Pueperal Psychosis

Having your baby is one of the best times of your life and you should be feeling on top of the world. Most of us will be, but for a small number of us this time can be extremely confusing and traumatic.

The chances that you are suffering from puerperal psychosis are small; approximately only one or two mothers in every one thousand suffer from this disorder. However, you and those around you should be aware of this condition. Your midwife will usually make you aware of puerperal psychosis during pregnancy and your health visitor will also look out for symptoms at their routine during the postpartum period. Puerperal psychosis is also known as postnatal or postpartum psychosis and it is a very different type of disorder from the more commonly known postnatal depression.

Many of us are worried when those around us talk about 'psychosis', as we don't understand what it means. For someone diagnosed with a psychosis it means medically that they have lost their 'contact' with reality and that they are suffering from delusions. Put simply, puerperal psychosis is psychosis caused by childbirth.

When would I develop puerperal psychosis?

There is a chance that you may experience puerperal psychosis straight after giving birth although most sufferers tend to start experiencing this between two days and three weeks after giving birth.

How will I feel if I am suffering with puerperal psychosis?

Puerperal psychosis is unique to every sufferer but there are some aspects that are common to most sufferers. You may hear voices or see things that aren't there, which are also known as hallucinations. You will probably have thoughts that are strange to others, such as you knowing that your baby is the devil even though those around you will not listen to you or believe you.

There is a chance that you will worry constantly and may believe that there is something very wrong with the baby. Not only can this make it more difficult to bond with the newborn, but you may try and avoid the baby. In extreme cases, you may try to harm the baby or yourself. this is because the feelings that you are experiencing are very real, whatever those around you may say.

Other symptoms may be extreme confusion, flexibility or rigidity of arms and legs. There is also a chance of symptoms becoming more 'depressed' or 'manic'. The symptoms of severe depression will probably include lack of interest in the baby and yourself, eating problems, sleep disruption and even suicidal thoughts. Mania is almost the opposite, when you may become hyperactive and do everything at top speed and be unable to stop doing things - even to go to sleep.

Risks of suffering from puerperal psychosis

There is a higher chance that you may suffer with this if:

• You have experienced puerperal psychosis with a previous pregnancy.
• Have existing manic depression (bipolar disorder).
• Have family history of puerperal psychosis or manic depression.
• You are a first time mother who has undergone a C-section.

If you think that you, or someone close to you, may be at risk of suffering from puerperal psychosis then it is very important to speak with the medical professionals including the doctor, midwife or health visitor.

Causes of puerperal psychosis

It is thought that puerperal psychosis is caused by hormone changes but this has yet to be confirmed. There are some genetic links, meaning that if a close relative of yours has suffered with this then there is more of a risk of you developing the disorder.

What should I do if I think I am suffering from puerperal psychosis?

If you are experiencing any of these feelings or symptoms then you must seek help. Puerperal psychosis can be treated and medical professionals will support you as much as they can.

If you think that your partner, or friend or family member is suffering with this then you must seek medical help as soon as possible on their behalf as sufferers may not be able to seek help themselves.

Treatment of puerperal psychosis

Each treatment of puerperal psychosis is unique. This is because sufferers experience different symptoms. There is a chance that you can stay at home while you're recovering, if you or a partner is able to look after the child and you are willing to be treated. If necessary, you may be moved to a mother and baby unit (MBU) that will allow you to keep your baby close by while being treated.

Medical treatments can be offered to you during pregnancy if you are at risk of developing puerperal psychosis after birth, although you may be worried about this because of the risk to your unborn baby. Medical professionals, including a psychiatrist, will take as much information as possible into account when prescribing drugs during pregnancy and will make the same considerations when prescribing drugs after birth while you are breast feeding.

Common drug options may include antidepressants such as fluoxetine (Prozac), citalopram or fluvoxamine. A mood stabiliser such as lithium may be used during pregnancy or after birth and neuroleptic drugs may also be prescribed. These are a group of drugs that are used to treat psychosis when a calming effect is needed. Very rarely, electroconvulsive therapy or ECT may be recommended if other types of treatment are not working. This is probably the most terrifying type of treatment, but it is administered under a general anaesthetic. Afterwards, nausea, headaches and temporary memory loss may occur, but these are not long-lasting. It's important that your medications are taken as prescribed. Make sure you tell your doctor about any side effects that you may be experiencing.

There are different types of counselling therapies and if these are available they can help you to challenge some of your feelings with the support of mental health professionals.

Whether you are suffering from puerperal psychosis, another type of disorder or you are just totally overwhelmed by the birth of your child, remember that support from those around you is very important. When suffering, it can take three times as long to do a simple job such as preparing a meal; this doesn't even take into account the lack of sleep you may be experiencing. Do allow friends and family to support you and don't be frightened to say no or to ask them to leave when you have had enough. Always allow your medical professionals, such as your health visitor, to support you and your new baby.