Perinatal Mood Disorders Explained

After having a baby, it’s common to have heard about postpartum depression. But, you may be feeling a variety of other emotions and challenges that don’t fit in the box of this definition. Perinatal mental health disorders affect nearly 20% of pregnant or postpartum women. More research is also being done on fathers, but it’s estimated that 1 in 10 fathers also experience symptoms of anxiety and depression during the perinatal period.  

While postpartum depression and/or anxiety are common, there are a whole host of mood disorders that can come along with pregnancy or postpartum experiences. Knowledge is power so our hope in this post is to help educate you on the kinds of common perinatal mood disorders, the symptoms of each, and how they can be addressed with therapy or other treatment options.

Pregnancy, childbirth and the first postpartum year (and longer), are filled with shifts in hormones and life circumstances that have a direct impact on one’s mental health. Taking care of yourself should always be a priority and we encourage anyone who is struggling to reach out to your doctor or a mental health provider. (We have therapists available at Parent Wellness Group if you’re in MA or RI!). 

We will briefly break down a few of the postpartum mental health struggles below, but please know that talking through your symptoms with a trusted professional is the best way to understand your potential diagnosis and most importantly, explore treatment options. 

Potential Risk Factors for Perinatal Mental Health Disorders: 

Note: list below is provided for you to reflect on whether you may be more at risk, but it’s not a guarantee that if you have one of these factors, you will experience a mental health disorder 

• A history of anxiety or depression personally or within the family

• Previous pregnancy loss or loss of a child

• Having personal health struggles or having a partner with health struggles

• Caring for more than one child

• Isolation and lack of support from partner and/or network after birth

• Personality type i.e. “natural worrier”

• Having a baby who is hard to comfort and whose sleep and hunger are irregular/don’t seem to be regulating

• First child

• Having a baby with special needs or health complications

• Other stressors such as loss of job, move, death or serious illness of a loved one

• Financial or employment problems

• Significant change in hormones

• Struggles with breastfeeding if that is desired route of feeding the baby

• Struggles with getting pregnant/fertility/pregnancy

• Miscarriage

• Challenging test results

Postpartum Depression

With approximately 15% of new mothers and 10% of pregnant mothers struggling with symptoms of depression, perinatal depression is one of the most common side effects of pregnancy and childbirth. The good news is that depression is very treatable and does not last forever. Seeking help from a therapist, a support group, and/or your doctor is a great next step if you are experiencing the following:

Symptoms:

• Extreme feelings of sadness that don’t seem to let up

• Lack of energy

• Difficulty bonding with your baby, or the future of motherhood 

• Loss of interest in things that used to bring you joy

• Increased crying and irritability

Postpartum Depression vs. Baby Blues

Even more common than postpartum depression is what’s called the “Baby Blues.” As hormones take time to regulate after childbirth, nearly 70-80% of new mothers experience negative emotions or mood swings. Popping up anywhere from a few hours to a few days after childbirth, the baby blues are typically only felt for some parts of the day and typically resolve and regulate within two weeks.

Symptoms:

• Crying without knowing cause

• Difficulty concentrating or brain fog

• Irritability

• Insomnia

• Anxiety

• General sadness

One of the best things you can do to help with the baby blues is to get rest and support from your partner, a trusted professional or your community. With the influx of information, responsibility, hormone changes, lack of sleep, and change on so many levels in your life, it’s very common to need time to adjust to having a baby. Taking care of yourself is key in this process.

Postpartum Anxiety

Another very common symptom of pregnancy and childbirth is anxiety. Approximately 6% of pregnant women and 10% of postpartum women experience anxiety, either in a generalized form or as a panic disorder (frequent panic attacks). It’s important to note, too, that postpartum anxiety and depression is also felt by fathers - with approximately 1 in 10 fathers experiencing symptoms of one or both after the birth of a child. Welcoming a child into the world is a loaded responsibility, and along with hormones at play again, it isn’t uncommon for mothers and fathers to have anxiety about their new role. 

Symptoms:

• Feeling worried all the time

• Inability to sleep or sit still due to racing thoughts

• Fear that something may happen to you or your baby

• No appetite

• Hypervigilance

Perinatal Obsessive Compulsive Disorder (OCD)

Developing OCD during pregnancy or after a baby affects approximately 3-5% of women. This typically goes hand in hand with anxiety because the compulsions or obsessions are effectively trying to calm down the anxiety. Speak to a doctor if you find you are having any of the following, particularly if it’s becoming all consuming.

Symptoms:

• New obsessions that seem to take over

• Recurrent and unwelcome thoughts that commonly involve disturbing images, fears, doubts or ideas (Examples include: “What if I drop my baby down the stairs? What if I drown or burn my baby?) 

• Needing to check things multiple times, repetitively cleaning, or needing order or organization to a more extreme degree

• Fear of something happening to the baby or being left alone with the baby

Postpartum Post-Traumatic Stress Disorder (PPTSD)

Experiencing trauma in pregnancy, childbirth, postpartum or even in your past can spark Postpartum Post-Traumatic Stress Disorder. Approximately 9% of women experience PPTSD after childbirth in some way or another. The cause is typically due to real, scary experiences that happened to you - miscarriage, unplanned c-section, traumatic birth - and can be carried into other parts of your life.

Symptoms:

• Repetitive thoughts or flashbacks to traumatic experiences

• Easily triggered by something that relates to the traumatic event

• Hypervigilance and constant feelings of tension, irritability or stress

• Anxiety and panic attacks

• Feeling detached from yourself or your experiences

• Nightmares or difficulty sleeping

Postpartum Psychosis

Postpartum Psychosis affects approximately 1 to 2 deliveries in every 1,000. While Postpartum Psychosis is temporary, treatable and extremely rare, it is also very serious and needs immediate attention if you suspect you or someone you know is experiencing symptoms. It can occur within the first few weeks of giving birth, but can also show up later, typically within the first year postpartum.

Symptoms:

• Insomnia

• Mood swings

• Irrational thoughts

• Delusions and troubling beliefs that feel very real and rational to the mother

• Paranoia, feeling suspicious or fearful

• Trouble communicating

• Hallucinations (ie. seeing, smelling, hearing or feeling things that aren’t really there)

• Manic or Depressed mood (or mixture of both)

• Loss of inhibitions

• Behaving in a way that is out of character

Potential Risk Factors:

• Previous psychotic episode

• Family history of bipolar or psychosis

Important to note: Postpartum Psychosis is a rare, temporary and treatable disorder, but it is also very serious.Thoughts of self-harm or harming others, particularly one’s children, can be part of the condition but are uncommon. Among mothers suffering from postpartum psychosis, about 5% will attempt suicide and 4% will commit infanticide. (Postpartum Support International, 2023). If you suspect you or someone you love is experiencing psychosis, it is an emergency and you should seek immediate help.

Finally, if you are feeling any of the above symptoms or just not feeling yourself or your best after baby, please reach out to a therapist near you. Treatment for any of the above will include therapy or consulting your medical provider. We serve parents virtually in MA and RI at Parent Wellness Group, but you can also consult Zencare for a localized list of providers near you.