Postpartum

Spotting the signs of postpartum depression and anxiety

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hether you’ve just had your first baby or your third, you probably have so much going on that it’s hard to know what is a normal amount of stress. You’re feeding, changing, rocking, singing, and cajoling around the clock. You’re eating a banana, nursing, and reading a parenting blog on your phone all at the same time (oh, and you’re in the bathroom). And don’t forget, the kitchen could use some work…

This is a stressful time, and it’s normal to feel overwhelmed, worried, tired, and moody. That being said, it isn’t normal to feel like there’s no escape from these emotions – to feel like your old self has been lost and that you are trapped with no way of getting on top of things. It is not normal to feel no hope or enjoyment, to be angry all the time, or to be unable to sleep, even when you’re exhausted and your baby is asleep.

There are some incredibly unhelpful (and contradictory) myths about postpartum depression, anxiety, and new parenthood in general floating around out there:

  • It is a blissful time of boundless joy and snuggliness, and all moms love it
  • You will instantly bond with your baby and feel nothing but love for him or her
  • You will instinctively know how to be a mother from day one
  • It is intensely difficult, miserable, and full of stress, and you just have to learn to deal with it

In my experience, the truth is somewhere in the middle, and the mixture is different for every new parent. It’s important to remember that no new mom feels completely blissed out all the time – but it also isn’t normal to be struggling all the time.

Normal feelings new parents experience

So, now that you know the myths, let’s talk about the facts. The normal period of emotional upheaval in the first few weeks after having a baby is known as “baby blues,” and technically affects about 85% of new moms. Frankly, I think that the number is more like 100% of new moms. I have yet to meet a mom who describes her transition into motherhood as smooth and unmemorable.

Here are some normal things you might experience during your first month as a new parent:

Feeling tired and drained

All new parents struggle to get enough sleep; plus, even if you are getting enough hours of sleep, broken sleep (getting up every few hours) is less restorative. Newborns require a lot from you physically: soothing, feeding, and holding them is draining. This gets better with time, and if you find that most of the time you can sleep when your baby is sleeping, and you are eating healthy food regularly, these are good signs.

Feeling a lot of mixed emotions, with periods of crying

This is likely the biggest life adjustment you have experienced to date. You’re trying to comprehend what being a parent means to you, the loss of your freedom, and the loss of your old identity. It may be that parts of this process have not been like you thought they would be, whether in pregnancy, birth, or after.
Physically (no matter your method of delivery), your body is trying to heal and recover, and is experiencing a rapid hormone dump. When you are pregnant, the levels of hormones such as estrogen, progesterone, and endorphins (endorphins make you feel good and reduce anxiety) slowly increase in your body throughout the pregnancy. After you give birth the level of these hormones drops quickly, which can contribute to feeling pretty awful emotionally.

Feeling overwhelmed and anxious (but you can be reassured)

There is a lot to learn in a very short period with a new baby. If this is your first baby, you’re trying to figure out how to know what they need, when they need it, and how to provide it. If this is not your first, you’re learning how to care for a newborn (who may have a different temperament than your first) and still care for and interact with your older kid(s) at the same time.
It’s also normal for new parents to have anxiety about their baby’s health, feeding, and sleeping. It doesn’t help that we live in a society that tends to reinforce these fears by plastering warnings on everything and making all parenting decisions sound like life and death. These feelings are normal as long as they are not constant and other’s peoples’ assurances help to calm you down.

Change in appetite

It is common for new moms to experience a change in appetite. Breastfeeding moms need to be taking in more calories to support milk production. Often, the business of being a new parent means that you forget to eat, so fluctuations in appetite are normal (but try to remember to eat, it will help your mental and physical health).

Some loneliness and feeling isolated

Being a parent of a newborn is an isolating experience. It can be a logistical nightmare to get a baby out of the house. Also, your friends and family may not be in a similar stage of life and aren’t always aware of the challenges of getting out as a new parent. It is harder during this time to see people and go to social events.

Frustration with others

Lack of sleep, being uncomfortable physically, and the unpredictable nature of newborns (crying for 4 hours straight must be some kind of record) all make it easy to feel frustrated at yourself, your partner, and your newborn.

The important thing to remember about these symptoms is that they should come and go, start getting better after a few weeks, and go away entirely by about a month after having your baby.

Signs of Postpartum Depression and Anxiety

So, when is it not normal? I want you to remember something important here: you know you better than anyone else – if things feel off and you don’t feel like yourself and haven’t for quite a while, trust yourself.

There isn’t a magic tipping point where you suddenly qualify for help because now you are struggling enough. If you are struggling and you feel like you could use some help, that’s all that matters.

On the other hand, many moms are so preoccupied with the business of being a parent that they don’t notice that something’s off, or they don’t feel like they can take the time to examine their own needs. Often, it is your friends and family who notice that you don’t seem like yourself. If you are struggling, talk to the people who are close to you and really listen to what they have to say – they care about you and want you to feel well.

These are some signs to pay attention to and that may indicate that you are dealing with more than the baby blues:

Extreme fatigue and difficulty sleeping

You will be tired as a new parent, but if you’re finding that you can’t sleep, even when the baby is sleeping and even when you are exhausted, that is cause for concern.

Intense mood swings and persistent negative emotions

If you are experiencing mood swings that are very dramatic (for example, screaming at your partner, quickly followed by dissolving into tears), feeling angry or deeply sad most of the time, or crying for hours and feeling like you can’t stop, all of these can be signs of needing additional support.

Lack of interest in the things that you used to enjoy

It’s important to pay attention if you are finding that nothing gives you pleasure anymore and there doesn’t seem to be anything that motivates you to get out of bed each day.

Feeling trapped and as though things will never get better

Every new parent feels stuck and discouraged at times; however, if you are finding that you can’t see any way through your current problems and feel like there is no hope that things will ever improve, it may be time to reach out for more help.

Scary, repetitive, and intrusive thoughts

Most people, and especially new parents, have occasional scary thoughts that pop into their heads, but they are brief and go away quickly. It isn’t normal to have scary thoughts that pop up all the time, intrude on your life, and cause you to change your routine (for example, checking on your baby every 10 minutes while she is sleeping, or never taking your baby up a flight of stairs).

Please note: you are not going to lose your baby simply because you have had scary thoughts about hurting him or her, but it is important that you see a mental health professional so that you can talk through them and get some peace and relief. If you are seriously concerned that you actively want to hurt yourself or your baby, then it is important to call 911.

Any persistent negative, uncomfortable feelings that last beyond the first month and don’t seem to be getting better on their own are a good reason to seek help.

How to deal with Postpartum Depression and Anxiety

If any of this resonates with you, I want you to understand: postpartum depression and anxiety are very treatable. With help, you will get better. In the meantime, here are some suggestions to take care of yourself (attention all mamas, these are useful tips no matter how much you are struggling!) and to get the support you need:

  • Try to sleep whenever you can, and if that isn’t possible, at least take some down time to rest. I know this point gets hammered a lot, but it’s for a reason: sleep is a significant contributor to mental health. If you are exhausted it is tough to regulate your emotions and think rationally
  • Eat nutritious food regularly, especially if you are breastfeeding, and even if you aren’t particularly hungry. Bananas, cheese, yogurt, nuts, and protein bars are good, quick, snack options. Avoid things like alcohol, caffeine, and snacks that are high in sugar.
  • Get outside. Go for a walk around the block or sit outside with your baby (as weather permits). Even just a few minutes spent getting outside and moving around can help your mood.
  • Let people help you when you are overwhelmed. Chances are that your family and friends want to support you, but they may just not be sure how to do that. Ask people to do specific things for you like cooking a meal, taking out the trash, or running errands. If you need a break from you baby, ask for that. Ask for what you need.
  • If you are worried about how you are feeling, tell someone you trust. You are not alone, and you don’t have to get through this all by yourself. Enlist the emotional support of at least one person you love and who loves you.
  • Find the right help resources for you. There are many ways to get help if you are struggling after having a baby. My recommendation is to join a support group in your area for new moms/dads and find a good therapist or psychiatrist who you feel a connection with. If you feel overwhelmed by finding someone to help, a good place to start can be your OB/GYN, pediatrician, or primary care doctor.

Having a new baby is a wild and fascinating journey, but it is not meant to be a time of constant misery and struggle. You deserve to be well and whole enough to climb all the mountains and enjoy the views from the top.

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