Postpartum Resources - ICAN of Phoenix

Postpartum Depression and Post-Traumatic Stress Disorder

Emotional Recovery: Postpartum Depression and Post-Traumatic Stress Disorder

By: Lisa Houchins

Published: July 23, 2013

Emotions vary widely after birth. Mothers may experience a wide spectrum of emotions, ranging from

excitement, bewilderment, joy, worry, uncertainty, and confidence. Creating a postpartum plan before

birth can help you to process and deal with these emotions.

Postpartum Plan:

• Remember to take care of yourself

• Be realistic and forgiving

• Develop a support system before delivery

• Make a list of things others can do to help

• Grocery shop/cook meals ahead of time but be sure not to tire yourself before delivery

We will be focusing on negative feelings since many do not feel concern over positive feelings after a

birth. Each woman is affected differently by postpartum adjustment with symptoms ranging from mild

to severe. The mild condition is called “The Baby Blues”; the moderate condition is known as

Postpartum Depression; and the severest condition is called Postpartum Psychosis. Additionally, we

will examine Post Traumatic Stress Disorder in relationship to birth.

Baby Blues

The baby blues are experienced by 50-75% of new mothers. This is the most common and least severe

of the postpartum reactions. Symptoms include:

• Crying for no apparent reason

• Impatience, loneliness

• Irritability, loss of identity

• Restlessness, sadness

• Anxiety, low self-esteem

• Increased sensitivity and vulnerability

These symptoms are unpleasant, but manageable. They often start around the third to fourth day after

delivery and last for a week or two. A woman often experiences a sense of disorientation. Highs are

followed by lows. Gather your support around you. Share your feelings with your partner, another

mother, or a professional. However, if the symptoms persist and interfere with your ability to care for

yourself or your baby, then you may have postpartum depression.

Postpartum Depression

Postpartum Depression affects at least one in ten new mothers. Some within days of delivery, for other

moms the symptoms come on gradually, up to a year or more later.

Symptoms include:

• Sadness, depression, hopelessness

• Sluggishness, fatigue, exhaustion

• Poor concentration, confusion

• Appetite and sleep disturbances

• High anxiety levels

• Memory loss

• Over concern for the baby

• Uncontrollable crying, irritability

• Lack of interest in the baby

• Feelings of guilt, inadequacy, worthlessness

• Fear of harming yourself

• Fear of harming the baby

• Exaggerated highs and/or lows

• Lack of interest in sex

Most women are unprepared and feel bewildered when these symptoms are experienced. PPD does not

take the same form for every woman. If you have several of these symptoms, ranging from mild to

severe, you could have postpartum depression. You may have alternating “good” and “bad” days. Any

of these symptoms can be reason to seek professional help.

Postpartum Distress

Some women may not feel depressed, but instead may feel anxious. Postpartum anxiety or panic

disorder is characterized by:

• Intense anxiety and/or fear

• Rapid breathing

• Fast heart rate

• Sense of doom

• Hot or cold flashes

• Chest pain

• Shaking, dizziness

Postpartum distress may include obsessive-compulsive symptoms; such as:

• Intrusive, repetitive thoughts

• Repeated thoughts of harming baby

• Anxiety, depression

These thoughts are scary and out of character for the woman experiencing them.

Post Traumatic Stress Disorder

Connie Banack, past national ICAN president, talks to us about Post Traumatic Stress Disorder:

“PTSD has only recently been attributed to birth trauma. It’s important if you have any symptoms to acknowledge that you need more support. I would recommend a postpartum support group.”

Post Traumatic Stress Disorder is a severe anxiety reaction to a traumatic event that occurs outside the

range of usual human experience.

PTSD can occur as an acute disorder soon after the trauma, or have a delayed onset in which the

symptoms occur more than six months after the trauma. It can occur at any age and can follow a natural

disaster such as flood or fire, a man-made disaster such as war or imprisonment, rape, or assault. It can

also apply to a traumatic birth experience, often without acceptable informed consent. Such events can

produce stress in anyone, but not everyone will develop PTSD. The cause is not known, but

psychological, genetic, physical, and social factors may contribute to it. In studies of Vietnam war

veterans, those with strong support systems were less likely to develop PTSD than those without

support systems. People with PTSD persistently re-experience the event in at least one of several ways:

recurrent distressing dreams; recurrent recollections of the event; a sense of reliving the experience

(flashbacks); and intense distress at events that symbolize an aspect of the event (such as

anniversaries).

Post Traumatic Stress Disorder symptoms include:

• Recurrent distressing memories of the event

• Recurrent dreams of the event

• Flashback episodes

• Inability to recall aspects of the trauma

• Lack of interest in activities

• Feelings of detachment

• Sense of foreshortened future

• Sleeping difficulties

• Irritability or outbursts of anger

• Difficulty concentrating

• Exaggerated startle response

• Sense of guilt about the event

Additional symptoms that may be associated with this disease:

• Excessive sweating

• Paleness, headache

• Heartbeat sensations

• Fever, fainting, dizziness

• Agitation, phobia

• Anxiety, stress, and tension

• Alcohol and/or drug abuse

It might be helpful in preventing PTSD for those who have experienced extremely stressful situations

to seek counseling or other psychiatric intervention as soon after the event as possible. Characteristic

symptoms that persist after a history of unusual trauma lead to the diagnosis of PTSD.

The aim of treatment is to reduce the symptoms by encouraging the affected person to express grief and

complete the mourning process (a very important first step). Support groups are effective at providing a

setting where people who have had similar experiences can share feelings. Treatment for depression,

alcohol use or substance abuse, or associated medical conditions may need to take place before

psychological problems can be effectively addressed. Behavior therapy can be used to treat avoidance

symptoms. Behavior techniques used include the graded exposure and flooding technique (frequent

exposure to an object that triggers symptoms). Anti-depressive and anti-anxiety medications are

sometimes used as well. These medications act on the central nervous system to reduce the feelings of

anxiety and associated symptoms.

Contributing Factors

Any woman who is pregnant, had a baby, miscarried, or even recently weaned a child from breast-

feeding can be affected, regardless of how many previously uncomplicated pregnancies or postpartum

adjustments she has made. There are contributing risk factors, biological, psychological, and in your

relationships, that might predispose you to suffering in your postpartum period. These include:

• History of personal or family depression, anxiety, panic, mania, obsessive thoughts, or behavior

• Feelings of inadequacy; low self-esteem

• Marital conflict; Single parent

• Lack of support

• Super woman syndrome

• Hormonal risks, thyroid imbalance, PMS

• Physical exhaustion, lack of sleep

The best prognosis (probable outcome) is associated with symptoms that develop soon after the

trauma, and with early diagnosis and treatment. Go to the emergency room or call the local emergency

number (such as 911) if you are feeling overwhelmed by guilt, if you are impulsive and unable to

control your behavior, or if you are experiencing other symptoms of PTSD. Know that you are not

alone- there are people who understand and who can help.