It’s Not Postpartum Depression: 4 Other Perinatal Mood Concerns, Their Signs and Symptoms


Having a baby is one of the single biggest changes you’ll go through in your life. Your entire identity shifts in a single instant as you go from woman to mother, and in one moment you are never the same again. There are so many wonderful things about this transition, especially the unconditional love you may feel that you had no idea was possible before.

However, motherhood is often over-glorified, and the hard parts overshadowed. Many new mothers struggle with conflicting feelings once they have a baby and feel like they are defective because they aren’t happy every single moment of every day. They crumble under the pressure to post photos of themselves looking perfect with their new baby on social media, like their peers are doing.  And they wonder what’s wrong with them when they don’t feel an instant connection to their newborn.

Most new moms, if they are aware enough of what they are experiencing, chalk the feelings up to “normal” motherhood. Some may wonder if they are experiencing symptoms of postpartum depression, but often believe that their symptoms don’t completely fit that diagnosis. But, the truth is, these moms often lack information or have the wrong idea about typical postpartum emotions, lumping them all under the label of baby blues, typical postpartum adjustment, or even worse, blame themselves for being a terrible mother.

What’s also surprising is that many doctors are misinformed and miss opportunities to screen for postpartum concerns other than depression and make referrals to a therapist trained in maternal mental health. Which makes it all the more difficult for new moms to express what they are going through and find the right help.

Perhaps for you, it plays out like this…

You finally took the leap and ventured out of your home for the first time with your new baby. The idea of getting ready with no help at home and getting out of the door on time was nerve-wracking but you thought checking out the new moms’ group at your midwife’s office would be worth it.

So, you made it out the door and arrived at the group only a few minutes late. As you settled in, the group was talking about the typical postpartum struggles: getting enough sleep, ways to spend your day, feeding issues, etc…

You related to these challenges on a surface level, but you started to notice your struggles were different. You seemed to be the only one who’s worried about random horrifying things and who didn’t understand where these thoughts are coming from.

For a split second, you thought about sharing the terrible car accident you imagined getting into on your drive to group, but you didn’t want everyone to think you were crazy. So you continue to struggle in silence, confused by your symptoms.

You don’t know what is going on with you, but this can’t be postpartum depression. After all, you love your baby and don’t want to hurt her or yourself. You’re not even sure if these random thoughts mean anything, yet you can’t help but wonder if there is something wrong with you as a mother.

You don’t identify with postpartum depression because you aren’t sad all the time. You love your baby and would never do anything to hurt her. But your thoughts and your actions definitely don’t make you feel like yourself. You turn to Google and your doctor for answers. The classic response is for you to get more sleep and that all moms worry, yet this doesn’t make you feel better. You’re still worried.

It’s undeniable that you are struggling emotionally since you had your baby, but you also don’t feel like you fit into the postpartum depression category.

The truth is, there is actually an entire category of mood disorders that can affect new moms, and depression is only one of them. By learning about other types of postpartum-related issues, you’ll be able to shed some light on what you’re really going through, and you will no longer feel alone or confused by your symptoms.

Keep reading to find out the other struggles new moms face beside postpartum depression.

It’s Not Postpartum Depression…

According to perinatal specialists, postpartum depression is defined as excessive crying, mood swings, and difficulty bonding with your baby that can manifest a few weeks after giving birth or even up to a year after having your baby.

You’ve been through the criteria several times and you’re positive that you don’t have PPD. However, you know there is something not quite right. Even the fact that you can’t stop thinking about what might be wrong is a sign that your thoughts and behaviors aren’t the same since giving birth.

You tend to over analyze everything now, and it often takes you a long time to make a decision. It’s not just that though, you also intensely worry about the decisions you’ve made and how they will affect your baby. You’re confused about your symptoms. And since you don’t seem to fit in any box, you feel guilty and like you are failing as a mother.

The biggest downside to not addressing these symptoms is that you may be afraid to bond with your baby because you are worried about the terrible things that can happen. Or you might avoid doing certain things because of these fears. You might also isolate yourself because of how ashamed you feel.  Left untreated, these symptoms will not go away and will get worse.

Addressing Postpartum Anxiety

You may find it comforting to know that what you’re going through is actually a common response to motherhood. And while postpartum anxiety can be scary and have detrimental effects on your life, it is not something you can’t overcome. In fact, postpartum anxiety affects close to 10% of all new mothers and can even start to develop while a woman is still pregnant.

Having a clear understanding of what you’re going through can help you feel more connected to your baby, your partner, and friends. Knowing that the scary thoughts that pop into your head are ok and something you can work through means that you are not failing as a mom and that you will be able to adjust to being a new mom.

4 Other Postpartum Mood Concerns

Learning about the different signs and symptoms of postpartum mood disorders can ensure you feel more prepared and more empowered to navigate whatever it is you are struggling with. Arming yourself with knowledge will help you feel less alone and more able to cope.

It’s important to know that postpartum mood disorders are treatable when brought to the attention of a trained professional. So if you are struggling with any symptoms related to what’s described below seek help from a perinatal mental health specialist.

1. Postpartum Anxiety

There are other types of postpartum mood disorders and symptoms besides postpartum depression. One of the most common is postpartum anxiety, otherwise known as PPA.

PPA symptoms include feeling like your mind won’t turn off, feeling like something bad is going to happen, constant worry, and physical symptoms such as dizziness, racing heart, or nausea.

Some moms experience scary thoughts or images also called intrusive thoughts, which typically involve their baby, themselves, or their partner getting hurt. These thoughts or images are persistent, repetitive, and very upsetting to experience.

Another form of postpartum anxiety is postpartum OCD, which includes the behaviors moms will do to alleviate their fears and intrusive thoughts. Common obsessions can include concerns about the baby’s development, germs or toxins, harm coming to the baby sometimes even caused by the mother, or disturbing thoughts about sexually abusing the baby.

Here at Postpartum Health and Harmony, we work with many new mothers to first understand that what they are experiencing is anxiety and not an indication that they are going crazy or intend to harm their baby.  Next, we develop coping strategies to address this anxiety so that they can enjoy their baby and their new role as a mother.

2.  Postpartum PTSD

Another postpartum mood disorder that is common among new moms is postpartum PTSD (post-traumatic stress disorder) which often occurs when a mom has experienced a traumatic birth or traumatic event postpartum.

The trauma may include such things as unplanned interventions used during the birth, baby going to the NICU, having a severe physical complication related to pregnancy or childbirth such as preeclampsia, 3rd or 4th degree tearing, postpartum hemorrhage, and/or feeling powerless during labor or delivery.

Women who have experienced a previous trauma before pregnancy or childbirth are at a higher risk of experiencing postpartum PTSD as well. Symptoms include panic attacks, flashbacks, nightmares, intrusive images of past traumatic event, difficulty sleeping, irritability, feeling on guard all the time or extremely aware of your surroundings, easily startled, and feeling detached or out of touch.

We work with many women at PHH who have experienced traumatic births and we do extensive work to help them integrate the experience and work toward overcoming any symptoms of PTSD.  We emphasize alleviating the guilt associated with the birth or traumatic event and empowering moms to feel more in control and confident.

3. Postpartum Bipolar Disorder

For some women, pregnancy or the postpartum period is the first time they recognize signs of having Bipolar Mood Disorder.

Bipolar disorder involves 2 distinct phases, the lows (depression) and the highs (mania or hypomania). Symptoms can include little need for sleep, increased energy, anxiety, irritability, overly confident, speaking very fast, trouble concentrating, feeling like your mind won’t turn off, periods of depression, periods of feeling extremely happy (acting on top of the world), and impulsiveness or poor judgment. In more severe episodes, delusions (beliefs that are not true but mom firmly believes they are) and hallucinations may be present.  If this is the case, it’s extremely important for mom to be evaluated right away, as her reality is not accurate and there is a risk of harm.

Not everyone experiences all of these symptoms and they can be present in varying severities. If a mom notices any of these signs, it is important that she sees a specialist in perinatal mental health who will be able to best assess her symptoms and make appropriate treatment recommendations.  

4. Postpartum Psychosis

Postpartum psychosis is much less common than postpartum depression or anxiety, occurring in 1 or 2 out of every 1,000 moms.

It usually occurs within the first two weeks after giving birth and comes on suddenly. Symptoms include delusions, hallucinations, irritably, significantly less sleep or inability to sleep, paranoia, rapid mood swings, and difficulty communicating.

Postpartum psychosis is always an emergency and a mom needs to be evaluated by a doctor immediately, as her symptoms involve losing touch with reality. In this state, her beliefs make sense to her and the risk of harm is increased.  

The postpartum period is full of many ups and downs and is a highly emotional time. It’s important to remember that postpartum depression is not the only mood disorder that can occur after birth and many women struggle with a variety of symptoms.

Whatever you may be going through as you transition to being a mom, please know that you are not alone, and your symptoms are treatable. You can find relief and move on toward a motherhood that feels much more like you thought it would.

If you are struggling as a new mother and wondering if you have a postpartum mood disorder, schedule a session here at Postpartum Health and Harmony today so we can get started on the road to relief.