Postpartum Depression: More Than the Baby Blues

Nearly 80% of women experience down days, commonly referred to as “the baby blues”. Kate Ferguson, founder of Kate Ferguson Therapy, discusses what symptoms to look for, how to get help and feeling better.

Becoming a mother comes with extreme physiological changes, sleep deprivation, and an entirely new role in life. Yet, it still comes as a surprise to people that postpartum women struggle with their mental health. My work is dedicated to raising awareness and offering support to mothers and their families as they navigate this transition to parenthood. 

PMAD: A Perinatal Mood or Anxiety Disorder, Postpartum Depression

Nearly 80 percent of new mothers experience down days, commonly called “The Baby Blues.” But for an estimated 20 percent of moms, these feelings can signal that they face the most common complication for pregnant and postpartum women: a perinatal mood or anxiety disorder (referred to as a “PMAD”). PMADs can include a variety of disorders, including postpartum depression, postpartum anxiety, postpartum obsessive-compulsive disorder, post-traumatic stress disorder, and rarely, postpartum psychosis. While giving birth is often the triggering event for a perinatal mood disorder, please note that symptoms can occur anytime during pregnancy. Also, adoptive mothers, as well as new Dads, may notice they are experiencing symptoms.

Symptoms can include:

  • Frequent crying
  • Sleep and appetite changes
  • Feelings of loneliness, sadness, helplessness
  • Frequent mood swings
  • Repetitive, sometimes scary thoughts that won’t go away
  • Anger, frustration, irritability
  • Difficulty bonding with baby
  • Anxiety, panic, excessive worry
  • Feelings of being trapped
  • Fear of being left alone with the baby
  • Sense of doom
  • Lack of interest in life, feeling sluggish, fatigued, exhausted
  • Difficulty making decisions or discerning what’s best for you or your baby
  • Feeling overwhelmed
  • Feeling speeded up or wired
  • Thoughts of hurting yourself or those around you

I notice these symptoms when I hear women in my office say things like: “I feel like this was the biggest mistake of my life,” “every day feels like 100 hours, and I just watch the clock,” and “I wish I’d never had this baby….” Shame about having these thoughts and feelings can keep women from seeking help, but consider that these may be your symptoms talking. Having a new baby is hard, but it shouldn’t be miserable. Your life shouldn’t feel over, just profoundly changed.   

These symptoms can also manifest in a client’s indecision and feeling overwhelmed. For example, my clients who obsess over following a suggested schedule, struggle with breastfeeding, or guilt over not breastfeeding. Who revisit and ruminate over decisions or have an exceptionally hard time adjusting if the day doesn’t go exactly as planned.  Sometimes this is just a Mom’s personality and isn’t a symptom, but if this resonates with you and you are having a hard time with basic functioning, consider that you may want to consult a professional for additional help and support. 

Finally, women in the throes of postpartum anxiety can’t sleep. And sleep is hard to get with a newborn. So I like to ask: “Given the opportunity to sleep, can you sleep?” if the answer is “no,” and you are feeling speeded up, irritable, and anxious, you might be experiencing anxiety that warrants treatment. The scenario can look like this: Baby fed and asleep at night, Mom in bed wide awake, exhausted, with racing thoughts or racing heart…not just once, but again and again. 

Let me share some other information that can be helpful to know.

What Factors Increase My Chance of Developing a PMAD?

  • Personal or family history of depression, obsessive-compulsive disorder, anxiety or panic disorder, bipolar disorder, or any other emotional illness, including pregnancy or postpartum mood disorders
  • History of severe Premenstrual Syndrome (PMS)
  • Unplanned or unwanted pregnancy
  • Thyroid disease or other chronic illnesses
  • Lack of support from family or friends
  • High level of physical, emotional, or financial stress
  • History of sexual, verbal, physical, or mental abuse
  • Pregnancy complications and/or a traumatic delivery
  • History of infertility
  • Chronic sleep deprivation
  • Abrupt weaning from breastfeeding, breastfeeding challenges
  • History of miscarriages or pregnancy losses

What can I do to help myself avoid Postpartum Depression (PMAD) or feel better if I think I am experiencing it?

  • FIRST: Self-help measures are essential, but do not delay getting additional treatment if needed.  The longer you wait to treat a perinatal mood disorder, the harder it is to treat. 
  • Ask for help. Being a mom is hard work. New and expectant mothers cannot do it all. Ask for help and support from loved ones. 
  • Educate yourself. Learn the factors that increase the risk of developing PMAD and be aware of the signs and symptoms. Knowledge is power.
  • Educate your loved ones about PMADs. Share the information you are learning here. They must be aware of the signs and symptoms.
  • Eat a balanced diet. Take your prenatal vitamins and ensure you get various foods in your diet. Avoid high-fat and high-sugar foods.
  • Limit caffeine and AVOID alcohol altogether (Alcohol throws gas on the fire of anxiety. Not popular to say, but essential).
  • Exercise is important. Walking 3-4 days per week benefits your mental health.
  • Get plenty of sleep. Take a nap when you can. Listen to your body and rest when it tells you to rest. I often recommend Mom’s on Call for this exact reason – It allows predictability to the day (nap windows for Mom!) AND supports good rest for the baby, which means good rest for Mom and Dad!
  • Take time for yourself.

Support for Postpartum Depression

There are excellent resources (online support groups, information, reading) and a directory of clinicians in your area that can be found on Postpartum Support International’s website, www.postpartum.net.  Your pediatrician or OBGYN can also be a resource for local support (sometimes, not always).  

As I often say to those I’m talking with, I love you; keep going. As bad as you feel, I want you to know you are loved. Some people care and want you to feel better. And keep going because no matter what, you are worth the effort and work it may take to feel better. 

Kate Ferguson is the founder of Kate Ferguson Therapy and Associates in Atlanta, GA. Her website is www.katefergusontherapy.com and you can also follow her on Instagram @katefergusontherapy

Be sure to follow us on Instagram and Facebook to stay up-to-date with our content! Also, visit momsoncall.com to check out all the resources we offer.

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Newborn Resources

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Moms on Call’s Guide to Postpartum Care

Moms on Call’s Guide to Postpartum Care

From one mom to another, we’ve put together a checklist of must-have items to have ready at home and after-delivery care essentials. Guide to Perinatal & Postpartum Care Peri or squirt bottle Used to rinse off the perineal before and after urinating as the area heals Ice packs Often the hospital will send you home with a few extras if you ask for those first few days home Have some soft ice packs ready in the freezer for when you run out Witch hazel pads  Used to prevent postpartum hemorrhoids and help with perineal pain Maxi pads  Until postpartum bleeding lets up, these will come in handy. Stock up for at least 2-3 weeks Large cotton undies  Sitz bath  Designed to help with postpartum pain Acetaminophen Will help with overall aches, and pain and is safe while breastfeeding. Stool softener & fiber Fill up on fiber to prevent constipation and stool softeners, to get things going, if needed Check-in with your doctor Our emotions are high and easily go from up to down. Check in and be truthful with your doctor to be sure you are receiving all the care you need! Read our blog post, More Than the Baby Blues, to help you know what’s normal and when it may be time to reach out. Nursing  Nursing bras  Invest in a few comfy nursing bras that fit you well. Size up from your original size to give your new growing breast room and comfort Have a few on hand, as these get soaked pretty regularly Nursing pads Reusable or disposable  Have these on hand for in-between nursing. Your breast will leak when the baby cries Nipple cream  Breast pump or breast pump order/Rx (Set this up ahead of time with your insurance carrier; most are provided for free.) Miscellaneous Items for the Home Paper plates and plastic silverware  Stocking up on these seems silly, but the last thing you’ll want to do is a mountain of dishes along with sanitizing bottles.  Frozen homemade meals  This will surely come in handy! During your pregnancy, cook a few of your favorite freezable meals OR ask friends and family to drop off frozen homemade meals! Nothing better than Grandma’s Lasagna! MealTrain.com also provides a great an easy way to organize meals for friends after birth, surgery, or illness. Your postpartum care is so important! We all get wrapped up in the excitement of baby, we tend to forget about ourselves. From moms who have been there a time or two (or more), learn how to take care of you and your body! The better you are taken care of, the more energy and love you will have to share with that beautiful baby you have created.  Be sure to follow us on Instagram and Facebook to stay up to date with all of our content! Visit momsoncall.com to check out all of the resources we have to offer.
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Postpartum To Do’s

Postpartum To Do’s

You have planned, dreamed and waited for this day! It’s finally time to bring home baby. And now that you’ve had your little one, what’s next? For that little one They are adjusting to new smells, new sounds and this whole digestive thing! Baby is feeding every 2-3 hours, swaddled well and you’ve prepared by creating the ideal sleep environment with the right sound machine which will help as they transition to this new world. For Moms and Dads You are both having to navigate emotional ups and downs. These new emotions are incredible and sometimes so hard to understand! You will both find yourselves laughing one minute and crying the next! Dads Expect a new “normal”.  You will be doing things that you may not have ever done before. Give yourself time and be patient as you find this new routine as “Dad”. Check out our post with David Feldman, as he discusses how becoming a father rewired his brain!Take over some of those middle-of-night diaper changes.During the day let Mom nap while you take care of the baby.Bring her snacks and water while she feeds.You may have to do grocery runs, cook meals and make sure the laundry gets swapped to the dryer.Moms on Call Consultant, Katherine Bridges, wrote To Dad, Love Mom: How to Support Me Before & After Baby Arrives to bring new dads some encouragement and ideas! Parenthood is an on-the-job training and you do not have to be qualified to start! You will get through the day to day realities one dirty diaper at a time. Baby blues are expected and normal. Dad, you may experience some blues too! Make sure to talk with your friends/family and seek professional treatment if needed. With Mom, be on the lookout for lack of ability to sleep, bouts of crying, irritability and extreme mood swings. We know that those first few weeks it is normal to have some of these emotions. However, if lasting more than 6-8 weeks or worsening over a few days, encourage her to mention it to her doctor and if needed you may have to seek out the help for her. Bring patience, confidence and a sense of humor! Moms Whether you delivered naturally, with meds, vaginally, c-section or adoption the postpartum period can be tough! Here are a few must-haves: Nursing tankSocks with gripsPeri or squirt bottle Used to rinse off the perineal before and after urinating as the area heals. Postpartum Mesh UnderwearLarge Maxi-Pads (Can also place a few in freezer) Until postpartum bleeding lets up, these will come in handy. Stock up for at least 2-3 weeks. Ice packs Often the hospital will send you home with a few extras if you ask for those first few days home.Have some soft ice packs ready in the freezer for when you run out. Witchhazel pads Used to prevent postpartum hemorrhoids and help with perineal painDermoplast SprayAcetaminophenWill help with overall aches, pain and is safe while breastfeeding.Stool SoftenersAbdominal Binder (C-section)Scar Cream/Oil Massage and Protect your C-section scarLarge cotton undies We prefer high wasted, to help with postpartum pain.Stool softener & fiber Fill up on fiber to prevent constipation and use stool softeners to get things going, if needed. The preparation and the waiting are done. It is normal to be ecstatic and thrilled one moment and crying and overwhelmed the next. Now what!? Get moving!Eat and take in plenty of fluids.Ask for help and accept help.Know the differences between baby blues and post-partum depression. Educate yourself and your loved ones for signs to be watchful of. Licensed therapist, Kate Ferguson, shares about common perinatal mood or anxiety disorders, the symptoms to look for, how to get help and feeling better in her blog post More Than the Baby Blues.Please visit Postpartum Support InternationalOne thing that is helpful is to take some time to connect with each of your senses every day.Be specific and find some things you can see, touch, hear, smell and taste. Pause on each item for 60 seconds.Proper vaginal and c-section care will help the healing process.Check out Moms on Call’s CEO, Morgan Eddy, blog post about her experience with C-Section Preparation and Recovery. Whether you delivered or “received” your special delivery, this is a time of adjustment. Give yourself permission to not have it all together. To be happy, sad, angry, full of joy and despair all within the same minute. But here is the truth: YOU are doing a great job! YOU are exactly who this little one needs and You are enough! You’ve got this!
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Kate Ferguson

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