Friday, May 26, 2006

What is PPD?

Postpartum Depression (PPD) has become an umbrella term for a spectrum of postpartum mood disorders affecting mothers within the first year of the birth of a baby (or later if a breastfeeding mom weans after one year). The spectrum of what is often referred to as PPD includes Baby Blues, Postpartum Depression, Postpartum Anxiety, Postpartum Obsessive Compulsive Disorder, and Postpartum Psychosis. A woman’s symptoms could fall neatly into one of these categories or she could exhibit signs associated with more than one disorder.


Many women who do not develop postpartum mood disorders feel weepy, sad, overwhelmed, isolated, resentful, guilty, and anxious within the first few days of giving birth. These feelings can be surprising and scary to a new mom, who is often led to believe she will be nothing but happy, if a bit sleepy, in the postpartum period. Many of these negative feelings are hormonally driven, but can also stem from lack of practical support, evidenced by the emotional adjustment adoptive parents can experience. These Baby Blues usually resolve themselves within a couple of weeks as a mom adjusts to new demands on her time, builds confidence in her mothering skills, begins bonding with her baby and reaches out for practical help. Up to 80% of mothers experience some form of Baby Blues.

10% - 20% of mothers will develop a more serious postpartum mood disorder.

Postpartum Depression symptoms include:

  • Frequent crying
  • Feeling sad most of the time
  • Inability to concentrate
  • Inability to enjoy pre-baby hobbies and activities
  • Lack of energy
  • Insomnia
  • Feeling like a failure
  • Lack of appetite – everything tastes like sand or an aversion to texture of food
  • Sugar and carbohydrate cravings, compulsive eating
  • Inability to laugh
  • Hopelessness about the future – thinking that she will always feel this bad
  • Feeling that partner and new baby would be better off without her
  • Aversion to caring for the baby
  • Lack of sex drive
Postpartum Anxiety Disorder symptoms include:
  • Racing obsessive negative thoughts
  • Inability to sit still
  • Fear of leaving the house
  • Inability to concentrate
  • Fear of being alone with the baby
  • Shaking, trembling hands
  • Bursts of anger
  • Impulse to run away from home or to hide
  • Inability to comprehend what she reads
  • Gastrointestinal pain, diarrhea, nausea
  • Panic attacks
    • Pounding, racing heart
    • Thinking she is dying or having a heart attack
    • Feeling like she is choking

Postpartum Obsessive Compulsive Disorder symptoms include:

  • Recurring thoughts and images of doing harm to herself or her baby
  • Recurring thoughts and images of outside harm inflicted on her baby
  • Preoccupation with cleanliness and germs
  • Doubts about her ability to care for the baby
  • Excessively elaborate routines to complete common, simple activities

Postpartum Psychosis affects 1% of postpartum women and is considered a postpartum emergency requiring immediate medical attention from her doctor or a visit to the hospital emergency room. Onset of symptoms typically occurs within the first six weeks postpartum and includes:

  • Delusional thoughts and hallucinations
    • Thinking the baby is evil or Satan
    • Feeling that some external force is compelling her to harm herself or her baby
  • Rapid mood swings (irritability to euphoria to depression)
  • Having a concrete plan for harming herself or the baby and a timetable for acting on it
  • Loss of touch with reality for extended periods of time

Risk Factors for Postpartum Depression and/or Anxiety include:
  • Postpartum depression or anxiety with previous pregnancy (50 to 80 percent risk of recurrent episode)
  • Previous depression or anxiety (personal or family history)
  • Depression or anxiety during pregnancy
  • Abrupt weaning
  • Social isolation; few social supports
  • History of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD)
  • Mood changes while taking birth control pill or fertility medication
  • Thyroid dysfunction

Risk Factors for Postpartum Obsessive-Compulsive Disorder (OCD) include:
  • Personal or family history of OCD

Risk Factors for Postpartum Psychosis include:
  • Personal or family history of psychosis, bipolar disorder, or schizophrenia
  • Previous postpartum psychotic or bipolar episode*

Remember, “Risk factors do not cause depression.
They merely set the stage or create an opportunity for it.”**

A woman who is experiencing symptoms for any of the postpartum mood disorders described should get a complete medical exam to rule out other possible sources that have similar symptoms (such as a thyroid condition). A mental health professional is also essential in diagnosing and treating postpartum mood disorders. Please see our link to mental health professionals in Brooklyn.

*Bennett, Shoshana S., Ph.D. and Pec Indman, Ed.D., MFT. Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression. San Jose: Moodswings Press, 2003.


**Kleinman, Karen, M.S.W. The Postpartum Husband: Practical Solutions for Living with Postpartum DepressionThe Postpartum Husband: Practical Solutions for Living with Postpartum Depression. Philadelphia: Xlibris, 2000. 

No comments:

Who We Are

We are two moms of young boys who each struggled with postpartum depression and anxiety. Between us we experienced insomnia, loss of appetite, over-concern about the baby, suicidal thoughts, escape fantasies, debilitating guilt, worthlessness, agitation, inability to concentrate, hospitalization, hopelessness, excessive crying, anger, confusion and other symptoms associated with postpartum mood disorders, and have made full recoveries.

Molly has a master of social work degree from Southern Connecticut State University, where she conducted research on peer support and also co-led psychoeducational groups.

Chris has been a phone volunteer through Depression After Delivery and The Postpartum Resource Center of NY since 2002 and is a postpartum doula with the Brooklyn-based Birth Day Presence.

What We Do

We established a peer support group in Brooklyn in 2006 as a place where pregnant and postpartum women can get support if they think they are at risk for PPD, are experiencing symptoms and need further help and resources, or are in the care of a therapist and want to attend the group as part of their treatment plan. The group is free, meets monthly, and babies are welcome to join us. Women are encouraged to attend for as many meetings as they feel the group is helpful, whether once for information or monthly for ongoing support. Please note that the function of this group is to provide a forum for the exchange of peer support. It does not replace care provided by a licensed mental health practitioner. Please understand that this is a closed group; only women experiencing symptoms of a perinatal mood disorder will be allowed to participate. Graduate students, researchers and well-meaning friends and partners may not sit in on meetings.

Emotional support from empathetic listeners is one key part of expediting a woman's recovery from PPD. A support group might be the only place a mom feels safe to share her feelings without being judged or gossiped about, as it is private and confidential. Women in the group share and validate each others experiences, and women further along in the recovery process set an example of wellness and hope to those moms in despair.

For more information about the symptoms of and recovery from postpartum depression please see our section titled "Helpful Websites". We are growing this site and will be adding more educational information, strategies for recovery, and resources for partners, family and friends in the near future.

Postpartum Support International's Universal Message:

You are not alone
This is not your fault
You will feel better