Over the last several years, postpartum mood disorders have gained more attention from the media and the public. You might even be wondering if you or someone you know is suffering from a postpartum mood disorder. It is important to understand that this is a broad term for the wide range and variety of emotions a woman can experience after having a baby. Postpartum mood disorders are normally divided into three subcategories that include “baby blues”, postpartum depression (PPD), and postpartum psychosis (PPP). In recent years, new categories have been added to the group of postpartum mood disorders, including postpartum anxiety (PPA), postpartum obsessive-compulsive disorder (PPOCD) and postpartum post-traumatic stress disorder (PPTSD). These subgroups have a variety of symptoms and vary in severity and intensity.
What are the “Baby Blues”?
The “baby blues” are the least severe form of postpartum depression. Approximately 50% to 75% of all new mothers will experience some negative feelings after giving birth. Normally these feelings occur suddenly four to five days after the birth of the baby. The most common symptoms include:
- Crying for no apparent reason
- Mood swings with irritability and anxiousness
- Feel overwhelmed
- Change in eating and sleeping
While these symptoms are quite unpleasant, they typically resolve on their own within a week to two weeks. Getting as much rest as possible and having a good support system can help these symptoms seem less severe.
What is Postpartum Depression (PPD)?
Approximately 15% of new mothers will experience what is classified as postpartum depression (PPD). Symptoms may occur a few days after delivery or sometimes as late as a year later. Women who experience postpartum depression will have alternating good days and bad days. Symptoms can be mild or severe, usually lasting for over 2 weeks. A few of the symptoms include:
- Feelings of sadness, hopeless and overwhelmed
- Trouble sleeping and eating
- Feelings of guilt and being worthless
- Loosing interest in things that you used to enjoy
- Withdrawing from family and friends
- No interest in the baby
- Thoughts of hurting yourself or your baby
Because postpartum depression can range in severity, its very important than any woman experiencing these symptoms talk with her health care provider. Treatmeant may range from therapy to medication.
What is Postpartum Anxiety (PPA)?
Postpartum anxiety affects about 10% of postpartum women. These women may experience anxiety alone or may also experience depression with the anxiety. Postpartum anxiety can also include postpartum panic disorder which includes having panic attacks along with feelings of anxiety. Symptoms include:
- Changes in eating and sleeping
- Racing thoughts that you can’t get control of
- Constant worry
- Impending fear that something bad is going to happen
- Trouble with sitting still and focusing
- Physical symptoms such as dizziness, hot flashes, and nausea
Postpartum anxiety is treatable and often will go away once the right treatment is found.
What is Postpartum Obsessive-Compulsive Disorder (PPOCD)?
Postpartum obsessive-compulsive disorder is one of the newer disorders that is part of the postpartum mood disorders group. It is estimated that about 3-5% of postpartum women will experience some of the symptoms of PPOCD. Symptoms may include:
- Overly occupied with keeping the baby safe
- Compelled to do certain things over and over again to help relieve her anxiety and fears. This can include counting things, ordering things, listing things, checking and rechecking actions already performed, and cleaning repeatedly. May manifest itself in cleaning, feeding or taking care of the baby.
- May recognize these obsessions but feels horror and shame associated with them
- Obsessions or thoughts that are persistent, are repetitive and can include mental images of the baby that are disturbing
- Fear of being alone with the baby
Women who suffer from PPOCD often know that these thoughts, actions and feelings are not normal and do not act on them. But the obsession can get in the way of a mom taking care of her baby properly or being able to enjoy her baby. With the right treatment, women with PPOCD can can experience freedom from being controlled by these obsessions and compulsions.
What is Postpartum Post-traumatic Stress Disorder (PPTSD)?
Postpartum post-traumatic stress disorder often affects women who experienced a real or perceived trauma during childbirth or immediately after the baby was born. It is believed that approximately 1-6% of women experience postpartum post-traumatic stress disorder after giving birth.
Traumas that might cause postpartum post-traumatic stress disorder include:
- Unplanned Cesarean
- Emergency complication such as prolapsed cord
- Birth that includes invasive interventions such use of vacuum extractor or forceps
- Baby having to stay in NICU
- Lack of support and assurance during the delivery; lack of communication from the birth and support team; feelings of powerlessness
Symptoms of PPTSD may include:
- Nightmares and flashbacks to the birth or trauma
- Anxiety and panic attacks
- Feeling a detachment from reality and life
- Irritability, sleeplessness, hyper vigilance, startles more easily
- Avoid anything that brings reminders of the event such as thoughts, people, places, smells, noises, feelings
- May begin re-experiencing past traumatic events, including the event that triggered the disorder
Women who are experiencing PPTSD need to talk with a health care provider about what they are feeling. With the correct treatment, these symptoms will lessen and eventually go away.
What is Postpartum Psychosis (PPP)?
Postpartum psychosis (PPP) is the most severe form of postpartum depression, but fortunately it is the rarest form. It occurs in 1 to 2 out of every 1,000 pregnancies. The onset is very sudden and severe, normally within 2 to 3 weeks after giving birth. Symptoms are characterized by a loss of touch with reality and can include:
- Bizarre behavior
- Suicidal thoughts
- Hallucinations and/or delusions
- Thoughts of hurting the baby
- Rapid mood swings
Postpartum psychosis is considered a medical emergency and should be treated immediately.
If you or someone you know is struggling with any form of postpartum depression, please contact a physician, a friend, or the American Pregnancy Association so that the appropriate help can be located.
Compiled using information from the following sources:
Williams Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 55.
MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); [updated 2006 Feb 21]. Postpartum Depression; [updated 2006 Feb 9; reviewed 2006 Jan 25; cited 2006 Feb 22]. Available from: http://www.nlm.nih.gov/medlineplus/postpartumdepression.html
Depression during and after Pregnancy Fact Sheet, http://www.womenshealth.gov