An illustration of a woman going through postpartum
An illustration of a woman going through postpartum

Puerperal Psychosis: Rare but serious mental condition

That an illness or a disease condition is rare does not mean it is not real.

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Such a reality becomes stark for someone who is affected by that rare condition and in most cases, such an occurrence has negative cascading effects not only on close family members but also on a community, not to talk about the affected person’s working life.

Puerperal psychosis is one such condition that is rare yet it has real devastating effects on those affected, their marital life, working life and their new-born babies. What is puerperal psychosis.
   

Puerperal Psychosis 

This condition is also called postpartum psychosis. It is a rare but serious mental health condition that affects women soon after they have given birth to a baby hence it is called postpartum or postnatal psychosis.

Psychosis itself basically refers to loss of sense of reality. It is a collection of symptoms that affect the mind, and the affected person demonstrates loss of contact with reality. As such, the affected person’s thoughts and perceptions are disrupted and he or she may have difficulty recognising what is real and what is not.  

A woman who has postpartum psychosis, for example, may see or hear things that are not there (hallucinations), feel everyone is against her (paranoia) and experience powerful delusions (beliefs that do not match with reality).

Postpartum psychosis can cause serious and major changes in the affected woman’s mood and behaviour. It means that every woman who gives birth is susceptible to postpartum psychosis, with the greatest risk being women who already had some mental condition or have a family history or mental illness or they had in the past experienced postpartum psychosis.

However, postpartum psychosis can occur even in the absence of these factors. This condition can occur suddenly even within a few hours after the woman has given birth.

Symptoms may take weeks or months to manifest more noticeably. A postpartum psychosis patient usually needs a specialised psychiatric treatment to recover. 

Incident Rate

According to health experts, the incidence of postpartum psychosis is about one or two in every 1,000 lactating mothers. This makes the condition rare, but it is serious and difficult to fight when it occurs. Incidence or incident rate of a disease is the frequency of new cases of a disease condition or events over a specified period for the population at risk for the disease or event.

In medical practice, therefore, incidence is usually the newly identified cases of a disease or condition per population at risk over a specified timeframe.  

Symptoms and Diagnosis

As indicated earlier, postpartum psychosis causes changes in the mood and behaviour of the affected lactating mother. The affected woman’s mood may become manic (overexcitement), psychotic (altered sense of reality) and/or she may experience depression (low energy and mood).

The specific symptoms of postpartum psychosis may include but not limited to:  
•    extreme sudden mood swings
•    being aggressive, violent or agitated
•    Incoherent or a nonsensical speeches and finding it hard to concentrate
•    feeling paranoid, having irrational or delusional thoughts or beliefs
•    having hallucinations and changes in sense perception (like smelling, hearing or seeing things that are not there)
•    not being able to sleep (insomnia), sometimes for days 
•    responding in an unusual or inappropriate way towards her baby
•    thinking of or planning to harm her or her baby
•    in situations where the baby dies, a postpartum psychotic mother refuses to accept this reality.

Diagnosis and Treatment

Advisedly, if a family or husband notices these changes in a woman who has just given birth, it is important to help the person to seek medical or psychiatric care. This is because, postpartum psychosis is a very serious mental illness, its diagnosis must be made by a doctor or a psychiatrist who can offer the most appropriate treatment for the condition.

Delaying medical or psychiatric care for a postpartum psychotic can worsen her situation. Just like any mental health condition, postpartum psychosis can be treated. A timely and successful treatment leads to full recovery.

However, the treatment of this condition can take weeks or months, depending on the symptoms and how well the patient responds to treatment. It may take time and further treatment for the patient to recover fully.

Medications such as antidepressants, mood stabilisers and antipsychotics may be prescribed and appropriately administered to the patient over time. Psychological therapies such as cognitive behaviour therapies (CBT) may also help the recovery process.

Electroconvulsive therapy (ECT) can also help the patient. It involves a process that stimulates brain neurons with an electric current to treat mania, psychosis and severe depression. 
Depending on the severity or otherwise of the condition, one or a cocktail of the foregoing treatment options may make the patient recover.

During treatment, the baby may be separated from the mother or the mother is monitored closely not to harm the baby. 

Conclusion

Postpartum psychosis is a rare but a serious mental illness that affects women after they have given birth (postpartum). This condition must not be stigmatised. It must be treated as a medical emergency or else it will get worse rapidly and risk the safety of the mother and baby.

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Advisedly, therefore, a suspected loved one showing symptoms of postpartum psychosis may need to arrange urgent medical assessment and psychiatric treatment for the patient. 
Delaying treatment can make things complicated and recovery may take a long period.

An episode of postpartum psychosis is sometimes followed by a period of depression, anxiety and low confidence. It might take a while for the patient to come to terms with what happened. 

The writer is a Hospital Administrator 
Email: [email protected] 

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