According to Action on Postpartum Psychosis (APP), postpartum psychosis (PP) is a severe, but treatable, form of mental illness that occurs after having a baby. Postpartum psychosis (PP) is a rare illness, compared to the rates of postpartum depression or anxiety. It affects around 1 in 500 mothers after giving birth. Postpartum Support International (PSI) states that it occurs in approximately 1 to 2 out of every 1,000 deliveries, or approximately .1 -.2% of births. The onset is usually sudden, usually within the first 2 weeks postpartum. It can happen ‘out of the blue’ to women without previous experience of mental illness. There are some groups of women, women with a history of bipolar disorder for example, who are at much higher risk. PP normally begins in the first few days to weeks after childbirth. It can get worse very quickly and should always be treated as a medical emergency. Most women need to be treated with medication and admitted to a hospital. With the right treatment, women with PP do make a full recovery. Recovery takes time and the journey may be tough. The illness can be frightening and shocking for both the woman experiencing it and her family. Women do return to their normal selves and are able to regain the mothering role they expected. There is no evidence that the baby’s long-term development is affected by postpartum psychosis. The period after childbirth can be a devastating time to experience a severe mental illness. For women who experience PP, their partners, friends, and family, it can be hard to find high-quality information about the symptoms, causes, and treatment.

Symptoms of Postpartum Psychosis

Symptoms of postpartum psychosis can include:

  • Delusions (strange beliefs that could not be true)
    • Hallucinations (seeing, hearing, smelling, or feeling things that aren’t there)
    • Severe confusion
  • Mania (high mood with loss of touch with reality)
  • Being more talkative, sociable, on the phone an excessive amount
  • Having a very busy mind or racing thoughts
    • Hyperactivity (feeling very energetic and like “super-mum” or agitated and restless)
  • Feeling very irritated
  • Decreased need for or inability to sleep
  • Paranoia or suspiciousness of people’s behaviors
    • Feeling that things are connected in special ways or that stories on TV or radio have special personal meaning
    • Feeling that the baby is connected to God or the Devil in some way
  • Behaving in a way that is out of character or out of control
  • Depression
  • Anxiety
  • Rapid mood swings
  • Difficulty communicating at times

There are many other symptoms that can be experienced.


Unfortunately, we know little about the causes of PP. Research points to biological, probably hormonal, factors related to pregnancy and childbirth, but many other factors are likely to be involved.

Risk Factors

The most significant risk factors for postpartum psychosis are a personal or family history of bipolar disorder, or a previous psychotic episode. Of the women who develop postpartum psychosis, research has suggested that there is approximately a 5% suicide rate and a 4% infanticide rate associated with the illness. This is because the woman experiencing psychosis is experiencing a break from reality. In her psychotic state, the delusions and beliefs make sense to her; they feel very real to her and are often religious. It is also essential to know that many survivors of postpartum psychosis never experienced delusions containing violent commands. Delusions take many forms, and not all of them are destructive. Most women who experience postpartum psychosis do not harm themselves or anyone else. However, there is always the risk of danger because psychosis includes delusional thinking and irrational judgment, and therefore women with this illness must be quickly assessed, treated, and carefully monitored by a trained healthcare perinatal mental health professional.

Treatment for Postpartum Psychosis

Immediate treatment for a woman going through postpartum psychosis is imperative. Postpartum psychosis is temporary and treatable with professional help, but it is an emergency, and it is essential that you receive immediate help. If you feel you or someone you know may be suffering from this illness, know that it is not your fault, and you are not to blame. Call your doctor or an emergency crisis hotline right away so that you can get the help you need.

This article is provided by Dr. Ralph Kueche (Child Psychologist). Dr. Kuechle is a Child and Adolescent Clinical Psychologist who specializes in treating children and their families who may be struggling with mood and behavioral issues. Learn more about Dr. Kuechle.