Here comes a tough topic. 80% of women experience a change in their mental health after having a baby. That’s right. Postpartum depression is the most commonly known, but did you know there are other things to watch out for?
I went to the Maternal Mental Health Conference recently and learned so much about this topic, but it’s been really hard to write about it, because there is so much ambiguity and misinformation. Maybe we hear about baby blues or postpartum depression so much that we think it will probably happen to us and make us miserable. Maybe we only hear about how wonderful and cute babies are, and so are left unprepared for rocky starts. Almost all of us have some struggles right after having a baby. Any new big life transitions are challenging. Keeping that in mind, know that it IS temporary, that it can ALSO be wonderful and magical, and that you can help things go more smoothly by doing some things for yourself.
Here is some other good news. There are risk factors to look out for when talking about the more severe postpartum mood disorders, so check that out and you might feel better. Early detection and intervention can make a big difference, and there are a lot of resources out there to help.
A “change in mental health” can mean a lot of things.
The Baby Blues
Most of us get a bit of this. Within a few days after giving birth you might experience:
- feelings that things are a little more out of your control than usual.
- that your emotions are really close to the surface and seem kind of erratic.
- weepiness or crying for no apparent reason
- restlessness
- some anxiety
- fatigue
- trouble sleeping (even when the baby is sleeping)
- sadness
- trouble concentrating
This is all pretty darn normal. Of course you’re fatigued. You’re having trouble sleeping with a new baby and your body is recovering from birth AND doing new and wild things. You’re anxious. Who wouldn’t be a little anxious? Maybe we’ve never been responsible for a new baby, or for a new baby PLUS our older kid(s). There are some things to work out and get used to. Sadness and irritability are normal. It’s hard to be perfectly happy and content when you’re sore, tired, sleep deprived, leaking, and adjusting to a very new life and hormones.
We get through the “Baby Blues” with a little time, nutritious food, rest, and support from family and friends. It helps to know that you will likely experience some of this and that it will pass quickly. It also doesn’t mean that you can’t find real bliss in those special moments with your new baby and new life.
Postpartum Depression (PPD)
Postpartum depression is NOT the Baby Blues. ONLY about 15% of women experience PPD. Some of the symptoms seem very similar, but they are more severe and they last much longer, especially without treatment. The Pregnancy & Postpartum Health Alliance of Texas is a great resource and lists these warning signs of PPD:
- Anger or irritability
- Lack of interest in the baby
- Eating too much or too little
- Sleeping too much or too little
- Crying and sadness
- Feelings of guilt, shame, or hopelessness
- Feeling like life is not worth living
- Loss of interest, pleasure, or joy in the things you used to enjoy
- A general feeling that something is not right
- Possible thoughts of harming yourself or the baby
The Edinburgh Post Natal Depression Scale (EPDS) is a quick and easy test to try if you suspect you might be suffering from depression. Your doctor or midwife will likely be asking you questions to determine your risks, but sometimes symptoms appear after you’ve completed care, so you will need to watch out for yourself or ask a loved one to be on the lookout for symptoms.
Postpartum Anxiety
And now here’s another even more rare condition to watch for. Postpartum anxiety might include some or all of the symptoms of depression, but other symptoms will take center stage. You might feel constantly worried, have trouble sitting still, have racing thoughts, feeling of dizziness, hot flashes or nausea, and possibly even panic attacks which can feel like you’re having a heart attack. Panic attacks are really scary, but essentially harmless. Try to remember that if you’re having one.
Postpartum Obsessive-Compulsive Disorder (OCD)
This is very rare and can be pretty scary if you don’t know about it. You can get this whether or not you had OCD before you were pregnant, but it’s definitely more likely to show up if you’ve had trouble with OCD before.
This disorder is characterized by unwanted obtrusive thoughts that are often very scary and have no basis in reality. Often the thoughts are of the mother harming her baby or of germ contamination. When a mother has these thoughts, she is not purposely hurting her baby. In her imaginings, things just happen, and she has no idea how and has no control. For example, she is at the top of a staircase and imagines that her arms just drop the baby down the stairs. She may not be very willing to go near staircases if she is experiencing these thoughts. It is very troubling and terrifying, especially when she doesn’t know that she won’t actually hurt her baby and that she is just experiencing a postpartum mood disorder. I REPEAT… Women with this disorder don’t actually hurt anyone.
She might feel like she will let something bad happen to her baby as a result of irresponsibility, so she might respond by checking on her baby obsessively or by obsessively cleaning and removing potential dangers from their environment. This usually comes on in the first 6 weeks postpartum, but is very rare, occurring in less than 3% of women. You should know that many of us experience some of these sorts of thoughts and feelings sometimes, and this can be very normal. For a woman suffering from OCD, these thoughts and feelings take over.
Postpartum Psychosis
This condition is SUPER RARE occurring 1-2 times out of 1,000 postpartum women. This is the scariest. Women with this condition become irrational, confused, disorganized, delusional and are at risk for hurting themselves or others. Early symptoms include extreme restlessness, irritability and insomnia. Onset of symptoms usually occur within the first 2 weeks but can start later. Recent evidence suggests that many of these cases are actually manic episodes of already established bipolar disorder. So, if you have been diagnosed with bipolar disorder, make sure you talk to your doctor about how to manage your medications while pregnant and postpartum.
What do I do if I’m having these symptoms?
- If you are experiencing some or all of these symptoms, TELL SOMEONE. Get help. It will very likely make a huge difference in the way you feel and make for a better outcome.
- Find support groups. There are probably some near you, or try some online resources such as the FREE service Daily Hope for daily inspiration and support from Postpartum Progress.org.
- When medications become necessary, take the time to learn about your options. There are many that do not interfere with breastfeeding, so you can feel comforted that you will be doing the right thing for both you and your baby. Try a site like LactMed, a searchable database that provides information about medicine and breastmilk. There are plenty of medications that do not affect your milk or your baby. Mommymeds is another great site and has a mobile app that can help you determine which meds are safe.
Can I do something to prevent this?
There are some things you can do to lower your risks. This is not a guarantee, but being proactive can definitely help you make the most of this time, even for the most of us who don’t experience a mood disorder.
- Organize postpartum help for yourself while you’re pregnant.
- Set up a house cleaner for your first couple of months.
- Ask friends and neighbors to bring meals, help with laundry, walk your dog, watch your older kid(s), etc.
- Ask a helpful mother or sister or someone close to you to come stay for a little while.
- Hire a postpartum doula.
- Consider an overnight doula or night nanny or loving family member for help with sleep.
- Set up grocery delivery for a little while.
- Ask a friend to set up a meal/help calendar site so your loved ones have a concrete way to extend help. Or set one up for yourself! People who want to help love this. CareCalendar.org or Lotsa Helping Hands are 2 sites that make it easy.
- Simplify your life while you’re pregnant. Even small things can feel overwhelming right after you’ve had a baby. Set yourself up to take it easy.
- Get rid of extra stuff you don’t need. Remove clutter.
- Make and freeze some meals. Maybe you could organize a party of friends to spend a day doing this with you.
- Get your calendar in order. Make sure all of your important appointments, etc. are on there. THEN…..
- Cancel classes, trips, events, parties, anything that might be unnecessary and hard to do postpartum.
- Have your baby supplies ready. I think it’s a great idea to create a baby registry with a mama friend who you admire. She might help you simplify by giving you advice on what you might or might not need for your baby.
- Maximize your bond with your baby. Better bonding can create Oxytocin which gives us better feelings. Oxytocin is a very powerful hormone and can give you some immunity against bad moods.
- Have as much skin to skin contact as possible with your baby.
- Breastfeed on demand.
- Gaze at your baby (it might be hard not to!).
- Spend plenty of time in bed with baby and whoever else might like to join you.
- Eat good food. Evidence suggests that the most powerful thing you can do contribute to your good health and baby’s during pregnancy and after is to nourish your body with good food. That doesn’t mean that eating well guarantees a perfect outcome, but it is something very concrete that you can do to lower your risks for certain complications AND to make you feel better.
- Prepare for birth. I’ll admit I’m biased towards natural childbirth. There’s some evidence that the hormones produced during a physiological birth can prime your body and your baby’s for an easier transition. It can also be a very empowering experience when you’re fully immersed in it.
But anything can happen, so don’t get hung up on a particular birth experience. You might be preparing for and dreaming of a water birth at home, and life conspires to change your plan to a cesarean birth in the hospital. Or maybe you wanted a very well scheduled birth in the hospital with an epidural and plenty of rest, and life gave you a super fast, spontaneous, and wild car birth. These changes of plans can cause serious trauma for some women.
I think that being prepared for birth means having your own intentions, but then letting them go and remaining open to the flow of life. If you can feel good about the birth experience you have, whatever it is, you are less likely to encounter some of the hardships postpartum.
Please remember this very important piece of information. Even with great preparation and health, you will probably experience some hard stuff, and it’s likely that you will even see that you have some of the symptoms listed above. But the odds are that it’s just transitional. You’re most likely experiencing normal stuff that comes with such big life (and body) changes. Talk to people….especially other women who have been through this. Ask for help if you suspect something more.
Author Info
Well said! I love you!