Postnatal Depression and Psychosis: How to Tell the Difference?

So, you’ve had a baby, and instead of the joy and happiness everyone promised, you feel the complete opposite.

Not only do you feel sad, anxious, or low, but you’re also having thoughts and feelings that terrify you.

You’ve heard of postnatal depression (PPD) and postpartum psychosis before, but you have no idea whether either of them could explain what you’re experiencing.

And if they do, which one is it?

You want the answers, but you also feel ashamed about the idea you might have either.

So you Google symptom after symptom, trying to understand what’s happening to you.

If this sounds familiar, you’re in the right place.

My name is Ivana Poku, and I’m a mum of three (including twins) and a postnatal depression survivor.

Firstly, I want you to know this: You are not alone, and you are not the first mum to feel this way.

You’re simply a new mum whose mind and body is going through a lot.

Sadly, many mums don’t get enough information about postnatal mental health conditions.

And as a result, they often suffer in silence, unsure of what’s happening and afraid to speak up.

In this post, I’ll explain the difference between postnatal depression and postpartum psychosis, how to recognise the signs, and how to recover.

 

 

Before we dive in, there’s one important thing I want you to remember: If something feels wrong, that’s reason enough to ask for help.

You do not need to figure out exactly what condition you have before reaching out.

Your job isn’t to diagnose yourself. Your job is to get the support you need.

Please speak to your GP, health visitor, midwife, or another healthcare professional as soon as possible. The sooner you reach out, the sooner you’ll feel better.

However, I know that can feel scary and is easier said than done.

I’ve been there myself.

So in this post, I’ll also help you ease the fear, guilt, and shame so that you can take that first step towards feeling better and enjoying your baby.

If you feel something is wrong, that’s a reason enough to reach out for help.

 

You might also like:

• Are antenatal classes contributing to postnatal depression?
• PPD Survivors Reveal What They Knew About It Before It Hit – Their Answers Will SHOCK You)
• Preventing Postpartum Depression Is Simple – So Why Aren’t We?

 

My story…

When I had my twins in 2016, I felt nothing like I’d expected.

I missed my old life so much, I didn’t feel like a mum, I didn’t enjoy being with my babies, and I desperately wanted to turn back time.

I wished my babies would die.

And at one point, I even felt a strong urge to hurt one of them.

Despite having been educated about postnatal depression and psychosis, it didn’t even occur to me that I could be experiencing either.

I simply felt like I was failing on every level, and I felt incredibly ashamed about it.

I thought I was losing my mind.

My depression was never officially diagnosed, and neither was a potential psychosis.

I only realised I had postnatal depression after I pulled through. For a long time, I didn’t realise I had also experienced signs of psychosis.

But I believe I did.

So let me explain the difference between these two conditions, so you can understand what you might be experiencing.

 

What is postnatal depression?

Postnatal depression is a mental health condition that can happen to mums and dads after a baby is born – most often in the first year, but sometimes even later.

It lasts longer than the ‘baby blues’ and feels much heavier. You may not be able to function or cope with day to day activities like getting out of bed or brushing teeth.

It can leave you feeling:

• lonely or sad for no obvious reason
• anxious about your child’s safety
• like you can’t cope
• numb
• rage
• like you’re failing

There are also some little known signs people don’t talk about and that can be extremely hard to spot. I share some the most common one in the post 5 Signs of Postpartum Depression No One Talks About.

None of this says anything about you as a mum or as a person.

Postpartum depression can happen to anyone because your body and brain go through huge changes during pregnancy and birth. On top of that, you’re adjusting to a completely new life, which can feel incredibly overwhelming.

Personally, the symptom I experienced most was feeling like I wanted to cry all the time. I desperately wanted my old life back, and I struggled to see the point in anything.

I would go for a walk and watch people walking, shopping, chatting with friends, and going to restaurants. And all I could think was: “What’s the point of all this?”

It felt as though something dark had taken over my mind.

For a full guide to postpartum depression, read my post: Everything you need to know about postpartum depression.

 

What is postnatal psychosis?

Postnatal psychosis is a rare, serious mental health condition that usually starts very quickly – often within the first few days or weeks after birth.

Unlike postpartum depression, a person with postnatal psychosis may struggle to tell what is real and what isn’t.

This can feel incredibly frightening and confusing.

Here are some signs of postnatal psychosis:

• Seeing or hearing things that other people can’t
• Believing things that aren’t true
• Feeling very confused
• Extreme mood changes
• Not sleeping at all for days
• Strong beliefs that don’t match reality
• Very unusual or risky behaviour
• Talking about harming themselves or someone else
• Acting very out of character and in ways that are unsafe

Postnatal psychosis is not your fault or something you choose to have. (Honestly, who would choose to feel like this?)

It does not mean you are a bad mum or a bad person.

It is a medical condition that needs urgent help and treatment.

I remember one particular moment when one of my twins was sitting on my lap, smiling, but I felt a strong urge to hurt him. It was as though something was telling me to do it.

It freaked the hell out of me.

Luckily, I still had enough awareness in that moment to know something wasn’t right. Many people experiencing psychosis don’t, and that’s part of the illness itself.

So I strapped him safely into his chair and locked myself in the bedroom.

It was the most terrifying moment of my life that I don’t wish on anyone.

Key differences

Here are key differences between postpartum depression and postpartum psychosis:

 

	Postnatal Depression	Postnatal Psychosis
What it is	A mental health condition that makes you feel very low and overwhelmed after having a baby	A rare but serious condition where a person loses touch with reality after having a baby
How common it is	Quite common	Very rare
When it starts	Usually within the first year after birth	Often very quickly, within days or weeks after birth
How it feels	Very sad, anxious, tired, or numb	Very confused, frightened, and not thinking clearly
Connection to reality	You still know what is real, even if things feel hard	You may struggle to tell what is real and what isn’t
Common symptoms	Low mood, anxiety, anger, guilt, feeling like you can’t cope	Seeing or hearing things others can’t, strong false beliefs, confusion, not sleeping
Day-to-day life	Hard to cope with normal tasks	Can become very disorganised and hard to function safely
Is it an emergency?	Not usually an emergency, but still needs support	Yes — it needs urgent medical help
Treatment	Talking therapy, support, sometimes medication	Hospital care, medication, and close medical support
Recovery	Most people recover well with support	Most people recover well with fast treatment

 

Warning signs of psychosis

 

When to seek urgent help

If you notice the above signs in yourself or someone else, please seek medical help straight away.

It’s always better to be safe than sorry.

 

Emergency numbers

For mums in the UK:

• Call 999 if there is immediate danger
• Contact your GP urgently and ask for an emergency same-day appointment
• Call your local NHS mental health crisis team (you can usually find this via your GP or NHS 111)
• Call NHS 111 if you’re unsure what to do next
• You can also contact Samaritans (116 123) if you need someone to talk to right away

For mums in the US:

• Call 911 if there is immediate danger
• Call or text 988 (Suicide & Crisis Lifeline) for 24/7 support
• Go to your nearest ER (emergency room)
• Contact your OB-GYN or primary doctor urgently and explain what’s happening
• Reach out to Postpartum Support International (PSI)

 

Treatment and support

Both postnatal depression and postnatal psychosis can be treated.

The help you need depends on how strong your symptoms are and how much support you need.

 

Postnatal depression:

1. Speak up

Speaking up is crucial. Speak to your doctor, GP or mental health professional.

If this feels impossible right now, talk to someone you trust. Ideally, a fellow mum who has been there and truly understands.

Your friends/family can also help you find the confidence to speak to a doctor, or even go with you.

My 60 prewritten texts can help massively with this. They help you speak up without actually having to say a word.

Check them out here. 

 

 

2. Talking therapies

Things like CBT, counselling, or other forms of therapy can help you understand your thoughts and feelings and start to feel more in control of your own mind again.

3. Medication

They don’t heal you, but they help ease the intensity of symptoms so you can function, think more clearly, and take steps towards recovery.

4. Supportive community

This can be baby groups, classes, mum meet-ups, family support, or online communities (make sure to do your research first though, as some of them can be toxic).

Feeling less alone makes a huge difference in recovery.

I dive deeper into recovery and what helped me pull through in my post How I Recovered From Postnatal Depression (And How You Can Too).

 

Postnatal psychosis:

1. Get urgent help

Postnatal psychosis is a medical emergency. You need to get help straight away.

Call your GP, midwife, or mental health team immediately. If you feel unsafe or things feel out of control, go to A&E or call emergency services. You do not have to go through this alone.

If you can, ask someone you trust to stay with you and help you get support.

2. Specialist mental health care

A special mental health team will look after you. They understand postnatal psychosis and know how to help.

They will talk with you and figure out what support you need.

3. Hospital care (sometimes)

Some people need to stay in hospital for a little while so they can be safe and get better support.

Sometimes mums can stay with their baby in a mother and baby unit, so they don’t have to be separated.

4. Medication

Doctors may give medicine to help calm your thoughts and feelings. This can include antipsychotic medicine, and sometimes mood stabilisers.

These don’t change who you are, they just help your brain feel more steady again.

5. Ongoing support

Doctors and nurses will check on you often and help you day by day until you start feeling better.

6. Important to remember

Postnatal psychosis can feel scary, but it can be treated, and people do get better.

 

Will they take your baby away from you?

This is perhaps the most common concern for reaching out for help.

But let me reassure you, no, your baby will not be taken away.

Doctors and nurses want to help you feel better while keeping you together.

A baby would only be separated for a short time if there was a serious concern that the baby was not safe, for example:

• if someone was unable to care for themselves or the baby right at that moment
• or if urgent treatment was needed and no safe alternative care was possible

Even then, it is usually temporary, and the aim is always to bring mum and baby back together as soon as it is safe.

In many situations, mums are treated in a Mother and Baby Unit, where they stay together while getting help.

The most important thing to know is this:

Asking for help early makes it more likely you stay together, not less.

Postnatal depression and postpartum psychosis can sound scary, but they are treatable conditions, just like other serious illnesses.

I hope this post helped you understand that there is nothing “wrong” with you. You are just unwell and need help and support.

Please reach out for help as soon as you feel something is off.

It is not your job to figure out exactly what you have. Your job is to make sure you and your baby are safe and supported.

So speak to someone today.

If you want to reach out to me, I’m here for you too. You can email me at ivana.poku@mumsjourney.com or DM me on Instagram.

And if you want something that will give you a great comfort and show you hope right now, see my post A Letter to Myself During Postnatal Depression (And What I Want Every Struggling Mum to Know).

With all my love,
Ivana xx