Feeling sad, empty or anxious after your baby’s birth? Up to 80% of women feel sad of anxious during the first few weeks after childbirth. If these feelings continue or worsen, you may have Postpartum Mood Disorder (PPMD).
It can happen to any family.
It is not your fault. It is completely treatable and you are not alone.
Postpartum Mood Disorder (PPMD) can interfere with mother-infant bonding, can negatively influence maternal health and can create stress amongst family members.
Some people may be more at risk for a postpartum mood disorder. Some risk factors include:
- Personal or family history of a mental health disorder
- Depression and/or anxiety during pregnancy
- Unwanted or unplanned pregnancy
- Difficult reproductive history (such as miscarriage, abortion, infertility)
- Stressful life events or past traumatic experiences
- Lack of social support or relationship difficulties
- Low self-esteem
- Tendency to worry or feel nervous
- Financial concerns
- Unexpected, difficult or traumatic delivery
- Severe premenstrual syndrome (PMS)
- High expectations for birth or parenthood
- Premature or sick baby
The baby blues is the most commonly experienced postpartum mood change with up to 80% of new mothers reporting symptoms. It is common for women to feel highly emotional, tearful, fatigued and overwhelmed.
Symptoms tend to start 3-4 days after birth and can last anywhere from a few days up to 2 weeks. The most common symptoms can include:
- Mood swings
- Frequent crying or feeling sad
- Sadness, irritability, frustration, anxiety or feeling overwhelmed (including fears of not being able to look after the baby, fears of being a bad mother)
- Loss of appetite
- Feeling tired
- Difficulty concentrating
In most cases, people experiencing the baby blues will have symptoms disappear by 2 weeks postpartum. Talking to friends or family, getting more support, and making time to rest seem to help ease the symptoms.
If the symptoms get worse and last longer than 2 weeks, the baby blues can turn into depression.
Depression is a mood disorder where one may experience a sad mood and loss of pleasure almost every day for at least 2 weeks. It prevent someone from accomplishing certain daily activities and interferes with relationships.
Postpartum depression includes at least five of the following symptoms, plus the symptom of being in a depressed mood or experiencing a loss of interest and/or pleasure. The additional symptoms may include:
- Sad or irritable mood
- Loss of interest/pleasure in activities (including low sex drive)
- Feeling overwhelmed or anxious
- Feeling hopeless
- Feeling “out of control”
- Reduced or increased appetite or weight
- Difficulty sleeping, or sleeping all the time.
- Tiredness or loss of energy
- Feeling of low self-esteem or excessive guilt (such as feeling like a bad mother, or having trouble forming a bond with the baby)
- Unable to concentrate or make a decision
- Thoughts of death and/or suicide
- Fear you might harm your baby
Anxiety is a feeling of worry, nervousness or unease, usually about a particular event or something with an unknown outcome. Anxiety can be a common reaction to a stressful situation, but it can also become problematic when someone is not able to control it.
Postpartum anxiety is reported in about 10% of new mothers. Symptoms of anxiety can get worse over time.
- Constant fear that you know is irrational but is still hard to control
- Panic attacks
- Concerns, images, or thoughts causing excessive worry
- Feeling distracted
- Physical symptoms (including heart palpitations, trembling, sweating, muscle stiffness, feelings of suffocation, tingling or trouble sleeping)
- Avoidance or repetitive behaviours to manage the anxiety
- Changes in normal functioning (such as keeping to yourself or not sleeping)
It is common for women who have anxiety disorders during pregnancy to also suffer from depression. Anxiety disorders during pregnancy can increase the risk of anxiety disorders or depression in the postpartum period.
Fathers may also experience psychological distress during their partner’s pregnancy or after the baby is born. In general, men between the ages of 25 and 44 run the highest risk of depression, as they are most likely to become fathers during those years.
It is estimated that about 10% of men have symptoms of depression during the prenatal and postpartum period with symptoms peaking around 3-6 months after the baby is born.
There are some particular risk factors more specific to men that put them at greater risk. These include:
- Personal history of depression
- Unplanned or unwanted pregnancy
- Changes in family structure
- Spouse has depression
- Low level of happiness in marriage/relationship
- No or low social support
- Financial concerns
The symptoms of postpartum depression in men are the same as those in women. However, there are some symptoms that are most commonly observed in men. These may include:
- Mood swings
- Fits of anger or rage
- Irritability or aggression
- Inability to control impulses
- Physical symptoms (including fatigue, stomach pain, indigestion, headache or difficulty breathing)
- Alcohol or drug abuse
- Hyperactive behaviour
- Suicidal thoughts or intentions
Postpartum psychosis is reported as occurring in 1 or 2 women per 1000 births. There is a particular risk of psychosis if there is a diagnosis of bipolar disorder already in the person’s history.
Postpartum psychosis often happens within 48-72 hours after birth, but can happen up to four months postpartum.
Some early symptoms can include:
- Feeling excited or high
- Not needing to sleep or not being able to sleep
- Feeling active or energetic
- Talking more or feeling very chatty
Other symptoms can include:
- Delusional beliefs (such as denying the birth happened, a belief that the child is possessed or has special powers)
- Being hypervigilant (extra cautious) about the baby, or becoming agitated or distressed if separated from the baby
If a mother shows any of these symptoms, it is strongly recommended that the safety of both mother and child be the first concern. Postpartum psychosis is a medical emergency and requires medication and hospitalization immediately.
If someone you know has a postpartum mood disorder, you can help by encouraging them to speak to their healthcare provider about their symptoms. You can also:
- Learn about postpartum mood disorders and available supports
- Be patient, loving and supportive
- Support decisions to seek professional help
- Share household tasks
- Spend some time playing with the baby
- Reassure them that they are a good parent
There is external help available for both family members and someone who is experiencing PPMD:
- Talk to your health care provider
- Call the Canadian Mental Health Association Crisis Line: 1.866.933.2023
- Call the Postpartum Depression Hotline: 519.434.HOPE
- Visit Mental Health Services at Woodstock General Hospital or call: 519.421.4223
- Contact Southwestern Public Health: 1.800.922.0096
In an emergency, call 911 immediately.
Websites that might be helpful:
- Healthy mom, healthy family: Understanding pregnancy and postpartum mood and anxiety disorders
- Fathers respond to perinatal and postpartum mood and anxiety disorders
- Perinatal mental health (PMH)
- Postpartum Support International
- Life with a new baby is not always what you expect
- Postpartum men
- Pacific Postpartum Support Society