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Welcoming a new baby is a momentous time in one’s life, marked with a wide range of emotions: excitement and joy, fear and anxiety, and, occasionally, depression. While most new mothers experience postpartum “baby blues,” some experience a more severe, long-lasting form of depression known as postpartum depression (PPD).
Baby Blues
According to the American Pregnancy Association, approx. 70–80% of all new mothers experience some negative feelings or mood swings after the birth of their child. This is commonly referred to as “baby blues.”
“Baby blues is a normal and anticipated response to several coinciding changes following birth, including but not limited to the major, rapid decrease in hormones, acute sleep deprivation, and transition from the hospital to the home,” said Robyn Hardie, PsyD, PMH-C, a licensed clinical psychologist and perinatal mental health provider with Trinity Health’s Behavioral Health team.
Symptoms of baby blues include:
• Mood swings
• Anxiety
• Sadness
• Irritability
• Feeling overwhelmed
• Tearfulness
• Reduced concentration
• Appetite problems
• Trouble sleeping
• Fatigue
These symptoms typically last only a few days to a week or two after delivery and usually resolve without intervention or treatment.
Postpartum Depression
Unlike the baby blues, postpartum depression is not a regular or expected part of being a new mother.
The American Pregnancy Association says that approximately 15% of new mothers will experience postpartum depression. PPD may be mistaken for baby blues at first — but the signs and symptoms are more intense and last longer, and may eventually interfere with your ability to care for your baby and handle other daily tasks.
“Baby blues can be confused with PPD as many symptoms overlap. Severity, timing, and duration of symptoms help us distinguish between baby blues and PPD,” said Dr. Hardie.
Postpartum depression signs and symptoms may include a combination of the following:
• Feeling sad, hopeless, and/or overwhelmed
• Trouble sleeping and eating
• Feelings of guilt and worthlessness
• Agitation
• Restlessness
• Anxiety
• Rage
• Increased somatic symptoms (headaches, GI distress, back pain, etc.)
• Poor concentration
• Indecisiveness
• Losing interest in things that you used to enjoy
• Isolation
• Withdrawing from family and friends
• No interest in your baby
• Thoughts of hurting yourself or your baby
• Recurrent thoughts of death or suicide
• Thoughts that the baby would be better off without you or with someone else
(It’s important to note that you don’t have to experience every one of these symptoms to have PPD.)
Postpartum depression will often have an onset between one and three months postpartum, although symptoms can occur as early as a few days after delivery or sometimes as late as a year after. These symptoms last at least two weeks, but if left untreated, can last for many months or longer.
Risk Factors for Postpartum Depression
“Postpartum depression does not discriminate,” said Dr. Hardie, “However, some women are at higher risk for developing the condition.”
Risk factors for PPD include:
• History of depression or previous postpartum depression
• Bipolar disorder
• Family history of mental illness
• Diabetes or thyroid issues
• History of sexual trauma or abuse
• Traumatic pregnancy or delivery
• Unplanned or unwanted pregnancy
• Birth of multiples
• Pregnancy or infant loss
• Financial struggles
• Single or teen mother
• Relationship problems
• Breastfeeding difficulties
• Weak support system
Although any woman can develop PPD, there are certain ways to help minimize the risk of developing the condition.
“Creating a postpartum coping and support plan can help. This care plan can include things such as identifying where baby will sleep, who will care for baby at night, family and friends that can help, and who will take care of cleaning, laundry, meals, grocery shopping, etc.,” said Dr. Hardie.
Allowing and accepting help, rest, proper nutrition, staying hydrated, avoiding alcohol, limiting caffeine and sugar, movement/exercise, and personal time can also help minimize the risk.
Reaching Out for Help
“There are so many assumptions and myths surrounding pregnancy, childbirth, and parenting. We may downplay our feelings, tell ourselves it will get better and that other people have it worse,” said Dr. Hardie, adding that social media “frequently fuels images and unrealistic expectations about motherhood/ parenthood.”
Some women don’t tell anyone about their symptoms. They may feel embarrassed, ashamed, or guilty about feeling depressed when they are “supposed to be happy.”
It’s important to remember that any woman can become depressed during pregnancy or after having a baby. It doesn’t mean you are a bad mom, you are not to blame, and there is help.
“Trust your gut,” said Dr. Hardie. “If you feel it will not go away and think, ‘This doesn’t feel like me,’ do not hesitate to talk to someone.”
If you’re struggling with symptoms of PPD, call your provider, or reach out to any healthcare professional who has contact with pregnant or postpartum women, such as your Ob/Gyn or midwife, or your child’s pediatrician. Pharmacists, therapists, nurses, doulas, lactation consultants, and childbirth educators also can assist in getting you the help you need.
“Ask for help. Do not suffer in silence. Let someone know you are struggling.”
If you have thoughts of harming yourself or your baby, immediately seek help and call 911 or go the Emergency Room.
Supporting New Mothers
“It is important to maintain ongoing support [to new moms] throughout the postpartum period. Often support is available the first month after birth and then slowly dwindles,” said Dr. Hardie. “Weekly check-ins, a quick text message or phone call, helping with household tasks, encouraging activities outside the home, etc. Facilitating the mother’s ability to engage in self-care activities is of great help.”
Additionally, family and friends should be aware of the signs and symptoms of postpartum depression, as people struggling with the condition may not recognize or acknowledge that they’re depressed. Loved ones may be the first to recognize that a woman is experiencing PPD.
If you suspect that a friend or loved one has PPD, help them seek medical attention immediately.
Postpartum Support International
Postpartum Support International (PSI) is an organization dedicated to increasing awareness among public and professional communities about the emotional changes that women experience during pregnancy and postpartum. They offer more than 14 online support groups and provide a list of local resources in every state and more than 40 countries. PSI can help with referrals to local providers and professionals with advanced knowledge of perinatal disorders. For more information, visit their webpage www.postpartum.net, or call the PSI helpline at 1-800-944-4PPD (4773). Please note, this is not a crisis hotline and does not handle emergencies. In case of an emergency or crisis, call 911 or the National Suicide Prevention Hotline at 1-800-273-TALK (8255).
