Giving birth is usually a time full of joy and happiness. Bringing a new baby into a family is a lifelong dream for many, with months spent preparing for the wonder of welcoming a new life into the world.
But the days and weeks after giving birth can also be full of stress, anxiety, and sadness. Some of those emotions are to be expected as families figure out new routines, deal with middle-of-the-night awakenings, and cope with crying babies.
However, if you’re a new mom struggling with sadness, extreme exhaustion, excessive anxiety, or feelings of worthlessness, you may be facing postpartum depression and should reach out to your physician for help.
Baby Blues vs Postpartum Depression
After having a baby, a mom may feel sad, moody, and cranky. Moms may cry a lot or feel overwhelmed. Approximately 80 percent of women experience these feelings, which are referred to as “baby blues.” Baby blues are a normal response to huge hormone shifts occurring in women’s bodies during a time when they are sleep-deprived and stressed.
Baby blues usually start about two or three days after delivery and last for about two weeks. The feelings go away on their own, and no medical treatment is necessary.
If the symptoms of baby blues last more than about two weeks, the mom may have postpartum depression. Postpartum depression affects about 10 percent of women. It can develop at any point within the first year of giving birth.
The symptoms of postpartum depression include:
- Feeling depressed, sad, irritable, or hopeless
- Excessive crying
- Lack of pleasure in activities you used to enjoy
- Sleep problems beyond what is associated with having a newborn
- Decreased appetite
- Difficulty concentrating or making decisions
- Feelings of inadequacy, such as thinking you’re not a good mom
- Having thoughts of hurting yourself or your baby
A doctor can diagnose postpartum depression and recommend therapy, support groups and/ or medication for treatment. Most prescription medications used to treat depression are safe for breastfeeding moms. An important note: If a pregnant woman has a history of depression or postpartum depression and has been on medication, we usually plan to continue or restart medication immediately after delivery.
Who is at Risk for Postpartum Depression
Postpartum depression is more prevalent in women who have a history of depression or postpartum depression with a prior pregnancy, or have a family history of depression. Women who faced anxiety during pregnancy are also at risk for postpartum depression, as are those who experienced stressful life events—such as a death in the family or job loss—while pregnant.
Women who had particularly difficult birthing experiences or breastfeeding problems are at high risk, as are moms of babies who spent time in a neonatal intensive care unit.
Women with low levels of social support, including single moms or those who live far from close friends and family, also are at risk.
Moms with known risk factors should line up someone to monitor them for signs of postpartum depression, because mothers may not be able to recognize the symptoms in themselves. Often signs are recognized by friends or a partner.
Friends and partners should not be judgmental, but should instead say: “I have noticed you are crying and not eating. I am worried these may be signs of postpartum depression. Let’s call or message your doctor.”
Plan Ahead and Accept Help
Fortunately, women and their partners can take steps to mitigate the risk by planning ahead. In the weeks and months before giving birth, start lining up help for after delivery. Partners who are able to take time off from work after the baby is born should line up those details in advance.
If you have a friend or family member willing to help, whether by running errands, doing household chores, or caring for your baby so you can nap or shower, say yes!
If you have people willing to help for extended periods of time, line them up consecutively rather than concurrently to maximize the length of time you’ll have someone to support you at home. Friends and family who are fully vaccinated against COVID-19 are good candidates to lend a hand. Please refer to the U.S. Centers for Disease Control and Prevention for guidelines regarding travel and visiting for both vaccinated and non-vaccinated individuals, as the guidelines are frequently updated.
Also look into support groups where you can connect with other new moms. These are great social outlets and can serve as a reality check that you really are doing a great job. Many groups continue to meet virtually during the pandemic.
Although easier said than done, take care of you. That means in the days and weeks following delivery, find time to sleep. Get out of the house every day, even if it’s just a 10-minute walk around the block. Talk or text with friends. Stick to a healthy diet, and avoid sleeping pills and alcohol.
Dads Can Experience Symptoms Too
Bringing a new baby into a family can be stressful for men, too. Depression in new dads is a relatively common phenomenon, affecting between 2 and 25 percent of them during their partner’s pregnancy or in the first year postpartum. This rate is even higher when the mother also has postpartum depression. The symptoms in men can be different than in women: rather than being tearful or feeling sad, they may experience intense jealousy, agitation, or anger. Men shouldn’t ignore their symptoms, and are encouraged to talk to their physician about treatment options.
What Is Postpartum Psychosis
Postpartum psychosis is an extremely rare condition, affecting approximately 1 to 2 out of every 1,000 women. It comes on suddenly, usually within the first two weeks postpartum. Symptoms include hallucinations, hyperactivity, inability to sleep, paranoia, rapid mood swings, and delusions. Some women also have thoughts of killing themselves or their baby.
Women who have a personal or family history of bipolar disorder or psychotic episodes are at risk for postpartum psychosis.
Postpartum psychosis is an emergency, and immediate help is required. Call your doctor or go to the emergency room.
Though scary, postpartum psychosis is treatable and temporary.
May is Maternal Mental Health Month
Every May, we recognize Maternal Mental Health Month. It’s a great time to learn about postpartum depression so you can recognize it in yourself or your loved ones. This year it is particularly important as COVID-19 has complicated pregnancy, delivery, and the postpartum period for many women, and needing support or extra help is nothing to be ashamed of.
If you need help, ask. Your friends, family and physicians are ready to help so that you can enjoy the precious and amazing moments that motherhood brings.
Amy Banulis, MD, is a board-certified obstetrician and gynecologist (OB/GYN) with the Mid-Atlantic Permanente Medical Group. She leads the medical group’s focus on serving women and especially mothers and children. She sees patients at the Kaiser Permanente Falls Church Medical Center.
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