I choose to write not just about postpartum depression (PPD) but of the spectrum of mood disorders that can follow the birth of a baby. There is not one particular way that these mood disorder presents, as each person can display different symptoms or severity/complexity of symptoms.
Often enough only PPD is discussed by a OBGYN, when in fact, there are many ways in which having a baby can change the behaviors and moods of a new mother.
There are six types of Postpartum Mood Disorders (PMDDs); postpartum depression, postpartum anxiety disorder, postpartum bipolar disorder, postpartum OCD, postpartum post traumatic stress disorder & post partum psychosis.
These events will typically occur within the first year of birth and are categorized by a variety of symptoms as listed below.
A less serious form of postpartum depression is coined "The Baby Blues". This usually occurs within the first 1-3 weeks of birth and has a range of short term symptoms such as; mood instability, crying/weeping, sadness, irritability, lack of concentration, feeling dependant on your care person, and anxiety.
As mentioned, "The Baby Blues" are short term ranging for a few days to a few weeks after delivery and can be a very normal adjustment to your new life as a mom. Hormones are changing, sleep is lost and often more stress abounds. However, if your symptoms are lasting longer or becoming increasingly severe please contact your doctor for a PPD reevaluation.
If your OBGYN can't see you right away call your family/general practitioner they are very widly used to help with PPD and depression.
Postpartum Depression (PPD)
PPD effects 10-15% of women after childbirth within the first year. Symptoms of PDD are very simular to some of the symptoms of depression. These symptoms without treatment can last up to a year or longer.
- Feelings of sadness or feeling down
- Crying easily
- Lost of interest of things that were previously enjoyable
- Irritability (often PPD can go un-diagnosed because feelings of lows are replaced by irritability. They can also occur simultaneously.
- Feelings of hopelessness
- Trouble sleeping; including falling asleep & staying asleep
- Decreased energy
- Feeling less or more hungry
- Weight gain or weight loss
- Feelings of guilt and/or shame
- Low self-esteem
- Frequent and intrusive thoughts of harming your baby (SEEK HELP IMMEDIATELY)
- Thoughts of hurting yourself (SEEK HELP IMMEDIATELY)
Postpartum Anxiety Disorder (PPAD or PPA)
There are so many unknowns about being a parent and so many "what-ifs". But what happens when you can't stop thinking about t those "what-ifs" and start to interfere in your daily life preventing you from doing the things to need in your family? This may be a sign of PPA.
Uncontrollable worries adversely impact your sleep, health, or ability to care for your little one. Sky-high anxiety can also trigger panic attacks.
- Feeling tense
- Worrying a lot
- Having shortness of breath or feeling like you’re choking
- Having hot or cold flashes
- Feeling tingling hands and/or feet
- Experiencing muscle tension
- Having chest pain
- Feeling agitated or restless
- Fearing that you might die
- Fearing that you might be going crazy
- Feeling anger or rage
- Experiencing intense fear of being alone or fears about your baby’s health
- Feeling dizzy or hyperventilating
- Having nausea, diarrhea, or vomiting
With anxiety please remember medication may make it easier but may not get rid of PPA. Therapy, talk and/or CBT will help ease your anxiety.
Post Partum Bipolar Disorder (PPBP)
Everyone goes through ups and downs, but bipolar highs and lows are severe. Often, bipolar disorder (previously called manic depression) remains undiagnosed for years. In women who have bipolar disorder or who have some of the risk factors for bipolar disorder, the birth experience, lack of sleep with a newborn, PPD or even stress may trigger symptoms.
With postpartum bipolar disorder, in addition to signs of postpartum depression, new moms may experience:
- Extreme mood swings, lasting for days or weeks
- Highly irritable mood
- Increased talkativeness
- Risky and/or impulsive behavior
- Racing thoughts
- Feeling easily distracted
- Feeling energetic, high or hyper
- Decreased need for sleep/insomnia
It is very important that if you suspect bipolar disorder that you seek help with a therapist and psychiatrist. Your OBGYN and general practitioner cannot provide you the level of help you may need to stay well.
Postpartum Psychosis (PPP)
This is a severe condition that occurs in only 1% of women and develops between one to two days and up to three weeks after birth. Because of the disturbances in perceptions of reality, high risk of harming yourself or someone else, and difficulty caring for an infant, postpartum psychosis is considered an emergency requiring immediate medical intervention and treatment.
A history of bipolar disorder increases the risk of developing postpartum psychosis, which includes symptoms such as:
- Delusional thoughts not based in reality
- Hallucinations often involving sight, smell, touch, or hearing voices
- Disorganized speech
- Excessively disorganized thinking that increases the risk of harming yourself, the baby, or another person
- Sleep disturbance and the inability to sleep even when the baby is sleeping
- Irritability, extreme agitation, restlessness
- Dramatic and drastic changes in mood
Unfortunately suffering an episode of PPP does increase the likely hood of suffering again with another pregnancy/birth.
People who suffer from PPP typically make full recoveries and do not experience another episode.
Postpartum Obsessive Compulsive Disorder (PPOCD)
A thought, impulse, or image consumes you. You perform a specific behavior to ease your discomfort. Things are better—for a while. That’s the nutshell version of OCD. In postpartum OCD, moms’ obsessive thoughts focus on the baby, especially on harm that can befall the child. For example, she may sterilize the bottles repeatedly to make sure all the germs are gone. In another manifestation of symptoms, she might secretly fear she will harm her baby or forget him somewhere.
Signs of postpartum obsessive compulsive disorder include:
- Recurring, persistent and disturbing thoughts, ideas, or images (frightening images of accidents, abuse, harm to baby)
- The urge to do something over and over again to reduce feelings of fear, to avoid harming baby (for example, putting away knives), or to create protection for baby (not leaving the house and/or constantly checking the baby, the house, etc.)
- Intrusive thoughts, fears, and images, and the inability to control them
- Hypervigilance (not being able to sleep for fear that something will happen to baby, being in a constant “fight or flight” mode)
- Being aware that these thoughts and behaviors are not typical, but still finding them very difficult to control
Postpartum Posttraumatic Stress Disorder
Posttraumatic stress is often associated with military service, a history of physical or sexual abuse, or other harrowing events. Yet a small number of women are so distressed by childbirth that they develop PTSD. About 2% to 5% of women experience full-blown PTSD, although many others experience isolated symptoms. Post-delivery PTSD can interfere with the mother-baby bonding.
Signs of postpartum PTSD include:
- Feelings of anxiety when exposed to situations similar to the traumatic experience
- Avoiding places, people, or things that remind the person of the trauma
- Irritability or feeling “on edge”
- Emotional numbing/detachment