PPA is similar to postpartum depression—and they can occur together. There are, however, some key differences in the mental and physical symptoms. Namely, PPD may include, according to Dr. Shepherd, “debilitating sadness or thoughts of harm to yourself or your baby.” This is one reason it’s so important to see a perinatal mental health provider or specialist, like a reproductive psychiatrist or psychologist. Someone “who can help you tease these things apart,” says Dr. Accortt, and recommend the right treatment.
And remember, “just because you have postpartum anxiety, that does not automatically mean you have postpartum depression or will have postpartum depression,” says Dr. Shepherd.
What are some postpartum anxiety risk factors?
As doctors learn more about perinatal mood and anxiety disorders, it’s become clear that there are biopsychosocial risk factors, meaning a combination of biological, psychological, and social factors that put a parent at risk.
“A biological risk factor could be a medical complication,” says Dr. Accortt. This could be prior to pregnancy, like premenstrual dysphoric disorder (PMDD), or an issue that arises during pregnancy, like preeclampsia, that makes the pregnancy more complicated. The most common biological risk factor is a personal or family history of anxiety or depression prior to pregnancy. In fact, the latest research suggests there could be a genetic component even if you haven’t experienced symptoms of anxiety before.
In two recently published studies, Dr. Accortt and her team discovered biomarkers that may indicate an elevated risk for perinatal mood and anxiety disorders, including PPA. The first, published in the American Journal of Obstetrics and Gynecology, found that new mothers who struggled with mental health issues postpartum had “distinct protein signatures related to inflammation that were seen in their blood in their third trimester of pregnancy,” Dr. Accortt explains. Some of these women showed symptoms of anxiety or depression during pregnancy, but some did not, developing symptoms only at one month or three months postpartum, she adds. The second study, published in the American Journal of Reproductive Immunology, looked at women two to three years postdelivery who showed signs of anxiety and depression and found similar gene-linked results. With more research, doctors may soon be able to develop a simple screening test that could flag an increased genetic risk for postpartum anxiety during pregnancy or even before conception.
As for psychological risk factors for postpartum anxiety, the main one to watch for is anxiety during pregnancy, says Dr. Accortt. “Maybe you never had a history of anxiety, but now you’re having a lot of symptoms,” she says. High stress—a traumatic birth or stay in the NICU, for example—is also a major psychological risk factor that can trigger postpartum anxiety.
Finally, there are the social risk factors, which can include everything from the strength of your support network to feelings of validation during pregnancy. “Women of color, for example, experience racism and discrimination, and we know that that’s a risk factor for psychological distress,” Dr. Accortt says.
How long does postpartum anxiety last?
Unlike the “baby blues,” postpartum anxiety won’t just eventually resolve itself. (Same goes for postpartum depression.) “If it’s more than two weeks postpartum, it’s not baby blues and it’s not going to go away on its own,” says Dr. Accortt.
