What Causes Perinatal Mood Disorders?

Perinatal mood disorders are caused primarily by hormonal changes which then affect the neurotransmitters (brain chemicals).  Life stressors, such as moving, illness, poor partner support, financial problems, and isolation are certainly important as well and can negatively affect the woman's mental state.  Conversely, strong emotional, social, and physical support will greatly facilitate her recovery.

Perinatal Mood Disorders...

1. "Baby Blues"-Not considered a disorder since the majority of mothers experience it.

The " Baby Blues" occurs in about 80% of mothers.  Its onset is usually within the first week following delivery and symptoms may persist for up to three weeks.  Some of the causes of the "Baby Blues" include rapid hormonal changes, physical & emotional stress of birthing, and fatigue & sleep deprivation.

Symptoms include:

•  Mood instability
•  Weepiness
•  Sadness
•  Anxiety
•  Lack of concentration
•  Feelings of dependency

2. Perinatal Depression and/or Anxiety

This mood disorder occurs in 15-20 percent of new mothers.  Its onset is usually gradual, but it can be rapid and begin any time within the first year.  A new mother has a 50-80 percent risk of experiencing this disorder if she experienced a previous postpartum depression.  Some other risk factors include depression and/or anxiety during pregnancy, abrupt weaning, a history of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), and thyroid dysfunction.

Symptoms include:

•  Excessive worry or anxiety
•  Irritability or short temper
•  Feeling overwhelmed, difficulty making decisions
•  Sad mood, feeling of guilt, phobias
•  Hopelessness
•  Sleep problems (too much or too little)
•  Physical symptoms or complaints without apparent physical cause
•  Discomfort around the baby or a lack of feeling about the baby
•  Loss of focus and concentration ( may miss appointments, for example)
•  Loss of interest or pleasure, decreased libido
•  Changes in appetite; significant weight loss or gain

3. Perinatal Obsessive-Compulsive Disorder

This mood disorder occurs in about 3-5 percent of new mothers.  A risk factor for this mood disorder is a personal or family history of obsessive-compulsive disorder.

Symptoms include:

•  Intrusive, repetitive, and persistent thoughts or mental pictures.  Thoughts are often about hurting or killing the baby.  There is usually a tremendous sense of     horror and disgust about these thoughts.  Thoughts may be accompanied by behaviors to reduce the anxiety (for example, hiding knives).   
•  Counting, checking, cleaning or other repetitive behaviors.

3. Perinatal Panic Disorder

This mood disorder occurs in about 10 percent of postpartum women.  Risk factors include a personal or family history of anxiety or panic disorder as well as thyroid dysfunction.

Symptoms include:

•  Episodes of extreme anxiety
•  Shortness of breath, chest pain, sensations of choking or smothering, dizziness
•  Hot or cold flashes, trembling, palpitations, numbness or tingling sensations
•  Restlessness, agitation, or irritability
•  During the panic attack the woman may fear she is going crazy, dying, or losing control
•  Often no identifiable trigger for panic
•  Excessive worries or fears (including fear of more panic attacks)

4. Perinatal Psychosis

This mood disorder occurs in one to two per thousand.  Onset is usually two to three days postpartum.  This disorder has a 5 percent suicide and 4 percent infanticide rate.  Risk factors include a personal or family history of psychosis, bipolar disorder, or schizophrenia as well as a previous postpartum psychotic or bipolar episode.

Symptoms include:

•  Visual or auditory hallucinations
•  Delusional thinking (for example, about infant's death, denial of birth, or need to kill baby)
•  Delirium and/or mania

5. Postpartum Psychiatric Illness Posttraumatic Stress Disorder

There is no available data regarding the prevalence or onset.  A risk factor for this disorder is past traumatic events.

Symptoms include:

•  Recurrent nightmares
•  Extreme anxiety
•  Reliving past traumatic events (for example, sexual, physical, emotional, and childbirth)

Consequences of Untreated Perinatal Mood Disorders...

Maternal depression was placed at the top of the list entitled, "Most significant mental health issues impeding children's readiness for school" (Mental Heatlh Policy Panel, Department of Health Services, 2002).  There is a tremendous amount of data regarding the profoundly negative impact of untreated maternal depression on infants, toddlers, preschoolers, school age children, and adolescents.  There is an increased incidence of childhood psychiatric disturbance, behavior problems, poor social functioning, and impaired cognitive and language development.  When a depressed mother goes untreated, every member of the family and all the relationships within the family are affected.  The quicker the mother is treated, the better the prognosis for the entire family.

Information provided by Postpartum Support International's Website @ www.postpartum.net

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Last modified: 10/01/07