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Published on: Postpartum Mood Disorder

Other Perinatal/Postpartum Mood Disorders Besides Depression

Society has a lot of expectations around pregnancy and new mothers. We expect a new mother to be excited, happy, in awe of the miracle of life. We anticipate an atmosphere of love and joy, thoughts of shopping and picking the right fits and colors of baby clothes, and so on.

However beautiful, pregnancy and birth are complicated events, emotionally, logistically, and chemically. There is no single right way to feel. For some women, anxiety, apprehension, and sadness accompany the birth of their child. Perfectly normal women feel all sorts of complex emotions. But when difficult feelings persist, it’s likely these women may be suffering from a number of perinatal/postpartum mood disorders. Although postpartum depression is relatively well-known, perinatal and postpartum states can come with a host of mood disorders less commonly acknowledged.

Perinatal/Postpartum Mood Disorders

The line between difficult emotions in complicated situations and mood disorders can be a fine one. Most women pass from the “baby blues” into whatever normal motherhood is supposed to be without much intervention. In some cases, though, the blues never stop, while in others, they get worse or more complicated. For some mothers, pregnancy can trigger a variety of uncommon mood disorders which will require some form of treatment, often within the first three-months after delivery.

Postpartum bipolar mood disorder

In a recent study, researchers found that about twenty-two percent of women diagnosed with postpartum depression were actually suffering from bipolar disorder. Bipolar disorder is characterized by a combination of  depression and mania or hypomania. These moods can shift in accordance with triggers that are not entirely clear to those suffering or their loved ones.

The symptoms of this disorder include extreme despair, heightened elation, restlessness, disinterest in activities, irritability, excessive sleeping or insomnia, and being easily distracted. Some women may have suicidal thoughts. Diagnosing postpartum bipolar disorder requires close care and attention. The moods are not always clearly distinguishable and some come in the form of “mixed states” in which  both depressive and manic symptoms coincide. 

Postpartum psychosis

This is an extreme mood disorder that is quite rare and should be treated as a medical emergency. If you or someone you know is exhibiting symptoms of postpartum psychosis seek immediate medical attention. 

Postpartum psychosis occurs in roughly 1 out of 500 women. The most common symptoms include:

  • hallucinations – hearing, seeing, smelling or feeling things that are not there
  • delusions – thoughts or beliefs that are unlikely to be true
  • a manic mood – talking and thinking too much or too quickly, feeling “high” or “on top of the world”
  • a low mood – showing signs of depression, being withdrawn or tearful, lacking energy, having a loss of appetite, anxiety, agitation or trouble sleeping
  • sometimes a mixture of both a manic mood and a low mood – or rapidly changing moods
  • loss of inhibitions
  • feeling suspicious or fearful
  • restlessness
  • feeling very confused
  • behaving in a way that’s out of character

Patients might be a risk to themselves and other, or even their babies.

Postpartum anxiety 

In a recent study examining postpartum conditions with the added stressor of COVID-19, over 1 in 5 women reported experiencing postpartum anxiety. According to Elena Ali, researcher at University of Calgary, this disorder is associated with, “disrupted mother–infant attachment, postpartum depression, reduced likelihood of breastfeeding, increased risk of infant abuse, delayed cognitive and social development in infants, and an increased likelihood of anxiety in children.” 

Symptoms of postpartum anxiety are typically:

  • constant or near-constant worry that can’t be eased
  • feelings of dread about things you fear will happen
  • sleep disruption (yes, this is a hard one to pick out, since a newborn means your sleep will be disrupted even without having anxiety — but think of this as waking up or having trouble sleeping at times when your baby’s sleeping peacefully)
  • racing thoughts

This anxious state can include chest pain, rapid heartbeat, severe headache, consistent panic attacks, and insomnia. The below diagnoses are more specific forms of postpartum anxiety disorder, with most women suffereing from more than one type. 

Postpartum post-traumatic stress disorder (P-PTSD)

For some women, childbirth can act as a stressor and trigger for post-traumatic stress disorder. When an event is registered traumatically, it can upend one’s sense of self or worldview. Women with P-PTSD usually experience anxiety, difficulty in sleeping, nightmares, and flashbacks to difficult times and experiences like hard labor and painful delivery.

Postpartum obsessive-compulsive disorders

Women diagnosed with postpartum obsessive-compulsive disorder typically have intrusive thoughts – obsession – and feel the need to perform some behavior (or compulsions) repeatedly to alleviate the obsessive thoughts. Postpartum OCD has a powerful anxiety element. These women have thoughts that are centered around their babies’ health and well-being and may develop elaborate rituals to reduce the anxiety or display avoidant behavior that leads to the neglect of their child.

Although postpartum OCD may manifest differently in different women, some common symptoms include constant worry that their babies might be in danger, infanticidal thoughts, or thoughts of harming their spouses.

Causes of Perinatal/Postpartum Mood Disorders

Although there is no one direct known cause of these disorders, there are some factors that can contribute:

  • Hormonal causes like a decrease in progesterone and estrogen after delivery
  • History of anxiety, bipolar disorder, or depression
  • Family history of mood disorders like depression
  • Stress
  • Challenging birth and post-birth situations like prolonged labor, c-section delivery, painful breast and breastfeeding, and so on.
  • Hard life changes like an unsupportive partner, uncaring family members and friends, change of location, loss of job, illnesses, financial distress, etc.
  • Peer and societal pressure to fit in the image of an ideal parent
  • Past traumatic experiences

Conclusion

Pregnancy and parenthood are transformative times. Most media platforms glamorize thes states, highlighting only the glitziest scenarios. But as with anything worth doing, there are many risks involved and complications that may need to be addressed. Aside from depression, women can experience other perinatal/postpartum mood disorders such as postpartum posttraumatic stress disorder, postpartum bipolar disorder, and even postpartum psychosis. These conditions can be extremely challenging, but there are effective medical treatment options. Contact us today to learn more.

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