When Is It More Than The ‘Baby Blues’?

Pregnancy is a time of many emotions that change at the drop of a hat. It can also be a time when some women may experience more serious emotional symptoms that need to be treated. Estrogen and progesterone levels approach their highest peak in the last trimester of pregnancy only to fall precipitously after delivery. These hormonal changes are responsible for the mood swings common in late pregnancy and postpartum. The combination of fatigue, fear and hormones can get the better of anyone.

The baby blues affect up to 80 of all women who deliver a baby. Baby blues symptoms are similar to the premenstrual symptoms that many women experience. The blues come on about 3 days after delivery and should go away by 2 weeks postpartum. A mother may feel fearful, irritable and anxious about her responsibilities as a mother. She may complain of moodiness and break into tears for no reason. But she also experiences periods of pleasure and enjoys her new baby. Her appetite is good, and she is able to sleep when the baby sleeps. As a matter of fact, she is desperate for sleep and falls asleep easily.

One of the most frightening things about the baby blues is that many women don’t expect them and aren’t sure what is happening or why. Women are told by television, books and other mothers that giving birth is one of the most fulfilling things they can do. If the bonding process is interrupted by the baby blues, they add to the women’s fear that she won’t be a good mother.

Sometimes there is something more serious going on than the baby blues – postpartum depression. One out of ten women is affected by postpartum depression. I believe this is one of the most underrecognized, underreported and undertreated illnesses that affect women. The symptoms of postpartum depression are similar to those of general depression, but there are subtle differences. Decreased or increased appetite, frequent crying, depressed moods, sleep disturbance, feelings of helplessness and worthlessness, decreased energy, decreased concentration and sometimes suicidal thoughts can all be symptoms of depression. Women with postpartum depression may have all of these symptoms but sleep disturbance is the hallmark of the disorder. Women with postpartum depression cannot sleep no matter how desperately tired they are.

In my experience, the single best question to ask a new mother who I suspect is suffering from postpartum depression is: “Are you able to sleep when the baby is sleeping?” For some women, 2 or 3 nights of uninterrupted sleep can make a tremendous difference in the way they feel and may eliminate the need for antidepressant or antianxiety medication. But other women need more help. If you or someone you know could be suffering from postpartum depression, call The Women’s Place – Center for Reproductive Psychiatry at 832-826-5281 for an appointment.

For urgent needs, call the Hope Line: 1-800-PPD-MOMS (1-800-773-6667), a free, confidential resource for postpartum depression. Or check out the website for Postpartum Support International.​