Symptoms

Postpartum anxiety

Because there are so many unknowns about being a parent, it’s normal to think about the “what ifs.” But what if you can’t stop thinking about those “what ifs?” What if the anxiety gets in the way of day-to-day life? That may be a sign of postpartum anxiety.

Uncontrollable worries adversely impact your sleep, health, or ability to care for your little one. Sky-high anxiety can also trigger panic attacks.

Symptoms of postpartum anxiety disorder include:

• Feeling tense
• Worrying a lot
• Having shortness of breath or feeling like you’re choking
• Having hot or cold flashes
• Feeling tingling hands and/or feet
• Experiencing muscle tension
• Having chest pain
• Feeling agitated or restless
• Fearing that you might die
• Fearing that you might be going crazy
• Feeling anger or rage
• Experiencing intense fear of being alone or fears about your baby’s health
• Feeling dizzy or hyperventilating
• Having nausea, diarrhea, or vomiting

Postpartum bipolar disorder and psychosis

Postpartum bipolar disorder
Everyone goes through ups and downs, but bipolar highs and lows are severe. Often, bipolar disorder (previously called manic depression) remains undiagnosed for years. In women who have bipolar disorder or who have some of the risk factors for bipolar disorder, the birth experience and lack of sleep with a newborn may trigger symptoms.

With postpartum bipolar disorder, in addition to signs of postpartum depression, new moms may experience:

• Extreme mood swings, lasting for days or weeks
• Highly irritable mood
• Hostility
• Increased talkativeness
• Risky and/or impulsive behavior
• Racing thoughts
• Feeling easily distracted
• Feeling energetic, high or hyper
• Decreased need for sleep/insomnia

Postpartum psychosis
This is a severe condition that occurs in only 1% of women and develops between one to two days and up to three weeks after birth. Because of the disturbances in perceptions of reality, high risk of harming yourself or someone else, and difficulty caring for an infant, postpartum psychosis is considered an emergency requiring immediate medical intervention and treatment.

A history of bipolar disorder increases the risk of developing postpartum psychosis, which includes symptoms such as:

• Delusional thoughts not based in reality
• Hallucinations often involving sight, smell, touch, or hearing voices
• Disorganized speech
• Excessively disorganized thinking that increases the risk of harming yourself, the baby, or another person
• Sleep disturbance and the inability to sleep even when the baby is sleeping
• Irritability, extreme agitation, restlessness
• Dramatic and drastic changes in mood

Postpartum obsessive-compulsive disorder

A thought, impulse, or image consumes you. You perform a specific behavior to ease your discomfort. Things are better—for a while. That’s the nutshell version of OCD. In postpartum OCD, moms’ obsessive thoughts focus on the baby, especially on harm that can befall the child. For example, she may sterilize the bottles repeatedly to make sure all the germs are gone. In another manifestation of symptoms, she might secretly fear she will harm her baby or forget him somewhere.

Signs of postpartum obsessive compulsive disorder include:

• Recurring, persistent and disturbing thoughts, ideas, or images (frightening images of accidents, abuse, harm to baby)
• The urge to do something over and over again to reduce feelings of fear, to avoid harming baby (for example, putting away knives), or to create protection for baby (not leaving the house and/or constantly checking the baby, the house, etc.)
• Intrusive thoughts, fears, and images, and the inability to control them
• Hypervigilance (not being able to sleep for fear that something will happen to baby, being in a constant “fight or flight” mode)
• Being aware that these thoughts and behaviors are not typical, but still finding them very difficult to control

Postpartum posttraumatic stress disorder

Posttraumatic stress is often associated with military service, a history of physical or sexual abuse, or other harrowing events. Yet a small number of women are so distressed by childbirth that they develop PTSD. About 2% to 5% of women experience full-blown PTSD, although many others experience isolated symptoms. Post-delivery PTSD can interfere with the mother-baby bonding.

Signs of postpartum PTSD include:

• Feelings of anxiety when exposed to situations similar to the traumatic experience
• Avoiding places, people, or things that remind the person of the trauma
• Nightmares
• Irritability or feeling “on edge”
• Emotional numbing/detachment