Living with puerperal psychosis: a qualitative analysis.

OBJECTIVES: To explore women's experiences of the relatively uncommon postnatal illness of puerperal psychosis, and to gain understanding into living through and past the illness.
DESIGN: An interview-based study using grounded theory principles to analyse the qualitative data.
METHODS: Interviews were conducted with 10 women who had been diagnosed and treated for puerperal psychosis (defined according to DSM-IV criteria, with onset within six weeks of childbirth) during the last 10 years.
RESULTS: Three main categories were identified from the interviews: puerperal psychosis as a separate form of mental illness, loss, and relationships and social rules. Further, two higher order concepts were identified, termed 'living with emotions' and 'regaining and changing self'. These concepts emerged across, and linked, the categories previously identified.
CONCLUSIONS: Women felt that the illness took away the ability to experience normal emotions, as affective responses were viewed as potentially pathogenic. Although puerperal psychosis was described as a life-changing experience, the women used feeling like their 'old sense of self' as a marker for recovery. Anger and frustration were directed towards health services because of their lack of provision of adequate information and support for the women and their families. More support may have alleviated the stresses placed on relationships and informed families about the nature of the illness. Further work is needed to establish the long-term effects of suffering from puerperal psychosis.