Overview

Did you or someone close to you recently have a newborn baby? The exhaustion, anxiety and stress that come during the time after childbirth are not foreign to anyone. However, little do most people know about the root cause of these negative emotions that exist among new mothers during postpartum. 

Postpartum rage refers to intense, uncontrollable feelings of anger or irritability experienced by some mothers after giving birth. It is a severe manifestation of postpartum mood disorders or postnatal depression and can significantly impact daily functioning and relationships. Postpartum distress or postnatal depression is defined by mothers as a numb feeling and a sense of feeling and being mechanical following childbirth.¹ Postpartum emotional distress or depression is often related to maternal autonomy and the huge lifestyle changes that come with childbirth and sometimes can be expressed in the form of anger or rage. Postpartum rage is caused by a number of factors such as income, maternal sleep quality, infant sleeping patterns, depressive symptoms and the number of children they have to care for.¹ 

It is important for new mothers to get checked for a wave of heightened anger following childbirth so that adequate treatment and support can be provided to them. This is crucial for the well-being of both the mother and the baby as mothers have reported to have had positive outcomes upon receiving support from their partners, family and their social circle to manage postpartum rage.¹ 

Understanding postpartum rage

Symptoms and characteristics

The primary symptoms of postpartum rage include:

1. Sudden outbursts of anger
2. Irritability
3. Difficulty controlling emotions
4. Racing thoughts
5. Physical tension
6. Aggressive behaviour 

Risk factors and causes

Although more research is essential to understand and study the risk factors and causes of postpartum rage, some of the obvious causes could be:

1. Hormonal changes
2. Sleep deprivation²
3. Infant sleep pattern 
4. Stress
5. Financial struggles 
6. Underlying mental health conditions
7. Adjustment to motherhood
   • Compromises that need to be made by the new mother 
   • Lifestyle changes

Differentiation from other postpartum mood disorders

Although most new mothers face postpartum rage as a result of postpartum depression and both are considered to be postnatal mood disorders, postpartum rage can sometimes happen on its own. There exists a spectrum of postpartum psychiatric disorders and an appropriate diagnosis should be made by a professional healthcare practitioner or a psychologist.³ Different classifications of earlier postpartum disorders are as follows:

1. Postpartum blues
2. Postpartum depression
3. Postpartum psychosis
4. Postpartum posttraumatic stress disorder
5. Anxiety disorders specific to the puerperium
6. Obsessive-compulsive disorder 

Postpartum rage seems to fall somewhere in between postpartum blues and postpartum depression, which is the phase in which mothers face a heightened emotional liability to their newborn following childbirth which leads to frequent episodes of emotional distress and crying, irritability, confusion and anxiety.³

It is however worth noting that not all depressive episodes lead to rage and not all postpartum rage occurrences can be linked to PPD. A research done to study anger post-childbirth concluded that a substantial group of new mothers reported elevated levels of anger regardless of their depressed mood.⁴ 

Diagnosis of postpartum rage

There are several methods used by healthcare providers to diagnose postpartum rage, including:

1. Survey questionnaires to assess the risk factors and symptoms 
2. Talking therapy to understand the bigger picture

Different screening tools and assessments are often applied together to reach an accurate diagnosis.⁵ A counselling session could include timed talking therapy with a trained professional therapist along with survey forms or questionnaires to be filled in to assess the severity of postpartum distress or rage of the mother and assess risk factors and symptoms. Screening questionnaires can also be taken independently by new mothers at home to self-assess their possibility of suffering from postnatal distress or rage. The self-screening results would then suggest available help within their community or you can get in touch with your GP to get referred to the right specialist. 

The importance of early detection of postpartum rage cannot be stressed enough as early detection is the only way to attain a timely and effective treatment plan. 

Treatment approaches

Support systems

Seeking help is the bravest and most crucial part of recovery from postpartum rage as heightened rage and distress are signs that a mother has done as much as she can and that it is time for external help. Help can come in different ways such as:

1. A support group 
2. Connecting with other new mothers in the community
3. Learning to communicate their emotions with their partner, family members and friends 
4. Setting boundaries
5. Development of a self-care plan
6. Financial aid to buy diapers and formula

Social support from family, friends, and even healthcare providers is crucial for mothers in managing and overcoming postpartum rage. The involvement of family and friends can be crucial in providing new mothers with emotional validation, practical assistance, and encouragement during recovery and could aid a faster recovery which in turn would highly benefit the well-being of both the mother and the baby.

Another useful approach to cope with postpartum rage is to connect with other new mothers in the community. A little community can be formed where new mothers can take a stroll in the park together with their little ones and share their emotions. Being able to communicate with someone who would be able to relate to your overwhelming emotions could help in making it not so overwhelming. 

Healthcare providers play a role in making new mothers aware of this phenomenon of postpartum distress and the rage that follows, validating their emotions and the huge emotional shift that is happening to their lives while reassuring them that support is readily available in the form of counselling and other community support groups where they can openly discuss their feelings. Openly talking about their emotions and getting their feelings validated while having a support system to fall back on in case their emotions get overwhelming would be a huge relief. 

FAQ’s

What are the symptoms of postpartum rage?

Symptoms may include sudden outbursts of anger, irritability, difficulty controlling emotions, racing thoughts, physical tension, and sometimes aggressive behaviour. These symptoms can be distressing and interfere with daily activities and interactions.

What causes postpartum rage?

Postpartum rage is caused by a combination of risk factors such as hormonal changes, sleep deprivation, stress, existing mental health conditions, and adjustment to motherhood.

What treatment options are available for postpartum rage?

Treatment typically involves a combination of psychotherapy, pharmacotherapy, lifestyle interventions, and support systems. 

Can medication help with postpartum rage?

In some cases, antidepressants or anti-anxiety medications may be prescribed to help regulate mood and alleviate symptoms of postpartum rage. However, medication should be used under the guidance of a healthcare provider and is often combined with other forms of treatment.

Summary

Postpartum rage refers to intense, uncontrollable feelings of anger or irritability experienced by some mothers after giving birth. Some of the symptoms of postpartum rage include outbursts of anger, irritability and sometimes physical aggression. Risk factors that contribute to this condition range from existing mental health disorders to hormonal changes and sleep deprivation. Postpartum rage is diagnosed through assessment and screening tools by trained psychotherapists who would then suggest treatment plans including psychotherapy, pharmacotherapy using antidepressants or lifestyle interventions, or sometimes a combination of these options. 

More research and clinical trials need to be carried out to better explore the topic of postpartum rage so that there can be a better understanding of symptoms, diagnostic methods and treatment plans. Having more readily available resources on postpartum mood disorders could also benefit new mothers in being better aware of this condition during their pregnancy period so that they can seek necessary help and join support groups to help with their mood. 

It's important to speak with your loved ones about your feelings and seek help from a healthcare professional as soon as you feel overwhelmed with your emotions. They can provide an accurate diagnosis, recommend appropriate treatment options, and offer support and guidance throughout recovery. Understanding and diagnosing postpartum rage promptly is pivotal in ensuring that the newborn and the mother have a good quality of life and well-being.