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It is not uncommon to experience major mood and emotional changes postpartum. The transition to motherhood, in addition to changes in your hormone levels, can lead to depressed mood, sleep disturbances, exhaustion, stress and feelings of anxiety and isolation. This is what is commonly referred to as the “baby blues” and it can appear within the first few days of giving birth. A more severe form of these feelings is a condition called Postpartum Depression (PPD) and it can start as early as those first few weeks.
What is Postpartum Depression (PDD)?
Postpartum Depression is a clinical diagnosis of either Major Depressive Disorder or a Bipolar Disorder that starts within four weeks postpartum and occurs in about 15 to 20 percent of mothers.
Symptoms associated with Postpartum Depression:
- Depressed mood
- Lack of pleasure or interest in activities that were normally enjoyable
- Sleep disturbances and the inability to rest or sleep even when baby is sleeping
- Loss of energy, even if you’re able to nap, sleep or rest
- Agitation and restlessness
- Excessive feelings of guilt or worthlessness
- Reduced ability to concentrate, issues with memory or feelings of indecisiveness
- Frequent thoughts of death or suicide
Keep in mind that a few on this list are very common after childbirth due to newborn care and sleep deprivation (for example, loss of energy and the inability to concentrate well). However, having five or more of these symptoms, in additional to having a depressed mood that lasts daily, every day for at least two weeks, is enough to be considered for a PPD diagnosis.
PDD can also present as Bipolar Disorder. This involves a different set of symptoms from the more common depressive disorder above. A mother would have to experience at least four to seven days of elevated or irritable mood in addition to four of the following, which tend to occur in an exaggerated or excessive form.
Symptoms associated with PPD-related Bipolar Disorder:
- Inflated self-esteem
- Decreased need for sleep
- Excessive talking or pressured speech
- Racing thoughts
- Distractibility
- Anxiety or restlessness that causes unintentional and repetitive movements (also called “psychomotor agitation”)
- Involvement in high-risk activities
How is Postpartum Depression diagnosed?
The most used diagnostic tool is a self-assessment questionnaire. This is a screening tool where the mother gives a score for each of the symptoms listed above based on the intensity and duration of each one experienced. Following this, your doctor can do an in-depth evaluation, including identifying social support systems, and review appropriate treatments.
What treatments are common for Postpartum Depression?
A treatment plan is created by your healthcare practitioner based on your symptoms and your individual situation, including an evaluation of your social support network. Mental health support most commonly comes in the form of psychotherapy, but in certain cases medications may also be used.
Interpersonal psychotherapy (IPT) and cognitive behavioural therapy (CBT) are two of the most evidence-based psychotherapies. Both are designed to include 10 to 16 weekly sessions that draw attention to the present moment (which can help avoid spiralling thoughts)) and can help new mothers in their ability to control their mood and functioning.
Interpersonal Psychotherapy for PPD
With IPT, a psychotherapist or registered social worker (RSW) engages and talks with you to help you feel understood and helps to redirect your thoughts and actions. They can help you link how you’re feeling to what you’ve just experienced either with childbirth, breastfeeding, and newborn care.
Cognitive Behavioral Therapy for PPD
By comparison, CBT, which can be conducted individually or in a group setting, helps new mothers recognize the connection between their thoughts, emotions, and behaviours. Sessions allow you to work through negative or self-sabotaging thoughts and reframe them to improve emotional outcomes. Group sessions can also help women connect with others who are struggling and having similar reactions.
What is Postpartum Anxiety?
Unlike PPD, Postpartum Anxiety doesn’t have official diagnostic criteria (i.e. It’s not listed in the Diagnostic and Statistical Manual of Mental Disorders), so it technically falls under the standard diagnosis for anxiety disorders. This includes experiencing excessive anxiety and worry more days than not and having difficulty in controlling these feelings. This occurs in addition to three or more of the following, leading to significant distress and interfering with normal functioning.
Learn More About Postpartum Anxiety →
The transition to motherhood can be incredibly difficult, and your postpartum experience—whether it’s your first or fourth—can bring up new feelings and emotional challenges. If you are experiencing any symptoms of PPD, Postpartum Anxiety, or if your baby blues last longer than two weeks, seek help as soon as possible. Reach out to your family doctor, your obstetrician or midwife, a registered social worker, postpartum doula—basically, anyone and everyone who can help set you up with the tools needed to manage these experiences and symptoms. Some hospitals run postpartum health programs and CBT groups for new mothers which can be incredibly helpful. Don’t be afraid to ask for help and say yes to help when it is offered. It can make a world of a difference.
