Baby Blues Vs. Postpartum Depression: Let’s Break It Down
Dr. Haynes is a board-certified psychiatrist practicing in Austin at Reproductive Psychiatry Clinic of Austin. She helps women move toward mental wellness by using a whole-person approach including therapy, medications, engaging social supports and helping identify lifestyle modifications. Dr. Haynes received her undergraduate degree in psychology from Baylor University. She received her doctorate at University of North Texas Health Science Center and went on to residency at University of Texas Medical Branch where she served as assistant chief resident. She has worked in a number of psychiatric settings including inpatient where she founded and served as medical director for an exclusively women’s unit, outpatient at RPC, partial hospitalization, intensive outpatient, forensics and using telemedicine.
You made it through your pregnancy and delivery. Now you’re home and everyone is asking you how you’re doing. You smile and say, “Oh it’s so great!” When up to 85% of women experience the baby blues, being “great” is often not the case.
Baby blues can present in a number of ways. Symptoms include crying spells, fatigue, insomnia, sadness, irritability, poor concentration, irritability and impatience. These symptoms typically present around 4-5 days postpartum. If the birth of the baby was difficult or traumatic in some way, these symptoms may present earlier. Baby blues is thought to originate from the drop in your hormones. During pregnancy, your body and the placenta work together to increase hormones to keep you pregnant. These hormones increase fairly steadily throughout pregnancy and peak at delivery. Then, after delivery they drop dramatically over the course of about a day to your pre-pregnancy levels.
Our hormones and our mood have a very complicated relationship, one we do not fully understand yet. So, with such a dramatic drop in hormones after delivery, combined with sleepless nights and a big change in responsibilities, it is no surprise a majority of women experience the baby blues. They usually reside about 2 weeks postpartum and do not cause significant impairment. Most cases of baby blues are self-limited, meaning they resolve on their own with little, or even no intervention. While it can be difficult to get through the baby blues, most of the time it resolves on its own.
However, sometimes the symptoms do not resolve on their own. If symptoms persist past 2 weeks postpartum or appear outside the first 2 weeks, there is concern for postpartum depression. Postpartum depression is a constellation of symptoms which can include some of the following:
Changes in sleep with difficulty falling asleep even when everyone else is asleep or sleeping more than normal
Decreased interest in the things you previously liked to do or lack of interest in the baby
Feelings of worthlessness or guilt
Lack of energy or motivation, or motivation to care for the baby
Changes in concentration
Loss of pleasure, inability to feel joy
Eating more or less than usual
Worrying about harming the baby
Thoughts about death, dying or suicide
These problems are sometimes difficult to distinguish from transition to motherhood. Of course, you’re sleeping less and you have a baby who wakes up at all hours of the night. Of course you’re tired, you’re up at all hours of the night! One thing to consider is “how difficult is it to get through each day?” If you notice it is very difficult to do the tasks of motherhood. Does it take significant energy to get up and take care of things? Do you feel joy at times? Do you feel like you’re connecting with your baby on any level?
If you’re noticing some of these symptoms, you may be experiencing postpartum depression. This usually occurs within the first year after childbirth and most symptoms present during the first 3-6 months. It is generally thought to occur in about 1 in 7 women. The UN reports 360,000 babies born a day, but why aren’t we seeing 50,000 women every day seeking help? If we think about the number of women who give birth and the number of women who seek treatment, there is a gross disparity. A lot of women delay or never seek treatment for fear of judgement or belief these symptoms are just part of being a mother.
Women deserve treatment. They deserve to enjoy motherhood. Postpartum depression can rob them of some of the joy of motherhood and leave them with feelings of guilt and inadequacy. This absolutely does not need to be the case.
If you’re recognizing some of these symptoms in yourself, what can you do? When you’re likely to only get one postpartum OBGYN visit, it can feel daunting to think about bringing this up. I hope you do! You can also talk to your baby’s pediatrician. They absolutely care about postpartum depression too. You know that saying? It’s a joke in my house. “If momma ain’t happy, ain’t nobody happy!” Well, it is kind of true. Thank goodness for the wisdom of our great-great grandmothers. They knew what it took us years to study. The evidence is really robust here: When mom suffers, others suffer too. When mom is experiencing postpartum depression, there can be an increased risk for behavioral problems in a child even years later, language delays and milestone delays, and increased risk for depression in the child.
There is absolutely high quality treatment for postpartum depression. If symptoms of baby blues last longer than about two weeks, there is concern for postpartum depression. The treatment options vary based on situation, but are largely based on lifestyle modifications like leaning on support and getting improved sleep, therapy and medications. If you’re struggling with symptoms of postpartum depression, please reach out to your doctor or someone you trust. There is always hope in feeling better and enjoying your new role.
You can keep up with Dr. Nichelle Haynes, on Instagram and tune into the The SnapBack for her takeover on Friday!