Levels and Effects of PPD

Perinatal and postpartum depressions can be separated into several levels – from postpartum depression and anxiety to postpartum psychosis.

Understanding the signs and symptoms of each level will help health care providers better understand how to treat each level of PPD.

Postpartum Depression and Anxiety (PPD)

Symptoms

• Sad mood
• Feelings of guilt or inadequacy
• Sleep troubles – too much or too little
• Physical symptoms or complaints exceeding physical causes
• Marked fear of criticism
• Excessive fear about baby’s well-being
• Excessive worry or fatigue
• Loss of focus
• Appetite/weight changes

Risk Factors

• 50% higher with previous PPD episode
• Depression or anxiety during pregnancy
• Family history of mental illness
• History of severe PMS
• Social isolation
• Poor support system

Rate of Incidence

• 10-20% of mothers (20% for those with “baby blues”)
• Lasts for 3-14 months
• Will become chronic if left untreated

Postpartum Obsessive-Compulsive Disorder (OCD)

Symptoms

• Intrusive, repetitive and persistent thoughts or mental pictures
• Thoughts often are about hurting or killing the baby
• Tremendous sense of horror and disgust with these thoughts
• Thoughts may be accompanied by irrational behaviors

Risk Factors

• Personal and/or family history of OCD

Rate of Incidence

• 3-5% of new mothers might develop obsessive symptoms

Postpartum Panic Disorder

Symptoms

• Episodes of extreme anxiety, worry or fears often called a panic attack
• Shortness of breath, chest pain, sensations of choking or smothering, dizziness
• Hot or cold flashes, trembling, palpitations, numbness or tingling sensations
• Restlessness or irritability
• Fear of going crazy, dying or losing control
• May awaken from sleep in a panic

Risk Factors

• Personal and/or family history of anxiety or panic disorder
• Thyroid dysfunction

Rate of Incidence

• 10% of postpartum women can be affected

Postpartum Post Traumatic Stress Disorder (PTSD)

Symptoms

• Repetitive flashbacks
• Intrusive thoughts and images of events
• Nightmares and “daymares”
• Hyper vigilance and startled easily
• Co-occuring depressive symptoms and anxiety
• Conditioned insomnia

Risk Factors

• Traumatic birth experience
• Previous traumatic birth
• History of sexual abuse or victim of sexual assault

Rate of Incidence

• 10% of postpartum women can be affected
• An event beyond the usual range of stressors that involves intense horror

Postpartum Psychosis

Symptoms

• Begins soon after baby’s birth (about three days postpartum)
• Fatigue
• Tearfulness
• Mood instability
• Marked confusion, suspiciousness and obsessive  concern about the baby
• Delusional thinking – infant death, denial or birth, “need” to kill the baby
• Hallucinations

Risk Factors

• Personal and/or family history of bipolar mood disorder or psychosis
• Difficult labor
• Other factors: First child, perinatal death, older mother, premature delivery, low birth weight and unmarried mother

Rate of Incidence

• 1-2 per 1,000 women
• 5% suicide and 4% infanticide rate
• Requires immediate hospitalization

If a pregnant woman or new mom is showing signs of psychosis, hospitalize her immediately! If it is an emergency, call 911 or your local emergency number.

Source: Mead Johnson WIC Nutritionist Letter, Volume 6 Series 1

PPD, if left undiagnosed and untreated, can result in:

• Poor pregnancy outcomes, including: low birth weights, perinatal telencephalic leukoencephalopathy (PTL), Small-for-Gestational-Age (SGA) infants, Respiratory Distress Syndrome (RDS) and pregnancy-induced hypertension
• Poor mother-infant attachment
• Language delays
• Behavioral difficulties
• Low cognitive performance
• Mental health disorders
• Attention problems

In addition, mothers could show poor prenatal behaviors, poor parenting behaviors, symptoms lasting longer and an increase risk of relapse.

Return to Diagnosis
Continue to Additional Ailments

For more information call:
TEL-LINK: 1-800-TEL-LINK or 1-800-835-5465
Email: info@dhss.mo.gov