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Postpartum psychosis - Postnatal depression

Postpartum psychosis is a rare but severe form of mental illness. It is sometimes called postnatal or puerperal psychosis. Around 1 in 500 women who give birth get postpartum psychosis. 499 in 500 do not.

Postpartum psychosis often happens ‘out of the blue’. You may experience it even if you have never had mental health difficulties before.

You are most at risk of postpartum psychosis if you have:

  • had it before
  • been diagnosed with bipolar disorder
  • a close relative who has bipolar disorder

Signs of postpartum psychosis

Symptoms of postpartum psychosis begin suddenly. They usually happen within the first 2 to 3 days after childbirth but can begin anytime in the first few weeks.

You may have symptoms of mania or depression, or a combination of both.

Symptoms may include:

  • feeling ‘high’ or ‘on top of the world’
  • racing thoughts
  • being more talkative, active, and sociable than usual
  • finding it hard to sleep or not wanting to sleep
  • being tearful
  • feeling withdrawn and not wanting to talk to people
  • loss of appetite
  • anxiety
  • having delusions – unusual thoughts or beliefs that are unlikely to be true
  • hallucinations – you see, hear, feel, or smell things that aren’t really there
  • mood swings
  • irritability
  • restlessness
  • feeling suspicious or fearful
  • confusion
  • behaving in a way that is out of character for you

You may also have other symptoms of psychosis and thoughts of harming yourself or your baby.

Emergency action required: Contact your GP, midwife, public health nurse or mental health service urgently if:

  • you are experiencing any of these symptoms

They will arrange rapid assessment by the HSE Mental Health Services.

Go to your nearest emergency department (ED) if you cannot get an appointment with your GP.

Advice for partners and families

If your partner or family member is experiencing postpartum psychosis, it can be very distressing.

Your loved one may not understand that they are unwell. You may have to seek help on their behalf.

Emergency action required: Contact your GP, midwife, public health nurse or mental health service urgently if:

  • you are worried your partner or family member has postpartum psychosis

Ask them to arrange rapid assessment by the HSE Mental Health Services.

Take them to your nearest emergency department (ED) if you cannot get an appointment for them with a GP.

Treatment

Postpartum psychosis is usually treated as an emergency. It is important that you get help quickly. Early treatment can help you recover quicker.

The first step in treatment is medicine. These include antipsychotic medications or mood stabilisers. You may need to be admitted to hospital.

When your symptoms have improved, you may be offered support with talking therapy and help with bonding with your baby.

You may be referred to a perinatal mental health service, if this is available in your area.

Page last reviewed: 25 April 2023
Next review due: 25 April 2026