Welcoming a new baby into the world is an occasion marked with many emotions –from joy, adoration, and attachment, to feelings of worry, isolation, and even depression. As many as 8 out of 10 new parents report feeling overwhelmed and sad within the first few weeks after delivery. But what if these feelings persist? Or become debilitating? Or even revisit us several weeks later? It could mean it’s time to seek mental health support for postpartum depression.
What is Postpartum Depression?
Postpartum depression (PPD) is a form of depression that occurs after childbirth and affects 1 in 7 new parents. Occasionally it's called peripartum depression because it can start during pregnancy and continue after childbirth. Rarely, people may develop an extreme mood disorder called postpartum psychosis after childbirth. PPD primarily affects the delivering mother but has been reported in their partners as well.
Baby Blues vs. Postpartum Depression
As an expectant parent, you’ll probably hear the term “baby blues” often. Many people experience this brief period of unexplained crying marked by mild feelings of sadness and irritability for the first 2-3 weeks after delivery. But how can you tell if what you’re experiencing is more than that? Postpartum depression differs from baby blues in its severity and duration. If left untreated, PPD can persist for months or even years. People with PPD experience more severe emotional highs and lows, frequent crying, fatigue, guilt, and anxiety, some even have thoughts of self-harm or harm toward their baby.
Signs and Symptoms of Postpartum Depression
If you’re feeling withdrawn from your baby, excessively overwhelmed, anxious, or sad, express your concerns to your healthcare provider so they can begin to screen and monitor for depression. Additional symptoms of PPD may include:
- Depressed mood or severe mood swings
- Excessive crying
- Difficulty bonding with your baby
- Withdrawing from family and friends
- Loss of appetite or eating much more than usual
- Inability to sleep (insomnia), or sleeping too much
- Restlessness, overwhelming tiredness, or loss of energy
- Lack of interest and pleasure in activities you used to enjoy
- Intense irritability and anger
- Feelings of worthlessness, shame, guilt, or fear of inadequacy
- Reduced ability to think clearly, concentrate or make decisions
- Severe anxiety and panic attacks
- Thoughts of harming yourself or your baby
- Recurring thoughts of death or suicide
Signs and Symptoms of Postpartum Psychosis
Although rare –only affecting 1 in 1000 new mothers– postpartum psychosis is an extreme form of PPD. Women with a personal or family history of depression or other mental health conditions are at higher risk of developing PPP. Other factors that are believed to contribute to this condition are; vitamin deficiencies, electrolyte imbalances, PPD/PPP in previous pregnancies, hormone changes, sleep deprivation, and other health conditions such as preeclampsia. Symptoms of PPP may include:
- Making attempts to harm yourself or your baby
- Feelings of paranoia
- Feeling confused and lost
- Having obsessive thoughts about your baby
- Experiencing hallucinations/delusions
- Trouble sleeping
- Having heightened energy
Diagnosis and Treatment
Prompt diagnosis and treatment of PPD through your medical provider are important for both you and your baby. Although there is no single test to diagnose postpartum depression, having an open and honest conversation with your doctor about how you’ve been feeling since delivery is best. During your postnatal follow-up appointment, your doctor will have you complete a brief survey about your mental state –it’s critical you answer the questions honestly and to the best of your ability as your responses can indicate if you’re experiencing PPD. During this appointment, your doctor may also discuss your personal and family medical history, ask you how you’re adjusting to motherhood, and conduct a physical or pelvic exam. Occasionally doctors will order a blood test to rule out any thyroid conditions as many symptoms of thyroid disease are similar to those of depression.
There are many treatment options available for postpartum depression which include antidepressants or anti-anxiety medication, talk therapy, and support group participation. Treatment options for PPP include medication for depression, anxiety, and psychosis. If deemed a risk to yourself or others, you may be admitted to a treatment facility for observation while you adjust to your medications. In some cases, electroconvulsive therapy (ECT) can be administered if other treatments fail.
If you’re breastfeeding, talk to your healthcare provider about treatment options that are safe for nursing mothers. Medications that you take will transfer (at a generally low rate) through your milk to your baby.
Can I Prevent PPD/PPP?
Although depression isn’t entirely preventable, having realistic expectations for yourself and your baby can help to prevent it. The days of early motherhood go by much faster than you realize. Take this time to bond with your baby, establish routines that work for you, be aware of where you spend your time and energy, and reserve it for the things that matter. Limit visitors and set boundaries, go for a daily walk or run (once you’re cleared for physical activity), take supplements formulated for postnatal health such as our Postpartum Mood Support and our Total Postnatal + DHA, ask for help, and allow others to help, stay involved in the things that bring you joy, and accept that there will be good days as well as not-so-good days.
Postpartum depression is a common mood disorder that affects nearly 15% of all new parents. You cannot control the chemical, biological, and physical factors that lead to PPD. The best thing you can do is advocate for yourself and your baby and speak to your healthcare provider if you believe you’re struggling with postpartum depression.