What is PPA and PPD in Pregnancy?

Jun 27

6 min read

Becoming a parent is often depicted as one of life's most joyous milestones, filled with moments of unparalleled happiness and love. However, the reality of parenthood can be more complex, as in much much more complex. And then for some, postpartum might include navigating the challenging waters of Perinatal Anxiety (PPA) and Postpartum Depression (PPD). Understanding these conditions is crucial not only for those who may be experiencing them but also for the friends, family, and professionals supporting new parents.

What is Perinatal Anxiety (PPA)?

Perinatal Anxiety refers to the experience of anxiety during pregnancy and the postpartum period. Unlike the typical worries of parenthood, PPA involves excessive, persistent, and often debilitating anxiety that can interfere with daily functioning. Symptoms of PPA do not always look like typical anxiety and can include:

Constant Worry: Intense and overwhelming fears about your baby’s health, safety, or well-being.
Restlessness and Irritability: Feeling on edge, agitated, or unable to relax, even when circumstances seem calm.
Sleep Disturbances: Difficulty falling or staying asleep, even when the baby is sleeping.
Physical Symptoms: Heart palpitations, dizziness, shortness of breath, or gastrointestinal issues.
Intrusive Thoughts: Unwanted, distressing thoughts about harm coming to the baby or oneself.

It's important to note that approximately 6-10% of women experience PPA during the postpartum period, and it can also affect fathers.

What is Postpartum Depression (PPD)?

Postpartum Depression is a mood disorder that affects both mothers and fathers after the birth of a child. It extends beyond the "baby blues"—a term for the emotional ups and downs experienced by around 70-80% of new mothers, which typically resolves within two weeks postpartum. In contrast, PPD can last much longer and includes more severe symptoms:

Persistent Sadness: A deep and unshakable sadness or emptiness.
Loss of Interest: A lack of interest in activities that were once enjoyable, including bonding with the baby.
Feelings of Hopelessness or Worthlessness: Intense feelings of guilt, shame, or inadequacy as a parent.
Changes in Appetite and Sleep: Eating too much or too little, sleeping excessively, or struggling with insomnia.
Difficulty Bonding with the Baby: Feeling detached or uninterested in the baby.
Thoughts of Self-Harm or Harm to the Baby: In severe cases, experiencing thoughts of self-harm or harming the baby.

PPD is a serious condition that affects about 1 in 8 women and should not be ignored.

Recognizing the Overlap

While PPA and PPD are distinct conditions, they can co-occur, and their symptoms may overlap. It’s not uncommon for someone to experience both anxiety and depression simultaneously, which can compound the emotional challenges faced during the perinatal period. Some people may notice that their anxiety manifests physically, while others may primarily experience emotional symptoms. Both conditions can make it difficult to bond with your baby or enjoy the early months of parenthood.

Screening and Diagnosis

Healthcare providers often use screening tools like the Edinburgh Postnatal Depression Scale (EPDS) to help assess the severity of symptoms and determine whether someone is experiencing PPA, PPD, or both. Early detection through regular check-ups with your obstetrician or primary care provider is essential to preventing the conditions from worsening.

When to Seek Professional Help

Recognizing when it’s time to seek professional help is crucial for recovery. Here are some signs that indicate you should reach out to a healthcare provider:

Persistent Symptoms: If symptoms of anxiety or depression persist beyond two weeks and show no signs of improving.
Interference with Daily Life: If the symptoms are interfering with your ability to care for yourself, your baby, or perform daily tasks.
Inability to Bond with Your Baby: If you feel detached from your baby or struggle to feel any connection.
Thoughts of Self-Harm or Harm to the Baby: If you are experiencing thoughts of self-harm or harming your baby, it is critical to seek immediate help.
Extreme Mood Swings: If you experience severe mood swings that disrupt your daily functioning.
Isolation: Withdrawing from social interactions and support systems.

Seeking Help: You Are Not Alone

If you or someone you know is experiencing symptoms of PPA or PPD, it's essential to seek help. These conditions are treatable, and early intervention can significantly improve outcomes. Here are some steps to consider:

Talk to a Healthcare Provider: Share your feelings and symptoms with your obstetrician, midwife, or primary care doctor. They can help assess your symptoms and refer you to the right mental health professionals.
Therapy: Therapy has been shown to be highly effective. Look for a therapist who specializes in perinatal mental health, especially one who has advanced training in perinatal mental health.
Medication: In some cases, medication may be necessary. Your doctor can help find options that are safe for you, even if you are breastfeeding or pregnant. SSRIs, for example, have been shown to be safe and effective for many women.
Support Groups: Connecting with others who are experiencing similar challenges can provide comfort and understanding. Postpartum Support International (PSI) offers both in-person and online support groups.
Self-Care: Prioritize rest, good nutrition, and activities that promote relaxation and well-being. Consider mindfulness meditation, gentle exercise like yoga, or even short walks to help ease symptoms.

Supporting a Loved One with PPA or PPD

If you are a partner, friend, or family member of someone experiencing PPA or PPD, your support can make a significant difference. Here’s how you can help:

Be There: Offer a listening ear and provide emotional support without judgment.
Encourage Professional Help: Gently encourage seeking help from healthcare professionals if symptoms persist or worsen.
Offer Practical Support: Help with baby care, household tasks, or arranging breaks for the parent to rest.
Educate Yourself: Understanding PPA and PPD can help you better support your loved one.

Final Thoughts

PPA and PPD are serious conditions that can affect anyone during the perinatal period. Recognizing the signs and seeking help is crucial for recovery and well-being. Remember, experiencing anxiety or depression as a new parent does not reflect your abilities or worthiness as a parent. With the right support and treatment, it is possible to navigate these challenges and find joy in parenthood.

If you are interested in gaining professional support during your postpartum journey, see if Emily Turinas PhD is a good fit for you. She is a perinatal psychologist who has advanced training in perinatal mental health and specializes in therapy for new moms & dads, those on a fertility journey, and pregnant mamas in Austin, Texas & Denver, Colorado. Schedule a free consultation today to see how Dr. Turinas could help you build clarity and direction in the chaos of parenthood.

Frequently Asked Questions:

Q: How long does postpartum depression typically last?

Postpartum depression can vary in duration. For some, it may last several months, while for others, it can persist for a year or more if left untreated. Early intervention, including therapy and medication, can significantly shorten the duration and severity of symptoms.

Q: What’s the difference between baby blues and postpartum depression?

Baby blues are common emotional fluctuations that occur within the first two weeks after birth, while postpartum depression is more severe, lasts longer, and may require treatment.

Q: Can PPA affect fathers too?

Yes, fathers can experience both postpartum depression and anxiety, though the symptoms may look different. Approximately 10% of fathers report experiencing PPD.

Q: Can I prevent postpartum depression or anxiety?

While it’s not always possible to prevent PPA or PPD, there are steps you can take to reduce your risk. Building a strong support network, managing expectations, prioritizing self-care, and talking openly with your healthcare provider about your mental health history can help mitigate some risk factors.

Q: Can I still breastfeed if I take medication for PPA or PPD?

Yes, many medications prescribed for PPA and PPD, including certain antidepressants (like SSRIs), are considered safe while breastfeeding. Always consult your healthcare provider to find the best treatment plan for you.

Q: What should I do if my partner or friend seems to be struggling with postpartum anxiety or depression but won’t seek help?

If your loved one is resistant to seeking help, try to offer non-judgmental support, express concern for their well-being, and provide information about how treatment can help. Gently encourage them to talk to a healthcare provider. If the situation is urgent, particularly if there are thoughts of self-harm or harm to the baby, seek immediate medical assistance.

Pregnancy & Postpartum