What should you know about postnatal depression and psychosis?

Postnatal depression may cause persistent sadness, emptiness, anxiety, guilt, loss of interest, sleep disruption and difficulty bonding. Psychosis involves a break from reality, such as hearing or seeing things others do not, intense confusion, rapidly changing mood, unusual beliefs or behaviour that feels out of control. A person experiencing psychosis may not recognise that they are unwell. Depression can be present without psychosis, and low mood after birth does not by itself indicate psychosis.

For depression symptoms, contact a doctor, midwife or mental health professional for an assessment and ask about perinatal mental health support. Include any frightening thoughts, sleep loss or changes in behaviour. If psychosis is suspected, tell a trusted adult immediately, keep the person and baby supervised, reduce access to hazards, and seek emergency medical care. Do not argue about unusual beliefs or leave the person alone.

Call local emergency services or go to an emergency department immediately for hallucinations, severe confusion, extreme agitation, rapidly escalating behaviour, or beliefs that could lead to harm. Also seek urgent help for thoughts of suicide or harming the baby. A trusted adult can explain the symptoms to clinicians if the affected person cannot do so.

Ask how depression and psychosis are being distinguished, what warning signs require emergency action, how feeding and sleep will be supported, and who should coordinate follow-up after the urgent assessment.