions. There are visual and sensory hallucination, they feel as though they are not in control of their thoughts or feelings. Many are affected by severe anxiety, agitation, mood swings and insomnia. There are many thoughts going through their mind, and it is incredibly hard to concentrate. Finally, there can be thoughts and/or plans to self-harm or to even harm their baby.
Postnatal psychosis presents extremely quick, within a few hours after birth to the first few weeks. The key is to recognise the symptoms early and access help through GP, crisis team, or hospital ASAP. This is an emergency issue and needs urgent treatment.
Treatment options have a very high success rate; however, they are often required to be admitted to the hospital for assessment and treatment. Not all hospitals have the facilities to have the baby with the mother, and the baby may need to be looked after by the partner or family. Some patients can be treated in the community but often after the patient is stabilised. There will first be assessment, diagnosis and plan created by a psychiatrist. The first line of care is often medications and counselling, then if ineffective, the next line of treatment is electroconvulsive therapy (ECT). There are three main types of medication that can be used. Antipsychotics to help reduce hallucinations such as risperidone and olanzapine. Mood stabilizers to reduces the manic episode such as lithium. And benzodiazepine to be used to reduce anxiety such as diazepam.
ECT is when electromagnetic stimulation is created in the brain to trigger brief seizure activity helping to reset the imbalances. It is conducted under sedation, so the patient feels no pain and is unaware of what is happening. This is a quick acting but short-term treatment, and the patient needs to be able to consent as there can be a side effect of memory loss. This usually resolves within a few weeks.
So why does his happen? Well, it’s not entirely known. There are a few risk factors that have been related such as a history of mental health illness such as bipolar for the patient or their family. Sleep deprivation, hormonal changes, and difficulty during delivery such as medical problems. There are many people who have they risk factors but do not have any concerns postnatal.
After all this, the patient is often full of heavy emotions and thoughts. They feel scared and confused by what has happened, causing a lack of confidence. There can be residual depression and anxiety. With lost time they can feel sad about missing out and even find it hard to bond with their baby. This can be recovered from, it just takes time. There is counselling and support groups available.
I couldn’t imagine going through all of this, it would be so hard. If you or anyone you know are showing signs, be sure to act fast and get them the help they need.