Disorders Related to Postpartum
Depression During Pregnancy
Depression that occurs during pregnancy or within a year after delivery is called perinatal depression. Researchers believe that depression is one of the most common complications during and after pregnancy. Factors that may increase the likelihood of depression during or after pregnancy can include; history of depression or substance abuse, family history of mental illness, inadequate support from family and friends, anxiety about the fetus, problems with previous pregnancy or birth, marital or financial problems, young age (of mother or newborn). Tiredness, problems sleeping, stronger emotional reactions, hormonal changes, and changes in body weight normally occur during and after pregnancy, but these symptoms may also be signs of depression.
It is natural for women to experience changes in their feelings and mood during pregnancy, including feeling more tired, irritable or worried. However, while mild mood changes during pregnancy are common, mood symptoms can sometimes become severe enough to require treatment by a health provider. If feelings of depression or anxiety persist for a few weeks or interfere with daily activities, it is time to ask for help. Depression and anxiety during pregnancy can worsen and continue into the postpartum period.
Symptoms of Depression During Pregnancy:
Feeling sad, depressed, and/or crying a lot
Diminished interest in becoming a mother
- Feeling worthless or guilty, especially about not being a good mother
- Strong anxiety, tension, and/or fear either about your future child or other things
- Sleep problems (not being able to sleep despite feeling very tired or sleeping more than usual but not feeling rested)
- Thoughts of wanting to be dead or wanting to kill yourself
- Having low energy
- Loss of or increase in appetite or weight
- Trouble focusing, remembering things, or making decisions
- Feeling restless or irritable
- Having headaches, chest pains, heart palpitations, numbness, or hyperventilation
Experiencing miscarriage at any point in pregnancy can be a shocking and devastating event. Many women struggle with physical and emotional pain and grief that is powerful and overwhelming. Miscarriage can leave women feeling numb, helpless and isolated from others. Common reactions to miscarriage are sadness, anger, and guilt and depression.
Infertility occurs in 10-15% of couples of reproductive age. Investigation of the causes of infertility and treatment can bring on a “life crisis” that can tax a couple’s existing problem-solving resources, threaten achievement of life goals, and awaken unresolved past difficulties.
Postpartum Depression (PPD)
Many women have a variety of mood symptoms in the aftermath of delivery. 50-85% of women feel Postpartum Blues or “Baby Blues” for a short time, usually 1-3 weeks after delivery. Common symptoms of “Baby Blues” can be mood instability, depressed mood, weepiness, sadness, irritability, anxiety, lack of concentration and feelings of dependency. Symptoms of “Baby Blues” usually subside 1-3 weeks after delivery. These symptoms are often self-limited and are to be distinguished from a more severe condition often called Postpartum Depression (PPD) which has increased severity and duration of symptoms.
Postpartum Depression occurs in up to 10% of births. It typically emerges over the first 2-3 months after childbirth but may occur at any point after delivery. Symptoms of PPD last for more than 2 weeks. Depression after childbirth is a serious illness and can have significant and lasting impact on the patient, infant, and family.
Symptoms of Postpartum Depression:
- Feeling sad, depressed, and/or crying a lot
- Intense anxiety; rumination, obsessions (See Postpartum Anxiety Disorders below)
- Loss of interest in usual activities
- Feelings of guilt, worthlessness or incompetence
- Fatigue, irritability, sleep disturbance
- Change in appetite
- Poor concentration
- Feeling inadequate to cope with new infant
- Excessive worry about baby’s health
- Suicidal thoughts
Postpartum anxiety disorders such as panic disorder, obsessive compulsive disorder and generalized anxiety disorder appear to be as common as postpartum depression and even coincide with depression. Perinatal anxiety symptoms can include the following: panic attacks, hyperventilation, excessive worry, restless sleep, and repeated thoughts or images of frightening things happening to the baby.
Another form of Postpartum Depression is Postpartum Psychosis. Postpartum Psychosis is a serious illness that can be severe and life threatening. The psychotic symptoms include delusions (thoughts that are not based in reality), hallucinations (hearing or seeing things that aren’t there) or disorganized thinking. Often mothers who develop postpartum psychosis are having a severe episode of a mood disorder, usually bipolar (manic-depression) disorder with psychotic features. It is essential for women to get evaluation and treatment immediately. Please see the Perinatal Psychiatry Inpatient Unit page for more details on the services available for women with this serious condition. For crisis or emergency situations, please call UNC Crisis Psychiatry at (919) 966-2166.