Postpartum Mood Disorders
Any of the following five postpartum mood disorders can also occur during pregnancy.
• Depression and/or Anxiety
• Obsessive-Compulsive Disorder
• Panic Disorder
• Psychosis
• Postpartum Psychiatric Illness Posttraumatic Stress Disorder
“Baby Blues” — Not Considered a Disorder
• This is not considered a disorder since the majority of mothers experience it.
• Occurs in about 80 percent of mothers
• Usual onset within first week postpartum
• Symptoms may persist up to three weeks
Symptoms
• Mood instability
• Weepiness
• Sadness
• Anxiety
• Lack of concentration
• Feelings of dependency
Etiology
• Rapid hormonal changes
• Physical and emotional stress of birthing
• Physical discomforts
• Emotional letdown after pregnancy and birth
• Awareness and anxiety about increased responsibility
• Fatigue and sleep deprivation
• Disappointments including the birth, spousal support, nursing, and the baby
Depression and/or Anxiety
• Occurs in 15 to 20 percent of mothers
• Onset is usually gradual, but it can be rapid and begin any time in the first year
• Excessive worry or anxiety
• Irritability or short temper
• Feeling overwhelmed, difficulty making decisions
• Sad mood, feelings of guilt, phobias
• Hopelessness
• Sleep problems (often the woman cannot sleep or sleeps too much), fatigue
• Physical symptoms or complaints without apparent physical cause
• Discomfort around the baby or a lack of feeling toward the baby
• Loss of focus and concentration (may miss appointments, for example)
• Loss of interest or pleasure, decreased libido
• Changes in appetite; significant weight loss or gain
Risk factors
• 50 to 80 percent risk if previous postpartum depression
• Depression or anxiety during pregnancy
• Personal or family history of depression/anxiety
• Abrupt weaning
• Social isolation or poor support
• History of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD)
• Mood changes while taking birth control pill or fertility medication, such as Clomid
• Thyroid dysfunction
Treatment:
• Psychotherapy and psychiatrist for medication. Antidepressant and attending a support group for PPD MOMS. If the mom is bi-polar the treatment is mood stabilizers and no anti depressants as they can trigger an SSRI syndrome.
Obsessive-Compulsive Disorder
• 3 to 5 percent of new mothers develop obsessive symptoms
Symptoms
• Intrusive, repetitive, and persistent thoughts or mental pictures
• Thoughts often are about hurting or killing the baby
• Tremendous sense of horror and disgust about these thoughts (ego-alien)
• Thoughts may be accompanied by behaviors to reduce the anxiety (for example, hiding knives)
• Counting, checking, cleaning or other repetitive behaviors
Panic Disorder
• Occurs in about 10 percent of postpartum women
Symptoms
• Episodes of extreme anxiety
• Shortness of breath, chest pain, sensations of choking or smothering, dizziness
• Hot or cold flashes, trembling, palpitations, numbness or tingling sensations
• Restlessness, agitation, or irritability
• During attack the woman may fear she is going crazy, dying, or losing control
• Panic attack may wake her up
• Often no identifiable trigger for panic
• Excessive worry or fears (including fear of more panic attacks)
Risk factors
• Personal or family history of anxiety or panic disorder
• Thyroid dysfunction
Treatment:
• Psychotherapy and psychiatrist for medication. Antidepressant and anti-anxiety medication, attending a support group for PPD MOMS. If the mom is bi-polar the treatment is mood stabilizers and no anti depressants as they can trigger an SSRI syndrome.
Psychosis
• Occurs in one to two per thousand
• Onset usually two to three days postpartum
• This disorder has a 5 percent suicide and 4 percent infanticide rate
Symptoms
• Visual or auditory hallucinations
• Delusional thinking (for example, about infant's death, denial of birth, or need to kill baby)
• Delirium and/or mania
Risk factors
• Personal or family history of psychosis, bipolar disorder, or schizophrenia
• Previous postpartum psychotic or bipolar episode
Treatment :
• Immediate hospitalization. Psychotherapy and psychiatrist for medication. Antidepressants and attending a support group for PPD MOMS. If the mom is bi-polar the treatment is mood stabilizers and no anti depressants as they can trigger an SSRI syndrome.
Postpartum Psychiatric Illness Posttraumatic Stress Disorder
• There is no available data regarding the prevalence or onset
Symptoms
• Recurrent nightmares
• Extreme anxiety
• Reliving past traumatic events (for example, sexual, physical, emotional, and childbirth)
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