Usually when a baby is born it is a period of joy and jubilation for family and friends. This was also the case with Mo after the birth of her first child but it was short lived. While discussions were ongoing about plans for the naming ceremony, Mo was noticed to get easily agitated, continuously snapping at her mum who had come to be with her in the hospital since the day of delivery. It seemed the woman could do nothing right for her.
Mo began to murmur to herself and gesticulate when she was alone. She would respond to unseen people at times while at other times she complained that she was being talked about on the TV in her room. She became extra clingy towards her new baby believing that she could not trust anyone as people were out to harm her and her baby. She became afraid, tearful about her circumstances and felt she may not be able to protect her bay enough. Mo stopped sleeping, eating and could no longer take care of her baby. Initial attempts at calming her down failed and a few weeks after delivery a psychiatrist was called in to see her.
Mo was diagnosed with Postpartum Psychosis.
Postpartum psychosis or puerperal psychosis affects quite a number of women. It is an episode of mental illness which begins suddenly in the days or weeks after having a baby. It can happen to any woman and it is a frightening experience for women, their partners, family and friends. It could begin within the first few days to weeks of having a baby.
Some of the risk factors for postpartum psychosis include genetic predisposition. Personal or family history of a major psychiatric disorder such as schizophrenia and bipolar disorder, having a sister or a mother who has had postpartum psychosis and also a history of postpartum psychosis before are all risk factors. Other risk factors are lack of social support and single parenthood.
Symptoms in postpartum psychosis can change quickly from hour to hour or from day to day. These symptoms are: feeling elated or unduly happy and on top of the world, unhappiness, fearfulness, irritability, fluctuating mood, confusion, restlessness, anxiety, agitation, excessive speech and disorganized thoughts. Other symptoms are withdrawal from people and not talking to anyone, difficulty falling asleep, paranoid thoughts, undue suspicions, delusions (beliefs in ideas that are unlikely to be true), hallucinations (hearing, seeing, feeling or smelling things that are not really there). A woman in this condition is unable to care for herself or for her baby.
Postpartum psychosis is a psychiatric emergency and help should be sought as soon as possible. When it is already known that there are risk factors for developing postpartum psychosis or when it has occurred before in a woman, it is important to reduce stressors at the period surrounding delivery. Education and support of the woman is essential, trying to get enough sleep and help with caring for the baby may all help. Also for women already on medication for a psychiatric illness, continuing with some or all of the medication or switching to other safer options are decisions to be decided by her doctor for the best interest of mother and baby.
In the treatment of postpartum psychosis, in-patient care is advised and where possible mother and baby unit is preferable so as to be able to provide care for the woman while supporting her in caring for the baby. But where this is not available then the spouse or other family members will have to care for the baby while the woman recovers. Most women with postpartum psychosis need treatment with medication and this is often a source of worry due to breastfeeding. It is however possible to breastfeed while taking some medications after weighing the risks and benefits (by the psychiatrist). It may take weeks to months to fully recover from postpartum psychosis but the vast majority of women will recover fully.
After the illness most women tend to feel sad or anxious about the time missed out on early motherhood and whether they will be able to care for their baby. This feeling eventually passes and they get back to their usual selves. Many women who have had postpartum psychosis go on to have more children.
There is a high risk of having another episode, about 50 percent of women who have had postpartum psychosis will have it again after the birth of another baby but with proper disclosure of previous experience to one’s doctor and proper care it shouldn’t be as alarming as the initial time.
Mo is doing very well now. She has fully recovered from the postpartum psychosis and has settled down into her role as a mother. Although she is quite anxious about the next pregnancy, she is expected to do very well with the right support system and monitoring.