Postpartum period
During the subacute postpartum period, psychological disorders may emerge. Among these are postpartum depression, posttraumatic stress disorder, and in rare cases, puerperal psychosis. Postpartum mental illness can affect both mothers and fathers, and is not uncommon. Early detection and adequate treatment is required. Approximately 25% – 85% of postpartum women will experience the "blues" for a few days. Between 7% and 17% may experience clinical depression, with a higher risk among those women with a history of clinical depression. Prevalence of PTSD following normal childbirth (excluding stillbirth or major complications) is estimated to be between 2.8 and 5.6% at 6 weeks postpartum.
Postpartum psychosis
Postpartum psychosis is a rare psychiatric emergency in which symptoms of high mood and racing thoughts (mania), depression, severe confusion, loss of inhibition, paranoia, hallucinations and delusions set in, beginning suddenly in the first two weeks after childbirth. The symptoms vary and can change quickly. The most severe symptoms last from 2 to 12 weeks, and recovery takes 6 months to a year.
About half of women who experience it have no risk factors; but women with a prior history of mental illness, especially bipolar disorder, a history of prior episodes of postpartum psychosis, or a family history are at a higher risk. It is not a formal diagnosis, but is widely used to describe a condition that appears to occur in about 1 in a 1000 pregnancies. It is different from postpartum depression and from maternity blues. It may be a form of bipolar disorder.
Diagnosis of postpartum psychosis always requires hospitalization, where treatment is antipsychotic medication, mood stabilizers, and, in cases of strong risk for suicide, electroconvulsive therapy. Women who have been hospitalized for a psychiatric condition immediately after delivery are at a much higher risk of suicide during the first year after delivery.