Postpartum anxiety and depression occur more commonly in individuals with previous psychiatric diagnoses. However, they also occur in women with no previous history. Many women and providers attribute postpartum mood symptoms to temporary hormonal shifts. Hormones indeed contribute to shifting moods, but are more likely to cause “baby blues.” Baby blues occur in 80% of women and are characterized by sadness and moodiness beginning 2-3 days after birth, and typically dissipate after two weeks. Postpartum depression lasts longer and is more severe than baby blues. When symptoms endure past two weeks and/or interfere with functioning, a diagnosis is suspected. Postpartum depression and anxiety can occur up to one year after birth. Symptoms can include some or all of the below:

• Difficulty bonding with your baby
• Excessive crying
• Withdrawing from family and friends
• Loss of appetite or eating much more than usual
• Inability to sleep (insomnia) or sleeping too much
• Overwhelming fatigue or loss of energy
• Reduced interest and pleasure in activities you used to enjoy
• Intense irritability and anger
• Fear that you’re not a good mother
• Hopelessness
• Feelings of worthlessness, shame, guilt or inadequacy
• Diminished ability to think clearly, concentrate or make decisions
• Restlessness
• Severe anxiety and panic attacks
• Constant worry
• Thoughts of harming yourself or your baby
• Recurrent thoughts of death or suicide

The Importance of Early Detection and Treatment

It’s important for patients, families, and providers to monitor mood and irritability in post-partum women. Awareness of nonverbal cues such as withdrawal, distraction, and/or restlessness is critical as many women are hesitant to admit their history and symptoms. Recognizing and treating these symptoms early positively impacts infants’ psychiatric and neurological development. For example, mothers with depression and anxiety are more likely to have poor nutrition and higher rates of preterm birth and low birth rate. Studies have shown that babies and toddlers of mothers with postpartum depression are less adaptable, more likely to suffer from psychiatric conditions, and have lower cognitive ability. It is incumbent on the provider to screen for these symptoms. Medical providers, psychiatrists, and therapists can create a safe space by acting nonjudgmentally of the difficulties associated with pregnancy and newborns.