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‘Baby blues’ may signal serious health issues

Source: The Columbian
Published: November 9, 2015

For many people, the birth of a baby is a time of joy and excitement. But for some women, those feelings may be accompanied by anxiety, sadness and, in some cases, depression.

Many women — anywhere from 40 to 80 percent — experience postpartum blues, or “baby blues,” after delivering a baby, said Lauren Andronici, a certified nurse midwife at The Vancouver Clinic. But some women — 8 to 15 percent — experience more severe, persistent symptoms leading to a diagnosis of postpartum depression, she said.

And while feelings of sadness are common, women may struggle to admit their feelings or seek help.

“There’s a perceived social expectation of a new mom to be so happy and thrilled with their new baby,” Andronici said. “They’re more reluctant to admit their symptoms because of social pressure that every new baby should make you thrilled.”

“I want to make sure they know they’re not alone, and this is common,” she added. “There is help, and they will feel better.”

A woman experiencing postpartum blues will have mild symptoms that appear within the first couple of days after delivery and last a couple of weeks. Those symptoms include increased crying, feeling overwhelmed, sadness, irritability and mild anxiety.

“The majority of women have some component of postpartum baby blues,” said Dr. Stella Dantas, an OB/GYN at Kaiser Permanente. “With the hormonal changes, the lack of sleep, everyone is bound to experience some turbulence with their mood.”

When those symptoms persist beyond a couple of weeks, that’s when clinicians worry about postpartum depression, Andronici said.

Postpartum depression is a mood disorder women experience one to 12 months after the birth of a child.

Women with postpartum depression will feel overwhelmed, guilty, inadequate and unable to care for their baby. They’ll likely experience mood changes, increased irritability and anxiety. And they may not be eating, not sleeping when they have the opportunity to and have a general sense of sadness that doesn’t go away.

“These are women who are struggling,” Andronici said.

Providers go over the symptoms of depression with women, but Dantas encourages partners and family members to watch for changes, too. Sometimes, women may begin to slide into depression and not recognize the signs themselves, she said.

It’s normal for women to feel a little more weepy — tearing up during a TV commercial, for example — or emotional, Dantas said. But when they can’t shake their sadness, or begin to lose interest in their baby or other things they used to enjoy, it’s time to speak up, she said.

“You know your partner, you know your family member, enough to see when things are changing,” Dantas said. “It’s better to ask than not ask and have it be too late.”

Some women are at increased risk for postpartum depression. Risk factors include a history of depression — either before pregnancy or a history of postpartum depression — a family history of depression, having a weak support system, financial hardship and experiencing increased stress.

In very rare cases, women may develop postpartum psychosis, which is “very different than postpartum depression,” Andronici said.

Women experiencing postpartum psychosis begin hearing or seeing things that aren’t there and have thoughts of harming themselves or their babies.

“When you see someone going through that, that’s an emergency, in my opinion, and you need to seek immediate help for that person,” Dantas said.

Both Kaiser and The Vancouver Clinic screen all of their new moms for postpartum depression using a questionnaire. The goal, the providers said, is to catch symptoms early and connect women with the appropriate resources.

Some women improve with additional support, such as counseling or talking with family members. Providers also can help women develop plans to focus on their sleep hygiene and increase their physical activity, which can help boost mood, Andronici said.

For some women, antidepressants may be necessary for six to 12 months, Dantas said.

Finding other new moms with whom they can connect — whether through postpartum group visits, baby groups or mommy exercise groups — also can help women to normalize the feelings they’re experiencing, Dantas said.

“I just really encourage people to not isolate themselves when they’re postpartum,” she said.

The more postpartum blues and postpartum depression are normalized, the more likely women will be to seek help, Andronici said.

“In a culture where we head back to work right away, our new moms have a lot of pressure on them to be a certain way,” Andronici said. “We need to support our mothers.”