Cedars-Sinai Blog

Beyond Baby Blues: Postpartum Depression

Anxiety is one of the most common symptoms of postpartum depression.

Even though many go through postpartum depression, it's all too common for women to remain silent and keep their feelings hidden. It can be hard to tell when the emotional and physical roller coaster of having a child is "baby blues" or when it's something more serious.

Mood swings, crying spells, exhaustion, and anxiety are common symptoms that mothers may experience the first few weeks after giving birth. But when those feelings linger longer than 2 weeks and interfere with daily tasks, it can be a sign of postpartum depression.

Postpartum depression can affect the mother's relationship with her infant, older children, and spouse, and it can interfere with her ability to have a healthy life, says Eynav Accortt, PhD, clinical psychologist and assistant professor in the Department of Obstetrics and Gynecology at Cedars-Sinai.

Postpartum depression facts

  • 1 in 5 women who give birth experience postpartum depression (PPD) or anxiety
  • Women at highest risk for PPD:
    • those with personal or family history of depression
    • African-American and Latina women
    • those who had medical complications before or after giving birth
    • those with babies in the NICU
  • Fathers and adoptive parents can also experience postpartum depression

During Maternal Mental Health Awareness Week, Accortt shares 5 more things you should know about postpartum depression:

A woman with postpartum depression doesn't always look depressed

Mothers with PPD often hide their feelings and say they're "fine" because they don't want to worry anyone or be judged. They may act strong for everyone else and hope things will get better on their own.

Read: Depression: Know the Signs

Common concerns can become obsessive and scary thoughts

For a mom with postpartum depression, a regular thought may become obsessive, which can be part of the anxiety that comes with the disorder. A question like Am I bathing the baby properly? can develop into a scary thought like What if I let go and the baby drowns?

Some depressed mothers who develop these obsessive thoughts may also think of hurting their child. The mother may hesitate to share these thoughts because she's worried someone could think she'll act on the thoughts and take her baby away.

Anxiety is one of the most common symptoms of postpartum depression

Some amount of worry is common for most new mothers. But when anxiety interferes with daily activities and a woman's ability to care for her baby, it may be an indication she should be evaluated for postpartum depression.

For example, a woman may become preoccupied with the cleanliness of the baby's bottle and take an hour to clean it—instead of 5 minutes—while the baby is crying from hunger.

The baby may not be the cause of sleep problems

It's true that a newborn wakes up hungry every couple of hours. And yes, this absolutely interferes with the mother's sleep. But anxious thoughts may also prevent her from sleeping. It's a cycle that feeds on itself and leaves the mother feeling sad, angry, and frustrated.

Medication isn't the only answer

In some cases, medications like antidepressants can help a woman with postpartum depression. But often women can benefit from talk therapy—such as cognitive behavioral therapy or interpersonal psychotherapy—alone. There are several effective treatments for depression and anxiety—before, during, and after pregnancy.

What can you do to help?

Accortt cautions against dismissing a mother's symptoms as part of adjusting to taking care of a new baby. Especially if those symptoms interfere with her sleeping, eating, or taking care of herself.

Simply asking how she's coping can prevent her from feeling singled out, help get her feelings out in the open, and encourage her to seek help by talking to her obstetrician, primary care physician, or mental health professional.