Postpartum Mood Disorders
Most of us have heard of postpartum depression and are a bit familiar with it. But there are other disorders that may be diagnosed for the first time or become more severe in a woman’s lifetime after a pregnancy or birth of a child. Pregnancy and childbirth are major, although natural and normal, events in a woman’s lifetime that involve huge hormonal, physical, emotional, and often psychological changes. It is important for health care providers and those caring for the postpartum women to recognize the abnormal in her ability to cope with life during and after her pregnancy and birth of her child, and that she be correctly diagnosed and helped if help is needed.
Postpartum depression should be taken seriously, although many may dismiss it as just a few weeks of feeling emotional or the “baby blues”, it can actually be quite overwhelming for the postpartum family and even devastating at times. “Even though PPD is very common, only a small fraction of women who experience it ever get the help they need” (Kleiman and Raskin, 3). Some of the symptoms of postpartum depression include frequent crying or feeling depressed, inability to concentrate, sadness, lack of interest in activities, lack of interest in sexual activity, insomnia, feelings of inadequacy or guilt, fatigue, change in appetite, anxiety and anger, hopelessness, and even suicidal thoughts (Kleiman and Raskin, 5).
There are also other mood disorders that can make an appearance during or soon after a woman experiences pregnancy and childbirth. “Many women experience their first problems with depress or anxiety in their adult years during pregnancy, the postpartum period, or menopause. Some have problematic premenstrual symptoms. . . in fact, hormonal events are powerful enough on their own to thrust the brain biochemistry into dysregulation. The reproductive events in and of themselves do not constitute an abnormality. Rather it’s the impact of these ‘normal’ hormonal fluctuations on loaded neurochemistry that can create the problem” (Sichel and Driscoll, 97).
This can include the often ignored PMDD – or premenstrual dysphoric disorder. According to Sichel and Driscoll, symptoms of PMDD (a more severe form of the popularized term PMS) can include headaches, irratibility, breast tenderness, depression, cramps, tearfulness, social isolation, anxiety, bloating, social avoidance, lack of concentration, sadness, hot flashes, clumsiness, anger, oversensitivity, palpitations, change in appetite, and fatigue. This disorder, when enough symptoms are present, can interfere with a woman’s ability to function as she normally does.
“Soft” bipolar, or bipolar 2, is often misdiagnosed because symptoms match those of depression, although with the added symptoms of marked highs and lows, while not as dramatic as those of a person with bipolar 1. this disorder too can have a major impact on a woman and her family postpartum.
There are numerous other forms of anxiety and depression that can surface during this time such as postpartum OCD, anxiety and panic disorders that begin in pregnancy, and postpartum psychosis, a very severe and frightening form of postpartum depression in which a woman may become suicidal or actually attempt to harm herself or her child as her ability to separate reality from her imaginings disappears.
All of these disorders can cause trauma, isolation, and hopelessness for the new family. One factor that can help with some of these is having adequate postpartum support – followup care from OBs and midwives, along with good support at home for mother and baby by the father, family, and a postpartum doula can all help the mother to care for herself and bond with her baby. Those caring for mom – the doula or midwife, or her physician, should be aware of the possibility for these types of disorders that fall outside the norm and may be causing havoc in the mother’s emotional well-being, so they can refer her to help, natural, with depression medication, or a combination. It’s especially important for the mother to know that there is help for her, if she develops anxiety or depression, that she isn’t alone and doesn’t have to suffer. “Whether the pattern is related to hormonal events or not, acknowledging that you are in need of help with an emotional illness is one of the first steps toward healing. . .They are not signs of personal weakness but are treatable brain diseases that warrant prompt attention” (Sichel and Driscoll, 287).
Jessica Costello is a postpartum doula trained through Birth Arts International. She knows the joys and struggles with becoming a new parent and loves to help new families in their adjustment. Facebook.com/sweetpeadoulaservices
Sichel, Deborah and Jeanne Watson. Women’s Moods. New York: William Morrow and Company, Inc. 1999.
Kleiman, Karen and Valerie Raskin. This Isn’t What I Expected. Boston: First da Capo Press. 2013.