Four years ago, after having my first baby at age 38, I struggled with a little-known emotional change in the fourth trimester, postpartum rage.
I wasn’t sad, I didn’t cry, I didn’t have feelings of hopelessness. I was just angry.
I would get angry over the smallest things to the point I felt I was going to explode. I resembled the character “Anger” from the Disney movie Inside Out. I would lash out at just about anyone around.
There were days that I would get so angry I could have probably punched a hole in the wall or ripped a door off its hinges. Looking back on it now, I don’t know that I could have vocalized why I was getting so angry in the moment. It just happened and then I would eventually cool down.
As an ob/gyn physician who diagnoses and treats postpartum mood disorders such as postpartum depression and anxiety, you would think I would have recognized something was awry.
But I didn’t.
I didn’t because at no point in all of my training, experience, or journal article readings was there mention of postpartum anger and rage. Why? Because it had not been defined or studied. Most likely women, like me, have been too embarrassed to complain of this symptom to their physicians.
Our society is more accepting of a weeping woman and less likely to be sympathetic to an angry woman who is capable of punching a hole in a wall. As a result, women have suppressed their anger in fear of the lack of sympathy or the repercussions of sharing this information. As a result, there is a general lack of knowledge of postpartum anger and rage. For years, doctors haven’t known to ask about it. In fact, the most commonly used tool to screen for postpartum depression (the Edinburgh Postnatal Depression Scale) does not include any questions in regard to anger or rage.
Our society is more accepting of a weeping woman and less likely to be sympathetic to an angry woman who is capable of punching a hole in a wall.
Fortunately, there have been some recent studies published in the past two years that are starting to shed some light on this little-discussed postpartum emotion or mood instability. A study published in the Journal of Maternal-Fetal and Neonatal Medicine in 2018 found that the expression of anger towards other people or objects in the postpartum period was associated with the development of postpartum blues (baby blues), while the suppression of angry feelings during the postpartum period may be a risk factor for postpartum depression (1).
A second study by Christine Ou published in Birth in 2018 found that postpartum anger and rage may coexist with postpartum anxiety and postpartum depression (2). The author also suggested that postpartum rage may occur as a result of feeling powerless after birth, unrealized expectations of motherhood, or possibly due to unmet expectations of postpartum support from friends and family (2).
Currently, it is unclear if postpartum rage is a diagnosis of its own or if it is a symptom of postpartum depression or postpartum anxiety. If it is a symptom of postpartum depression or postpartum anxiety it is uncertain which occurs first. More research is needed to further delineate and describe postpartum anger and rage.
The good thing is, the conversation has been started.
If you or someone you know are suffering from postpartum anger or rage, seek help. Talk to your Ob/Gyn, pediatrician or mental health provider. Help is out there. You don’t have to suffer in silence.
Not only will you be helping yourself by speaking up and seeking help, but you will be a light for the women behind you. Let’s keep the conversation going.