Becoming a parent can bring enormous emotional and physical change. Even when a new baby is deeply wanted and loved, the postpartum period can include exhaustion, anxiety, sadness, overwhelm, uncertainty, and feelings that do not resemble the version of new motherhood many people expected.
For some new and expecting parents, those feelings become more persistent or intense and develop into a perinatal mood and anxiety disorder (PMAD), such as postpartum depression, postpartum anxiety, postpartum OCD, or postpartum psychosis.
These conditions are often grouped together in everyday conversation, but they are not the same. Understanding the differences matters, both because it can help people receive the right care and because misunderstanding maternal mental health can make an already struggling parent more afraid to tell someone what they are experiencing.
Postpartum psychosis, in particular, is a rare but serious psychiatric emergency involving a disruption in a person’s perception of reality. It is very different from postpartum depression, anxiety, or the unwanted intrusive thoughts that can occur with postpartum OCD.
The more accurately we understand these conditions, the easier it becomes to replace fear and stigma with appropriate care.
If you are struggling during pregnancy or after having a baby and are unsure what kind of support you need, you can schedule a free consultation call with Upshur Bren Psychology Group. Our care coordination team can learn more about what you are experiencing and help determine the most appropriate next step.
What Are Perinatal Mood and Anxiety Disorders (PMADs)?
Perinatal mood and anxiety disorders are mental health conditions that can develop during pregnancy or after childbirth. While many people are familiar with postpartum depression, PMADs actually encompass several different conditions, including perinatal depression, anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and postpartum psychosis.
Symptoms can look very different from one person to another.
Postpartum depression may involve persistent sadness, hopelessness, loss of interest or pleasure, difficulty connecting with others, or thoughts of death or suicide.
Postpartum anxiety may feel like constant worry that is difficult to turn off. A parent may find themselves repeatedly imagining worst-case scenarios, feeling unable to relax, experiencing panic, or noticing physical symptoms such as a racing heart.
Postpartum OCD often includes intrusive, unwanted thoughts or images. These thoughts can be particularly frightening because they may involve something terrible happening to the baby.
And postpartum psychosis involves a loss of contact with reality that may include delusions, hallucinations, paranoia, severe confusion, or dramatic changes in behavior.
The distinction between these experiences is incredibly important.
Postpartum OCD vs. Postpartum Psychosis: Understanding Intrusive Thoughts
One of the most frightening experiences a new parent can have is an unwanted thought or image of harm coming to their baby.
Understandably, someone experiencing this may become terrified by the thought itself. They may wonder what it says about them as a parent, worry that telling someone will result in judgment, or fear that simply having the thought means they might act on it.
With postpartum OCD, intrusive thoughts are typically unwanted and deeply upsetting. The parent recognizes that the thought does not reflect what they want to happen. In fact, they may become so frightened by it that they change their behavior to prevent the feared event from occurring.
Postpartum psychosis is fundamentally different because a person’s ability to accurately perceive reality has been disrupted. Someone experiencing psychosis may believe a delusion is true or perceive a hallucination as real. They may not recognize that what they are thinking, seeing, or hearing is a symptom of an illness.
That difference between being frightened by a thought and believing something that is not grounded in reality is one reason accurate assessment by a mental health professional with appropriate expertise matters so much.
It is also why we need to be careful about how we talk about maternal mental health. When every frightening postpartum thought is treated as evidence that a mother is dangerous, people may become more afraid to disclose what they are experiencing. Shame can keep people from getting help precisely when talking openly could connect them with effective treatment.
If intrusive thoughts, anxiety, depression, or other emotional changes are interfering with your daily life or making the transition to parenthood feel increasingly difficult, our clinicians at Upshur Bren Psychology Group provide therapy for women during pregnancy and the postpartum period. Reaching out can be an important first step toward understanding what you are experiencing and finding the right care.
What Are the Signs and Symptoms of Postpartum Psychosis?
Unlike postpartum depression or anxiety, postpartum psychosis affects a person’s ability to accurately interpret reality. Symptoms can also fluctuate, which means someone may appear relatively like themselves at one moment and significantly confused, agitated, or unlike themselves later.
Warning signs can include:
- Hallucinations, including seeing or hearing things that other people do not
- Delusions or strongly held beliefs that are not based in reality
- Intense paranoia or unusual suspiciousness
- Severe confusion or disorganized thinking
- Speech or thoughts that are difficult to follow
- Dramatic agitation, irritability, or changes in behavior
- Appearing unusually energized, manic, or unable to settle
- Commands or beliefs involving harm to oneself or someone else
These symptoms may be more apparent to a partner, family member, or friend than to the person experiencing them. Because psychosis changes a person’s perception of reality, they may not recognize that something is wrong.
Postpartum psychosis is a psychiatric emergency. If you believe you or someone you know may be experiencing psychosis or is in immediate danger, call 911 or go to the nearest emergency room. If you or someone you know is experiencing suicidal thoughts or a mental health crisis, call or text 988 for the Suicide & Crisis Lifeline.
Postpartum Psychosis Is Treatable
The word psychosis can sound frightening, particularly because postpartum psychosis is often discussed publicly only in the context of extremely rare tragedies.
But those stories do not represent the experience or outcome of every person who develops postpartum psychosis.
Postpartum psychosis is treatable.
Treatment generally requires immediate psychiatric care to stabilize symptoms and protect the parent and baby. Depending on the situation, this can involve hospitalization, medication, and ongoing psychiatric and psychological care. After stabilization, continued treatment can help a parent recover and support their emotional health over time.
Experiencing postpartum psychosis does not mean someone will remain psychotic indefinitely or can never feel like themselves again. With appropriate intervention and follow-up care, recovery is possible.
Why Maternal Mental Health Support Matters Before a Crisis
Mental health care during pregnancy and postpartum should not begin only when someone reaches a crisis point.
The transition to parenthood can bring changes to identity, relationships, sleep, work, body image, family dynamics, and a person’s sense of themselves. It can also bring grief, anger, loneliness, ambivalence, anxiety, or sadness alongside love and joy.
There is often tremendous pressure to feel grateful and fulfilled after having a baby. When someone’s actual experience does not match that expectation, it can be easy to assume they should simply be coping better.
That pressure can make it harder to say, “I’m not doing well.”
Maternal mental health care creates space to say it anyway.
Therapy can help during pregnancy, after birth, and throughout the transition to parenthood. You do not need to wait until symptoms feel unbearable, and you do not need to know exactly what diagnosis fits before reaching out.
At Upshur Bren Psychology Group, our clinicians work with women experiencing postpartum depression, anxiety, intrusive thoughts, identity changes, relationship stress, and other challenges during the perinatal and postpartum period. We take the time to understand the whole person and what this transition looks like within the context of their relationships, family, history, and everyday life.
You can schedule a free consultation call with our care coordination team to talk through what you are experiencing and learn more about therapy and other options for care.
How to Support a Partner or Loved One Experiencing Postpartum Mental Health Symptoms
One of the most important things partners, relatives, and friends can do is pay attention to meaningful changes in how a new or expecting parent seems to be feeling, functioning, or behaving.
Rather than dismissing distress as hormones, sleep deprivation, or something every new parent goes through, make room for honest conversation.
If someone tells you they are struggling, listen without immediately judging, minimizing, or trying to convince them that everything is fine. Help them connect with professional care, and when appropriate, offer practical help with making appointments, caring for the baby, getting rest, or communicating with other members of their care team.
If their behavior seems dramatically out of character, they appear disconnected from reality, or you notice hallucinations, delusions, severe confusion, paranoia, or other signs of possible psychosis, seek emergency medical care rather than trying to reason them out of what they are experiencing.
For less acute but persistent symptoms of depression, anxiety, OCD, overwhelm, or difficulty adjusting to parenthood, connecting with a therapist who understands perinatal mental health can provide an important layer of care.
Getting Help for Postpartum Depression, Anxiety, OCD, or Psychosis
Struggling during pregnancy or postpartum does not have to reach a particular threshold before it deserves attention.
Sometimes getting help means emergency psychiatric care. Sometimes it means finding a therapist who understands perinatal mental health. In other moments, getting help may be as simple as telling a partner, friend, OB-GYN, primary care doctor, or another trusted person that something does not feel right.
What matters is that you do not have to determine the right level of care by yourself.
If you are experiencing postpartum depression, anxiety, intrusive thoughts, or difficulty adjusting to motherhood, Upshur Bren Psychology Group offers evidence-based therapy for women during pregnancy and the postpartum period. Schedule a free consultation call with our care coordination team to talk through what you are experiencing and find the right support for you.
If you or someone you know is experiencing symptoms of postpartum psychosis, suicidal thoughts, or an immediate mental health crisis, seek emergency care by calling 911, going to the nearest emergency room, or calling or texting 988 for the Suicide & Crisis Lifeline.
Be the first to leave a comment