Pregnancy Mental Health Series: What Are The Baby Blues And Postpartum Depression?

I often tell the story of bringing my first child home from the hospital. My son was three days old, and a strapping 7lbs, 2 ounces. I will never forget sitting in the back seat of the car driving home with my little baby in his seemingly gigantic car seat. He looked so vulnerable, and I felt so helpless. I cried the entire 45-minute drive home. I was tired, I was scared and, like 85% of women, I was reacting to my plummeting hormone levels. I had the Baby Blues.

What Are Baby Blues?

Levels of estrogen and progesterone peak during pregnancy at over 100X their pre-pregnancy baseline. There is only one direction for the levels to go after delivery: down, like a ton of bricks. This massive hormonal shift causes mood symptoms termed ‘The Baby Blues’ for over 85% of new moms. Symptoms of the Baby Blues may include (but are not limited to):

  • Mood swings
  • Anxiety
  • Sadness
  • Irritability
  • Crying
  • Decreased concentration
  • Trouble sleeping

Most women first experience the Baby Blues at 3 days postpartum, and by definition the symptoms self-resolve within no more than 2 weeks.

How Is Postpartum Depression Different From The Baby Blues?

Unlike Baby Blues, symptoms of Postpartum Depression are more severe, last longer (at least two weeks or more) and can persist for months or longer if left untreated. These symptoms often present themselves from 4 months up to a year postpartum and likely require treatment by a psychologist or psychiatrist. Postpartum depression frequently impairs a woman’s ability to function, care for herself, her baby and her family.

Symptoms of Postpartum Depression include, but are not limited to:

  • Difficulty bonding with baby
  • Disinterest in the baby / not wanting to care for or hold the baby
  • Feelings of shame, guilt or inadequacy
  • Frequent crying
  • Lack of joy in life
  • Change in appetite
  • Loss of interest in things that were once fun/exciting/enjoyable
  • Loss of motivation
  • Overwhelming fatigue
  • Profound anxiety, often focused on the baby, though not always
  • Sleep disturbance (sleeping too much or too little)
  • Severe mood swings
  • Thoughts of harming self (suicide) and/or of harming the baby (infanticide)
  • Withdrawal from family and friends

Remember, You Are Not To Blame

There is no shame in experiencing a postpartum mood episode. You did nothing wrong and are not to blame for your feelings. Your mood symptoms mean nothing about you as a mother, but rather reflect the hormonal changes that your body is experiencing.

Untreated depression and anxiety may become very severe, so the sooner you ask for help and begin treatment, the better. Getting help will benefit not only you, but also your baby and the rest of your family.

What Can I Do To Feel Better?

The postpartum period is stressful and overwhelming for all new moms. The adjustment to the new role of mom can be exciting and nerve wracking at once. If you are feeling sad, crying often or having any of the other symptoms listed above, ask for help:

  • Reach out to your partner, to family and friends for support.
  • Consider joining a mommy’s group with other moms with similarly aged babies.
  • Ask your OBGYN or midwife for a referral to a therapist and/or a psychiatrist specializing in mood symptoms during and after pregnancy.
  • Keep an open mind about what else might be going on physiologically. In addition to providing referrals, your OBGYN may check your thyroid function. Abnormal thyroid function during and after pregnancy is very common, and may mimic symptoms of a postpartum mood episode.

Depression Is Only One Part Of A Spectrum Of Illnesses

The term Postpartum Depression is often used to describe any mood disorder experienced during or after pregnancy. However, it has become increasingly clear that there is a range of mood disorders that may affect women both during and after pregnancy (aka the perinatal period). These disorder are grouped under the name Perinatal Mood and Anxiety Disorders (or PMAD). PMAD includes:

  • Depression and/or anxiety during pregnancy
  • Postpartum Depression
  • Postpartum Anxiety Disorder Postpartum
  • Posttraumatic Stress Disorder (PTSD
  • Postpartum Obsessive Compulsive Disorder (OCD)
  • Postpartum Panic Disorder
  • Postpartum Psychosis

Next month’s post will delve more into Perinatal Mood and Anxiety Disorders. Until then, take care of yourself and be well.

Carly Snyder, M.D. is a Psychiatrist in New York City with a focus and expertise in Reproductive Psychiatry. Dr. Snyder is the Clinical Course Director for the Reproductive and Perinatal Psychiatry Program at Beth Israel Medical Center. She holds faculty appointments in Psychiatry and Obstetrics and Gynecology at Beth Israel Medical Center, and a teaching appointment at Mount Sinai Medical Center. Dr. Snyder serves on the Board of Directors for Postpartum Support International, and is a member of the Women’s Mental Health Consortium in NYC. Dr. Snyder also sees patients in her private practice located on the Upper East Side of New York City. She received her undergraduate degree from Emory University, attended NYU School of Medicine and completed residency at Beth Israel Medical Center, with additional sub-specialized elective training at Weill Cornell’s Payne Whitney Women’s Program.

Dr. Snyder treats women experiencing emotional and psychiatric challenges at any age. Her approach uses a combination of traditional psychiatric methods with integrative medicine-based treatments to optimize the whole body, mind and well-being. Dr. Snyder provides individualized treatment that focus on improving a woman’s physical and emotional health. In addition to more traditional psychiatric modalities, she has extensive experience treating patients with natural supplements, either alone or in combination with pharmacotherapy. For more information, visit Dr. Snyder’s website or follow her Twitter.