As much progress as we've made in having conversations about maternal health, we tend to forget that mental health is a huge part of the discussion.
"It’s not easy to admit that the worst time of your life was when your baby was born," Dockrill wrote in a blog post, explaining that she went through a period of experiencing "mania, mood swings, insomnia, delusions, paranoia, anxiety, severe depression with a lovely side order of psychosis."
Postpartum psychosis, unlike postpartum depression, is extremely rare and affects about 1% of the population (while postpartum depression affects 10-20% of the population).
"[Postpartum psychosis] represents a psychiatric emergency," Marra Ackerman, MD, clinical assistant professor of psychiatry at NYU Langone Health, told us earlier this year. "Patients who develop this set of symptoms need to be taken to an emergency room and admitted psychiatrically almost 100% of the time, because it carries a very high risk of suicide and infanticide."
Usually, the symptoms are distinctive, and according to the UK's National Health Service, they appear within two weeks of giving birth or, more rarely, several weeks after the baby is born. Patients may lose touch with reality, have hallucinations, or go into manic moods.
Karen Kleiman, MSW, LCSW, founder of The Postpartum Stress Center, says that postpartum psychosis is a severe mental illness that requires emergency intervention and hospitalization that typically lasts several weeks (though treatment varies from person to person). And when someone is released from the hospital, she says, they need to follow up with ongoing medication and intensive outpatient therapy and support.
Women at high risk should be monitored identified during pregnancy and referred for psychiatric care.
Karen Kleiman, MSW, LCSW
"As with any mental illness a patient is in the clear when she experienced a significant reduction in symptoms, distress, and interference in functioning," she says. "With postpartum psychosis, she will experience a return to reality with less delusional thinking, less paranoia, her thoughts will stop racing, she will be less hyperactive and better able to sleep."
But as someone recovers, they're still at risk for depression, and should continue with therapy and support until doctors think the patient is fit to stop. Once someone experiences a postpartum psychosis episode, Kleiman says, they have a 50% risk of going through it again.
"Women at high risk should be monitored and identified during pregnancy and referred for psychiatric care," she says.
The good news, however, is that Kleiman says that when postpartum psychosis is identified, "the prognosis is generally good for a full recovery."
If you are experiencing postpartum depression or postpartum psychosis, please call the Postpartum Support Helpline at 1-800-944-4773.