Postpartum Psychiatric Illnesses


Postpartum "Blues":occurs in 50-80%, onset usually between day 3 and day 14 postpartum, symptoms may persist from several days to a few weeks.

Postpartum "Blues"

-occurs in 50-80%
-onset usually between day 3 and day 14 postpartum
-symptoms may persist from several days to a few weeks


  • mood instability
  • weepiness
  • sadness
  • anxiety
  • lack of concentration/inability to carry out activities of daily living
  • feelings of dependency


  • 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-about the birth, spousal support, nursing, the baby, etc.

Postpartum Depression
-occurs in 8-15%, 20% of those with postpartum blues develop depression
-onset is usually insidious although it can be rapid, and can occur any time in the first year
-may last from 3 to 14 months, most recover within 1 year


  • excessive worry or fatigue
  • sad mood, feelings of guilt, loss of interest, phobias
  • sleep problems (often can't sleep)
  • physical symptoms or complaints in excess of or without physical cause
  • marked fear of criticism of mothering skills
  • excessive concern about baby's health or well-being
  • infant's failure to thrive
  • loss of focus and concentration (may miss appointments)
  • loss of interest or pleasure
  • appetite changes-poor appetite or weight gain

Risk factors:

  • 50-80% risk if previous postpartum depression
  • depression or anxiety during pregnancy
  • past psychiatric disorder (especially depression) or family history of depression
  • presence of anti-thyroid antibodies
  • marital conflict, single parenthood, irritable infant

Postpartum Obsessive-Compulsive Disorder
-3%-5% of new mothers may 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 the anxiety (hiding knives)

Risk factors:

  • history of Obsessive-Compulsive Disorder
  • negative feelings resulting from unrealistic expectations

Postpartum Panic Disorder
-may occur in up to 10% of postpartum women


  • episodes of extreme anxiety
  • shortness of breath, chest pain, sensations of choking or smothering, dizziness
  • hot or cold flashes, trembling, palpitations
  • may experience restlessness, agitation, or irritability
  • during attack may fear she is going crazy, dying, or losing control
  • panic attack may awaken from sleep
  • often no identifiable trigger for panic
  • excessive or obsessive worry or fears

Risk factors:

  • previous history of anxiety or panic disorder
  • thyroid dysfunction

Postpartum Psychosis
-occurs in 1-2/1000, this disorder has a 5% suicide and 4% infanticide rate


  • begins about 3 days postpartum
  • fatigue
  • tearfulness
  • mood instability
  • confusion, suspiciousness, and obsessive concern about baby
  • delusional thinking (infant death, denial of birth, need to kill baby)

Risk factors:

  • history of psychosis or bipolar disorder
  • family history of mental illness
  • difficult labor
  • possible other factors include: first child, perinatal death, advanced maternal age, premature delivery, low birth weight, unmarried mother



Dunnewold, Ann, Evaluation and Treatment of Postpartum Emotional Disorders

Professional Resource Press, Sarasota, Florida, 1997

Knops, GG. Postpartum mood disorders: a startling contrast to the joy of birth. Postgraduate Medicine 1983;93(3):103-116.

Stowe ZN, Nemeroff CB. Women at risk for postpartum-onset major depression.

Am J Obstet Gynecol 1995;173(2):639-644.

Related Videos
raanan meyer, md
The importance of maternal vaccination | Image Credit:
Haywood Brown, MD | Image credit: © USF Health
image of interview
Related Content
© 2024 MJH Life Sciences

All rights reserved.