Postpartum depression

Baby Blues

The first step in battling the severity of postpartum depression is knowing how to spot the symptoms.

By Kathryn McGrath, MSW, LSW, CD(DONA), LCCE, FACCE

Postpartum depression is a part of pregnancy for which most women are unprepared. Our culture tends to downplay the difficulty of the early weeks, telling us we should be thrilled with motherhood and grateful for the experience. However, the reality is that the postpartum period is a mix of joyous and difficult moments. The unpredictability of each day, the lack of control over your schedule, the sleep deprivation, the fact that the baby can’t tell you what he or she wants and the sheer amount of work, all on top of a host of dramatic physical and hormonal changes, make for a challenging situation.

Nobody expects to feel sad after the birth of a baby, but in fact, many women do. Approximately 15 percent to 20 percent of all new mothers develop a postpartum mood disorder (PPMD), the best known of which is postpartum depression. A PPMD can affect any new mother, with any health history, in any circumstances. Although a PPMD most commonly begins during the first three months after birth, it can start any time within the first postpartum year.

The vast majority of moms with a PPMD are wonderful, loving mothers who are unfortunately experiencing a medical illness that is no fault of their own. While you can’t prevent PPMDs, the good news is that they are treatable, and you may also be able to lessen their severity by knowing how to spot the symptoms. Getting help early on and not waiting for the condition to reach a crisis point usually means a more rapid recovery and a happier, less stressful time for everyone.

The difference between normal postbirth emotions and postpartum depression is not always clear-cut. A majority of women (60 percent to 80 percent) experience the “baby blues” in the first or second week after birth: They feel occasionally weepy, irritable and perhaps a little anxious, and these feeling come and go. What you need if you’re experiencing the blues is usually a hug and a nap. By the end of the first or second week, the blues should be gone. Symptoms that extend or worsen after that time are more likely to be signs of postpartum depression.

Most women with a postpartum illness know that something isn’t right - they just don’t feel like themselves - so trust your instincts. PPMDs affect each woman differently, but some of the more common symptoms include a persistent sad or “down” feeling, tearfulness, a poor appetite, sleeplessness (even when the baby is asleep), and feeling guilty, overwhelmed and hopeless. Women with postpartum depression often find it difficult to get through the day because they feel like everything is an effort. Not much - not even the baby - brings them joy. Some women feel postpartum illness in a different way: They feel anxious, “sped up” and worried about everything.

If you have been experiencing several of these symptoms listed for 2 weeks or longer, and nothing you or your partner are doing is providing relief, it’s time to call for help. Usually the best place to start is with your doctor, midwife or childbirth educator. They should be very familiar with the signs of a PPMD and know where to refer you. A therapist who specializes in women’s mental health would also be an excellent person to turn to. Of course, if you are having any thoughts about harming yourself or your baby, you should immediately call 911 or go to the emergency room. 

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