Having a baby can bring a lot of emotional ups and downs that can be difficult to put into words. While many parents find themselves feeling sadness, guilt, and anxiety at times after the birth of their child, it’s important to understand when these feelings may be symptoms of postpartum depression and postpartum psychosis. These conditions vary in severity and can affect a mother’s thoughts, emotions, and ability to feel connected to her new baby.
In this guide, you’ll find the most common symptoms of each condition, learn the key differences between them, and discover what to do next if you suspect you or a loved one need extra support.
If you or someone you love is in immediate danger, call 911 or go to the nearest emergency room now.
Other crisis and support resources:
- 988 Suicide and Crisis Lifeline: call or text 988
- Crisis Text Line: text HOME to 741741
- National Maternal Mental Health Hotline: call or text 1-833-TLC-MAMA (1-833-852-6262)
- Postpartum Support International Helpline: 1-800-944-4773
What Is Postpartum Depression?
Postpartum depression is a mood disorder that usually develops gradually in the first few weeks after giving birth, but can sometimes come on up to a year afterwards. It shows up as persistent sadness, anxiety, and exhaustion, along with difficulty bonding with your baby and a loss of interest in things that usually bring you joy. It’s distinct from the “baby blues,” which involve similar feelings of sadness and worry but resolve on their own within about one to two weeks as your hormones adjust after giving birth.
Postpartum depression affects about 1 in 8 mothers, making it one of the most common complications of childbirth. Karin Lindquist, a therapist at Cornerstone Healing Center’s Phoenix outpatient treatment center, described what it looks like in a recent Arizona news interview: “With postpartum depression, it’s that drastic drop into a low where you’re just in the pits.”
If you’re the one experiencing these feelings, you’re not alone and you’re not failing in your new role as a parent. If you’re a partner or family member reading this, know that the person you love may not recognize these symptoms in herself, even when they’re obvious to you.
The good news is that postpartum depression responds well to mental health treatment. Therapy, medication, and practical support all make a difference. Seeking out support is not a sign there is something wrong with you. It is a sign that you are brave enough to ask for help.
What Is Postpartum Psychosis?
Postpartum psychosis is a psychiatric medical emergency that requires immediate hospital-level care. It involves a break from reality and is not simply a more intense version of sadness, depression, or anxiety.
Someone experiencing it may hear or see things that aren’t there, believe things that aren’t true, or experience rapid shifts in their mood. Karin Lindquist described it this way:
When you think of psychosis, you think of hearing voices, seeing things that are not there, maybe sometimes even feeling things that are not there. There are so many other parts to it where it might be rumination on thoughts, having delusions. I kind of think of it as like your teleprompter getting stuck.
While postpartum psychosis is rare, it does happen more often than most people realize. As Karin put it in her interview, “When it comes to psychosis, it’s actually a lot more prevalent than what we give it credit for. It’s one in every thousand, maybe even two in every thousand women.”
One of the most significant known risk factors for developing postpartum psychosis is a history of bipolar disorder or a related condition. A personal or family history of psychosis raises your risk as well.
It’s important to remember that postpartum psychosis isn’t the next step in a progression if postpartum depression goes untreated. These are separate conditions with different underlying causes, different symptoms, and different treatment needs.
What Is the Difference Between Postpartum Depression and Psychosis?
There are many key differences between postpartum depression and postpartum psychosis to be aware of. Learn about what separates these conditions from each other.
Postpartum Depression | Postpartum Psychosis | |
|---|---|---|
Symptoms | Mood-based: persistent sadness, anxiety, guilt, difficulty bonding with your baby | Break from reality: hallucinations, delusions, disorganized thinking, extreme behavioral changes |
Onset Timeline | Builds gradually, most commonly surfacing within the first three months after delivery | Comes on quickly, typically appearing anywhere from 24 hours to three weeks after delivery; clinicians watch closely when a new mother has gone 48 hours or more without sleep |
Prevalence | Affects about 1 in 8 mothers | Affects roughly 1 to 2 in every 1,000 mothers |
Type of Care Needed | Usually treated on an outpatient basis with therapy, medication, and support | Almost always requires hospitalization for immediate stabilization and safety monitoring |
Risk Level | Serious and treatable | A psychiatric emergency requiring immediate care |
Postpartum Depression vs. Psychosis Symptoms
When considering whether you or a loved one have postpartum psychosis vs postpartum depression, it’s important to understand that each condition has their own distinct set of signs. Though a list of symptoms does not replace a professional diagnosis, it can be helpful when determining whether it’s time to reach out for help for yourself or whether you need to have a compassionate conversation with a loved one. Some symptoms include:
Postpartum Depression Symptoms
- Persistent low mood or frequent crying
- Overwhelming anxiety or panic
- Trouble sleeping, even when your baby sleeps
- Difficulty bonding with your baby
- Feelings of worthlessness or guilt
- Withdrawing from family and friends
- Loss of interest in things you used to enjoy
- Thoughts of harming yourself or the baby (contact a doctor immediately if these occur)
Symptoms vary in intensity, and not everyone experiences all of them. If you recognize even a few of these symptoms in yourself or your partner, reach out to your OB, midwife, or primary care provider, or contact the Postpartum Support International helpline for guidance.
Postpartum Psychosis Symptoms
- Hallucinations, including hearing voices or seeing things others cannot
- Believing things that are not true (delusions), sometimes involving your baby
- Extreme agitation or restlessness
- Rapid or dramatic mood shifts, including elation followed by confusion or fear
- Disorganized or incoherent speech and thinking
- Severe inability to sleep that is not explained by the baby’s schedule
These are signs of a psychiatric emergency. Do not wait to see if they will resolve on their own.
Call 911 or go to the nearest emergency room now.
Can Untreated Postpartum Depression Lead to Psychosis?
Postpartum psychosis is not the next step if postpartum depression has gone unnoticed or untreated. It’s a separate condition that tends to emerge rapidly and has a strong association with bipolar disorder or a personal or family history of psychosis. It is not simply depression that has gone on for too long.
That being said, leaving postpartum depression untreated can cause symptoms to become more intense and make it harder for a new parent to care for their baby and themselves. It is important to seek treatment for postpartum depression as soon as you can.
Risk Factors: Who Is More Likely to Experience Each Condition?
The risk factors of postpartum psychosis vs postpartum depression differ and are important to be aware of when considering whether you or a loved one are struggling with one of these conditions. Known risk factors include:
Postpartum depression risk factors:
- A previous history of depression or anxiety
- Limited social support
- Relationship stress
- A difficult birth experience
- A history of trauma
- Sleep deprivation
Postpartum psychosis risk factors:
- A personal or family history of bipolar disorder
- A personal or family history of psychosis related to a different condition
- A personal history of postpartum psychosis in a previous pregnancy
- A history of schizoaffective disorder
While these factors increase the risk of developing one of these conditions, they don’t guarantee it. Postpartum psychosis can occur in first-time mothers with no prior psychiatric history, though this is less common. Whether you have risk factors or not, it’s important to seek help if you have concerns.
If you’re pregnant and have bipolar disorder or a history of postpartum psychosis, talk with your psychiatrist before delivery about a monitoring and prevention plan.
Treatment Options: What Does Help Look Like?
Both postpartum depression and postpartum psychosis can get better with the right care. You also don’t have to figure out exactly what kind of help you need all on your own. That’s what your care team is for. Learn more about what treatment may look like for these conditions.
Treating Postpartum Depression
If you’re dealing with postpartum depression, treatment usually starts with talking to someone. Therapy, especially cognitive behavioral therapy or interpersonal therapy, helps many people work through the heaviness and start feeling like themselves again. For some, medication may be part of their treatment, and many antidepressants can be compatible with breastfeeding. Your doctor can walk you through what’s safe for you and your baby.
Peer support groups can also help more than you might expect. Sitting in a room with other parents who understand exactly what you’re going through can offer significant relief for many people. Recovery from postpartum depression is very possible with the right support and treatment.
Treating Postpartum Psychosis
When you’re experiencing postpartum psychosis, the first priority is safety, which often means a hospital stay to get you stable. This can be frightening to hear, but it’s the right kind of care for a condition that moves fast and needs close monitoring.
Treatment typically includes mood stabilizers, antipsychotic medication, and close supervision from a psychiatric team. Therapist Karin Lindquist wants families to know this isn’t as frightening as it sounds:
It’s not this big scary thing where they’re going to take away your kids. They’re going to be there to help. And postpartum psychosis is completely reversible.
With treatment, most people recover from postpartum psychosis. The acute phase is serious and can be frightening, but it does not have to be the end of the story.
Supporting a Loved One Who’s Struggling
If you’re supporting a partner or loved one, you don’t have to fully understand the clinical side of it in order to help. Karin described effective support in her interview as “Giving mom a little bit of a break. Maybe you want to go take a shower, I’ve got your baby… let me make you a handful of meals you can just slap in the microwave.”
Your job as a support person is to show up, help create a calm and safe home for the transition back from the hospital, and help your loved one follow their treatment plan. You’re not meant to manage this alone, and no one expects you to.
If you’re still not sure whether what you or someone you love is going through is depression or psychosis, don’t wait to find out. Reach out and get evaluated. It’s always better to ask and be reassured than it is to wait until it has become a serious situation.
Get the Care You Deserve
Reach out to our team to learn about our treatment options for postpartum depression and psychosis.
What to Do If You Think Someone You Love Has Postpartum Psychosis
If you’re reading this article because you’re scared that someone you love is experiencing postpartum psychosis, do not wait to seek care. Take the appropriate steps to make sure your loved one stays safe.
- Don’t leave the person alone, especially not alone with the baby.
- Call 911 or go to the nearest emergency room. Don’t wait for a scheduled appointment.
- Tell the emergency team you’re concerned about postpartum psychosis specifically, so they can prioritize care appropriately.
- If possible, have someone else watch the baby while you accompany your loved one.
It can be hard to accept that something this serious might be happening, but acting quickly is the safest thing you can do. Postpartum psychosis is treatable, and getting help fast improves outcomes. This is frightening and exhausting for you too, and support exists for families, not just for the person who gave birth.
Therapist Karin Lindquist offered this note for anyone in this position who is worried about being judged or feeling ashamed: “There are so many support groups. There are so many people who are willing to listen and hear you out and give you that grace and space.”
You are not overreacting. If you’re seeing the signs of postpartum psychosis, get help now.
Taking the Next Step
Postpartum depression is a serious but treatable mood condition. Postpartum psychosis is a medical emergency requiring immediate care. When determining whether you or a loved one are struggling with postpartum depression vs postpartum psychosis, it’s vital to recognize that they They are different conditions, and they call for different responses, but both are treatable.
Whether you’re the parent experiencing symptoms or the partner watching someone you love, trust what you’re seeing and reach out. The postpartum period can be one of the hardest seasons of life. Whatever you’re facing, help exists and recovery is possible. Cornerstone Healing Center is here for you. Verify your insurance and call our team to learn more about treatment options.
If you or someone you love is in immediate danger, call 911 or go to the nearest emergency room now.
Other crisis and support resources:
- 988 Suicide and Crisis Lifeline: call or text 988
- Crisis Text Line: text HOME to 741741
- National Maternal Mental Health Hotline: call or text 1-833-TLC-MAMA (1-833-852-6262)
- Postpartum Support International Helpline: 1-800-944-4773
