What is a Postpartum Mood Disorder?

A postpartum mood disorder is a mental health disorder striking within the first year of giving birth. All women of childbearing age should be aware that a PPMD can strike any woman after delivery regardless of whether you are a first time mother or have had previous pregnancies.

Could I have a postpartum mood disorder?

The baby blues affects up to 80 percent of all new mothers, with onset usually between 3 and 14 days postpartum. Symptoms may last only a few days or weeks. These symptoms may include feeling tense, anxious, or exhausted, alternating between joy and sadness, an inability to concentrate and a lack of energy. Twenty percent of women with baby blues will go on to develop postpartum depression.

Postpartum depression affects up to 25 percent of new mothers. Symptoms can be exhibited right away or several months after delivery. Prior incidents of PPD puts a woman at a 50 to 80 percent higher risk of recurrence. Symptoms may include chronic crying, panic attacks, anxiety, sadness, compulsiveness, rapid weight loss or gain, sleep problems, a feeling of detachment from the baby, anger, excessive fear for the baby’s health and safety, and frightening thoughts.

Postpartum psychosis, which is believed to affect only one to two new mothers in 1,000, can occur very soon or a couple of weeks after giving birth. In addition to symptoms of baby blues or PPD that may be apparent, a woman with PPP may also experience severe or rapid mood swings, extreme fatigue, hyperactivity, confusion, incoherent statements, thoughts of harming self or baby, losing touch with reality, hallucinations and/or irrational thoughts, and delusional thinking. It is believed that PPP results in a suicide rate of five percent, and an infanticide rate of four percent. Women suffering from PPP can ‘cycle’ rapidly, going from lucid to irrational quickly. PPP requires immediate medical intervention.

Women in the postpartum period may also experience panic disorder and/or obsessive compulsive disorder. Panic disorder can manifest with symptoms such as terror, racing or pounding heart, chest pains, dizziness, nausea, shortness of breath, hot or cold flashes, and irrational fears. People experiencing panic attacks often go to the emergency room, fearing they are having a heart attack. Obsessive behaviors are hallmarked by unwanted ideas or impulses that flood the mind. Fears about safety and hygiene and an unrelenting drive for perfection are common. Compulsions are actions a person feels she must take, such as repetitive hand washing, repeating, and constantly rearranging objects. Postpartum onset of OCD can also include a visual ‘loop’ of something horrible happening, unwanted thoughts about harming or killing the baby, and tremendous repulsion about having these thoughts.

Treatments of these illnesses may require medication, psychotherapy and, in extreme cases such as PPP, hospitalization.

What can I do if I suspect I have a PPMD?

The first thing you should do is contact your doctor, who may refer you to a psychiatrist and/or therapist. If your doctor advises medication, don’t be afraid to try it. For many women with PPMDs medication is a helpful and necessary treatment. Don’t berate yourself if you do require medication. It can help.

Where can I find out more about Postpartum Mood Disorders?

There are several good books available on postpartum mood disorders and clinical depression. Here is a brief list of recommended titles:

Women's Moods : What Every Woman Must Know About Hormones, the Brain, and Emotional Health by Deborah Sichel, M.D. and Jeanne Watson Driscoll, M.S., R.N., C.S. (Quill)

The Postpartum Husband: Practical Solutions for living with Postpartum Depression by Karen Kleiman, MSW (Xlibris)

This Isn’t What I Expected by Karen Kleiman, MSW, and Valerie Raskin, M.D. (Bantam Books)

Shouldn’t I Be Happy: Emotional Problems of Pregnant and Postpartum Women by Shaila Misri, M.D. (Simon and Schuster)

There are also several organizations that offer information, support and advice, including:

Depression after Delivery
P.O. Box 1282 Morrisville, PA 19067
1-800-944-4PPD

Postpartum Support International
927 North Kellogg Avenue Santa Barbara, CA 93111
1-805-967-7636

Postpartum Depression
The National Women's Health Information Center
The Office on Women's Health - US Department of Health and Human Services
1-800-994-WOMAN

Suggestions for taking care of yourself during the postpartum period

Even if you are unable to sleep, try to rest when the baby sleeps. Your body has worked hard to create the baby you delivered, and your body needs to recover.

Eat healthfully. Avoid ‘junk food’ and try to eat recommended servings of fruits, vegetables and grains daily. Avoid caffeine, alcohol and sugary drinks, opting for water instead.

Try to exercise regularly. Physical activity releases endorphins in the brain, resulting in a ‘natural high’.

Ask for and accept help. Realize that there are no perfect mothers, and that everyone needs help from time to time. Also remember that others are unable to read your mind, but are often willing to help in any way possible. Concrete suggestions (“please wash and put away the baby’s laundry”) will ensure that you are getting the help you want the most.

Avoid stress when possible. For example, if you know the news broadcast on the radio will upset you, put in some favorite music or change the station. Take time for your relationship. Try doing things you enjoyed doing ‘pre-baby’ together.

Make regular ‘dates’ with yourself. Schedule time for you to go to the park, get your nails done, take a walk, or whatever it is that soothes you. As a mother you give of yourself seemingly constantly. You need time to ‘replenish the well’ so that you can feel healthy and more relaxed.