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Baby Blues or Something More?

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Baby Blues or Something More?

Baby Blues
You have been home from the hospital for 3 days. You find yourself happy one minute and crying the next. Your feelings about motherhood don’t match what you expected. You fear you are “losing it”. 80% of new mothers will experience the “baby blues” in the first week or so after childbirth. This is a normal adjustment period and is not considered a mood disorder. Symptoms will almost always go away in a few days to weeks. “Baby Blues” symptoms may include:
- Mood swings
- Weepiness
- Sadness
- Anxiety about the new baby / being a mom
- Feeling overwhelmed
- Lack of concentration
- Feelings of dependency

Prenatal and Postpartum Depression and Anxiety
It’s been 3 months since the baby was born. You thought you just had the “blues” and things would get better. You feel horrible most of the day and are unable to cope with everyday life. Prenatal and Postpartum Depression and/or Anxiety develop for 15-20% of mothers. Symptoms can start anytime during pregnancy or the first year postpartum.
Symptoms will differ for everyone, but may include:
- Sad mood, tearful, feelings of guilt
- Irritability, anger, short temper, rage
- Excessive worry/anxiety, phobias
- Feeling overwhelmed, difficulty making decisions
- Sleep difficulties (often insomnia) – unable to sleep even when baby is sleeping, fatigue/lack of energy
- Loss of focus and concentration, forgetfulness
- Physical complaints in excess of, or without physical cause
- Loss of interest and pleasure
- Appetite change, significant weight loss or gain
- Loss of sex drive
- Feelings of worthlessness, low self-esteem, feel you are not “good enough”
- Hopelessness, Suicidal thoughts, scary thoughts
- Feel numb
- Discomfort around the baby, lack of feeling or resentment towards the baby

Postpartum Obsessive Compulsive Disorder
Sometimes women with postpartum mood disorders experience scary thoughts, ideas or images that are recurrent and time consuming. Postpartum OCD, or Obsessive Compulsive Disorder is the most misunderstood and misdiagnosed postpartum mood disorder. A woman may have an image of throwing the baby off the balcony, or thoughts of putting the baby in the oven. Such thoughts are obsessive and cause great distress, horror, shame and guilt. The new mom is aware that her thoughts are bizarre, and is very unlikely to ever act on them. Most women will try to decrease their discomfort and anxiety by engaging in mental rituals or compulsive behaviors that make them feel safe. About 3-5% of new mothers will experience this type of anxiety. Symptoms may include:
- Intrusive, repetitive and persistent thoughts or mental pictures
- Thoughts about harming or killing the baby
- Tremendous sense of horror and disgust about such thoughts
- Fear of being left alone with the baby
- Hypervigilance about protecting the baby
- May be accompanied by behaviors to decrease anxiety (e.g. hiding knives)
- Counting, checking, cleaning, or other repetitive behaviors

Postpartum Psychosis
Postpartum Psychosis is probably something you’ve heard about on TV, or read about in the newspaper. Many may be familiar with Andrea Yates, the mother who killed her 5 young children by drowning them in the bathtub. Postpartum Psychosis is very rare, occurrence is 1 to 2 per 1000 women. Onset is very sudden, most often within the first 4 weeks postpartum. This disorder does have a 5% infanticide rate. Most women who experience psychosis do not harm themselves or others. However, there is always an increased risk of danger due to delusional thinking and irrational judgment. Postpartum Psychosis is an emergency and must receive immediate attention. Symptoms may include:
- Delusional thinking (denial of birth, need to kill the baby), bizarre thoughts
- Visual or auditory hallucinations
- Delirium, mania, paranoia
- Confusion, disorientation
- Extreme agitation

Postpartum mood disorders are temporary and very treatable with professional help. If you feel you may be suffering, or know of someone who is, start by talking with your health care provider, find a referral to a specialist who works with women’s reproductive mental health. Know that it is not your fault, you’re not to blame, and you’re not alone.

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