Pregnancy and Beyond: Is it the Baby Blues or Postpartum Depression?

By Melissa Geraghty, Psy.D.

Many people expect that pregnancy and afterwards will be one of the happiest times in their lives. However, what society does not discuss are the natural up and downs that come along with being pregnant as well as all the psychological, physical, and social changes that occur after giving birth.

In fact, many women find themselves questioning if they are suffering from the baby blues or postpartum depression. 15 to 20% of women experience significant depression or anxiety that is beyond the baby blues. Below explains the general differences between the two.

Baby Blues
This is in reference to typical feelings most new mothers experience. Symptoms may include, but are not limited to: feeling exhausted, having anxiety, feeling nervous, worries about motherhood, and feeling overwhelmed of this new responsibility.

Perinatal Mood and Anxiety Disorders
The term “Perinatal” is used to describe the time all throughout pregnancy as well as up to a year after childbirth. The term “Postpartum Depression” is used most frequently, yet the wording “Perinatal Mood and Anxiety Disorders” better reflects the spectrum of disorders that can affect mothers during pregnancy and after childbirth. Below are definitions of these disorders.

Postpartum Depression
“Postpartum” refers to after childbirth. Symptoms for all postpartum disorders can appear days or months after childbirth. Symptoms specific to postpartum depression may include, but are not limited to: feelings of irritability, lack of interest in the baby, continual crying, and sadness.

Postpartum Anxiety
Symptoms may include, but are not limited to: constantly worrying, feeling as if something bad is going to happen to the baby, and racing thoughts.

Postpartum Panic Disorder
This disorder is a form of anxiety. Symptoms may include, but are not limited to: reoccurring panic attacks and having multiple fears.

Postpartum Obsessive-Compulsive Disorder
Symptoms may include, but are not limited to: obsessions which are intrusive, repetitive thoughts related to the baby, compulsions (which are things the mother may do over and over again in attempt to reduce obsessions), and hypervigilance in protecting the infant.

Postpartum Post-Traumatic Stress Disorder
This is caused by a real or perceived trauma that occurred during delivery or after childbirth. Symptoms may include, but are not limited to: flashbacks, nightmares, panic attacks, and hypervigilance.

Postpartum Psychosis
This is a rare disorder when compared to the prevalence of postpartum depression and postpartum anxiety. Women who are at significant risk for postpartum psychosis have a personal or family history of bipolar disorder or a past psychotic episode. Symptoms may include, but are not limited to: delusions or strange beliefs, hallucinations, hyperactivity, paranoia, and rapid mood swings. There is a 5% risk of infanticide or suicide that is associated with postpartum psychosis, thus it is imperative that immediate treatment is obtained.

For a more detailed explanation on the spectrum of perinatal mood and anxiety disorders, view the Postpartum Support International (PSI) website at: https://www.postpartum.net/

When dealing with perinatal mood and anxiety disorders, significant others need support too. A partner may feel unsure of how to respond to their loved one who is struggling, and they often can feel overwhelmed. A therapist that specializes in these disorders can provide significant others with education and tools to learn how to be more supportive and understanding, in addition to dealing with their own anxiety concerning the new baby.

A new mother may have difficulty recognizing if she is indeed suffering from anxiety or depression due to being tired, overwhelmed, and adjusting to being a mother. New mothers may also not want to reach out for help as some are afraid of being seen as not being able to handle motherhood. It is always best to reach out for help if one is unsure if they are struggling or not. After all, new mothers who do not meet the criteria for a perinatal mood and anxiety disorder also need and are entitled to proper support.

It is important to note that if a woman does not receive appropriate intervention, maternal depression and anxiety can have long-term implications for mother, baby, and the entire family. These disorders do not go away without treatment. However, perinatal mood and anxiety disorders are 100% treatable. As PSI’s saying goes, “You are not alone. You are not to blame. With help, you will be well.”