Two weeks ago I met a pregnant woman who described experiencing depression after her first pregnancy but received no help or support. Her family physician said she was just going through the baby blues – this was five months after she had given birth. She did her best to carry on as if nothing was wrong. Nearly two years later and pregnant with her second child she was admitted to a hospital with suicidal ideation. Her postpartum depression went undiagnosed and, therefore, untreated. Everyone missed it and this young mother was left in her experience alone wondering what was wrong with her, feeling guilty and ashamed of her inability to “snap out of it.” “I just thought, well, this is what it was like to be a mother,” she said to me. A new mom may experience mood swings ranging from extreme happiness to weepiness. During pregnancy and postpartum a woman obviously goes through tremendous physical, hormonal, and emotional changes. Though it is not uncommon to often experience feelings of sadness during the first few days to 2-3 weeks as the body and emotions adjust to new circumstances, baby blues last 2 to 3 weeks at the most and do resolve on their own. In fact, up to 80% of new moms experience baby blues to some degree but they do not last for several months nor do they leave a mother feeling sad, worthless, helpless, hopeless, and unable to feel any joy. Baby blues is not postpartum depression and postpartum depression is not the same as baby blues! It might seem that the line between the baby blues and postpartum depression is not a clear one, especially, because so much is changing so quickly, and people often have unrealistic expectations about what a mom should feel and do. While it is normal and expected to feel exhausted, sleep deprived, irritable, overwhelmed with new and never ending responsibilities, and, at times, angry and even resentful of the baby and those around, it is not normal to believe that you are hopeless and worthless, feel perpetually guilty and profoundly sad, and believe that you are a bad mother. Sometimes, new moms begin having thoughts that the baby would be better off without them. Experiences are subjective, so how is a mom and those around her supposed to know when the baby blues are no longer the baby blues? What should partners, parents, and friends be aware of? It is overwhelming and scary at times, but not all of the time. Postpartum depression is a qualitatively different experience; up to 15-20% of new moms experience it; it interferes with a mother’s daily functioning: she can’t shower (which is different from not having time nor energy to do so), can’t sleep even when exhausted, eat, have a conversation, may have difficulty breastfeeding, withdrawing or isolating herself, etc. Though this can be said about any new mom some of the time it does not describe her all of the time, especially, not past 2-3 weeks postpartum. If a mom seems to be getting worse and symptoms become more severe, frequent, and last longer it is time to reach out for help. It is also important to mention that anxiety is, in fact, more common than depression during pregnancy and postpartum. Often, anxiety and depression co-occur. However, anxiety is less talked about and acknowledged perhaps, because, as new mothers, women are expected to have some anxiety when preparing for a birth of a new baby. It is also more accepted to exhibit signs of anxiety as opposed to depression during the period in a woman’s life when she is supposed to be experiencing only happy thoughts and emotions. Some levels of anxiety are not only healthy but also necessary at any point in our lives, especially, when there is a new baby to take care of. However, when worry becomes so intrusive and incessant that it interferes with the daily life, and restlessness and hyper vigilance take over, do not wait – reach our for help as soon as possible. If you don’t feel like yourself and feel that something is wrong – listen to yourself! No one knows you better than you do. If your doctor brushes it off as the baby blues when you are past your second month after giving birth, ask more questions, mention it to your child’s pediatrician – moms often report that pediatricians are more receptive to hear about how they feel. There is much help out there – you just need to reach out or ask your partner or a family member to reach out because, often they feel helpless not knowing what to do. Do not worry about appearing weak, ungrateful, or incompetent – there are many amazing physicians who do listen and can help. There are many online resources available. Postpartum Support International is an excellent place to start. It has evidence-based up-to-date information for moms, partners, family, friends and helps find local resources. https://www.postpartum.net/
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