Postpartum psychosis

Postnatal psychosis is a condition in which a woman is tormented by a manic syndrome to do something with herself or with a child. It is caused by complications arising after childbirth. It is important that a woman having problems of this nature is under the supervision of a highly qualified specialist. This condition is not always fulfilled. Because not all mummies suspect of having a problem. Yes, and to recognize the symptoms of psychosis is not always easy.

ICD-10 code

Other maternal illnesses classified elsewhere, but complicating pregnancy, childbirth and the puerperium (O99). This heading includes the conditions that led to complicated childbirth. The cause may also be hidden in the care provided by midwives. Hence the exclusion of infectious and parasitic diseases, as well as traumas that took their toll during childbirth.

• O99.0 Anemia complicating pregnancy, childbirth and the postpartum period. States classified under D50-D64
• O99.1 Other diseases of blood and hematopoietic organs and certain disorders involving the immune mechanism that complicate pregnancy, childbirth and the postpartum period. States classified under D65-D89
• O99.2 Diseases of the endocrine system, eating disorders and metabolic disorders complicating pregnancy, childbirth and the puerperium.
• O99.3 Mental and nervous system disorders 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 lie in somatic and psychogenic factors. So, an enormous role is played by an aggravating heredity. In this case, we are talking about the presence of someone from their own mental illness, as well as disorders. The problem can arise on the background of complex births. Especially if they were accompanied by strong physical stresses. This leads not only to mental disorders, but also to hormonal changes. Often the problem affects the vegetative system and leads to shifts. As a result, there is psychosis.

Heavy and prolonged labor, protein shifts and blood loss lead to a number of abnormalities. Affect the psychosis is capable of dehydration, changes in pressure and impaired functionality of the liver. To hide everything is possible even in the usual overwork, lack of sleep and the difficult situation in the family. Finally, not all women are ready for childbirth and motherhood. This depresses them and leads to different thoughts in the head. Some personal qualities can contribute. This may be suspiciousness, anxiety and previous severe mental trauma.

[1], [2]

Pathogenesis

It should be noted that no apparent pathomorphological and pathophysiological changes are observed. The main specificity of the disorder is the presence of depressive and stressful condition in the last weeks of pregnancy. The representative of the fair sex begins to worry, to think about the upcoming birth and to wind herself. Sometimes this condition is complicated by the presence of family problems. This all affects the pregnant psychogenically. The situation is supplemented by certain risk factors.

If during pregnancy, the level of hormones responsible for the blood flow sharply increases, and at the time of birth the uterus contracts, then at the end of the process there comes an ordinary emotional decline. This leads to the fact that the woman feels uncomfortable. She does not understand all that is happening. The main thing is to support it and not give emotions the upper hand. In this case, the situation will begin to improve and the body will return to normal work.

Symptoms of postpartum psychosis

The first thing a woman begins to pester maniacal manifestations. Mania is a condition of painfully increased arousal. It is characterized by the presence of obsessive ideas, as well as representations that do not rest on any real events. Mania can carry a paranoid character. In some cases, there is megalomania, but for a young mother this is not typical.

Hallucinations. This symptom is the most common. Often, auditory hallucinations are pestering, visual ones are not so common.

A woman can abnormally reflect. Her condition is changing, overtaking a severe depression. There is no possibility to organize yourself, to start to think normally. A woman becomes difficult to formulate her own opinion. The conversation becomes incoherent.

Lack of adequate self-esteem. Often, women are not able to assess their condition. Therefore close it is necessary to convince the victim to address to the doctor. Naturally, avoid quarrels and scandals will not succeed. 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 the thought of suicide and the desire to do anything with your own child. This feature is one of the most common.

First signs

The first symptomatology begins to manifest itself within the first few weeks. The woman is constantly in a bad mood, especially worsened in the morning. Awakening too early, appetite reduced. In addition, there is always a sense of guilt, self-blame without a reason. There are many negative thoughts in my head, up to suicide.

It's easy to notice a woman's psychosis. She behaves inadequately with the baby. He irritates her, you can hear constant cries. A woman is capable of injuring a child. Do not exclude the violation of concentration, as well as fluctuations or indecision during the adoption of important decisions.

A woman suffers from a mental disorder called agedonia. It is characterized by a lack of feelings of joy. There is anxiety, excessive concern about one's own condition and the health of the baby. Irritability and nervous overexcitation are always present. Sleep is broken, lost, interests in life, there is excessive fatigue. Suddenly, suicidal thoughts occur. Women refuse to have sex, because they have a fear of once again becoming pregnant.

[3]

Acute postpartum psychosis

This condition is often associated with severe childbirth. Women receive a so-called birth trauma and can not leave it for a long time. It occurs when long births, which last from several hours to days. Mental changes do not occur immediately, and this is the main danger. The first manifestations can be identified after a few days or weeks.

After discharge from the hospital, the young mother returns home in a depressed mood. Instead of joy, it is filled with negative emotions. She is not happy with the appearance of the child, you can see both indifference and aggression in his direction. Relation to relatives over time is also able to change. Even the slightest problems with sleep may indicate a problem.

Over time, the behavior of women becomes strange and even unusual in relation to the child. So, the mother may not approach the baby at all, or vice versa, not leaving it for a minute. Sometimes she starts to think negatively of someone from her family, they say, they supposedly want to harm the child. There are thoughts that the kid is trying to steal, kill. The most dangerous thing is that a woman can begin to treat the child for an unreasonable illness without reason. In this case, very strong medicines are being 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 answer for her actions. She can safely throw the baby out of the window or cause him irreparable harm. If you do not help the woman in time, her condition will be greatly aggravated. Changes can progress, leading to unpredictable consequences.

Postpartum schizophrenic psychosis

This condition is particularly dangerous. After all, in addition to the fact that a woman experiences difficulties associated with the birth of a baby, she begins to visit serious thoughts in order to get rid of him. Often this condition can be caused by the intake of steroid hormones. Usually, to eliminate psychosis try using hormonal drugs, but it can cause its consequences. So, there were recorded cases when a woman acquired acute schizophrenic psychosis. In this state, the patient is filled with fears and hallucinations.

True postpartum psychosis and is the main postpartum schizophrenia. Such a state can occur at any age, regardless of the number of births and their severity. Nonspecific fragility of the nervous system, anxiety and neurotic disorders can manifest themselves. In addition, there may be a sharp increase in conflict, which is closely related to the theme of procreation. It should be noted that the picture of psychoses is not monotonous. In each individual case, their problems and symptoms manifest themselves. The main thing is to notice deviations in time and not to aggravate the situation.

Effects

The most dangerous consequence in this case is irreparable harm to the child. This condition can not affect the health of women. Simply put, it will not go beyond the mental disorder. Over time, it can fade away and the young mother returns to her usual life. But, you need to give her appropriate help. After all, without it, there is a risk of serious injury to the baby.

Psychoses are different. Some women just do not sleep well, eat and do not enjoy their life at all. Perhaps this is the safest form. When there are obsessions, a young mother screams at her baby, beats, you should give her medical help. This condition is characteristic of a schizophrenic episode. Often, moms try to throw the baby out of the window, etc. It's very scary. When a woman regains consciousness, she may not even remember her own deeds. Therefore, it is important not to let her do harm to herself or the baby. With timely assistance, the consequences will not be.

[4], [5], [6]

Complications

Postpartum psychosis is a fairly common condition. He can be called as heavy births, and some mental deviations in women, present even before the moment of procreation. It is important to follow the young mother and help her in every possible way. To lower the state on its own is dangerous both for her life and for the health of the baby. If a strange symptomatology is found, you can not leave the young mother alone with the child, in order to prevent the development of a suicidal scenario.

Complications after psychosis is the presence of serious mental disorders. If the mother does not start on time to treat, her condition will begin to worsen. In this case, the risk increases. Because not in all cases, a young mother is able to independently return to normal life. Psychosis is a serious violation. Wait until it passes independently is very risky. It is necessary to drink a number of sedatives, so that a woman comes to her senses. With the timely elimination of the problem, complications are completely excluded.

[7], [8],

Diagnosis of postpartum psychosis

Objective pathological signs are not observed. Usually, when collecting an anamnesis, special attention is paid to the presence of depressive diseases in relatives. If this is the case, then in almost 50% of cases, postpartum psychosis occurs.

After the history is collected, a physical examination is carried out. It is necessary to determine the degree of severity of the condition. Then proceed to laboratory research. It is important to take a blood test, bacterial culture. This will determine the level of leukocytes, ESR and other components that affect the human condition.

Next screening is carried out. This is a special examination of the mother, following which you can record her having a depressive condition. Particular symptomatology is observed at the 6th week after childbirth. After the main research has been carried out, quality treatment is prescribed. If there are any doubts, conduct additional studies. This applies to cases where a woman before birth had a mental disability.

Analyzes

The first thing is going to anamnesis of the patient's life. Usually, pathological signs are absent, and it is not so easy to determine the presence of abnormalities in a woman. Therefore, detailed information about her relatives is collected. The fact is that if someone in the family has a mental disorder or suffered from psychosis, the risk of having the same problem in the parturient woman is great. Practically in 50% of cases the situation is repeated. After collecting all the necessary information, they begin to examine the patient. Some of the signs are bright. This moment is important to fix. Because the forms of psychosis can be different, including burdening.

When the details are collected, proceed to the analysis. They do not represent anything serious. This is an ordinary blood test, as well as bacterial culture according to the indications. It is important to examine Mummy, and to identify her signs of depression. There are no other examinations or manipulations. In most cases, the clinic is "on face".

[9], [10], [11], [12]

Instrumental diagnostics

There are no special diagnostic measures in this case. It is enough simply to gather information about the patient and conduct a physical examination. So, the probability of developing psychosis increases if someone in the family suffers from serious disorders. Especially often this manifests itself in cases when someone has postpartum psychosis. The probability of a repetition of the situation is as much as 50%. Naturally, burdensome consequences can be if a woman is constantly suffering from depression.

After collecting the information, you need to examine the patient. No tools are needed for this. It is enough simply to visually assess its condition. Based on the data obtained, an evaluation is made of the severity of certain symptoms. It is important, especially carefully examine the woman for the first time weeks after childbirth. The peak of development of negative symptoms is observed at week 6. Correct diagnosis and quality treatment will eliminate mental stress and return the woman to a 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 should be hospitalization in a hospital. It is important that the medical institution has the opportunity to provide both gynecological and psychiatric care.

It is not excluded that fact that psychosis is associated with bipolar affective disorder. This condition was called manic-depressive psychosis. It often occurs in women who have schizophrenia or other mental disorders. In most cases, they were not diagnosed before delivery.

The first symptoms manifest themselves in the form of persecution mania, severe depression and schizophrenic manifestations. Such signs take place already in the second week after childbirth. Patients may suffer uncontrolled fear, hallucinations. A young mother may be afraid of the condition of her baby.

[13], [14], [15], [16]

Treatment of postpartum psychosis

Most women should be hospitalized. This is the only way to manage to observe them and prescribe quality treatment. If there is a possibility, then both mother and child are hospitalized. Unfortunately, not every medical institution can boast of having a department for people with mental disorders, in the walls of which there can be both a young mother and her baby.

In order to alleviate the condition of a woman, prescribe special antipsychotic drugs and mood stabilizers. As a rule, during the period of taking medication a woman should not breast-feed a child. When the condition begins to gradually stabilize, it is important to surround the affected relatives with support. In no case can not nothing to blame the young mother. In most cases, such a state is not controlled at all.

Full recovery occurs about a year later. Everything depends on the complexity of the situation and the condition of the patient herself. Usually, the most severe symptoms stop pestering in just 2-12 weeks. After recovery often comes a period of depression and anxiety. Cope with this, help support close people.

Medications

Antidepressants help to reduce the manifestation of symptoms. However, in this case it is not necessary to breast-feed the child so that the sedative effect is not passed to him. Psychotropic drugs are prescribed exclusively when absolutely necessary. This is done after examining the psychiatrist and under his supervision.

If excessive anxiety and agitation are pestering, Amitriptyline and Pirazidol are resorted to. With the prevalence of adynamic symptoms, 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 necessary therapeutic effect is observed.

• Amitriptyline. The dosage of the drug should be administered on an individual basis. Usually appoint to 50-75 mg per day, this is 2-3 tablets. The dose 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. Assign with a minimum dosage. Usually this is 50-75 mg 2-3 times a day. Over time, the dose may both increase and decrease. Contraindications: acute inflammatory diseases of the liver, 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 agent has the same action as Paroxetine. You need to take it in the morning hours once a day. Over time, the dosage can be adjusted depending on the condition of the person. Contraindications: hypersensitivity. Side effects: dry mouth, nausea, increased sweating.

Alternative treatment

Alternative medicine can have an incredible effect and calm the nervous system. But, it is possible only in those cases when the symptomatology is not pronounced. With a schizophrenic episode, only antidepressants will help.

Women suffering from psychosis, it is more often to take baths with infusion of poplar leaves. It is enough to take the main ingredient and pour it with boiling water. After the agent is infused, add to the bathroom. 

It is worth paying attention to the infusion of ginseng root. Prepare it simply. It is enough to take the main ingredient with pour it with boiling water and pre-cook it.

Peppermint has always been considered the number one tool against nervousness. You can add it to tea and eat without restriction. You can drink directly infusion of mint. Enough half a glass morning and evening. The chicory root also has a similar action. It is necessary to take a tablespoon of the product and pour a glass of boiling water. Take a tablespoon 6 times a day.

[17], [18]

Herbal Treatment

Herbal treatment is very effective, but only if the person has some knowledge in this area. After all, many herbs have a poisonous effect and are capable of harm. At psychoses, nervous disorders it is recommended to pay attention to the spores.

• Trachea sporisha. Take one tablespoon of this ingredient and pour it with two cups of boiling water. Then let it brew for an hour. Take the drug in small amounts before eating.
• Mint. It is necessary to take a tablespoon of the main ingredient and pour it with a glass of boiling water, then boil 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 cheerfulness for the whole day.
• Thyme. To prepare an effective remedy, take 5 grams of grass and pour 500 ml of boiling water over it. Then give the infusion to stand for about 30 minutes in a sealed container. The finished product is used 2-3 times a day in small portions throughout the week. Significant simplification will come practical at once. After the application, a break is made for a couple of weeks, after which the course is repeated.

Homeopathy

Homeopathic treatment of mental disorders is very popular. Quite often homeopathy is used together with color therapy. This will affect the state of a person with the help of certain colors. The impact is on biological active points, zones and systems.

A number of different drugs are used to eliminate the underlying problem. 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 within 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. It removes excessive irritability, nervousness, impressionability. Most often, the drug is given to people who have obvious deviations from the head. Especially in those cases when the patient is feeling a sense of fullness in his head, pain.
• Medorrhinum (gonorrheal nosode) D30, C200, C1000. This remedy is potent. It is shown only in chronic course of mental disorder.

Detailed treatment should be specified by a homeopath physician. In general, it is recommended to resort to traditional medicine. This will avoid possible consequences and return the young mother in a normal life.

Homeopathy is really capable of having a positive effect. But choosing one or another method of treatment, it is worth considering all the pros and cons. Because at stake is the life of a young mother, or rather her mental state. In case of any wrong actions, there is a risk to leave it as it is. I mean, do not eliminate the mental disorder, but on the contrary make it worse.

Operative treatment

Surgical intervention in this form of disorder does not make sense. After all, the problem lies directly in the nervous system of a woman. In most cases, no disease affects it. The appearance of psychosis is associated with severe childbirth and not the mother's readiness to follow the child. Many women are very difficult to bear the process of procreation, after that they need a lot of time to recover. It is important to support a young mother in these periods and not give the problem worsen.

In severe cases, medicinal treatment is used. It will calm the nerves and completely bring the nervous system in order. To do this, apply both sparing medicines, and antidepressants. Specific treatment is prescribed only by the attending physician after a full examination of the patient and the collection of anamnesis. It is important to record the severity of the symptoms. Operative treatment is not applied due to the fact that it simply does not make sense.

Prevention

Prevention of this condition involves the use of predicative diagnosis, taking into account some factors. So, it is necessary to identify the presence of depression in the patient, as well as relatives and relatives. It is likely that someone from the environment has severe nervous disorders or depressive conditions. It is important to find out whether such problems were encountered in one of the relatives immediately after childbirth. This will help prevent a second scenario and in time "save" the young mother from a plaque of negative symptoms.

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

A special role is played by psycho-traumatic events that could occur both before and after pregnancy. Dangerous situations arise directly during the period of bearing of the child. They can affect the process of delivery and aggravate the situation.

Lack of sleep, overfatigue, the birth of a child out of wedlock - all this leaves a mark on the psyche of the mother. These situations need to be excluded and try to surround the woman in childbirth with positive emotions. This will help save the situation.

Forecast

If the treatment was adequate and timely, postpartum psychiatric disorder proceeds well. It is treatable and in most cases the woman returns to her usual life. In 75% of cases, complete recovery after a previous psychosis occurs.

It is 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 forecast in this case is able to take unfavorable course. Most often it concerns people suffering from schizophrenia. In this case, birth only provokes the development of negative symptoms and aggravates the condition of a woman. The risk of the appearance of mental disorders over time is great. Not necessarily a strong manifestation of abnormalities in the postpartum period, they may appear much later. Therefore it is important to get a consultation with a psychiatrist regarding further treatment. This will avoid serious consequences and make the forecast favorable.

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