Nobody warned me about postpartum rage

May 6th was World Maternal Mental Health Day, a day to bring awareness to the perinatal mental health disorders that many women and birthing partners face during pregnancy and postpartum. Approximately 1 in 5 women experience a perinatal mental health disorder, the most common complication during pregnancy and postpartum. And yet, the conversations around perinatal mental health are only just beginning. You’ve likely heard of postpartum depression, and might also be familiar with postpartum anxiety. Something that new mothers/birthing parents often experience, alongside feelings of shame and confusion, is postpartum rage.

What is postpartum rage?

Postpartum rage is not a standalone diagnosis that you’d find in the DSM. Instead, it is often thought of as a symptom of postpartum depression or anxiety. Rather than sadness, tearfulness or feeling numb like in depression, or constant worries and racing thoughts like in anxiety, postpartum rage manifests as intense, sudden, and overwhelming bouts of anger or irritability. This can look like yelling, screaming, slamming doors, feeling constantly on edge, and low frustration tolerance.

Why do I feel this angry after having the baby I was so excited for?

As with many things, there is not one singular cause, rather a collection of causes and triggers. A lot is happening within a woman’s body after giving birth, such as rapid hormonal changes. These drastic drops in estrogen and progesterone can result in increased feelings of depression, anxiety, irritability, and mood swings. Not only are these women facing rapid bodily changes, they are also healing from childbirth, taking care of a newborn (with or without other children to care for), and getting very little sleep. Sleep deprivation also affects our ability to regulate emotions. Imagine experience all of those things at once: rapidly shifting hormones, a body in recovery (and in pain), sleep deprivation, a newborn you are meeting for the first time that you now have to care for… that’s A LOT. Now imagine violated expectations — any other circumstance, the restaurant giving you the wrong order would have felt annoying but overall not that big of a deal. Now, getting the wrong food order when you haven’t eaten in six hours, haven’t slept more than two hours at a time, and all you want is a juicy burger and sweet potato fries, but instead you got a chicken sandwich… it can feel devastating. Insert: postpartum rage.

Postpartum rage can also be a sign of receiving inadequate support. If you’ve ever cared for a newborn, you know that their overnight sleep is very choppy and interrupted. They need to eat every few hours, and sometimes they straight up refuse to sleep in their bassinet. New mothers feel exhausted, sometimes stressed, and even resentful during these hours. They might feel frustrated that their infant is not sleeping by themselves, or angry that their partner is not stepping up more.

What is NOT postpartum rage? Having intrusive thoughts of harming your baby even though that goes against your values, and feeling fearful that you might somehow accidentally cause harm (but not wanting to). That is OCD. You can read more about OCD here. Having thoughts of harming your baby and feeling relief at the thought? Not postpartum rage; that is more consistent with postpartum psychosis and requires immediate medical intervention.

Will it get better? How?

If you are experiencing postpartum rage, I encourage you to reach out. With therapy, these symptoms can improve. We can uncover the layers to the feelings you’re experiencing and discover the areas in which you need more support — and brainstorm realistic ways to get those needs met. There is no “sleep when the baby sleeps” here. Sometimes that is not realistic. Instead, we will find strategies, changes, and supports that work for you and your life specifically. These changes can include finding ways to get more rest and sleep, finding ways to ensure adequate food and water intake, finding ways to receive more support from your partner, family, or friends in a way that actually feels helpful and realistic.

For more resources, check out PSI’s website. They offer plenty of free resources for those in the perinatal community. Their slogan says it best: “You are not alone. You are not to blame. With help, you will be well.” I truly believe that.

If you need some additional support from someone who gets it — someone who has been in your shoes before and someone who has specific training in perinatal mental health to back it up — please reach out. We can discuss what has been going on for you and figure out a way forward, together.