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Understanding Postpartum Depression and Anxiety

mother and babyMarin Mommies presents a guest article by Marin parent coach, infant/toddler sleep researcher, and family therapist Angelique Millette.

May is Postpartum Mood Disorders Awareness Month and it seems fitting to write about postpartum depression and anxiety since they are so often linked to sleep deprivation in parents. In fact, very often when parents do reach out to me to make sleep changes, not only may they be experiencing sleep deprivation but they may also have symptoms of depression or anxiety or both. In fact, depression and anxiety are so common postpartum that up to 15 to 20% of women will experience some mild mood changes during or after the birth of their child, making mood disorders the most common postpartum disorder. In addition, new research is showing that up to 10 to 15% of fathers will experience a mood disorder such as anxiety or depression following the birth of their child.

There are several different forms of more serious postpartum mood disorders with varying symptoms. Postpartum (or Pregnancy) Depression, PPD, may lead to feelings of anger, sadness, and guilt, lack of interest in baby, and changes in eating and sleeping, as well as thoughts of harming baby or oneself. Postpartum (or Pregnancy) Anxiety, PPA, may lead to extreme fears, worries, panic attacks, dizziness, a feeling of losing control, and fears for the safety and health of baby. Postpartum (or Pregnancy) Obsessive-Compulsive Disorder, PPOCD, can lead to upsetting and unwanted mental images, and the need to do certain things over and over again to reduce anxiety. Postpartum Post-Traumatic Stress Disorder, PPTSD, can occur following a traumatic childbirth, and may include flashbacks of the trauma, anxiety, and needing to avoid things related to the traumatic event. Finally, Postpartum Psychosis, PPP, can lead to hallucinations and hearing voices, may include periods of confusion, memory loss, and mania. While PPP is rare, it is the most serious of the pregnancy and postpartum mood disorders. If mothers (or fathers) are experiencing any of the above symptoms, they are encouraged to seek professional help.

If you are concerned about your moods or you are concerned about someone close to you, your spouse, partner, or close friend, encourage them to answer the following questions:

Perinatal Mood & Anxiety Disorders Overview:

  • Are you feeling sad or depressed?
  • Do you feel more irritable or angry with those around you?
  • Are you having difficulty bonding with your baby?
  • Do you feel anxious or panicky?
  • Are you having problems with eating or sleeping?
  • Are you having upsetting thoughts that you can’t get out of your mind?
  • Do you feel as if you are “out of control” or “going crazy?”
  • Do you feel like you never should have become a mother?
  • Are you worried that you might hurt your baby or yourself?

(from the Postpartum Support International (PSI) website:

Parents are encouraged to seek professional treatment for postpartum (or pregnancy) mood disorders. Research shows that when mood disorders are left untreated, there is a negative impact on the relationship between mother and child. Mothers who may have experienced anxiety or depression, combined with insomnia during pregnancy, may have babies who have more difficulty sleeping in the first few months postpartum. Mothers are encouraged to speak to their care provider during pregnancy if they are experiencing feelings of depression or anxiety.

When babies aren’t sleeping, parents aren’t sleeping either, and the sleep loss can also lead to postpartum depression or anxiety. Very often, simply by making sleep changes and helping baby to sleep longer stretches at night, parents begin to sleep better too, and fill up their “sleep bank.” This can lead to an improvement in depression or anxiety symptoms. When parents contact me, we will begin sleep changes at night first, since recovering night sleep loss can make a big difference in parents’ energy level(s) during the day. If your baby is having a difficult time sleeping at night, or going through a growth or developmental phase, try your best to take a nap. Even a short 30 min nap can help to fill up your sleep bank. Or, try to go to bed when baby goes to bed, at 8pm, so you can get a stretch of sleep before your baby’s first feed of the night. You can also enlist your spouse or partner’s help at night and use a “divide and conquer” approach to split up the night feeds so each of you gets a 4- to 5-hour stretch of sleep, including two of the restorative REM sleep cycles.

There are many treatments for postpartum (or pregnancy) mood disorders and mothers (and fathers) are encouraged to speak to their care provider about the best course of treatment. PSI also has a “warm line” and a trained person or volunteer will call you back. If you call between 9 and 4:30 pm Pacific time, somebody will pick up—(800) 944-4PPD (4773). There are excellent practitioners who provide support groups and individual counseling/therapy. Please click on this link to find additional resources including resources for fathers, military families, LGBT, and Spanish-speaking families.

Angelique Millette works throughout the Bay Area and across the country supporting families and helping them meet life's challenges. You can learn more about her and her services at She offers classes at locations in Marin and San Francisco; find the complete schedule on her website.