6 Reasons ADHD Symptoms can Worsen Postpartum

There is an increasing awareness on postpartum mental health for both the birthing parent and their partners. While the primary concerns are centered around postpartum depression and anxiety, the postpartum period, with its sleep deprivation, hormonal changes, and demands on new parenthood, can further influence ADHD symptoms.

6 Reasons ADHD Symptoms can Worsen Postpartum

1. Hormone changes during the “4th trimester.” In the first few months, “the fourth trimester”, the birthing person’s body is going through another dramatic transformation, physically and hormonally. Postpartum is associated with a dramatic drop in estrogen and progesterone levels, which can decrease dopamine levels and influence serotonin levels (Antoniou et al., 2021). These changes can heighten ADHD symptoms of forgetfulness, inattention, impulsivity, and emotion fluctuations.
2. Increased risk of comorbidities. Birthing parents with a history of ADHD can also have a higher rate of postpartum depression and anxiety (Andersson et al., 2023). At the same time, increased mood disruptions are associated with poorer memory (Orchard et al., 2023). Screening for postpartum depression is becoming more common, but ADHD is not routinely included in those screens and therefore often missed (Antoniou et al., 2021).
3. Stopped medication while nursing. For nursing (lactating) parents, the disruption in their typical ADHD medication may be further extended. As new parenthood demands increase, birthing parents that have decided to not take their ADHD medication while they are lactating can see a further exacerbation in their symptoms (Li et al., 2021). 
4. Sleep deprivation. It’s no surprise to any new parent that the infant phase is associated with high rates of sleep deprivation. Sleep deprivation is linked to a number of cognitive difficulties, such as decreased attention, working memory, and decision-making abilities (Alhola & Polo-Kantola 2007; Orchard et al., 2023). These symptoms can mimic and also exacerbate cognitive symptoms of ADHD.
5. Increased cognitive demand.  New parenthood comes with higher demands on your cognition. There are increased demands to plan ahead, create schedules, and multi-task: tasks that can already be hard for someone with ADHD. At the same time, there are several factors reducing your cognitive functioning in the postpartum period (Orchard et al., 2023). In fact, it’s now known that the birthing parent’s brain changes in the peripartum period (Orchard et al., 2023). There can be long term benefits to these changes, but in the short term feel like tasks before pregnancy are even harder.
6. Hormone changes after weaning. Another large hormonal shift that happens postpartum occurs after the birthing parent stops lactating. This time of hormonal and mood changes after weaning is less studied than other periods of postpartum, but it has been gaining increased attention. This hormonal change after weaning can mirror many of the symptoms more commonly associated with the first few months postpartum.

Seeking Professional Help

If you suspect you have ADHD or notice significant changes in your symptoms postpartum, consult your healthcare provider. A professional evaluation can determine the best approach to managing ADHD while protecting the well-being of both the mother and child. Timing interventions can contribute to a healthier, more balanced motherhood experience.

If you are interested in understanding the severity of your symptoms, please check out this free, online screening tool for ADHD.

Note, while this article predominantly discusses ADHD in terms of birthing parents, it is important to note that there are both sex and gender influences on ADHD presentation. More research is needed into understanding ADHD interactions with pregnancy for birthing parents that do not identify as women.