Postpartum mood and anxiety disorders: Common and treatable
Many women have mood swings after having a baby. They can be happy one minute and sad the next. Even when their baby is content and sleeping regularly, they may have difficulty sleeping and eating and feel a little depressed. If these symptoms begin a few days after delivery and go away in seven to10 days, they are in all likelihood the “baby blues.” The baby blues is a short-lasting condition that 50 to 80 percent of women who just had a baby feel. They are caused by changes in hormones, but don’t usually require medical intervention.
Clinically diagnosed postpartum mood and anxiety disorders (PMAD), however, are another story.
PMAD can affect 10 to15 percent of women any time from a month to a year after childbirth, not just right after childbirth. Women with PMAD may feel restless, anxious, sad or depressed. They may have feelings of guilt, decreased energy and motivation, and a sense of worthlessness. They also may have difficulty sleeping and experience unexplained weight loss or gain, not associated with losing “baby fat” or breastfeeding. Some mothers actually say they worry about hurting themselves or their baby.
In extremely rare cases - less than 1 percent of new mothers - women may develop something called postpartum psychosis. Postpartum psychosis usually occurs within the first few weeks after delivery. Symptoms may include refusing to eat, frantic energy, sleep disturbance, paranoia and irrational thoughts. Women with postpartum psychosis usually need to be hospitalized.
Researchers aren’t sure what causes PMAD, but research suggests they are caused by dramatic shifts in hormone levels during pregnancy and immediately afterward. These dramatic shifts may result in chemical changes in the brain leading to the condition. Childbirth itself also is a major life change that can create ongoing stress and contribute to depression. Additionally, the new mom’s responsibility for the baby, the household and returning to her work duties after maternity leave may increase her risk of developing PMAD. Mothers with PMAD, recall missing out on the enjoyment of their baby’s early development, continuing to fall deeper into the “dark side” of motherhood
The good news is that, like diabetes or heart disease, PMAD can be successfully treated with medicine and therapy. Women treated with antidepressant medicines and talk therapy usually show marked improvement. Depending on the type of medication they’re using, they may be able to continue breastfeeding. PMAD treatment is essential to healing. Mothers in treatment consistently report they wish they had gotten help and intervention earlier, as PMAD ultimately affects the entire family.
If you suspect a new mother is suffering from PMAD, it’s important to show understanding and patience during this stressful time. This will help her avoid the stigma and isolation often associated with this condition while providing her with the support and nurturance she needs for healing.
Flagstaff Medical Center offers voluntary PMAD screening for all new mothers before discharge. A free weekly Pregnancy and Postpartum Adjustment Group is available for women and their families suffering from PMAD. For PMAD screening and group information, contact Sheri Yeider, at 928 773-2319.
Sheri Yeider, M.S.W., I.T.M.H., is the parent educator and group facilitator in FMC’s Women and Infants’ Center. She has a master’s in social work and an advanced clinical degree in infant toddler mental health.