Here's the 411 on Postpartum Depression, Mood & Anxiety Disorders - Part One

This is such an important topic! One that is not often talked about. Did you know that maternal depression is the number one complication of childbirth and pregnancy and sadly the most under-diagnosed?  More than 400,000 infants are born to mothers who are depressed.  Postpartum mood and anxiety disorders fall under the maternal depression umbrella.  And the most important thing for you to know is that there is help. (Help will be discussed in Part Two.)

Postpartum depression is more common than you think and so are postpartum mood and anxiety disorders.

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Did you know that 1 in 6 women are affected and most suffer in silence?  Some sources state that up to 25% of new moms have postpartum depression.  And did you know that dads, partners and adoptive parents can also suffer from post partum mood and anxiety disorders too?  It's all true and I want to bring it to light.

First of all, if you are experiencing symptoms, the most important thing to remember is that you are not alone!  No one is immune to it.  It doesn't matter your age, income, where you are from, your nationality or your education level.  You did not cause it.  There is no shame in it either.  But like I said before, it's important to get help.  Getting help is better for you and better for the baby. A baby's brain is developing rapidly and studies show that if a mom is severely depressed, it can affect the long term health of her child.  That’s why it’s so important to promptly get the support and the treatments that work best for you. It will make you a better parent and it will also teach your kids how to ask for help.  It is a WIN-WIN! 

Perinatal mood and anxiety disorders can manifest in many ways and can occur anytime from conception through two years after delivery. And the symptoms are different for everyone.


You can't tell by just looking at someone whether they are suffering or not. Often women and men do not recognize the symptoms they are having. That is why loved ones are so important. - Gabrielle Kaufman of Maternal Mental Health NOW

Dropping the Stigma associated with Mood Disorders

I have been involved with NAMI (National Alliance on Mental Illness) for over 17 years. In fact, for years I have been educating law enforcement on how mental illness affects families. There is so much STIGMA regarding brain and mood disorders that it shames the person suffering into silence and not seeking treatment.  And what's so sad to me is that brain and mood disorders affect 1 in 4 - 5 people.  It's so common and nothing to be ashamed about.

The brain is an organ like any other organ in the body, and sometimes it doesn't work 100%. Sometimes the body gets imbalanced and needs help re-aligning.  Why should that be shameful?  It's no different then if someone has heart disease or a liver disorder or rheumatoid arthritis.  I was born with a less than perfect heart valve (mitral valve prolapse)..... no shame in the fact that my valve doesn't work 100%. 

Lets get clear on what postpartum depression is and isn't. And what postpartum mood disorders are. 


The first thing to identify when it comes to looking for signs of postpartum depression is any sort of noticeable and concerning change in personality, mood and behavior. These may come and go or they may be chronic and long-lasting. - PostpartumDepression.org

Postpartum Mood and Anxiety Disorders? 

I wanted to quickly go over common postpartum mood and anxiety disorders. Please keep in mind that these can show up anytime during pregnancy, right after the baby is born or even up to 12 months and after.  Who knew!?!?

What falls under this postpartum depression umbrella?  Some people experience one or more of the following symptoms or diagnosis. According to Postpartumdepression.org...

  • Psychosis - experience severe hallucinations, paranoia and delusions which cause bizarre and horrifying behaviors surrounding the care for the baby.  Sometimes postpartum psychosis will also be referred to as puerperal psychosis, postnatal psychosis, bipolar disorder triggered by childbirth, mania or schizoaffective disorder.  YOU MUST GET HELP! This is rare, but very serious. Spouses must pay attention!

  • Major Depressive Disorder - symptoms range for each affected person, but they generally include a combination of mood swings, anger and irritability, fatigue, excessive crying, inability to bond with the baby, feelings of fear, worry and anxiety.

  • Generalized Anxiety Disorder - It is believed to affect 10% of new mothers.  The primary symptoms of postpartum anxiety are characterized by intense worry, feeling overwhelmed, fear and nervousness that severely disrupts daily life.  Person may say, "I don't know what to do".  Up to 50% of cases, postpartum depression and postpartum anxiety will occur together.  

  • Panic Disorder - this falls under a type of anxiety disorder. The panic often gets triggered by an event, a sound, a smell and is characterized by primary symptoms that involve intense fear and worry that prevent the person from functioning.  These anxious thoughts cause physical responses in the form of panic attacks, rapid breathing and heart pounding.

  • Obsessive Compulsive Disorder - this falls under a type of anxiety disorder.  It is characterized by constant and repetitive thoughts and behaviors that are in response to a perceived danger towards the baby.  These thoughts and behaviors are intrusive, and they can severely disrupt daily routines.

  • Post Traumatic Disorder - the result of a traumatic experience that took place before, during or after delivering the child. The person can suffer from flashbacks, dreams or memories that continue to remind them of the trauma they experienced. Other symptoms can include, difficulty sleeping, exaggerated startle, hyper vigilance and difficulty concentrating. They often want to avoid any associated stimuli so as not to trigger it.

Often our society and the media confuses the Baby Blues and Postpartum Psychosis with  Postpartum Depression.  They are not the same.  So I want to clarify the three for you. 

 

The Baby Blues


80 - 90% of new moms experience the baby blues. Mood swings after the birth are not uncommon.  The baby blues show up around day 2 - 3 after the baby is born and lasts about 2 weeks. There is a big shift hormonally once the baby is born and most moms notice the difference. All of a sudden the new baby high wears off and the exhaustion kicks in. Symptoms can be mild or not, but are temporary as the body re-adjusts.

Signs:

  • Feeling overwhelmed

  • Restlessness

  • Poor concentration

  • Sadness

  • Tearfulness

  • Exhaustion

  • Hypo-manic (decreased need for sleep, irritable, feeling energetic, racing thoughts, super-talkative) 

  • Resolves on its own after a couple of weeks with good nutrition, rest and support. 

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If your symptoms last longer than two weeks you might be dealing with more than just the baby blues. 

 

Postpartum Depression

1 in 7 Moms and 1 in 10 Dads suffer from postpartum depression.  In order to be diagnosed with postpartum depression a person must exhibit 5 or more of the following symptoms and the symptoms must last for more than 2 weeks:

  • Depressed mood-tearfulness, hopelessness, and feeling empty inside, with or without severe anxiety.

  • Loss of pleasure in either all or almost all of your daily activities.

  • Appetite and weight change-usually a drop in appetite and weight but sometimes the opposite.

  • Problems with sleep-usually trouble with sleeping, even when your baby is sleeping.

  • Noticeable change in how you walk and talk-usually restlessness, but sometimes sluggishness.

  • Extreme fatigue or loss of energy.

  • Feelings of worthlessness or guilt, with no reasonable cause.

  • Difficulty concentrating and making decisions.

  • Thoughts about death or suicide. Some women with PPD have fleeting, frightening thoughts of harming their babies. These thoughts tend to be fearful thoughts, rather than urges to harm.

 

Postpartum Psychosis


Develops during the first 3 weeks after childbirth. Often the media portrays postpartum psychosis as postpartum depression. They are not the same.

According to PostpartumDepression.org Postpartum psychosis symptoms include:

  • Experiencing hallucinations of things or sounds that aren’t there

  • Becoming delusional with paranoid, suspicious or irrational beliefs

  • Exhibiting extremely agitated or even violent behavior

  • Becoming easily confused or disoriented

  • Obsessing over the baby

  • Being extremely fearful or anxious

  • Displaying bizarre behaviors that are uncharacteristic of the individual

  • Extreme and rapid mood swings

  • Refusing to eat or sleep

  • Taking self-harming actions

  • Suicidal thoughts

  • Suicidal attempts

  • Thoughts of harming or killing her baby

Postpartum psychosis is an emergency requiring immediate medical treatment. If you have any psychotic symptoms, seek emergency help immediately. Until you tell your doctor and get treatment, you are at high risk of suddenly harming yourself or your baby.

 
 

 

RED FLAG Warnings to look out for:

Here are a few red flags that you should be aware of when it comes to postpartum depression and/or the mood and anxiety disorders. You can't always tell 100% if someone is symptomatic or not. 

  • A mom who always looks "too good" and has the perfect looking baby. It can be an over compensation for their feelings of irritability, OCD and/or anxiety. Think of those Instagram moms with the perfect life, who always look perfect and their kids always look perfect. I see a lot of those mamas and I always wonder how they are "really" doing.

  • A mom who keeps saying:

    • "I just don't feel like myself".

    • "I don't know what to do".  

It can be her way of saying "HELP ME!".  

  • The feeling of Anger and Rage - these feeling are more common than not. She just feels very angry all the time or a lot of the time. 

  • If she can't take care of herself or the baby or can't get out of bed.....get help immediately.

 

What are the Risk Factors or Root Causes for Postpartum Mood and Anxiety Disorders?

There are a lot and just know that someone can be dealing with one or more of the following:

  • History of depression or mood disorder

  • Family history of depression or mood disorder

  • History of PMS

  • Medical problems (for example, hypothyroidism, severe nausea and vomiting in pregnancy, or a pregnancy-related medical problem)

  • Blood sugar problems, including both hypoglycemia and elevated blood sugar

  • A traumatic pregnancy or birth experience

  • History of a pregnancy loss or loss of a child

  • Unhealthy relationship with partner

  • Not enough support from partner, family, work or social support

  • Financial issues (money, job stress, living situation)

  • High stress levels

  • Lack of movement

  • Lack of sunshine

  • Poor sleep and not enough sleep

  • A pregnancy that was not planned, you feel ambivalent  

  • Teen pregnancy

  • Military service (self or partner)

  • Domestic violence (often increases during pregnancy and postpartum period)

  • Nutritional deficiencies, protein, omega-3 fats, iron, vitamin D, B12, to name a few.  (1, 2)

  • History of substance abuse

  • Food sensitivities or gut dysbiosis (unhealthy changes in the gut flora or microbiome)

  • Environmental toxins - (heavy metal toxicity, usually from eating too much high mercury fish such as tuna) or (hormone mimicking chemicals such as plastics from food packaging and water bottles) Here are blog posts on environmental toxins and fake foods to avoid. 

  • Inflamation

  • Thyroid issues 



It’s true, having a baby is incredibly demanding physically, and at the same time, we’re going through a tremendous amount of personal, psychological, emotional, and social adjustment. But exhaustion, feeling down, difficulty losing weight, intense struggle to produce enough breast milk, and hair loss aren’t always just a normal part of having had a baby. They can also be telltale signs of hypothyroidism  - Aviva Romm M.D.

 

What Helps

  1. Understanding the role of inflammation and gut health
  2. Myth Busting
  3. Snowball - (sleep, nutrition, omega 3's, walk, baby break, adult time, liquids, and laughter)
  4. Breastfeeding
  5. Meditation & Gratitude
  6. Medical tests you should get
  7. Therapy and support groups
  8. Medication

I get more in detail in Here's the 411 on Post Partum Depression, Mood  & Anxiety Disorders, Part Two.

For Dads.....

Here is a video of dads giving advice and what the experienced with wives that had postpartum depression. 

 
 

 

I hope you find this information useful! 

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Sources:

 

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