Baby Blues or Postpartum Mood and Anxiety Disorder? What to Notice

So much happens to a woman during and after pregnancy.  Hormonally, things are drastically shifting, as are a woman’s identity and her relationship with her partner, not to mention changes in her work situation, social life, hobbies, sense of self, and sleep deprivation.  Due to all these factors, it’s not unusual for women to experience what is often referred to as the “baby blues”. As many as 80% of women report feeling tearful, anxious, sad, and lonely during the first 2 weeks after giving birth.  All of the above can contribute to the “baby blues”, but perhaps the biggest factor is the hormonal shift that occurs. A woman’s hormones decline 200% within minutes of giving birth. This drastic hormonal shift is likely a large factor in the “baby blues” that so many women report feeling.

But what is the difference between the “baby blues” and having a Postpartum Mood and Anxiety Disorder (otherwise known as a PMAD)? Here we will outline the major signs to look for and the risk factors for developing a PMAD:

• Symptoms for “baby blues” include excessive tearfulness, feelings of worry about your baby,  and feelings of sadness, inadequacy, irritability, etc.
• Symptoms for a PMAD are not much different: excessive tearfulness, and feelings of worry, sadness, inadequacy, worthlessness or shame.  More uncommon, but also important to be aware of, are thoughts of harming your baby, or thoughts of death or suicide.
• The hallmark difference between baby blues and a PMAD are the length of symptoms.  Typically symptoms lasting longer than 2 weeks may be a PMAD.
• “Baby blues” symptoms are usually gone within the first 2 weeks, whereas symptoms for PMAD usually arise between 4-6 months postpartum, (but can develop anytime within the first year).
• Women using assisted reproductive technology are more likely to experience a PMAD.
• Women who have experienced loss – miscarriage, stillbirth, or infant loss – are more likely to experience a PMAD.
• Women with a history of depression or anxiety are more likely to experience a PMAD.

The good news is there is help, and people get better.  So what do you do if you notice these symptoms and are worried about having a PMAD or developing one?

• Reach out for help.  Talk to your OBGYN or your pediatrician or find yourself a therapist.  You can get help, and you can get better.
• Find social support: join a new mom’s group.  Get connected.
• Ask friends to arrange for a meal train – the last thing you should be worried about is dinner.  Ask family and friends for help.
• Practice self care: go for walks, talk to a friend, write, exercise – try to incorporate coping tools that you used before your baby arrived into your post-baby life.  
• Most importantly: if you are worried about a PMAD, get help.  It may feel hopeless, but there is help, and you can get better.