Postpartum Mood Changes

When parenting isn't all sunshine and joy.

The birth of a child is a major life change! Every part of your life is touched; physical, emotional, spiritual and mental. It is important for women and their support network to understand postpartum mood changes and disorders before they happen so that if a new mother experiences some of the feelings and physical symptoms associated with the various postpartum mood disorders she can be treated promptly, as quick intervention has been proven to reduce the length and severity of the issue.*

No one knows if a new mother will develop a mood disorder. It can happen to anyone and it is important to acknowledge that it is not the mother's fault. Postpartum mood disorders can happen anytime during the postpartum period. The length of a woman's postpartum period depends on many things, including how fast she heals physically, how long she breastfeeds for, how long it takes the baby to sleep through the night, etc. While medical text books tend to consider the first 6 weeks the postpartum period, most mothers would agree that it is a lot longer than that.

There are certain situations that increase a woman's risk of developing a mood disorder, but often women with no “red flags” can be affected.

 

Mild Mood Disorders:

The most common cause of mild, postpartum mood disorders in women with no previous mental health issues, are hormones* and lack of sleep.

 

Hormones:

There are 3 times in the postpartum period where mood changes can be caused by fluctuating hormones

  1. The first week when all those pregnancy hormones drop really quickly, and when other hormones increase to produce breast milk

  2. Weaning:

    A) Anytime you reduce the number of feeds/day. For example, when baby stops waking at 2 am and you move from 8 feeds/day to 7 feeds/day.

    B) When you wean completely. Baby lead weaning reduces hormone fluctuations as weaning is gradual. Weaning quickly, or stopping “cold-turkey” greatly increases a mother's chances of developing a mood disorder.

  3. 2-4 weeks before your period returns

 

How does sleep deprivation cause/worsen mood disorders?

  • Everything seems worse when you are tired.

  • Focus and concentration problems (chronic sleep deprivation is linked to ADD/ADHD)

  • You react quicker and out of proportion to situations

  • Increased anxiety, feeling overwhelmed

  • Increased irritability and anger

 

Healing Yourself:

 

What can you do to heal yourself?**

  • Identify what you are feeling

  • Identify what might be triggering your feelings

  • Decide what you can do to feel better about the cause of each feeling and make a plan

  • Follow through with your plan, this may mean enlisting help of someone you trust or reaching out to a therapist

  • Know when you need medical help and get it sooner rather than later.

  • Avoid caffeine and sugar!  Studies have shown that ingesting caffeine and sugar makes PPMD symptoms worse.*

This printable worksheet is something that I developed** to help myself and clients focus our thoughts and feelings in order to identify the cause of those feelings and actions we can take to feel better. If you find that your symptoms are not going away or are getting worse talk to your doula, doctor or a therapist, all of whom have referrals that may help you. There is a lot of help available don't be afraid to ask for it.

 

Other tips for healing from postpartum mood challenges can be found in my pathway to healing visual guide.  This guide is an adaptation of the Steps to Wellness found in Jane Honikman's book I'm Listening.

 

Dads, partners and adoptive parents can also struggle with postpartum mood disorders.  Don't be afraid to reach out for help and support!

 

Books and Online Resources

 

Books:

I'm Listening, Honikman

Overcoming Postpartum Depression & Anxiety: Sebastian

This Isn't What I Expected: Kleinman

The Postpartum Husband: Kleinman

Down Came the Rain: Brooke Shields

 

Online:

www.postpartumstress.com – self assessment tools, information

www.mooddisorders.ca/faq/postpartum-depression

 

 

PPMD Banner 1

Mothering the New Mother, Sally Placksin
** Please note I am not a doctor, therapist or counsellor.  The suggestions I give have been deleveoped from experience, reading and self education.  If you are struggling with any postpartum mood issues please seek appropriate support.

 

Postpartum Mood Disorders: Risk Factors

If you struggle or have struggled with any of the following consider taking a proactive approach to postpartum mental health and set your self up for success by creating a support network before baby arrives.  That circle of support may include understanding and trusted family and friends, a doula, a public health nurse, counselor, doctor or therapist.  Finding support before the birth of your child helps reduce the panic of trying to find someone trusted and available after.  

If you are struggling with postpartum mood disorders and have experienced any of the following finding quality supportive help that understands your situation may help you heal and move forward in a positive way.

It is important to recognize the symptoms of postpartum mood disorders so you can identify and seek help quickly should you or your partner experience any of them.

 

  • History of Bipolar Disorder in self or family

  • History of Depression in self or family

  • History of Postpartum Depression in self or family

  • History of Anxiety Disorder in self or family

  • History of PMS

  • History of eating disorders

  • Thyroid disease

  • Multiple births

  • History of insomnia or not receiving at least 2 blocks of 3 hours of REM sleep in the postpartum period

  • Traumatic or disappointing childbirth experience

  • Unresolved losses (especially reproductive in nature- i.e., miscarriage, infertility, abortion)

  • History of sexual or physical abuse or neglect

  • Recent stresses (i.e., an illness in self or family; divorce; a move; a change in jobs; death. change in financial status, etc.)

  • Perfectionist personality; very task oriented; inflexible

  • Isolated (lives far from family, few if any friends or peers with children)

  • Relationship struggles with partner

  • Relationship struggles with mother

  • Relationship struggles with the baby (i.e., colicky, high needs, temperament differences, illness/injury, developmental delays)

 

 

Printable PPMD risk factors

 

 

 

Source: DONA International  Postpartum Doula Workshop Manual 2013

Postpartum Mood Disorders: Symptoms

If you find you are suffering from any of the following it is important for your health and that of your whole family that you seek appropriate help.  That may be simply talking to a trusted friend, doula or doctor or it may mean finding a therapist that can help you work through your postpartum journey.  Postpartum mood disorders happen to more women than report it and there is nothing to be ashamed about.  It takes a village to raise a healthy family!

 

Printable List of PPMD Symptoms

 

Depression:

  • Feelings of despair/hopelessness

  • Crying, tearfulness

  • Anger and irritability

  • Sleep disturbances (too much/little)

  • Loss of energy and interest

  • Physical symptoms (clumsiness, slowed speech, etc.)

  • Suicidal thoughts

  • Frightening thoughts about self or baby or other family members

  • Weight loss or gain

  • Feelings of guilt, shame, inadequacy

  • Hypochondria; excessive worries

Mania (part of bipolar disorders)

  • Feel great/high energy

  • Irritability

  • Decreased need for sleep/insomnia

  • Feeling “speedy”

  • Easily Distracted

  • Mind racing; cannot shut thoughts off

  • Pressured, fast speech

Anxiety

  • Muscle tension; chest pain

  • Shortness of breath; choking sensation

  • Hot/cold flashes

  • Tingling hand/feet

  • Agitation/restless

  • Fear of dying

  • Fear of going crazy

  • Faintness

  • Irritability

  • Anger/rage

  • Fear of being alone; fears of baby's health; agoraphobia

  • Feeling trapped, immobilizing guilt

  • Racing heartbeat

  • Hyperventilating

  • Nausea/vomiting

  • Diarrhea

  • Dizziness

Obsessive-Compulsive

  • Recurring, persistent and disturbing thoughts, ideas or images (scary images of accidents, abuse, harm to baby)

  • Ritual behaviours done to avoid harming baby (e.g., put away knives) or to create protection for baby (e.g., only wear white, don't ;eave the house) constantly checking the baby, house, etc.

  • Intrusive thoughts, fears and images

  • Person cannot control thoughts

  • Person understands that to act on these thoughts would be wrong

  • Hyper vigilant (e.g., can't sleep for fear that something will happen to baby; constant “fight or flight” mode)

Post-traumatic Stress Disorder

(usually occurs quickly after birth)

  • Previous trauma (recent or in the past- abuse, accident, etc.)

  • Feeling of anxiety when exposed to situations similar to the trauma

  • Sensations of “being in the trauma” now

  • Emotional numbing/detachment

Psychosis (very rare)*

  • Paranoia

  • Delusions (about baby)

  • Hallucinations

  • Irrational thoughts

  • Impulsivity

  • Refusal to eat

  • Poor judgement

  • Lack decision-making

  • Break in reality

  • Severe insomnia

  • Confusion

  • Higher risk if bipolar disorder in self or family

  • Missing moral compass

 

 

*Requires immediate treatment often including hospitalization and medication

 

Source: DONA International Postpartum Doula Workshop Manual 2013