In previous posts we talked about the most frequent affective disorder of postpartum onset: postpartum depression. However, in 1 in 1000 women the affective picture can be complicated, leading to a psychotic episode.
The puerperal psychosis It is an important condition that occurs in the first hours or within the first four weeks after giving birth and that sometimes requires urgent hospitalization.
Its main feature is the sudden onset of delusional ideas, referring especially to the child, auditory hallucinations that can order him to harm the baby, a disorganized language and / or behavior or catatonic and, in general, a Loss of contact with reality.
Sudden mood swings also appear (from great euphoria to a deep depressive mood), anxiety, motor disturbances and difficulty falling asleep or nightmares.
Why do some women suffer?
As usually happens when defining the origin of affective disorders, there is no single cause that can explain the appearance of a psychotic episode of postpartum onset. However, it seems that in most cases these are women with psychiatric background, especially with a story of manic depressive disorder (Bipolar Disorder I).
It also seems to be more frequent in primiparous women, with a history of substance abuse and in those that they have already suffered previously, hence some authors defend the need to start preventive psychopharmacological treatments if they become pregnant again, not only during the period of pregnancy, but also immediately after giving birth.
And, as is the case in Bipolar Disorder, there are genetic factors that influence the predisposition to suffer it, as well as biological factors that play a role that is yet to be determined, as is the case of some neurotransmitters such as serotonin and hormones such as progesterone and / or estrogens.
What can happen?
Normally, all the paintings that imply loss of contact with reality generate a lot of anxiety and fear in the environment. That is why it is important to know that the prognosis of a psychotic episode of postpartum onset is, in general, favorable in a short time, reaching full remission. However, a small percentage of women may eventually develop psychological disorders, such as obsessive or anxiety conditions, hence the importance of following up.
What does seem clear is that the risk of re-developing a psychotic episode in future pregnancies reaches and even exceeds 50% of the time, but the future mother should not be alarmed, because with a correct preventive treatment the symptomatology is considerably reduced.
What to do if it happens to someone close?
Although it does not always imply the same severity, to avoid tragic consequences such as mistreatment of your child or yourself, immediate intervention is required and due to the state of the woman, it is usually a family member or couple who request the medical care. During that time and until the delusions and hallucinations have disappeared, it is convenient that the mother does not take care of her child.
Normally the treatment consists in the administration of psychoactive drugsfollowed by a psychosocial assistance to, among other things, reinstate the mother-child relationship and reduce the possible burden of guilt that may appear after the episode.
Follow-up is essential to ensure proper adaptation to the situation and reduce the likelihood of future relapses.
