I have not posted in a while, because parenting and working during a pandemic has truthfully been hard. One goal I have for 2021 is to get back to bringing content to my website. As you may or may not know, I am very passionate about working on healthy relationships between parents and their children. Through my years as a trauma therapist I have found that supporting parents in their mental health can greatly benefit not only them, but their children, broader families and communities. 

This has been especially challenging during a pandemic. So many of our coping skills have become inaccessible, our support systems have been relegated to zoom and phone calls instead of visits and hugs.  This is why I am so excited to introduce my first (but not last!) guest blogger. 

Joanna Strait is a Licensed Clinical Social Worker in the DMV area. She has a passion and advanced training in supporting moms experiencing perinatal mood and anxiety disorders. She is the owner of TogetherWell Therapy and she runs a FREE Prenatal and Postpartum Stress Support Group at The Breastfeeding Center in DC (more info here.)

Let’s Talk About Prenatal and Postpartum Rage:

Written By: Joanna Strait LCSW-C, LICSW

Now, more than ever, we are working hard towards breaking the stigma related to the common, but difficult, experiences within the perinatal (prenatal and postpartum) period.  Mothers and their advocates are increasingly engaging in open conversations about infertility, miscarriage, prenatal, postpartum and paternal mood disorders, the struggle to breastfeed, and parental attachment (just to name a few).  These conversations are so important to help highlight the unrealistic expectations that our society has of parents, and that we consequently end up believing ourselves. 

Despite all of the increased transparency around mental health in the perinatal period, there is a common experience that remains hidden from public view and conversation, increasing the shame, judgement, and isolation that many women feel.  Postpartum rage is often an intense and scary experience, one that catches many of us off guard and makes us wonder whether we have broken or snapped. The good news is that the rage does not mean either of these things, no matter how real they might feel, and that rage serves as a red flag that we need to attend to our overall mental health. 

What is perinatal rage? How is it different from anger? 

Postpartum rage is one of the lesser known symptoms of prenatal and postpartum depression.  It can manifest in slightly different ways for different people, but it is often a sudden feeling of intense irritability or explosive anger, one that can feel like you have lost emotional and physical control.  Women often describe it as “seeing red.” You might find that you are unable to stop yourself from yelling, or even feel an impulse to harm your partner, a family member, or even your baby.  The difference between rage and anger, is often the sudden onset and intensity of the feeling. 

What causes perinatal rage? 

It’s unclear whether perinatal rage causes depression or if the depression causes the rage, but it is a common symptom of prenatal and postpartum depression. 1 in 8 women experiences a perinatal mood disorder (and I suspect that number is even higher due to underreporting and inconsistent screening). Sadness, tearfulness, exhaustion, appetite changes, and hopelessness are common symptoms of depression that many people can readily identify. Rage is often the manifestation of similar underlying feelings: frustration, loneliness, feeling overwhelmed, and lack of control.   Because rage isn’t discussed, moms who experience it often feel shame and are therefore less likely to report the symptom and seek support. 

Will perinatal rage permanently impact my baby or older children? 

If perinatal depression (including rage) goes untreated, there are possible risks to the parent child relationship to include the disruption of healthy bonding and attachment.  In severe cases, there is also the risk of violence against a partner, baby or self.  Because of this risk, it is important to share scary feelings and violent thoughts with a supportive loved one, your doctor, or a mental health provider. The great news is that perinatal depression is very treatable with the appropriate treatment and support.  The sooner you seek help, the sooner you can lower the chance of any negative outcomes for you and your family. 

If you are currently in crisis or fear you might act on violent impulses, you can call the following 24/7 mental health support hotlines:

SAMHSA National Helpline: 1-800-662-HELP (4357)

National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

To Find Local Non-Crisis Resources:

Postpartum Support International Hotline: 1-800-944-4773

What can be done to minimize or eliminate the rage? 

Because rage is a symptom of underlying depression, treating the depression (whether it is with therapy, counseling, medication or a combination) is the most effective treatment.  Seeking out a mental health provider who has specialized training in perinatal mental health can help you sort through options and make a solid plan to quickly introduce strategies to reduce rage and other symptoms of depression. 

Are there ways to reduce the risk of experiencing rage in subsequent pregnancies? 

While the chance of a perinatal mood disorder is higher for women who have had it before, engaging in supportive therapy, possible medication, and building up trusted support systems early-on can help lower risk and mitigate severity. Women who have experienced depression with rage symptoms before are usually much better able to identify symptoms and seek support. If you are at risk for perinatal depression or anxiety, talk with your doctor or therapist about creating a supportive prevention plan. 

Photo by Yan from Pexels