Abstract

Postpartum hypomania: future perspective

Author(s): Jessica Heron, Femi Oyebode

Hypomanic symptoms are common in the days following childbirth. A link between postnatal hypomania and later depression has been demonstrated, but further study of this common phenomenon is needed to fully understand the implications of these symptoms for: maternal attachment; mothering; and the prediction and treatment of later mood disorder. We review what is known regarding the prevalence and clinical relevance of postnatal hypomania and suggest areas for future research. There are many assumptions regarding the way women ‘should’ feel in the days following childbirth. The archetype of motherhood is that of a domestic goddess; radiant and energetic, full of loving emotions and abreast of all the tasks necessary for a beautifully dressed baby and sparklingly clean house. The state of motherhood has been portrayed throughout the centuries as a near spiritual state of ultimate completion. While much research attention has been devoted to understanding why some women fail to possess this joyous state – in terms of postnatal depression (PND), the baby blues and disorders of maternal attachment – postpartum manic and hypomanic mood states have received considerably less attention. Severe manic and psychotic illness show a dramatic increase in the weeks following childbirth [1,2]. A large case registry study in Denmark reported a 23â�?�?�?�?fold increase in admissions for bipolar disorder in the postpartum month compared to a fivefold increase in admissions for depression [2]. Childbirth is a potent precipitant of bipolar relapse, and is commonly related to the initial onset of bipolar disorder. Episodes of hypomania and milder forms of high mood also increase following childbirth [3,4], but have been largely unstudied, perhaps because of our views regarding how women ‘should’ feel after having a baby.