May is Postpartum Mood Disorders Awareness Month. As a pediatric sleep consultant and researcher, it seems fitting to write about postpartum depression and anxiety since they are so often linked to sleep deprivation in parents. Very often, when parents reach out to me to make sleep changes, they also have symptoms of depression or anxiety or both.
In fact, depression and anxiety are so common in postpartum that up to 15-20% of women will experience some mild mood changes during or after the birth of their child, making mood disorders the most common postpartum disorder. In addition, new research is showing that up to 10-15% of fathers will experience a mood disorder such as anxiety or depression following the birth of their child.
An overview of postpartum mood disorders
There are several different forms of more serious postpartum mood disorders with varying symptoms:
- Postpartum (or Pregnancy) Depression, PPD, may lead to feelings of anger, sadness, and guilt, lack of interest in baby, and changes in eating and sleeping, as well as thoughts of harming baby or oneself.
- Postpartum (or Pregnancy) Anxiety, PPA, may lead to extreme fears, worries, panic attacks, dizziness, a feeling of losing control, and fears for the safety and health of baby.
- Postpartum (or Pregnancy) Obsessive-Compulsive Disorder, PPOCD, can lead to upsetting and unwanted mental images, and the need to do certain things over and over again to reduce anxiety.
- Postpartum Post-Traumatic Stress Disorder, PPTSD, can occur following a traumatic childbirth, and may include flashbacks of the trauma, anxiety, and needing to avoid things related to the traumatic event.
- Postpartum Psychosis, PPP, can lead to hallucinations and hearing voices, may include periods of confusion, memory loss, and mania. While PPP is rare, it is the most serious of the pregnancy and postpartum mood disorders. If mothers (or fathers) are experiencing any of the above symptoms, they are encouraged to seek professional help.
If you are concerned about your moods or you are concerned about someone close to you, your spouse, partner, or close friend, encourage them to answer the following questions*:
- Are you feeling sad or depressed?
- Do you feel more irritable or angry with those around you?
- Are you having difficulty bonding with your baby?
- Do you feel anxious or panicky?
- Are you having problems with eating or sleeping?
- Are you having upsetting thoughts that you can't get out of your mind?
- Do you feel as if you are "out of control" or "going crazy?"
- Do you feel like you never should have become a mother?
- Are you worried that you might hurt your baby or yourself?
Parents are encouraged to seek professional treatment for postpartum (or pregnancy) mood disorders. Research shows that when mood disorders are left untreated, there is a negative impact on the relationship between mother and child. Mothers are encouraged to speak to their care provider during pregnancy and postpartum if they are experiencing feelings of depression or anxiety.
The connection between PPD and sleep
To add insult to injury, mood disorders experienced during pregnancy can affect your baby's future sleep habits, making it even harder for you to deal with the effects of any postpartum mood disorder you might experience. Studies show that mothers who may have experienced anxiety or depression, combined with insomnia during pregnancy, may have babies who have more difficulty sleeping in the first few months postpartum.
When babies aren't sleeping, parents aren't sleeping either, and the sleep loss can also lead to or exacerbate postpartum depression or anxiety. Very often, simply by making sleep changes and helping baby to sleep longer stretches at night, parents begin to sleep better too, and fill up their "sleep bank." This can lead to an improvement in your depression or anxiety symptoms.
In my practice as a pediatric sleep consultant, I generally focus on nighttime sleep changes first, since recovering night sleep loss -- that is, making a deposit in your sleep bank -- can make a big difference in parents' energy level(s) during the day.
If your baby is having a difficult time sleeping at night, or going through a growth or developmental phase, try your best to take a nap. Even a short 30 min nap can help to fill up your sleep bank. Or, try to go to bed when baby goes to bed, at 8pm, so you can get a stretch of sleep before your baby's first feed of the night. You can also enlist your spouse or partner's help at night and use a "divide and conquer" approach to split up the night feeds so each of you gets a 4-5 hrs stretch of sleep, including two of the restorative REM sleep cycles.
Getting help with PPD and postpartum mood disorders
There are many treatments for postpartum (or pregnancy) mood disorders and mothers (and fathers) are encouraged to speak to their care provider about the best course of treatment.
Postpartum Support International has a "warm line" and a trained person or volunteer will call you back. If you call between 9-4:30pm Pacific Time, somebody will pick up -- 1.800.944.4PPD (4773).
There are also excellent practitioners who provide support groups and individual counseling/therapy. You can find many here on NaturallyBorn, and more help, including resources for fathers, military families, LGBT, and Spanish speaking families, by visiting PSI's website.
Hang in there, get help, and be sure to get lots of rest!