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Pregnancy & Postpartum Mood Disorders 101

Get educated and informed on what to look out for as you grow and welcome your baby into the world so you can enjoy this time instead of suffer!

pregnant woman holding belly her black dress blending in with the black background
"Each morning we are born again. What we do today is what matters most." - Buddha

What are postpartum mood disorders?

Most new mothers, up to 85%, will experience postpartum mood disorders to some degree. The majority of women will experience what is known as the postpartum blues or baby blues. These are mood swings that, while very intense, will ease after the first couple weeks after birth.

The baby blues are mostly due to fluctuating hormones after birth as the body adjusts to the postpartum period. Your body has just gone from building a human, to now creating milk and healing from birth. A lot is changing and this will manifest in your emotional and mental states as well.

Women may also experience:

  • Pregnancy or postpartum depression

  • Pregnancy or postpartum anxiety

  • Pregnancy or postpartum OCD

  • Postpartum PTSD

  • Bipolar mood disorders

  • Postpartum psychosis

The instances of these become less common, the more severe the disorder. So while it is reported that about 15% of mothers go through postpartum depression, only about 1-2 per 1000 live births will result in a mother with postpartum psychosis.

When mood disorders may show up

It is important to know that these disorders can appear at any point during pregnancy or during the first year after birth.

black and white pregnant belly against black background

Signs, symptoms and risk factors

While there is some overlap and some women may experience more than one of these mood changes, it is important to know what each of these disorders looks and feels like in a new mother. There are treatment options available that can help with all of them, no one needs to suffer! Here is what to look out for:

Pregnancy or Postpartum Depression (PPD)

  • Tearfulness, crying spells

  • Lack of interest in the baby

  • Loss of appetite

  • Insomnia

  • Feeling angry or irritable

  • Feeling guilty, shameful or hopeless

  • Loss of interest in things you once enjoyed

  • Thoughts of harming yourself or the baby

Women who meet any of the following criteria are at an increased risk for PPD

  • Financial stress

  • Marital stress

  • Teen mothers

  • Lacking proper support

  • Pregnancy or birth complications

  • Mothers with infants in Neonatal Intensive Care (NICU)

  • Mothers of multiples

  • Major life change; loss, move, unemployment

  • Personal or family history of depression or postpartum depression

  • Women with PMDD or severe PMS

  • Mother’s who’ve gone through infertility treatement

  • Women with a thyroid imbalance

  • Women with any form of diabetes (1,2 or gestational)

Pregnancy or Postpartum Anxiety (PPA)

  • Incessant worrying

  • Fear that something bad is going to happen

  • Racing thoughts

  • Problems with sleep or appetite

  • Restlessness

  • Dizziness, hot flashes and nausea

  • Panic attacks

Women who meet any of the following criteria are at an increased risk for PPA

  • Personal or family history of anxiety

  • Thyroid imbalance

Pregnancy or Postpartum Obsessive Compulsive Disorder (PPOCD)

  • Obsessions: intrusive, persistent or repetitive thoughts or mental images related to the baby. These are thoughts the woman has never before experienced.

  • Compulsions: the need to do things repeatedly to ease the obsessions. This may be cleaning excessively, counting or reordering things or checking things over and over again.

  • Fear of being alone with the baby

  • Overprotectiveness of the baby

  • A sense that the thoughts are horrifying, and very unlikely to ever act on them

Women who meet any of the following criteria are at an increased risk for PPOCD

  • Personal or family history of OCD

Postpartum Postpartum Post-Traumatic Stress Disorder (PPPTSD)

  • The experience of a real or perceived trauma during delivery or postpartum such as:

  • Prolapsed cord

  • Unplanned C-section

  • Vacuum extractor or forcep use

  • Baby going to NICu

  • Feeling unsupported, powerless or having poor communication during childbirth

  • Severe physical complication or injury from pregnancy or birth

Women who meet any of the following criteria are at an increased risk for PPPTSD

  • Previous trauma such as sexual abuse or rape

Bipolar Mood Disorders (BMD)

  • Extreme highs, or manic episodes which may include hallucinations or psychotic delusions

  • Extreme lows, or depressive episodes which may include suicidal thoughts

  • Highs and lows lasting more than 4 days that cause problems with functioning and relationships

  • Rapid speech

  • Little need for sleep

  • Overconfidence

  • Racing thoughts

To diagnose a thorough examination of the woman’s mood history is crucial. Many women are first diagnosed with BMD during pregnancy or postpartum, but it can look like extreme depression or anxiety.

Postpartum Psychosis (PPP)

  • Delusions

  • Hallucinations - seeing or hearing things that others can’t

  • Extremely irritable

  • Being hyperactive

  • Decreased need for or inability to sleep

  • Paranoia and suspiciousness

  • Rapid mood swings

  • Difficulty communicating

Women who meet any of the following criteria are at an increased risk for PPP:

  • Personal or family history of bipolar disorder

  • Previous psychotic episode

This must be treated as an emergency situation as there is a risk for suicide or infanticide. While very rare, it must be taken seriously and treated immediately by a professional.

newborn clenching a finger black and white

Stigma and seeking help

The high prevalence of these mood disorders should reassure you that there is absolutely nothing to be ashamed about if you experience any of these symptoms.

Many, many mothers have suffered through these (including me!) and you do not need to! There is help available to you and it will make your life and the postpartum period so much better.

Lacking the proper information and feeling afraid of the thoughts I was having, I did not know how or where to ask for help. Admitting to the suicidal thoughts I was experiencing for the first time was terrifying and the constant images of my baby being harmed fogged my days.

Now, as I gear up to have my third child I am prepared to seek any help that I may need. In fact, I have already gained help from doing sessions with a professional after my last miscarriage and in processing the loss of my friend.

Here are some places online where you can go for more information and to start getting any help you may need:

Postpartum Support International

MCH Center for Women’s Mental Health (patient resource page)

Take care of yourself mama!