Depression & Anxiety During Postpartum in Women with ADHD

Research Spotlights highlight scientific research focused on girls and women with ADHD and  inform non-scientists about the research process. This Spotlight breaks down “Depression and anxiety disorders during the postpartum period in women diagnosed with attention deficit hyperactivity disorder,” published in March 2023.

Study Goal

To compare the risk of postpartum depression and anxiety disorders among women with and without an ADHD diagnosis using a registry-based study.

What is already known about the topic? 

  • Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with an increased risk of having co-occurring mental health concerns, such as anxiety and depression. 
  • Globally, postpartum depression occurs in 13-20% of women, while postpartum anxiety occurs in 10% of women. 
  • ADHD diagnosis may increase the risk of postpartum depression and anxiety. 
  • However, understanding of ADHDrelated challenges and impairments during the perinatal period is limited, and few studies have studied these patterns in larger population-based samples.

How was this study done? 

  • The Swedish Medical Birth Register has collected health data on all pregnancies in Sweden since 1973. Data from this register was used to identify 773,047 women who gave birth to their first and/ or second child between 2005 and 2013 in Sweden, of which 3515 (0.5%) had an ADHD diagnosis prior to pregnancy. 
  • Depression and anxiety disorders were recorded up to one year after delivery by the Swedish National Patient Register. 
  • The rates of postpartum depression and anxiety were compared for women with and without the diagnosis of ADHD.

What were the findings?

  • As shown in the table below, women with ADHD had significantly more postpartum depression and anxiety compared to women without ADHD.
 

Women with ADHD
(N=3,515) 

Women without ADHD
(N=769,532) 

Anxiety

24.92%

5%

Depression

16.76%

3.29%

  • These results were still statistically different after accounting for other well-known risk factors for postpartum depression and anxiety (e.g., mother’s age, socioeconomic status, and history of depression and anxiety disorders). 
  • Of note, the study did not evaluate whether these results differed between women with different presentations of ADHD (e.g., predominantly inattentive vs. predominantly hyperactive/impulsive diagnoses). Additionally, women treated for ADHD may have ongoing psychiatric care; so, they may have a higher likelihood of being diagnosed with anxiety or depression disorders as part of their psychological treatment than women without ADHD. 

Why are these findings important?

  • The findings suggest having an ADHD diagnosis may increase the risk for developing postpartum depression and anxiety disorders.   
  • Women with ADHD may benefit from enhanced social support during pregnancy and after childbirth as well as education about increased risk for postpartum mental health conditions.  
  • Healthcare providers will want to discuss risks with their patients with ADHD, and may want to closely monitor for postpartum psychiatric symptoms. 

Suggestions for Support and Additional Information 

Clinicians who care for perinatal women can:

  • Refer to a free toolkit developed in partnership with NC MATTERS. Information about how ADHD symptoms can look different from typical pregnancy symptoms, links to ADHD screening measures, and updated information about ADHD treatment is included. 

Women with ADHD who are considering pregnancy, are pregnant, or postpartum can

  • Talk to their healthcare team — including their psychiatrist, gynecologist, and primary care provider — about options for tracking depression and anxiety symptoms in the postpartum period.  
  • Access free, virtual support groups for pregnant and postpartum people with ADHD through Postpartum Support International.  
  • Listen to this podcast episode, “The Unspoken Truths of Postpartum Depression: Help for Women With and Without ADHD,” ADDitude Magazine’s Podcast 470.

Terms to Know

  • Postpartum Period: The one-year period after a person gives birth in which they may experience medical, psychological, or psychiatric changes. 
  • Postpartum Depression and Anxiety: These are mental health conditions affecting people after having a baby. Symptoms of depression may include persistent and strong feelings of sadness, irritability, and fatigue. Symptoms of anxiety may include persistent feelings of severe worry or dread. 
  • Registry-Based Study: An organized system that collects clinical data about a population (e.g., all people in a country who gave birth within a specific timeframe). Registry-based studies allow for investigating clinical patterns and events in large groups of individuals with a specific condition, such as ADHD.