Baby Blues Vs. Perinatal Depression: What is the Difference and When to Seek Help

By Maura L. Johnson, LCSW, PMH-C

The arrival of a new baby is often considered a joyous occasion in a woman’s life, a time of celebration and transition. Whether it be from no children to one, two or three or more, each new addition brings new adventures and challenges to the family unit. While many may feel happy, albeit exhausted, in those early days and weeks postpartum, some notice that things don’t seem quite right.

Approximately 70-80% of women will experience what is often referred to as the “Baby Blues’’ in the immediate days after giving birth (Source: The American Pregnancy Association). These emotional shifts are a natural reaction to the incredibly dramatic decrease in hormones immediately following birth. These symptoms may include weepiness/crying for no known reason, impatience, irritability, restlessness, anxiety, fatigue, insomnia, mood changes and trouble concentrating. The adjustment to sleep deprivation, change in routines and limited time for self-care, may all contribute to these symptoms, as well. What’s important to know is that the Baby Blues is generally short-lived and does not leave the mother feeling unable to care for herself and/or her baby. Symptoms are often relieved by complementary measures and this condition usually resolves within two weeks. If symptoms persist beyond two weeks, or include feelings of hopelessness, helplessness, severe anxiety, lack of motivation, insomnia, trouble caring for self and/ or baby or thoughts of suicide, it’s time to seek help for a postpartum depression.

Postpartum Depression is considered a Perinatal Mood and Anxiety Disorder, or PMAD. It is estimated that anywhere from 15-20% of women experience a PMAD (Source: Postpartum Support International). In addition to the symptoms mentioned above, there may also be intense anxiety and panic attacks, difficulty bonding with the baby, feeling “crazy” or out of control, feelings of anger or rage, low mood, low or increased appetite and neglecting basic self-care. Symptoms will persist beyond a two-week period and may impair functioning in a variety of areas. These symptoms may begin at any time within

the first 12 months postpartum and may also occur during pregnancy. PMAD’s are family illnesses and require support, education and prompt treatment. It is imperative that partners and support persons learn to recognize the signs and assist in seeking treatment. In the event that a woman is endorsing suicidal thoughts, plan or intent, seek help immediately. Please also be aware of symptoms of Postpartum Psychosis, which is severe and constitutes a medical emergency. These may include a decreased need for sleep/not feeling tired despite not sleeping, hallucinations, delusions, paranoia, hyperactivity, feeling very irritated and rapid mood swings.

Most women’s first points of contact in seeking help are their OB/GYNs, Midwives or PCPs. This is often a positive step in starting the treatment process. We are incredibly lucky to have a wealth of perinatal mental health treatment facilities in our area, including the Alexis Joy D’Achille Foundation at AHN and the NEST Program at UPMC Magee Women’s Hospital. In addition to these, here are some easily accessible, free resources and support groups available within our community and beyond:

• https://www.postpartum.net/ get-help/provider-directory/

• https://www.postpartum.net/ get-help/psi-online-supportmeetings/

• Postpartum Support International Warmline: 1-800-944-4PPD

• Text Support: 800-944-4773

• BabySteps Support Group- St. Clair Hospital (currently meeting virtually)

The most important thing to remember is you are never alone in this, and with the right help and support, you will recover.

Maura Johnson is a licensed clinical social worker currently in practice at Cranberry Psychological Center. She is a certified perinatal mental health provider, as well as a contributing staff member with Postpartum Support International. While her primary focus is treating PMADs, she also treats a variety of conditions and clients of all ages. She resides in the Pittsburgh area with her husband, Brendan, daughter, Sloane, and dog, Max.