Postpartum Mental Health: Understanding PPA, PPD, PPOCD, and PPP
The author for this blog post on postpartum mental health is Samantha Huguelet, Director of Sagent's Mother-Baby Program, APRN, CNS.
Having a baby can be a pivotal moment in life and can bring a wide range of emotions. Joy, excitement, love, and relief may be expected. However, worry, sadness, exhaustion or frustration can emerge, which can be surprising or even scary.
The postpartum period brings significant hormonal changes, disrupted sleep and major lifestyle adjustments, all of which can make this transition challenging. When difficult feelings become persistent or begin to affect daily life, they may be signs of an emerging postpartum mental health condition, like postpartum anxiety (PPA), postpartum OCD (PPOCD), postpartum depression (PPD), or postpartum psychosis (PPP).
Understanding these conditions can make it easier to recognize when you or someone you love may need additional support. Asking for help does not mean you are doing something wrong or that you are a bad parent. Postpartum mental health conditions are real, and they can affect any new mother.
Let’s explore postpartum mental health and when it may be time to seek support below.
What is Postpartum Anxiety?
Having a baby can change your life in many ways, and it is natural to worry about your new baby and their well-being from time to time. You may wonder whether your baby is eating enough, sleeping safely, or feeling well. While all these concerns are normal, worry can sometimes become persistent or overwhelming.
Postpartum anxiety, or PPA, can involve excessive worry, racing thoughts, and a feeling that you can’t relax or turn off your mind.
PPA may look like:
- Constantly worrying that something bad will happen to your baby
- Feeling unable to relax, even when your baby is sleeping
- Racing or repetitive thoughts
- Feeling restless or on edge
- Difficulty sleeping because of worry
- Irritability
- Repeatedly checking on your baby or seeking reassurance
Some moms may also experience intrusive thoughts, which are unwanted or upsetting thoughts or images. These thoughts can feel frightening because they are so out of character.
Having an intrusive thought does not mean you want to or will act on it. However, if these thoughts are distressing and frequent, it may be helpful to discuss them with a mental health professional.
What is Postpartum Obsessive-Compulsive Disorder (PPOCD)?
Postpartum OCD, or PPOCD, is a form of obsessive-compulsive disorder that can occur during pregnancy or after having your baby. It is often considered part of the broader range of postpartum anxiety disorders.
PPOCD is often associated with having intrusive thoughts or images that go against what a mother wants or believes to be true. These thoughts may involve something bad happening to their baby or fears that she could somehow cause harm to them.
Someone experiencing PPOCD may:
- Have unwanted thoughts or images about harming their baby
- Excessive worry about their baby becoming sick or dying
- Be fearful of germs
- Repeatedly check on their baby or seek reassurance from others
- Feel compelled to repeatedly clean, wash or perform other rituals
A key feature of postpartum OCD is that the mother recognizes that these thoughts are unwanted and distressing and takes active precautions to prevent harm. This awareness can help distinguish PPOCD from postpartum psychosis, where a person may lose awareness of what is real.
What is Postpartum Depression (PPD)?
Postpartum depression is a form of depression that can develop after childbirth that affects mood, energy, sleep, concentration, and a person’s ability to enjoy everyday life. It is not simply an adverse reaction to the changes and adjustments to life as a new mom.
It can be caused by a hormonal imbalance, sleep deprivation, and other environmental factors. PPD affects approximately 15% of new moms following birth, making it more common than many people realize.
Symptoms can include:
- Persistent sadness, emptiness or feeling down
- Loss of interest in things you normally enjoy
- Feeling hopeless or worthless
- Intense guilt or shame
- Intense anger, rage or irritability, irritability or anger
- Significant changes in sleep or appetite
- Feeling tired or disconnected
- Difficulty concentrating or making decisions
- Difficulty bonding with your baby
- Thoughts of death, suicide, or harming yourself or your baby
Developing PPD does not mean that you don’t love your baby or regret becoming a parent. This diagnosable mental health condition is also not a reflection of whether you are a good parent. Seeking help for symptoms of PPD is a sign of strength, and doing so can help you feel more in control and connected during this time of significant change.
Related Reading: Postpartum Mood Disorders: Understanding the Differences | Sagent Behavioral Health
What is Postpartum Psychosis (PPP)?
Postpartum psychosis is different from postpartum anxiety and depression. It is rare, affecting 1-2 women out of every 1,000. Even though it is rare, it is a serious psychiatric emergency that requires immediate medical attention.
Symptoms can include:
- Hallucinations, such as seeing or hearing things that aren’t there
- Delusions or beliefs that aren’t based in reality
- Severe confusion or disorientation
- Paranoia
- Extreme agitation
- Mania, or unusually elevated mood or energy
- Behavior that seems vastly different from the person’s usual behavior
Postpartum psychosis symptoms can be fleeting or present only for a few minutes at a time before the person regains insight. This inconsistency can make it difficult to diagnose or notice right away as the person may not recognize that what they are experiencing isn’t real, or the symptoms come and go too quickly to be fully understood in the moment . Because of this, a partner or family member may sometimes be the first person to recognize that something is seriously wrong.
If you or someone you know is experiencing symptoms of postpartum psychosis, seek emergency medical care immediately by calling 911 or by going to the nearest emergency department.
Why Does Mental Health Change After Birth?
Pregnancy, childbirth, and the postpartum period involve significant physical, hormonal, and emotional changes, which can impact a new mom in many ways.
Factors that can contribute to a change in mental health post-birth include:
- Hormonal changes during and after pregnancy
- Sleep disruption
- The demands of childbirth and caring for a newborn
- Stressful life circumstances like financial or housing instability
- A history of mental health conditions
- A difficult pregnancy or birth experience
- Limited social or practical support
PPA, PPOCD, PPD, PPP, and other perinatal mental health conditions are not caused by something a new mom did or did not do. These conditions can affect people regardless of their circumstances and should never be seen as a failure or something to be ashamed of.
How Are Postpartum Mental Health Conditions Treated?
There isn’t a singular approach that treats every condition or helps every new mom in the same way. Treatment depends on the symptoms a person is experiencing, their mental health history, and their individual needs.
Therapy
Therapy provides a supportive space to talk through the emotional challenges of becoming a parent while developing strategies for managing anxiety, depression, relationships, and everyday life.
Medication
In some cases, psychiatric medications, like antidepressants, can be used to treat perinatal mental health conditions. Your healthcare provider or psychiatric provider can discuss potential benefits and risks and will take factors like breastfeeding into consideration.
Sagent’s Mother Baby Program
Sagent’s Mother Baby Program addresses the variety of changes that motherhood can bring by providing a supportive and non-judgmental atmosphere for moms to learn strategies for coping with postpartum mental health concerns. It also provides the opportunity to find and build a community with other new moms.
It can be hard for new moms to separate their own care needs from their role as a parent, so our Mother Baby Program recognizes and supports the connection between the two. In most cases, mothers are encouraged to bring their babies with them to therapy or group work. Offering care in a setting that considers both moms and their babies can make it easier to focus on their mental health while continuing to build connection and confidence as a parent.
The transition to motherhood can be complicated. You can love your baby and still struggle, and you can feel grateful and overwhelmed at the same time. Experiencing anxiety, depression, or other mental health symptoms does not make you a bad parent.
If something doesn’t feel right, don’t wait until you are in a crisis before reaching out for help. Sagent Behavioral Health offers support for pregnancy and postpartum mental health, and we are here to help you find the right next step and a path forward.
Frequently Asked Questions
How do I know if I’m experiencing a postpartum mental health condition?
Persistent or overwhelming anxiety, sadness, intrusive thoughts, difficulty functioning, changes in sleep or appetite, or feeling disconnected from yourself or your baby may be signs of a postpartum mental health condition.
What is the difference between postpartum anxiety, OCD, and depression?
Postpartum anxiety often involves excessive worry, racing thoughts, and feeling unable to relax. Postpartum OCD may involve distressing, unwanted intrusive thoughts along with compulsive behaviors or reassurance-seeking. PPD, or postpartum depression, can cause persistent sadness, loss of interest, guilt, hopelessness, low energy, and difficulty connecting with your baby.
When should I seek help for postpartum mental health symptoms?
You don’t have to wait until symptoms become severe or reach a crisis point. If anxiety, sadness, intrusive thoughts, or other emotional changes are persistent, overwhelming, or interfering with your daily life, consider reaching out to a mental health professional. If you or someone you know is experiencing symptoms of postpartum psychosis, seek emergency medical care immediately by calling 911 or going to the nearest emergency department.
