Chapter 16: Postpartum Psychosis

Question 1

Postpartum Blues

Answer 1

-common
-self-limiting, last several days, and often peak by the end of the first week
-S+S: tearfulness, mood swings, anxiety, fatigue, sadness, insomnia, forgetfulness, confusion
>extra rest, reassurance, and therapeutic listening help
-can recover and are able to enjoy their newborns and families

Question 2

Postpartum Depression

Answer 2

one of two symptoms exist most or all of the day: a depressed mood or decreased interest/pleasure in previous enjoyable activities
-can occur within first 2 to 6 months postpartum

Question 3

Signs and Symptoms of Postpartum Depression

Answer 3

• anorexia or weight loss
• insomnia/ fragmented sleep
• fatigue or loss of energy
• inability to concentrate
• anhedonia
• withdrawal
• decreased self-esteem
• suicidal thoughts
• infant neglect or abuse

Question 4

Management for Postpartum Depression

Answer 4

• ruling out a physical cause such as hypothyroidism
• then, Cognitive behavior therapy (CBT) and Interpersonal Psychotherapy (IPT) can begin
• if do not respond to nonpharmacological treatment, SSRI’s or SNRI’s can be prescribed
• tricyclic antidepressants if cant sleep

Question 5

Medications to Treat Postpartum Depression

Answer 5

• SSRI: fluoxetine, paroxetine, sertraline
• SNRI: venlafaxine, duloxetine, doxepin
• Tricyclics: nortriptyline, imipramine

Question 6

Post Partum Psychosis

Answer 6

mental illness

• onset first 8 postpartum weeks
• may present with signs of PPD
• signs of psychosis: hallucinations, delusions, agitation, confusion, disorientation, sleep disturbances, suicidal or homicidal thoughts, and a loss of touch with reality
• may resemble sudden manic attack; require constant supervision

Question 7

Behavioral Cues that Signal Psychosis

Answer 7

• demonstrates hyperactivity, agitation, confusion, or suspiciousness
• reports auditory hallucinations to inflict harm to the infant
• voices delusions that the infant is dead or defective or the birth did not occur
• voices excessive complaints
• exhibits obsessive concerns about the baby’s health and welfare

Question 8

Infanticide

Answer 8

the killing of an infant

Question 9

Management of Postpartum Psychosis

Answer 9

-hospitalized, mental health experts involved
-mood stabilizer (lithium and valproic acid)
-antipsychotic medications (e.g. chlorpromazine, thioridazine, and trifluoperazine)
-anti-anxiety meds (e.g. benzodiazepines: alprazolam, chlordiazepoxide, diazepam)
>if taken lithium; serum levels drawn