Getting Help When the Baby Blues Don’t Go Away

What you can do about postpartum depression and anxiety

The baby blues is a common condition whereby new mothers feel overcome with emotions such as worry, disappointment, and sadness after birth. For some mothers, the baby blues fade away after a few weeks, but what happens when they continue to linger or get even worse?

When those feelings last longer than a few weeks, its called postpartum depression (PPD) or postpartum anxiety (PPA). Teresa Tan, MD, an obstetrician/gynecologist (OB/GYN) at Stanford Medicine Children’s Health in Mountain View, explained the difference between baby blues and PPD/PPA.

“The main difference between postpartum baby blues and postpartum depression is really a timing and intensity issue postpartum,” she said. “Postpartum [depression] requires that the symptoms be present for at least two weeks. And typically these symptoms include intense feelings of sadness, anxiety, or despair that prevent a woman from being able to do her daily tasks and activities.”

OB/GYNs like Dr. Tan screen all their pregnant patients before and after the baby is born for signs of PPD. However, your child’s pediatrician also plays a role in supporting new moms as they adjust to the shifting hormones and demands of a newborn.

While the symptoms vary, these are some common signs:

• Sadness
• Anxiety
• Hopelessness
• Fatigue or exhaustion
• Poor concentration

Routine screening

It’s easy for the new baby to become the focus of everyone’s attention, but it is important for new parents to prioritize their own mental health. According to Jody Ullom, MD, a pediatrician at Stanford Medicine Children’s Health Town and Country Pediatrics in Mill Valley, there are screening measures in place to help make sure that mom’s emotional and mental health is not falling through the cracks.

“To identify women who might be experiencing persistent sad feelings beyond the first two weeks, we do postpartum screens in all our routine well baby visits up to the first six months,” she explained. “In addition to this validated screening tool, most pediatricians ask how the mom is doing directly. Identifying women who might be experiencing postpartum depression is important for both the mom and the baby.”

In addition to screenings for mothers, fathers are also at risk for depression after a baby is born, according to Nivedita More, MD, a pediatrician at Stanford Medicine Children’s Health Bayside Medical Group in Fremont.

“If the father shows up for the visit and not the mother, he gets screened, since the American Association of Pediatrics also recommends screening fathers at least once in the first year of their baby’s life,” she shared. “Believe it or not, one in 10 fathers can get depressed after the birth of their child!”

Speak up

Dr. Ullom encourages parents to speak up about their struggles during office visits. “It is really important that the moms feel comfortable talking to us about their fears. One of our jobs as a pediatrician is for patients to be able to share whatever fears and worries they have and for us to be able to reassure them,” she said. “If these worries do not subside with reassurance, that would be another situation where consulting and an experienced therapist might be helpful.”

If any of these symptoms last more than two weeks, or if they start to negatively affect daily life, Dr. Tan recommends seeking help from a health care professional. “Anyone who is thinking about harming herself or others should seek immediate medical attention.”

Getting help from a trained therapist also can be beneficial for people dealing with PPD or PPA. While talking about it in a safe space can help many parents, sometimes the symptoms merit a prescription drug.

“Many people are concerned about taking psychiatric medications during breastfeeding—they worry, ‘Does it affect the baby?’ The answer is yes, it does cross into the breast milk, but just a little bit,” assures Dr. Tan. “So we really are weighing the risks and benefits. We want a healthy mom because a healthy mom means a healthy baby. We want moms to be able to take care of their children in the best way possible, and sometimes medication is what’s needed to really calm those anxious thoughts down or help somebody get out of a real depressive episode.”

In addition to medical help, reaching out to family, friends, and other new parents can provide social support to help get through those first few months.

“Finding a good support system is really important for new moms,” Dr. Tan says. “When there’s not a strong support system, there’s a higher risk of depression and anxiety.”

Many communities both online and in person offer support groups where new parents can connect and share their parenting experiences. It’s a great opportunity to share and learn with other people who are in the same boat. Stanford Medicine Children’s Health has a free online support group for parents of babies up to 10 months old.

For more information, visit classes.stanfordchildrens.org.