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Symptoms of Postpartum Posttraumatic Stress Disorder
It may be beneficial to your recovery to understand ways in which to frame your current experience: a biologically-based depression or a trauma-based disorder. If you feel that you relate to many of the symptoms of trauma described below, or you think you may have “Posttraumatic Stress Disorder” (PTSD), your options for recovery may take a new direction. Please use our interview questions to ask a mental health professional to find an appropriate mental health professional to aid in your healing. You may also want to discuss the symptoms you identify here with your current therapist to assist him/her in making an accurate diagnosis. In addition to professional support, you may wish to visit our online community for healing birth trauma to gain peer support and to find many resources for healing. If you would like to talk to someone in person about your struggles with birth trauma, please call our warmline to talk to a peer counselor.
You may find that you identify with many of the symptoms here, but do not fit the entire criteria for PTSD as laid out in the Diagnostic and Statistical Manual (DSM, 4th ed). Many woman with birth trauma do not have all 9 symptoms required for the diagnosis of PTSD, however, they do suffer from debilitating traumatic stress. If you feel that you fall into this category, you still deserve health, balance, a fulfilling experience of mothering. You may want to pursue the same avenues of healing that you would if you had diagnosable PTSD.
From the DSM IV- TR, the criteria for PTSD are as follows:
Criterion A: stressor
The person has been exposed to a traumatic event in which both of the following have been present:
1. The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.
2. The person's response involved intense fear, helplessness, or horror.Criterion B: intrusive recollection
The traumatic event is persistently re-experienced in at least one of the following ways:
1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions.
2. Recurrent distressing dreams of the event.
3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated).
4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
5. Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
Criterion C: avoidant/numbing
Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:
1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma
2. Efforts to avoid activities, places, or people that arouse recollections of the trauma
3. Inability to recall an important aspect of the trauma
4. Markedly diminished interest or participation in significant activities
5. Feeling of detachment or estrangement from others
6. Restricted range of affect (e.g., unable to have loving feelings)
7. Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)
Criterion D: hyperarousal
Persistent symptoms of increased arousal (not present before the trauma), indicated by at least two of the following:
1. Difficulty falling or staying asleep
2. Irritability or outbursts of anger
3. Difficulty concentrating
4. Hyper-vigilance
5. Exaggerated startle response
Criterion E: duration
Duration of the disturbance (symptoms in B, C, and D) is more than one month.
Criterion F: functional significance
The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Specify if:
Acute: if duration of symptoms is less than three months
Chronic: if duration of symptoms is three months or more
Specify if:
With or Without delay onset: Onset of symptoms at least six months after the stressor
From TABS Trauma and Birth Stress – PTSD After Childbirth website:
When should a woman suspect that she has a trauma-based postpartum mood disorder as opposed to postpartum depression? When she:
• experienced an event perceived by her to be traumatic
• experiences flashbacks of the event, with vivid & sudden memories
• has nightmares of the event
• finds an inability to recall an important aspect of the event
• has an exaggerated startle response, constantly living “on edge”
• finds hyper-arousal, always being “on guard,” won’t go away
• is hypervigilant, constantly looking around for trouble or stressors
• notices herself avoiding all reminders of the traumatic event
• experiences intense psychological stress at exposure to events that resemble or remind her of the trauma
• has physiological reactivity on exposure to events resembling the traumatic event, such as panic attacks, sweating, palpitations
• is plagued by fantasies of retaliation
• finds herself to be uncharacteristically experiencing cynicism and distrust of authority figures and public institutions
• may be hypersensitive to injustice
When PTSD goes untreated or persists, one or more of the following cover-up symptoms may develop:
• Alcohol and drug abuse
• Eating disorders: bulimia nervosa, anorexia nervosa, compulsive eating
• Compulsive gambling or compulsive spending
• Psychosomatic problems (body symptoms of an emotional origin)
• Homicidal, suicidal behavior
• Inflicting injury to herself
• Phobias
• Panic disorders
• Depression or depressive symptoms
• Dissociation symptoms
• Fainting spells
While all of these symptoms sound frighteningly severe, and they can be very distressing, they are remarkably direct to treat. Evidence-based treatments for trauma of any source are just as effective in the perinatal period. These treatments may include EMDR (eye movement desensitization and reprocessing), hypnosis, psychotherapy, group therapy, acupuncture, medical and naturopathic remedies, and more. The key is to find the support just right for you. You do not deserve to suffer, and help is available.