There are several different ways postpartum mood disorders – sometimes referred to collectively as postpartum activity or postpartum distress – can present themselves. Sometimes they start before or immediately after giving birth and other times it can take weeks, even months or up to one year after delivery for the symptoms to fully present themselves.
People might be familiar with postpartum depression, but it's not the only postpartum mood disorder. Here's a breakdown of some of the most common disorders:
Postpartum depression (PPD) is one of the most common diagnoses. Approximately 15% of new mothers will experience PPD. According to the National Institute of Mental Health, symptoms of PPD include feelings of sadness and anxiety that might interfere with a woman’s ability to care for herself or her family. She may also cry more often or for no apparent reason, have trouble sleeping or sleep too much and have thoughts of harming herself or her baby.
"I’ll never forget feeling so absolutely exhausted in the middle of the night after six feedings every hour, [and] going into the kitchen to get a glass of water. I have absolutely no idea why, but when I saw the knife block on my kitchen counter, I saw the most absolutely horrifying vision of one of the knives being stabbed into my infant baby girl!!!! I started shaking and couldn’t get the image out of my head for a few days (I’m far from a violent person, had never had thoughts like this before and PPD is the only explanation for it). "I couldn’t even share this vision with my OB, but said I was having ‘abnormal thoughts’ at my postpartum checkup, and that was enough for him to know I needed Lexapro. Literally after one week of taking Lexapro, no more crazy, weird, scary visions popped into my head again...Thanks for letting me share this with you privately as this is never been shared before, and I shared it to help you add to your data collection that PPD is a very real and scary thing!" – Sandra, Austin-area mother
Postpartum anxiety (PPA) has similar symptoms and affects up to 10% of new mothers. Many mothers with PPA have racing thoughts that they have difficulty controlling – like that something bad will happen to their child – and they cannot concentrate, sleep or eat properly because of those thoughts, according to AmericanPregnancy.org.
"I began imagining morbid scenarios in which I was the accidental cause of my baby’s death or injury. I wouldn’t take her near stairs because I was afraid I’d drop her. I wouldn’t take her near a balcony because I was afraid I’d drop her. I wouldn’t do anything if it even remotely caused me to fear an implausible scenario of me accidentally harming her. I had intrusive thoughts of her dying. I was sick. Mentally and physically, I felt sick. I had never experienced this before, and I began to feel guilty for feeling sick." – Hillary, Austin-area mother.
Postpartum OCD, while less common, affects 3% to 5% of postpartum women. Symptoms can include being afraid of being alone with the baby and being overly occupied with keeping your baby safe. Women may also do things over and over to try and calm their fears, like listing or counting things and repeatedly cleaning or feeding the baby beyond the "normal" amount of times.
"An undiagnosed lip tie made it impossible to breastfeed my first son. I bled for every feeding and it left both of us in tears, to say the least. I was determined to give him breast milk so I exclusively pumped for 8 months, but the damage was done. I felt like a failure. I told my husband I felt inadequate to be a mother and found myself crying often. Then the anxiety and OCD kicked in. I’d imagine myself falling down the stairs with the baby or waking up to his face pressed downward in his bassinet. The bottles and nipples had to be perfectly aligned or I’d find myself in a panic. It wasn’t until I stopped 'breastfeeding' that I started to feel better. But I still haven’t forgiven myself." – Celina, Austin-area mother.
Postpartum PTSD primarily affects women who have a traumatic birth or a birth that they think was traumatic and varied from their idea of what it would be like. Situations like an unplanned C-section, emergency complication or a baby rushed to the NICU can trigger post-traumatic stress symptoms in new moms. Women may have flashbacks of the birth or feelings of re-experiencing the panic of the birth as well as anxiety and panic attacks.
"I went into labor around 10 p.m. on a Tuesday, and he was born at 9:30 the next morning. He got stuck on his way out, and it was almost an emergency C-section. He inhaled amniotic fluid into his lungs for his first breath at life, and that's where his trouble started. But in the months after he was born, I started having thoughts about all the different ways he could die, then I would get angry at nothing at all. Emotions I couldn't control." – Stephani, Austin-area mother.
Postpartum psychosis is much rarer. The onset is quicker, more intense and involves a loss of grounding with reality. It may involve hearing things others don't hear, delusional thinking or intrusive thoughts.