Major Depression

It is common for many women to experience feelings of sadness and fatigue following the birth of a baby. This is often referred to as "baby blues." However, if these feelings persist beyond 2-weeks postpartum and they begin to interfere with the mother's ability to function, then she is coping with something more severe--postpartum depression. For some women, they have experienced depressive episodes before and this is a recurrence of those symptoms; but for others, these feelings are new, unfamiliar, and unexpected. Research has shown that 1 in 7 women experience postpartum depression within the first year following their baby's birth. Symptoms of depression include

  • Feelings of anger or irritability

  • Lack of interest in the baby

  • Appetite and sleep disturbance

  • Crying and ongoing sadness

  • Feelings of guilt, shame or hopelessness

  • Loss of interest, joy or pleasure in things you used to enjoy

  • Possible thoughts of harming the baby or yourself

Anxiety Disorders

Approximately 6% of pregnant women and up to 10% of postpartum women experience intense feelings of anxiety. This anxiety may show as uncontrollable worry, sleeplessness, feelings that something bad is going to happen, and physical symptoms such as hot flashes, nausea, and dizziness. Sometimes, the anxiety is more than just generalized anxiety. Some women develop obsessive-compulsive symptoms during and after pregnancy. These symptoms might include 

  • Obsessions, which are intrusive thoughts or mental images related to the baby. These thoughts are very upsetting and not something the woman has ever experienced before.

  • Compulsions, which are behaviors the mother may do over and over again to reduce her fears and obsessions. This may include things like cleaning constantly, checking things many times, or counting things.

  • A sense of horror about the obsessions

  • Hypervigilance in protecting the infant

  • Moms with postpartum OCD know that their thoughts are bizarre and are very unlikely to ever act on them

Post-Traumatic Stress Disorder

 

Bipolar Disorder

 

Postpartum Psychosis

Something that is often overlooked is the possibility of trauma occurring during or after childbirth. Approximately 9% of women suffer from Post-Traumatic Stress Disorder (PTSD) following childbirth. Traumatic events include prolapsed cord, unplanned C-section, infant going to NICU, feelings of powerlessness during delivery, and severe physical complications related to pregnancy or childbirth. The symptoms of PTSD include 

  • Intrusive re-experiencing of a past traumatic event (which could be the childbirth itself)

  • Flashbacks or nightmares

  • Avoidance of things associated with the event, including thoughts, feelings, people, places and details of the event

  • Persistent increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response)

  • Anxiety and panic attacks

  • Feeling a sense of unreality and detachment

Pregnancy and the postpartum period can trigger the onset or recurrence of a Bipolar Mood Disorder. In Bipolar Disorder, the individual experiences depressive episodes and manic/hypomanic episodes. These phases look very different: depression is as described previously (sad mood, low energy, appetite changes, feelings of worthlessness); mania/hypomania is characterized by expansive mood, increased energy, less need for sleep, rapid speech, and racing thoughts. The symptoms of mania are more severe than hypomania--in mania, an individual might partake in risky behaviors and/or experience delusions.  Occasionally, an individual experiences both depressive and manic symptoms at the same time--this is called a "mixed" episode.

Postpartum Psychosis is a rare illness which affects approximately 0.1% - 0.2% of women following childbirth.  Although it is rare, it is an emergency situation requiring immediate intervention.  If you believe you or someone you love is suffering from postpartum psychosis, please know that help is available. Please call your doctor or an emergency hotline right away. 

The symptoms of Postpartum Psychosis might include delusions or strange beliefs, hallucinations, sleep disturbance, paranoia, rapid mood swings, and difficulty communicating at times. The most significant risk factors for postpartum psychosis are a personal or family history of bipolar disorder, or a previous psychotic episode.