In plain words
Delirium is a sudden change in attention, awareness, and thinking. A person may seem confused, drowsy, agitated, or unable to focus, and the state often shifts through the day. It starts over hours or days, not months. Delirium is usually caused by something physical, such as infection, very high or low blood pressure, thyroid disease, a reaction to a medicine, or a brain condition. After birth it can be a sign of a serious problem, including or infection. It is not the same as the ordinary tiredness of new parenting, and it is not . Sudden confusion in a new mother is an emergency. Call 911 or go to the nearest emergency department now.
The deeper version
Delirium is defined in DSM-5-TR (American Psychiatric Association, 2022) by disturbance in attention and awareness that develops over a short period and fluctuates, with an additional cognitive change and evidence of a medical cause. In the postpartum period the differential includes eclampsia, sepsis, thyroid disease, intracranial hemorrhage, venous sinus thrombosis, drug or medication effects, electrolyte disturbance, and autoimmune encephalitis. Inouye and colleagues (Lancet, 2014) reviewed the pathophysiology in older adults, describing neuroinflammation and disrupted neurotransmission as shared mechanisms. Postpartum delirium is less studied, and its rates are not well established. The main clinical principle is to treat the underlying cause and to exclude the most dangerous causes urgently.
Where it comes up
What mothers here say about delirium
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Sources
- American Psychiatric Association — Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR), 2022
- Inouye SK, Westendorp RGJ, Saczynski JS — Delirium in elderly people. The Lancet, 2014