I had read and heard about a condition known as postpartum depression before and during my pregnancy. However, I didn’t know that there is a spectrum of conditions a woman might experience. Postpartum Support International (PSI) uses the term “perinantal mood and anxiety disorders.” This term is broader than “postpartum depression” and refers to a range of disorders that a woman may have during pregnancy or within the first twelve months of giving birth. A perinatal mood or anxiety disorder can begin at any point in that time frame. Experts in the field of maternal mental health recognize the following disorders:
- Postpartum depression
- Postpartum panic disorder
- Postpartum obsessive compulsive disorder
- Postpartum posttraumatic stress disorder
- Postpartum psychosis
- Depression and/or anxiety during pregnancy
One of the reasons I felt so terrified and alone immediately after childbirth was because my symptoms didn’t neatly match the descriptions of postpartum depression. Not knowing there was a spectrum of mood disorders, I concluded that what I was experiencing was grossly abnormal and untreatable. I have briefly described the variety of mood or anxiety disorders a woman might face during the postpartum period to help anyone else who might be feeling as I did. I have summarized what I know about these conditions based on books I have read, experiences I have had and conversations I have had with other women. There are other resources available that can provide more information about these topics. See Resources.
Postpartum depression – A woman might experience some or all of the following symptoms:
- Overwhelming sadness
- Strong feelings of guilt
- Lack of interest in her baby
- Lack of interest in activities she used to enjoy
- Changes in appetite
- Trouble concentrating
- Thoughts of hurting herself or the baby
Postpartum Panic Disorder – This is a type of anxiety disorder that is characterized by nervousness and repeated panic attacks. When having a panic attack, a person might experience shortness of breath, feel tightness in the chest, have hot flashes and/or have heart palpitations.
Postpartum Obsessive Compulsive Disorder – According to the PSI fact sheet, this is “the most misunderstood and misdiagnosed of the perinatal mood disorders.” Symptoms for this type of anxiety disorder include, but are not limited to:
- Excessive worry
- Intrusive or obsessive thoughts – unwanted images (often violent) related to the baby; the mother is often confused and horrified by these images. The mother is very unlikely to act on these thoughts, yet worries and fears that she will.
- A mother might say, “I’m afraid to be alone with my baby” due to the intrusive thoughts she has had.
- Avoidance behaviors – the mother might attempt to avoid any situation that might trigger an intrusive thought
- Compulsive behavior – the mother might develop ritualistic and repetitive behavior to reduce her intrusive and obsessive thoughts
Postpartum Posttraumatic Stress Disorder – According to the PSI Fact Sheet, a woman with this disorder usually has a traumatic childbirth experience followed by re-experiencing of the trauma. She will often avoid all situations associated with the traumatic event. She might also experience some or all of the following symptoms:
- Sleeping disturbances
- Exaggerated startle reflex
- Nightmares or flashbacks
- Intense fear
Postpartum Psychosis – This condition is very rare. It begins suddenly, usually in the first postpartum month. Symptoms include:
- Feeling highly irritated
- Significant mood changes
- Incoherent babbling
- Decreased need for sleep; inordinate energy
- This condition often rapidly escalates in severity and requires immediate treatment.
*Postpartum Support International, 2009. Perinatal Mood and Anxiety Disorder Fact Sheet
*Sichel, D. and Driscoll, J.W. 1999. Women’s Moods: What Every Woman Must Know about Hormones, the Brain, and Emotional Health