Table of ContentsView AllTable of ContentsThe LinkEmergency SignsHospitalizationStigma Around PPPMedicationsComplementary TherapiesPatient Support
Table of ContentsView All
View All
Table of Contents
The Link
Emergency Signs
Hospitalization
Stigma Around PPP
Medications
Complementary Therapies
Patient Support
Postpartum psychosis (PPP) is a rare and severe mental health emergency requiring treatment. It occurs in about 1 to 2 out of every 1,000 births.PPP typically begins between 24 hours and three weeks after delivery.The onset of PPP is sudden and may involve:
This article reviews the link between postpartum and psychosis, emergency signs and symptoms, stigma, and treatment.
Dobrila Vignjevic / Getty Images
What Is Postpartum Depression, and What Helps?
What’s the Link Between Postpartum and Psychosis?
Childbirth can trigger mental health disorders such as PPP. The highest risk for developing PPP is within the first two weeks after birth.The onset of this condition could be due to a sudden drop in reproductivehormonessuch as estrogen or an increase in the stress hormone cortisol, but research is unclear.
Postpartum Psychosis (PPP) DiagnosesWhile theDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5)contains diagnostic criteria forpsychosis, it does not contain PPP-specific criteria. This can make diagnosis challenging as PPP often presents differently than other types of psychosis.
Postpartum Psychosis (PPP) Diagnoses
While theDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5)contains diagnostic criteria forpsychosis, it does not contain PPP-specific criteria. This can make diagnosis challenging as PPP often presents differently than other types of psychosis.
Hormonal shifts can impactneurotransmitters(chemical messengers) in the brain and change brain function. These changes occur in the area of the brain that regulates mood, thoughts, and perception.
A history of mental health conditions, such as bipolar or schizoaffective disorder, is the most significant risk factor. PPP affects 20% to 30% of those with bipolar disorder. However, anyone can get PPP, and only 33% have a prior psychiatric history.
The following are other risk factors.
Postpartum Mental Health ComorbiditiesWhile each of the following mental health concerns is a unique, separate disorder, childbirth can trigger them independently or alongside another mental health condition, including the following:DepressionGeneralized anxiety disorderBipolar spectrum disorderSchizophrenia spectrum disorderSubstance use disorder
Postpartum Mental Health Comorbidities
While each of the following mental health concerns is a unique, separate disorder, childbirth can trigger them independently or alongside another mental health condition, including the following:DepressionGeneralized anxiety disorderBipolar spectrum disorderSchizophrenia spectrum disorderSubstance use disorder
While each of the following mental health concerns is a unique, separate disorder, childbirth can trigger them independently or alongside another mental health condition, including the following:
Emergency Signs Someone May Have Postpartum Psychosis
In addition to hallucinations and delusions, PPP may also present with mania, depressive symptoms, cognitive problems (such as disorganized thoughts), or a mixture.
Early warning signs of PPP may include:
Emergency signs that someone may have PPP and need immediate medical intervention include:
Suicide Prevention
Postpartum Psychosis and Hospitalization
Postpartum psychosis is a mental health emergency requiring immediate psychiatric evaluation and hospitalization.It is an emergency because it is associated with a high risk of maternal suicide or infanticide.
Hospitalization provides specialized care from mental health providers, monitoring, and medical treatment that protects the parent from hurting themselves or their babies.
Severe symptoms of PPP typically resolve within two to 12 weeks of starting treatment. However, it can take up to a year to completely recover.
Stigma Around Postpartum Psychosis
Thestigma(negative attitudes, beliefs, stereotypes) surrounding PPP can harm the individual and family coping with this condition.
Many people lack accurate information about PPP, leading to misconceptions and misunderstandings, harsh judgment, and blame. Some may misperceive PPP as a personal weakness. However, this is not the case, as PPP is a medical condition.
It’s essential to raise public awareness and provide accurate information to decrease misconceptions and change the stigma surrounding PPP.
Racial DisparitiesResearch shows disparities (unequal treatment or access to care) for psychosis among people in traditionally underrepresented communities, including people of certain racial and ethnic groups. Racial disparities can cause mistrust in the healthcare system, impacting treatment.Some key factors contributing to racial disparities include:Misinterpretation of cultural expressions that influences how providers perceive and diagnose symptomsDecreased access to care and insuranceTreatment disparities (less likely to receive treatment, which increases the risk of poor outcomes)Higher risk of misdiagnosisHigher risk of involuntary hospitalizations
Racial Disparities
Research shows disparities (unequal treatment or access to care) for psychosis among people in traditionally underrepresented communities, including people of certain racial and ethnic groups. Racial disparities can cause mistrust in the healthcare system, impacting treatment.Some key factors contributing to racial disparities include:Misinterpretation of cultural expressions that influences how providers perceive and diagnose symptomsDecreased access to care and insuranceTreatment disparities (less likely to receive treatment, which increases the risk of poor outcomes)Higher risk of misdiagnosisHigher risk of involuntary hospitalizations
Research shows disparities (unequal treatment or access to care) for psychosis among people in traditionally underrepresented communities, including people of certain racial and ethnic groups. Racial disparities can cause mistrust in the healthcare system, impacting treatment.
Some key factors contributing to racial disparities include:
Medications to Treat Postpartum Psychosis
Medications to treat PPP include:
Complementary Therapies During Postpartum Psychosis Treatment
Complementary therapies can be valuable for stress reduction, relaxation, and well-being. However, for those with PPP, they should not be the primary initial treatment. They should occur in addition to medical treatment.
Examples of complementary therapy include:
Consult a healthcare provider before considering any natural supplement or herbal remedies, as they could decrease the effectiveness or interact with medications that treat PPP.
Postpartum Psychosis Patient Support
The following are some possible forms of support for those recovering from PPP:
SAMHSA National HelplineTheSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat800-662-HELP (4357)provides around-the-clock information and referrals if you or a loved one are facing mental health or substance use issues. This confidential service does not provide counseling but can direct you to helpful resources, treatment facilities, and support groups in your area.
SAMHSA National Helpline
TheSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat800-662-HELP (4357)provides around-the-clock information and referrals if you or a loved one are facing mental health or substance use issues. This confidential service does not provide counseling but can direct you to helpful resources, treatment facilities, and support groups in your area.
Summary
21 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Friedman SH, Reed E, Ross NE.Postpartum psychosis.Current Psychiatry Reports. 2023;25(2):65-72. doi:10.1007/s11920-022-01406-4American Congress of Obstetricians and Gynecologists.Summary of perinatal mental health conditions.United States (U.S.) Department of Health and Human Services Office on Women’s Health (OASH).Postpartum depression.Osborne LM.Recognizing and managing postpartum psychosis.Obstetrics and Gynecology Clinics of North America. 2018;45(3):455-468. doi:10.1016/j.ogc.2018.04.005Davies W.Understanding the pathophysiology of postpartum psychosis: Challenges and new approaches.World Journal of Psychiatry. 2017;7(2):77. doi:10.5498/wjp.v7.i2.77Madora MJ, Knopf HS, Prakash M, et al.Postpartum psychosis or something else?.Prim Care Companion CNS Disord. 2023;25(1):22nr03269. doi:10.4088/PCC.22nr03269Albers SM, Wen T, Monk C, et al.Postpartum psychosis during delivery hospitalizations and postpartum readmissions, 2016-2019.Am J Obstet Gynecol MFM. 2023;5(5):100905. doi:10.1016/j.ajogmf.2023.100905988 Suicide Crisis Lifeline.988 suicide & crisis lifeline.Forde R, Peters S, Wittkowski A.Recovery from postpartum psychosis: A systematic review and metasynthesis of women’s and families’ experiences.Archives of Women’s Mental Health. 2019;23(5):597-612. doi:10.1007/s00737-020-01025-zFleischman EK, Connelly CD, Calero P.Depression and anxiety, stigma, and social support among women in the postpartum period.Nursing for Women’s Health. 2022;26(2):95-106. doi:10.1016/j.nwh.2022.01.008Oluwoye O, Stiles B, Monroe-DeVita M, et al.Racial-ethnic disparities in first-episode psychosis treatment outcomes from the raise-ETP study.Psychiatric Services. 2018;69(11):1138-1145. doi:10.1176/appi.ps.201800067American Psychological Association.Focusing on maternity and postpartum care for Black mothers leads to better outcomes.Oyarzabal EA, Seuferling B, Babbar S, Lawton-O’Boyle S, Babbar S.Mind-body techniques in pregnancy and postpartum.Clinical Obstetrics & Gynecology. 2021;64(3):683-703. doi:10.1097/grf.0000000000000641Qian J, Sun S, Wang M, Sun X, Yu X.Art-based interventions for women’s mental health in pregnancy and postpartum: A meta-analysis of randomised controlled trials.Frontiers in Psychiatry. 2023;14. doi:10.3389/fpsyt.2023.1112951Buttner MM, Brock RL, O’Hara MW, Stuart S.Efficacy of yoga for depressed postpartum women: A randomized controlled trial.Complementary Therapies in Clinical Practice. 2015;21(2):94-100. doi:10.1016/j.ctcp.2015.03.003Yahya FD, Ahmad M, Usman AN, Sinrang AW, Alasiry E, Bahar B.Potential combination of back massage therapy and acupressure as complementary therapy in postpartum women for the increase in the hormone oxytocin.Enfermería Clínica. 2020;30:570-572. doi:10.1016/j.enfcli.2019.07.163Tsai SS, Wang HH, Chou FH.The effects of aromatherapy on postpartum women: A systematic review.Journal of Nursing Research. 2019;28(3). doi:10.1097/jnr.0000000000000331Choi MS, Lee EJ.Effects of foot-reflexology massage on fatigue, stress and postpartum depression in postpartum women. JKorean Acad Nurs. 2015;45(4):587-94. doi: 10.4040/jkan.2015.45.4.587Yang W, Bai Y, Qin L, et al.The effectiveness of music therapy for postpartum depression: A systematic review and meta-analysis.Complementary Therapies in Clinical Practice. 2019;37:93-101. doi:10.1016/j.ctcp.2019.09.002Woroń J, Siwek M.Unwanted effects of psychotropic drug interactions with medicinal products and diet supplements containing plant extracts.Psychiatr Pol. 2018;52(6):983-996. doi: 10.12740/PP/OnlineFirst/80998Substance Abuse and Mental Health Services Administration (SAMHSA).National helpline.
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Friedman SH, Reed E, Ross NE.Postpartum psychosis.Current Psychiatry Reports. 2023;25(2):65-72. doi:10.1007/s11920-022-01406-4American Congress of Obstetricians and Gynecologists.Summary of perinatal mental health conditions.United States (U.S.) Department of Health and Human Services Office on Women’s Health (OASH).Postpartum depression.Osborne LM.Recognizing and managing postpartum psychosis.Obstetrics and Gynecology Clinics of North America. 2018;45(3):455-468. doi:10.1016/j.ogc.2018.04.005Davies W.Understanding the pathophysiology of postpartum psychosis: Challenges and new approaches.World Journal of Psychiatry. 2017;7(2):77. doi:10.5498/wjp.v7.i2.77Madora MJ, Knopf HS, Prakash M, et al.Postpartum psychosis or something else?.Prim Care Companion CNS Disord. 2023;25(1):22nr03269. doi:10.4088/PCC.22nr03269Albers SM, Wen T, Monk C, et al.Postpartum psychosis during delivery hospitalizations and postpartum readmissions, 2016-2019.Am J Obstet Gynecol MFM. 2023;5(5):100905. doi:10.1016/j.ajogmf.2023.100905988 Suicide Crisis Lifeline.988 suicide & crisis lifeline.Forde R, Peters S, Wittkowski A.Recovery from postpartum psychosis: A systematic review and metasynthesis of women’s and families’ experiences.Archives of Women’s Mental Health. 2019;23(5):597-612. doi:10.1007/s00737-020-01025-zFleischman EK, Connelly CD, Calero P.Depression and anxiety, stigma, and social support among women in the postpartum period.Nursing for Women’s Health. 2022;26(2):95-106. doi:10.1016/j.nwh.2022.01.008Oluwoye O, Stiles B, Monroe-DeVita M, et al.Racial-ethnic disparities in first-episode psychosis treatment outcomes from the raise-ETP study.Psychiatric Services. 2018;69(11):1138-1145. doi:10.1176/appi.ps.201800067American Psychological Association.Focusing on maternity and postpartum care for Black mothers leads to better outcomes.Oyarzabal EA, Seuferling B, Babbar S, Lawton-O’Boyle S, Babbar S.Mind-body techniques in pregnancy and postpartum.Clinical Obstetrics & Gynecology. 2021;64(3):683-703. doi:10.1097/grf.0000000000000641Qian J, Sun S, Wang M, Sun X, Yu X.Art-based interventions for women’s mental health in pregnancy and postpartum: A meta-analysis of randomised controlled trials.Frontiers in Psychiatry. 2023;14. doi:10.3389/fpsyt.2023.1112951Buttner MM, Brock RL, O’Hara MW, Stuart S.Efficacy of yoga for depressed postpartum women: A randomized controlled trial.Complementary Therapies in Clinical Practice. 2015;21(2):94-100. doi:10.1016/j.ctcp.2015.03.003Yahya FD, Ahmad M, Usman AN, Sinrang AW, Alasiry E, Bahar B.Potential combination of back massage therapy and acupressure as complementary therapy in postpartum women for the increase in the hormone oxytocin.Enfermería Clínica. 2020;30:570-572. doi:10.1016/j.enfcli.2019.07.163Tsai SS, Wang HH, Chou FH.The effects of aromatherapy on postpartum women: A systematic review.Journal of Nursing Research. 2019;28(3). doi:10.1097/jnr.0000000000000331Choi MS, Lee EJ.Effects of foot-reflexology massage on fatigue, stress and postpartum depression in postpartum women. JKorean Acad Nurs. 2015;45(4):587-94. doi: 10.4040/jkan.2015.45.4.587Yang W, Bai Y, Qin L, et al.The effectiveness of music therapy for postpartum depression: A systematic review and meta-analysis.Complementary Therapies in Clinical Practice. 2019;37:93-101. doi:10.1016/j.ctcp.2019.09.002Woroń J, Siwek M.Unwanted effects of psychotropic drug interactions with medicinal products and diet supplements containing plant extracts.Psychiatr Pol. 2018;52(6):983-996. doi: 10.12740/PP/OnlineFirst/80998Substance Abuse and Mental Health Services Administration (SAMHSA).National helpline.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Friedman SH, Reed E, Ross NE.Postpartum psychosis.Current Psychiatry Reports. 2023;25(2):65-72. doi:10.1007/s11920-022-01406-4American Congress of Obstetricians and Gynecologists.Summary of perinatal mental health conditions.United States (U.S.) Department of Health and Human Services Office on Women’s Health (OASH).Postpartum depression.Osborne LM.Recognizing and managing postpartum psychosis.Obstetrics and Gynecology Clinics of North America. 2018;45(3):455-468. doi:10.1016/j.ogc.2018.04.005Davies W.Understanding the pathophysiology of postpartum psychosis: Challenges and new approaches.World Journal of Psychiatry. 2017;7(2):77. doi:10.5498/wjp.v7.i2.77Madora MJ, Knopf HS, Prakash M, et al.Postpartum psychosis or something else?.Prim Care Companion CNS Disord. 2023;25(1):22nr03269. doi:10.4088/PCC.22nr03269Albers SM, Wen T, Monk C, et al.Postpartum psychosis during delivery hospitalizations and postpartum readmissions, 2016-2019.Am J Obstet Gynecol MFM. 2023;5(5):100905. doi:10.1016/j.ajogmf.2023.100905988 Suicide Crisis Lifeline.988 suicide & crisis lifeline.Forde R, Peters S, Wittkowski A.Recovery from postpartum psychosis: A systematic review and metasynthesis of women’s and families’ experiences.Archives of Women’s Mental Health. 2019;23(5):597-612. doi:10.1007/s00737-020-01025-zFleischman EK, Connelly CD, Calero P.Depression and anxiety, stigma, and social support among women in the postpartum period.Nursing for Women’s Health. 2022;26(2):95-106. doi:10.1016/j.nwh.2022.01.008Oluwoye O, Stiles B, Monroe-DeVita M, et al.Racial-ethnic disparities in first-episode psychosis treatment outcomes from the raise-ETP study.Psychiatric Services. 2018;69(11):1138-1145. doi:10.1176/appi.ps.201800067American Psychological Association.Focusing on maternity and postpartum care for Black mothers leads to better outcomes.Oyarzabal EA, Seuferling B, Babbar S, Lawton-O’Boyle S, Babbar S.Mind-body techniques in pregnancy and postpartum.Clinical Obstetrics & Gynecology. 2021;64(3):683-703. doi:10.1097/grf.0000000000000641Qian J, Sun S, Wang M, Sun X, Yu X.Art-based interventions for women’s mental health in pregnancy and postpartum: A meta-analysis of randomised controlled trials.Frontiers in Psychiatry. 2023;14. doi:10.3389/fpsyt.2023.1112951Buttner MM, Brock RL, O’Hara MW, Stuart S.Efficacy of yoga for depressed postpartum women: A randomized controlled trial.Complementary Therapies in Clinical Practice. 2015;21(2):94-100. doi:10.1016/j.ctcp.2015.03.003Yahya FD, Ahmad M, Usman AN, Sinrang AW, Alasiry E, Bahar B.Potential combination of back massage therapy and acupressure as complementary therapy in postpartum women for the increase in the hormone oxytocin.Enfermería Clínica. 2020;30:570-572. doi:10.1016/j.enfcli.2019.07.163Tsai SS, Wang HH, Chou FH.The effects of aromatherapy on postpartum women: A systematic review.Journal of Nursing Research. 2019;28(3). doi:10.1097/jnr.0000000000000331Choi MS, Lee EJ.Effects of foot-reflexology massage on fatigue, stress and postpartum depression in postpartum women. JKorean Acad Nurs. 2015;45(4):587-94. doi: 10.4040/jkan.2015.45.4.587Yang W, Bai Y, Qin L, et al.The effectiveness of music therapy for postpartum depression: A systematic review and meta-analysis.Complementary Therapies in Clinical Practice. 2019;37:93-101. doi:10.1016/j.ctcp.2019.09.002Woroń J, Siwek M.Unwanted effects of psychotropic drug interactions with medicinal products and diet supplements containing plant extracts.Psychiatr Pol. 2018;52(6):983-996. doi: 10.12740/PP/OnlineFirst/80998Substance Abuse and Mental Health Services Administration (SAMHSA).National helpline.
Friedman SH, Reed E, Ross NE.Postpartum psychosis.Current Psychiatry Reports. 2023;25(2):65-72. doi:10.1007/s11920-022-01406-4
American Congress of Obstetricians and Gynecologists.Summary of perinatal mental health conditions.
United States (U.S.) Department of Health and Human Services Office on Women’s Health (OASH).Postpartum depression.
Osborne LM.Recognizing and managing postpartum psychosis.Obstetrics and Gynecology Clinics of North America. 2018;45(3):455-468. doi:10.1016/j.ogc.2018.04.005
Davies W.Understanding the pathophysiology of postpartum psychosis: Challenges and new approaches.World Journal of Psychiatry. 2017;7(2):77. doi:10.5498/wjp.v7.i2.77
Madora MJ, Knopf HS, Prakash M, et al.Postpartum psychosis or something else?.Prim Care Companion CNS Disord. 2023;25(1):22nr03269. doi:10.4088/PCC.22nr03269
Albers SM, Wen T, Monk C, et al.Postpartum psychosis during delivery hospitalizations and postpartum readmissions, 2016-2019.Am J Obstet Gynecol MFM. 2023;5(5):100905. doi:10.1016/j.ajogmf.2023.100905
988 Suicide Crisis Lifeline.988 suicide & crisis lifeline.
Forde R, Peters S, Wittkowski A.Recovery from postpartum psychosis: A systematic review and metasynthesis of women’s and families’ experiences.Archives of Women’s Mental Health. 2019;23(5):597-612. doi:10.1007/s00737-020-01025-z
Fleischman EK, Connelly CD, Calero P.Depression and anxiety, stigma, and social support among women in the postpartum period.Nursing for Women’s Health. 2022;26(2):95-106. doi:10.1016/j.nwh.2022.01.008
Oluwoye O, Stiles B, Monroe-DeVita M, et al.Racial-ethnic disparities in first-episode psychosis treatment outcomes from the raise-ETP study.Psychiatric Services. 2018;69(11):1138-1145. doi:10.1176/appi.ps.201800067
American Psychological Association.Focusing on maternity and postpartum care for Black mothers leads to better outcomes.
Oyarzabal EA, Seuferling B, Babbar S, Lawton-O’Boyle S, Babbar S.Mind-body techniques in pregnancy and postpartum.Clinical Obstetrics & Gynecology. 2021;64(3):683-703. doi:10.1097/grf.0000000000000641
Qian J, Sun S, Wang M, Sun X, Yu X.Art-based interventions for women’s mental health in pregnancy and postpartum: A meta-analysis of randomised controlled trials.Frontiers in Psychiatry. 2023;14. doi:10.3389/fpsyt.2023.1112951
Buttner MM, Brock RL, O’Hara MW, Stuart S.Efficacy of yoga for depressed postpartum women: A randomized controlled trial.Complementary Therapies in Clinical Practice. 2015;21(2):94-100. doi:10.1016/j.ctcp.2015.03.003
Yahya FD, Ahmad M, Usman AN, Sinrang AW, Alasiry E, Bahar B.Potential combination of back massage therapy and acupressure as complementary therapy in postpartum women for the increase in the hormone oxytocin.Enfermería Clínica. 2020;30:570-572. doi:10.1016/j.enfcli.2019.07.163
Tsai SS, Wang HH, Chou FH.The effects of aromatherapy on postpartum women: A systematic review.Journal of Nursing Research. 2019;28(3). doi:10.1097/jnr.0000000000000331
Choi MS, Lee EJ.Effects of foot-reflexology massage on fatigue, stress and postpartum depression in postpartum women. JKorean Acad Nurs. 2015;45(4):587-94. doi: 10.4040/jkan.2015.45.4.587
Yang W, Bai Y, Qin L, et al.The effectiveness of music therapy for postpartum depression: A systematic review and meta-analysis.Complementary Therapies in Clinical Practice. 2019;37:93-101. doi:10.1016/j.ctcp.2019.09.002
Woroń J, Siwek M.Unwanted effects of psychotropic drug interactions with medicinal products and diet supplements containing plant extracts.Psychiatr Pol. 2018;52(6):983-996. doi: 10.12740/PP/OnlineFirst/80998
Substance Abuse and Mental Health Services Administration (SAMHSA).National helpline.
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