cartoon of postpartum depression represented by a parent holding a baby with a dark cloud covering their face

Baby Blues or Postpartum Depression

The baby blues are experienced by most. Up to 80 percent of birthing parents report feeling weepy, having shifting moods, worry and general overwhelm in the weeks following delivery. The baby blues typically last between two days and two weeks, peaking three to five days after delivery. These symptoms can also extend to the non-birthing partner.

And it’s no wonder! 

The hormones that grew your baby suddenly and precipitously drop post-delivery. Emotional states are intricately connected to your hormonal state. This upheaval inevitably impacts your sense of wellbeing. The delivery may not have gone to plan. Now you and your baby are facing an extended or more complicated recovery than expected. Feeding your baby may be challenging. You may have to adapt or change methods to accommodate yours and your baby’s needs. Your body can feel unrecognizable, as returning to a physiologically ‘unpregnant’ state takes longer than most anticipate, and in many ways, your body is forever changed. 

You’re sleep-deprived and adjusting to being a first-time parent. Or you are readjusting as you add another member to your family. Daily routines are upended. You may have less time off of work than you require to fully recover. Or you may be juggling work at the same time. Negotiations between co-parents can be sticky and fraught, as both parents find themselves tapped out.

You have so many hopes and dreams for yourself, your baby, and your family. At the same time, you’re navigating the gauntlet of expectation—yours, your family’s, the community’s, and society. 

All to say, not feeling quite yourself is VERY normal. However, when this feeling extends or shifts dramatically, it is critical to pay attention and seek help! Two indicators to be aware of are duration and intensity. Has it been more than two to three weeks since your baby arrived? Do you cry only some or most of the day? Is your worry manageable or paralyzing? How much is your ability to function impacted?

cartoon of postpartum depression as shown with depressed mother standing over a baby's crib in distress

Perinatal Mood & Anxiety Disorders (aka postpartum depression)

Perinatal Mood and Anxiety Disorders (PMADs) are a cluster of emotional and physical symptoms which most typically present between one and three months after delivery. But for some, they can appear during pregnancy and even up to one year postpartum. They cut across all demographics, impacting birthing parents of every age, culture, race and income level. 

Under the PMAD umbrella, you find antenatal (during pregnancy) and postpartum anxiety, depression and bipolar disorder, as well as postpartum panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder and psychosis. Depression and anxiety are the most common PMAD, affecting 15-20% of people throughout pregnancy and afterwards. PMADs are the leading complication of childbirth in the United States and can have serious consequences for birthing parents, partners, children and families alike. 

Here are some of the risk factors that increase your chances of having a Perinatal Mood and Anxiety Disorder

  • Family history of depression or anxiety, PMADs, or other psychiatric illness
  • Inadequate social support
  • Environmental, financial, and social stressors such as access to food, housing and secure employment 
  • Unplanned pregnancy
  • Perfectionism or idealization of motherhood/parenthood
  • Pregnancy or birth complications, traumatic labor and delivery
  • Difficulty with breastfeeding
  • Reproductive losses: infertility, miscarriage, abortion
  • Relationship stress with significant others
  • Parent of multiples
  • Parents of Infant(s) in the NICU
  • Having a high-need baby: fussy, colicky, or ill
  • Thyroid imbalance
  • Vitamin D deficiency

PMADs can look and feel different than you might expect. Your symptoms may shift somewhat day to day, but their overall trend matters.

Here are some of signs that your baby blues may actually be postpartum depression or anxiety.

  • Feeling overwhelmingly sad or depressed
  • Struggling with daily tasks of living
  • Feeling worthless, have persistent self-doubt, or experience intense guilt 
  • Having difficulty concentrating, making simple decisions, or remembering things
  • Being troubled by excessive worry or fears (often about the health and safety of the baby)
  • Feeling tense, have shortness of breath or upset stomach
  • Feeling restless, notice your heart racing or have heart palpitations
  • Losing interest in or withdrawn from previously pleasurable relationships or activities
  • Wanting to sleep most or all of the time 
  • Being unable to sleep even though you’re exhausted 
  • Noticing dramatic changes to your appetite and eating patterns
  • Experiencing repetitive, unwanted, and upsetting thoughts or images
  • Having flashbacks of childbirth or other past trauma
  • Feeling intense irritability, resentment, anger or rage
  • Feeling disconnected from yourself or your baby
  • Hearing voices or seeing things others cannot
  • Thinking and/or believing that your family would be better off without you
  • Thinking about harming yourself or your baby**

** Please go to your local emergency room or call 911 if you have imminent thoughts of harming yourself, your children or anyone else. 

Treatment for Postpartum Depression

The hopeful news is that PMADs are treatable! Typically, this is accomplished with therapy, medication, or a combination of both. Awareness of your risk factors, early screening and prompt intervention can equip you and your family with the information and support you need.  

If you are experiencing any of the above symptoms or find yourself concerned about your current mental health, reach out to a professional. Your OBGYN, Primary Care Doctor, Pediatrician, local Emergency Room, or Licensed Therapist specializing in Perinatal Mental Health are all good places to begin. 

“You are not alone. You are not to blame. With help, you will be well.” (Postpartum Support International)

Additional Supports

About The Author

sabrina gibb, expert on postpartum depression

Sabrina Gibb is a Maryland and DC licensed graduate professional counselor and psychotherapist at Montgomery County Counseling Center.  She has completed Level 1 and 2 training in Emotion-Focused Therapy and recently completed initial training in Emotion-Focused Family Therapy. With specialties in traveling and long distance couples and perinatal mental health, she supports individual, couples and family. Sabrina guides clients to recognize and transform painful emotions, behavior and dynamics—freeing them to pursue a more fulfilling life and relationships. 

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