Whether from the stress of labor, a genetic predisposition, or even a perceived failure to live up to what you believe your motherhood journey should look like, postpartum depression can leave you feeling hopeless and broken.

While what you’re experiencing can make you feel isolated, you’re not alone. Within the year after delivery, 1 in 7 women find themselves depressed.

According to a study from The Cumming School of Medicine in Calgary, difficulty with breastfeeding may increase the odds of suffering postpartum depression. Mothers who sought advice and support for breastfeeding were less likely to suffer from depression.

What’s the difference between baby blues and postpartum depression?

You may have heard the term “baby blues” to describe the mood swings many new parents experience. The sudden hormonal changes after delivery can cause anxiety, stress, isolation, fatigue, loss of appetite, and difficulty sleeping. About 80% of new mothers report feeling tearful and emotionally fragile for the first few weeks postpartum.

Baby blues tend to subside after a few weeks, whereas postpartum depression persists for months, sometimes longer if untreated. Health care professionals also have helpful tools like the Edinburgh Postnatal Depression Scale to assess the emotions new moms are feeling. 

What causes postpartum depression?

Although we don’t know the exact causes of postpartum depression (PPD), researchers believe it may be from a combination of changes in brain chemistry or neural circuitry and changing hormones.

Many factors may contribute to and compound postpartum depression:

• A labor that didn’t go according to birth plan
• Fatigue from an arduous labor
• Lack of sleep from the constant demands of a newborn
• Breastfeeding challenges
• Physical discomfort during recovery
• Lack of family nearby to support the transition
• Difficulty adjusting to weight gain
• Changes in home and work routines
• Perfectionism and the desire to be a “perfect” mom
• Doubts about the ability to be a good mother

What are the signs of postpartum depression?

Clinical descriptions only tell part of the story. While many moms report feeling some of the same key emotions, postpartum depression and other postpartum mood disorders will be different for every person.

Some common symptoms of PPD may include

• Restlessness and an inability to sleep
• Lethargy and sleeping too much
• Chronic fatigue and brain fog, difficulty making decisions, and forgetfulness
• Eating much more or much less than usual
• Overwhelming sadness and hopelessness, with tearful episodes coming out of nowhere
• Lack of energy or motivation
• Intense feelings of guilt, inadequacy, or worthlessness
• Loss of pleasure or interest in everyday activities
• Withdrawal from family and friends
• Physical discomforts like indigestion, muscle aches, and headaches
• Relentless anxiety, panic attacks, and racing, scary thoughts
• Excessive irritability, anger, or agitation and lashing out at others
• Fear of not being a good mother or agonizing over loss of self

Women at the extreme end of the spectrum may have thoughts of hurting themselves or abandoning or hurting their babies.

Postpartum psychosis occurs in 1 to 4 out of every 1,000 births, with symptoms of confusion, hallucinations, and/or rapid mood swings.

Postpartum psychosis is a medical emergency. If you are experiencing thoughts of hurting yourself or your baby, go to the ER or call your doctor immediately.

What should you do if you think you have postpartum depression?

It can be really scary to admit what you’re feeling. If you recognize that you aren’t feeling like yourself and think you may have postpartum depression, acknowledge that what you’re experiencing isn’t your fault. Remind yourself that you’re not imagining your feelings. PPD is real and treatable. Remember, you're not alone.

Seek assistance to move toward feeling better. Often, labeling the condition and talking to someone about it can help. Professional treatments for PPD include various forms of psychotherapy, often combined with antidepressant medication. Treatment can help you gain the skills you need to cope with everyday challenges and manage your feelings.

If you think you’re experiencing a medical emergency, find someone to watch your baby while someone else takes you to your doctor or the ER.

How can you help a loved one who has postpartum depression? 

Since many people don’t respond well to a blunt “you need help,” try mentioning to your loved one that she doesn’t seem quite like herself.

Gently ask, “How are you doing? Can I help with anything?” Let her know you're there for her, no matter what, and that it will get better.

Andrea Schneider, LCSW and Psychotherapist, suggests the following ways to help:

• Seek competent help and educate yourself.
• Don’t try to diagnose her yourself.
• Tell her when you notice she is getting better.
• Encourage her to rest, exercise, and get good nutrition.
• Attend appointments with her.
• Work with healing professionals to support her.
• Get support for yourself.
• Remind her that she is experiencing a real medical condition.
• Make sure you are also getting rest.

You need to look out for your own mental health, too. Even if you understand what’s causing your loved one’s depression, it can be difficult not to internalize some of the struggle or question your own adequacy. Speaking with a therapist and taking some time for yourself can help you through this phase too.

If your loved one is experiencing a psychiatric emergency, seek help from a health care professional immediately. Call emergency services, her health care provider, or the hospital’s emergency department and follow their instructions.

Note: It’s also important to remember that partners can experience postpartum depression as well. While this depression (called Paternal Postnatal Depression in male partners) isn’t caused by the hormonal changes of pregnancy and delivery, it can be as debilitating and have as great an effect on the family as postpartum depression.

Who can help with postpartum depression?

There are many places to find help. You can start with your primary care doctor or OBGYN. Your doctor can refer you to a psychologist trained to help with postpartum depression. You can contact the American Psychological Association for a list of practitioners in your area at 800-374-2721 or www.apa.org.

You can also contact

• Department of Health & Human Services, Office on Women’s Health
  Phone: 800-994-9662
• Mental Health America
  Phone: 800-969-6642
• National Institute of Mental Health
  Phone: 866-615-6464 
• Postpartum Education for Parents
  Phone: 805-564-3888
• Postpartum Support International
  Phone: 800-944-4773

Postpartum doulas are another option to lighten the load. As Certified Doula Kym O’Malley puts it: “Postpartum doulas can help new parents who may be feeling overwhelmed or isolated by providing non-judgmental support, help with breast/bottle feeding issues, infant care, and sometimes just a listening ear and extra pair of hands.”  

Be brave. Be you.

Being open about our emotions takes incredible courage, but that bravery is one of the best gifts you can give your children. Showing them that it’s okay to be vulnerable will help teach them to be compassionate towards others and themselves.

With the right support system, postpartum depression is treatable. Like every stage of parenthood, it won’t last forever, and it will get better.