Study Reveals Higher Levels of Postpartum Depression and Anxiety in Women with ADHD

April 14, 2023

A recent study published in the Journal of Affective Disorders found that ADHD increases the probability of postpartum depression (PPD) and postpartum anxiety in women, with a greater impact than well-established risks like comorbid psychiatric disorders or sociodemographic factors. The research revealed that 25% of women with ADHD developed postpartum anxiety compared to 4.61% of those without ADHD. Additionally, almost 17% of women with ADHD experienced PPD, in comparison to 3.3% who did not have the condition.

According to the researchers, "ADHD is an important risk factor for depression and anxiety disorders postpartum. Therefore, ADHD needs to be considered in maternal care, regardless of sociodemographic factors and other psychiatric disorders." The scientists identified 3,515 women from a population-based register in Sweden who had been diagnosed with ADHD before their pregnancy out of 773,047 who gave birth to their first or second child between 2005-2013. They also analyzed data on depression and anxiety diagnoses before pregnancy, maternal age at delivery, maternal education level, cohabitation status with their child's father, and family history of depression and anxiety disorders.

The study showed that the risk of PPD and postpartum anxiety was lower in women who had received a psychiatric diagnosis before pregnancy or had a history or family history of depression or anxiety. Women diagnosed with ADHD and another psychiatric condition such as depression or anxiety before pregnancy received greater support and treatment during and after their pregnancies compared to those with ADHD alone.

Women diagnosed with ADHD had a lower level of education and were less likely to live with the father of their child than those without ADHD, as per the research. Furthermore, the study found that women with ADHD gave birth to their first baby at a young age (15-24 years) compared to women without ADHD (25-34 years). In addition, other studies found that girls with ADHD were more than three and a half times as likely as their peers to become pregnant between the ages of 12 and 15. Women with ADHD are more likely to have a history of early initiation of sexual activity, early intercourse, more sexual partners, more casual sex, less protected sex, more sexually transmitted infections, and more unplanned pregnancies than women without ADHD. Hormonal fluctuations also affect women with ADHD differently, emphasized Ellen Littman, Ph.D., in the ADDitude webinar Why ADHD is Different for Women: Gender Specific Symptoms & Treatments.

In the Swedish study, 59% of the women diagnosed with ADHD had an additional psychiatric disorder compared to only 5% of those without ADHD. The researchers noted that the combination of an ADHD diagnosis and pregnancy at a young age could increase vulnerability and the risk of a psychiatric disorder such as depression and anxiety postpartum.

In a recent ADDitude survey of 2,027 women with ADHD, one-third of mothers reported experiencing PPD. Some of the symptoms include a racing mind, irritability, impatience, and forgetfulness. "My ADHD got significantly worse postpartum," said a survey respondent who did not receive support from her spouse. Another respondent from Ontario, Canada, said, "Something in me definitely changed after giving birth. My doctors told me it was ‘anxiety’ and hormones. Although tired and sleep-deprived from the baby, I could not shut down my racing mind. I did suffer from postpartum depression after the birth of my second child. That is when I looked deeper into the root of my troubles. I have always wondered if I had PPD after my first child, or was my ADHD so out of control that I didn’t even notice?"

ADDitude survey participants who experienced PPD reported that their symptoms lasted:

Almost half of ADDitude survey respondents said their healthcare providers did not offer treatment for their postpartum depression or anxiety.

“The medical community didn’t take baby blues seriously when my children were born,” said one ADDitude reader. “I just ‘needed to exercise, lose the rest of the baby weight, and focus on my family.’ Then I would be all better.”

“No one talked about it, and my doctor never asked how I was doing. So, I assumed I was weak,” said another survey respondent.

One ADDitude reader found the help she needed on her own. “No doctor cared,” she said. “So I self-treated by researching natural treatments and took several supplements that helped.”

According to the ADDitude survey, 41% of respondents received prescriptions for antidepressants, and 20% received therapy for PPD.

“PPD made it hard to get through anything without going into a guilt-depression spiral,” an ADDitude reader said. “It was awful. Antidepressants changed everything so I could function without spiraling or wanting to disappear.”

Many ADDitude readers who experienced postpartum depression or postpartum anxiety were unaware of their ADHD diagnoses at that time.

“I had depression, anxiety, and just went into full paralysis,” an ADDitude reader said. “I didn’t know I had ADHD. I thought I sucked at everything, so I might as well add motherhood to the list.”

“I lost all sense of myself and pretended to cope,” said an ADDitude reader from Edmonton, Canada. “It wasn’t until I was diagnosed and looked back on my pregnancy that I realized how much ADHD and hormones played a role in my lack of coping. I wish I could go back and talk to that frightened, overwhelmed, and so very sad me and let her know there was a reason for it all.”

The Swedish researchers recommended that primary healthcare providers assess women with ADHD for the risk of PPD and postpartum anxiety beginning with the first prenatal visit. In addition, they said, women with ADHD should receive parental education before conception, psychological surveillance during pregnancy, and social support after childbirth.

According to Littman, women should find a doctor who understands the impact of hormones on ADHD and the interplay with medication. “Finding this professional is perhaps the most important and most difficult thing to do,” she said. “Be sure to ask about their experience treating ADHD in women.”