More than baby blues: Recognizing and recovering from postpartum depression

A new mother, glowing with joy, cuddling the precious newborn resting in her arms. It's an image held up as ideal: that the birth of a child brings total joy into a woman's life.

But for some mothers, life with a brand-new baby is anything but blissful. There are women like Raivon, who couldn't stop crying, overwhelmed by the feeling she was failing as a mother. Jessica, who barely slept and grew angry at the drop of a hat. Nicole, who treated each day as a lonely battle for survival as she struggled to bond with her baby Madeleine, who left most newborn care duties to her husband and baby nurse. And Lynn, who was hounded by frightening visions of hurting her newborn. All of these women suffered from a disorder that affects one in eight mothers: postpartum depression.

What is postpartum depression?

Sometimes known as peripartum depression, postpartum depression is often diagnosed within the first four weeks of a child's birth, but may be diagnosed as much as six months later. The disorder is typically associated with women, but as many as 1 in 10 new fathers suffer from it as well.

It’s different from "baby blues," which many mothers experience for up to two weeks after childbirth. "Baby blues is more like being a bit worried or having mixed feelings about being a new mom, and having some trouble eating or sleeping," explains Dr. Gabriela Cora, a board-certified psychiatrist and the medical director for Aetna Behavioral Health.

The symptoms of postpartum depression, however, are far more severe and longer lasting. They include those found alongside traditional depression, as well as symptoms specifically related to life with a newborn, including:

• Feeling low, frequent crying or an inability to experience pleasure
• Changes in eating and sleep patterns
  
• Severe fatigue or restlessness
• Severe anxiety or panic attacks
• Feelings of helplessness, hopelessness or shame
• Trouble bonding with the baby or fearing you're a bad mother
• Difficulty thinking clearly
• Thoughts about harming yourself or others

Although many new moms can find themselves struggling with one or two of these symptoms on occasion, experiencing them consistently for more than two weeks and finding that they interfere with your day-to-day life are signs of true postpartum depression.

What causes postpartum depression, and who’s at risk?

Fluctuating hormones during pregnancy and after childbirth are a major aggravating factor for postpartum depression, Dr. Cora says. A prior history of mental illness and social isolation can also increase your risk.

A 2012 study conducted by Ohio State University researchers suggests that chronic stress may also cause or increase postpartum depression symptoms. That’s what Madeleine Perez discovered when she gave birth to her son. Madeline had a difficult pregnancy, including gestational diabetes, frightening ocular migraines and a thyroid condition. Her son’s emergency delivery by Caesarian section left the Los Angeles mom with complications related to her C-section scar. Madeleine’s mental health deteriorated shortly thereafter. “The problem was that I spent so much of my energy pushing through the pregnancy that I had nothing left for the other side of it,” she says. (Caring for a baby, especially after a difficult pregnancy, can be overwhelming. Find out what’s in store by reading “5 things no one told me about life with a newborn.")

Different women, different stories

Though many women see similar symptoms as they cope with postpartum depression, no two experiences are identical. Raivon Lee’s crying spells dominated her life after she brought her son home. "I’d just be sitting on the bed, or in the back seat of the car with the baby and tears would flow," the Atlanta mom said. "I didn’t understand why. It was extremely confusing, like my mind and body weren’t connected.” She also worried she was a "failure" as a mother and obsessed over her son's poor sleep habits. "I kept telling myself, 'Something must be wrong with me or with him." (Watch Raivon’s story below.)

Jessica Smock, who suffered from both antepartum depression (which occurs during pregnancy) and postpartum depression, found that irrational anger often drove her to tears. The Orchard Park, N.Y., mom would burst out crying, for instance, if her husband came home late from work. The sleep deprivation she experienced didn't help. "I couldn't fall asleep when the baby slept – not at night or during the day. And then I just knew the next day would be terrible," says Smock, who later co-edited Mothering Through the Darkness, an anthology on postpartum depression.

Lynn Shattuck, of Falmouth, Maine, struggled with sleep as well as with intrusive, disturbing thoughts. "I'd have these images go through my head of hurting my son, like throwing him out the window. I couldn't control the thoughts," she says. Though Lynn never acted on the thoughts, they made her feel terrible. "What kind of a mother thinks such a thing?" she says. (Women who feel compelled to act on thoughts of harming themselves or others may be suffering from postpartum psychosis, a rare but severe form of mental illness, and should seek help immediately.)

As they cope with sleep deprivation, shame and more, mothers with postpartum depression may struggle to bond with their babies. Nicole Hayward, of Glen Rock, N.J., says she didn't speak much to her infant son. "It felt like, 'This is an alien and all it ever does is poop and cry. It's never happy,'" she remembers. Meanwhile, Madeleine often avoided being in the same room with her baby, and "checked out" in her bedroom.

Getting help

Postpartum depression doesn't automatically fade over time, so identifying the disorder and seeking treatment is important. An ob/gyn is often the first line of defense for detection and helping patients find resources. But anyone who spends a great deal of time with a new mother can recognize red flags and offer support, such as accompanying her to appointments.

Getting help as soon as possible is critical, says Dr. Cora. "Just like you would tend to any other medical issue, the earlier you seek help, the less severe the illness, the faster the recovery," she says. Treatment varies by individual and can include medication and psychotherapy. Many Aetna members who can’t make it to the doctor’s office, or are unsure who to turn to, can access help from counselors remotely through Aetna's Behavioral Health Televideo services.

Some moms find that more social interaction helps, too. Nicole’s loneliness faded when she returned to work. Raivon credits much her recovery to medication, but also found value in joining a postpartum depression support group. "I'll never forget that first [feeling] of, 'Wow, there are a lot of women going through this,'" says Raivon, now a mother of two who chronicles her family life on her own blog, Vain Mommy. She shares her story to give hope to other new moms. "Postpartum depression is very serious," she says, "but you can get better."