Perinatal mood and anxiety disorders
Adjusting to the physical and emotional demands of motherhood is challenging for any woman. Some moms find themselves on an emotional journey they never expected. They may feel increasingly overwhelmed, exhausted, inadequate, anxious, sad, confused, angry — even terrified. Many suffer in silence from fear or shame.
If you are like one of these women, you should know that postpartum depression is the most common complication of childbirth. It has a very real biological basis — and it’s highly treatable. The experts at Edward-Elmhurst Health understand what you’re going through, and we’re here to support you every step of the way.
What are perinatal mood and anxiety disorders (PMADs)?
Some mothers experience perinatal mood and anxiety disorders (PMADs) after the birth of their child. It is a complex mixture of physical, emotional and behavioral changes and can be divided into three categories: postpartum blues, perinatal depression, and postpartum psychosis.
- Postpartum blues (“baby blues”) - Up to 80 percent of all women experience postpartum blues, a very mild form of depression. It begins 3-6 days after childbirth and lasts for up to two weeks. Experts believe these feelings are caused by hormonal changes, fatigue and interrupted sleep.
- Perinatal depression - About 15-20 percent of women experience perinatal depression, a more serious condition. And, at least 50 percent of these women experience a continuation of depression symptoms that occurred during pregnancy. It usually begins around two weeks after childbirth, but sometimes may not appear until 3-6 months after giving birth. It can last for several months, and if left untreated, for several years.
- Postpartum psychosis - This is a relatively rare occurrence, affecting 1 in 1,000 births. It usually begins within the first three months of the postpartum period and tends to be severe and quick.
Symptoms of perinatal mood disorders
Postpartum blues symptoms include weepiness, anxiety, insomnia, mood swings, difficulty concentrating and fatigue. Patients describe being overwhelmed, confused and nervous, having their feelings hurt rather easily, and most troubling, a lack of feeling for the baby. While similar to PMADs, symptoms are milder and shorter-lasting.
Some common PMAD symptoms include:
- Depressed mood most of the day
- Noticeably decreased interest or pleasure in activities almost every day
- Noticeable weight loss or gain
- Decreased or increased appetite
- Insomnia or sleeping too much
- Agitation or apathy
- Feelings of worthlessness or inadequacy
- Inability to concentrate
- Panic attacks
- Lack of feeling for the baby
- Fantasies of hurting the baby
- Recurring thoughts of death or suicide
Postpartum psychosis symptoms include hyperactivity, confusion, agitation, inability to sleep, mood swings, rapid speech, and delusions or hallucinations both auditory and visual. Due to loss of contact with reality, new mothers experiencing psychosis may cause themselves or their babies harm. Treatment is urgent and may include hospitalization, family/partner education and support.
Can PMADs be prevented?
If you've experienced a perinatal mood disorder before, you have a 50-80 percent chance of experiencing this again. Women who have had major complications during pregnancy are twice as likely to have PMADs compared with those who had a relatively easy pregnancy. There is a 15-25 percent risk of PMADs in women with a prior history of depression or bipolar disorder, which significantly increases when moms discontinue medications during pregnancy.
If you had PMADs after past pregnancies, your doctor may prescribe antidepressant medication after you deliver to reduce the chances of PMADs returning. While perinatal mood and anxiety disorders cannot be prevented, here are some ways to help yourself:
- Plan ahead - Find someone who can help with household chores and the baby during your first week home from the hospital; choose child care so you get a break on an ongoing basis; and decide ahead of time what you need to have on hand when the baby arrives.
- Educate yourself - Take prenatal classes to teach parenting skills, reliance on assistance from support personnel including spouses, family members, friends and neighbors.
- Stay on top of symptoms - Screening questionnaires may help detect depression or risks for depression early. Do your best to answer screening questions honestly so that your behavioral health provider can help you.
- Talk about your feelings - Talk about your fears and anxieties before the baby arrives, and continue these discussions after delivery. Meeting with a professional counselor, attending support groups, and having good social support from loved ones can all help to reduce the symptoms of PMADs.
Treatment for perinatal mood and anxiety disorders
It’s important to understand that mood disorders are not something you can “snap out of.” Depression and anxiety develop when chemical changes in the way your brain works begin to affect how you feel. It’s a medical problem, and it requires help from a doctor.
The experts at Edward-Elmhurst Health provide a combination of treatments and supportive therapy for postpartum depression and anxiety so you can get back to living life, and enjoying motherhood.
All of our OB patients are educated and screened for perinatal mood and anxiety disorders. If you’re found to be at risk, your doctor may discuss with you the possibility of taking medications to correct hormone imbalances, or to treat depression-related changes in brain chemistry. Your doctor may also recommend professional psychotherapy with a trained counselor, as well as group therapy with other postpartum moms.
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Learn more about our treatment program for depression
Additionally, there are things you can do on your own to help ease PMADs:
- Allow yourself time to adjust to your new life.
- Ask for help with daily activities.
- Keep visits short with friends and family if you're feeling overwhelmed.
- Get as much rest as possible.
- Get out of the house whenever you have a chance.
- Get together with other new moms.
- Spend some time alone.
- Make time for moderate aerobic exercise, like walking.
Above all, if you think you may have a perinatal mood disorder, get help. Studies have shown that untreated depression and anxiety has long-term effects on mothers and babies. It also strains marriages, and can cause depression in fathers.
Edward-Elmhurst offers a variety of support groups for moms:
- Nurturing Mom - This is a support group for women experiencing postpartum depression and anxiety. Groups meet at Edward and Elmhurst hospitals. Call 630-527-6363 for information.
- Mom’s Line - This is a phone line dedicated to women, or anyone concerned about a woman, who may be experiencing signs or symptoms of postpartum depression. Call our Mom's Line at 630-527-7294. Messages on this line are checked daily and calls will be returned within 24 hours.
- SHARE - This is a support group for parents who have lost a baby through miscarriage, ectopic pregnancy, stillbirth or early infant death. Call 630-527-3263 for more information.
- Sharing HOPE - This is a support group for couples who have experienced a miscarriage, ectopic pregnancy, stillbirth or neonatal death and are now pregnant or considering pregnancy. Call 630-527-3263 for more information.
Learn more about our resources and support
View frequently asked questions about perinatal mood disorders.
Most likely, no. While the "baby blues" are common and some women get perinatal depression after delivery, you’re probably out of the woods. The majority of postpartum blues starts the first week after giving birth and postpartum depression and anxiety sets in after the second week.
That being said, postpartum anxiety and depression has been known to develop anytime within a year after giving birth. This is because there are multiple factors that influence its development, including hormonal changes and life stressors. Sometimes it is a culmination of factors over time that result in its development.
If you feel sad, anxious, overwhelmed or any of the other symptoms that won't go away after two weeks, you should contact your doctor.
New fathers, especially first-timers, may also have feelings of sadness or anxiety, especially about feeling left out when all of the attention is focused on the mother and baby. They also eventually suffer from lack of sleep and exhaustion as they care for the baby and try to manage work as well.
Now is a good time to talk to each other about being new parents. Try to spend some time alone together, even if it's just for an hour. Many parents try to plan a regular date night so they can be together without the baby. Keep in mind that dads can get depressed and anxious too, and should seek help if they have any of the symptoms of postpartum depression.
You should talk with your doctor and lactation consultant. Most medicines that moms take do show up in their breast milk. However, there are usually behavioral health medications that you can take safely while breastfeeding.
Discuss the options with your doctor. Some women benefit from therapy and don’t need to take medication, while others really need medical treatment. Make sure you find a treatment that works for you.