Baby Blues or Is this Something Else?

Have you wondered whether you’re experiencing typical baby blues, or is it actually something more?

The first few weeks after delivering a baby filled with brain fog, exhaustion, and mood swings have become known as “baby blues”. During this time our bodies are experiencing major changes.Our hormones are changing and our bodies are beginning to adjust to feed a baby as well as back to the way they were pre-pregnancy. It takes time, and it’s not always sunshine and rainbows. 

Many of us don’t even know about this period and are left reeling when we experience it. The Baby Blues leave us with questions like: What is normal? When do these symptoms typically fade? What if you experience them longer? And how are you supposed to know what postpartum depression, anxiety, or anything else feels like if you haven’t gone through it before?

When reaching out to well meaning family and friends, new mothers are often met with answers like “Oh that’s normal” or “It will pass.”. When describing symptoms or asking about the fogginess we hear “It's just Baby Blues.”. While it’s nice to know that what we’re going through isn’t abnormal, we need more information than what is being offered. The trouble is, because postnatal mood disorders, when they start, what they look like, and what they mean for families is not discussed, our friends and family are not equipped to give us the answers we need. 

In this blog post, we’re clearing up the confusion around baby blues and postpartum mood disorders. We’ll go through what they are, what they’re like, and when you might seek a professional’s help or guidance.

BeauGen is lucky to have a perinatal therapist on staff! Danielle Stone is a trained and licensed therapist in the states of Massachusetts and Connecticut. She currently practices and works with BeauGen both on our Mommy Care Team (customer service) as well as in our support circles on Facebook in our BeauGen Mom Community and The Mama Village facilitating Mama Support Groups and expert led sessions. 

What are Baby Blues

The first few weeks after delivering a baby are a blur. Birth can be an exhausting experience. Then, you’re up all night and all day with the new baby. And to top it all off, your body continues to experience changes after birth. On top of low energy, you can feel foggy, forgetful, and out of sorts. These are baby blues. Baby Blues are a short post delivery period of time when we are recovering from pregnancy and birth, and before our bodies really start to regulate our hormones and get back to our pre-pregnancy baseline.

Baby Blues affects approximately 60-80% of new mothers. 

How Long Does Baby Blues Last?

This foggy, forgetful and fluctuating experience typically lasts for about two to three weeks. That three week mark is right about when your body starts to get back into a rhythm and can start to re-regulate itself. If you experience symptoms longer than three weeks, it might be something more than baby blues. 

If you are experiencing these symptoms beyond that three week mark, it is strongly recommended that you reach out to your OBGYN / midwife to check in as well as a licensed therapist that specializes in perinatal care. These therapists can help walk through your symptoms and help you better understand what you are experiencing. The therapist can help explain what you are going through, what you might expect, what you want to watch out for, and what you can do.

Perinatal Mood and Anxiety Disorders

If your symptoms persist beyond the baby blues, you could likely have a Perinatal Mood or Anxiety Disorder (PMAD). This sounds like a mouthful and it also sounds a bit serious. This is simply a categorization of these symptoms and disorders. It’s nothing to be afraid or ashamed of. Seeking out a therapist that specializes in the perinatal period and PMADs can help you see and feel that you are not alone, because you are definitely not. One out of every five to seven women will experience a PMAD and since the pandemic, this statistic is thought to be much higher at this time. Women are not the only people who experience these disorders either. One out of 10 men will experience a PMAD.

With over 400,000 infants born every year to depressed mothers, this is the most under-diagnosed obstetric complications in America. This is largely due to a lack of routine and standardized screening and care providers not having these important conversations as well as the stigma around mental health in general. It’s so important to have the conversations and seek out a care provider that will listen and dialogue with you around normalizing the feelings and experiences.

Essentially, PMADs can affect anyone. They are not directly related to your stress levels and you can develop one without any previous psychiatric history though a risk factor for developing a PMAD is having a mental illness prior to pregnancy and birth.

Types of PMADs

PMADs are just as serious as any physical complication from pregnancy. They do not discriminate and can affect anyone. If left untreated, some of these cases can cause harm to the parents, and even the child or other family members. These extend beyond what we typically think of as postpartum depression and postpartum anxiety.

PMADs Include but are not limited to: 

• Perinatal Bipolar Disorder

• Perinatal Depression (PPD)

• Perinatal Psychosis

• Perinatal Anxiety

• Perinatal Obsessive Compulsive Disorder (PPOCD)

• Perinatal Post Traumatic Stress Disorder (PPPTSD)

When to seek help: 

As a new parent, therapy can be beneficial. Whether you are experiencing what is typically the baby blues, or something else, a therapist is always a great inclusion as part of your care team. Unfortunately, many healthcare providers do not screen for PMADs the way we do for things like hypertension and diabetes. This means it falls upon the impacted parent and / or their supports (i.e. partner, family, friends) to personally reach out and seek help. 

If you or anyone you know ever have thoughts where you are worried about harming your baby, yourself, or someone else - that requires a call to a crisis center or trip to your local emergency room immediately.

For some people, they experience thoughts where they are terrified harm might happen to their baby and they want to avoid those thoughts. These are thoughts that are irrational, illogical, or both. They could involve thinking you, someone else, or something else could cause harm - not you, someone else, or something else actually wanting to or trying to cause harm to your baby. This can be confusing to understand so lets use some examples to help differentiate when to seek urgent emergency care versus the intrusive thoughts that indicate it would be a good time to reach out to your care team or a therapist for help and support

Symptoms about when to seek urgent emergency care or a call to your local crisis center (**this list is not exhaustive and if there are concerns that something is wrong, seek immediate support**):

• Not sleeping, unable to “stop” or control the thoughts you’re having;
• Seeing or hearing things that other people are not seeing or hearing;
• Doing things or being in places with no understanding of how you got there;
• Worried or concerned that other people or things are out to get you or following you.

Wanting to harm your baby, self, or others.

Examples of intrusive thoughts where it would be a good idea to reach out to your care team for support:

“If I walk down the stairs with my baby, they will be harmed. Someone else can walk down the stairs with them and that’s okay, but if I do, they will be irreparably harmed.”

“I can’t sleep because even though my baby is in a safe sleep space I am terrified that they’re going to die in the middle of the night and I’m going to find them in the morning.”

“I’m the only one who can safely care for my baby; if I leave them alone with someone else, something terrible is going to happen, I just know it.”

As you can see the urgent emergency care thoughts are more where one is immersed into the experience not really being present in reality whereas the intrusive thoughts are just that, thoughts where one is so concerned that harm could happen that they want to avoid the thoughts.

These intrusive thoughts are frightening and they can be indicators of a perinatal mood disorder, which can be treated. Not all forms of treatment require medication. And a perinatal therapist should never judge you for needing help, or what kind of thoughts you are having, even if they seem frightening or overwhelming to you.

Still not sure? Take this short anonymous assessment.

The Cost of Suffering in Silence and Going Undiagnosed

First and foremost, PMADs drastically affect your health and overall wellbeing. You are a primary caregiver for your family. If you are struggling, there is no way that you can show up for your family 100%. While this is a very personal struggle, it does affect your family. If you don’t want to seek diagnosis or treatment for yourself, it can be helpful to think about how your day to day struggle is affecting those you love. 

Stress from this daily struggle directly impacts your milk supply. By not seeking help, you could be putting your breastfeeding journey at risk. No amount of pumping or trying can reduce the impact that stress can have on your supply. If you are struggling and see an impact on your supply, whether it's motherhood in general or because of a PMAD, reaching out for help can make an enormous difference for your family.

Other impacts of suffering from PMADs can be, straining your relationship with your partner, your personal hygiene can suffer, other medical conditions can worsen or flair up. Other children in the home, even your infant, may experience some level of neglect. 

Is your baby fussy? Do you feel like that is compounding things? Babies from a very young age pick up on the mood or tension around them. Reaching out to a therapist might benefit other people in your home as well. 

Reasons why moms might not reach out: 

As mentioned before, mental health in new parents is the most under-diagnosed health condition in the United States. Part of the reason this is so under-diagnosed is that new parents do not seek help or help isn’t offered by the care team. If you don’t communicate that you are struggling, it can be difficult for people around you to know what you are dealing with. 

It can be difficult to verbalize these thoughts because then it becomes real and out there. Sometimes we feel like we can’t take it back anymore. We become afraid that these thoughts will become part of a record that stays with us through life and future pregnancies. 

These thoughts could potentially be heard wrong. If we have the courage to speak to someone, and we are not heard and treated correctly, this experience can have an adverse effect. Having a poor experience in any form of healthcare can make it difficult to seek another provider but when it comes to our mental health it becomes increasingly challenging.

Other times people might reach out and not connect with their therapist. That’s okay. We won’t connect with every person we meet. You have the ability to interview a therapist to determine whether this person is a good fit for you. Most therapists will do a free consultation in which you can both get a feel for whether you have or can establish a connection. If you cannot, they likely will make another recommendation or offer to help you find a therapist with whom you can connect.

Many of us simply have no idea what to expect and that is terrifying. This is especially true if we have never sought the benefits of therapy before starting our pregnancy journey. Reaching out and taking advantage of that consultation will help to show you what a therapy session and overall journey will be like. You can openly ask questions and have the therapist address your concerns, fears, and preconceived notions about therapy.

What Can You Expect from a Therapy Experience?

Therapy should be a place where you feel comfortable, validated, supported, and heard. With outpatient programs, it may not feel clinical and shouldn’t feel cold or harsh. At first, you’ll get to know your therapist and establish a rapport or relationship with them. And then together you can progress to what you are feeling, thinking, and experiencing. 

Quote: Therapy is like speed dating - you need to be able to move on if you don’t feel comfortable. A therapist is not meant to work out for everybody. 

The actual therapy experience often comes down to the school of thought and the modalities a therapist uses. Some will give homework or exercises that can be used outside of a session, and others will not. Most sessions will be structured around open communication. A therapist may hold space for you to communicate what you would like, and others may ask you open-ended questions to help guide or aid in your communication.

How to Find Your Perinatal Therapist

When talking about mental health, there is often a hurdle to overcome at the very beginning. Beginning that dialogue with your support group can be helpful for a number of reasons. First, you are letting them know that you need support. Whether they know of a resource or not, they can be there for you more than they might have previously. They can also be there for you in different ways than before this conversation as well. If they have sought help for PMADs, they are a great place to start your search for your perinatal therapist. 

If you don’t feel comfortable reaching out to those close to you, or they haven’t been able to offer support, you can find groups on Facebook for parents struggling with mental health. These groups might be able to offer you a recommendation for an online or local therapist. Your healthcare provider might have a recommendation for resources who are covered by your insurance. Similarly if you used a midwife, doula, or lactation professional, they might be able to make a recommendation. 

Another incredible resource is Postpartum Support International. They have a list of perinatal therapists across the country. You can sort this list by location, by gender of the provider, by age, language, or their training/certification. You can also find support online through their website. 

Pro Tip: PSI offers a helpline that you can call or text at any time: 1.800.944.4773. Save this number in your phone mama, that way if you ever need it, you have it.