Postpartum reality: Little sleep and big emotions
Postpartum, or the period after giving birth, is a time of intense physical and emotional change. New mothers are expected to learn many new skills while running on very little sleep. These changes can elicit strong feelings of anger or frustration, known as postpartum rage.
While postpartum rage (sometimes referred to as postpartum anger) is not a formal psychiatric diagnosis, it’s something that many new mothers experience.
Defining postpartum rage
Postpartum rage is characterized by sudden, intense anger or irritability. Anger is the most common symptom of postpartum rage. Some triggers that can lead to these rage episodes include:
Sleep deprivation
Stress
Body changes and/or discomfort
Feeling unsupported by one's partner
There is much shame and stigma associated with feeling alone while experiencing these intense feelings . That’s why it’s so important to talk about and normalize the entire spectrum of emotional responses to the postpartum period.
Is postpartum rage related to postpartum depression/anxiety?
Postpartum rage and postpartum depression are closely related but different. Episodes of rage can occur with postpartum depression or anxiety, or they may occur on their own. Approximately 21-31% of new mothers report experiencing significant anger in the postpartum period.[1,2]
Do hormones play a role in postpartum rage?
Following delivery, there is an abrupt withdrawal of the reproductive hormones estrogen and progesterone. This withdrawal can significantly impact one’s mood and can lead to extreme mood swings. Hormone shifts may also cause the development of intrusive thoughts for a brief period.
Studies have shown that people with perinatal mood disorders are more susceptible to these shifts. [3-6] Two of the first symptoms to emerge are anger and irritability, which are key components of postpartum rage. Many other doctors and clinicians equate postpartum mood swings with those experienced in menopause.
Other common postpartum symptoms
It’s important to note that a person can experience feelings of rage without having symptoms of postpartum depression, just as a person with postpartum depression may not develop feelings of anger. However, postpartum depression, rage and anxiety can be experienced all together.
Postpartum depression
Postpartum depression affects approximately 13% of new mothers.[7,8] The most common symptoms include:
Low mood
Lack of interest; low motivation
Feeling overwhelmed or numbed out
Postpartum anxiety
One in five women experiences postpartum anxiety,[9] which is also extremely common but not discussed as often. Symptoms include :
Feeling keyed up or unable to relax
Intrusive thoughts
Excessive worry and irritability
Potential causes of postpartum rage
Several factors can lead to postpartum rage, including:
Lack of sleep or changes in sleep pattern
History of depression or anxiety
Hormonal changes
Overall changes in lifestyle, relationships and body
A clinical study observed 20 mothers during the first two postpartum years with their babies. The mothers reported feeling angry when their expectations were violated, their needs were compromised or they felt on edge, particularly around their baby's sleep schedule or when a partner was unsupportive.[10]
How long does postpartum rage last?
There is no established timeline for postpartum rage. It can affect anyone who has recently given birth. It’s most common to develop symptoms within the first six weeks to one year after giving birth. However, the severity of an individual’s condition and how they respond to treatment may vary.
5 ways to reduce postpartum rage
Getting back to the basics by prioritizing sleep, leaning on support from loved ones and seeking professional treatment can make postpartum rage easier to manage.
1. Focus on getting enough sleep
Getting quality sleep can make a world of difference in regulating emotions. Lack of sleep can increase irritability, anger and frustration during an already challenging time. New parents should aim for consistent rest whenever possible and turn to support to help ensure at least a few hours of uninterrupted sleep each night.
2. Set up regular support
Lean into a support system as much as possible. There is often a loss or shift of identity following the birth of a child. It’s essential to find moments that can help you feel like yourself again, like taking a walk or having coffee with a friend. Leaning on a support system such as a partner, family or friends to help with childcare, assist with household tasks or simply offer emotional support may be critical in reducing feelings of anger or resentment.
3. Try a support group
Connecting with others through support groups can also help one feel less alone. Organizations like Postpartum Support International provide valuable information and resources for individuals experiencing postpartum difficulties. Many local hospitals also offer support or educational groups for new parents.
4. Consider mental health treatment or medication
Cognitive behavioral therapy (CBT) and interpersonal therapy are two evidence-based therapeutic modalities that have proved effective. The treatment programs here at Pathlight Mood & Anxiety Center incorporate CBT into individual and group therapy sessions. Medications such as SSRIs also work well for the treatment of mood and anxiety disorders in this population, and a great deal of safety data is available on these meds.
5. Seek intensive care if needed
While some women do seek treatment for postpartum rage, depression or anxiety, getting intensive care during this chapter can be challenging. Many women face barriers such as access to childcare, financial strain or lack of specialized care available nearby. Getting out of the house in those first few months can feel like summiting a mountain. For some women, virtual mental health care is a preferred option while raising infants and young children as it allows one to get care from home.
Remember that it can get better
The postpartum stage is hard for everyone in different ways, and there shouldn’t be any shame in seeking help.
If you are struggling, you don’t have to wait to seek care until you notice a significant breakdown in your relationships or an inability to function. Seeking help promptly can have a profoundly positive impact on your postpartum recovery. Call us at (866) 622-5914 or fill out this form to see how we can help through evidence-based therapies and other specialized programs offered here at Pathlight Mood & Anxiety Center.