A Guide for Mothers, Partners and Families
Unless you have been living under a rock for the last few months, you will have undoubtedly seen or heard something about the Lindsay Clancy case.
To summarise this tragedy, Lindsay has been charged and is on trial for killing her three children. However, her defence team states that she was in the grips of postpartum psychosis when she committed these acts, in a very similar vein to Andrea Yates from 2001.
Now, this is and always will be a tragedy. It has raised some important questions around US healthcare for postpartum mothers, as well as highlighted the need for emergency intervention when postpartum psychosis is suspected. We can debate criminal responsibility, but the fact is that this condition impacts as many as 1 in 1,000 new mothers in the US and the world, meaning we need to talk more about it.
At My Family Psychologist, I have worked with mothers who are recovering from postpartum mental health issues, including depression, OCD and anxiety, and know how hard it can be to bond with a newborn when suffering from these conditions. Hence why I am an advocate for better mental health care for mothers after giving birth, to help them bond and to keep them engaging with their babies.
So, let’s have a look at what postpartum psychosis is, how to spot it in a relative and what the treatment options are in the UK.
What is Postpartum Psychosis?
The Lindsay Clancy case and the Andrea Yates case happened in the USA. Thus, we must be careful with potential differences in how this medical issue is treated, as, luckily, in the UK, we have more checks in place to help mothers post-partum. Is it perfect? No, but it is important for new mothers, fathers and families to be aware of this condition and how it is treated through the NHS.
According to the NHS and NICE guidelines, postpartum psychosis is:
“Postpartum psychosis is a serious mental health illness that can affect someone soon after having a baby. It affects around 1 in 1,000 mothers after giving birth.”
It is not as common as postpartum depression, which impacts 10-15% of new mothers. However, it is often more serious and requires emergency treatment.
At this stage, I should clarify that if you or your loved one is diagnosed with postpartum psychosis, this does NOT mean you are going to hurt your baby.
The symptoms of postpartum psychosis include:
- Hallucinations – hearing, seeing, smelling or feeling things that aren’t there.
- Delusions – suspicions about other people, fear, thoughts or beliefs that are unlikely to be true.
- Mania – this can be feeling overactive, having lots of energy, restlessness and loss of inhibitions.
- Low mood – you may have signs of depression, being withdrawn and tearful, lacking energy and having no appetite.
- Feeling extremely puzzled and confused.
- Insomnia (lack of sleep) or hypersomnia (sleeping excessively).
Again, having these symptoms does NOT mean you are going to hurt your baby.
So, why is it a psychiatric emergency? Postpartum psychosis can involve a loss of contact with reality and can place both the mother and baby at risk, particularly when severe symptoms such as confusion, delusions or suicidal thoughts are present. This is why urgent assessment and treatment are so important.
How Does it Present?
One of the great tragedies of this condition is that many people who have a partner who is experiencing it look back and say that the signs were as clear as day.
This is not to say that a person with postpartum psychosis may not notice them in themselves, but there are things to keep an eye out for. So, postpartum psychosis symptoms are:
- suddenly sleeping very little or no sleeping at all
- extreme agitation
- confusion
- rapidly changing mood
- hearing or seeing things others don’t.
- strongly held beliefs that appear irrational or frightening.
- becoming increasingly suspicious or paranoid
- appearing disconnected from reality
- talking about suicide or death
- behaving in ways that are completely out of character.
The person experiencing postpartum psychosis may not realise that they are unwell. Delusions have an incredible ability to seem logical to the person who is having them.
Even so, mothers who have experienced these sensations or experiences have reported that they felt fear about being open about them. Why? They were worried that their baby would be taken away from them, or that they would be seen as a bad mother.
This means that women who are experiencing this condition are more likely to hide it, which impacts their ability to ask for help.
What Causes It?
Now, this is where things can seem simple but can become complicated. What causes postpartum psychosis?
Much like postpartum depression, postpartum psychosis does seem to be linked to hormonal changes and there is a genetic factor as well. A study by Palacios-Hernandez et al. (2024) highlights the potential role of hormonal changes and postpartum psychosis. As for when does postpartum psychosis occur, it usually starts within two weeks, but it can even start to appear within hours or days of giving birth.
However, there are also environmental factors, which clinicians should assess for.
Severe Mental Health Issues: 50-75% of women with postpartum psychosis have a history of bipolar disorder, or less commonly schizoaffective disorder or schizophrenia. You can read more about these and other mental health conditions here.
Sleep Disruption: A new baby is going to cause a lack of sleep. However, extreme fatigue or circadian rhythm issues can be a huge stressor for those who may be predisposed to this condition.
Psychosocial Stressors: If there are high levels of stress (with a newborn!), mixed with the demands of motherhood and lack of social support, then this can also increase the chances of developing postpartum psychosis.
Early Life Trauma: If someone has a history of early childhood trauma, maltreatment or abuse, then the person may be more vulnerable.
Delivery Complications: Even if it goes well, childbirth or labour is NOT easy. However, women who have had physical trauma (episiotomy, C-sections) or severe maternal illness during delivery may experience additional physiological stress during the postpartum stage.
Treating Postpartum Psychosis
So, that’s the risks and the definition. Now, how is it treated? And does postpartum psychosis go away on its own? In a word, no.
One of the great tragedies of many cases of postpartum psychosis that end in a loss of life is that this condition can have a favourable outcome for mother and baby, provided it is identified early and treated appropriately.
According to NICE guidelines, in the UK, the treatment is usually based on the individual, the severity of the condition and, unfortunately, the local availability of a mother and baby unit.
Hospital Admission
Most women who develop postpartum psychosis will be admitted to a psychiatric hospital. Ideally, this will be a Mother and Baby Unit (MBU) where they can receive specialised treatment without being separated from their baby.
The NICE Guidelines state that if a woman requires this treatment within 12 months of childbirth, she should be admitted to a mother and baby unit. These units have staff on hand who are trained in perinatal mental health and infant care, and can offer help with caring for the baby, as well as help the mother to bond with her baby and learn coping skills.
In extreme cases, the woman who has postpartum psychosis may be given electroconvulsive therapy (or ECT).
Antipsychotic Medicine
The NHS highlights the need for some women with postpartum psychosis to be prescribed antipsychotic medication to ease mania and other psychotic symptoms.
The drug should consider other medications, the side effects, the impact on breastfeeding and the woman’s physical health.
Mood Stabilisers
The NHS specifically lists lithium as a mood stabiliser for postpartum psychosis, helping stabilise mood and prevent recurrence.
However, if the woman is breastfeeding, lithium may cause toxicity via the breast milk. So, the NICE guidelines recommend specialist consideration and monitoring in these instances.
Antidepressants
An antidepressant may be used if significant depressive symptoms are present but is not necessarily the first medication used. They are often used alongside a mood stabiliser if depression is more prominent.
Psychological Therapy
Therapy is not usually the main treatment for the acute psychotic episode.
Once the psychosis has settled, the psychological interventions in the UK can include cognitive behavioural therapy (CBT) or family therapy. These are aimed at preventing relapse and managing the impact of the illness.
Therapy may subsequently address things such as:
- understanding what happened during the episode.
- recognising early warning signs
- coping with distressing experiences
- rebuilding confidence as a mother
- processing the experience of hospitalisation
- strengthening relationships with partners and family
- reducing the risk of future episodes
As mentioned in this piece, the core treatment for postpartum psychosis is an inpatient stay in most cases until the condition is stabilised. However, keeping yourself stable through recovery in your home will require support from a trained therapist.
At My Family Psychologist, I can help you to work through difficult feelings, with no judgement and empathy. If you want to talk to someone about previous experiences with postpartum psychosis, please feel free to contact me.
FAQs
What is Postpartum Psychosis?
According to the NHS and the NICE guidelines, postpartum psychosis is defined as:
“A serious mental health illness that can affect someone soon after having a baby. It affects around 1 in 1,000 mothers after giving birth.”
It is a serious mental health issue and is deemed a medical emergency which requires urgent treatment.
Does Postpartum Psychosis Mean I/My Partner Will Hurt Our Baby?
No. Being diagnosed with postpartum psychosis does not mean you or your partner will hurt your baby.
However, because postpartum psychosis can involve severe confusion, delusions, hallucinations and a loss of contact with reality, it is important to seek urgent professional help if you suspect that you or someone you love may be experiencing it.
What is the Treatment for Postpartum Psychosis?
In the UK, the treatment for this is usually a stay in a specialist psychiatric unit, known as a Mother and Baby Unit (MBU), where appropriate. Antipsychotics are also commonly used, alongside other medication depending on the individual’s symptoms and circumstances.
Talk therapies like cognitive behavioural therapy (CBT) and family therapy may also be used when the psychosis is stable and the person is recovering.
References
Hazelgrove, K., Biaggi, A., Waites, F., Fuste, M., Osborne, S., Conroy, S., Howard, L. M., Mehta, M. A., Miele, M., Nikkheslat, N., Seneviratne, G., Zunszain, P. A., Pawlby, S., Pariante, C. M., & Dazzan, P. (2021). Risk factors for postpartum relapse in women at risk of postpartum psychosis: The role of psychosocial stress and the biological stress system. Psychoneuroendocrinology, 128, 105218. https://doi.org/10.1016/j.psyneuen.2021.105218
Kotla, R., Patil, P. S., & Ahluwalia, I. (2024). Postpartum psychosis as a precursor to schizophrenia: A comprehensive review. Cureus, 16(9), e68451. https://doi.org/10.7759/cureus.68451
Mental Health First Aid Course UK. (2026). Postnatal depression statistics UK: 2026 facts, data & key insights. https://www.mentalhealthfirstaidcourse.co.uk/blog/postnatal-depression-statistics
Michalczyk, J., Miłosz, A., & Soroka, E. (2023). Postpartum psychosis: A review of risk factors, clinical picture, management, prevention, and psychosocial determinants. Medical Science Monitor, 29, e942520. https://doi.org/10.12659/MSM.942520
National Institute for Health and Care Excellence. (2014). Antenatal and postnatal mental health: Clinical management and service guidance (NICE Guideline CG192). https://www.nice.org.uk/guidance/cg192
National Institute for Health and Care Excellence. (2014). Antenatal and postnatal mental health: Clinical management and service guidance: Recommendations (NICE Guideline CG192). https://www.nice.org.uk/guidance/cg192/chapter/Recommendations
NHS. (2023, October 18). Postpartum psychosis. https://www.nhs.uk/mental-health/conditions/post-partum-psychosis/
Nonacs, R. (2026, May 1). Postpartum psychosis awareness day: Educating mothers, families, and health care providers. MGH Center for Women’s Mental Health. https://womensmentalhealth.org/posts/postpartum-psychosis-awareness-day/
Palacios-Hernández, B., Ramírez-Alvarado, G., Téllez-Alanís, B., Lino-González, A. L., Penagos-Rivera, M., & Hernández-Galván, A. (2024). Hormones, psychotic disorders, and cognition in perinatal women: A mini review. Frontiers in Psychiatry, 14, 1296638. https://doi.org/10.3389/fpsyt.2023.1296638
Perry, A., Gordon-Smith, K., Jones, L., & Jones, I. (2021). Phenomenology, epidemiology and aetiology of postpartum psychosis: A review. Brain Sciences, 11(1), 47. https://doi.org/10.3390/brainsci11010047
Tsokkou, S., Kavvadas, D., Georgaki, M.-N., Papadopoulou, K., Papamitsou, T., & Karachrysafi, S. (2024). Genetic and epigenetic factors associated with postpartum psychosis: A 5-year systematic review. Journal of Clinical Medicine, 13(4), 964. https://doi.org/10.3390/jcm13040964