Anxious and Depressive Disorders after Childbirth

Understanding Perinatal and Postpartum Anxiety and Depression (PPD)

Postpartum anxiety and depression is a mental health condition consisting of experiencing varying levels of depression and anxiety after childbirth. Perinatal depression can begin during the pregnancy itself, while postpartum depression occurs afterwards.

Perinatal/postpartum anxiety and depression is often overlooked and overshadowed by other, more obvious changes that come with having a child. For that reason, many people feel alone in their experience with PPD after giving birth. Not only is pregnancy and childbirth a physically grueling process, but it can also be mentally daunting, especially to those who are going through it for the first time.

An estimated one in seven people may experience postpartum depression in their lifetime. Some people report having short periods of less intense sadness post-childbirth, but postpartum depression is much more severe and can affect a person’s ability to function in their day-to-day life.

People who develop postpartum depression are also more likely to experience depression later in life at other times. It’s also possible for those who have a history of depression to be at a greater risk for PPD.

The following are common causes or triggers of postpartum depression:

  • Sleep deprivation
  • Feeling overwhelmed by major change
  • Not participating in self-care
  • Feeling depressed after birth
  • Feeling guilty
  • Feeling lonely or lost

Carrying and giving birth to a child is no small feat, so it only makes sense to feel overwhelmed and like you need time to process the life change that has happened.

What Postpartum Anxiety and Depression May Look Like

For each person, postpartum depression and anxiety can look different and can depend on several factors. Many people report a mix of the following, including emotional, mental and physical symptoms:

  • Intense emotions, crying
  • Anxiety
  • Feelings of guilt, hopelessness, or sadness
  • Loss of interest in daily life
  • Fatigue
  • Difficulty concentrating
  • Intrusive thoughts
  • Changes in appetite
  • Changes in sleep patterns (insomnia or hypersomnia)
  • Repetitive thoughts
  • Irritability
  • Depression
  • Fear
  • Mood swings
  • Panic attacks

When a person is experiencing these intense symptoms and feelings, it can make it extremely difficult to properly care for themselves and their baby.

Symptoms of postpartum depression may appear immediately after childbirth or as late as a year after childbirth. This may be due to bodily changes, such as hormone levels, family history of mental health disorders, changes in stress levels or previous experience with adjustment disorders, depression or anxiety.

Postpartum Psychosis (PPP)

Although rare, postpartum psychosis can occur in up to four people in every thousand births and appear days to weeks after birth. Cases of PPP can be considered manic, depressive or mixed in symptoms, meaning a person is experiencing a mix of mania and depression. Postpartum psychosis is considered a mental health emergency. If you notice the following symptoms, seek immediate help:

  • Hallucinations
  • Delusions
  • Shifts in mood (manic or depressive episodes)
  • Insomnia
  • Difficulty concentrating
  • Irritability
  • Suicidal thoughts
  • Self-harm or harm to others
  • Dissociation
  • Disorganized speech
  • Confusion
  • Catatonia (or mutism)

Those who have preexisting mental health conditions, such as mood disorders, major depression and schizophrenia, are more likely to develop postpartum depression and psychosis. Depending on the severity of PPP, a person may be placed on psychiatric medications and require medical attention to ensure the health and safety of them and others.

If a person with postpartum psychosis puts themselves or others in danger, call 911.

Treatment

Treatment plans will vary depending on the diagnoses and personal factors of the individual experiencing mental health issues. Whether or not a person is experiencing manic, depressive or mixed symptoms of postpartum depression will determine their plan of action. Depression treatments are often a combination of approaches, and options like therapy, lifestyle changes and medication may be considered for their effectiveness and accessibility.

Therapy

Therapy can be a helpful tool in diagnosing and treating many mental health conditions. Not all therapeutic approaches are the same. Depending on a person’s diagnosis and personal needs, the following may be used:

  • Cognitive behavioral therapy (CBT) – Talk therapy focused on changing negative thoughts and behaviors caused by psychological distress
  • Dialectical behavior therapy (DBT) – Encourages changing negative thoughts and behaviors and focusing on self-acceptance
  • Psychotherapy – General talk therapy for mental or behavioral disorders

Lifestyle Changes

Implementing healthy habits can be the first step toward a more fulfilling experience for anyone. Although it may require discipline, there are easy, risk-free ways to lessen mental stress and emotional reactivity, all while improving physical health. Try creating and sticking to a daily routine, staying organized, minimizing excess stimuli when you need to focus and keeping your body active when possible. It may also be helpful to set time aside for yourself to prepare for your day or week and focus on what makes you feel calm and relaxed.

Eating nutritious foods, practicing deep breathing techniques, exercising and learning your triggers and reactions can tremendously help cope with mental health struggles, such as postpartum depression.

Medication

For some, a proper treatment plan may require taking medication. For those suffering with long-term postpartum depression, medications like anti-anxiety or antidepressants may be considered. Side effects of medication may vary and finding the right one may take some trial and error.

Support Groups

There are many kinds of support groups and joining one can have many benefits. Support groups can be a comforting space for those who feel alone in their struggles with mental health disorders, including PPD.

Being able to connect with others over a shared experience can help to lessen the burden and shame. In support group meetings, a person will learn healthy coping mechanisms and techniques to better deal with anxiety, depression and difficulty adjusting to life with a child.

Seek Help

Treating mental illness is imperative, especially in a vulnerable time after giving birth. If you or a loved one is experiencing perinatal or postpartum depression and anxiety, it’s important to seek proper support. If you or a loved one are having thoughts of harming yourself or others, call 911 immediately.