Introduction
Postpartum psychosis is a mental health condition experienced by new mothers shortly after they have been delivered. In this condition, the mother loses the sense of reality and may experience paranoia, delusions, disruption in thought process and/ or hallucinations. It affects 0.01- 0.02% of mothers and can happen until the 6th week post-delivery (Raza & Raza, 2019). Lack of sleep and hormonal fluctuations after birth, especially the rapidly falling levels of estrogen, can lead to symptoms (Kulkarni et al., 2008).
Symptoms of Post-partum Psychosis
Major symptoms of postpartum psychosis include:
- Hallucinations: Hallucinations refer to perceiving a stimulus which actually isn’t present. A person can experience hallucinations in any sensory form. E.g. hearing voices (auditory hallucination), seeing people (visual hallucination) etc.
- Delusions: Delusions are fixed, firm and false beliefs that people hold on to strongly even when no evidence is present for them to believe. For instance, people experiencing delusion of reference may believe that everybody around them is talking about them or observing them.
- Mood changes: The mood changes experienced in psychosis may either be due to the hallucinatory or delusionary symptoms being experienced by the patient or may be a separate symptom altogether. The patient may experience symptoms of depression such as sad mood, weeping spells, anhedonia, apathy, etc; mania, which includes agitation, irritability, aggression, increased speech rate, and delusion of grandiosity, or may experience mixed symptoms of depression and mania.
Importance of Family Support to Overcome Postpartum Psychosis
Family plays an important role in managing and supporting mothers suffering from post-partum psychosis. Studies have shown that the involvement of family members plays a vital role in the recovery of patients experiencing psychotic symptoms (Ewertzon et al., 2010).
During this condition, the mother may not experience an emotional bond with the baby, which makes the presence of the father and other relatives important. The family may motivate the mother to feed the child, which will not just ensure the healthy upbringing of the child but also stimulate the connection between the mother and her child. However, it should be considered that in some cases, people suffering from psychosis can become violent and vulnerable, because of which they may harm themselves or their babies. The presence of a reliable family member ensures their safety.
Treatment of Postpartum Psychosis
Effective treatment of postpartum psychosis is integral as it influences the patient as well as the child. A few ways to treat postpartum psychosis include
- Medication: Antipsychotics, mood stabilisers, lithium, etc, are some medicines prescribed to patients experiencing psychosis. SSRIs, carbamazepine, sodium valproate, and short-acting benzodiazepines can be consumed safely during breastfeeding (Austin& Mitchell, 1998).
- Electroconvulsive therapy (ECT): It is a safe measure to treat the symptoms (Grover et al, 2018). A small magnitude of current is passed through electrodes to a specific part of the scalp which activates certain areas in the brain that inhibit the occurrence of symptoms.
- Psychotherapy: While psychotherapy alone can’t aid in getting rid of the psychotic symptoms, a few therapies, such as CBT for psychosis, Compassion Focus therapy, etc, help in reducing the emotional effects of the symptoms and in managing the symptoms until they go away.
What Long-term Strategies Are Effective to Overcome Postpartum Psychosis- 7 tips
- Resting up: Hormonal fluctuations along with sleep deprivation have been shown to have a positive correlation with post-partum psychosis (Kulkarni et al., 2008). Therefore, resting and sleeping can help in overcoming the symptoms.
- Compliance: Psychotic disorders can not be treated with change situation factors or psychotherapies alone. Medicine is a must. Self-medicating or being non-compliant with the prescribed treatment can be harmful to the patient and child.
- Resist isolation: Experiencing hallucinations and delusions can cause patients to isolate themselves to protect themselves. However, this isolation can increase fear and anxiety. Being socially connected to friends and family can offer the support required.
- Breastfeeding: Studies have shown a negative correlation between breastfeeding and postpartum psychosis (Hamdan & Tamim, 2012). Therefore, practicing breastfeeding until the 6th month post-delivery is beneficial to the mother and the child.
- Diet: Foods rich in antioxidants and omega-3 can be vital in lowering the rate of post-partum psychosis
- Distress tolerance: Hallucinatory experiences and delusions can cause overwhelming emotional experiences in patients. Learning techniques to manage these emotions can be effective.
- Dissociation: Learning ways to dissociate oneself from one’s psychotic experiences can be beneficial in effectively overcoming them.
Conclusion
Postpartum psychosis is a severe mental health disorder experienced by new mothers. Patients can experience mood disturbances, hallucinations and delusions. Pharmacotherapy, psychotherapy and family support are important in managing this condition.
References
Raza, S. K., & Raza, S. (2019). Postpartum psychosis.
Kulkarni J, de Castella A, Fitzgerald PB, Gurvich CT, Bailey M, Bartholomeusz C, Burger H. Estrogen in severe mental illness: a potential new treatment approach. Arch Gen Psychiatry. 2008 Aug;65(8):955-60. doi: 10.1001/archpsyc.65.8.955. PMID: 18678800.
Ewertzon, M., Lützén, K., Svensson, E., & Andershed, B. (2010). Family members’ involvement in psychiatric care: experiences of the healthcare professionals’ approach and feeling of alienation. Journal of Psychiatric and Mental Health Nursing, 17(5), 422-432.
Austin, M. P., & Mitchell, P. B. (1998). Use of psychotropic medications in breast-feeding women: acute and prophylactic treatment. The Australian and New Zealand journal of psychiatry, 32(6), 778–784. https://doi.org/10.3109/00048679809073866
Grover, S., Sahoo, S., Chakrabarti, S., Basu, D., Singh, S. M., & Avasthi, A. (2018). ECT in the Postpartum Period: A Retrospective Case Series from a Tertiary Health Care Center in India. Indian journal of psychological medicine, 40(6), 562–567. https://doi.org/10.4103/IJPSYM.IJPSYM_105_18
Hamdan, A., & Tamim, H. (2012). The relationship between postpartum depression and breastfeeding. International journal of psychiatry in medicine, 43(3), 243–259. https://doi.org/10.2190/PM.43.3.d
