With a new baby comes new challenges: fewer hours of sleep, limited time to eat, and maybe the pressure to develop new baby-caring skills.

Very rarely, giving birth can also come with intense mental health symptoms, such as confusion, disorientation, and erratic behavior. In these cases, a postpartum psychosis diagnosis is possible.

Not to be confused with postpartum depression, postpartum psychosis is a much less common condition. It occurs in approximately 1 to 2 per 1,000 new mothers.

Both postpartum psychosis and depression can come with shifts in mood, anxiety symptoms, and insomnia. Symptoms of postpartum psychosis, though, are often more severe and might also include hallucinations or delusions.

Postpartum psychosis is more common in first-time mothers or those who live with bipolar disorder or have a family history of this condition.

The condition can be fully treated, although it requires immediate attention from a healthcare professional.

Only a healthcare professional can diagnose postpartum psychosis accurately. For that, they’ll compare the symptoms reported or observed in a new mother to the established diagnostic criteria.

Some professionals will go with the criteria set by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This is a reference handbook by the American Psychiatric Association.

Although postpartum psychosis is not included in the DSM-5 by itself, mental health professionals can use a specifier. These are extensions to other diagnoses that clarify specific features of the condition.

For example, the specifier “with postpartum onset” can be added to a diagnosis of brief psychotic disorder. This is to denote that the symptoms of this disorder are happening during pregnancy or within 4 weeks after giving birth.

Following the diagnostic criteria for “brief psychotic disorder with postpartum onset,” a health professional would look for the presence of one or more of four symptoms:

  1. delusions
  2. hallucinations
  3. disorganized or incoherent speech
  4. intensely disorganized or catatonic behavior

One of the first three must be present for a new mother to receive the diagnosis.

Also, cultural differences are taken into account. This means that if any of these symptoms is culturally sanctioned, it might not meet the diagnostic requirements.

To gather all the information to reach a diagnosis, a health professional will take different routes:

  • talk with you about how you feel and your concerns
  • make a list of possible symptoms based on what you tell them
  • make a list of possible symptoms based on what other people have observed or what the professional can observe themselves
  • request blood work to find out if your symptoms could be explained by another physical condition, an injury, or a substance you used
  • explore your family and personal medical history

Postpartum psychosis is a reality-altering mental health condition.

Your current thoughts in this state are not aligned with what is truly happening around you. You may see things that don’t exist or witness events that aren’t happening.

Postpartum psychosis symptoms have a rapid onset, usually occurring within the first two weeks after giving birth and as early as the day after.

In rare instances, symptoms may develop several months after pregnancy.

Restlessness, insomnia, and irritability might be the earliest signs of postpartum psychosis, followed by a quick progression to more intense symptoms.

At least one symptom of psychosis is the rule, hence the name of the condition. These symptoms refer to a disturbance in someone’s thoughts and perceptions.

In other words, symptoms of psychosis usually lead a person to perceive their world in a different way than other people in the same situation do. Delusions and hallucinations are examples of symptoms of psychosis.

General postpartum psychosis symptoms include:

  • intense shifts in moods that can quickly go from depression to elation
  • intense confusion and disorientation
  • restlessness
  • rambling speech
  • high and persistent levels of anxiety
  • intrusive thoughts about the baby’s safety
  • depression
  • insomnia
  • unexplained changes in behavior
  • high irritability
  • hyperactivity
  • paranoia
  • delusions
  • hallucinations
  • supernatural beliefs related to the baby

Not everyone will experience all of these symptoms or in the same intensity. Postpartum psychosis can feel and look different from case to case.

The symptoms that tend to be more common in postpartum psychosis include:

Rapid changes in mood

Everyone experiences shifts in mood from time to time, particularly during stressful times. However, if you have postpartum psychosis, these changes will feel very intense and might occur rapidly without any evident reason.

For example, you might go from crying intensely and not wanting to do anything to jumping up and down in elation in a matter of hours.

If this happens repeatedly and constantly, it could be a sign of postpartum psychosis.

Severe confusion and disorientation

Lack of sleep from new schedules can give anyone’s memory a jolt. It’s natural to forget a few things, including what you were about to say if you’re feeling more tired than usual.

If you have postpartum psychosis, though, confusion will be severe. This means that you could get disoriented in terms of time and space, for example, even if you’re in a familiar place.

You might also be confused about what others are telling you, feel incredibly restless or lethargic, experience difficulty expressing yourself, or forget about taking care of your baby.

Another sign of severe confusion might be not organizing your thoughts or expressing them in coherent ways. You might start rambling, for example.

How you act during these times of confusion is not a personal choice, and in some instances, you might not even be aware of how you’re acting.

Delusions

Delusions are false beliefs about yourself, others, or the world around you. You might be convinced of something despite all the evidence to the contrary.

For example, you may feel a family member is spying on you, or that someone you know is plotting against you and your baby.

Some of these delusions can be extreme. For instance, mothers with postpartum psychosis might be convinced that their baby is an emissary of God or, sometimes, the devil.

These delusions are part of the condition and not the mother’s responsibility or conscious choice.

Hallucinations

Hallucinations are different from delusions. They involve your senses and not only your thoughts.

A hallucination is seeing, feeling, smelling, tasting, or hearing something that others in the same situation do not.

An example of this would be “seeing” a bear in your bathtub or hearing someone speak to you when you are alone in your room.

Postpartum psychosis can be treated, but timely professional intervention is essential because of the intensity of some of the symptoms.

Postpartum psychosis may last between 1 day to 1 month. With treatment, full recovery is possible.

Once treated, you may never experience postpartum psychosis again, though approximately 64% of first-time moms will see reoccurrence with another child.

Knowing and understanding what you’re going through and what solutions are available is key.

Professional monitoring and symptom management throughout pregnancy and after birth can prevent new occurrences of postpartum psychosis.

Treatment options for postpartum psychosis include:

Safe accommodations

Sometimes, if a new mom is experiencing hallucinations and delusions that might put her and the baby’s safety in jeopardy, a health professional might recommend constant medical supervision.

A professional medical facility can ensure you receive the care you need and offer you and the baby a safe place to recover.

Support networks

Speaking with a mental health professional can help you discover and work through the potential stresses of being a new mother. It’s also a valuable tool for postpartum psychosis treatment.

You may see benefits after joining support groups, confiding in friends and family members, and participating in online forums.

It’s also advisable to involve your partner and family members in the recovery process, if possible, so they can support you.

Medications

Medication is an important part of postpartum psychosis treatment. It is also one of the main preventive options for women interested in having more children.

Medications can include:

  • antidepressants
  • antipsychotics
  • lithium
  • anticonvulsants
  • benzodiazepines
  • electroconvulsive therapy

Sleep schedule regulation

Sleep is incredibly important for everyone, especially new mothers.

In addition to helping your body recover from usual motherhood demands, regular sleep may help stabilize your mood.

Postpartum psychosis is different from postpartum depression. It’s rarer, for one, and also includes symptoms that are severe and might disturb how you see yourself, your baby, and your surroundings.

Symptoms of postpartum psychosis might include severe disorientation and confusion, delusions, and hallucinations.

Treatment is possible, however. Immediate care after noticing the first symptoms is highly advisable.

If you would like to learn more about postpartum psychosis treatment or need other avenues of assistance, trusted resources include: