Is it baby blues or postpartum depression?

There’s been a lot of news coverage about model and actress Chrissy Teigen since she wrote about her postpartum depression experience in Glamour magazine this spring.

Many new moms feel a jumble of unexpected emotions in the days, weeks and months after their baby is born. Moods can vary from joy to exhaustion to sadness in the span of just a few minutes. Some common symptoms of postpartum depression include severe mood swings, debilitating anxiety, excessive crying, overwhelming fatigue, loss of appetite, inability to sleep or withdrawing from friends and family.

The cause of most mood swings is hormone fluctuation, which is a normal part of pregnancy and childbirth. True perinatal depression can last up to 12 months after delivery, so it’s important to establish your “normal” before and during pregnancy up through labor.

In my practice, I find that hormone fluctuations compounded with an underlying tendency toward depression or extenuating life circumstances (like a divorce) exacerbate the seriousness of the depression. To help assess the severity, I ask patients questions such as “Do you ever feel like you want to stay in bed all day or don’t want to leave the house? Do you ever feel like you ever want to harm someone, hurt the baby or yourself?” In my experience, the first six weeks can be a really tough time.

The American Congress of Obstetricians and Gynecologists recommends that pregnant women perform a screening at least once during their peripartum time (right before or after delivery). It may seem strange to take a depression test on yourself, but it is actually a good thing to do. We use the Edinburgh Postnatal Depression Scale test, which asks questions including “I have blamed myself unnecessarily when things went wrong” and “The thought of harming myself has occurred to me.”

If your score indicates you’re somewhat at risk, you should talk to your doctor. There are plenty of safe medications out there, even if you are breastfeeding. There are lots of specially trained counselors who can help, too. Ask your doctor for referrals.

In my experience, family support for a new mom is always very important. It seems more frequent than not that patients who present as clinically depressed don’t have good family support. Many times, new moms are left at home all day while their partner is at work, or perhaps the partner is just not helpful with the baby. Those are prime cues for postpartum depression.

When mood swings hit, my advice is to get outside – get some fresh air and sunshine. Also, get some help from friends or family, even if it’s just 30 minutes a day, to get away from the house and go do something. Go to the bookstore, get a coffee, take a walk, sit at a park – do something for yourself each day. Being cooped up all day is not good for anyone.

It’s important to remember that postpartum depression is not your fault. If you or someone close to you is truly concerned, contact your physician.

This story was originally published April 16, 2017 at 6:25 PM with the headline "Is it baby blues or postpartum depression?."