Perinatal Mental Health
The perinatal period has been defined differently depending on the sources but is roughly the time from conception until 7 days to 1 year after birth. The time after birth can also be referred to as postnatal.
The first account of psychosis in the perinatal period dates back to 4th/5th BC in the Hipocrates era. Today 1 in 200 people in Australia will experience an episode of psychosis. (Moreno-Küstner et al., 2018). Making postpartum psychosis rare but a feared diagnosis among the population.
There is currently no agreed upon definition of perinatal psychosis and is often misdiagnosed, underdiagnosed or undetected. For some parents this perinatal period will be the first time in their lives they experience an acute psychosis episode. Others who have pre-existing mental health conditions may experience a recurrence of psychosis like symptoms in the perinatal period.
Characterized as altered perceptions of reality, this can include:
- Hallucinations
- Delusions
- Mania
- Mood swings and depression
- Suicidal infanticidal and homicidal ideation ie thoughts of harming yourself or the baby
It is important to know that if you know someone who you think has perinatal psychosis their thoughts are real to their reality. Their thoughts will differ from how others are perceiving and experiencing reality. Perinatal psychosis is a transient experience that resolves quickly with the right treatment and support.
Key components in an effective treatment are:
- Appropriate treatment modalities given in a timely manner
- Rest and time to recover
- Support of friends family and their partner
Sometimes there can be physical conditions that can be associated with psychosis or delirium. These include
- Headaches and migraines
- tumour/cancers
- Infections such as sepsis mastitis UTI’s
- Chronic pain
- Severe high fevers
- Medication or substance induced
- hearing /vision problems
- Strokes
- Poisoning
With a lack of research due to stigma and the complexity of the condition it can be difficult to identify underlying causes. However, there is a strong body of research to suggest that
having a previously diagnosed or undiagnosed mental health conditions can increase the chances of experiencing perinatal psychosis. Research has identified these conditions as a risk factor: (Perry, 2021; Perry, 2024)
- Schizophrenia
- Bipolar
- Borderline personality
- Major depressive disorder
- Co-morbid autism and or ADHD
- OCD
- PTSD
- Family history of psychotic disorders i.e. schizophrenia
- Persistent insomnia in the days/weeks after birth
- A past diagnosis of postnatal psychosis
- A first-time mother
The onset of postnatal psychosis can be sudden so it is important for family and friends to be paying attention to a new mother. Things to look out for include
- Inability to sleep.
- Disorganised thoughts, speech and behavior
Some questions that you may like to ask yourself or your loved ones after they have a new baby may be
- Can you sleep or rest when your baby is napping?
- What do you think might help you relax and unwind?
- Have you experienced sleep issues like this before?
As we know the inability to sleep at all after giving birth can be a trigger for perinatal psychosis.
Due to the stigma surrounding psychosis and psychotic conditions it has become one of the most poorly understood and widely feared mental health conditions. We all deserve care, compassion and support so you are concerned about yourself or someone’s mental health you can ring 1300 MH CALL. The team will be able to advise and direct you to the best assistance.
If you believe it is an emergency situation and you or someone you love needs immediate help or has expressed harmful thoughts to themselves or their baby, stay with them and call 000. Regarding mental health everyone needs to provide consent to care. If you are involved with someone not consenting to help and you still have concerns emergency services should be contacted for a welfare check.
Through what can be a difficult time is it important to remember this too shall pass. There is light at the end of it. Medical practitioners will work with you using a whole family approach to healing during and after a psychosis episode is vital. It is ok to admit everything is not ok and to ask for help no matter how small the issue.
Emergency numbers
000
1300 MH CALL (1300 642 255)