Heather Toum M.Ed LMHC
A very common question women ask during pregnancy or in the postpartum period is “How will I know if this is the baby blues or something more serious?” The biggest indicator is the time frame of the symptoms: The baby blues can begin immediately after childbirth but typically stops before 2 weeks postpartum. If symptoms progress longer than 2 weeks, it is no longer considered the baby blues. It has now progressed into a postpartum mood or anxiety disorder.
What is the Baby Blues?
Anywhere from 50-80% of new moms experience these symptoms after birth. During pregnancy, women’s hormones peak at the highest level, and then suddenly drop after delivery. These changes in hormones often result in the following symptoms:
- Irritable Mood
- Feeling sad or crying easily
- Sleep issues
- Difficulty Concentrating or making decisions
- Anxiety or Restlessness
- Feeling Overwhelmed
It is normal to struggle with these issues after childbirth. Introducing a baby into the world is not only physically demanding, but it is also a difficult adjustment period. A woman experiences pregnancy, which comes with its own set of challenges, like sleep issues, aches and pains, fatigue, nausea, gastrointestinal problems, and sometimes high-risk issues. She then experiences labor, which is intense and taxing on the body. Now, she has a newborn to take care of, who feeds at least every 2 hours, while still recovering from childbirth. Mom is sleep deprived and exhausted. She now suddenly has a tiny human who depends on her for survival! This is quite an adjustment!
While Postpartum depression or anxiety can strike anyone, some risk factors increase the likelihood, include:
- Depression or anxiety during pregnancy
- History of depression or anxiety any other time
- Limited support network
- Relationship Issues with partner
- Life stressors (examples: finances, moving, job changes)
- Complications with breastfeeding, pregnancy, or birth trauma
- History of Infertility
- Having multiples or babies in the NICU
If you find yourself at 3 weeks postpartum or more and still struggling with baby blues, more than likely your symptoms have manifested into a postpartum depression or anxiety disorder. Sometimes women report that symptoms do not strike until later in the postpartum period. Emotional distress is the most common complication during the perinatal (pregnancy and postpartum) period.
Postpartum Depression (PPD)
Postpartum depression is the most widely studied PMAD. See our PMAD webpage for more information http://cpw.care/pmads/. Occurrence rates vary anywhere from 15-20% or 1 in 5 new moms. Symptoms often begin during pregnancy and can present as:
- Eating Changes, including loss of appetite
- Mood swings or irritability
- Insomnia or sleeping too much
- Feelings of guilt or hopelessness
- Persistent feelings of sadness
- Suicidal Thoughts or Intrusive Thoughts
- Trouble concentrating or ‘brain fog’
- Anhedonia (loss of interest or pleasure)
- Trouble attaching with or feeling disconnected from the baby
Women may experience several of these symptoms or a combination of depression and anxiety. PPD is a variation of Major Depressive Disorder (MDD), a diagnosis in the DSM-5. If you have been diagnosed with MDD in the past, it is more likely to present itself again in the postpartum period.
It is important to seek treatment if you are experiencing postpartum depression for several reasons. Having a licensed mental health counselor evaluate your symptoms and rule out other PMADS including postpartum bipolar disorder and postpartum psychosis is essential for your and your child’s well-being. Unfortunately, PPD does not always dissipate on its own. It is not uncommon for us to see clients well past the postpartum period, who continue to struggle with emotional dysregulation.
Postpartum Anxiety (PPA)
Sometimes, women postpone treatment because they are not experiencing some of the hallmark PPD symptoms (aka. Disconnection from the baby, sadness, ect.) and do not know if what they are experiencing is normal. PPA has not been as widely researched as PPD but is estimated to effect at least 10-15% of the postpartum population. Like PPD, PPA may present itself during pregnancy as:
- Panic episodes
- Restlessness or inability to sit still
- Racing or intrusive thoughts
- Excessive worry or fear
- Feeling like “something bad is going to happen”
- Sleep Issues such as insomnia
- Trouble Concentrating or completing tasks
- Physiological symptoms like nausea, frequent headaches, dizziness, pain
- Reduction or loss of appetite
- Avoidance or compulsive behaviors
Postpartum anxiety may be featured as generalized anxiety, panic disorder, or obsessive-compulsive symptoms (OCD). Women may also present with post-traumatic stress anxiety symptoms related to childbirth. As with PPD, PPA may persist past the postpartum period, so it is important to seek treatment.
What Can I Do to Feel Better?
If you are struggling with the baby blues, remember to take care of yourself. Here at The Center for Perinatal Wellness, we attempt to help mom prepare for postpartum recovery through providing resources and creating a plan to help with the transition to motherhood. The NURSE model for postpartum recovery includes:
- Nourishment and Needs: Establish a well-balanced diet and meet your basic human needs, including staying hydrated and eating regular meals
- Understanding: Recognize stressors and utilize helpful coping strategies.
- Rest and Relaxation: Although you are in “survival mode”, sleep is critical! Focus on long stretches if possible and utilize sleep and relaxation strategies.
- Spirituality: Take time to process motherhood and your inner self, such as journaling.
- Exercise: Exercise works wonders for the mind and body.
Your most important treatment goal for the postpartum period is to Ask for and Receive Help. Recognize that this time in your life is hard but having knowledge and resources at hand to help you will make this transition in your life smoother. If you think you may have a perinatal mood or anxiety disorder, your treatment plan will include more specific goals based on your unique challenges.
We are here to help. Please reach out through phone 413-203-1300 or our contact page if you would like to speak to one of our trained professionals.