PERINATAL MOOD DISORDERS

An Overview

The perinatal period is from conception to 12 months after the birth of a baby.  Rapid changes take place in a woman’s body during this time, including hormone fluctuations.  Some of these fluctuations, along with a family or personal history of mood or anxiety disorders can contribute to the emergence of a perinatal mood or anxiety disorder.  Frequently called postpartum depression, it is important to note there are several types of Perinatal Mood Disorders (PMADs) aside from depression.

TYPES OF PERINATAL MOOD DISORDERS

  • Depression during pregnancy and postpartum

  • Anxiety during pregnancy and postpartum

  • Pregnancy of postpartum Obsessive Compulsive Disorder

  • Postpartum Post-Traumatic Stress Disorder

  • Bipolar Mood Disorder

  • Postpartum Psychosis

Risk Factors

  • Family or personal history of perinatal or clinical anxiety or mood disorder

  • Changes in hormone levels during pregnancy and after birth

  • Changes in thyroid function

  • Stress of new role changes

  • History of fertility treatments

  • History of diabetes (type 1, 2 or gestational)

Signs & Symptoms

The following list, while not comprehensive, includes symptoms of PMADs:

 

  • Feeling overwhelmed, exhausted or insecure

  • Feeling sad or depressed

  • Feeling more irritable or angry with those around you

  • Difficulty bonding with baby

  • Repetitive fears, worries or bothersome thoughts

  • Feeling anxious or panicky

  • Crying spells

  • Problems sleeping and/or eating

  • Feeling you are “out of control” or “going crazy”

  • Feeling like you should have never become a mother

  • Feeling worried you may hurt yourself or your baby.

BABY BLUES OR SOMETHING MORE?

50-85% of women experience baby blues.  The baby blues are characterized by feelings of sadness, worry, mood fluctuations.  Usually appear 2-3 days after birth and subside within three weeks.  PMADs usually do not decrease in symptomology and the frequency of symptoms increase.  PMADs continue after the 3 week postpartum mark and up to one year after birth.  If not treated, can last longer.

Types of Perinatal Mood Disorders

Depression during pregnancy and postpartum

  • Occurs in approximately 15% or 3 out of 20 women.

  • Symptoms include: Feelings of anger or irritability; Lack of interest in the baby; Appetite or sleep disturbance; Crying; Feelings of Sadness, guilt, shame; Loss of interest, joy or pleasure in things you used to enjoy; Possible thoughts of harming self or baby.

 

Anxiety during pregnancy and postpartum

  • Occurs in approximately 6% of pregnant women and 10% of postpartum women.  Can be experienced alone or with depression

  • Symptoms include: Constant worry; Feeling that something bad is going to happen; racing thoughts; Disturbances of sleep and appetite; Inability to sit; Dizziness; hot flashes and nausea

 

Pregnancy or postpartum Obsessive Compulsive Disorder

  • Largely misunderstood and misdiagnosed in the perinatal period.  One does not have to be diagnosed with OCD to experience these common symptoms of perinatal anxiety.  Approximately 3-5% of new mothers will experience these symptoms.  Symptoms such as obsessions, which include repetitive, intrusive images and thoughts can be frightening and come “out of the blue”.  Research has shown these images are anxious in nature, NOT delusional and have a VERY low risk of being acted upon.  It is far more likely that the parent with this symptom takes steps to avoid triggers and avoid what they fear is potential harm to the baby.  

  • Additional symptoms include: Compulsions, where mom may do certain behaviors repetitively in an effort to reduce fears and obsessions (including checking, cleaning, reordering); Moms with postpartum OCD know their thoughts are bizarre and are very unlikely to ever act upon them.  

 

Postpartum Post-Traumatic Stress Disorder

  • Approximately 9% of women experience PTSD following the birth of a child. Caused by real or perceived trauma during delivery or postpartum.  Traumas include: Prolapsed cord; Unplanned cesarean section; Use of vacuum extractor or forceps to deliver baby; Baby going to NICU; Feelings of powerlessness, poor communication and/or lack of support and reassurance during the delivery; past experience of trauma such as rape or sexual abuse are at higher risk of experiencing postpartum PTSD; Severe physical complication resulting from birth.

 

Bipolar Mood Disorder

  • Characterized by high and low mood fluctuations.  There are two different types of Bipolar Disorders (Bipolar 1 and Bipolar 2).  

  • Mood fluctuations are more extreme in Bipolar 1 and are less extreme in Bipolar 2

  • Delusions and or hallucinations can be present in Bipolar 1

 

Postpartum Psychosis

  • Occurs in approximately 0.1-0.2% of women after birth.  The onset is usually sudden and within the first 2 weeks after birth.  Uncommon when compared to rates of anxiety and depression in perinatal period.

  • Symptoms include: Delusions (strange beliefs); Hallucinations (seeing or hearing things that aren’t there); Feeling very irritated; Hyperactivity; Decreased need for or inability to sleep; Paranoia and suspiciousness; Rapid mood swings; Difficulty communicating at times.  

  • Immediate medical attention is needed since psychosis is a disconnect from reality.  

Disclaimer: The information on this page is for educational purposes and should not be used to diagnose yourself or someone else. If you or someone you know is showing signs or symptoms which are causing disruption in their lives, please contact a mental health professional.