First-time mums at greater risk of psychosis in first month post-childbirth

A new study shows that first-time mothers are at the greatest risk for developing postnatal psychosis, a rare but severe condition, in the first month after giving birth. And among those who develop psychosis, almost half have no previous history of mental problems.

Up to 80% of new mums experience the short-lived "baby blues" in the days after birth. But some have mild to moderate postnatal depression for weeks and months afterwards, and a very few (about 1 in every 1,000) experience postpartum psychotic illness (episodes involving delusional thoughts, hallucinations, and the inability to distinguish between reality and imagination). The condition is dangerous for mothers and their babies, upping the risk of self-harm and suicide.

The researchers theorise that the psychosis might be triggered by a woman’s biological vulnerability following birth due to extreme hormonal fluctuations, and recommend carefully monitoring women in the first month after delivery.

Levels of oestrogen and progesterone that have increased during pregnancy drop suddenly after delivery, and this can affect mood. These female hormones return to their pre-pregnancy levels within a week or so. As hormone levels normalise again, baby blues usually resolve on their own without medical treatment.

For some women, the feelings of sadness or exhaustion run deeper and last longer than baby blues. About 10% of new mothers experience postpartum depression, which is a true clinical depression triggered by childbirth, and it can last for several months or even longer if it goes untreated. With proper treatment, a woman can feel like herself again.

Postpartum psychosis is more serious and rare. It may include hallucinations, such as hearing voices or seeing things, or feelings of paranoia. With postpartum psychosis, a woman can have irrational ideas about her baby or herself – such as that the baby is possessed or that she has to hurt herself or her child. This condition can be extremely serious and disabling, and new mothers who are experiencing these symptoms need immediate medical attention and, often, a brief hospitalisation.

If you are experiencing symptoms, don’t delay getting medical attention. If you’re concerned that your partner or someone else you know is suffering from any kind of postpartum depression, it’s important to encourage her to talk to her doctor or a mental health professional.

(Source: Nemours Foundation: PLoS Medicine: March 2009)