What Should You Do If You Think You or Someone You Love Is Experiencing Postpartum Psychosis?

Written By Jennifer Kost

By Jen Kost, MSW, LCSW, PMH-C

woman with hands over her face

Recent public attention surrounding a high-profile case involving a mother and postpartum mental illness has prompted renewed conversations about postpartum psychosis, a serious mental health condition that can occur after childbirth.

For many people, the conversation raises an important question: How would you know if you or someone you love needs immediate help?

The most important thing to know is that postpartum psychosis is a psychiatric emergency that requires immediate medical evaluation and treatment.

What Is Postpartum Psychosis?

Postpartum psychosis is a condition in which a person loses touch with reality. It often begins suddenly, most often within the first two weeks postpartum, although it can occur later.

Signs can include:

  • Hearing or seeing things others do not

  • Believing things that are not based in reality

  • Severe paranoia or suspicion

  • Extreme confusion or disorientation

  • Rapidly changing or unusual behavior

  • Racing, disorganized, or difficult-to-follow thoughts

  • Significant agitation

  • Dramatic or unusual mood changes

  • Sleeping very little or not at all, particularly when accompanied by unusual energy, agitation, confusion, or changes in thinking or behavior

  • Thoughts of suicide or harming oneself or the baby

Someone experiencing postpartum psychosis may not recognize that what they are experiencing is a symptom of illness. What feels frightening or confusing to loved ones may feel completely real to the person experiencing it.

How Is This Different From Intrusive Thoughts?

This distinction matters.

Many postpartum parents experience unwanted, frightening intrusive thoughts, particularly with postpartum OCD or anxiety. A parent might think:

"What if I accidentally hurt my baby?"

Having a disturbing thought does not mean someone wants to act on it.

With postpartum OCD, the person generally recognizes the thought as unwanted and becomes distressed by it. With psychosis, a person may believe a hallucination or delusion is actually happening and may have difficulty distinguishing what is real from what is not.

Insight can vary, and these conditions can overlap. Only a qualified professional can determine what is happening. When in doubt, seek help.

What If You Are Worried About Your Partner, Friend, or Family Member?

Take your concerns seriously, especially if there has been a sudden and significant change in someone's behavior.

If they are hallucinating, severely confused, paranoid, experiencing unusual beliefs, unable to sleep, or having difficulty distinguishing reality from what they are experiencing:

Stay with them if it is safe to do so.

Bring in another trusted adult, particularly if there is a baby or young child present.

Seek immediate medical evaluation.

You do not need to convince someone that they are experiencing psychosis before getting help. In fact, someone experiencing psychosis may not recognize that they are ill or may disagree that anything is wrong.

Try to remain calm and avoid arguing about whether their experiences are "real." Instead, you might say:

"I can see that this feels very real and frightening. I'm here with you, and we're going to get help."

When Should You Call 911 or Go to the Emergency Department?

Call 911 or go to the nearest emergency department if someone:

  • Is threatening suicide or self-harm

  • Is talking about harming the baby or another person

  • Is experiencing severe hallucinations or delusions

  • Is severely confused or disoriented

  • Cannot safely care for themselves or their baby

  • Is extremely agitated, impulsive, or behaving unpredictably

  • Appears to be an immediate danger to themselves or someone else

Do not wait for symptoms to become more severe or for the person to agree that they need help.

Tell emergency responders:

"This person recently gave birth and may be experiencing postpartum psychosis."

That information can help communicate the urgency of the situation.

If there is an immediate safety concern, do not wait to see if symptoms improve.

Getting Help Is Not a Failure

Postpartum psychosis can be terrifying for the person experiencing it and for the people who love them. Shame and fear can make it difficult to ask for help.

But postpartum psychosis is a medical condition, not a parenting failure or character flaw.

With prompt treatment, many people with postpartum psychosis recover. The most important step is recognizing that something is wrong and getting help quickly.

You do not need to diagnose yourself or someone you love.

You just need to take the concern seriously.

If you are unsure whether your or someone else's symptoms require emergency medical attention, you can call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262) for support and guidance. If there is an immediate safety concern, suspected postpartum psychosis, or concern that someone may harm themselves or their baby, call 911 or go to the nearest emergency department.

This blog is for educational purposes and is not a substitute for medical or psychiatric evaluation. If you are experiencing an immediate mental health or safety emergency, call 911 or go to the nearest emergency department.

Sources & Further Reading

  • American College of Obstetricians and Gynecologists (ACOG), Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum

  • American College of Obstetricians and Gynecologists (ACOG), Treatment and Management of Mental Health Conditions During Pregnancy and Postpartum

  • National Institute of Mental Health (NIMH), Perinatal Depression

  • National Institute of Mental Health (NIMH), Understanding Psychosis

  • NHS, Postpartum Psychosis

  • International OCD Foundation, What is Perinatal OCD?

Jennifer Kost
Next

What Would You Tell a Client?