The Baby Blues: Masquerading as a Perinatal Mood Disorder

Pregnancy, from start to finish, is a massive change for mothers. What begins as a positive pregnancy test, eventually leads to morning sickness, mood swings, cravings, and of course—that beautiful baby bump! All of these things are just a small part of growing a living human and will stay with you up until you give birth. While birth is a wonderful experience, it is an extremely emotional adjustment, so much so, that new mothers may experience a tumultuous time of fluctuating hormones that can unfortunately last long past the
postpartum period.

A 48-Hour Emotional Rollercoaster
Birth requires a tremendous recovery period. Most obviously, the physical challenges of birth are the recovery after vaginal birth or a Caesarean section. Emotionally, birth is also a great adjustment. At no other point do a woman’s hormones plummet so fiercely as they do in the 48 hours after delivery. When a woman gives birth, because of that hormonal drop, there’s a tremendous shift in her emotions. For the first two weeks postpartum, the baby blues develop—tearfulness, overwhelming emotions, incessant crying, happiness, sadness, and a lot of other emotions. When these feelings last past the two-week postpartum period, it would be classified as a perinatal mood disorder. Anxiety, OCD, depression, and psychosis all fall under the postpartum depression umbrella.

“It’s not just depression,” says Samantha Rauber, LPC-S, NCC, PMH-C, and Founder of Baton Rouge Perinatal Counseling. “A lot of the symptomatology that women experience during the postpartum period includes intrusive thoughts and anxiety.”

Normal Postpartum Issues or a More Serious Problem?
During the postpartum period, women can expect that there will be adjustment symptoms that occur during recovery, given the tremendous physical experience of giving birth. What differentiates normal adjustment to a more serious postpartum situation depends on the length of the symptoms and if these symptoms interfere with daily life. Up to 85 percent of new mothers experience what is known as the “baby blues,” a mild form of depression caused by hormonal changes. The baby blues can cause a range of emotions, including sadness, anxiety, crying, irritability, and mood swings. While these feelings can be uncomfortable, they shouldn’t last longer than two weeks.    

At the two-week mark, if a woman is experiencing difficulty sleeping, ruminations, hopelessness, fatigue, difficulty concentrating, frequent crying, anger, rage, shame, or guilt, this is a sign that something more serious is going on.

Red Flags During Postpartum
When it comes to mental health, everyone is different. However, if a new mother is feeling suicidal, this is an immediate need for help. “If a new mother is concerned about how she feels, that itself is a red flag, and it might be time to seek help or counseling,” says Rauber. “A lot of these postpartum issues are treatable through counseling with a therapist.” If you are struggling, please reach out to The National Maternal Mental Health Hotline 1-833-943-5746 and the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

How to Manage Postpartum Anxiety and Depression.
According to Rauber, about one out of five women will not bounce back in their endocrine system after giving birth. This means that one out of five women will need support during the postpartum periodMany women during the postpartum period struggle to do any amount of self-care inside or outside of the bathroom. What postpartum self-care comes down to is working with a support system. For dads helping postpartum moms, this could look like extending patience, being compassionate, being encouraging, being supportive, and helping to meet her needs. In addition, parents should set up an alternating six-hour baby sleep schedule to help ward off depression caused by sleep deprivation. These small things can make a huge impact on recovering moms.

Make a Plan for the Postpartum Period
As with pregnancy, making a plan to deal with the postpartum recovery period is imperative for mothers who are processing the pregnancy, birth, and postpartum emotions. If a woman doesn’t have emotional support, the best thing to do is to acknowledge that a perinatal mood disorder is happening. A lot of women with PPD know they don’t feel good, but can’t figure out what the problem is. In order to take control of the situation, sometimes naming the problem can help women find relief.

“I encourage anybody who is trying to plan for children or in the process of pregnancy to educate themselves about these disorders after pregnancy. Anyone is at risk,” says Rauber. “The earlier you learn and have a therapeutic relationship, the better.”

This article was originally published in Spring 2024.