What Is Postpartum Rage?

Introduction

Postpartum rage occurs after the delivery of a baby, and this can result in feelings of anger, frustration, and a short temper. Mental and mood fluctuations are common after birth due to changes in hormones, health, and lifestyle. This can typically last weeks or even months after birth, and it can simultaneously occur with postpartum depression and postpartum anxiety. Postpartum rage and postpartum depression are two very different issues, but an individual is able to experience both. However, you are able to experience rage without depression and vice versa. Whilst this condition is not fully understood, healthcare professionals are able to help and guide those struggling. This article will delve into the factors associated with postpartum rage and how to identify this condition.

Understanding postpartum emotions

Females experience a range of emotions, not only after birth but during too. They experience a wide range of physical, psychological, and hormonal changes in addition to this. From joy to sadness, these emotions are common for all mothers after childbirth and can be classed as the “baby blues,” which can occur between 2 to 5 days after delivery. Fortunately, these intense emotions can decrease after 2 weeks. Symptoms include:

• Excessive crying
• Sadness
• Anxiety
• Irritability
• Sleep disturbance
• Appetite change
• Confusion
• Fatigue

BUT this does not affect your ability to carry out daily tasks.

On the other hand, women who experience these emotions continuously after 2 weeks can be thought to have postpartum depression. This condition is longer and can affect an individual’s ability to carry out day-to-day activities. It can also possibly lead to a chronic depressive disorder if not treated, and there is a risk this might come back in the future. Additionally, this can also affect both the father and the infant. The father can exhibit signs of depression too, and the infant is able to develop behavioural and emotional problems such as:

• Delay in language development
• Sleep disturbance
• Eating difficulties
• Excessive crying
• ADHD

What is the difference between emotional fluctuations and postpartum rage? Mood swings, on average, can last for a few hours or even days. These occasional mild to moderate emotional changes are a normal part of life and can occur more during different phases of life, such as menstruation. These also do not affect your ability to carry out daily tasks. However, in postpartum rage, the emotions are intense and can last between 6 months to 1 year. 

Causes of postpartum rage

There are many causes of postpartum rage these include:

• Drops in oestrogen and progesterone
• Family history of depression and/ or anxiety
• Changes in sleep patterns
• The feeling of new emotions
• Changes to the body, lifestyle, and relationships

There are many hormonal factors which play a factor in the causes of postpartum rage. Progesterone is the most dominant hormone present during pregnancy, and when it drops after birth, it may lead to postpartum depression or rage.⁴ This is because the metabolite (a substance for metabolism) associated with this hormone is known to decrease irritability. Therefore, when this drops the body does not have this hormone present until the first menstrual cycle when the ovaries are able to secrete progesterone again. 

Other hormones, such as oestradiol, are also seen to provoke rage or depression.⁵ This is because it is in charge of increasing and decreasing serotonin (the hormone responsible for feeling happiness),⁶ which can lead to a depressive or an agitated state. 

In addition, anger and sleep deprivation can also be a huge factor in postpartum rage. A study including 278 people showed that an individual’s sleep quality and anger were linked to the infants’ sleep quality.⁷ Many mothers are adjusting to these changes and catering to their infant’s needs. Therefore, this leads to sleep deprivation as they are trying to adapt to their new lifestyle. 

Moreover, postpartum rage can worsen due to the added responsibilities of being a mother, the added stress can lead to anger. Plus, these new tasks can put a strain on the relationship and, therefore, can add to postpartum rage. 

Signs and symptoms

Symptoms might vary for those who have postpartum rage. These can include:

• Lashing out excessively or abnormally
• The urge to scream at others
• Punching objects or slamming doors
• Thinking about an event for longer than usual
• Losing your temper
• Swearing or screaming more than usual
• Excessively feeling irritable or frustrated
• Unable to cope with emotions
• Excessive crying
• Anxiety
• Difficulty sleeping
• Withdrawal from loved ones
• Negative feelings to the infant
• Loss of interest in daily activities 

These symptoms can look different in every individual and there are many ways in which this can be helped. It is recommended to visit a doctor when:⁸

1. The symptoms don’t get better after 2 weeks
2. The symptoms get worse
3. You find it hard to take care of the baby
4. It is hard to complete daily tasks
5. You feel like self-harming or harming your baby

Risk factors

There are many reasons why someone can express postpartum rage; however, some mothers might be more prone to this than others. 

Family history can give a good indication of the risk of developing any mental condition and many illnesses, and postpartum rage is no different.⁹ If a family member struggles with this, it does not necessarily mean you will develop it; however, it can determine how high your risk would be. This allows you to pay closer attention to your signs, and therefore, you can get help sooner before the symptoms escalate. 

Furthermore, having a support network can help mothers in the postpartum period.[10] A study showed most mothers faced major challenges during the postpartum period with fulfilling basic personal needs, household chores and getting adequate sleep. Lack of support for these tasks was seen to cause depressive symptoms, which can coexist with postpartum rage. The study also identified that women felt their emotional and physical support could be aided by family members, especially their partner, their mother, father, friends, godmother and sisters-in-law. 

Moreover, little is known about how likely it is to develop postpartum rage again; however, studies show the risk of postpartum depression varies between 30% to 70%, depending on the severity of the symptoms initially.¹¹ Unfortunately, it is hard to predict if past experiences will affect your postpartum period in the same way.¹²

These can be prevented through prenatal education and awareness, recognising the signs early to get help, and building a support network.

Coping strategies

There are many ways to coping mechanisms if you are struggling through your postpartum period and there are many ways to overcome this:¹³

• Strengthen the bond with your baby:
  • Skin-to-skin contact: try to feed your baby while resting them on your skin. Wrap a blanket around you and the baby and comfort them. This can cause you both to relax and increase the bond between the two.
  • Baby massage: touch is important for the child’s development 
  • Smile: your baby will mimic your smile from 6 to 12 weeks, and when a mother sees her infant smile, an area of the mother’s brain lights up, which is linked to a reward
  • Sing: this not only provides sensory stimulation for the baby but also distracts you from negative thoughts.

1. Take care of yourself:
   • Eat omega 3: this is found in oily fish, and if consumed during pregnancy, it may reduce the risk of postpartum depression
   • Nap: this might be difficult, but sleeping when the baby sleeps is a good way to catch up on sleep if this is not possible, make sure to reach out to family and friends who are able to watch your baby while you sleep
   • Leave the house: make sure to leave the house to give you a change of scenery, this can change your mood.
   • Do what you like: keep up with your hobbies and things you like to do, whether it is watching your favourite show or doing something you enjoy

• Exercise:
  • Carry out some gentle exercise after you give birth, just to ease you in. Walking is a good start, and eventually, this can build up to heavier movement, whether it is at the gym or other vigorous activities.

• Psychotherapy and medication:
  • Psychotherapy: This is counselling, and it can help you think and talk out your feelings, set goals and learn how to respond to situations
  • Antidepressants: These may be recommended as a last resort and may be prescribed if your symptoms have not improved. Make sure to consult your doctor if you are breast-feeding 

Summary

In conclusion, whilst postpartum rage has not been studied extensively, there is help available to all women experiencing the difficult postpartum period. While these emotions are normal, if you experience an excessive amount of anger, be sure to see your local GP so you can get the help you need, not only for your benefit but for the infant and father, too. This condition is due to a range of factors, such as hormonal imbalance and sleep deprivation, and can be identified through a variety of symptoms which vary from person to person. There are a range of coping strategies which one can use to improve their state of mind and can overall save you from the misery of postpartum rage.