Information on Disorders

Depression

Peripartum depression, depressive symptoms experienced during pregnancy or postpartum, are quite common in new mothers. In fact, 10 percent of women experience depression during pregnancy and 1 in 5 women experience postpartum depression. More than 66 percent of women with postpartum depression will also experience significant anxiety symptoms. Peripartum depression is actually the most common complication of childbirth.

Women may experience symptoms during pregnancy, immediately following birth, or even one year postpartum. Common symptoms include:

  • Lack of joy in life and pleasure in things you previously enjoyed
  • Severe mood swings
  • Anger and irritability
  • Fatigue
  • Lack of concern for yourself or baby
  • Emotional numbness
  • Feelings of sadness, guilt, and hopelessness
  • Thoughts of harming yourself or infant

Bipolar Disorder

Bipolar Disorder is characterized as periods of time lasting at least 4 to 7 days of extreme irritability or euphoria (mania) and periods of time for at least two weeks of sad, depressed mood or anhedonia (depression). In pregnant and postpartum women, bipolar depression may first appear as severe depression, or even severe anxiety.

Common symptoms for Bipolar 1 and 2 include:

  • Unpredictable periods of depression and irritability
  • Periods of elated mood
  • Rapid speech and thought
  • Decreased need for sleep
  • Exaggerated sense of self
  • Impulsiveness & poor decision making
  • Delusions (grandiose and paranoid)
  • Anxiety

Anxiety

Peripartum anxiety disorders such as panic disorder and generalized anxiety disorder sometimes occur, and often worsen in women that have a prior history of panic disorder and generalized anxiety disorder. Although likely an underestimate, approximately 6 percent of women experience anxiety during pregnancy and 10 percent experience postpartum anxiety.

Common symptoms include:

  • Excessive worry
  • Sleep and appetite issues
  • Panic attacks
  • Uncontrollable obsessive thoughts
  • Racing thoughts

Post-Traumatic Stress Disorder (PTSD)

Approximately 9 percent of women experience PTSD in the following weeks, months, or even years after childbirth. Oftentimes, this is caused by a real or perceived danger of being physically harmed or losing one’s life during delivery or postpartum.

Traumas may include:

  • Unexpected C-section
  • Infant being place in the NICU
  • Poor communication or support during delivery
  • Physical complications as a result of pregnancy or childbirth

Common symptoms include:

  • Distressing flashbacks or nightmares of the traumatic event
  • Avoidance of symptoms, people and places associated with the event
  • Persistent negative mood
  • Anxiety and panic attacks
  • Feelings of detachment with reality
  • Inability to remember certain aspects of the event

Obsessive Compulsive Disorder (OCD)

Prenatal and postpartum obsessive symptoms are experienced by 3 to 5 percent of new and expecting mothers and fathers. The postpartum period is the most common time for the onset of OCD or OCD like symptoms for women. Women with OCD have disturbing and intrusive thoughts that can be quite variable and can include imagining harming or killing their baby, or harming or killing themselves. Women do not act on these thoughts, and these thoughts are not in line with how women really feel and therefore the thoughts are upsetting and distressing.

Common symptoms include:

  • Repetitive, intrusive thoughts related to the self and/or child
  • Obsessions or intrusive thoughts cause significant anxiety or distress
  • Compulsions that cause the mother to perform certain actions to reduce anxiety (cleaning, checking things multiple times, etc.)
  • Extreme preoccupation with protecting the infant
  • Struggling mothers understand their thoughts are unusual and are unlikely to act on them

Grief & Loss

The loss of a pregnancy, infant, or child brings intense pain and may leave families feeling hopeless and confused. The grieving process is unique to each individual and some may experience grief months or even years following the death of a loved one. We want you to know that support is available. You should never have to feel alone.

Resources:

Compassionate Friends

Griefwatch

Grieve Out Loud

Grief Recovery Method

Postpartum Progress

Postpartum Psychosis

The onset of postpartum psychosis is often sudden and the most severe symptoms occur within the first couple of weeks postpartum. It occurs in approximately .1 to .2 percent of births.

Common symptoms include:

  • Hallucinations (seeing/hearing things that aren’t there)
  • Delusions (odd beliefs, that are not consistent with reality)
  • Irritability
  • Hyperactivity
  • Decreased need for sleep
  • Paranoia
  • Confusion
  • Severe mood swings

Prescription Opioid Use & Pain

Approximately 15 to 20 percent of pregnant women will be prescribed an opioid (pain) medication during pregnancy and there has been a 4-fold increase in the chronic (daily) use of prescription opioid medication during pregnancy in the past decade. There are maternal, fetal and newborn risks associated with prescription opioid use during pregnancy. These risks need to be carefully weighed against the benefits of these medications and the risks associated with not taking these medications. Our clinic provides a comprehensive assessment of pain, functioning and medication evaluation and assists women in their decision to continue or discontinue opioid medication during pregnancy. We provide alternative pain management strategies for pregnant women and can assist in the slow tapering of opioid medications during pregnancy in collaboration with your obstetrics provider.

Substance Abuse

Approximately 5 percent of women will abuse substances during pregnancy. The most common substances of abuse are tobacco, alcohol and marijuana. Over the past decade there has been a 5-fold increase in opioid use during pregnancy, including prescription opioid (pain) medications and/or heroin. There are significant maternal, fetal and newborn risks associated with substances of abuse. Our program specializes in the treatment of Opioid Use Disorder including outpatient therapy and Buprenorphine.

Common Symptoms of Opioid Use Disorder include:

  • Difficulty controlling the use of opioids
    • Difficulty limiting the amount or length of time using opioids
    • Inability to decrease opioid use.
    • Significant amount of time spent obtaining, using, or recovering from opioid use
  • Social Impairment
    • Inability to satisfy work, education, or home roles and expectations due to opioid use
    • Opioid use despite recurrent problems caused by opioids
    • Reduction of important social, occupational, or recreational activities due to opioid use
  • Risky Use
    • Use of opioids in hazardous situations
    • Continued opioid use despite exacerbation of physical or psychological problems