Your baby has been born! Congratulations! Over the past 40 weeks, your body has done something amazing to accommodate and grow new life, and now your little one is finally here. But what do you do if it doesn’t feel like you expected it would? One minute you’re elated—you can’t get enough of those tiny coos and sighs. The next minute, you’re crying for no apparent reason. What’s going on? Maybe you’ve heard about postpartum depression, but you’re not sure if that’s what you’re experiencing.
It’s normal for your emotions to go up and down after having a baby. After all, your body is undergoing some major hormonal shifts. Plus, your life is completely different: you have a tiny person who needs ’round-the-clock care. And to say you’re tired is an understatement!
People have described that emotional rollercoaster and feelings of sadness after pregnancy as “baby blues.” They typically last a few days to a couple of weeks after giving birth.
However, if you’ve been feeling low for six weeks or longer after giving birth, you may have postpartum depression. Postpartum depression is a minor or major depression that develops in a woman within the first twelve months after giving birth to a baby. It is not caused by something you did or didn’t do—it can affect any mom. In fact, it’s estimated to affect 10-16% of moms in the U.S.
Seek help if you’re feeling low or sad, even if you think it might just be a longer-than-average case of the baby blues. We would rather you talk to us about it so we can help you. If you are diagnosed with postpartum depression, your OBGYN can prescribe treatment so you can feel better.
Symptoms of Postpartum Depression
The signs and symptoms of postpartum depression (PPD) are very different from one woman to the next, even from one pregnancy to the next. They include:
- Depressed mood
- Feeling sad, restless, hopeless, or overwhelmed
- Loss of interest or pleasure in things you used to like
- Change in appetite — eating too little or too much
- Sleep changes — unable to fall asleep easily, unable to stay asleep, or sleeping too much
- Very low energy or motivation
- Memory, focus, and concentration problems
- Having a hard time making decisions
- Feeling jittery, or moving too slowly
- Feeling worthless, guilty, or like a bad mom
- Not feeling connected to your baby
- Having thoughts about hurting your baby
- Having thoughts about hurting yourself or that your baby would be better off without you
- Suicidal ideation or behavior
Is it Baby Blues or Postpartum Depression?
What differentiates PPD from baby blues is when it begins, how long it lasts, and how it affects daily functioning. The baby blues (feelings of sadness, up-and-down emotions, crying) are normal but improve within two weeks. They don’t affect your ability to function.
Postpartum depression is more extreme. It can show up any time within the first year of your baby’s life, it lasts longer than a couple of days, and it disrupts your normal life. It can impact your relationships. Postpartum depression needs to be treated by a doctor.
Causes of Postpartum Depression
We don’t know exactly what causes postpartum depression. It could be triggered by hormonal changes. Researchers think the sudden changes in progesterone, estrogen, oxytocin, and thyroid hormones may lead to depression.
We do know that several physiological and social factors are involved and each woman’s case is different. Each pregnancy is different—having postpartum depression once before doesn’t mean you will have it again.
Factors that may affect whether you develop postpartum depression are:
- Genetic susceptibility (Did your mom, sister, or grandma experience it?)
- Hormonal changes (Some women may notice more symptoms after they stop breastfeeding)
- Psychological and social problems
- Stressful life events during and after pregnancy
- Previous pregnancy challenges or delivery trauma
Are You at Risk of Postpartum Depression?
Women with a history of depression are at the highest risk of developing postpartum depression. Some women develop depression during pregnancy, and it persists after the baby is born. Others may have no symptoms during pregnancy. If you have a history of depression or postpartum depression, your OBGYN will closely monitor you during pregnancy and for a few weeks after giving birth.
Other factors that put women more at risk of experiencing postpartum depression:
- Stressful life events during or after pregnancy (such as marital conflict or moving to a new city)
- Poor social and financial support during or after pregnancy
- Young age (<25)
- Single marital status
- Having given birth more than once
- Family history of postpartum depression or psychiatric illness
- Intimate partner violence or history of abuse
- Unintended pregnancy
- Fear of childbirth
- Poor physical health during pregnancy or after delivery
- Anxiety symptoms / disorders during pregnancy
- Sleep disturbance during pregnancy or after delivery
- Giving birth in fall or winter when there is less daylight
- Having a difficult pregnancy or difficult birth
- Having a child with special needs
- Breastfeeding difficulty
- Childcare stress, such as an inconsolable baby, infant sleep disturbance, etc.
Preventing Postpartum Depression
Because there is not a single known cause of postpartum depression, there is also not a known preventative measure. Postpartum depression is not caused by something you did or didn’t do during your pregnancy. You won’t be able to know ahead of time that you’ll experience postpartum depression. It’s impossible to predict potential mood changes after delivery if have no symptoms of depression during pregnancy,
If you do have a history of depression, your OBGYN will closely monitor you during and after your pregnancy. And if you were already being treated for depression with medication, you will discuss your treatment plan during your first prenatal visit.
Treating Postpartum Depression
If you have (or suspect you have) postpartum depression, it’s very important to get treatment and follow your doctor’s care plan. Not treating postpartum depression places you and your baby at risk.
The symptoms of postpartum depression—such as loss of interest, fatigue, and impaired thinking—can affect your ability to function and care for your baby. Untreated PPD is associated with poor nutrition and health for the baby by interfering with breastfeeding. It can also hurt your ability to bond with your baby, care for your other children, and interact with your partner.
The treatment for postpartum depression is based on the severity of your symptoms, your health history, and your values and treatment preferences. The two most common treatments are talk therapy and antidepressant medications. At Madison Women’s Health, we refer our patients to a therapist who specializes in treating postpartum depression.
Finding Support for Postpartum Depression
First of all, these feelings won’t last forever. It will go away, and you will feel normal again. Secondly, you did nothing to cause it. You could not have prevented it.
In many cases, moms who are struggling with feelings of sadness and loss of interest continue providing basic care for their children. They may prioritize caring for their child and family over taking care of themselves. But it is still very important to get help—not only for your family but also for yourself. You will be able to better care for your family if your depression is being treated.
Here are steps you can take to get support for postpartum depression:
- Reach out to your OBGYN or healthcare provider. Every woman is different and has different resources available. Reach out to us at 608-729-6300 so we can help you get the support you need.
- Follow your care plan. If you are prescribed a medication, make sure you take it. If you can’t leave your house to talk to a therapist, ask about virtual care or telehealth options.
- Ask friends and family for help. One in nine women has had postpartum depression. It’s nothing to be ashamed of. Talking to someone else who has gone through something similar can be helpful.
- Join a support group with other moms. Even if it isn’t specifically for postpartum depression, a mom/baby support group can help you see that you are not alone and that other people feel or have felt the same way you do.
Being depressed doesn’t make you a bad mom. Depression is common after pregnancy.
We can help you feel better. Please reach out to us for help. It’s what we are here for!
Stephanie Brasser, APNP, A.P.N.P., joined Madison Women’s Health in 2013, specializing in the provision of care for our patients’ non-OBGYN healthcare needs. Stephanie received both her Master’s Degree and Doctorate of Nursing from the University of Wisconsin-Milwaukee and is certified as an Adult Medicine Nurse Practitioner.