According to the American Pregnancy Association, most women experience mood swings and negative feelings shortly after giving birth. It’s sometimes referred to as the “baby blues,” and it affects 70%-80% of mothers. It usually strikes four to five days after you bring your bouncing little peanut into the world.
With the baby blues, you find you are irritable or impatient. You are restless, anxious, or sad. Fatigue, insomnia, mood changes, and an inability to focus may trouble you. Feelings most of us women are no stranger to; we do have that whole "monthly friend" that comes to visit. We know what it's like to find ourselves crying at small provocations or for no reason at all; pet commercials, hallmark movies. These symptoms can bother you a few minutes up to a few hours each day.
You can manage these symptoms by taking care of yourself, talking with others about what you’re feeling, asking for help in some of the new tasks you’re dealing with, eating a balanced diet, and taking breaks now and then. The baby blues usually go away in two weeks.
Beyond the Baby Blues
Unfortunately for some women, the baby blues persist beyond two weeks, or if the symptoms intensify markedly, we should be a bit concerned and if this happens to you, seek medical care as soon as you recognize what's happening with you. It is possible you may have postpartum depression (PPD), which occurs in 10%-20% of mothers. Best to call your provider as soon as the concern sets in.
PPD is a major depressive disorder. It includes all the symptoms of clinical depression, plus anger, fear, or extreme guilt. It can include obsessing over whether you’re an adequate parent or feelings of disconnection from your baby. It will likely also feature difficulty sleeping even when you’re exhausted. PPD sufferers generally feel as if they have no control over their lives, and without treatment the condition can potentially last for about a year.
Calling Attention to Symptoms
PPD often goes misunderstood and unrecognized, therefore untreated. The vast majority of new mothers experience the baby blues, so everybody around you — even your medical providers — will probably assume that your feelings are both normal and temporary. They downplay your concerns or don’t listen to them at all. But PPD doesn’t usually go away on its own. Treating it may require counseling and medication. And getting attention for the condition sometimes requires you to freak out. You don’t need to take my word for it. Our newest doublesolid ROCKSTAR had such an experience. Find her raw, honest and inspirational story among our stories of struggle and strength.
If you have a history of anxiety or mood disorders, you’re more likely to develop PPD. And if you’ve experienced PPD with a previous birth, you have a stronger chance of experiencing it again. But don't let that scare you, the help is out there so if you have a concern go ahead and get your village set-up to prepare just-in-case. Connect with your providers, your trusted friends and family and let them know of your concerns. Do not keep them to yourself. The self-awareness one needs in order to prepare for the effects of anxiety or depression, in our opinion, only helps us to grow and understand ourselves; making the next struggle just a tad bit easier to get through.
Beyond Postpartum Depression
PPD is vicious, but postpartum psychosis has an even more horrible grip. Fortunately, it is fairly rare, affecting 1-2 mothers in 1,000. Its rarity is a good thing, because 10% of cases result in suicide or infanticide. According to the Mayo Clinic, postpartum psychosis symptoms usually develop within a week after birth. They can include confusion and disorientation, obsessive thoughts about the baby, delusions and hallucinations, sleep disturbance, agitation, paranoia, and attempts at self-harm or attempts to harm the baby.
According to Arizona Behavioral Associates (a therapy practice), there are about a half dozen risk factors for postpartum psychosis. These include previous postpartum psychosis, bipolar history, prenatal stressors (such as lack of social support or a lack of a supportive partner), obsessive personality traits, and family history of mood disorders.
There is some evidence that about half of mothers with postpartum psychosis experienced symptoms during pregnancy. If you are worried, you should talk with your doctor or midwife even before the birth. A CDC task force recommended in 2020 that providers begin screening patients for signs of PPD during pregnancy. So don’t wait until delivery to voice your concerns.
You are unlikely to overcome PPD by yourself. The most important thing you can do is ask for help. Don’t let your family and medical providers brush you off. Keep asking for help until you get it. Be your best advocate!
Cover art by Chad Wheeler, tattooist and resident artist @singleneedle
DOUBLESOLID’s ROCKSTAR, Carolina, shares her mental health journey through Postpartum Depression here.