What are the Baby Blues?

Baby blues, also known as postpartum blues, affects approximately 70-80% of new mothers. These feelings typically arise within the first week after childbirth and may last a few days or up to two weeks. Baby blues are characterized by tearfulness, irritability, anxiety, restlessness, and fatigue. These emotional fluctuations are often caused by the significant changes the body goes through before, during, and after delivery. These changes include the physical stress of giving birth and major shifts in certain key hormones. Baby blues are also often caused by the sudden adjustment to new motherhood and the dramatic disruption of daily routines such as work schedules, social interactions, and leisure activities. Relationships may be impacted. These changes can affect our sense of well-being and even our sense of identity. Sleep deprivation is common and can make anyone feel bad. Time to prepare meals also often goes down, leading to changes in nutritional status that can impact mood, too.

It is essential to recognize that baby blues are temporary, last only a few weeks, and generally resolve without requiring medical intervention. Support from loved ones, rest, self-care, and reassurance can be immensely helpful during this time. Open communication about your emotions with your partner, family, and friends can also provide much-needed understanding and support. However, it is important to know that not all cases of feeling down should be left to the "watch and wait" approach.

Understanding Postpartum Depression

While baby blues are relatively common and subside within a couple of weeks, postpartum depression (PPD) is a more serious condition that requires skilled professional intervention. Approximately 1 in 9 new mothers experience PPD. The standard diagnostic criteria recognize PPD as occuring within the first few weeks postpartum, but clinically we often see PPD manifest within the first year after childbirth. PPD symptoms include persistent feelings of sadness, hopelessness, guilt, loss of interest in activities, difficulty bonding with the baby, changes in appetite and sleep patterns, and even thoughts of suicide or harming the baby. About two out of three women with PPD also have significant anxiety symptoms.

If you are having thoughts of hurting yourself or your baby, get help from your partner, friends, or family in looking after the baby and call 911 or call your local crisis service, or go to your nearest emergency department. The 988 suicide prevention number is free and available 24/7. If you suspect that someone you know is experiencing post-partum depression, help them seek help immediately. People with depression often do not recognize they are depressed, or may need help navigating how to get help for their depression. Post-partum depression is treatable but needs prompt medical attention.

PPD is believed to result from a combination of physical, emotional, genetic, and social factors. Hormonal changes, a history of depression or anxiety, lack of social support, sleep deprivation, and the stresses of caring for a new baby can contribute to the development of PPD. Studies have also shown that a family history of post-partum depression increases a mother’s risk of developing PPD. It is crucial to remember that PPD is not a reflection of a woman's character or ability as a mother. It is a treatable medical condition that requires professional help.

Occasionally, changes the body goes through during and after birth can contribute to other medical conditions that affect mood. Examples include thyroid changes and certain autoimmune conditions that, though rare, can emerge in the weeks and months postpartum. Getting regular checkups postpartum and discussing any concerns you have about your health with your doctor supports both physical and psychological wellness.

Recognizing the signs and symptoms of PPD is important for early intervention and treatment. If you or someone you know is experiencing persistent feelings of sadness or struggling with daily functioning after childbirth, it is important to seek help. Reach out to your healthcare provider, obstetrician, or a mental health professional specializing in postpartum mood disorders.

Treatment for PPD often involves a form of talk therapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT). Medication can also play an important role in helping women feel more like themselves faster. Many medications for depression do not require you to stop breastfeeding, though an individual discussion with your doctor can help you decide what treatment is right for you. Support groups, where mothers can share their experiences and receive emotional support, can also be beneficial, though should not be the only intervention for PPD.

Caring for Yourself

In addition to seeking professional help, there are several self-care strategies that new mothers can adopt to support their well-being:

1. Remember self-care: Make time for activities you enjoy, even if it's just a few minutes a day. Engage in gentle exercises like walking or yoga to boost your mood and reduce stress.

2. Get enough rest: Rest is crucial for physical and emotional recovery. Whenever possible, try to nap or rest when your baby is sleeping.

3. Accept help: Don't hesitate to ask for and accept help from family and friends. Allow them to assist you with household chores or caring for the baby, giving you some time.

References

1. Depressive disorders. In: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision DSM-5-TR. American Psychiatric Association; 2022. https://dsm.psychiatryonline.org. Accessed May 30, 2023.

2. Postpartum depression. Office on Women's Health. https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression. Accessed May 30, 2023.

3. Diseases & Conditions: Postpartum Depression. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617. Accessed May 30, 2023.

4. FAQs. Postpartum depression. American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/faqs/postpartum-depression. Accessed May 30, 2023.