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Postpartum Mood Disorders Guide
May/June 2007 - Issue 142

While postpartum psychosis is rare, other postpartum mood disorders are not—but few health care professionals screen for them. If you or someone you know may be struggling, keep seeking treatment until you get the help you need. Postpartum mood disorders are treatable, and healing is possible.

Within the spectrum of postpartum mood disorders, mothers may experience a broad variety of symptoms and conditions. Some mothers hear sensational stories about extreme cases of women with severe postpartum mood disorders and think, "I'm not suicidal, and I have never wanted to hurt my baby, so I guess I must not be depressed enough to ask for help." It's essential to realize that every mother's experience is different, and that if a mother feels bad, she should seek professional care.

Early intervention and professional treatment can prevent months and even years of suffering and can keep the mood disorder from becoming worse. Because mood disorders interfere with the way a mother bonds with her baby and strain family relationships, when a mother gets the support and treatment she needs, the entire family benefits. "If Mama ain't happy, ain't nobody happy."

Baby Blues

• affects 80 percent of new mothers
• occurs between the third day and second or third week postpartum
• is considered normal
• goes away on its own
• Indicators: crying for no reason; feelings of dependency, impatience, irritability, anxiety; temporary mild depression

• affects 20 percent of new mothers
• occurs anytime up to a year postpartum
• lasts for at least two weeks
• Indicators: physical complaints without physical cause; changes in appetite or weight; sleeping too much or too little; loss of interest in activities; irritability or short temper; feelings of anxiety, worthlessness, guilt, anger, sadness, hopelessness, being overwhelmed; difficulty in concentrating; extreme worry about the baby's and/or the mother's own health; recurring thoughts of death or suicidal ideation

• affects 10 percent of new mothers
• Indicators: panic attacks (sudden episodes of extreme ?anxiety or fear, accompanied by accelerated breathing and heart rate, constriction in chest and throat, chest pain); nausea, hot or cold flashes, trembling; fear of losing control, of going crazy, of dying

• affects 3-5 percent of new mothers
• often co-occurs with postpartum depression
• mother is not at risk of actually harming her baby, except by neglect or avoidance based on fear of causing harm
• Indicators: repetitive, intrusive thoughts and violent images of harming baby; awareness that thoughts are irrational, with a sense of horror and shame about them; hypervigilance in protecting baby; repetitive behaviors such as counting, checking, frequent hand-washing, obsessive neatness

• affects 1-3 percent of new mothers^{1, 2}
• occurs following childbirth, especially in women who experienced a history of childhood sexual or physical abuse and/or had a traumatic childbirth
• Indicators: extreme anxiety; persistent re-experiencing of traumatic events; avoidance of stimuli associated with the trauma; numbness; hyperarousal, insomnia, jumpiness and heightened startle response; nightmares

• affects 0.1-0.2 percent of new mothers
• occurs usually in the first week postpartum, with sudden onset
• risk of suicide and/or infanticide
• Indicators: rapid speech; visual or auditory hallucinations, delusions, delirium, mania, extreme agitation, inability to sleep, irrational speech or behavior; paranoia
• PPP is a medical emergency for which aggressive treatment is critical

Adapted from:
Indiana Perinatal Network, "Indiana Perinatal Mood Disorders Guide" (April 2005): www.indianaperinatal.org/files/education/EMPG1004%20PPD_Guide.pdf.
Shoshana Bennett, PhD, and Pec Indman, EdD, MFT, Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression (San Jose, CA: Moodswings Press, 2003), 38?48.

NOTES
1. S. Ayers and A. D. Pickering, "Do Women Get Posttraumatic Stress Disorder as a Result of Childbirth? A Prospective Study of Incidence," Birth 28 (2001): 111-118.
2. J. Czarnocka and P. Slade, "Prevalence and Predictors of Posttraumatic Stress Symptoms Following Childbirth," British Journal of Clinical Psychology 39 (2000): 35-51.
Both studies cited in Kathleen Kendall-Tackett's Depression in New Mothers: Causes, Consequences and Treatment Alternatives (New York: Haworth Press, 2005), 65-66.