A: Yes and no. Some adjustment is normal, but sudden changes in how you feel may be a sign that you are experiencing a mood or anxiety disorder in the perinatal period (sometimes called a PMAD).
TL; DR: It is normal to experience feelings of anxiety, sadness, fatigue, irritability and other symptoms after you have a baby. But, when they go on for more than two weeks after you have the baby or are getting worse, it may be time to seek additional support.
So do a lot of people really go through this?
For sure. If you just had a baby, up to 80% of new mothers experience something called the “baby blues.” You can have both physical and emotional symptoms like fatigue, irritability, sleep problems, and worries about being around the baby. For most people, this is an adjustment period and you will feel better after a few weeks. Making sure you eat, sleep, and get support to care for the baby will help you to get better.
If you don’t feel better after two weeks, you could be experiencing more than the baby blues. Up to 20% of pregnant people will experience a perinatal mood and anxiety disorder (PMAD), which can happen during or after pregnancy, and can include symptoms consistent with depression, anxiety, obsessive-compulsive disorder, and/or postpartum psychosis. These symptoms can even develop up to one year after you have a baby. Partners can have symptoms too. Changes in your body, relationship, support system, role adjustment, and genetics all play a role in who develops symptoms in this period. Know that you are not alone and that you did not cause this.
So what are PMADS?
People with perinatal depression have symptoms of depression during or after pregnancy like persistent sad feelings, hopelessness, and lack of interest in caring for themselves or the baby. Bipolar disorder can also begin in the postpartum period so if someone has depression it is important to see a professional who can help figure out what they might be experiencing. People with perinatal anxiety can have symptoms of anxiety like severe worry or fear about the baby and often have panic attacks. People with perinatal OCD can have intrusive thoughts or images that are unwanted and not consistent with how they feel. They can also worry about harm coming to the baby. A lot of times this can feel scary to the person so they are not likely to tell others about them. Symptoms of post-traumatic stress disorder can also emerge in the postpartum period and can be made worse by the birth or by bringing up past traumatic events. Postpartum psychosis is a medical emergency and if someone is experiencing this, they should seek help immediately. Someone can hear voices or see things that other people don’t see, lose touch with reality, and/or have symptoms of mania.
And what should someone do if they are having these symptoms?
If you have these symptoms, tell someone. If you can’t talk to a loved one or a family member, there are many resources at Postpartum Support International www.postpartum.net. You can also call or text “Help” to 1-800-944-4773 (#2 for Spanish) to talk to someone and get help (In Spanish, Text “Help” to 971-203-7773. Support groups, talking to people one on one, seeking community support (like from a faith group or community organization), and/or talking to a professional can all be helpful.
If your loved one wants to know how to help, here are some suggestions.
1. Acknowledge that what you are going through is real. Don’t say things like, you should be happy or everyone is anxious after having a baby.
2. Help with care of the baby or help organize someone to help you. Taking care of a baby is a new role and can be overwhelming, so helping reduce that stress and give you a break can be helpful.
3. Help you get sleep. Sleep is medicine. Helping to promote it by taking over nighttime feeding, watching the baby while you nap, or getting a family member or trusted person to help overnight can be critical.
4. Ask you what type of support you need. You may need something else like cooking, cleaning, or time for something you enjoy. Your loved one can’t anticipate all needs, but can ask you what will be helpful.
5. Make a plan with your loved one for how you can get help if they are not there.
6. Let your loved one know some signs that you are not feeling well and when it might be very important for them to help you get additional support.
7. Show them resources that help them understand that this is a normal experience that many pregnant people experience.
8. Share the resources below for information about how people get better. For most people, it will involve a combination of talking, therapy, support from peers, friends, and family, and medication. Many medications are also safe in pregnancy and breastfeeding. Please note that if someone is experiencing postpartum psychosis or bipolar disorder, immediate medical care and medication are a critical part of treatment.
The bottom line: Many people experience anxiety after having a baby. But when it goes beyond two weeks after having a baby, it is more than just the baby blues. Getting help can help you get better. The people around you can support you by acknowledging that what you are going through is real and helping you find the best way to get better.
Stay Safe. Stay Well.
Those Nerdy Girls
Please note: If you or a loved one are having a crisis related to maternal mental health, please know that you can call 988 in the U.S. or the National Maternal Mental Health Hotline at 1-833-9-HELP4MOMS.