Weeks after giving birth, Ms. Ngoc was constantly in a state of panic, believing someone was watching and trying to harm her. She even "didn't believe the newborn was her child" and refused to hold or care for the baby. After nearly three months, her symptoms worsened, and she lost control.

Master. Doctor Nguyen An Khai, from the Mental Health Unit at the Neuroscience Center, Tam Anh General Hospital TP HCM, reported that the patient was admitted with anxiety, panic, persecutory delusions, and impaired reality perception. She had a history of mixed anxiety-depression disorder due to work-related stress. After combining her symptoms with test results and imaging to rule out physical causes such as encephalitis, stroke, brain tumors, and other neurological conditions, doctors diagnosed her with acute postpartum psychosis.

Postpartum psychosis is a condition where the brain loses its ability to accurately assess reality, affecting approximately 1-2 per 1,000 mothers. Patients tend to harm themselves or their babies, believe in unreal things, and cannot be swayed by explanations from those around them.

"The drastic hormonal changes after childbirth, combined with prolonged sleep deprivation, the stress of childcare, and a history of mental disorders, can unbalance neurotransmitters in the patient's brain," Doctor Khai explained. He added that the brain then struggles to distinguish between reality and subjective thoughts, leading to delusions.

Ms. Ngoc received treatment with antipsychotic medication combined with sleep aids, and her progress was closely monitored. After 5 days, she was able to sleep, ate normally, and her mental state stabilized, with significant improvement in her symptoms.

The patient needs to continue medication, attend regular follow-up appointments, and receive psychological support to reduce the risk of relapse and adapt to postpartum life. Patients may also receive supplementary treatment with transcranial magnetic stimulation for related issues such as insomnia, headaches, and anxiety disorders.

Doctor Khai consults with Ms. Ngoc during a follow-up visit. *Photo: Tam Anh General Hospital*

Prolonged insomnia is an early warning sign of postpartum psychosis, but it is often underestimated. This condition impairs emotional regulation, cognition, and behavior, potentially triggering psychosis in individuals with risk factors.

Doctor Khai emphasized that postpartum psychosis is a severe psychiatric emergency. New mothers require immediate specialized examination if they experience prolonged insomnia, groundless suspicions, abnormal speech or behavior, hallucinations, refusal to eat due to fear of poisoning, or intentions to harm themselves or others. Early treatment helps control symptoms, reduces the risk of recurrence, and ensures the safety of both mother and baby.

Trong Nghia

*Patient's name has been changed