What to know about postpartum psychosis, a rare but serious mental health condition after childbirth

A Massachusetts murder trial has drawn attention to postpartum psychosis, a rare but severe mental health condition that can develop after childbirth and affect a person's sense of reality. The issue is central to the trial of Lindsay Clancy, a former nurse accused of killing her three children in 2023. While both prosecutors and defence lawyers agree the children died at her hands, they differ on whether postpartum psychosis affected her mental state and criminal responsibility. What is postpartum psychosis? Postpartum psychosis is considered the most severe psychiatric condition that can occur after giving birth. According to experts, it affects approximately one to two women per 1,000 births. The condition is classified as a psychiatric emergency because it can significantly impair a person's perception of reality. Unlike the more common "baby blues" or postpartum depression, postpartum psychosis can cause hallucinations, delusions, paranoia and severe changes in thinking and behaviour. Who is at risk? The condition can affect anyone after childbirth, but the risk is higher among people with a history of mental health disorders. Research has found that around half of individuals who develop postpartum psychosis have a prior psychiatric history. One of the strongest known risk factors is bipolar disorder, a condition characterised by extreme mood swings. When does it occur? Postpartum psychosis typically develops within the first few days after childbirth, although symptoms can emerge anytime within the first six weeks following delivery. What are the symptoms? Symptoms may include: Hallucinations Delusions Paranoia Disorganised thinking Confusion Severe mood swings Mania or depression Agitation and irritability Insomnia Unusual or erratic behaviour Experts warn that severe cases can place both the mother and child at risk if urgent treatment is not provided. How is it different from postpartum depression? Postpartum depression is far more common, affecting a significant proportion of new mothers. Symptoms typically include: Persistent sadness Anxiety Feelings of hopelessness Loss of interest in daily activities Guilt or worthlessness Difficulty concentrating Low energy Changes in appetite and sleep patterns The "baby blues," which affect many women shortly after childbirth, are generally milder and usually resolve within a short period without significantly interfering with a mother's ability to care for herself or her baby. Postpartum psychosis, however, involves a loss of contact with reality and is considered a medical emergency. What treatment is available? People experiencing postpartum psychosis usually require immediate medical care and often inpatient psychiatric treatment. Treatment options may include: Antipsychotic medications Mood-stabilising medications Intensive psychiatric care Electroconvulsive therapy (ECT) in severe cases Mental health specialists emphasise that early diagnosis and treatment significantly improve outcomes. When should help be sought? Experts advise seeking immediate medical assistance if a new mother exhibits symptoms such as hallucinations, delusions, severe confusion or behaviour that suggests a loss of contact with reality. Family members and partners are often encouraged to watch for warning signs, as people experiencing psychosis may not recognise that they need help. Health professionals stress that postpartum psychosis is a treatable medical condition and that prompt intervention offers the best chance of recovery.