It might come as a surprise to no one that anger can be related to postpartum mood problems in women, and yet that very emotion is not once included in the widely used Edinburgh Postnatal Depression Scale screening tool. (You know, the sheet your ob-gyn likely had you fill out at your six-week postpartum appointment, that included prompts like "I have blamed myself unnecessarily when things went wrong" or "I have been anxious or worried for no good reason.")
However, a new study from the University of British Columbia shows that anger is, in fact, a significant feature in postpartum mood disturbances, and researchers recommend that women be screened for it, in addition to depression and anxiety, specifically.
"Many mothers have expressed feeling let down by others in terms of support from partners, family members, and health-care providers as well."
"There's some evidence that indicates that being both angry and depressed worsens the intensity and length of depression," PhD candidate Christine Ou, who authored the study that was published in Birth, said in a university interview. "That can have many negative effects on the mother, child, and family, and on the relationship between parents."
The data analysis — which examined postpartum depression literature over a 25-year time period — also found that feelings of powerlessness, a mismatch between reality and expectations of motherhood, and unmet expectations of support contributed to anger in the context of postpartum depression.
"Mothers may feel that they have not met their own expectations and that also others may judge them because, for example, they're formula-feeding instead of breastfeeding," Ou said. "Many mothers have also expressed feeling let down by others in terms of support from partners, family members, and health-care providers as well."
Because postpartum anger hasn't been closely examined up until now (according to Ou, the reason is because in some cultures, it's not seen as "acceptable"), the results can't determine which comes first — depression or anger. To that end, Ou and her coauthor Wendy Hall believe this analysis serves as a vital starting point.
"We know that children who are exposed to parental anger or depression are at a greater risk of developing emotional problems," Hall said. "It's important for healthcare providers to examine maternal anger in the postnatal period in order to understand and manage that risk."