Psychological interventions for managing postpartum psychosis: a qualitative analysis of women’s and family members’ experiences and preferences

Abstract

BackgroundPostpartum psychosis is a rare, yet severe disorder, in which early identification and immediate intervention are crucial. Despite recommendations for psychological input, little is known about the types of psychological intervention reported to be helpful. The aim of this study was to explore the experiences, needs and preferences for psychological intervention from the perspective of women with postpartum psychosis and from the perspective of family members.MethodsThirteen women and eight family members, including partners were interviewed. The data from these semi-structured interviews were audio-recorded, transcribed and inductively analysed using thematic analysis.ResultsTwelve subthemes were identified and then organised around three main themes: 1) Seeking safety and containment, 2) Recognising and responding to the psychological impact and 3) Planning for the future. These themes highlight the temporal element of recovery from postpartum psychosis, because women’s psychological needs and preferences changed over time. Emphasis was initially placed on ensuring safety, followed by a need to connect, process and adjust to their experiences. Additional needs were reported by women and family when planning for the future, including managing the fear of relapse and help to reach a decision about future pregnancies.ConclusionThe results illustrate a range of areas in which psychological intervention could be delivered to facilitate and enhance recovery. Further research is needed to develop meaningful and effective psychological interventions and to investigate the most appropriate timing for this to be offered.

Pentadic Cartography: Mapping Postpartum Psychosis Narratives

“…Debbie provided an illustration of this when she felt unsupported by her midwife and Nancy who felt unsupported by her husband. Previous qualitative research highlighted this need for women who shared how much they valued and needed family and friends' support in their recovery from postpartum psychosis (Forde et al, 2019;Heron et al, 2012). McGrath et al (2013) also reported that important to women's recovery was the context of factors in their lives such as informal support networks, women with similar experiences, and the mental health system.…”

“…Thirteen women who had postpartum psychosis and eight family members from the United Kingdom were interviewed about their experiences of postpartum psychosis, interventions and support, and the family's role (Forde et al, 2019). Interview data were analyzed using thematic analysis.…”

The effect of postpartum psychosis on partner’s and infant’s life

“…As a result, those patients are completely unprepared for what they are facing. Many times, the lack of information and prior counseling creates a feeling of shame, which may prevent her relatives from seeking help [13]. In the acute phase of PP, patients experience loss of their identity and sense of self, feel abandoned by their family and fear for the future [14].…”

“…Even after the psychotic symptoms have passed the feeling of losing control and upset in every aspect of their life remains. Therefore, the need for support from the family, both during their hospitalization and afterwards, is considered imperative [13]. The couple's decision to have another child in the future is also affected [12].…”

“…Others claim that some events (e.g., their child's birthday) trigger bad memories of that period and bring back feelings of fear, sadness, guilt for several years, while there are memories that are never sure if they were true. facts or hallucinations due to PP [13].…”