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Differentiating Between Postpartum Mood Disorders

By Doula Jen

postpartum depressionBefore conception, parents have likely heard the terms “Baby Blues” and “Postpartum Depression.”  They may think that the phrases are interchangeable or they may understand that the conditions are quite different.  They may or may not have heard of Postpartum Anxiety or Postpartum OCD.  They have likely seen or heard a sensationalized news story on Postpartum Psychosis and may have–unfortunately–heard it inaccurately described as Postpartum Depression.

Many birthers experience a few mood swings as a result of the hormonal shifts after birth and many experience the classic Baby Blues. Approximately 20% of birthers will experience something more significant, something that would be easily diagnosed as a Postpartum Mood Disorder.

It goes beyond what we commonly hear and know. Here’s a simple breakdown.

Postpartum or Antepartum Depression:

Characterized by feelings of anger, irritability, guilt, or shame. A significant lack of interest in the baby. Intense crying and sadness. Loss of appetite. Difficult sleeping or excessive sleepiness. Sometimes struggles with thoughts of hurting the baby or self.

Risk factors include a personal or family history of depression, history of intense PMS, lack of support during birth and after, financial stress, marital stress, mothering multiples, Baby is in NICU, fertility struggles, thyroid imbalance, diabetes, and major life events coinciding with welcoming baby home (such as moving, job change, or loss of a loved one).

Postpartum or Antepartum Anxiety:

Often marked by a fear that something will happen to Baby or a fear of being unable to properly care for Baby. Feeling that something bad is going to happen. Racing thoughts, trouble sleeping, difficulty eating. Difficulty sitting still. Dizziness, hot flashes, nausea, heart palpitations, perhaps full blown panic attack. Excessive, relentless worry.

Risk factors include history of anxiety, thyroid imbalance, and birth trauma. Postpartum Panic Disorder and Postpartum OCD are forms of Postpartum Anxiety.

Postpartum or Antepartum OCD:

Presents in the form of obsessions or intrusive thoughts–repetitive, disturbing thoughts or images linked to the baby. The experience may also include compulsions–things the parent does over and over again to reduce anxiety. Fear of being left alone with the infant. Overprotective of infant, even for a new parent. Parents with this disorder understand that the thoughts are unusual; they are very unlikely to act on them.

Risk factors include a personal or family history of anxiety or OCD.

Postpartum Post-Traumatic Stress Disorder:

Usually related to a traumatic birth scenario. Intrusive flashbacks of traumatic event. Nightmares. Avoidance of anything associated with the event. Irritability, difficulty sleeping. Startles easily. Panic Attacks. Detachment.

Risk factors include unusual, emergent birth procedures as well as a history of previous trauma–rape, sexual abuse, hospitalization, etc.

Postpartum Psychosis:

This is a rare illness, occurring in 1 out of 1,000 deliveries. The onset is sudden and most often within the first month after birth. Delusions, hallucinations, intense irritation, hyperactivity, inability to sleep. Paranoia, difficulty concentrating and/or communicating. There is a 5% chance of suicide or infanticide, so it is important to get a mama in this state into treatment as quickly as possible. It is important to understand that not all delusions associated with this disorder include harming the baby. Most women do not go on to harm anyone, however, the risk is there because Postpartum Psychosis is a complete break from reality. 

The most significant risk factors include a personal or family history of bipolar disorder and/or a previous psychotic episode.


This information is not meant to scare or alarm you. On the contrary, we hope that it empowers you.

If you or anyone you know fits one of these descriptions, seek help. Help is real, available, and plenty.  Call us at 952-942-5676 or visit the Postpartum Support International website.

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