Pregnancy psychosis is a rare but severe mental health condition that involves losing touch with reality during pregnancy.
Untreated psychosis can affect your ability to care for yourself and maintain a healthy pregnancy.
Psychosis is considered a medical emergency that requires professional intervention. Medication, therapy, and social support can help improve symptoms.
Pregnancy can be stressful. Between the fluctuating hormones, growing belly, and restless sleep, you might not feel like yourself. However, there’s a difference between normal pregnancy changes and something more serious, like pregnancy psychosis.
Pregnancy psychosis is a rare mental health condition that can endanger the life of both the mother and baby. It’s known to involve extreme confusion, irrational beliefs, and difficulty trusting others. Fortunately, timely treatment can resolve symptoms so that you can continue to focus on a healthy pregnancy.
Symptoms of pregnancy psychosis
Psychosis refers to a series of symptoms that are characterized by a loss from reality. While it’s more common for psychosis to occur in the weeks following childbirth, some women will experience psychosis during their pregnancy. With pregnancy psychosis, a person may experience hallucinations and delusions while pregnant.
Other warning signs or symptoms of pregnancy psychosis [1] include:
Extreme mood swings, including mania, hypomania, and depression
Confusion and difficulty thinking clearly
Being suspicious or mistrustful of others
Withdrawal from friends, family, and usual activities
Changes in hygiene and personal care
Thoughts of self-harm* or harming others
*The 988 Suicide and Crisis Lifeline offers 24/7 confidential support through trained crisis counselors. If you or someone you care about is experiencing emotional distress, self-harm, or a suicidal crisis, please call or text 988. For life-threatening emergencies or immediate assistance, call 911.
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How psychosis can impact pregnancy
Pregnancy psychosis can make it difficult to care for basic needs, like taking prenatal vitamins and getting enough sleep. You might miss doctor appointments or feel paranoid around loved ones.
Psychosis is associated with the risk of pregnancy concerns [2] like preeclampsia and gestational diabetes. People who experience psychosis while pregnant may be more likely to have babies who are premature or require extra care.
Watching a loved one experience psychosis can also affect noncarrying partners. They may feel guilty for not recognizing it earlier. They might also have concerns about how symptoms will impact the baby.
Unmanaged psychosis can have significant consequences for your mental and physical health. However, early intervention has been shown to help manage symptoms that may affect them or their child.
What causes psychosis during pregnancy?
Psychosis during pregnancy can be scary — especially when you don’t know what’s causing it. Research shows that women with bipolar disorder may be more likely [1] to experience pregnancy psychosis. It’s also linked to major depressive disorder (MDD), schizophrenia, and schizoaffective disorder.
Other factors that increase the risk of pregnancy psychosis include:
Sleep deprivation: A prolonged lack of sleep can lead to symptoms like hallucinations and delusions.
A history of psychosis: A personal or family history of psychosis may increase your risk during pregnancy.
Pregnancy hormones: There's some evidence linking hormonal changes during pregnancy to mental challenges [3]. However, research on hormones and psychosis is limited.
What to do if you suspect pregnancy psychosis
Psychosis during pregnancy is a medical emergency and needs immediate care. Some mood changes are normal during pregnancy, but psychosis is different. If you notice sudden or severe changes in thinking or behavior, such as paranoia, seeing or hearing things that aren’t there, or feeling disconnected from reality, contact a healthcare provider right away.
During an evaluation, providers will ask when symptoms started, how they’re impacting daily life, and if you feel safe. They'll review personal and family health histories, and order blood tests to identify any underlying issues.
Treatment for pregnancy psychosis
When managing mental health challenges during pregnancy, it's important to find treatment that’s both effective for the mother and safe for the baby. With psychosis, this will depend on your health history, current medications, and how far along [1] you are in the pregnancy.
Medication is often used to manage symptoms like hallucinations and delusions. Medications like antipsychotics are considered safe for pregnancy [4], but you'll want to work with your provider to find the right prescription and dosage for you.
Therapy can be helpful after symptoms are stabilized and is another effective approach for pregnancy psychosis. For example, cognitive behavioral therapy (CBT) can help people cope with lingering distress and improve daily functioning. Your provider may also suggest family therapy so that loved ones can understand your experience and how to support you.
Once stabilized, remember to remain mindful of your mental well-being. If you have an existing mental health challenge, continue going to therapy and taking your medication as prescribed. You might also consider creating an emergency plan to manage any future episodes during or after your pregnancy.
On top of that, self-care is always a good idea — especially when you’re growing a child. This might mean healthy eating, good sleep hygiene, and plenty of time for rest and relaxation.
A common mistake is assuming the symptoms are normal pregnancy stress or waiting to see if they pass. Psychosis is different from typical mood changes, and delaying care can allow symptoms to worsen instead of getting the prompt treatment that helps people stabilize more quickly.
Brandy Chalmers, LPC
Clinical reviewer
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With physical and hormonal changes, pregnancy can take a toll on your mental health. However, some challenges are more severe than others. If you’re showing signs of pregnancy psychosis, it’s important to get help as soon as possible. Treatment can help you manage symptoms so you can focus on a healthy pregnancy.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
References
- A Review: Integrative Perspectives on the Features and Clinical Management of Psychotic Episodes in Pregnancy https://www.mdpi.com/2077-0383/12/2/656
- Examining a Case of Acute Late-Pregnancy Psychosis: How Best to Coordinate Care https://www.psychiatrictimes.com/view/examining-a-case-of-acute-late-pregnancy-psychosis-how-best-to-coordinate-care
- Hormones, psychotic disorders, and cognition in perinatal women: a mini review https://pmc.ncbi.nlm.nih.gov/articles/PMC10797067/#s4
- Antipsychotic use during pregnancy and risk of specific neurodevelopmental disorders and learning difficulties in children: a multinational cohort study https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370%2824%2900110-X/fulltext#:~:text=Antipsychotics%20are%20commonly%20prescribed%20to,autism%20spectrum%20disorder%2C%20and%20insomnia.
Alex Bachert
Alex Bachert is a freelance copywriter and mental health advocate. Since earning her masters degree in public health, she has focused her career on creating informative content that empowers people to prioritize their health and well-being. Alex has partnered with organizations like Ro, WellTheory, and Firsthand, and her work has been recognized by the Digital Health Association.
When she’s not writing about mental health, Alex is usually playing pickleball, meeting with her local board of health, or enjoying time with her three kids.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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