The period following a baby's birth brings difficult moments for every mother: they must get used to the presence of a newborn and its rhythms at a time when they are weakened by the exertion of childbirth and searching for a new identity after the changes brought on by pregnancy.
In this situation, most women (around 80%) experience physiological, episodic bouts of baby blues, 18 to 20% develop postpartum depression, and 0.1% are affected by postpartum psychosis.
Postpartum psychosis is a serious mental illness with a sudden onset that affects mainly first-time mothers and appears in the first weeks after birth, although symptoms often begin to show already during pregnancy. The risk is higher for women who have already had previous psychotic episodes or bipolar symptoms, or who have a family history of schizophrenia.
It is characterized by insomnia that produces deep exhaustion, refusal to eat, alternating depressive and manic episodes, loss of contact with reality and a confused state (difficulty orienting in space and time, memory gaps, anguish), and delusional and persecutory symptoms (visual and auditory hallucinations, perceptual disturbances). The delusion may involve denying motherhood altogether, take on religious overtones (identifying with the mother of God), or attribute evil powers to herself or to the baby: this can make both suicide and infanticide possible outcomes.
One of the reasons this situation is so serious is that the woman is not aware of how absurd her thoughts and behavior are, so she does not feel the need to ask for help, and in fact often refuses it. It falls to the sensitivity of her family members to recognize certain oddities in her behavior (rather than assuming that everything will resolve itself over time) and to step in to convince her to accept treatment, even if this means hospitalization, taking medication, or starting psychotherapy.
If caught early, postpartum psychosis has a favorable prognosis; otherwise it can recur in various situations in which the woman is under stress.