Do I have Baby Blues or Postpartum Depression?
Motherhood is no easy feat.
From pregnancy to labour, your body goes through some of the most dramatic changes it would ever experience. In between all the diaper changes, feeding every two hours, sleep deprivation and wondering whether her cries signal something you should be worried about, your body has a lot of healing to do, not to mention your hormones are all out of whack.
All of this can be very overwhelming; while you would no doubt have many moments of joy and excitement, it is also natural to feel upset, helpless and all kinds of difficult emotions.
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Most women will experience “baby blues”, characterized as mood swings, tearfulness, irritability, and having trouble sleeping.
About 40-80% of women in Hong Kong get postnatal blues, which typically appears two to three days after childbirth. The symptoms are relatively mild and would ease off within a week or two.
What is postpartum depression?
While similar to postnatal blues, the symptoms of Postpartum Depression (PPD) are more severe with a later onset. Symptoms of postpartum depression usually kick in within six weeks after giving birth and may last up to a year or more.
Whether it is your first or third pregnancy, you may experience Postpartum Depression.
According to Hong Kong’s Centre for Health Protection, postpartum depression affects one in ten new mothers in Hong Kong, while the global prevalence rate for the condition is 13-19%.
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It is also quite likely that many cases of Postpartum Depression have gone undiagnosed, as not all women seek help even if they recognise any of the symptoms.
There is no one single cause of Postpartum Depression, but may result from a combination of factors, such as, changes in hormone levels after childbirth that may trigger mood swings, constant sleep deprivation, a genetic predisposition towards depression or other mental health conditions, stressful life events, especially during or soon after pregnancy, mixed feelings about the pregnancy, and a lack of a strong support system.
Understanding your state of mental health and identifying symptoms and signs are important in order to seek help early on. If you are the partner, a family member or friend of someone who has just given birth, it can help to look out for these symptoms and provide the appropriate support.
Major signs and symptoms of Postpartum Depression
Prolonged periods of feeling sad, empty or hopeless
Frequent crying or crying for no apparent reason
Loss of interest in activities that are usually enjoyable
Changes in appetite
Sleep problems
Fatigue or loss of energy
Difficulty concentrating or making decisions
Feelings of anger, irritability or anxiety
Feelings of worthlessness or guilt or persistent thoughts of inadequacy as a parent
Having trouble bonding with the baby
More advanced signs may include:
Thoughts of suicide or of harming oneself or the baby
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When and where to seek help for Postpartum Depression
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If any combination of the above symptoms of PPD persist for more than two weeks and is affecting your daily functioning, talk to someone and seek professional help as soon as possible.
Since the symptoms of this condition are broad and may vary between individuals, a mental health professional can help to figure out whether you are experiencing Postpartum Depression or something else.
Your mental health is important, and Postpartum Depression can impair your ability to care for your infant, reduce mother-infant bonding and have other negative impacts on the well-being of the mother, child and family.
Regardless of whether you are in the private or public health system for postnatal care, all mothers should be assessed for the condition as part of their postpartum check-ups, using measures such as the Edinburgh Postnatal Depression Scale (EPDS) and the Center for Epidemiologic Studies Depression Scale (CES-D).
Your postnatal appointments with your OB-GYN or with a nurse at a Maternal and Child Health Centre would be a good time to bring up any concerns you have. You can also consult your family doctor or see a psychiatrist or clinical psychologist or speak with a Common Care therapist for professional assessment and treatment. If you are experiencing some of the above symptoms, find out more about available help.
What you can do to reduce the chances of developing Postpartum Depression
If you have experienced Postpartum Depression or other forms of Depression previously, it may be helpful to take certain measures before the baby arrives, to hopefully reduce the chances of developing or the severity of postpartum depression.
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This may include:
family and financial planning before pregnancy
Having realistic expectations for parenthood and the challenges you may face after the birth
Planning and division of parental responsibilities to avoid imbalance in workload, which may help to reduce marital conflict and feelings of resentment and helplessness
Thinking of ways to ensure you get enough sleep. This may mean getting help from your partner, helper, doula or family members
Learning more about pregnancy, childbirth and childcare to feel more prepared and less anxious (e.g. attending breastfeeding and parenting workshops and events)
Avoiding social isolation by staying connected with friends and seeking out other mothers and couples with babies of a similar age
Taking care of yourself. Staying active and maintain a healthy and balanced diet as best you can, and continuing to do activities you enjoyed pre-pregnancy (e.g. sports, hobbies, going out with friends)
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This article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a mental health condition.
Sources:
1 Postnatal Mental Health. Hong Kong SAR: Family Health Service, Department of Health (FHS-MH13A), August 2017. https://www.fhs.gov.hk/english/health_info/woman/14750.pdf
2 Lee D, Yip A, Chiu H, et al. A psychiatric epidemiological study of postpartum Chinese women. Am J Psychiatry 2001; 158(2):220-6. https://www.ncbi.nlm.nih.gov/pubmed/11156804
3 O'Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol 2013; 9:379-407. https://www.ncbi.nlm.nih.gov/pubmed/23394227