Postpartum depression is a very serious condition affecting 10-15% of mothers in most developed countries (that’s 400,000-600,000 women per year in the US). Research shows that mother really is the heart of the family, and when she is hurting, the whole family unit is at risk, where the stress and low quality of mother-infant interactions can affect the child’s brain development, with long-term negative consequences for school years and beyond.

Despite how common and devastating postpartum depression can be, or how effective therapy is, it is still a societal taboo. Many mothers don’t even want to mention the words, with studies showing that most women choose to hide their burdens and turn down much needed help.

A large part of this may be due to a potentially major vulnerability factor that also makes getting over both the largely inevitable prelude (the baby blues) and the main event (postpartum partum depression) a damned sight harder – the mother’s personality. How can a new mother escape feeling ashamed and submitting herself to the blame game if her personality may be a big part of the problem?

Clearly a lack of family and social support, genetics, previous history of anxiety and/or depression and stressful life events during pregnancy all contribute. But why then can some mothers have all the ingredients for postpartum depression and come out unscathed? And why can others, who appear risk-factor free, be ravaged by their hormones and dip into seemingly never-ending baby blues on steroids?

Could it be their personalities that allow them to more easily overcome challenging changes in brain chemistry and squash postpartum depression before it gets out of hand, or on the other hand, allows them to easily succumb to the pressures induced by hormonal changes, giving postpartum depression the chance to take over? With all of the following personality traits also being associated with depression in non-pregnant people, especially during stressful life transitions, it’s safe to say, “YES!”

If you are an expecting mother or hoping to be one soon and have any of the personality traits outlined below, don’t fret. Contrary to popular belief, your personality and associated behaviors are definitely NOT set in stone. You can not only seek help in advance of potential problems occurring, but a therapist can provide tools and guidance to help mold your personality to one that is more protective of your mental health for when your bundle of joy finally comes alone.

1) Neuroticism

Multiple studies place neuroticism as the main personality trait that can predict postpartum depression. The latest research indicates that non-depressed pregnant women with high neuroticism scores have an almost fourfold (400%) increased risk of developing postpartum depression symptoms both 6 weeks and 6 months after delivery.

Neuroticism is characterized by high sensitivity to stress including anxiety, fear, moodiness, worry, envy, frustration, jealousy and loneliness. As such, researchers have speculated that mothers that score high for neuroticism may be more sensitive to the inherently stressful challenges of early motherhood, from lack of sleep to hormonal changes.

2) High worry and low self-confidence (psychic trait anxiety)

Although worry, anxious anticipation of dangers and low self-confidence (psychic trait anxiety) are aspects of neurotic personalities it is worthy of individual mention. Women with high scores on psychic trait anxiety have a double risk of developing depressive symptoms after childbirth.

Being self-confident is known to help us stay calm, cool and collected under pressure. And dealing with a new born child’s nearly constant demands is undoubtedly associated with new pressures and challenges. If a woman’s personality is often anxious at the best of times, it’s perfectly understandable that as a new mother her feelings of anxiety may be overwhelming.

Relatedly, the more physical aspects of anxiety, such as restlessness and bodily tension (somatic trait anxiety) are also associated with an increased risk for postpartum depression at 6 weeks after childbirth.

3) Mistrust

A new discovery is that women with high mistrust of others — suspiciousness and not trusting people’s motives— are more at risk for postpartum depression 6 months after delivery than more trusting women. This may involve a lack of sharing of baby related responsibilities in the family and lack of seeking help for postpartum depression, further exasperating stress and depression symptoms. As a new risk trait, more research is needed.

4) High introversion/low extraversion

Introverts are considered quiet, reflective and focused on the inner (mental) world, while extraverts are considered outspoken, outgoing and predominately concerned with what’s going on with the outer world. A new mother having high scores in introversion tests have been shown in multiple studies to be an accurate predictors of developing postpartum depression.

Often introverts feel mentally at their best with many hours of “alone time”, they get energy and strength from solitude. The constant lack of personal space and time to reflect between feeding, holding, carrying and playing with a newborn can be overwhelming for highly introverted mothers.

5) Perfectionism

Multiple studies point to women with more perfectionist personalities, i.e. having a great need to be or appear perfect, can place women at high risk for postpartum depression. One study identified that high-perfectionism, and particularly high-concern over mistakes, are personality traits associated with major postpartum depression.

However, this is in contrast with other studies that have not found the level of a mother-to-be’s perfectionism to be an effective predictor of postpartum depression. Studies on perfectionism have involved different research methods on mothers from different countries and backgrounds where there are clear differences in societal and cultural pressures that may make perfectionism more or less of an issue. More research is required to iron out the specifics and get down to the root of the matter.

Yet it makes logical sense that being overly critical, with an all or nothing attitude regarding near impossible standards of perfection will be stressful simply for general day to day happiness in our less than perfect and often hectic modern lives, never mind when we throw a baby into the mix.

6) Harm avoidance

Overly harm avoidant personalities are those that over worry, are pessimistic, shy, fearful, doubtful, and easily fatigued and therefore tend to avoid new experiences and challenges. This is a second trait that there are conflicting results for in science research. While there are many studies that have found connections between harm avoidance and postpartum depression in multiple countries, one study on Japanese women did not find any link.

It goes without saying that being avoidant may severely limit a new mother’s opportunities for expansive experiences for both her and her child. Many non-depressed women report feeling isolated, bored and lonely during the transition into parenthood, being avoidant instead of being open to new experiences will only make matters worse.

7) Interpersonal sensitivity

Interpersonal sensitivity refers to an individual’s hypersensitivity to their own inadequacies and inferiority in relation to others, where one is fearful of criticism and rejection. In an Australian study, high interpersonal sensitivity was the greatest maternal risk factor for the development of depression at 6 months after birth.

Notably, this particular study indicates that different aspects of personality are greater risk factors for postpartum depression at different time points in motherhood.

A new mother who is quick to take offense, is unduly sensitive to ridicule, feels uncomfortable in the presence of other people and shows a negative set of expectations in her dealings with others will undoubtedly create the perfect breeding ground for anxiety and depression if this socially phobic sensitivity is not addressed, as it may lead to panic attacks and avoidance of all social activities.

8) High body image dissatisfaction

In an analysis of 19 separate studies, the majority found that body image dissatisfaction is consistently but weakly associated with a higher risk of both prenatal and postpartum depression. Moreover, it seems there is a push and pull relationship where more depression leads to more body image dissatisfaction and more body image dissatisfaction leads to more depression – a vicious cycle.

Is it any wonder that in a modern age where we are bombarded with overly perfect and unrealistic photoshopped representations of “healthy” women and men, that women’s body dissatisfaction rises after giving birth when many aim to return to their pre-pregnancy physique?

Women who are proud and happy in their bodies are more accepting of the rapid trimester-specific changes in body weight and size that essentially occur at lightning speed compared to bodily changes when not pregnant. Having less education about the changes a women goes through during pregnancy, eating/appetite abnormalities, greater weight, worse mental health, fewer immediate family relationships, as well as being non-black and a non-breastfeeder, have all been shown to be linked with high rates of body dissatisfaction postpartum.

9) Trait anger and personal distress empathy

When someone has high trait anger, they perceive a wide range of situations as annoying or frustrating, and they tend to respond by getting increasingly angry. Multiple studies have found associations between high trait anger levels and postpartum depression.

While someone with high levels of personal distress empathy may be highly observant of their own distress, but have low feelings of sympathy and concern for unfortunate others.

A study revealed that the unwanted and intrusive thoughts a mother has about harming her baby that is triggered by prolonged crying, are related to the level of the mother’s personal distress empathy and trait anger, as well as higher frustration, negative emotions, and the urge to escape the infant—as found in postpartum depression. Interestingly, research in Canada revealed that ~50% of new mothers have unwanted and distressing thoughts of harming their baby, with or without postpartum depression!

Future research will likely look at differences in trait anger and personal distress empathy between depressed and non-depressed mothers during the postpartum period.

References

Fairbrother N, Barr RG, Pauwels J, Brant R, & Green J (2015). Maternal thoughts of harm in response to infant crying: an experimental analysis. Archives of women’s mental health, 18 (3), 447-55 PMID: 25377762

Fairbrother N, & Woody SR (2008). New mothers’ thoughts of harm related to the newborn. Archives of women’s mental health, 11 (3), 221-9 PMID: 18463941

Furumura K, Koide T, Okada T, Murase S, Aleksic B, Hayakawa N, Shiino T, Nakamura Y, Tamaji A, Ishikawa N, Ohoka H, Usui H, Banno N, Morita T, Goto S, Kanai A, Masuda T, & Ozaki N (2012). Prospective study on the association between harm avoidance and postpartum depressive state in a maternal cohort of Japanese women. PloS one, 7 (4) PMID: 22506046

Gelabert E, Subirà S, García-Esteve L, Navarro P, Plaza A, Cuyàs E, Navinés R, Gratacòs M, Valdés M, & Martín-Santos R (2012). Perfectionism dimensions in major postpartum depression. Journal of affective disorders, 136 (1-2), 17-25 PMID: 21930303

Gjerdingen D, Fontaine P, Crow S, McGovern P, Center B, & Miner M (2009). Predictors of mothers’ postpartum body dissatisfaction. Women & health, 49 (6), 491-504 PMID: 20013517

Iliadis SI, Koulouris P, Gingnell M, Sylvén SM, Sundström-Poromaa I, Ekselius L, Papadopoulos FC, & Skalkidou A (2015). Personality and risk for postpartum depressive symptoms. Archives of women’s mental health, 18 (3), 539-46 PMID: 25369905

Jones L, Scott J, Cooper C, Forty L, Smith KG, Sham P, Farmer A, McGuffin P, Craddock N, & Jones I (2010). Cognitive style, personality and vulnerability to postnatal depression. The British journal of psychiatry : the journal of mental science, 196 (3), 200-5 PMID: 20194541

Kersten-Alvarez LE, Hosman CM, Riksen-Walraven JM, van Doesum KT, Smeekens S, & Hoefnagels C (2012). Early school outcomes for children of postpartum depressed mothers: comparison with a community sample. Child psychiatry and human development, 43 (2), 201-18 PMID: 22011810

Maia BR, Pereira AT, Marques M, Bos S, Soares MJ, Valente J, Gomes AA, Azevedo MH, & Macedo A (2012). The role of perfectionism in postpartum depression and symptomatology. Archives of women’s mental health, 15 (6), 459-68 PMID: 23053217

Matthey S, Barnett B, Ungerer J, & Waters B (2000). Paternal and maternal depressed mood during the transition to parenthood. Journal of affective disorders, 60 (2), 75-85 PMID: 10967366

Silveira ML, Ertel KA, Dole N, & Chasan-Taber L (2015). The role of body image in prenatal and postpartum depression: a critical review of the literature. Archives of women’s mental health, 18 (3), 409-21 PMID: 25895137

Sweeney AC, & Fingerhut R (2013). Examining relationships between body dissatisfaction, maladaptive perfectionism, and postpartum depression symptoms. Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG, 42 (5), 551-61 PMID: 24004109

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