By Dr. Sarah Ruiz, a clinical pediatric psychologist at Rady Children’s Health Orange County
A rare but serious mental health emergency
About 1 or 2 out of every 1,000 people who give birth experience something called postpartum psychosis. Postpartum means “after giving birth”. Psychosis is a condition in which a person cannot tell the difference between what is real and what is not.
Although rare, postpartum psychosis is serious. People with postpartum psychosis describe feeling overwhelmed, scared and confused. Some who have recovered from postpartum psychosis say it felt like they missed out on the joy they expected as new parents. Knowing the risks and warning signs can help.
In this Q&A, Dr. Sarah Ruiz, a pediatric psychologist at Rady Children’s, shares early warning signs and how to help loved ones.
Psychosis usually includes:
- hallucinations: seeing or hearing things that aren’t there
- delusions: strongly believing things that aren’t true
- major changes in how a person acts, thinks, or speaks.
Postpartum psychosis is specific in that it also includes:
- severe depression symptoms
- mania: extreme energy or happiness that feels out of control
- delusions focused on their babies.
These symptoms can develop quickly within the first two weeks after birth. While rare, some may try to harm themselves or others. It’s crucial to take these symptoms seriously. Some people will show all the signs listed here; some will show just a few.
What are the early warning signs I should look for?
Becoming a new parent can be a happy but stressful time with lots of change and little sleep. With all of these changes, “Baby blues,” or temporary feelings of sadness, are common after birth. Baby blues are different, however, from postpartum psychosis.
Hallucinations or delusions might not start right away in postpartum psychosis. Early warning signs can include:
Sometimes the person starts to feel very sad or depressed, and sometimes they feel uncontrollably happy and energetic. Some people also notice feeling angry or agitated as well as becoming aggressive. Untreated postpartum psychosis can be very dangerous, with a higher risk of parents harming themselves or others.
Those with a history of postpartum psychosis are at greater risk in future pregnancies. If you’re worried about your risk, talk to your doctor to create a tailored treatment plan.
How should I respond if someone I love believes things that aren’t real?
It can be scary when someone we love sees, hears, or thinks things that are not real.
Try to remain calm in these situations. Remember, to the person experiencing psychosis, hallucinations or delusions feel very real. Listen compassionately and let them know you care. Do not try to correct them or argue with them about what is happening.
Use simple and short sentences to keep communication clear. Try saying things like “I can see this is scary for you. I’m here for you.” Arguing about what the person is experiencing can be overwhelming in the moment. Avoid saying things like “stop it” or “that’s not real.”
If the situation starts to feel scary, remain calm, speak clearly, and try to gently help them calm down. If they calm down and are safe, contact their doctor and let them know what happened. If the person is saying they want to hurt themselves or others, seek emergency help. Do not leave your loved one alone or unsupervised while help is on the way.
What should I do if my loved one shows signs of psychosis?
If you are concerned that your loved one has postpartum psychosis, this is a very serious emergency. Postpartum psychosis can start quickly. The good news is that most people also recover quickly with the right treatment. If you are concerned, it is important to act fast and seek help for your loved one right away.
When and how do I seek professional help?
If you are concerned about yourself or a loved one having postpartum psychosis it is important to seek help right away. There can be a lot of stigma, shame, and misinformation around postpartum psychosis. Families may be scared to share their experiences, but during a crisis reach out and get the help you need.
Call 911 or go to the closest emergency department, if you can do so safely. If you are in the Orange County area you may also be able to call the Mobile Crisis Assessment Team (CAT) to your home for an emergency evaluation. The CAT team is available 24 hours a day, 7 days a week to respond to behavioral health emergencies.
How can I support them while also taking care of myself and my family?
It can be hard and scary when a loved one has postpartum psychosis. Partners often feel uncertain and powerless. Postpartum psychosis hits right when you are already adjusting to a growing family. In an emergency situation, use your village as much as possible. If you have other children at home, let family help with childcare. You can only care for your loved ones if you are taking care of yourself as well. For free online support groups for birthing parents and partners, visit Postpartum Support Internation (PSI).
For more information on perinatal mental health, check out this these Rady Children’s Health article and webinar to read further.
