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Postpartum psychosis

What is postpartum psychosis?

Postpartum psychosis is a very rare but severe mental health condition that occurs in one or two out of every 1,000 women in the weeks after the baby is born.

Postpartum psychosis is very serious as there is a risk of self-harm for the mother and there is a risk of potential harm to the baby and/or other children in the family (if any).

It is not clear exactly what causes postpartum psychosis, but it is known that women with a history of bipolar disorder or who have experienced postpartum psychosis after previous births are at a much greater risk of this condition.

Women who experience postpartum psychosis can become very confused and put themselves or others at risk. Urgent help is needed for women with suspected symptoms of postpartum psychosis.

Symptoms of postpartum psychosis

Postpartum psychosis leads to changes in a woman’s usual behavior. These changes usuallystart within 48 hours to weeks after birth, but can develop up to 12 weeks after birth.

They can be extremely exhausting for both the woman and her family.

Early changes in usual behavior include:

– feeling that it is difficult to sleep;
– feeling full of energy or restless and irritable;
– a feeling of power , power and invincibility;
– strange beliefs (for example, that there are people who try to harm the baby);

This may be followed by a combination of manic or depressive symptoms, including:

– manic symptoms – eg high energy, hearing voices or seeing things that are not there (hallucinations), believing things that are not based on reality (delusions), talking fast;

– depressive symptoms – eg low energy expenditure, mother’s inability to sleep or eat, thoughts of harming herself or the baby, feelings of hopelessness or helplessness as a mother;

The woman may appear confused and distracted, experience mood swings in a very short period of time and have difficulty concentrating.

Women experiencing symptoms of postpartum psychosis may become very confused and may be at risk of harming themselves, others or even their baby.

If you experience these symptoms or notice any changes similar to those described here in a woman who has recently given birth to a baby, seek help from a GP, mental health specialist or hospital emergency room as soon as possible.

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Often, partners and/or family members will need to provide the mother with assistance and play an important role in the continued care of the woman until she fully recovers.

Treatment

As postpartum psychosis is a serious and complex mental health condition, the woman should consult with a specialist psychiatrist and ensure continued care until permanent and improvement.

Medications

Treatment is essential to control and improve the condition of the postpartum psychosis sufferer. Medications for postpartum psychosis should not be stopped suddenly.

Mood stabilizers and antipsychotics are prescribed with the advice of a psychiatrist and should be used with caution, especially if the woman is breastfeeding.

Medications such as clozapine should be avoided during breast-feeding. If you are taking antipsychotics, physical activity and a healthy diet are extremely important to minimize the risk of weight gain.

If you have been treated for postpartum psychosis it is important to discuss this with a specialist if you are planning another pregnancy when the pregnancy is confirmed and after delivery.

Folic acid supplements are important if you take mood-stabilizing medications while trying to conceive or during the first trimester of pregnancy, as it may reduce the increased risk of birth defects from taking these medications.

If a woman suffers from postpartum psychosis, she will almost always need to spend some time in a psychiatric hospital, especially if she or her partner or family feel they may be at risk of harming themselves.

This allows healthcare professionals to monitor and provide treatment and ongoing support while the woman is in a safe place.

Electroconvulsive therapy (ECT) is a specialized treatment available in many specialist hospitals. It is a safe way to treat acute mania, psychosis and severe postpartum depression. Prescribed medication will be most effective in combination with good psychological therapy.

Types of therapy

If you need treatment, your GP, OB/GYN or nurse will be able to help you find the best treatment approach for you.

If necessary, you may be referred to other health professionals depending on the services available at the relevant health facility.

You and your partner or support person, together with your healthcare professional, should decide on your treatment plan, but this will be done after a thorough discussion of your wishes and after weighing the benefits and risks of each treatment .

The most important thing is to talk to a health professional about getting the right treatment. Remember, the faster you get help, the faster you can recover.

Psychological therapy

Psychological therapy is considered an effective way to treat depression and anxiety. It includes cognitive behavioral therapy and interpersonal psychotherapy.

Hospitalization

Sometimes health professionals will recommend that the affected woman go to hospital. That way, she will be in a safe place, and the specialists will be able to develop the best treatment for the respective case.

This is most likely when the woman:

– has serious symptoms
– has complicated medical problems
– when he is in danger to himself or others
– when he needs more intensive treatment and monitoring.

Time in the hospital helps stabilize symptoms and allows a woman to begin treatment in a safe place and under constant supervision.

When possible, mothers and babies are kept together. This provides a safe and supportive environment for the mother and her baby to receive care and be monitored 24 hours a day.

Electroconvulsive therapy

Electroconvulsive therapy is a specialized treatment that is effective in treating certain mental health conditions (eg major depression and some forms of mania).

During pregnancy, electroconvulsive therapy is used only when the risk of untreated symptoms (eg, strong suicidal urges) outweighs those of treatment.

Treatment can only be prescribed by a psychiatrist and is carried out with careful monitoring of the woman by a psychiatrist, obstetrician-gynecologist and specialist obstetrician-anesthesiologist. The risks for the woman and the baby from the treatment are low.

Alternative Medicine

The use of alternative methods of treatment, including herbal and homeopathic therapies, is increasingly common. Some women may choose these methods to improve their general health and also because they are perceived as “safe” alternatives to drugs.

However, there is no scientific evidence of the benefits or safety of these therapies during pregnancy and breastfeeding. Also, these supplements may interact adversely with some medications (for example, St. John’s wort should not be taken with some antidepressants). Other herbs may contain ingredients with unknown effects.

You should always talk to a healthcare professional about any alternative medicines you are taking or plan to take.

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