Is it Baby Blues or Postpartum Depression?

The birth of a baby is often a joyous event. However, it can also result in something you, as a new mom, may not expect: depression. As many as 80% of birthing people experience what's called the "baby blues" within the first few days to two weeks following delivery. They cry more easily, feel irritable or like they're on an emotional roller coaster, and are fatigued. Fortunately, this is usually a relatively short and mild experience that generally lasts a few days and resolves on its own. But one in seven women will have a more serious condition known as postpartum depression (PPD). With PPD, you will experience a range of symptoms that are more intense, including:

• Sadness, hopelessness
• Anxiety/fear
• Losing interest in activities that are usually enjoyable
• Feeling guilt or worthlessness
• Low energy or fatigue
• Decreased concentration and decisiveness
• Eating too little or too much
• Withdrawing from family and friends
• Trouble bonding with your baby
• Agitated movement or a slowing of movement
• Sleep changes (either too much sleep or an inability to sleep)
• Thoughts of harming yourself or your baby

It's important to know that PPD doesn't always occur right after giving birth. In fact, it can happen up to a year postpartum. Additionally, if doctors screen women for depression in pregnancy and after delivery, as much as 60% of pregnancy-related depression starts before delivery. It's for this reason that we encourage obstetric providers to screen women at the first pregnancy visit, in the middle of pregnancy and at their postpartum visit. Pediatricians also will screen at baby well-child visits until a year of life. The hope with all this screening is that it's identified early and that women can get help sooner when it's easier to treat.

What Causes Postpartum Depression?

Postpartum depression doesn't have a single cause, but likely results from a combination of physical and emotional factors, including:

• Hormones: After childbirth, the levels of estrogen and progesterone quickly drop, leading to chemical changes in the brain that may trigger mood swings.
• Genetics: A family history of depression or other mental health issues could contribute.
• Personal history of depression: Having depression in a prior pregnancy or having mood changes during your menstrual cycle could be a cause.
• Sleep deprivation: This can lead to physical discomfort and exhaustion, which can add to PPD symptoms.
• Stressful life events or situations during pregnancy or after giving birth: Sexual assault, partner abuse, job loss or death of a loved one are examples.
• Inadequate social support: A lack of support, emotional or otherwise, from your spouse, partner, family or friends could be a cause.
• Being a teen mom: Up to one in three teen moms experience PPD, likely related to inadequate social support.
• Medical complications: These can occur during pregnancy, delivery and following childbirth.
• Difficulty breastfeeding

Importantly, PPD does not occur because of something you did or didn't do. In other words, PPD is not your fault.

How Is Postpartum Depression Treated?

The mainstay of PPD treatment is counseling, also called talk therapy. It involves talking one-on-one with a mental health professional, or in a group with other new moms who also are experiencing PPD. Depending on your preference, history, your current state, and the severity of your PPD, antidepressant medications may be appropriate in addition to therapy. These medications act on the brain chemistry that regulates mood.

When To Seek Help

If you're worried about what or how you're feeling or thinking after giving birth, talk to your doctor. The earlier we identify and address PPD, the easier it is to treat. There is no shame in asking for help in dealing with this very common condition. If you're concerned about someone else, speak up. And do so more than once, if necessary. Tell them you're worried and urge them to speak with their doctor. Sit with them while they make the call. Accompany them to the appointment. Being a new mom is hard, and you deserve support. Emotional complications after pregnancy are extremely common and, like any other condition, they should be treated. All too often, everyone focuses on having a healthy baby. But the best way to ensure a healthy baby is to have a healthy mom, in mind, body and spirit. Guest Blogger: Tiffany Moore Simas, MD, MPH, MEd, Chair, Obstetrics and Gynecology