What’s the Difference Between Postpartum Depression and Postpartum Psychosis?

What is postpartum depression (PPD)?

Postpartum depression is a mental health condition where you feel sad, hopeless, or anxious for more than 2 weeks after childbirth. 

It is the number one health problem in childbirth, affecting 10% to 20% of all women. 

In addition to feeling down, common symptoms of PPD are:

• Irritability

• Guilt

• Having a hard time feeling connected to your baby

• Having a hard time feeling connected to your friends and family

• Crying a lot

• Feeling tired

• Sleeping less or more than usual

• Eating less or more than usual

• Feeling nervous about your ability to care for your baby

• Having trouble thinking clearly

• Having thoughts about hurting yourself or your baby

PPD can also happen in men, birth mothers and adoptive parents, and grandparents. 

What is postpartum psychosis (PPP)?

Postpartum psychosis is a rare mental health condition that causes psychosis. People with psychosis have an altered experience of reality. This interferes with their ability to function normally in everyday life.

PPP usually starts suddenly in the first couple weeks after childbirth. Symptoms include:

• Paranoia

• Dramatic mood changes

• Hallucinations

• Delusions

• Suicidal and/or homicidal thoughts

PPP only happens in 1 or 2 women out of every 1000. But your risk is much higher if you have a history of schizoaffective or bipolar disorder, or if you — or your mother or sister — have had PPP before (more on this below). 

Am I at risk for postpartum depression?

The biggest risk for PPD is having depression during your pregnancy. 

You might also have a higher risk for PPD if you:

• Have a history of bipolar disorder

• Have a family member with depression or bipolar disorder

• Don’t have a good support network

• Have relationship or money problems

• Are under age 20

• Have a history of alcohol or drug use problems

• Have a baby with special needs

• Experience problems with pregnancy or breastfeeding

• Have an unplanned or unwanted pregnancy

Am I at risk for postpartum psychosis?

PPP usually affects 1 or 2 women out of every 1000. This means that for most people, the chance of getting PPP is less than 1%. 

Your risk for PPP is higher if you:

• Have bipolar disorder or schizoaffective disorder. If you have one of these conditions, you have a 25% chance of developing PPP after childbirth. This risk goes up to 50% if you also have a mom or sister who has had PPP — and up to 70% if you’ve had PPP yourself in the past. 

• Have had an episode of PPP in the past. If you’ve had PPP before, you have a 50% chance of having it again. 

• Have a mother or sister who has had PPP. If you have a mom or sister who has had PPP, your risk of having it yourself is 3%.   

Can postpartum depression lead to postpartum psychosis?

No. PPD and PPP are different conditions, though they can occur together. 

When should I see a healthcare provider?

If you have PPD symptoms, talk to your healthcare provider as soon as possible. Your provider can work with you to make a diagnosis of PPD and get you started with treatment if needed. 

PPP is considered a medical emergency. If you (or a loved one) are having PPP symptoms, contact your provider immediately. If you are in a life-threatening situation, you should call 911 or go to the nearest emergency room. 

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