By: Nicki Reid, Bilingual BA
*** Trigger Warning: this blog contains sensitive content, please proceed with discretion. ***
Mental health challenges postpartum impacts a significant portion of the birthing population. Feeling highs (joy, awe, and wonder) as well as feeling lows (stress, overwhelm, and exhaustion) can be a normal and common part of the postpartum period. If you or someone you know is amongst the 49% who experience depression, anxiety, rage, or psychosis postpartum then keep reading because in this blog, we’ll explore where to get help in Canada.
Postpartum Depression
Postpartum depression is a psychiatric disorder and a form of depression which impacts around 10-15% of women who give birth. It can also develop after stillbirth or miscarriage and impact fathers, adoptive parents, and women who’ve had children before. Some signs are: feeling sad or hopeless, anhedonia (the inability to experience pleasure in otherwise pleasurable acts - which can include interacting with your baby) trouble sleeping, feeling restless, problems focusing, repeated thoughts of death or suicide (in this context, thinking “the world would be a better place without my baby and I in it”), sleep deprivation, a personal or family history of depression, hormonal changes, lack of familial / partner support, socioeconomic disparities, and other life stressors. Treatment involves cognitive behavioral therapy (CBT), increased social support, antidepressants, maternal relaxation or massage, hormone therapy and / or bright light therapy. Postpartum depression can sometimes be confused with the baby blues, however; the latter generally improves more quickly and on its own, whereas postpartum depression persists over weeks or months.
Postpartum Anxiety
While postpartum depression often happens alongside postpartum anxiety, they differ in presentation. Postpartum anxiety is excessive worrying that occurs after childbirth or adoption and impacts 13.8% of Canadian mothers. Symptoms can be physical (shortness of breath or elevated heart rate), emotional (panic attacks, obsessing over irrational fears, and imagining the worst possible outcomes) or behavioural (avoiding certain activities, people or places and constantly checking your baby, its environment, feeding schedules, etc.). You may become so preoccupied with preventing bad things from happening to your child that you miss being in the present moment with them. Some contributing factors are: lack of sleep, hormonal changes, and stressful events such as a traumatic delivery or other prior traumatic encounters. Depending on the severity, treatment may look like lifestyle support such as online or in-person support groups for new mothers, seeking assistance from friends and family, exercise, quality sleep, cognitive behavioural therapy (CBT) and / or medications. Postpartum anxiety can display as attentiveness and can be overlooked during screening which is why it’s crucial that your primary care provider knows the specifics of your experience so that they can best support you.
Postpartum Rage
Postpartum rage aka postpartum anger, or maternal rage or anger is a common indication of postpartum depression and anxiety but can also show up independently. It’s an intense and sudden feeling of agitation, frustration or anger that transpires in the weeks or months after childbirth. You may have difficulty controlling your temper (throwing / breaking objects, yelling / cursing), be overwhelmed by daily demands, and feel intense emotions. Some causes are: sleep deprivation, hormonal fluctuations, lack of support, personal or family background of mental health, the discrepancy between expectations (a blissful bonding period) versus the reality of motherhood (exhaustion, overwhelm, lack of sleep etc.), mental load and invisible labour (for instance, keeping track of baby feeding times and amounts, diaper changes, ongoing demands, decision fatigue). Due to a lack of research and dedicated attention, it’s unknown how many are impacted. Consequently, many (newly) postpartum mothers don’t get the support and care they need which results in them suffering alone. When speaking with your healthcare provider, it’s important to provide a detailed account of your experience as standard screening might overlook your symptoms. In addition, therapy can equip you with the knowledge and skills to deal with your emotions like anger and frustration and teach you how to self-regulate, set boundaries, and manage expectations. Online or in-person peer support groups can also be beneficial as well as reaching out to friends, family, and community members for relief.
Postpartum Psychosis
Although all postpartum mental health conditions should be handled with urgency and care, postpartum psychosis (disconnection from reality after childbirth), while rare, occurs in roughly 1-2 cases per 1000 births. The danger is that symptoms progress through phases so a mother can seem happy, intact, and even functional which makes it harder for those around her to identify what’s going on. It can develop suddenly and escalate quickly within the first few days or weeks of childbirth. Some causes include: hormonal fluctuations, lack of sleep, stress, a history of bipolar disorder and previous postpartum psychosis. Symptoms vary in frequency, intensity, and type per person. Some signs are: feeling detached from the world, their baby and others, having thoughts not based in reality (delusion) for instance: a mother thinking someone is going to harm their child or that their breast milk is poisonous, hallucinations involving their senses eg. hearing voices (auditory) or seeing things that others don’t (visual), disorganized speech or thoughts, feeling confused and disoriented, abrupt and intense mood changes, and thoughts of harming themselves or their child(ren). Given the severity of this condition and possible risk of suicide or infanticide, postpartum psychosis is regarded as a psychiatric emergency. Treatment involves immediate assessment by a medical professional, medication, psychotherapy, peer / communal / familial support to lessen childcare responsibilities, and getting quality sleep.
From one mama to another, if you identify with anything shared in this blog, I encourage you to speak to a trusted healthcare professional at the first sign of distress in order to get the support and care you deserve. Gently release any feelings of guilt, shame, or whatever else that might arise. You matter, your baby matters, your family matters. Take deep care mama, stay informed, and be well.
Nicki Reid, Bilingual BA
Certified Transformational Health and Life Coach | Certified Yoga and Meditation Teacher | Certified Emotional Emancipation Facilitator | Certified Reiki Practitioner | Founder, Wholesome Mind Health Coaching
