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Puerperal Psychosis: All You Need to Know as a New Mother

Medically reviewed by Ruben Macapinlac, MD, DPPS · Pediatrics · Philippine Pediatric Society

Written by Nikita Bhalla · Updated Sep 07, 2022

    Puerperal Psychosis: All You Need to Know as a New Mother

    After delivering a child and going through a nine-month stretch filled with profound changes in their body, new mothers can become prey to their mind. This, combined with the hormonal whirlpool that pregnancy is, is why there are moms who suffer from Postpartum or Puerperal Psychosis. Though depression is a much relevant condition nowadays, psychosis, on the other hand, is an extremely delicate mental condition that should be treated as soon as it’s visible to the family members.

    Do not make the mistake of confusing puerperal psychosis with madness or aloofness. If not managed immediately, then it can be fatal for the mother and the child. There are various factors that add together to be diagnosed as puerperal psychosis. It is, therefore, necessary to understand what signs to look for and how they need to be handled.

    Let us take a look at deconstructing puerperal psychosis:

    Difference between Puerperal Depression and Puerperal Psychosis

    puerperal psychosis

    The major difference between psychosis and depression is that the former includes losing touch with reality. This means that the person, who is suffering from any kind of psychosis, will, therefore, be hallucinating or making sense of a reality different from those who surround them. This can be delusional and often turn into extreme situations.

    Puerperal psychosis means that the new mother will be sad or non-enthusiastic about this new addition to her life and consequently this sadness turns into destructive thoughts. Puerperal psychosis can lead to permanent mental damage if the right treatment is not applied. And this is purely dependent and differs from woman to woman on their specific conditions.

    Postpartum depression, on the other hand, is defined as when the mother is constantly feeling demotivated, sad, gloomy, miserable, and regretful of having a child. The symptoms of this can set in even after a month of delivery. Women with postpartum depression can also have suicidal tendencies.

    Both puerperal psychosis and postpartum depression can overlap at some point. Experts are unable to name this phase and it is not necessary that women will go through either or both at the same time. But, if you see the following symptoms mentioned in the below paragraph, consult a psychiatrist right away.

    Symptoms of Puerperal Psychosis

    The symptoms of puerperal psychosis can be similar to postpartum Depression and postpartum Blues, hence talking to a therapist and a psychiatrist will help you identify how to get maximum help for this condition:

    • Constant Sadness
    • Guilt
    • Gloomy and erratic behavior
    • Insomnia
    • Extreme fatigue
    • No enthusiasm
    • Confusion
    • Hallucinations and delusional actions
    • Weak bond with the baby or no connection with the baby at all
    • Irritation and agitation
    • Irregular eating habits and massive appetite changes
    • Feeling no emotion
    • Violent and catastrophic thoughts

    Puerperal psychosis can have similar episodes to a person with bipolar disorder. This is because the mother is almost living in a negative fantasy world with aggressive thoughts that can hurt the baby before anyone else. The above-mentioned symptoms can often lead to more dangerous situations.

    Diagnosis of Puerperal Psychosis

    The diagnosis of puerperal psychosis should be done specifically by a psychologist or a psychiatrist, depending on how severe the problem is and whether medicines would be required to treat it.

    As the thyroid level of the body is haywire post-delivery, the concerned doctor will check the levels of the same. Such erratic mood issues could be a byproduct of the thyroid hormones as well.

    During this process of diagnosis, the doctor will most likely ask the new mother questions regarding their current feeling plateaus. It is advised to let the doctor know whatever you are feeling and not shy away. A proper diagnosis can help you in the long run and potentially save your relationship with your baby.

    Another way of diagnosis for puerperal psychosis is through a depression or psychosis test, which will determine the degree of this condition. These are routine questions, which analyze how deep your problem could be and what could be given for treatment.

    However, it is important to remember that none of the above-mentioned virtual and actual tests are demeaning in any way. Counsellors and psychiatrists are always the best options to help eradicate an issue, which may cause permanent damage.

    Risks involved

    Sometimes, due to existing factors, there are increased chances of puerperal psychosis in women. These can potentially lead to a shift in mood and consequently to dull and gloomy times. These are initial times to take note of by the family members, as well as ask the pregnant women about her family history.

    Following are elements that can possibly intensify the risks of puerperal psychosis:

    • Family history of bipolar disorder. This is a genetic disorder that runs in the family.
    • Family mental history of schizophrenia or pre-condition of schizophrenia
    • Puerperal psychosis or depression during the first pregnancy
    • If the pregnant woman concerned has stopped taking her medication for any other mental issue

    Treatments for Puerperal Psychosis

    There are multiple ways of going about the treatment for puerperal psychosis. These are in-the-hospital treatment, medication to be taken at home, therapy, and ECT.

    In the hospital

    Since puerperal psychosis is detected within the first three weeks of delivery, this course of treatment can begin right from the hospital.

    If caught in time, then the baby and mother could be kept in separate wards till the mother stabilizes. This does not mean that the two will be kept far for a long time. Mothers will get to meet their babies every day.


    There are different types of medications used to treat puerperal psychosis. These are antipsychotic drugs, antidepressants, and mood stabilizers. They are used and customized on the basis of conditions. Please consult a doctor before taking any of the three.


    Psychotherapy is the most common method of treatment for mental conditions like puerperal psychosis. Conversation with a neutral person can help resolve a lot of unspoken issues, and thereby bring about a change in behavior. Before opting for medication, ask your doctor if psychotherapy should be the first step towards mental healing.

    ECT or Electroconvulsive therapy

    This process involves using electromagnetic stimulation to balance brain chemicals that have disordered. Though, this is the last option and is only used in extremely severe depression or psychotic cases.

    As the family of the new mother along with the husband should always pay attention to her. This will help notice any signs of the oncoming puerperal psychosis and catch it at an early stage.

    Therefore, look for anything unusual during the delivery and make sure to report it to the concerned doctor. This will keep both the mother and child safe.

    Learn more about managing the postpartum period here.


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    Ruben Macapinlac, MD, DPPS

    Pediatrics · Philippine Pediatric Society

    Written by Nikita Bhalla · Updated Sep 07, 2022

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