We found that hypomanic symptoms (or a mixed state) occurred immediately in the postpartum period in 11 patients, and these patients were treated with mood stabilizers and/or antipsychotics. However, we also decided to treat seven patients without hypomanic symptoms (or a history of hypomanic symptoms) with mood stabilizers. These seven patients were diagnosed with a major depressive episode with psychotic features and an onset of symptoms within 4 weeks of the postpartum period. Of these, six were treated with lithium and antipsychotics and one refused treatment. For all except one woman, the depression went into complete remission. The one patient who did not respond to treatment with lithium and antipsychotics received ECT, and her depression subsequently remitted.