-depressive illness, depressed. Early postpartum euphoria may predict depression weeks later. Women with histories of both a bipolar episode unrelated to childbirth and a puerperal episode have been found to have a more than 50 percent risk of an affective episode following a subsequent delivery. It has been stated that the female bipolar patient in the postpartum period, is at the highest risk of an episode, particularly if she has had a previous puerperal episode (Leibenluft, 1996).
Symptoms for postpartum psychosis are reported to differ from other psychotic episodes, due to marked disturbances in cognition, and changes in level of consciousness and confusion, which results in bizarre behavior. Manic symptoms have been found to be more common in puerperal women; women with postpartum mania were found to have more Schneiderian symptoms, suggesting that they are symptomatically like schizoaffective disorder. Puerperal women with major depression have been found to be more likely to be psychotic, perplexed, agitated and emotionally labile (Wisner, Peindl, & Hanusa, 1994).
Bipolar women are more likely than men to develop a rapid-cycling form of the illness, they are more likely to suffer from depressive or mixed episodes (Leibenluft, 1996). More than 90 percent of individuals with a single manic episode, have future episodes, an average of four episodes occur in 10 years. Approximately 5-15 percent have multiple mood episodes. Rapid cycling of moods is associated with a poorer prognosis. Characteristics associated with Bipolar I Disorder include: suicide (10-15 percent), child abuse, spouse abuse or other violent behavior during severe manic or psychotic phases, occupational failure, divorce, and antisocial behavior (DSM-IV, 1994).
Theories regarding Bipolar I disorder, with postpartum onset include the study of: socioeconomic status, biochemical and endocrine differences, genetic contributions and familial influence...