Postpartum Mood: Baby Blues, Depression, Anxiety, Psychosis & PTSD

The early days of your postpartum period can be exhausting. Stressful. Overwhelming. All of these feelings are common, but can ultimately lead to a number of different mood disorders. Sleep efficiency is low early on due to caring for your baby and fatigue can have physical, as well as, mental ramifications. Possible prolonged fatigue effects include: depression, early breastfeeding weaning, and poor functional status. These feelings can often be overlooked by healthcare providers and shrugged off as "normal" during this transitional period. This is one of the main reasons Dr. Sarah and Dr. Caitlin have women schedule their first postpartum appointment within two weeks of birth. We need to be aware of how these changes affect women and we need to help them find the correct support as soon as possible!

Factors that worsen fatigue include: lack of sleep, no help with baby, not napping, interruptions in sleep, extended hours of crying, worrying about baby, knowing you should be sleeping, but cannot, stress of having housework to do, and overdoing activities. Factors that improve fatigue include: rest, sleep, naps, showers, support, alone time, daylight, coffee, tea, having fewer chores, knowing there is help, laughing, and bonding with other women in the same transition.

Approximately 80% of postpartum women will experience "baby blues". Baby blues are the worried, unhappy and fatigue feelings that tend to not interfere with daily function. These feelings often resolve one to two weeks following birth. It is normal to experience a variety of emotions postpartum, which is a result of your body's estrogen and progesterone dropping significantly from the very high levels of pregnancy. These feelings are to be considered abnormal if they are affecting your ability to take care of yourself or your baby. 

Up to 12.9% of postpartum women will experience postpartum depression. These women often experience depressed moods or apathy towards activities. Other symptoms include: sleep disturbance, anxiety, irritability, feeling overwhelmed, fatigue, excessive guilt, obsession with infant care/feeding, feelings of worthlessness, and poor concentration. Risk factors include: a history of mood or anxiety disorders, untreated depression/anxiety in pregnancy and a family history of depression or other mood disorders. 

13-40% of postpartum women report symptoms of postpartum anxiety. These symptoms tend to decrease over time for women, but are largely associated with postpartum depression. Risk factors include: cesarean birth, fear of birth, lack of control during labor, low confidence in self and birthing staff, premature childbirth, lack of family support and prenatal depression/anxiety. 

Although postpartum psychosis is rare, it is important to understand its prevalence. Approximately 1-2 women per 1000 births experience psychosis and it can occur as early as 2 days following birth. Symptoms include: confusion, agitation, bizarre behaviour, sleeplessness, hallucinations, delusions, depression or an extremely elevated mood. When this is seen, emergency hospitalization is required. 

Postpartum Post-Traumatic Stress Disorder occurs as a direct result of birth events in 1-3% of women. We see increased rates with high risk pregnancies, preterm or still born births and life-threatening complications during labor or childbirth. Unfortunately we see high rates of comorbidity with postpartum depression and anxiety. Spouses and partners can also experience PTSD in relation to childbirth. 

Mental health is not something to take lightly - postpartum or not. There are many incredible resources for families throughout the city. Please find some of them below:

Kerry Bauer, LCSW:

JLF Counseling Services:

Christina Smalley Counseling:

Parenting Village Nurture Program:

Dr. Sarah and Dr. Caitlin are here to support you as a pregnant or postpartum mother. With anything you need. 

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