Postpartum Mood – Deciphering the Baby Blues from Postpartum Anxiety and Depression

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Postnatal mom with baby blues holding baby feet

The postpartum (or postnatal) period is a time of BIG emotions – it’s an exciting time, however can also come with lots of uncertainty and changes. A mom’s body is going through significant shifts in hormones, is often nutrient depleted, and then you have the added task of caring for a new little one!

Did you know?

The drop in estrogen and progesterone after birth is similar to what women experience in menopause? While oxytocin, our feel good hormone, helps buffer this, it’s no wonder moms can feel overwhelmed – that’s a big shift in a short period of time!

Often we hear moms reporting feeling really overwhelmed and exhausted in the early days. These feelings are natural and will subside with time. However, what I wanted to cover below is when these feelings go from the baby blues to postpartum depression or postpartum anxiety. Often in the moment it’s hard for a mom to be able to decipher, therefore, providing this information to those close to you when you are expecting can be beneficial for earlier detection and receiving much needed support. Approximately half of women who have feelings of postpartum depression or anxiety will talk to a partner, friend or family member and not a professional, and therefore, the more educated our loved ones are, the better we can support our mamas!

Within Canada, 23% of new moms report symptoms that are consistent with postpartum depression or postpartum anxiety. With higher likelihood in the following:

  • Moms under the age of 25
  • Previous diagnosis of depression or anxiety
  • Stressful events before or during pregnancy (including birth trauma)
  • Insomnia
  • Lower socioeconomic status
  • Exposure to Pitocin during birth

Did you know?

In our society the postnatal period (or 4th trimester) is often considered the first 6-12 weeks, however, a new mom’s body is in a state of healing for at least 6 months, and in some cases the postnatal period is considered up to four years!

What are the Baby Blues?

In the first few weeks of life (usually developing in the first 2-3 days and lasting the first 10-14 days), mom can experience large swings in emotions – from being overjoyed and proud to crying and fear they are not doing a good enough job. Often moms report feeling exhausted, irritable, overwhelmed, and anxious. These emotions are usually short-lived.

When is it may be more than the Baby Blues?

One of the biggest differences in baby blues versus postpartum depression is the severity and length of symptoms. With postpartum depression a mom may experience larger bouts of crying, withdrawal from loved ones, a feeling of disconnect, worry about hurting their baby, not being able to bond with the baby, and feelings of guilt surrounding their adequacy as a mom. These symptoms will be present longer than 2 weeks and tend to be more persistent than the up and down swings of emotions seen with baby blues.

Common symptoms of postpartum depression include:

  • Feeling down, depressed, hopeless or worthless
  • Loss of interest or pleasure in activities
  • Fatigue or abnormal decrease in energy
  • Persistent sadness, crying or anxiety
  • Difficulty concentrating
  • Irritability or anger
  • Difficulty sleeping (for postpartum moms this is especially if unable to sleep once baby is asleep)
  • Abnormal appetite
  • Difficulty forming attachment to the baby
  • Continuous doubting of ability to care for new baby
  • Withdrawal from loved ones
  • Thoughts of self-harm or suicide
  • Thoughts of harming the baby or worry that you or they may harm the baby

Unsure about how you or how the mama in your life is doing? This New Mom Checklist can be a great resource to begin the conversation.

Looking for further insight into what it’s like to experience postpartum depression and anxiety? I highly recommend the book Amanda Munday, titled Day Nine: A Postpartum Depression Memoir.

If you suspect you or someone you know may be experiencing postpartum depression or anxiety, please reach out to your healthcare provider (Family doctor, Naturopathic Doctor or Psychologist). You do not need to be confident this is occurring to start a conversation and provide additional support for mom. Even if a new mom is not experiencing postpartum depression or postpartum anxiety, support during this time can be very beneficial.

How Can a Naturopathic Doctor support your mental health postpartum?

As a Naturopathic Doctor our goal is prevention whenever possible. Nutrient deficiencies and large shifts in hormones can make an individual more susceptible to experiencing mood changes postpartum. This is one of the reasons why we recommend testing in the postpartum period (at about 4-6 weeks) the following:

  • Thyroid (including TSH, free T4, free T3 and anti-TPO) – your thyroid values should return to pre-pregnancy levels by 4 weeks postpartum, an elevated anti-TPO marker in combination with a low free T4 increases a woman’s risk of postpartum depression
  • Blood sugar including fasting insulin (this can contribute to shifts in mood especially anxiety)
  • Ferritin (a marker of your iron)
  • Vitamin B12 (contributes to low energy)
  • Vitamin D (contributes to low energy and mood)
  • If symptoms, including mood changes, persist for a mom then often we will consider salivary or urine hormone testing to examine cortisol (your stress hormone).

In combining a postpartum mom’s symptom picture along with the testing listed above, we then initiate treatment plans to support mom’s healing and mental health. This could include dietary recommendations, supplements such as vitamins and/or botanicals, stress management strategies and nutraceuticals to support mental health.

When needed, your Naturopathic Doctor can also provide the appropriate referral to a psychotherapist, psychologist or Family Doctor counselling and/or pharmaceutical support postpartum.

Yours in Health,
Dr. Stephanie
Naturopathic Doctor and Co-Owner of Abaton Integrative Medicine

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