Postpartum Depression and Anxiety: When It’s More than Just the Baby Blues

Postpartum Depression and Anxiety: When It’s More than Just the Baby Blues

Postpartum depression and anxiety are experienced by many new parents. Here, Dr. Shirazian and licensed therapist Julia Colangelo share warning signs to watch out for and strategies to handle experiencing these conditions. 

Feeling down, stressed, and anxious in the first few days after giving birth is common. Affecting up to three-fourths of women, this non-clinical phenomenon is called the ‘baby blues.’ The baby blues typically occur in the first 1 to 3 days postpartum and can last from a few days to two weeks before going away.

But when postpartum feelings of stress and anxiety become intense, last over 2 weeks, and begin interfering with your ability to go through daily life, there may be more serious issues at hand - including the possibility of postpartum depression and anxiety. 

Pregnancy-related depression and anxiety can affect up to 1 in 4 women, and postpartum depression most often begins about 1–3 weeks after childbirth. The American College of Obstetricians and Gynecologists (ACOG) estimates that between 5 and 25 percent of women experience postpartum depression. Postpartum anxiety occurs at slightly lower rates, affecting about 1 in 10 women.

According to the NIH National Child and Maternal Health Program, women with depression or anxiety during or after pregnancy often report feeling:

  • Extremely sad or angry without warning
  • Foggy, with difficulty completing tasks
  • "Robotic," like they are just going through the motions
  • Very anxious around their baby and other children
  • Guilty and like they are failing at motherhood
  • Unusually irritable or angry 

They also often have:​

  • Little interest in things they used to enjoy
  • Scary, upsetting thoughts that don't go away

Although pregnancy-related depression and anxiety can happen to anyone, there are some factors that make some of us more likely to experience them. These factors include a personal or family history of depression and/or anxiety, a difficult pregnancy or birth experience, lack of social, relationship, or family support during pregnancy, unplanned pregnancy, and financial stressors. It is important to note that nothing you do causes these feelings and you should never feel personal blame for what you may be experiencing. 

Share how you are feeling with your doctor

Pregnancy-related depression and anxiety are common and legitimate medical issues that affect many women, and they require medical care. If you feel that you are experiencing them, you should visit your physician as soon as you can - don’t wait until your next postpartum doctor’s visit. 

Mommy Matters’ physician founder Dr. Taraneh Shirazian urges the importance of reporting your feelings to your doctor. “Postpartum depression is a serious health issue that is isolating and overwhelming for many new mothers. After pregnancy, it can be easy to focus completely on the new baby - but understanding how we change mentally and physically is extremely important for recovery,” she says. “Also, I think every woman should have a recovery plan that includes a strong social network of family, friends and other new mothers. Having that network optimizes recovery, makes each woman less isolated, and gives us the collective perspective of knowing we are not alone.”

Consider these therapist-recommended strategies

Care plans for postpartum depression and anxiety may include the prescription of talk therapy and/or antidepressants. New York City therapist Julia Colangelo suggests these steps for managing pregnancy-related depression and anxiety:

Have an action plan ready.

Even before any potential signs of depression or anxiety, early in your pregnancy or postpartum period, you can gather a list of local providers who specialize in postpartum depression and anxiety as well as centers who take your insurance and are either located in your vicinity or offer in-home or remote sessions. Having this available to you before you enter the stages of depression or anxiety while also managing pregnancy or early postpartum symptoms (and a newborn) can provide a sense of ease and calm for you and your caregiver. Let your partner or loved one know where this information is (for example, in an iPhone note, Google doc, or on the fridge). If you want, consider calling some providers even if you “don’t feel any symptoms yet.” This can help establish the relationship so if or when it is needed, the process is simplified.

Set up some regularity in your life.

This could mean that one day a week you integrate something “lighter” into your schedule and routine. When possible, include a friend, neighbor, or outing in this (even if it’s just  walk around the park). Sometimes anxiety and depression can be so overwhelming that it feels impossible to leave the house or bedroom for days or weeks on end, and then the cycle can be more difficult to break. Julia encourages a “Fun Friday” where you treat yourself with your favorite walk, coffee, or other low-budget event.

Have a text chain of love.

This means tapping into your inner circle of true confidants and encouraging each other with support, love, and gratitude. This may feel a bit outside the box for you or you may already be doing this. Choosing this person or group of friends requires picking people who truly respect and honor that you may not be in the headspace to receive their positivity during different stages and phases of anxiety and depression, and they won’t stop reaching out to you because of your withdrawal.

Look into mom groups.

While it may take a while to find your chosen group with whom you feel most comfortable, exposure to other pregnant moms or new moms can establish a sense of community apart from our immediate family, partner, or child. Of course when you’re anxious or depressed you may not be feeling up for leaving the house, so starting on Facebook is a great idea because it is free and accessible from your phone. Moms tend to keep it real, which can help reassure you that you’re not alone in this journey or struggle.

The good (and frustrating!) part about anxiety and depression symptoms as they relate to pregnancy is that they are impermanent and change day-to-day. This means some moments, hours, or days will be easier to manage than others. The more we are able to acknowledge our anxiety and depression without judging ourselves for having them, the better equipped we are to cope and eventually thrive with these symptoms. Julia shares, “I always reassure my clients that they are equipping themselves with power to thrive and connect with their own emotions, which will add to their toolbox and help empower them to feel like Superwoman even amidst pregnancy-related depression and anxiety symptoms.”

How can I help my partner when I think they may be going through postpartum depression or anxiety?

For fathers or non-birth mothers, it may be difficult to know how to handle your partner’s feelings of postpartum depression or anxiety. The first step is being able to recognize signs of postpartum depression and anxiety. Julia advises that major shifts in how your partner is interacting with others, caring for themselves, or organizing themselves are often clues that something is off.

If you suspect that your partner is suffering from postpartum depression or anxiety, Julia suggests validating these feelings and helping remove stressors while understanding that you may not receive a reward or response for your efforts. She says:

“As a partner, you can validate any and all experiences even if the reactions you're viewing are confusing to you. For example, if you hear your partner say they love their child but also feel sad, you may not ‘get’ what they are talking about. The great news is that you don't need to ‘get’ anything but rather validate and support your partner. Instead of giving her an option to let you help or not, step graciously into taking action to alleviate any stresses that may be amplifying the postpartum depression and anxiety.

“When postpartum depression or anxiety are at their heights, offer your presence and assistance, but don't expect praise or a thank you for your contributions. In fact, sometimes you helping out may cause more stress and anxiety for your partner. Ultimately, you know them best and can test out what would alleviate some stress or pressure and what would cause them specifically for your relationship.”

The best thing you can do for your partner is to get her the help that she needs. 

More resources

For more medically approved information, you can access the American College of Obstetricians and Gynecologists’ resource list on postpartum depression and anxiety.

If you are experiencing these feelings and feel like you need urgent help, ACOG-recommended Postpartum Support International offers a support line at 1-800-944-4773 (or text 503-894-9453). This organization also offers local postpartum support groups and other resources across the United States. 

For a comprehensive list of providers who specialize in postpartum depression and anxiety throughout the United States, Canada, and Australia, you can visit Postpartum Progress’s website.

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Disclaimer: This is general medical information and not specific medical advice.  It does not and should not replace diagnosis or treatment by your healthcare provider. If you are seeking personal recommendations, advice, and/or treatment, please consult your physician. If you have an emergency, you should contact 911 or go to the nearest Emergency Room.