What Should You Do If You Think You or Someone You Love Is Experiencing Postpartum Psychosis?
By Jen Kost, MSW, LCSW, PMH-C
*Updated 8/14/26
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, typically within the first few weeks after childbirth, 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
Mania, markedly elevated or irritable mood, or rapidly changing mood
Sleeping very little or not at all, particularly when accompanied by unusual energy, agitation, confusion, paranoia, 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.
Postpartum psychosis can worsen quickly. If someone who recently gave birth develops hallucinations, delusions, severe confusion, paranoia, significant disorganization, or major changes in mood or behavior, they need urgent medical evaluation even if they are not expressing thoughts of harming themselves or anyone else.
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. They may go to significant lengths to prevent the feared outcome, seek reassurance, or avoid situations that trigger the thought.
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 postpartum OCD and psychosis 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 the concerns seriously, especially if there has been a sudden and significant change in someone's behavior after childbirth.
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. 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."
Remember that experiencing psychosis does not automatically mean someone will harm themselves or their baby. The concern is that losing touch with reality can significantly affect judgment, behavior, and the ability to recognize danger. That is why prompt medical evaluation is so important.
When Should You Call 911 or Go to the Emergency Department?
Suspected postpartum psychosis requires immediate medical evaluation. Depending on the circumstances, this may mean going to an emergency department or contacting emergency medical services.
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
You do not need to wait for symptoms to become more severe or for the person to agree that they need help.
When seeking emergency care, tell responders or medical staff:
"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 may be 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.
The hotline can provide support and help you determine appropriate next steps, but it is not a substitute for emergency medical care when postpartum psychosis is suspected or there is an immediate safety concern.
If someone may harm themselves, their baby, or someone else, or if there is an immediate safety concern, 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
National Health Service (NHS), Postpartum Psychosis
International OCD Foundation (IOCDF), What Is Perinatal OCD?
U.S. Office on Women's Health, Postpartum Depression
