Postpartum Irritability

Understanding the postpartum emotion of irritability, its connection to depression, and key treatment options

You may have read many articles already on postpartum depression, either this one on Mind Body Pregnancy or others. You may have even been prepared for the possibility of feeling depressed postpartum and had a plan for how to potentially address that feeling. But what if you do not feel particularly depressed? What if the primary emotion is irritation?

A number of my patients have described feeling angry, irritable, even rageful postpartum. This comes out in many ways. It could mean feeling more easily annoyed by your partner, even about minor things that would not have bothered you in the past. If you have other children, having less patience with them. And a small turn of events can lead to a fit of anger or tears of frustration.

While not the classic presentation, this too is postpartum depression. Irritability is more often recognized as a primary symptom of depression in men, but it could also be the way a woman’s illness develops.

Additional symptoms of PPD

It is important to consider other possible symptoms of postpartum depression.

  • Does the irritability make it less likely that you want to engage socially with others or even be with your baby?
  • Does the rage lead to ruminating thoughts and difficulty falling asleep?
  • Does all the energy spent on these emotions leave you feeling drained and tired?
  • When you feel angry, is it hard to eat?
  • Do you feel so upset that you’ve even begun to think about running away, harming yourself, or ending your life?

An exception – Postpartum mania

In more rare cases, postpartum irritability may in fact be due to postpartum mania. The additional symptoms to consider in this case include: a decreased need for sleep, hyper productivity, grandiose ideas, paranoia, racing thoughts, very rapid speech, and impulsive or uncharacteristic behaviors. If you are experiencing this constellation of symptoms, it is very important to see a doctor quickly. (see my Postpartum Mania article)

Treatment options

After recognizing these symptoms, the next step is to reach out for help. Fortunately, postpartum depression with an irritable subtype is treated similarly as postpartum depression with sadness or anxiety. I recommend speaking with your provider – either your obstetrician or pediatrician or primary care physician for a referral to a mental health professional. There are medications that are safe in breastfeeding that can help. Psychotherapy can provide a supportive environment and cognitive and behavioral skills to manage the anger. Groups can be an additional source of support.

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You deserve an emotionally healthy & rewarding pregnancy! I started Mind Body Pregnancy to provide you with expert guidance on mental wellness during pregnancy and postpartum. My background as a Harvard-trained clinician with current joint appointments at OB/GYN & Reproductive Psychiatry at UCSF Medical Center enable me to be your partner and guide.