The postpartum period begins soon after the delivery of the baby and usually lasts six to eight weeks, ending when the body has almost completely returned to its pre-pregnancy state.
Some new parents are vulnerable to a range of perinatal mental illnesses during this period and beyond, two of which are postpartum depression and, less commonly, postpartum psychosis – a serious medical emergency.
Postpartum ⏐Menopause & perimenopause⏐ Domestic violence ⏐ Perinatal ⏐ Childhood abuse ⏐ Eating disorders⏐ Sexual violence ⏐ Pre-menstrual
In partnership with Action on Postpartum Psychosis
“Before APP existed as a charity, postpartum psychosis (PP) accounted for almost half of all maternal suicides. As APP has grown, so too has national awareness of PP, health professional training, Mother and Baby Unit (MBU) beds, and support services designed to better manage women with PP. The last decade has seen a sharp decline in PP related deaths, and PP became rare in national suicide figures. However, in the post pandemic period, PP deaths are again increasing. We believe this increase has multiple and complex causes and we must do all we can to continue in our mission of awareness-raising and supporting families affected by PP.”
Postpartum Depression
Postpartum depression (PPD) is a mood disorder that many parents (including men and partners) experience after having a baby. It’s a common problem, affecting more than one in every ten women within a year of giving birth and can last for months. If not treated, it can lead to suicidal thoughts. This is different from the ‘Baby Blues’, when the sudden postpartum hormonal and chemical changes can cause a new parent to feel very low for a week or so after birth. The good news is that PPD is treatable and 80% of people affected will make a full recovery. If you have symptoms that go on for more than a couple of weeks, it is important to get the help you need from professionals and to take steps to look after your mental health.
Postpartum Psychosis
Postpartum psychosis (PP) is a serious mental illness that usually occurs in the hours, days and weeks after having a baby. Some people who get PP have no previous history of mental illness, however, if you have a history of bipolar disorder, you might have a higher risk of experiencing PP. It’s important to note that PP isn’t the same as postpartum depression, however, some women with PP may experience depression and anxiety alongside or following the acute symptoms of PP. It affects around 1,400 women every year in the UK but it is eminently treatable and almost all mums recover fully with the right treatment. PP is a serious medical emergency, and it is very important to get the help you need.
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Speak to your GP or healthcare professional to discuss what tests, treatment and support are right for you.
Find resources, peer support, NHS guidance and more on the Action on Postpartum Psychosis help pages.
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It is important to recognise and treat postpartum depression (PPD) as it severely affects day-to-day functioning and can lead to suicidal ideation. PPD also affects the relationship with the baby. Research shows as many as half of cases of PPD go undiagnosed because of conflict in personal privacy and not wanting to disclose these feelings to close family members (Beck, 2006).
When it comes to postpartum psychosis (PP), urgent medical treatment is always required. Therefore, if a new parent is acting unusually and PP symptoms are present/suspected, speak to your GP as a matter of urgency, call 111 or attend an A&E department. If you are concerned about immediate risk to life call 999.
According to the Maternal Mental Health Alliance, 40% of maternal deaths in the first post-natal year were due to mental ill health. Suicide remains the leading cause of direct maternal death in the first post-natal year. It also finds that many of the women who die have faced multiple disadvantages, including mental health problems, domestic abuse and addiction. Having difficulty conceiving or a traumatic birth are also other risk factors for suicide. If you are concerned about someone, encourage them to talk about how they feel and to contact their healthcare professional or one of the resources on this page as soon as possible. PPD is quite common and there are well-established ways to help treat it.
Action on Postpartum Psychosis have a range of resources for families who are supporting someone with PPD or PP.
Healthcare professionals may find useful studies and information on the Action on Postpartum Psychosis research pages.
The Royal College of Psychiatrists have Standards for Community Perinatal Mental Health Services available here
Family Lives have a video channel dedicated to free parenting advice, courses and ideas.
The National Institute of Health have published a paper on the identification and treatment of postpartum depression and psychosis.
Royal College of Psychiatrists guidance on postpartum psychosis.
Early symptoms of PP include:
Acute symptoms of PP are similar to that of bipolar disorder and include:
When Brooke had her first baby, she didn’t ‘feel at all joyful’ and describes facing feelings of panic, dread and sadness. She was overwhelmed and felt disconnected from her baby. Brooke had suicidal thoughts and said she wanted to ‘disappear’, believing her newborn would be better off without her.
She was ultimately diagnosed with Postpartum Depression (PPD) and treated with medication and therapy. She encourages women to realise these are chemical imbalances, out of your control, and to seek help. Brooke advocates for women not to feel embarrassed or ashamed about their struggles, which have the “nothing to do with” your love or feelings towards your child.
“When I got pregnant unexpectedly with my third child, my husband made it clear that he did not want this baby, and he tried to force me to have an abortion. I refused and he told me that the child would be my responsibility. He kept his word. It was a difficult birth, despite it being at home. He did not support me with the baby and left me to cope with two young children and a newborn baby without any support from him, his family or my family (as my family were all abroad). Soon after, he left the marriage and refused to pay maintenance for the children. I was truly alone.
Quickly, I started suffering from postnatal depression, which started escalating. I went to the GP, who was not very helpful and did not offer any support. I tried to get help several times as I was starting to have suicidal thoughts.
Eventually, I was seen by a locum GP who was simply brilliant. She cancelled her other patients that afternoon and just listened to me. She held me whilst I cried. She arranged a Community Psychiatric Nurse to come and see me at home. She ensured I would come back and see her the following week. She was there for me when I could not see a way forward anymore. The psychiatric nurse came every week for several months. She was able to help me see a future for me and my children. She listened to me, she supported me, she helped me move forward. It taught me not to give up if you ask for help and you don’t get it at first. Keep asking, keep looking, help is out there for you.”
A month after the birth of her son, Laura was on suicide watch in a psychiatric ward, experiencing severe delusions due to postpartum psychosis (PP). PP is a mental illness that affects around one in a thousand new mothers, who can suffer delusions, hallucinations, paranoia and manic moods.
Laura has written a memoir, What Have I Done? about her experience of PP and she challenges the idea that being a parent is always blissful and serene. She also wants people to understand that PP is treatable.
Find advice and sources of support for other aspects of women’s mental health.
Learn more about how to have a conversation with someone at risk of suicide.
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