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Health Information | 03/12/2019

The Baby Blues and Postpartum Depression

By  Atrius Health
Obstetrics and Gynecology Primary Care
For many people, the experience of having a baby is a wonderfully happy time. To prepare, soon-to-be moms read books and mommy blogs about what to expect and how to manage their new arrival. Many women are excited about their role as a new mom and want to try to be the “perfect” parent. One thing that a lot of women are not prepared for is the mood fluctuations that can be experienced after giving birth. The hormonal changes that occur following labor and delivery may cause mild mood changes commonly known as the baby blues. However, persistent, negative changes in one’s mood may be a sign of postpartum depression (PPD). Fortunately, these commonly identified complications related to childbearing are highly treatable.

Baby Blues

The baby blues is a common reaction to childbirth that 50-80% of new moms experience. It is characterized by acute sleep deprivation, feeling mildly overwhelmed, uncertain, and weepy in the first two weeks following childbirth. This cluster of symptoms is due to hormonal and emotional fluctuations that emerge following delivery. Generally, symptoms peak 3-5 days after delivery and resolve on their own around two weeks post-delivery. This time frame might extend slightly for mothers who experienced a C-section.

Postpartum Depression

Postpartum depression is a mood disorder that can affect up to 13% of women after childbirth through the first year postpartum. PPD does not have a single cause, but likely results from a combination of factors. Some of the more common symptoms include:
  • feeling sad, hopeless, and empty
  • feeling moody, restless, or irritable
  • significant appetite changes
  • lack of feeling or interest toward your baby
  • guilt and shame
  • isolation
  • anger or rage
  • thinking about harming yourself or your baby
Unfortunately, PPD is often underdiagnosed and undertreated because of stigma and because many of the symptoms of PPD are similar to “new parenthood” (fatigue, difficulty sleeping, poor appetite, etc.) Postpartum depression will not go away without intervention.

Postpartum Psychosis

In rare cases, just 1-2 out of every 1,000 births, a woman may develop postpartum psychosis. Postpartum psychosis generally presents within 3 weeks after delivery. It is characterized by delusions, hallucinations, confusion/disorientation, and disorganization in thinking and behavior. Postpartum psychosis will not resolve without intervention and requires immediate evaluation and medication management.

Getting Help for Postpartum Mood Disorders

Women may experience the baby blues and/or depression differently with each pregnancy, if at all. If you had postpartum depression after a previous pregnancy, you may be at higher risk of developing PPD again. If you experience any of the symptoms of the baby blues, PPD or postpartum psychosis, it’s important for you to talk to your OB/GYN or primary care provider about how you’re feeling. They can assess your symptoms, determine if you need medication, and refer you to therapy if necessary. Having a baby, and in particular, having your first baby involves some significant changes to your body and your lifestyle. Go easy on yourself. Here are some strategies that may help new moms:
  • Don’t expect everything to be perfect. It takes time to adjust to all of the physical, mental, and emotional changes that are associated with becoming a parent.
  • Try to maintain a well-balanced diet and find some time, no matter how short it is, to get in some physical activity. By maintaining a healthy lifestyle, you’ll be better able to cope with challenges such as sleep deprivation that can come along with being a new parent.
  • Ask for help! It’s easy to think you should be able to do it all, but many times that’s just not realistic. You’re tired and maybe feeling a bit overwhelmed, so take your family and friends up on their offers to assist with errands or housework.
  • Don’t let shame or guilt stop you from seeking help for postpartum depression. You are not the first or the last patient that your OB/GYN, primary care or mental health provider have treated for this condition. Remember, help is available!
Atrius Health providers have the ability to consult with specially trained doctors to determine safe and effective medications to use to reduce symptoms—even if you are breastfeeding. Many of the behavioral health staff at Atrius Health have been trained in treating postpartum depression through various types of therapy. Our therapists can work with you to refer you to support groups and resources in your area so that you can feel heard and supported every step of the way.

Learn more about postpartum depression: 
National Women’s Health Information Center: http://www.womenshealth.gov/
Parental Stress Line: http://www.parentshelpingparents.org/ phone: 800-632-8188
Online PPD Support group: http://www.ppdsupportpage.com/
Postpartum Progress blog: http://postpartumprogress.com/

Local Resources:
 Postpartum Support International of Massachusetts Jewish Family & Children’s Services
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About The Author

Atrius Health

Atrius Health, an innovative healthcare leader, delivers an effective system of connected care for adult and pediatric patients at more than 27 medical practice locations in eastern Massachusetts. By establishing a solid foundation of shared decision making, understanding and trust with each of its patients, Atrius Health enhances their health and enriches their lives.

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