You may have pictured dreamy, cozy scenes of cuddles, love, and joy when you imagine life with your new baby.
And while some new moms are lucky enough to have those visions become a reality, others find themselves grappling with feelings like irritability, restlessness, and even intense anger.
This mix of symptoms is sometimes known as postpartum rage, and it may point to a case of depression, anxiety, or another perinatal mood disorder.[1]
Read on for more about postpartum rage so you’re able to recognize the signs and learn how it’s diagnosed and treated.
What is postpartum rage?
Postpartum anger and rage don’t appear in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR®). But these feelings can be signs of other perinatal mood disorders such as postpartum depression, a serious medical condition that may affect up to 1 in 8 new moms.
Episodes of irritability and fury are often misunderstood and even overlooked in light of the more traditional depressive symptoms such as crying, disrupted sleep, and anxiety.[2]
One study recommended that symptoms of anger be screened for at post-delivery checkups. The reason? Rage (which is characterized by a feeling of antagonism toward someone or something you feel has deliberately wronged you) plays a significant role in postpartum mood disturbances.[3]
While anger can often be justified and may even be a good thing sometimes, excessive fury and feelings of uncontrollable rage can be harmful.
The same study also found that women who were both angry and depressed struggled with their depression more intensely and for a longer period of time than those who didn’t have the accompanying symptoms of rage.
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Some experts believe that postpartum rage may also have a connection to bipolar disorder. A woman dealing with postpartum bipolar disorder may have stronger emotions during the manic state, which can include severe anger and possible psychosis.[4]
What are the symptoms of postpartum rage?
Women who have a perinatal mood or anxiety disorder that features postpartum rage may experience one or more of the following:
- Intense anger
- Extreme irritability
- Feelings of powerlessness
- Excessive crying
- Anxiety
- Difficulty sleeping
- Withdrawal from loved ones
- Negative feelings or little interest in her baby
- Loss of interest in daily activities
- Feelings of worthlessness
What causes postpartum rage?
Postpartum rage isn’t an official diagnosis. But perinatal mood disorders sometimes accompanied by rage can have several contributing factors, including:
- Hormonal changes. Progesterone and estrogen drop sharply in the postpartum period, which cause mood swings.
- Depression in the family. A history of depression, whether your own or that of a close family member, can increase your risk of a postpartum mood disorder, including depression.
- Wide-ranging emotions. Feelings of powerlessness, anxiety and doubt are just a few. Similarly, you may feel angry or guilty if your baby needs extra time in the hospital or has a physical impairment or illness, or if you experienced a difficult birth.
- Fatigue. Not getting enough sleep or the necessary time to recover from labor and delivery can cause daytime fatigue, making it difficult to get through typical activities like driving a car or doing errands.
- Life disruptions. Changes in work and home routines, struggles with your new job as a parent, a move, money trouble or relationship issues can also cause feelings of frustration and excessive anger.
Feelings of postpartum rage can also be complicated by societal expectations, including the stigma that women should soldier on and never express anger or discontent.
New moms are also often under a great deal of pressure to be the “perfect parent,” but in reality, it’s common to be recovering from possible medical complications and dealing with sleep deprivation, the stress of taking care of a baby, and possibly also working.
Going it alone, silently, can lead to pent-up frustration and shame. Often, feelings of postpartum rage can also be worsened by not having a safe place to express difficult emotions.
How is postpartum rage different from postpartum depression (PPD)?
Postpartum rage can be a symptom of postpartum depression.[5] Women with postpartum anger issues and irritability may also be suffering from postpartum anxiety, which is an exaggerated fear or extreme worry that something is wrong. Racing thoughts, a sense of dread, and constant agitation are a few common signs.
How is postpartum rage diagnosed?
Postpartum rage may be recognized at a well-baby visit or OB/GYN checkup, since postpartum mental health screening is now recommended for all new mothers by the American Academy of Pediatrics (AAP)[6] and the American College of Obstetricians and Gynecologists (ACOG).
Even though these questionnaires do not directly ask about rage, be sure to mention it to your doctor if you think you might be experiencing these feelings.
Your doctor (or your baby’s pediatrician) should screen you to determine how you’re feeling and take note of any signs of anger, anxiety or depression. A blood test or other diagnostic might also be ordered to rule out whether something physical is affecting your mood.
Remember, your doctor is there to help and support you. Many new moms worry about judgment around expressing negative feelings associated with their pregnancy or baby, but rest assured that perinatal psychiatrists and OB/GYNs deal with these emotions often.
How is postpartum rage treated?
Postpartum rage can be treated with a combination of psychotherapy, which involves talk sessions with a mental health professional, and antidepressants, usually selective serotonin reuptake inhibitors (SSRIs). Fortunately, most antidepressants can be taken while breastfeeding, since very little passes to your baby via breast milk.
Postpartum rage can be serious and overwhelming, but if you're experiencing these symptoms, it's important to remember that you're not alone and help is available.
While professional care is important, feeling postpartum rage can also be a sign that you’d benefit from more self care. That might include taking breaks to practice deep breathing and meditation, going on walks with a trusted friend, or writing in a journal.
Try to take it easy on yourself too. Remind yourself that feeling postpartum rage doesn’t mean you’re not a good mom. The postpartum period can be challenging for all new parents, but help is available and you will get through this difficult time.
The following resources offer more information and support if you or someone you know may be suffering from postpartum rage or depression:
- Office on Women's Health (800-994-9662)
- Postpartum Support International (800-944-4PPD)
- National Alliance on Mental Illness (800-950-NAMI)
- Postpartum Progress (offers online support forums)
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