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Are you suffering from severe mood swings, and you have just had a baby? Postpartum depression might seem like the most likely candidate, but postpartum mood swings can be caused by other things, too.

Ten to 20 percent of new mothers will experience postpartum depression and anxiety [1]. Now that postpartum depression is commonly talked about in the media, it is easier for affected women — who know there is "something" wrong — to think about the possible cause of their feelings, look up the signs of postpartum depression, and start reaching out for help, rather than struggling in silence. 

Mood swings, which can be summed up as extreme mood fluctuations, or "having significant emotional ups and downs", tend to be associated with bipolar disorder, anxiety disorders, or a combination of the two [2]. Could they also point to postpartum depression?

The Existential Changes Of New Motherhood Can Lead To Mood Swings

An important thing to keep in mind is the fact that pregnancy, childbirth and new motherhood are among the most profound existential transitions any human being can experience. Physically, emotionally, and hormonally, the postpartum period represents immense changes. [3] You will be dealing with physical recovery, an emotional adjustment to life with a new baby, and sleep deprivation. All of these factors, independently, can lead to mood swings all by themselves. 

Mood swings in women who have just had a baby, taken in isolation, therefore, do not have to mean that they are suffering from postpartum depression. They can, however, be one symptom.

The Baby Blues: 'Mini Postpartum Depression'

The so-called Baby Blues refer to a difficult postpartum period characterized by feeling like crying all the time, sadness, worries or anxiety, fatigue, insomnia, a lack of concentration, and — mood swings. The Baby Blues tend to make their appearance three to four days after your baby's birth. Affecting an estimated 50 to 70 percent of all new mothers [4], they are an absolutely normal phenomenon that does not require psychotherapy or antidepressant medication and tend to go away all by themselves after a week or two. 

The very fact that mood swings are an integral part of the symptoms of the Baby Blues can, in fact, be seen as good news — women who go through mood changes that take them up and down are not stuck in a permanent state of depression, and are able to experience positive emotions, as well. 

Are Mood Swings Present In Women With Postpartum Depression?

To be able to put your mood swings in context and begin deciding whether you would benefit from a chat with your doctor to discuss possible treatment, it is important to understand the wider clinical picture of postpartum depression. The possible postpartum depression signs are identical to those of any other major depressive episode with the difference that these symptoms appear during the postpartum period.

The symptoms of depression are a depressed mood, feelings of guilt or worthlessness, loss of motivation, interest or pleasure, changes in sleep (insomnia or sleeping a lot), appetite changes and accompanied weight fluctuations, fatigue and low energy, noticeable physical changes in speech or movement, lack of concentration, and intrusive thoughts about death or suicide. [5]

In order to qualify for a diagnosis of depression, it is necessary to have at least five of these symptoms during a period of at least two weeks, and they need to be present on most days for a large portion of the day as well as causing significant distress. 

While you notice that "mood swings" do not form an official part of the diagnostic picture of postpartum depression, the very qualifiers "on most days" and "a large portion of the day" do in fact indicate possible mood swings: if you are not feeling depressed all the time, mood fluctuations are occurring.

While this is understudied, one Polish study did note that so-called "soft bipolarity features", meaning mild mania and hypomania, did affect a portion of women who met the diagnostic criteria for postpartum depression. The study observed that such bipolarity features were more common in younger mothers. [6] Older mothers were found to be more likely to suffer from unipolar depression, on the other hand. 

We should also make it clear that women who already suffered from bipolar disorder are at risk of experiencing severe episodes during the postpartum period [7], something that does not fall under the diagnostic category of postpartum depression. Women with bipolar disorder who are pregnant or hoping to become pregnant benefit from discussing the management of their condition during pregnancy and the postpartum period with their healthcare providers at their earliest convenience. 

Whatever's Causing My Mood Swings, I Need Help!

Of course you do, and help is available.

If you are suffering from the Baby Blues, a combination of catching some sleep, receiving household help and help with baby care, and a listening ear will be sufficient and your mood will improve greatly given just a little bit of time.

If your mood swings persist beyond two weeks postpartum and you are suffering from severe mood swings, you will need to make contact with a healthcare provider. Whether you turn to your family doctor for help, approach your OBGYN, or decide to see a psychologist, if you need assistance they are unable to provide, they will be able to refer you to someone who can give you what you need — beginning with a diagnosis.

Remember that though significant emotional distress during the postpartum period is now most commonly associated with postpartum depression, it is also possible that you are suffering from another mood disorder, such as bipolar disorder, even if you were not previously diagnosed [8, 9, 10].

Postpartum women with severe mood swings caused by a depressive disorder will most likely be advised treatment in the form of a combination of talk therapy and medications. Where their depression is severe enough, inpatient treatment is warranted.

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