Postpartum Depression: Baby Blues

What are the "Baby Blues"?
by Carole Kanusky RN, MSN, CNS

You’ve had your baby and now everything is changed. You were prepared for the physical discomforts associated with the postpartum period, but not the emotional roller coaster you are on. You have this beautiful baby now and you and your partner are thrilled. So why do you feel overwhelmed, cry at the slightest provocation, and wonder if you’ll ever feel "normal" again?

Take comfort in knowing that you are not alone and that these feelings are shared by many new mothers. The "baby blues" or postpartum blues are actually a common biological response to childbirth, usually short in duration, and easily managed. More than half of all new mothers experience crying spells, mood swings, and fatigue during the first week or so. Fluctuating hormones, exhaustion, and feelings of inadequacy offer an explanation. What’s a new mom to do? You can best handle fatigue by resting when your baby is sleeping, accepting help from others while you take care of the baby, and being sure to eat a balanced diet with plenty of water. If you are a first time parent, rest assured you will eventually feel more confident and competent in your new role. Many new parents overlook the need to stay close to their partner. A suggestion is to plan a few "private moments" together each day to engage in adult conversation.

Occasionally, a new mother may experience other ailments beyond the baby blues, including adjustment reaction, postpartum depression, or even postpartum psychosis. With an adjustment disorder, the new mother reflects back on how her life was before the baby and has difficulty making the transition to motherhood. An example of this is a top level executive who traveled and socialized with her husband regularly and now finds herself at home with a newborn. She misses her old life and is anxious to return to work where she feels in control, which only increases her sense of sadness and guilt. Through family support, possibly professional counseling, and networking with other working mothers, recovery can quickly occur.

Maybe you have read or heard about postpartum depression which is a more common disorder afflicting 10% of all new mothers. Symptoms of postpartum depression include agitation, sadness, anxiety, insomnia, mood swings, decreased appetite, and a sense of general confusion and inability to handle things. The woman may feel guilty and ashamed and think she is a bad mother for having negative thoughts about her baby. Women who experience postpartum depression can be successfully treated with medication, therapy, and support from family and friends.

Some researchers believe women who typically have severe symptoms of premenstrual syndrome (PMS) are more likely to experience postpartum depression but this is an unreliable predictor. For many women there is a pronounced shift in the production of naturally occurring progesterone after childbirth that may trigger severe depression.

In a few cases, 2 in 1,000 childbearing women, depressive symptoms can evolve into postpartum psychosis, a complete break with reality. Immediate professional help and possible hospitalization is indicated to prevent harm to the mother or her infant.

As a new mother do not be afraid or feel ashamed if there are days when you just want to cry or stay in bed with the covers over your head. Mild postpartum blues normally disappear on their own within days, but if symptoms of postpartum depression become severe or last more than two weeks, professional help should be consulted. Early treatment can usually get a mother back on track in a relatively short time and minimize the disruption to the family. Remember the importance of adequate rest, good nutrition, and the loving support of family and friends.

How Your Partner Can Help

  • Provide constant reassurance that you love her.
  • Allow her to express her concerns and emotions to you.
  • Learn more about postpartum disorders so that you can better understand and relate to her.
  • Encourage the new mom to rest and eat well.
  • Find outside help if needed for household chores.
  • Talk to a friend, pastor, or counselor when you feel stressed.

Editorial and tips provided by Carole Kanusky RN, MSN, CNS, Community Educator-Women’s & Children’s Services at Memorial Hospital Southwest in Houston, Texas.