Postpartum Depression FAQ

Postpartum depression (PPD) can be scary, confusing and overwhelming, but hope and help are available.

Postpartum depression (PPD) is characterized by the onset of profound sadness, anxiety and fatigue at any point during the first year following childbirth. Being worried, unhappy and stressed for a brief period after the arrival of a new baby is perfectly normal. These feelings are often referred to as “baby blues” and they usually subside and become less severe after a short time.

When these feelings become intense and persistent, postpartum depression may be the cause. If you feel you may be suffering from a postpartum mood disorder, seek help from your obstetric of family provider. Below you’ll find some of the more commonly asked questions related to PPD.

Is postpartum depression common?

Absolutely. According to the American Psychological Association, as many as 1 in 7 women experience it, and roughly half of those women have no prior history of depression. When you’re struggling through PPD, it can be comforting to know that you are not alone, and many others have been down this path before. Lots of moms are experiencing the same symptoms.

What are the symptoms of postpartum depression?

 A wide range of symptoms vary from patient to patient, but some of the more common ones are:

• Feelings of intense sadness and hopelessness
• Severe anxiety or obsessive worrying
• Withdrawing from social interactions
• Changes in appetite (overeating or not eating enough)
• Insomnia or sleeping too much
• Feelings of guilt and worthlessness
• Loss of interest in activities previously enjoyed
• Difficulty bonding with the new baby
• Thoughts of self-harm or harming the baby (intrusive thoughts).

What causes postpartum depression?

While a single cause cannot be identified, psychologists think postpartum depression results from a combination of physiological and emotional factors. Right after birth, two key hormones in a woman’s body, estrogen and progesterone, drop rapidly.

This sudden change can have a profound effect on mood and overall feelings of wellbeing. Plus, a sleep-deprived routine of caring for a baby can leave any new parent feeling stressed, inadequate and overwhelmed.

Remember, postpartum depression is not your fault. It is an emotional and physical response to a significant life event.

How long after the baby is born can postpartum depression develop?

It’s important to clear up the common misconception that postpartum depression only occurs immediately following childbirth. While the onset can happen within the first four or five days following birth, it can occur anytime during your baby’s first year.

What’s the difference between postpartum depression and “baby blues?”

The so-called “baby blues” is a brief period of time right after birth when a new parent experiences feelings of worry, fatigue and general unhappiness. These are very common side effects of adjusting to the arrival of a new baby, and the majority of new mothers will experience some form of the “baby blues.” Postpartum depression however, carries a much more intense set of emotions that persist over a longer period of time (more than a few weeks).

I’m having disturbing, unwanted thoughts about hurting my baby. Is this normal?

The psychological term for this is “intrusive thoughts,” and when PPD is accompanied by these thoughts it’s often referred to as postpartum OCD (obsessive compulsive disorder). A study conducted by the Journal of Reproductive Medicine found that up to 11 percent of women may experience symptoms of postpartum OCD.

It’s very important to remember that in most cases these thoughts are merely a passing symptom. These thoughts frequently revolve around the baby, but sometimes thoughts of self-harm or harm directed at a partner or family member may arise. Oftentimes patients experiencing these uncomfortable thoughts will imagine that they are losing their mind. They think a good parent couldn’t possibly have monstrous thoughts such as these.

Actually, these feelings of concern are proof that you are not in fact going crazy. Remember, you are not your thoughts. These are just symptoms being manifest by your brain, and they, too, will pass.

What is postpartum psychosis?

Postpartum psychosis is a rare postpartum disorder in which a woman experiences delusions, hallucinations, hyperactivity, extreme mood swings, and other intense symptoms of psychological unrest. According to Postpartum Support International, the disorder occurs in 1 to 2 out of every 1,000 births. Women with a history of bipolar disorder or psychotic episodes are at an increased risk of experiencing postpartum psychosis.

While this is a serious condition requiring professional help, it is treatable. Women who suspect they are experiencing postpartum psychosis are advised to contact their physician, or dial 911 in an emergency situation.

Where can I get help?

Contact your obstetrician or midwife if you think you are experiencing symptoms of postpartum depression, OCD or psychosis. Your providers can help diagnose the problem and connect you with the appropriate resources.

At University of Colorado OB-GYN we have a special resource called the PROMISE Clinic that was established specifically for women experiencing mood disorders during pregnancy and following the birth of a child. PROMISE stands for Perinatal Resource Offering Mood Integrated Services & Evaluation. Our team of specialists at the clinic develops a comprehensive treatment plan tailored for each patient based on specific symptoms, risk factors and medical history. For more information on the Promise Clinic, contact us online.

What can I do if I need help right now? 

If you are in crisis or experiencing symptoms that may be putting you or your baby in immediate danger, you are advised to either dial 911, go to the emergency room, or call the National Suicide Prevention Hotline at 1-800-273-TALK.

What things can I do to get better?

Anyone suspecting they may be experiencing PPD should schedule an appointment with a doctor for professional diagnosis and care. Sometimes counseling and/or medication are advisable treatment options, and your physician can help you determine what’s best for your specific situation. PPD sufferers can do a few things on their own that will help ease symptoms and expedite recovery:

• Sleep. First and foremost, get plenty of rest. This may seem impossible with a newborn baby, but if you’re able to find a friend or family member to help out so you’re able to sneak in a few extra naps here and there, it will go a long way.
• Talk it out. Be open and honest about your thoughts and feelings. Remember that there is no shame in what you’re experiencing, and that many have gone through this. You may even find it helpful to seek out an online PPD support group or message board.
• Exercise. Just a simple walk around the block can be especially beneficial for the brain. But do be sure and check with your doctor before starting an exercise routine, especially if you’ve just recently given birth.
• Go easy on yourself. At this point in time, you should direct your focus toward your recovery and wellbeing. Try not to feel guilty that you aren’t doing more. Set realistic, modest goals as you care for yourself and your new baby and practice the art of self-compassion.

How can I support my partner or family member while they go through postpartum depression?

Partners, close friends and family members can play pivotal roles in helping PPD sufferers on the road to recovery. Here’s what they can do:

• Seek out help for you. Oftentimes, close family members are the first to notice that something may be wrong. If you suspect that someone you love may have symptoms of PPD, you can assist them in scheduling an appointment with a doctor, and help them follow through with the doctor’s recommendations.
• Listen. It’s important for anyone experiencing PPD to be open and communicative about how they’re feeling and what they’re thinking. Be that listening ear for them.
• Lend a hand. One of the common symptoms of PPD is feeling overburdened by all of the new tasks and expectations that accompany the arrival of a baby. Offer to share some of the workload, and help your partner or family member set realistic goals and expectations when it comes to these new responsibilities.
• Keep things in perspective. Remember that these symptoms and struggles will only be around for a season. While you may wonder if your loved one will ever return to her or his normal self, you have every reason to believe in a full recovery. If you don’t, that will be apparent to your loved one and that may make things worse.

How are postpartum mood disorders treated?

Each mom will need an individualized care plan, but common treatments include psychotherapy, lifestyle modification and medication. Many new moms are reluctant to seek help because they fear taking medication while breastfeeding will harm their infant.

This is a common misconception that can be clarified with your provider. It is important to recognize that early intervention leads to faster and easier recovery. Don’t wait to ask for help.