Postpartum psychosis

Postpartum psychosis is a condition in which a woman is plagued by a manic syndrome to do something to herself or her child. It is caused by complications that arise after childbirth. It is important that a woman with problems of this nature be under the supervision of a highly qualified specialist. This condition is not always met. Because not all mothers suspect that they have a problem. And it is not always easy to recognize the symptoms of psychosis.

ICD-10 code

Other maternal diseases classified elsewhere but complicating pregnancy, childbirth and the puerperium (O99). This category includes conditions that have led to complicated childbirth. The cause may also be hidden in the care provided by obstetricians. Infectious and parasitic diseases are excluded from this, as well as injuries that originate during childbirth.

• O99.0 Anaemia complicating pregnancy, childbirth and the puerperium - Conditions classified to D50-D64
• O99.1 Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy, childbirth and the puerperium. Conditions classified to D65-D89
• O99.2 Diseases of the endocrine system, nutritional disorders and metabolic disorders complicating pregnancy, childbirth and the puerperium.
• O99.3 Mental disorders and diseases of the nervous system complicating pregnancy, childbirth and the puerperium.
• O99.4 Diseases of the circulatory system complicating pregnancy, childbirth and the puerperium.
• O99.5 Diseases of the respiratory system complicating pregnancy, childbirth and the puerperium.
• O99.6 Diseases of the digestive system complicating pregnancy, childbirth and the puerperium.
• O99.7 Diseases of the skin and subcutaneous tissue complicating pregnancy, childbirth and the puerperium.
• O99.8 Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium.

Causes of Postpartum Psychosis

The main reasons are rooted in somatic and psychogenic factors. Thus, aggravating heredity plays a huge role. In this case, we are talking about the presence of mental illnesses and disorders in one of the relatives. The problem can arise against the background of difficult childbirth. Especially if they were accompanied by strong physical stress. This leads not only to mental disorders, but also hormonal changes. Often the problem affects the vegetative system and leads to shifts. As a result, psychosis occurs.

Difficult and protracted labor, protein shifts and blood loss entail a number of deviations. Dehydration, changes in blood pressure and liver dysfunction can affect psychosis. Even ordinary fatigue, lack of sleep and a difficult family environment can hide everything. Finally, not all women are ready for childbirth and motherhood. This depresses them and leads to various thoughts in their heads. Some personal qualities can make their contribution. This can be suspiciousness, anxiety and previous severe mental trauma.

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Pathogenesis

It should be noted that there are no obvious pathomorphological and pathophysiological changes. The main specificity of the disorder is the presence of a depressive and tense state in the last weeks of pregnancy. The representative of the fair sex begins to worry, think about the upcoming birth and wind herself up. Sometimes this condition is complicated by the presence of family problems. All this affects the pregnant woman psychogenically. Certain risk factors complement the situation.

If during pregnancy the level of hormones responsible for blood flow increases sharply, and at the moment of birth the uterus contracts, then at the end of the process there is a normal emotional decline. This leads to the woman feeling uncomfortable. She does not understand everything that is happening. The main thing is to support her and not let emotions take over. In this case, the situation will begin to improve and the body will return to normal functioning.

Symptoms of postpartum psychosis

The first thing a woman starts to be bothered by manic manifestations. Mania is a state of morbidly heightened arousal. It is characterized by the presence of obsessive ideas, as well as ideas that are not based on any real events. Mania can be paranoid. In some cases, megalomania occurs, but this is not typical for a young mother.

Hallucinations. This symptom is the most common. Auditory hallucinations are the most common, visual hallucinations are not so common.

A woman may think abnormally. Her condition changes, she becomes severely depressed. There is no way to organize herself, to start thinking normally. It becomes difficult for a woman to formulate her own opinion. Conversation becomes incoherent.

Lack of adequate self-esteem. Often women are unable to assess their condition. Therefore, relatives should convince the victim to see a doctor. Naturally, it will not be possible to avoid quarrels and scandals. But, nevertheless, there is a chance to alleviate the condition of the young mother. In addition, the woman does not want to eat at all. Finally, the most severe symptom is thoughts of suicide and the desire to do something with your own child. This sign is one of the most common.

First signs

The first symptoms begin to manifest themselves within the first few weeks. The woman is constantly in a bad mood, especially worse in the morning. Waking up too early, appetite is reduced. In addition, there is always a feeling of guilt, self-accusation without reason. There are many negative thoughts in the head, up to and including suicide.

It is easy to notice psychosis in a woman. She behaves inappropriately with the child. He irritates her, constant screams are heard. The woman is capable of injuring the child. Impaired concentration, as well as hesitation or indecision when making important decisions are not excluded.

The woman suffers from a mental disorder called anhedonia. It is characterized by the absence of a sense of joy. Anxiety, excessive concern about one's own condition and the health of the baby appear. Irritability and nervous overexcitement are always present. Sleep is disturbed, interests in life are lost, excessive fatigue appears. Suicidal thoughts rarely arise. Women refuse to have sex because they are afraid of getting pregnant again.

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Acute postpartum psychosis

This condition is often associated with difficult childbirth. Women receive so-called birth trauma and cannot recover from it for a long time. This occurs during prolonged childbirth, which lasts from several hours to a day. Mental changes do not occur immediately, and this is where the main danger lies. The first manifestations can be detected after several days or weeks.

After being discharged from the maternity hospital, the young mother returns home in a depressed mood. Instead of joy, she is overwhelmed with negative emotions. She is not happy about the birth of the child, and one can notice both indifference and aggression towards him. The attitude towards relatives can also change over time. Even the slightest problems with sleep can indicate the presence of a problem.

Over time, the woman's behavior becomes strange and even unusual in relation to the child. Thus, the mother may not approach the baby at all or, on the contrary, not leave him for a minute. Sometimes she begins to think negatively about one of her relatives, like, they allegedly want to harm the child. Thoughts appear that they are trying to steal or kill the baby. The most dangerous thing is that the woman can start treating the child for a non-existent disease without reason. In this case, very strong medications are used, which can cause irreparable harm.

In addition to delirium, hallucinations appear over time. As a result, the young mother is no longer able to be responsible for her actions. She can easily throw the baby out of the window or cause him irreparable harm. If the woman is not helped in time, her condition will significantly worsen. The changes can progress, leading to unpredictable consequences.

Postpartum schizophrenic psychosis

This condition is especially dangerous. After all, in addition to the fact that a woman experiences difficulties associated with the birth of a baby, she begins to have serious thoughts about getting rid of it. Often, such a condition can be caused by taking steroid hormones. Usually, they try to eliminate psychosis with the help of hormonal drugs, but this can cause its own consequences. Thus, there have been cases where a woman acquired acute schizophrenic psychosis. In such a state, the patient is constantly overwhelmed with fears and hallucinations appear.

True postpartum psychosis is the main type of postpartum schizophrenia. This condition can occur at absolutely any age, regardless of the number of births and their severity. Non-specific fragility of the nervous system, anxiety and neurotic disorders may manifest themselves. In addition, conflict, which is closely related to the topic of childbirth, may sharply increase. It should be noted that the picture of psychosis is not uniform. Each individual case has its own problems and symptoms. The main thing is to notice deviations in time and prevent the situation from worsening.

Consequences

The most dangerous consequence in this case is causing irreparable harm to the child. This condition is not capable of affecting the woman's health. Simply put, it will not go beyond a mental disorder. Over time, it can fade away and the young mother returns to her normal life. But, she needs to be given the appropriate help. After all, without it, there is a risk of causing serious injuries to the baby.

Psychoses come in different forms. Some women simply sleep poorly, eat poorly, and do not enjoy their lives at all. This is probably the safest form. When obsessive ideas appear, a young mother yells at her baby, beats him, she should be given medical assistance. This condition is typical for a schizophrenic episode. Often mothers try to throw the baby out of the window, etc. This is very scary. When the woman comes to, she may not even remember her own actions. Therefore, it is important not to let her harm either herself or the baby. If help is provided in a timely manner, there will be no consequences.

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Complications

Postpartum psychosis is a fairly common condition. It can be caused by both difficult childbirth and some mental disorders in a woman that are present even before the moment of childbirth. It is important to monitor the young mother and help her in every possible way. Letting the condition slide is dangerous for both her life and the health of the baby. If strange symptoms are detected, the young mother should not be left alone with the child in order to prevent the development of a suicidal scenario.

Complications after psychosis are the presence of serious mental disorders. If the mother does not start treatment in time, her condition will begin to worsen. In this case, the risk increases. Because not in all cases a young mother is able to return to normal life on her own. Psychosis is a serious disorder. Waiting until it goes away on its own is very risky. A number of sedatives should be taken so that the woman comes to her senses. If the problem is eliminated in a timely manner, complications are completely eliminated.

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Diagnosis of postpartum psychosis

There are no objective pathological signs. Usually, when collecting anamnesis, special attention is paid to the presence of depressive diseases in relatives. If this is the case, then postpartum psychosis occurs in almost 50% of cases.

After collecting the anamnesis, a physical examination is performed. It is necessary to determine the severity of the condition. After that, laboratory tests are started. It is important to take a blood test, bacterial culture. This will determine the level of leukocytes, ESR and other components that affect the person's condition.

Next, screening is carried out. This is a special examination of the mother, based on the results of which it is possible to record the presence of a depressive state in her. Particularly pronounced symptoms are observed in the 6th week after childbirth. After the main studies have been carried out, high-quality treatment is prescribed. If there are any doubts, additional studies are carried out. This applies to those cases when the woman had mental disorders before childbirth.

Tests

The first step is to collect the patient's life history. Usually, there are no pathological signs, and it is not so easy to determine the presence of deviations in a woman. Therefore, detailed information about her relatives is collected. The fact is that if someone in the family has mental disorders or suffered from psychosis, the risk of the same problem occurring in the mother is high. In almost 50% of cases, the situation is repeated. After collecting all the necessary information, they begin to examine the patient. Some signs are pronounced. It is important to record this point. Because the forms of psychosis can be different, including aggravating ones.

Once the details are collected, they begin the tests. They are nothing serious. This is a regular blood test, as well as bacterial culture according to indications. It is important to examine the mother and identify signs of depression in her. No other examinations or manipulations are performed. In most cases, the clinic is "on the face".

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Instrumental diagnostics

There are no special diagnostic measures in this case. It is enough to simply collect information about the patient and conduct a physical examination. Thus, the probability of developing psychosis increases if someone in the family suffers from serious disorders. This is especially common in cases of postpartum psychosis. The probability of a recurrence of the situation is as much as 50%. Naturally, aggravating consequences can occur if the woman constantly suffers from depression.

After collecting the information, you need to examine the patient. No tools are needed for this. It is enough to simply visually assess her condition. Based on the data obtained, an assessment of the severity of certain symptoms is made. It is important to examine the woman especially carefully in the first weeks after childbirth. The peak of negative symptoms is observed at 6 weeks. Correct diagnosis and quality treatment will eliminate mental stress and return the woman to normal life.

Differential diagnostics

It should be noted that postpartum psychosis in most cases indicates the presence of sepsis. This condition requires urgent differential diagnosis. In most cases, the examination is followed by hospitalization. It is important that the medical institution has the ability to provide both gynecological and psychiatric care.

It is not at all excluded that psychosis is associated with bipolar affective disorder. This condition is called manic-depressive psychosis. It occurs quite often in women with schizophrenia or other mental disorders. In most cases, they were not diagnosed before childbirth.

The first symptoms manifest themselves in the form of persecution mania, severe depression and schizophrenic manifestations. Such signs occur already in the second week after birth. Patients may suffer from uncontrollable fear, hallucinations. A young mother may experience fear regarding the condition of her baby.

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Treatment of postpartum psychosis

Most women need to be hospitalized. This is the only way to monitor them and prescribe quality treatment. If possible, both the mother and the child are hospitalized. Unfortunately, not every medical institution can boast of having a department for people with mental disorders, within whose walls both the young mother and her child can be.

In order to ease the woman's condition, special antipsychotic drugs and mood stabilizers are prescribed. As a rule, during the period of taking medications, the woman should not breastfeed. When the condition begins to gradually stabilize, it is important to surround the victim with the support of relatives. In no case should the young mother be blamed for anything. In most cases, such a condition is not controlled at all.

Full recovery occurs in about a year. Everything depends on the complexity of the situation and the patient's condition. Usually, the most severe symptoms stop bothering literally in 2-12 weeks. After recovery, a period of depression and anxiety often sets in. The support of loved ones will help cope with this.

Medicines

Antidepressants can help reduce the symptoms. However, you should not breastfeed your child, so that the sedative effect is not passed on to him. Psychotropic drugs are prescribed only when absolutely necessary. This is done after examination by a psychiatrist and under his supervision.

If excessive anxiety and agitation bother you, then resort to the help of Amitriptyline and Pirazidol. If adynamic symptoms prevail, it is worth paying attention to Paroxetine and Citalopram. Therapy should begin with minimal doses, this will reduce the likelihood of complete clouding of the mind. Over time, the dosage is increased until the desired therapeutic effect is observed.

• Amitriptyline. The dosage of the drug should be prescribed individually. Usually 50-75 mg per day is prescribed, which is equal to 2-3 tablets. The dosage can be adjusted depending on the patient's condition. Contraindications: hypersensitivity, heart failure, acute liver and kidney disease, peptic ulcer. Side effects: constipation, dry mouth, headache, nausea.
• Pyrazidol. The dose is also prescribed individually. It should be prescribed with a minimum dosage. Usually it is 50-75 mg 2-3 times a day. Over time, the dose can both increase and decrease. Contraindications: acute inflammatory liver diseases, hypersensitivity, blood diseases. Side effects: dry mouth, sweating, tachycardia.
• Paroxetine. The drug is taken once a day in the morning. At the initial stage, one tablet is enough. The dose is selected individually for 2-3 weeks after the start of treatment. Contraindications: pregnancy, lactation, hypersensitivity. Side effects: constipation, dry mouth, visual impairment, urinary retention.
• Citalopram. The drug has the same effect as Paroxetine. It should be taken in the morning hours once a day. Over time, the dosage can be adjusted depending on the person's condition. Contraindications: hypersensitivity. Side effects: dry mouth, nausea, increased sweating.

Folk remedies

Traditional medicine can have an incredible effect and calm the nervous system. But, this is only possible in cases where the symptoms are not pronounced. In case of a schizophrenic episode, only antidepressants will help.

Women suffering from psychosis should take baths with poplar leaf infusion more often. Just take the main ingredient and pour boiling water over it. After the remedy is infused, add it to the bath.

It is also worth paying attention to the infusion of ginseng root. It is easy to prepare. It is enough to take the main ingredient, pour boiling water over it and leave until fully cooked.

Mint has always been considered the number one remedy against nervousness. You can add it to tea and drink it without limitation. You can drink mint infusion directly. Half a glass in the morning and evening is enough. Chicory root has a similar effect. You should take a tablespoon of the remedy and pour a glass of boiling water over it. Take a tablespoon 6 times a day.

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Herbal treatment

Herbal treatment is very effective, but only if a person has some knowledge in this area. After all, many herbs have a poisonous effect and can cause harm. In case of psychosis, nervous disorders, it is recommended to pay attention to knotweed.

• Knotweed herb. Take one tablespoon of this ingredient and pour two glasses of boiling water over it. Then let it brew for an hour. Take a small amount of the remedy before meals.
• Mint. You should take a tablespoon of the main ingredient and pour a glass of boiling water over it, then boil it on low heat for about 10 minutes. The medicine is taken in the morning and evening hours. It helps to cope with depression and give energy for the whole day.
• Thyme. To prepare an effective remedy, take 5 grams of the herb and pour 500 ml of boiling water over it. Then let the infusion sit for about 30 minutes in a closed container. The finished remedy is used 2-3 times a day in small portions for a week. Significant relief will come almost immediately. After use, take a break for a couple of weeks, after which the course is repeated.

Homeopathy

Homeopathic treatment of mental disorders is especially popular. Quite often, homeopathy is used together with color therapy. This allows you to influence a person's condition with the help of certain colors. The effect is on biologically active points, zones and systems.

To eliminate the main problem, a number of different drugs are used. Thus, Aconitum napellus, Belladonna and Medorrhinum are widely used.

• Aconitum napellus (wrestler) D3, D6, D12. This remedy is widely used for anxiety disorders, it should be taken for 10-15 days. A person feels better in the open air. Deterioration is possible due to loud sounds, tobacco smoke and cold air.
• Belladonna (belladonna) D3, D6. The remedy relieves excessive irritability, nervousness, and sensitivity. Most often, the drug is prescribed to people with obvious deviations with the head. Especially in cases where the patient is bothered by a feeling of fullness in the head, pain.
• Medorrhinum (gonorrhoeal nosode) D30, C200, C1000. This remedy is potent. It is indicated exclusively for chronic mental disorders.

Detailed treatment should be clarified with a homeopathic doctor. In general, it is recommended to resort to traditional medicine. This will help to avoid possible consequences and return the young mother to normal life.

Homeopathy can really have a positive effect. But when choosing one or another method of treatment, it is worth considering all the pros and cons. Because the life of a young mother, or rather her mental state, is at stake. In case of any wrong actions, there is a risk of leaving everything as is. That is, not eliminating the mental disorder, but on the contrary, aggravating it.

Surgical treatment

Surgical intervention for this type of disorder does not make sense. After all, the problem lies directly in the woman's nervous system. In most cases, no disease affects it. The appearance of psychosis is associated with difficult childbirth and the mother's unwillingness to look after the child. Many women have a very difficult time with the process of childbirth, after which they need a lot of time to recover. It is important to support the young mother during these periods and not let the problem worsen.

In severe cases, drug treatment is used. It will calm the nerves and completely restore the nervous system to order. Both gentle medications and antidepressants are used for this. Specific treatment is prescribed only by the attending physician after a full examination of the patient and collection of anamnesis. It is important to record the severity of the symptoms. Surgical treatment is not used because it simply does not make sense.

Prevention

Prevention of such a condition involves the use of predictive diagnostics taking into account certain factors. Thus, it is necessary to identify the presence of depression in the patient, as well as in her close and dear ones. It is quite possible that someone from the environment has pronounced nervous disorders or depressive states. It is important to find out whether such problems have occurred in any of the relatives immediately after childbirth. This will help to prevent a repeat scenario and “save” the young mother from the onset of negative symptoms in time.

The psychological situation in the family should also be identified, the main thing is that it is not dysfunctional. In this case, it will be necessary to either change the place of residence or all relatives become more united and not allow quarrels and conflicts during the woman's pregnancy.

Psychotraumatic events that could have occurred both before and after pregnancy play a special role. Cases that occur directly during the period of bearing a child are dangerous. They can affect the process of childbirth and worsen the situation.

Lack of sleep, overwork, the birth of a baby out of wedlock - all this leaves imprints on the mother's psyche. These situations should be excluded and try to surround the mother with positive emotions. This will help save the situation.

Forecast

If the treatment was adequate and timely, then postpartum mental disorder proceeds well. It is treatable and in most cases the woman returns to her normal life. In 75% of cases, complete recovery from psychosis is noted.

It is also necessary to remember the fact that many women are subject to the influence of aggravating heredity. This aggravates the situation and can lead to the development of serious consequences. The prognosis in this case can take an unfavorable course. Most often, this concerns people suffering from schizophrenia. In this case, childbirth only provokes the development of negative symptoms and worsens the woman's condition. The risk of mental disorders over time is high. It is not necessary for deviations to be strongly manifested in the postpartum period; they can appear much later. Therefore, it is important to consult a psychiatrist regarding further treatment. This will help to avoid serious consequences and make the prognosis favorable.

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