Postpartum Psychosis – how does it affect a family?

Postpartum Psychosis – is a pretty stark term and scary for new parents facing all the other pressures and changes that can accompany the arrival of their first baby.

But postpartum psychosis is rare for a first time mother who has had no prior mental illness: about 1 in 1000 births. Women and their partners may worry about the causes and how to avoid these. These are clearly complex and include the obvious things such as the sudden changes in body shape, hormones, lifestyle and the loss of sleep.

For some women, the pregnancy also opens up a previously closed story on conflicts about dependence when faced with the responsibility of taking care of this little person who is so totally dependent on her. The good news is well known: most postpartum psychoses resolve in a matter of weeks, and may not recur, although in a proportion they do with a second pregnancy.

Although this is positive, the dramatic and sometimes extreme changes in the mother’s behaviour can still leave their effect, both on herself, as well as on her partner and other children. She may be shocked when remembering her thoughts or the possible actions that played out in her mind. She may also feel ashamed, and for some time, doubt and question her feelings about a myriad of things.

Her partner – whether male or female – may feel he or she has suddenly been introduced to someone they do not know, and the shadow of that may carry over into their relationship, despite being told that it was a sudden and curable illness.

Something similar may also happen to any older children, who may not only feel a loss of trust in a mother they were close to, but also feel both angry with the new baby, as well as feel guilty about that, and even blame themselves for what happened to their mother. Any normal previous argument may then be blown up in their minds and used as the reason for the cause of her breakdown.

So, when it is brief and sudden, the parents and children need, if possible, not to sweep what happened under the carpet, but talk to each other, and share what it was like for each person individually, as though they had all been through a storm together. However, if this illness happened on the basis of a previous or even a current mental illness then the chances of a cure within a few weeks are less.

In this case it needs to be responded to like any other mental illness with professional and family support for the mother and support also for the partner and children. This is what should happen. Of course, it is more complicated, because if there were conflicts in the partner relationship these may have added to the severity of the illness. In addition, the children may have become hyper-alert already, monitoring their mother for signs of something going wrong.

So, if you are a friend or relative what advice can you offer?

  • Be open about what happened and encourage the family to share their experiences with each other
  • Be respectful of the mother’s possible need for distance and don’t constantly question her
  • Discuss together what may be the current stressors and how these might be avoided or minimised
  • Try not to be afraid of what others outside the family may think or say, and be clear that this could happen to anyone
  • Make sure that each partner takes regular leisure time for themselves and that the children have ‘lives outside’ the family
  • Accept outside help from family, friends, and professionals – so long as sensitively offered