The term postpartum refers to the period immediately after a woman gives birth and extends up to 12 weeks after the birth, according to the American College of Obstetricians and Gynecologists (ACOG). However, the length of time may vary, with some considering postpartum to extend up to a year after birth.
Postpartum mood disorders, commonly known as post partum depression and refer to a range of distressing thoughts, feelings, and behaviors that begin either during pregnancy (known as peripartum onset) or after childbirth (postpartum).
Many often refer to the “baby blues” when discussing the hormonal shifts women experience after pregnancy and childbirth, however postpartum mood disorders are a serious and diagnosable, but treatable, condition. Studies have shown up to 1 in 5 women and even 1 in 10 men experience symptoms of depression or anxiety after the birth of a new baby.
The human body undergoes major hormonal and chemical changes during pregnancy, childbirth and the postpartum period, so much so that many are beginning to refer to postpartum as “the fourth trimester”. Hormones including estrogen, progesterone and prolactin may play a role in mood disorders, as these hormones drop significantly after childbirth, although research is continuing to develop.
Risk factors for post-partum mood disorders include a personal or family history of mental health conditions, complications or trauma in pregnancy, childbirth and/or breastfeeding, domestic violence or abuse in the relationship, personal history of trauma, financial or relationship stress, unplanned or unwanted pregnancy, lack of support system, having an infant who needed to be taken to the neonatal intensive care unit, and pregnancy or infant loss (miscarriage or stillbirth). Additional risk factors may be present as well.
Postpartum Depression
The most well-known of the postpartum mood disorders, postpartum depression is often referred to as “PPD” or often simply as “postpartum”. Symptoms can begin at any point in pregnancy and are unique to each person. Symptoms can include:
- Severe changes in mood to include irritability, anger, rage
- Feeling disconnected with or uninterested in your baby
- Sleep and appetite changes
- Uncontrollable crying, sadness,
- Feelings of guilt, shame, hopelessness
- Loss of interest in prior enjoyable activities
- Thoughts of harming yourself or your baby
Postpartum Anxiety
Postpartum anxiety is becoming more recognized as an independent condition, however it often occurs concurrently with postpartum depression. Symptoms are similar to that of a generalized anxiety disorder, with a preoccupation on the health, safety, and well-being of the newborn baby. Symptoms may include
- Excessive worry, restlessness, intrusive thoughts related to baby’s well-being or ability to care for baby
- Panic attacks and physical symptoms
- Feeling something bad may happen
- Nervousness and “on edge”, difficulty relaxing
There is growing recognition for a potential diagnosis of Obsessive Compulsive Disorder with perinatal or postpartum onset, with symptoms including obsessions (intrusive thoughts) and compulsions (repeated behaviors) relating to the baby being contaminated, hurt, or abused.
Postpartum Psychosis
Postpartum psychosis occurs in 1-2 of every 1,000 deliveries and often has an onset in the first 2 weeks after childbirth, but can be experienced up to a year postpartum. This is a serious disorder requiring immediate treatment and support. Symptoms include:
- Severe agitation
- Delusions (beliefs lacking a basis in reality)
- Hallucinations (hearing or seeing things that are not actually there)
- Increased energy levels that are out of character
- Severe depression (flat affect)
- Feeling paranoid or suspicious of others, or even of the baby
- Mood swings
- Inability or decreased need for sleep
Individuals experiencing postpartum psychosis are at higher risk of harming themselves or others, including their newborn baby, although the majority do not. An individual experiencing psychosis is having a break from reality where their beliefs make sense and feel real, thus requiring immediate treatment. Postpartum psychosis often requires inpatient hospitalization and stabilization with medication, with ongoing support through therapy.
Postpartum Treatment options
Postpartum mood disorders are best treated through pharmacological treatment and psychotherapy. Reach out to your support system and healthcare provider for help if you feel you are experiencing symptoms of a postpartum mood disorder
If you are noticing symptoms of a post-partum mood disorder, our licensed therapists can help you with finding support, navigating the challenges of new motherhood, and improving your quality of life. If you are having serious thoughts of harming yourself or your baby, reach out to your healthcare provider such as your OBGYN or primary care provider, or 911 if you are in crisis.
Works Cited
- https://pmc.ncbi.nlm.nih.gov/articles/PMC10438791/
- https://www.postpartum.net/perinatal-mental-health/
- https://llli.org/breastfeeding-info/postpartum-mood-disorders/
- https://iocdf.org/wp-content/uploads/2014/10/Postpartum-OCD-Fact-Sheet.pdf
- https://my.clevelandclinic.org/health/diseases/24152-postpartum-psychosis
Livia Ledbetter, LCSW
Hi! My name is Livia and I am a Licensed Clinical Social Worker in the state of Florida. I received my undergraduate degrees from the University of Florida in 2019, and my Masters in clinical social work from Florida State University in 2021. I began my social work journey as an intern working with families reunifying after involvement in the child welfare system. This, along with my outpatient therapy and school-based clinical experiences has given me a passion for and unique insight into the mental health struggles and needs facing children, families, parents and guardians.
