‘Baby blues’ or postpartum depression?

You’re a new mom. This should be the happiest time of your life, right? So why do you feel completely and utterly unhappy?

First of all, your body’s been through a rollercoaster of emotional and physical strain, you’re exhausted, and now you’re responsible for a crying, needy newborn. A little lack of joy is completely normal.

In fact, 50 percent to 80 percent of new moms experience mild “baby blues” – sadness, crying, anxiety, irritability, and fear. These feelings usually set in on the fourth or fifth day after delivery and last no longer than a few weeks. While the baby blues may cause a few tears, they do not interfere with how you function.

But 10 percent to 15 percent of new mothers experience postpartum depression, a debilitating condition that can take a toll on you and your family if it is not treated properly.

What is postpartum depression?

Postpartum depression is more severe and persistent than the baby blues. Symptoms include a significantly sad or depressed mood, loss of interest in hobbies, feelings of guilt or worthlessness, sleep disturbance, poor concentration, and suicidal thoughts. These feelings often show up within four to six weeks after delivery, though they can appear as late as three months after the baby arrives.

If you have a history of depression or bipolar disorder, anxiety or depression during pregnancy, recent stressful life events, or inadequate support at home, you may be more vulnerable to postpartum depression. If you’ve had postpartum depression before, you’re at higher risk for developing it again.

However, you could experience postpartum depression even if you have adequate family support and no previous emotional conditions. Either way, it’s a good idea to arm yourself with a variety of resources before you give birth, including: 

• Counseling and education. Learning what the postpartum period is really like can help you develop realistic expectations about life with a new baby. It can also help you distinguish normal “baby blues” from a more serious problem.
• Breastfeeding consultation. If you choose to breastfeed, be ready for the challenges that often come along with the process. It can be physically and emotionally draining for new moms, so get all the education you can about it before the baby comes.
• Community and family resources. The support of a partner, family members, or friends is one of the most important factors in determining whether postpartum depression will resolve quickly or become chronic. Pinpoint people who can help you with emotional support, watching the baby so you can rest, and taking care of household duties. Determine where in your community you can find help if you need it.

Though setting yourself up for success may not prevent postpartum depression, it will prevent a scramble for help after the baby comes.

Treating postpartum depression

Your treatment will be based upon the severity of your symptoms. Common treatments include counseling with a mental health provider and antidepressant medication after delivery. Women with severe postpartum depression may choose to receive medications in addition to or instead of talk therapies (or psychotherapies).

Behavioral, cognitive, and interpersonal therapy is useful in treating postpartum depression. You may prefer this route if you are reluctant to use medication because of breastfeeding or if you have a mild case of postpartum depression.

When adequately treated, most women who experience postpartum depression return to a more normal level functioning in 2 to 3 months. Your physician will continue to monitor you as your symptoms improve during a follow-up period.

Other severe postpartum disorders

Aside from depression, other serious conditions can manifest after delivery, including severe anxiety and panic attacks. Disturbing, intrusive thoughts can also occur. If you have these thoughts, contact your physician right away.

The most severe form of postpartum psychiatric illness is postpartum psychosis. It is a rare condition – occurs in approximately 1 in 1,000 women after childbirth. Postpartum psychosis is an emergency situation that often requires inpatient treatment. Symptoms are often dramatic and start as early as 48 to 72 hours after delivery.

The earliest signs are restlessness, irritability, and sleep difficulty. Patients may shift rapidly from depression to elation and often act erratic, disorganized and confused. Delusional beliefs are common and often center around the baby. Auditory hallucinations (also called “voices in your head”) can occur that instruct the mother to harm herself or her baby. Tragic cases have been reported where women with postpartum psychosis have killed themselves or their baby.

Getting help

We encourage you to watch for postpartum depression symptoms after you’re home with your baby. Some women don’t report their symptoms for fear that their family or physician will think they are “crazy” or will try take their baby away. That’s not the case; most postpartum depression cases are completely manageable if you seek help from your physician.

It’s important to understand that postpartum depression is not your fault. We can help, and you can request an appointment here or by calling 214-635-8300.