Not Just The Baby Blues

The postpartum period is a wild ride. You’ve just birthed a baby — whom you’re now completely responsible for. On top of that, your hormones are plummeting. Your sleep is…not what it used to be.

depressed woman holding infant - Postpartum Depression and Anxiety: What You Need to Know

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For the vast majority of people, this combination leads to some big feelings in the first couple weeks after birth, complete with mood swings and crying spells. You’ve probably heard this mood dip called “the baby blues.” For some people, things level off after about 2-3 weeks, and they feel more or less like themselves again. But, for others, the big feelings continue and things just don’t feel right. For this group, this “not right” feeling may be a sign of postpartum anxiety or depression, and it’s important to get help. Read on for what you need to know about postpartum anxiety and depression.

What Are Postpartum Anxiety and Depression?

Postpartum anxiety and depression are terms used to describe episodes of anxiety and depression that begin after the birth of a child. While postpartum anxiety and depression often begin within a month of birth, and almost always within a year, some studies have reported postpartum mood disorders that begin up to four years after birth[1]“Prevalence of postpartum depression and interventions utilized for its management,” Reindolf Anokye, et. al,Annals of General Psychiatry, 2018, … Continue reading.

You might also hear the term “peripartum” or “perinatal” also used to describe this type of anxiety or depression. “Peri” is a prefix meaning around or about, and these broader terms reflect the fact that, according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, “Fifty percent of ‘postpartum’ major depressive episodes actually begin prior to delivery.”

Specifying depression and anxiety’s connection to pregnancy and birth is important because of the way it can impact how at-risk for the disorders you are, how the disorders show up, and what you can do about them.

It’s Common

Times of stress and change can leave you susceptible to mental health issues, and the time around giving birth certainly qualifies. That’s probably part of why postpartum depression and anxiety are relatively common in people postpartum. Postpartum depression affects up to 15% of mothers[2]“Postpartum Depression,” Dr Teri Pearlstein, et. al, American Journal of Obstetrics and Gynecology, April 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918890/, while an estimated 8.5% of postpartum mothers experience one or more anxiety disorders[3]“Anxiety disorders in postpartum women: A systematic review and meta-analysis,” Janice H.Goodman, et. al, Journal of Effective Disorders, October 2016, … Continue reading. Those rates may be higher for people with a history of pregnancy loss, which is a known risk factor for postpartum mood and anxiety disorders[4]“Increased Risk for Postpartum Psychiatric Disorders Among Women with Past Pregnancy Loss,” Stephanie A.M Giannandrea, et. al, Journal of Women’s Health, September 2013, … Continue reading [5]“Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study,” Jessica Farren PhD, et. al, American Journal of … Continue reading [6]“Identifying the women at risk of antenatal anxiety and depression: A systematic review,” Alessandra Biaggi, et al, Journal of Effective Disorders, February 2016, … Continue reading. This is to say, if you do end up being diagnosed with postpartum depression or anxiety, especially as a loss mama, you should know: You are not alone.

What To Look Out For

So how can you tell if you have postpartum depression or anxiety?

The truth is, it can be difficult to suss out postpartum depression and anxiety from normal emotional ups and downs post delivery. That’s why it is important if you have that “not right” feeling to find a provider you can speak to honestly who can help you figure it out (more on that below).

Adding to the complexity, postpartum depression and anxiety show up differently for different people. According to the American Psychological Association, the symptoms of postpartum depression can include:

  • A loss of pleasure or interest in things you used to enjoy, including sex
  • Eating much more, or much less, than you usually do
  • Anxiety—all or most of the time—or panic attacks
  • Racing, scary thoughts
  • Feeling guilty or worthless—blaming yourself
  • Excessive irritability, anger or agitation—mood swings
  • Sadness, crying uncontrollably for very long periods of time
  • Fear of not being a good mother
  • Fear of being left alone with the baby
  • Misery
  • Inability to sleep, sleeping too much, difficulty falling or staying asleep
  • Disinterest in the baby, family, and friends
  • Difficulty concentrating, remembering details, or making decisions
  • Thoughts of hurting yourself or the baby[7]“Postpartum Depression,” American Psychological Association, https://www.apa.org/pi/women/resources/reports/postpartum-depression.

The bottom line: Postpartum depression and anxiety make it difficult to do what you need to do, so if you notice your thoughts or feelings getting in the way of living your life the way you want to, it’s important that you get help.

How to Get Help

One of the paradoxes of postpartum anxiety and depression is that you need outside help to get better, but the disorders themselves (not to mention the responsibilities of new parenthood) make getting outside help incredibly difficult. Here is a break-down of what kind of help is out there.

Medication.

Outside help generally looks like medication and/or talk therapy. While it’s common to feel uneasy at the idea of adding a prescription when you’ve just added a new person to your family, there are many medications with a long track record of safety after delivery and while nursing. A skilled provider will be familiar with what these are.

Talk therapy.

But before medication, the first step for most people who have postpartum anxiety and depression will be to talk to a licensed therapist. There are a variety of ways to find a licensed therapist.

Note: Many people find the process of connecting with a therapist daunting. If you feel that way, you can forward this article to a friend or family member and ask them to help you find someone and schedule a first appointment. The people who care about you often want to help, but don’t know how. Letting them do this for you is a kindness.

  • Your midwife or OB. You can contact the care team that helped you deliver your baby and ask for their help. Don’t wait until your first postpartum check-up or next scheduled appointment. They’ve seen this before (lots) and they will be plugged in to resources in your community, including support groups and therapists, who are ready to help.
  • Psychology Today. Psychology Today has a reputable database of licensed therapists. Their search options make it easy to find someone that fits the parameters that are important to you. For instance, you can search specifically for providers in your area who specialize in issues related to “pregnancy, prenatal, and postpartum.”
  • Local parenting groups. Most areas have local mama, parenting, and new parent groups on Facebook. You can post to these groups (you can now post anonymously in many groups) and ask for recommendations on who locally has been helpful to new parents in your community.
  • Your insurance provider. You can login to your health insurance portal or call the number on the back of the insurance card and ask for help from member services to find a provider who is in your health insurance network.
  • Helplines. Postpartum Support International has a helpline you can call for basic information, support, and resources on perinatal mood and anxiety disorders. You can call or text this number: 1-800-944-4773. If you are in crisis, you can always call the free and confidential National Suicide Prevention Hotline at 1-800-273-8255.

Home care.

There may be a wait to get in with the right therapist. But you don’t have to wait to start treating suspected postpartum anxiety and depression at home. A good first line treatment for postpartum anxiety and depression is to prioritize sleep. Too little or poor quality sleep is known to make mental illness worse. While sleep is notoriously difficult with a newborn, getting enough sleep often helps immensely with the worst postpartum anxiety and depression symptoms. A keystone of your home care plan should be to find ways to get 3-4 consecutive hours of uninterrupted sleep and 8 or more hours of sleep across a 24 hour period.

Finally, remember: You can be grateful to have a living child *and* experience postpartum anxiety or depression.

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