More Than Just the Baby Blues

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Having a child is a huge transition and brings changes for the entire family. This time of transition is often difficult for all members of the family, but is further complicated when PMADs enter the picture. PMADs stands for Perinatal Mood and Anxiety Disorders and encompasses diagnoses of depression, anxiety, PTSD, OCD, and postpartum psychosis. Symptoms can occur at any point during pregnancy and within the first 12 months after childbirth, so it is important to continually be on the lookout for changes. PMADs impact 1 in 5 women and are the number one complication of childbearing. Research is also showing that PMADs can occur in around 10% of fathers, and this number can increase if the mother is experiencing symptoms. The good news is that there is help. Postpartum Support International believes that, “You are not alone. You are not to blame. With help, you will be well.”

The first step in that process is knowing what to look out for. Often, we hear of what is called the “baby blues”. This is a normal period of adjustment in the first two weeks after birth while your body begins adjusting to the hormonal changes that have occurred. The problem is that many women are misdiagnosed as having the baby blues instead of a PMAD, which prolongs them getting help and can lead to feelings of invalidation. Main differences between the baby blues and a PMAD are the duration and intensity. Symptoms of the baby blues occur within the first couple of hours to the first two weeks following birth and may include symptoms similar to PMS. Anything lasting longer than two weeks and/or more severe than what would be expected in PMS is something we want to look into. An example of this difference is becoming tearful for no particular reason vs sobbing uncontrollably. Particular symptoms to look out for are:

  1. Changes in appetite
  2. Changes in ability to fall asleep or stay asleep
  3. Irritability or anger
  4. Upsetting thoughts that stick in your mind
  5. Increased somatic symptoms such as headaches and stomachaches
  6. Feeling like a failure as a parent
  7. Thoughts of hurting yourself or your baby

So what do you do if you find yourself having these symptoms? First, know you are not alone and you can get better. The most important thing in the postpartum period is sleep, which I know sounds impossible to new parents. If at all possible, guarding a four hour block of uninterrupted sleep a day is imperative because that is how long your body needs to achieve deep sleep and even begin to be able to think clearly and feel rested! Second, if you can, develop and utilize a support system who you trust. This can look different for each person. I am going to link a website at the end that has a free download for a wonderful postpartum plan. This plan has practical ways to ask for help and can help break down barriers, as well as help you think of things that you may not think of on your own. This plan also provides education on different things in the postpartum period that you may not expect.

Differences in expectations, or not knowing what to expect, can sometimes perpetuate symptoms. This idea of expectations is also relevant to the journey to becoming a parent. Very rarely does everything go as planned in our heads during conception, pregnancy, and/or labor. Sometimes these changes can lead to traumatic experiences for moms and non gestational parents that linger during the postpartum period and beyond if they are not able to receive the support and resources needed to heal both physically and emotionally. Other areas of experience where this is relevant include adoption, pregnancy and infant loss, and people who are experiencing issues with fertility. The journey to become a parent can present mental health symptoms that deserve extra support and attention as well.

Seeking professional help may also be a good next step. There are therapists out there, such as myself, who have dedicated time to obtain additional training and certification in PMADs through Postpartum Support International (PSI). Below, I am including some resources that Postpartum Support International provides. On their website, you can find many different educational resources, a directory of PMH-C therapists, and free support groups for a variety of situations. Meeting with a specialized therapist can help you learn skills and receive support to help you through challenges specific to this transition, as well as find healing from aspects of your experience that may have been traumatic. Medication may also be something that should be discussed with your doctor. Many medications are safe for pregnancy and breastfeeding, so it is worth talking with your doctor about what options are available to you.

My biggest message to people anywhere on the path to becoming a parent is that while this transition is going to be full of ups and downs, if there are more downs than ups it is time to try something different. You feeling peace and happiness during this time is worth facing any fears you have of seeking help. In closing I want to reiterate PSI’s motto, because they say it best. “You are not alone. You are not to blame. With help, you will be well.”

~Olivia Brower, LMSW, PMH-C


PSI Helpline: Call 1-800-944-4773 or text 800-944-4773 for help in English or text 971-203-7773 for help in Spanish.

Find a PMH-C therapist: 

Free virtual support groups: 

Free Survival Kit/Postpartum Plan: