There are many feelings a new mother (and father) have after the birth of a baby, including joy, excitement, and love. But most mothers will have other feelings too, including exhaustion, anxiety, sadness, fear, and inadequacy. There are a variety of reasons for these feelings, which are usually called the “baby blues.” Almost every mother experiences these to some degree; when they are more serious, the condition is called postpartum depression.
What are the symptoms?
The symptoms are common and everyone experiences them sometimes. When the symptoms are more frequent, more severe, and when several are happening at the same time, then depression is more likely. If you have more than one of the following symptoms, and they are more intense than normal, and they occur every day for more than two weeks, then you may have postpartum depression. Symptoms include:
- Frequent crying
- Feeling sad most of the time
- Severe fatigue
- Loss of appetite (or eating too much)
- Feeling trapped by circumstances
- Loss of pleasure and enjoyment
- Withdrawal from family and friends
- Not caring for yourself or your baby
- Emotional numbness
- Difficulty sleeping
- Feelings of failure, guilt, or worthlessness
- Feelings of panic or of being unable to cope
- Mood swings
- Thoughts of disappearing, getting out, or harming yourself
Symptoms may start right away or up to a year after delivery. They can last for months or longer if untreated.
What causes it?
No one is sure what causes it. Fatigue and exhaustion definitely contribute to it. Most mothers are physically tired from delivery, recovery, postpartum body changes, and breastfeeding. They are sleep deprived from caring for the newborn baby. There is natural anxiety about caring for a newborn, especially when it is the first child. There are many hormonal changes after delivery in the first month, which definitely have an effect.
Other factors that contribute to it include stressors such as lack of support and financial concerns. Fussy or needy babies can also contribute to fatigue and feelings of inadequacy, or cause concern about the health of the baby. Caring for other young children can contribute to fatigue.
Postpartum depression risk factors also include a history of anxiety or depression, high-risk pregnancy, poor birth experience or delivery complications, and relationship problems.
Whatever the cause, it is not your fault and it does not mean that you are a bad mother.
How is it diagnosed and treated?
Like other forms of depression, it is usually diagnosed based on how many symptoms you have and how severe they are. Screening questionnaires have been proven reasonably effective at detecting postpartum depression. Any healthcare provider can screen moms, and the tests are available online as well. Since mothers do not see their doctor until 6 weeks after delivery, it is now recommended that pediatricians screen all mothers for postpartum depression.
There are two main treatments:
- Counseling can help you reframe your thinking and how you handle stress and cope with your feelings, as well as new strategies for solving problems. Counseling can also help you improve relationships.
- Medication can be very helpful in treating postpartum depression and can make counseling more effective. Newer antidepressant medications have fewer side effects and are safe to use while breastfeeding.
Ways you can help yourself
- Get plenty of rest. Take a nap while your baby is sleeping. See if someone can watch your baby or your other children while you get a few hours of sleep.
- Eat a healthy diet. Drink plenty of water, eat a lot of fruits and vegetables and some protein. Avoid too many sweets, and also avoid alcohol.
- Get some exercise. Just going for a walk is good exercise. Do some gentle stretching if you are allowed to.
- Get out of the house. Go for a walk, out to eat, to church, a park, or a friend’s house. It’s okay to take your baby out.
- Try to have a normal routine. Having a baby makes it hard, but try to get into a routine, including meals, getting dressed, showering, etc.
- Go easy on yourself. You don’t have to be perfect. You don’t have to have it all together or have everything figured out. It’s okay not to get everything done, to have a messy house, or whatever it is. People on Instagram and Facebook posting about their perfect babies, perfect postpartum bodies, and perfect lives, are not normal or likely even really the whole truth.
- Use your support system. Talk to your friends and family about how you are feeling. Have someone help you or stay with you if you need to. You don’t have to do it all by yourself. Whatever you do, don’t isolate yourself.
- Find a support group for mothers or for mothers with depression. It helps to find out that you are not alone. Some of these groups are available online.
- Talk to your doctor or your baby’s doctor.
How can it be prevented?
Recent research shows that counseling is effective not only at treating but also at preventing postpartum depression and depression during pregnancy as well. It is now recommended for women at risk during or after pregnancy. Self-care methods listed above may also help.
What to do next
Call your doctor if you think you have symptoms of postpartum depression.
Go to an emergency room or call 911 if you have thoughts about harming yourself or your baby.
Where to get help
- Postpartum Support International www.postpartum.net 1-800-944-4773
- SAMHSA’s National Helpline – 1-800-662-HELP (4357)
- MedEdPPD www.mededppd.org
- Atlanta Postpartum Meetup www.meetup.com/PPDAtlanta
- Mental Health America of Georgia www.mhageorgia.org publishes an extensive, updated list of statewide resources
- Apex Family Healthcare Services 678-782-7272 Psychological, counseling, and psychiatric services
- Fresh Start for the Mind 404-666-8646 Psychological, counseling, and psychiatric services
- Crossway Counseling Center 678-782-7718