Postpartum Depression: Symptoms & 21 Ways To Increase Well-being As A New Mom

When New Mothers Give Birth, Do They Become Depressed?

It’s estimated that as many as one in seven women experiences PPD (postpartum depression) within the first year after birth. With the annual birth rate being at around 4 million in the US, this could mean that PPD might affect around 600,000 new moms each year. (1)

Recent studies show that the numbers may have tripled amid the COVID-19 pandemic, possibly due to moms’ fears over motherhood, isolation, and getting sick. (2)(3)

PPD isn’t a character flaw or a sign of weakness, mama. It’s a medical condition commonly experienced by new moms. Don’t think it’s your fault.

However, it’s important to seek help if you have or suspect you have PPD because it can make it difficult to care for your new baby or yourself.

You might be asking questions like:

“What are the signs of postpartum depression?”

“How long does it take for postpartum to go away?”

“Why is postpartum so hard?”

“How do I cope with postpartum?”

You can find answers and more information about PPD below.

What’s Postpartum Depression?

PPD or postpartum depression is a medical condition a mom can experience after having a new baby. It’s a kind of perinatal depression (the perinatal period is from pregnancy to two years after giving birth).

Often, PPD happens during the first year after birth, but you can still experience it when your baby is over one year of age.

There are many signs and symptoms of postpartum depression. Still, it’s often associated with strong feelings of sadness, worthlessness, tiredness, or anxiety (worry) that last for a long time after giving birth.

PPD symptoms might begin to show within one to three weeks after your baby is born. Sometimes, it can take longer for the symptoms to appear, but many moms experience it within the first three months. (4)

Signs & Symptoms Of Postpartum Depression

You might have PPD if you have five or more of the following signs and symptoms that last longer than two weeks. (5)(6)

Changes in how you feel:

• Feeling sad
• Crying for no reason
• Having a depressed mood (7)
• Having severe mood swings
• Feelings of guilt or shame (8)
• Feeling of worthlessness
• Feeling panicked or scared

Changes in your daily activities:

• Difficulty thinking, concentrating, and making decisions
• Loss of pleasure/interest in activities you used to enjoy
• Changes in appetite
• Loss of energy or increased fatigue
• Increase in purposeless physical activities (such as pacing, hand wringing, or inability to sit still)
• Slowed movements or speech (severe enough to be observable by others)
• Trouble sleeping or sleeping too much

Changes in your feelings about yourself and your baby:

• Lack of interest in your baby
• Not feeling bonded to your baby
• Feeling very anxious about or when you’re around your baby
• Feelings of being a bad mother
• Fear of harming the baby or yourself (8)
• Thoughts of death
• Suicidal thoughts (9)

When To See A Doctor

• If you have experienced many (at least five) of the symptoms mentioned above for over two weeks
• Your depressed or guilty feelings are getting worse
• Strong thoughts of suicide and/or harming your child
• You’re having trouble taking care of your baby or doing daily tasks

You can find help from the PSI hotline (Postpartum Support International) by calling 1-800-944-4773 or texting “Help” to 800-944-4773 (English) or 971-203-7773 (Spanish).

If you have strong feelings and think you might harm yourself or your baby, you can call the Lifeline hotline (National Suicide Prevention Lifeline) at 1-800-273-TALK (8255) or emergency services at 911.

How Do I Cope With Postpartum Depression?

A mental health counselor can help with PPD. However, there are also other ways to help you cope.

Here are 21 ways to cope with PPD and increase well-being as a new mom:

1. Identifying and reducing your stressors; learn new stress management habits.
2. Finding emotional support from family members and friends.
3. Joining a mom’s support group and learning from their experiences.
4. Getting good nutrition by eating an anti-inflammatory diet.
5. Resting as much as you can (you sleep when your baby sleeps).
6. Move your body mindfully and regularly by practicing yoga.
7. Doing the things you do to relax before you gave birth (such as reading a book, listening to music, taking a walk, etc.)
8. Cultivate a daily gratitude practice for better brain health.
9. Take up a daily meditation practice.
10. Start paying attention to the things that bring you joy, even if for a brief moment.
11. Finding some “me time” (make time to go out and visit your friends or your partner)
12. Learning to ask for help.
13. Practice breathwork.
14. Stay hydrated by drinking at least 1.5 liters of water daily.
15. Accepting that you can’t do everything by yourself.
16. Using essential oils to help improve your mood.
17. Take a quality daily probiotic and eat pre and probiotic-rich foods.
18. Learn how to incorporate mindfulness into your daily life.
19. Studies show that chanting a mantra can help quiet the anxious mind.
20. Don’t drink alcohol because it can be a depressant or interact with your PPD medicine. It’s also important to avoid alcohol if you’re breastfeeding because you can pass it to your baby through your breast milk. (10)
21. Don’t take recreational drugs (such as weed) because these can affect how your body works and cause problems with your PPD medication (and pass to your baby through breast milk). (10)

How Is PPD Diagnosed?

There aren’t specific tests to diagnose postpartum depression. However, it’s a real illness that can greatly affect women’s health. It shouldn’t be taken lightly.

If you’re a new mother who experiences the symptoms or signs mentioned above, seek evaluation by a medical professional.

Your OB-GYN can make referrals to a psychiatrist or other mental health professionals.

To diagnose whether you have PPD, your doctor will make a thorough assessment, including medical and psychiatric evaluations. This can help rule out mental disorders or physical problems with similar symptoms to depression (including vitamin deficiencies and thyroid problems). (5)

PPD Causes: Why Is Postpartum So Hard?

There are many reasons why the period after birth (postpartum) is hard and can lead to depression:

• The birthing process is physically hard on your body.
• You’re exhausted after childbirth, but you also can’t get much-needed rest because your baby’s needs come first.
• You experience many physical changes in your body: hormones, blood loss, nutrient loss, stomach, breast, and metabolism. (6)
• Your body goes through many hormonal changes. The sudden drop in progesterone and estrogen hormone levels can affect your mood and sleep cycle. (7)
• Thyroid hormones might also drop quickly, making you feel sluggish, tired, and depressed. The thyroid gland in your neck produces these hormones to help your body use and store energy from food. (8)

Risk Factors

Some new mothers have a higher risk of depression than others. There are certain risk factors that can make you more likely to experience PPD.

The following are the most common factors that contribute to an increased risk of developing PPD: (9)

• Unplanned or unwanted pregnancy
• You’re younger than 19
• Genes or family history of depression (because parents pass genes to their children, you might have a higher risk for PPD if you have a family member with depression)
• Previous experience or diagnosis of major depression, mental health condition (bipolar disorder), and other mood disorders
• Stressful life events (illness or death of a loved one)
• Sexual or physical abuse
• Problems with your partner (including a recent breakup)
• Being a single mom
• Domestic violence
• You’re unemployed or have low income
• Health problems (diabetes, heart problems, high blood pressure, etc.)
• Limited education
• No financial or emotional support from family or friends
• Smoking, drinking alcohol, and/or using recreational drugs
• Complications in previous pregnancies (premature birth or your baby was born before 37 weeks, congenital disabilities, pregnancy loss, or being pregnant with multiples)
• Trouble breastfeeding or caring for a previous baby (due to the child’s health conditions or because you had trouble adjusting to being a mom)

Having risk factors doesn’t automatically mean you’ll have PPD, but they can increase your chances.

It’s important to consult your health care provider to check if you’re at risk for PPD. Screening during prenatal checkups can help you get early treatment.

Prevention

Screening

The USPSTF (U.S. Preventive Services Task Force) recommends health information and depression screening in pregnant or postpartum women. (11)

Counseling

The USPSTF also recommends counseling or therapy interventions to help prevent perinatal depression (including postpartum depression) in high-risk pregnant women. (11)

A counselor can help you understand what you feel, know your fears, solve some problems, and cope with things that might be bothering your everyday life.

If you have an increased risk for PPD, your healthcare provider can help you get treatment.

Be honest with your doctor about your life, feelings, and pregnancy, mama. They can help you find counselors for treatment.

Postpartum Depression Complications

If left untreated, postpartum depression can affect you and your family:

Effect On Moms

• It can affect your health and quality of life.
• It can progress into chronic depressive disorder.
• It might cause bonding issues with your baby.

Still, even if PPD is treated, it can increase your risk of future episodes of major depression. (8)

Effect On Babies

• It can affect your baby’s well-being, especially if they’re born prematurely, have low birth weight, or have other health complications.
• It might contribute to sleeping and/or feeding problems for your baby.
• It can also lead to poorer cognitive, language, motor, social-emotional, and adaptive behavior development that can extend to adolescence. (12)

How Long Does It Take For Postpartum To Go Away?

Research published in the Pediatrics journal (2020) shows that postpartum depression can persist even up to three years after birth. (13)

As many as 25% of moms still show signs of PPD, leading researchers to recommend maternal depression screening beyond the postpartum period (from pregnancy to two years after birth).

Postpartum Depression Treatment

Family & Social Support

The NIMH (National Institute of Mental Health) recommends seeking family support. Sometimes, family members might recognize the first signs of postpartum depression. (14)

Because treatment is important for recovery, your family can help encourage you to find help, provide emotional support, and assist with daily tasks, including caring for your baby.

The NIMH also recommends seeking help from advocacy groups like Postpartum Support International or finding other support groups to help you cope with PPD.

Psychotherapies

APA (American Psychiatric Association) recommends treating pregnant or breastfeeding women with major depressive disorder using psychotherapy (talk therapy) without medication. (15)

It’s considered the first-line treatment for mild to moderate depression or anxiety.

Common forms of talk therapy used for PPD:

CBT (Cognitive Behavioral Therapy)

• It helps manage your negative thoughts by improving how you think and act.
• Your therapist helps you identify negative thoughts or behaviors and set goals to start thinking and acting differently.

IPT (Interpersonal Therapy)

• It helps you identify and deal with conditions or problems in your personal life and other interpersonal relationships (with your partner, family, neighborhood, or work).
• It might also help you in dealing with having a medical condition or losing a loved one.
• Some common techniques include role-playing, decision analysis (looking closely at how you make decisions), answering open-ended questions (not just “yes” or “no” questions), and communication analysis (how you communicate with others).

Antidepressants

Antidepressant medication can be the primary treatment for moms with severe anxiety or PPD.

APA and other health experts, including ACOG (American College of Obstetricians and Gynecologists), still recommend breastfeeding even if you’re taking antidepressants. However, make sure to first check with your doctor. (15)

Note that antidepressants are linked to sexual dysfunction and similar side effects (reduced sexual desire, etc.) in women within one to three weeks from the start of treatment. Talk to your doctor so they can recommend complementary therapy (such as exercise, acupuncture, or using essential oils). (16)

Estrogen Patch

Your doctor might also recommend wearing an estrogen patch to increase hormone levels in your body. However, this isn’t advisable if you’re breastfeeding because the hormone can pass to your baby through breast milk. (17)

Baby Blues Or Postpartum Dysphoria

What’s Postpartum Dysphoria?

Baby blues is the feeling of worry, tiredness, or sadness that a new mom experiences after childbirth.

The CDC (Centers for Disease Control and Prevention) explains that baby blues, also known as postpartum dysphoria, is different from PPD.

This condition can affect as many as 85% of new moms and usually lasts just for a few days, then disappears without any medical treatment. (18)

Factors that can affect the intensity of baby blues can include: (19)

• Reduced self-esteem with motherhood
• Increased stress due to childcare

Studies show that although psychological factors can influence them, baby blues aren’t related to depression syndrome.

Although baby blues can also show periods of irritability, restlessness, anxiety, and crying for no reason, the symptoms usually last for just a week or two, then resolve on their own. Often, it doesn’t interfere with your daily activities. (20)

In contrast, postpartum depression can affect you emotionally and physically and continue for many months. Seeking treatment is important because it might not go away on its own. (20)

Symptoms Of Baby Blues

Some of the most common symptoms of baby blues: (21)

• Crying for no apparent reason
• Insomnia (even when your baby is sleeping)
• Anxiety
• Fatigue
• Impatience
• Irritability
• Restlessness
• Sadness
• Mood changes
• Poor concentration

Postpartum Psychosis

Although postpartum depression might need treatment, postpartum psychosis is a serious mental disorder considered a medical emergency. It requires immediate medical attention because the symptoms could worsen and put you and your child at risk. (22)

The most common signs of this mental illness can include the following: (22)

• Behaving out of character
• Feeling too suspicious or fearful
• Feeling very confused
• Restlessness
• Showing signs of depression or low mood (crying, being withdrawn, lacking energy, loss of appetite, agitation, anxiety, or trouble sleeping)
• Delusions (sharing beliefs or thoughts that aren’t likely to be true)
• Hallucinations (smelling, hearing, seeing, or feeling things that aren’t there)
• Manic mood (talking and thinking too quickly or too much, and feeling “high”)
• A mixture of manic and low moods (or rapidly changing between these moods)
• Loss of inhibitions

Postpartum Depression & New Fathers

New dads can also experience postpartum depression symptoms, which can include:

• Fatigue
• Changes in sleeping or eating

As many as 21% of new dads may have experienced PPD. (23)

Dads can have an increased risk of experiencing PPD if:

• They’re experiencing financial difficulties
• They have a history of depression
• They’re younger (but the study didn’t indicate exact parental age to be considered as “young”)

REFERENCES

(1) https://www.postpartumdepression.org/resources/statistics/

(2) https://pubmed.ncbi.nlm.nih.gov/33844945/

(3) https://pubmed.ncbi.nlm.nih.gov/34816146/

(4) https://medlineplus.gov/ency/article/007215.htm

(5) https://www.psychiatry.org/patients-families/postpartum-depression/what-is-postpartum-depression

(6) https://minddoc.de/magazin/en/baby-blues-postpartum-depression/

(7) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363269/

(8) https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Depression/Major-Depressive-Disorder-with-Peripartum-Onset

(9) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561681/

(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3742364/

(11) https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/perinatal-depression-preventive-interventions

(12) https://jamanetwork.com/journals/jamapediatrics/fullarticle/2770120

(13) https://publications.aap.org/pediatrics/article/146/5/e20200857/75352/Trajectories-of-Maternal-Postpartum-Depressive

(14) https://www.nimh.nih.gov/health/publications/perinatal-depression

(15) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871019/

(16) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6711470/

(17) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782667/

(18) https://pubmed.ncbi.nlm.nih.gov/19272290/

(19) https://pubmed.ncbi.nlm.nih.gov/16142048/

(20) https://www.psychiatry.org/patients-families/postpartum-depression/what-is-postpartum-depression

(21) https://americanpregnancy.org/healthy-pregnancy/first-year-of-life/baby-blues/

(22) https://www.nhs.uk/mental-health/conditions/post-partum-psychosis/

(23) https://pubmed.ncbi.nlm.nih.gov/20819960/