Postpartum depression versus postpartum psychosis

Childbirth is one of the most special occasions in a woman's life. While it brings a lot of joy and new experiences, the intense experience can also bring about psychological distress and disorders. There are two major psychological disorders that may occur after pregnancy:  Postpartum depression and postpartum psychosis.  

Although they share some similarities, these disorders are quite different from each other.  

Let's look at 5 ways in which they differ from each other:  

What does each disorder entail?  

Postpartum depression is a mood disorder that occurs after childbirth in which there is low mood, feelings of hopelessness, and difficulty connecting with one's child. It usually occurs in the first two weeks after childbirth.   

Postpartum psychosis (PPP) is also known as postnatal psychosis or puerperal psychosis.  This is a severe mental disorder in which there are changes in mood and behaviour as well as a loss of contact with reality. Postpartum psychosis can begin very suddenly, within hours of childbirth, or may take weeks or months to appear. If PPP is not treated immediately, it places mothers at a 5% risk of suicide and a 4% risk of committing infanticide. 

They have different prevalence's. 

Postpartum psychosis is rare compared to postpartum depression. About 1 or 2 in every 1,000 mothers will experience postpartum psychosis, while postpartum depression affects an estimated 1 in 7 new mothers annually and between 10% and 20% of all women.   

They manifest different symptoms. 

There are important symptoms that differentiate these disorders from each other.  

Key symptoms of postpartum depression include:  

• Low or depressed mood  
• Feelings of worthlessness, hopelessness, and guilt 
• Loss of interest or enjoyment in one's hobbies and favourite activities  
• Difficulty bonding with one's baby 
• Feeling overwhelmed when faced with childcare and caring for oneself 
• Fatigue  
• Sleep disturbances  
• Poor concentration  
• Thoughts of harming oneself or the baby 

Key symptoms of postpartum psychosis include:  

• Hallucinations: hearing, seeing, feeling, or smelling things that are not there or real. 
• Paranoia: having irrational beliefs and thoughts 
• Loss of touch with reality 
• Inability to sleep for long periods of time 
• Sudden and extreme mood swings, alternating between high energy and racing thoughts to low mood. 
• Disordered thoughts and speech 
• Being agitated, violent, and/or aggressive 
• Having thoughts of harming oneself and the baby 

They have different risk factors or causes. 

Postpartum depression tends to have social causes or risk factors, while postpartum psychosis often results from biological factors.  

You are at risk for postpartum depression if you: 

• Have depression during the pregnancy 
• Have a personal history or family history of bipolar disorder, anxiety, or depression 
• Have a history of drug or alcohol use 
• Experience a major life event such as death of a loved one, job loss, divorce, etc. 
• Experience complications in childbirth, pregnancy, or breastfeeding 
• Have a poor support system 
• Have multiple children or a baby with special needs 
• Are under the age of 20 

Your risk for postpartum psychosis (PPP) is higher if you: 

• Have a pre-existing disorder such as bipolar disorder, schizophrenia, or schizoaffective disorder  
• Have a family history of bipolar disorder, psychosis, or postpartum psychosis  
• Have had PPP in the past (50% chance of experiencing it again) 
• Stop using psychiatric medication during pregnancy 

They are treated or managed in different ways. 

Postpartum psychosis is considered a medical emergency because both the mother and baby are at high risk. Thus, it is often treated through hospitalization in an inpatient setting.  

Postpartum depression, on the other hand, can be treated in outpatient settings with medication, therapy, or both. 

Conclusion 

These disorders are not a sign of weakness, laziness, or a personal failing. They result from biological and/or social factors. Both postpartum depression and postpartum psychosis can be resolved with the right treatment and care.