postpartum psychosis

[jt92]

If it is at all possible I am looking for some reassurance and advice from someone with personal experience of postpartum psychosis on behalf of my wife. This is personal so she feels more comfortable if I write this on her behalf.

My wife has Generalised anxiety disorder and depression. She is now concerned that having these increases her risk of getting postpartum psychosis if we were to have a second child .We already have a 4 year old son and my wife did not experience this after the birth of our son but did experience anxiety and post natal depression.There is a family history of post natal depression but not the psychosis.

We would like to have a second child but the vague information about how a mental health history could heighten the risk has now made my wife hesitant .so if anyone with experience of this could comment on what happend with them and how the issue was dealth with that would be amazingly helpful in my efforts to reassure her.. Her anxiety is mainly around the issues of hospitlization and social service involvement if she were to get this,

Looking for responses from other people based within the UK with experience of postpartum psychosis if possible, Many thanks in advance

Hi I'm bipolar and I had a 50% chance of getting severe post partum depression and/ or psychosis when I had my daughter. I got both.

If you have bipolar or other conditions that come with psychosis risk there is a 50% chance of getting it post partum. Women that have previously had post partum pyschosis or have a mother or sibling who have had post partum psychosis have a raised risk but most women have a 1 in 1000 risk.

Mine started around 3 weeks after having my daughter. It surrounded my daughter not being real. I was offered a bed in a mother and baby unit when she was 10 weeks old but we agreed a treatment plan that allowed me to stay in the community. I saw my HV every other week and my cpn from the perinatal mental health team in person every other week and had a phone call in the other week. The HV arranged for me to have a baby massage course and did a referral to the infant parenting service for therapy around my bond with my daughter. Unfortunately the treatment in the community didn't help and by 10 months it was treatment resistant and i didn't believe my daughter was mine and /or had been swapped. I went into a mother and baby unit for 10 weeks. We had a new treatment plan and this took away the psychosis but it was another year before I recovered completely from the depression.

It took until my daughter was 3 to consider a second but a year on I'm pregnant with number 2. I will have a lot of support in pregnancy and afterwards. I probably would go into hospital earlier if I had severe depression or psychosis again. This time around my risk is at least 50%

Dear JT92

Diagnostic confusion can drive unnecessary fears.

You have referenced three entirely separate groups of psychiatric disorders. Anxiety, mood and psychosis.

Mood episodes that are severe - Depression or Bipolar Affective Disorder Type 1 (BPAD) - may include psychotic phenomena. These include delusions (false and unshakeable beliefs out of keeping with social background) and hallucinations (perceptions without a stimulus in any of the five senses).

Post-Partum Psychosis (PP) - as you may know - is fairly rare. It occurs in the population about 2:1000 deliveries.

Key risk factors include BPAD, a personal history of PP or a family history of PP.

Any one of the risk factors above increases one’s risk considerably to approximately 1:5 deliveries. Two of the three key risks would need to be present to increase the risk to 1:2 or 50%.

Generalised Anxiety Disorder (GAD) or Depression would not increase the risk of PP to a comparable degree.

Other relatively lesser risk factors include a late first pregnancy (not in issue with your wife), a prolonged or traumatic labour or of course any risk factor present during pregnancy for psychosis in general.

That said, GAD itself can be awful and would drive any number of fears related to any possible future pregnancy. Reinforcing prior learnt coping mechanisms or seeking a medical review for the GAD may be useful and certainly worth a conversation with one’s GP or, if seeing one, Psychiatrist.

I wish you well.