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Can You Diagnose PPA Before Giving Birth? Experts Explain

by Steph Montgomery

As a mom of five, I can tell you that it's completely normal to want to get things right as a mom, and to constantly worry about effectively protecting your kids. But if your worries become obsessive, overwhelming, illogical, or interfere with your ability to function, you might be suffering from postpartum anxiety (PPA) — a mood disorder that impacts one out of seven women after their babies are born. But can you diagnose PPA before giving birth? After all, preparation is the name of the new-mom game.

According to the experts at Anxiety.org, while you can't necessarily diagnose PPA before your baby is born, there are factors that could increase your risk of developing postpartum anxiety, or other postpartum mood disorders after birth, that you can consider before you have your baby. Having one or more of these risk factors doesn't mean you will necessarily get PPA, but you can learn about symptoms, talk to your health care provider about coping strategies, and create a plan for treatment, should you need one. Also, because anxiety during pregnancy is one of those risk factors, all pregnant women should be screened for anxiety. The aforementioned screening, and a treatment plan, could potentially reduce their risk of negative pregnancy outcomes and developing a postpartum mood disorder.

According to Julie Bindeman, PsyD, a reproductive psychologist who specializes in mood disorders during and after pregnancy, postpartum anxiety (PPA) is more common than you might think — impacting one out of seven women. But since it's completely normal to worry when you're a new mom, people often dismiss anxious thoughts when they happen, or hesitate to talk about them because they are worried about what people might think.

Bindeman warns that the difference between worry and anxiety is subtle, telling Anxiety.org the following:

Worry tends to be something transient, and can be managed with looking at how true the thought might be (or how based it might be in reality). An example is worrying that the baby is too cold (or too hot). With basic worry, you can ask yourself, how would I know if the baby needed his or her temperature adjusted, and solve that. Once it is solved, the worry evaporates. However, with anxiety, even if you solve the problem (and often times, anxiety doesn't let reality come in easily), the relief might be short-lived, as the thought persists.

According to Postpartum Support International, symptoms of PPA include worrying constantly, or having thoughts that something bad is going to happen, racing thoughts, insomnia, appetite changes, feeling unable to sit still, dizziness, hot flashes, and nausea. Elizabeth Fitelson, MD, director of the Women's Program at the Columbia University Department of Psychiatry, told Parents that PPA can be triggered by one or many things that happen to new moms, including postpartum hormone changes, sleep deprivation, the stress of caring for a newborn, and the pressure to be a perfect parent.

So, rather than just worrying about it, can you get diagnosed with PPA before you give birth and start treatment in advance? Unfortunately, according to anxiety.org, you can't predict who will develop a postpartum anxiety disorder. However, you might be able to identify risk factors that increase your odds. Risk factors for PPA include having a personal or family history of anxiety or other mental health conditions, a history of PMS or feeling mood swings when taking hormonal birth control, and having thyroid problems. Other non-health-related risk factors include experiencing pregnancy loss, being a pregnant teen, lower socioeconomic status, a lack of social support, or living in crisis.

According to the same site, having anxiety during your pregnancy can mean that you are more likely to have anxiety during the postpartum period. For this reason, Dr. Bindeman recommends that women be screened for anxiety, and that anyone with risk factors meet with a health care professional to make a plan for what to do if they develop PPA after their baby is born.

The good news is that postpartum anxiety disorders are treatable. According to the Postpartum Support Network, PPA treatment plans will be different for each mom, but might include self-care, social support, therapy, symptom management or medication. Most importantly, you don't have suffer alone.

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