Postpartum psychosis affects approximately one to two per 1,000 births, begins abruptly within days of delivery, and is in most cases an episode of bipolar-spectrum illness rather than a schizophrenia-spectrum disorder. It is missed with striking regularity, partly because most affected women have no prior psychiatric history and bear no resemblance to the public image of a person with chronic psychosis, and partly because postpartum psychosis is a thought disorder in which insight is characteristically impaired, so that the failure to disclose symptoms is something the illness produces rather than something the patient chooses. This article, prompted by renewed public attention following the Lindsay Clancy trial but making no claim about that case, describes how postpartum psychosis actually presents; how it differs from chronic schizophrenia, from the ordinary intrusive thoughts of new parenthood, and from perinatal obsessive-compulsive disorder; and what the evidence supports for assessment, emergency treatment, prevention in high-risk pregnancies, and safety planning for mothers, infants, and families. A free relapse-prevention plan template is included.

Important Safety Note: This post is for educational purposes. If you or a loved one are experiencing severe distress, postpartum warning signs, or suicidal thoughts, please call or text 988 to reach the 988 Suicide & Crisis Lifeline, or access specialized care through Postpartum Support International’s helpline and resources.