As moms-to-be and new moms, we spend months and months imagining and planning what our lives will look like with the arrival of a baby and the years after that. From the general—nursery themes, names, clothes, photos, family vacations, birthday parties, etc; to the personal philosophies—type of birth, parenting styles, sleep training, nanny vs daycare, and so much more—we read books, listen to podcasts, talk to friends and family. We work through every scenario to ensure this precious new addition is safe, healthy and happy. But what happens when the joy of motherhood is overshadowed by feelings of sadness and dread beyond our control and are so debilitating that they impede our functionality as parents?
May is Maternal Mental Health Awareness Month, so it’s a great time for us to revisit the signs and symptoms of postpartum (or prenatal) depression and anxiety in yourself and those you love. In the immediate postpartum period, 80-85% of women report that they have experienced “baby blues,” usually defined as short and mild periods of tearfulness, worry, irritability and fatigue. An alarming 10-20% of new mothers do develop more significant symptoms of depression or anxiety – and likely even more due to underreporting. While the range and time of symptoms can differ from person to person, they all affect the most critical time in a new mother’s life when all we want to do is connect with and love our child.
Baby Blues vs Postpartum Anxiety vs Postpartum Depression
Baby blues are typically associated with the the sudden hormonal and chemical changes that take place in the body after childbirth. With nearly 85% of women experiencing a mood disturbance in the few weeks after birth, baby blues could be considered normal as long as they meet the characteristics of baby blues— the most important of which is that the feelings of uncertainty, irritability and fatigue should absolutely NOT last beyond 2 weeks after giving birth. Most women experience baby blues 2-5 days after birth. While these symptoms may be unsettling, they should not interfere with a mother’s ability to function.
Postpartum Depression (PPD)
Postpartum depression can develop as early as pregnancy (prenatal depression), but typically emerges over the first two to three months after birth and up to a year postpartum. Postpartum depression symptoms often include, but not limited to:
- Depressed or sad mood
- Feelings of anger and irritability
- Feelings of hopelessness
- Loss of interest in usual activities
- Feelings of guilt
- Feelings of worthlessness or incompetence
- Sleep disturbance
- Change in appetite
- Poor concentration
- Thoughts of harming oneself or others, including the baby
According to Postpartum Support International, 1 in 7 mothers suffer from PPD. Statistically, this means many of us have a friend, family member, co-worker or someone we have met that has battled PPD. Additionally, 1 in 10 fathers have also experienced postpartum depression. Unfortunately, as high as these numbers are, it is believed that the number of parents that have or had PPD is much higher due to the underreporting of cases. Sadly, this means that some of the people fighting PPD are not getting the treatment they need. It’s also important to note that these statistics only include live births. Women who have experienced a miscarriage or a stillbirth may experience PPD as well.
Postpartum Anxiety (PPA)
PPA can be defined as having an irrational fear or nonstop worry that something is catastrophically wrong. PPA symptoms can be similar to those of PPD and can include fatigue, poor concentration, and change in appetite. However, PPA symptoms can also manifest as:
- Extreme worry and dread
- Racing thoughts
- Hot flashes or chills
- High blood pressure
- An overwhelming sense of burden and stress about the baby and the ability to be a good parent
- Rapid heartbeat and/or rapid breathing. Chest pain, especially if the anxiety takes the form of panic attacks
While postpartum anxiety is closely linked to postpartum depression, with 50-75% of mothers with PPD also showing signs of PPA, it is important to note the additional disruptive symptoms of PPA and be vocal with healthcare providers and loved ones about any feelings or actions that are not normal, no matter how insignificant the changes may seem.
Mental Health Care Planning
Just like CPR training, birth classes and meal prep, incorporating mental health care into postpartum care is a great way for new moms and loved ones to prep for the massive life change coming their way. Here are some tips to do before the baby arrives:
Find A Therapist or Counselor
Women usually take the time to find an OB/GYN that they feel comfortable with even before they get pregnant. Someone that knows them and their bodies. Why not take the time to find a therapist that knows you before you deliver a baby? This way you may feel comfortable enough with them to share your feelings and not just out of necessity. Go see the therapist before you deliver. If nothing else, think of it as adding a little “me-time” to focus on yourself for 45-55 min. And definitely schedule a postpartum appointment 2-3 months after your delivery.
Keep the appointment
Go to that postpartum appointment with your therapist. Even if you’re feeling like you’re on top of the world and you got this parenthood thing down, keep the appointment. Undoubtedly, those first few months have been hard. Whether it’s a colicky baby or intrusive in-laws, and everything in between, take the time for yourself and sit down with someone that will focus entirely on you. Give yourself a break. Talk to someone that will listen.
Commit to listen to your loved ones before birth
More often than not, your partner, family and friends will notice if something is off or if your baby blues are lasting beyond the two weeks. It may be intimidating for them to share their concerns with you, especially during a highly emotional time. This is risky for you and the baby. Protect your health and that of your baby by giving your loved ones permission to speak to you and go with you to the therapist or doctor. Share the list of warning signs of postpartum concerns with them during pregnancy. And most importantly, commit to listening and acting on their concerns.
Find Your Tribe
Sometimes all you need is for someone to listen or to validate your concerns. And when you’re pregnant or a new mom, you may want someone that has shared your similar path. Someone that you can text a picture of some abnormal looking spit up at 3am to see if it’s normal or someone that can tell you if something is not. Find that someone or multiple someones to be your tribe. Whether it's a friend or someone you meet in a support group, don’t be shy. Start reaching out to them. They’ll probably appreciate it more than you know.
Ask for Help/Take the Help
Ask for help and/or take the help when it is offered before the baby even comes. Friends and family really do want to help but often when the baby comes it may be overwhelming to figure out one more thing. So why not confirm helpers before the baby arrives? Make a list of people who have offered to help and share that list with your partner. For example, if you already know that you have a doctor’s/therapist’s appointment scheduled, go ahead and confirm someone to watch the baby. Need something from the grocery store or pharmacy? Don’t hesitate to ask. There is no medal for doing everything on your own. There is, however, a better version of you as a parent if you are taking care of yourself and getting the help you need.
Resources for Expecting and New Moms on Maternal Healthcare
Postpartum Support International
National Child and Maternal Health Education Program
Maternal Mental Health Now
Let’s continue the conversation over on our Instagram, @shop_larken. Share your postpartum mental health journey.
As always, our content is based on personal experience and is not medical advice. Please consult your doctor and health team for medical advice.