Brief Overview

The following is taken from Chapter 2 of Beyond the Blues, by Shoshana S. Bennett, PhD, and Pec Indman, Ed.D., MFT.  The authors have generously given permission to have this chapter posted on this website.  To get a copy of this very helpful book visit

Postpartum Mood Disorders

There are five postpartum mood disorders.  This list details each of the principal disorders, some of their most common symptoms, and risk factors.  It is important to note that symptoms and their severity can change over the course of an illness.


“Baby Blues” — Not Considered a Disorder

This is not considered a disorder since the majority of mothers experience it.

  • Occurs in about 80% of mothers

  • Usual onset within first week postpartum

  • Symptoms may persist up to three weeks


  • Mood instability

  • Weepiness

  • Sadness

  • Anxiety

  • Lack of concentration


  • Rapid hormonal changes

  • Physical and emotional stress of birthing

  • Physical discomforts

  • Emotional letdown after pregnancy and birth

  • Awareness and anxiety about increased responsibility

  • Fatigue and sleep deprivation

  • Disappointments including the birth, spousal support, nursing, and the baby.

Depression and/or Anxiety

  • Occurs in 15 to 20 percent of mothers

  • Onset is usually gradual, but it can be rapid and begin any time in the first year


  • Excessive worry or anxiety

  • Irritability or short temper

  • Feeling overwhelmed, difficulty making decisions

  • Sad mood, feelings of guilt, phobias

  • Hopelessness

  • Sleep problems (often the woman cannot sleep or sleeps too much), fatigue

  • Physical sypmtoms or complaints without apparent physical cause

  • Discomfort around the baby or a lack of feeling toward the baby

  • Loss of focus and concentration (may miss appointments, for example)

  • Changes in appetite; significant weight loss or gain

Risk Factors

  • 50 to 80 percent of risk if previous postpartum depression

  • Depression or anxiety during pregnancy

  • Personal or family history of depression/anxiety

  • Abrupt weaning

  • Social isolation or poor support

  • History of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD)

  • Mood changes, while taking birth control pill or fertility medication, such as Clomid

  • Thyroid dysfunction

Obsessive-Compulsive Disorder

3 to 5 percent of mothers develop obsessive symptoms.



  • Intrusive, repetitive, and persistent thoughts or mental pictures.

  • Thoughts often are about hurting or killing the baby

  • Tremendous sense of horror and disgust about these thoughts (ego-alien)

  • Thoughts may be accompanied by behaviors to reduce anxiety (for example, hiding knives)

  • Counting, checking, cleaning or other repetitive behaviours

Risk Factors

  • Personal or family history of obsessive-compulsive disorder


Panic Disorder

  • Occurs in about 10 percent of postpartum women


  • 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 attack the woman may fear she is going crazy, dying, or losing control

  • Panic attack may wake her up

  • Often no identifiable trigger for panic

  • Excessive worry or fears (including fear of more panic attacks)

Risk Factors

  • Personal or family history of anxiety or panic disorder

  • Thyroid dysfunction


  • Occurs in one to two per thousand

  • Onset usually two to three days postpartum

  • This disorder has a 5 percent suicide and a 4 percent infanticide rate


  • Visual or auditory hallucinations

  • Delusional thinking (for example, about infant’s death, denial of birth, or need to kill baby)

  • Delirium and/or mania

  • Personal or family history of psychosis, bipolar disorder, or schizophrenia

  • Previous postpartum psychotic or bipolar episode

Posttraumatic Stress Disorder

  • There is no available data regarding the prevalence or onset


  • Recurrent nightmares

  • Extreme anxiety

  • Reliving past traumatic events (for example, sexual, physical, emotional, and childbirth)

Risk Factors

  • Past traumatic events


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