Causes of postpartum psychosis and what you need to know about this diverse medical condition

Postpartum psychosis became a household name when the news broke on June 20, 2001 that a mentally ill woman named Andrea Yates had drowned all five of her children in a bathtub in an effort to secure their eternal fates. The news hit America hard. Since then postpartum psychosis has been more widely discussed although it is without a consensus as to what causes it and why some women succumb to the condition and others do not. Needless to say, it is terrifying for any new mother to consider that her mind could slip into darkness during what should be the happiest time of her life.

When I was growing up I was always told in some way that if you think you are going crazy you are likely not going crazy. Pardon the political incorrectness of that statement but the sentiment makes sense. People that have lost their grip on reality are not aware that they have done so. Such is true with postpartum psychosis as something in the mind of a new mother breaks in such a way that reality is no longer understood. Andrea Yates was found to be capable of discerning right from wrong at the time that she killed her children. She was sentenced to life in prison although many believe that her mental health at the time was seriously in question.

So what exactly is postpartum psychosis? How can you tell if someone has postpartum psychosis? Is it something that can be avoided? If you’ve just had a baby and you’re concerned about your own mental health, is it possible that you have postpartum psychosis? What can be done to prevent and/or treat this devastating illness? We will analyze some of these questions and take a look at this debilitating illness in this article.

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Postpartum psychosis: Defined

Postpartum psychosis is a relatively rare condition following the birth of the baby that affects roughly 1 to 2 women out of a thousand. It is a serious medical condition that gravely affects the woman’s ability to understand reality and to care for her infant. Symptoms can come on quickly and soon after delivering a baby, typically within the first few weeks. While many more women suffer from postpartum depression, the symptoms of postpartum depression and postpartum psychosis diverge in some distinct ways. Here is a comparison of the symptoms of postpartum depression and postpartum psychosis.

Postpartum Depression symptoms

  • Sadness
  • Irritability
  • Crying and mood swings
  • Lack of concentration
  • Loss of appetite or excessive appetite
  • Sleep disturbances
  • Anxiety and worry
  • Fear
  • Isolation
  • A general feeling of having the “baby blues”

These symptoms may come on after the birth of the baby and continue for weeks or months.

Postpartum Psychosis symptoms

  • Confusion
  • Irritability
  • Extreme agitation
  • Hyperactivity or manic behavior
  • Issues in bonding with the baby
  • Suicidal ideation
  • Thoughts of harming or hurting the baby
  • Delusional beliefs
  • Hallucinations
  • Severe changes in appetite or eating habits
  • Flat affect which refers to a very blank facial expression and lack of emotional response
  • Sleep disturbances that go beyond what seems normal for a new mother
  • Homicidal thoughts toward the baby
  • Suicide attempts or attempts to harm the baby

Postpartum psychosis is a serious psychiatric disorder that absolutely must be treated by healthcare professionals. One complication is that when someone is suffering from postpartum psychosis they typically are not able to recognize it in themselves. Previous mental health problems could be a precursor but generally speaking, little is known about what causes postpartum psychosis to develop. Many doctors and healthcare professionals suspect the sudden shift in hormones within the woman’s body following the birth of a baby may trigger the psychiatric disorder to develop.

Can you tell if someone has postpartum psychosis?

If a woman is not discussing what is going on in her mind, you are often left to only see the outward manifestations of symptoms. What can appear to be a problem with baby blues or depression could be postpartum psychosis. It is important if you suspect that someone is suffering from postpartum psychosis that you take action immediately to try and get them to a doctor to discuss their symptoms and their condition. It’s also important to provide supportive care for the infant in her care. Remember that this is a medical condition and if a mother is suffering from this condition and having terrible thoughts toward her infant, it is a result of her condition. Immediate intervention may be necessary in order to protect the welfare of the infant but also to secure immediate help for the mother.

You may recognize some of the symptoms from the list of symptoms above. You may spend some time with the mother asking questions or observing. In the case of Andrea Yates, it was commonly known within the family and by her husband that she had a long history of psychiatric illnesses. Some attempts had been made to offer her supportive care, to help her with the children, and to keep an eye on her. But even up until the day of the deaths of all five of her children, Andrea Yates was still left alone to care for five children in her very weak and vulnerable psychiatric state. If her illness had been taken seriously and had been treated properly, perhaps the lives of all five of those children could have been spared. While most women who suffer from postpartum psychosis do not go on to murder their own children, it is still important to intervene for the sake and welfare of the children.

If you notice that the mother is not themselves at all personality-wise, mood-wise, and behavior-wise, you should pay attention and raise your concerns carefully. Offer to help out as much as you can. Look for signs of delusion, a break from reality, or signs that she is experiencing hallucinations.

The substance abuse and mental health services administration has a national hotline that you can call for free. You can ask questions or find out where to get support.

SAMHSA’s National Helpline – 1-800-662-HELP (4357)

Website: National Helpline

Can postpartum psychosis be avoided?

While little is known exactly why postpartum psychosis develops, there are some risk factors that are suspected to contribute. For example, if there are previous episodes of psychiatric disorder, bipolar disorder, previous psychotic breaks, or other severe depressive episodes, it is suspected that the risk for developing postpartum psychosis is higher.

The most important thing that you can do if you have experienced these previous psychiatric or psychological disorders is to talk very openly with your doctor about your condition and your previous diagnoses. Communication with your doctor especially during those first few weeks after your child is born is crucial to have that outside interpretation of your symptoms and to have another set of eyes on your mental health care. It is much easier for a woman to spot a problem within herself regarding postpartum depression or what is commonly called the baby blues, but when it comes to postpartum psychosis the symptoms can often cloud her judgment to self-diagnose and therefore seek help.

While it may not be possible to avoid developing postpartum psychosis, one can certainly have a contingency plan in place just in case they develop a psychotic break that requires intervention. Your support system is crucial here. The best thing that you can do is plan ahead just in case, and be prepared for your support system to take appropriate action if you are mentally not well enough to make decisions for yourself and your baby.

It’s also important here to note that many women are fearful over losing their baby and try to avoid mental health conversations with their doctors. It is important to understand that your baby’s welfare should be first and foremost. Your welfare should be first and foremost. The only way to assure yourself that you and your baby will be well, safe, and healthy, is to deal with medical conditions. Mental health medical conditions are just as important to manage, treat, and cope with for you to be a successful and caring parent. Honesty with medical professionals in advance can help to show them that you care about your new baby and to establish where your mind is before a condition could develop such as postpartum psychosis. You want your mental health care professionals and your doctors to know who you are and what you stand for so that if a serious psychiatric condition develops, they will better understand the changes that have taken place. This can help them to develop a treatment plan for you and your baby.

If you’ve just had a baby and you’re concerned about your own mental health, is it possible that you have postpartum psychosis?

One of the most difficult things about postpartum psychosis is that some of the symptoms involve a confusion about reality. There may be long bouts of time that seemed to be slipping away, confusion about the days or activities, breaks in memory patterns, sudden strange belief systems that take over thinking, and hallucinations that can complicate a mother’s reality. The important thing to do is to focus on early intervention. Postpartum psychosis can come on very suddenly. If you have just had a baby and you are experiencing symptoms that seem to go on the normal exhaustion of new parenting or the normal readjustment for your body, write down your experiences. Put dates, your personal observations, and share with your close support system what your concerns are. If you do this early enough there may be established a starting point for when your symptoms began developing.

If you suspect that you are losing your grip on reality, call your doctor immediately. It is important to address mental health concerns as soon as possible especially when there is an infant involved that is in your care.

What can be done to prevent and/or treat this devastating illness?

I often wonder if Andrea Yates’ condition had been treated and intervention had been made, if all five of those children would have survived. I often wonder if Andrea Yates could have had a healthy and well-adjusted life had her mental health care sufficiently addressed her needs. Today Andrea Yates is in prison. I find it very sad that a mental health condition led to the imprisoning of a woman for life and the deaths of five innocent children.

It is very hard when you are close to a situation, living with a partner, and observing them every day to sometimes notice small changes that turn into big changes. It is shocking how quickly you can adapt to new personality and new behaviors in a partner. It is easier in our minds to try to rationalize what is happening and try to make sense of it on our own than it is to back up and see it as a group of symptoms that work together. The only way that you can do this is to keep good records of the changes that are happening and to work with medical and mental health care professionals who are trained to identify these problems.

If your medical professional is treating you for postpartum depression and you are having symptoms that go beyond postpartum depression, it is important to communicate this to your doctor and stand your ground if you know that something is really wrong. Your partner may have to do this on your behalf. If your partner is not able to do this for you perhaps a trusted friend or family member who understands your psychiatric history can help you get the medical and mental health care that you need.

It goes without saying that if you are having images and thoughts or even planning on hurting your children, that someone needs to intervene on behalf of those children. You should not be left alone with your children if you are experiencing these medical and psychiatric symptoms.

This condition does not mean that you do not love your children. This condition means that you are ill. If you were to have cancer at some point in your body you would work with the doctors to find that place in your body that is sick and treat it. If there is an illness that is inside of your brain that is preventing you from parenting your new baby, then it must be treated. Thankfully, some of the stigma is beginning to come down regarding mental health care. While we press for more understanding and better equality for mental health care and for persons that suffer from psychiatric treatment disorders, we also press toward thorough and adequate treatment.

Postpartum psychosis does not always mean that there will be violent tendencies. Delusions can come in many forms and erratic or irrational behaviors can also be nonviolent. Thankfully the majority falls into this category. But irrational behavior and an inability to make complex judgment calls that are required of parenting a newborn, can interfere with the health and safety of both mom and baby.

Your team of healthcare professionals and mental health care professionals will devise a treatment plan suitable to your condition. This may involve medication, counseling, supportive services, or if required, a hospital stay to complete the diagnosis and develop an ongoing treatment plan.

Here is a comprehensive list of helpful resources if you or someone you know may be suffering from postpartum psychosis:


Postpartum Psychosis

What Is Postpartum Psychosis? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Postpartum Psychosis: Symptoms, Treatment and More

Postpartum psychosis

Recognizing and Managing Postpartum Psychosis: A Clinical Guide for Obstetric Providers

The takeaway here is that the most important thing you can do is to stay alert, communicate with your support system, communicate with your doctors and mental health care professionals, and address a serious psychiatric issue as soon as possible.

This article is brought to you by the blogging contributors at Babienet Parenting Community, a community of caring parents just like you! We welcome you to share your journey with us.


Here are some other Babienet articles on the postpartum topic:

Babienet Blog–Postpartum topics

Author Bio:

Christina M Ward is a mom, grandmother, and writer of lots and lots of words. When she’s not busy obsessing over writing poetry and well-living articles, she is out in nature exploring or doing needlepoint crafts in front of Netflix. She loves books and reading, learning geeky things about nature, and helping other people live their best life.

Christina M. Ward

Babienet blog contributor

Mother and grandmother

Postpartum Psychosis–Here’s What You Need to Know provides an overview of the very serious psychiatric disorder of postpartum psychosis, symptoms, and seeking treatment.