What is it?
The terms Postpartum blues and post-baby blues are frequently and synonymously used for ‘Baby blues’(BB). It might be reassuring to hear that the 'baby blues' are common and affect 80% of new mothers. The 'blues' are a period of temporary low mood which tends to occur three to 10 days after giving birth. Medical professionals believe the cause of the 'blues' primarily to be hormonal adjustment during this period.
What are the symptoms?
No symptom can be described as typical or characteristic of baby blues. Feeling sad for no reason, irritability, anxiety, insomnia, feeling exhausted, loss of appetite etc. are the frequently experienced symptoms by the new mother during this period. Symptoms of BB are generally mild and need to be differentiated from depressive illness. Many clinicians prefer screening the patients with Edinburgh Postpartum depression scale to make this distinction. This scale can be used for self-assessment also (https://perinatology.com/calculators/Edinburgh%20Depression%20Scale.htm)
How long do they last?
The symptoms develop soon after delivery to within two three days, reach peak within a week and resolve within two weeks.
Who is most at risk?
Psychological symptoms during pregnancy: Any woman who has undergone delivery is predisposed to develop BB. However, the predisposition increases if there have been any mood changes during pregnancy/menstrual cycles and/or there is a history of depressive disorder earlier. Consulting a nurse during pregnancy can be of great help. Multiple pregnancies too predispose the woman to develop BB.
Emotional issues: These are another possible causes of the baby blues. You may be nervous about taking care of your new baby or be worried about how your life has changed since the baby was born. These thoughts can make you feel sad or depressed. Discussing it with your partner and doctor can ease out your worries. It is not surprising to see that new fathers may also develop BB because of the similar reasons.
Lifestyle factors: living a sedentary life predisposes to many physical and psychological conditions besides depression and BB.
How is it different from Postpartum Depression?
Baby Blues are different than postpartum depression in the following ways:
- Baby blues lasts only for around two weeks and gets better on its own after that while postpartum depression can last much longer than that
- The main symptoms of ‘baby blues’ are irritability, fatigue, and sadness while symptoms of postpartum depression are often more severe and include aggression, extreme stress, and sometimes no attachment to the baby. Feeling of worthless and guilt are common in depressive disorder but not in BB. In depressive disorder the symptoms lasts beyond two weeks. Further many times a depressive patient may be suicidal also requiring hospitalisation.
Do Fathers also get ‘Baby Blues’?
Almost 10% of men feel the baby blues after they become fathers. Testosterone levels may drop and oestrogen levels may rise in new fathers. Other hormones, such as cortisol, vasopressin and prolactin, may also rise. All of these hormone changes can cause depression. Being a new father can also surface feelings of being overwhelmed, helpless and anxiety.
Does BB predispose the any other illness?
BB in itself runs a very benign course. However, it does expose the mother’s predisposition to develop postpartum depression and postpartum anxiety disorder later or in subsequent pregnancies.
Can BB be prevented?
Prevention is the best way to deal with BB. It can be achieved through many ways:
Planning Pregnancy : Planning prevents many obstacles and emotional problems. Multiple/unwanted pregnancy can lead to mood changes and adjustment problems. Planning and being ready to have a baby make the woman prepared to dealing with difficult situations if arise in the due course. Discuss your preparedness with your partner.
Modifying lifestyle: There is often a myth that during pregnancy the expecting mother needs to rest a lot. Instead, eating a healthy diet, taking recommended exercises, listening to music, and meeting friends help a lot in preventing BB. Social bonding also helps in early identification of the symptoms.
Consult your nurse regularly: Many women as noted above develop mood symptoms during pregnancy. If you discuss with your nurse, she would educate you better about it. Knowing that such symptoms are common from an expert is very reassuring.
What should I do if I have symptoms of BB?
Physically and mentally, you will have been through a great deal post your baby's birth, so self-care is critical. Most of the times, knowing about BB, support and reassurance from family are often necessary and sufficient to deal with BB.
It is important to
- Give yourself space to feel and express these emotions.
- Tell your partner or family how you feel and ask for their support as you move through your feelings.
- Take out time for yourself and enjoy a bath or take a nap or relax in a quiet space.
- Engage yourself in baby care or other activities and hobbies etc. that bring you joy.
- Don't forget to acknowledge how amazing you are to have grown and birthed your baby.
- If your partners show these symptoms, understand that it is not only the person who has given birth who can experience the baby blues, so be patient.
Baby Blues disappears on its own after two weeks
However, if your symptoms persist after day 14, you may be experiencing postpartum anxiety or depression. You may require treatment and support. Reach out to your general physician/obstetrician/psychiatrist who would be able to guide you to the appropriate professional.
Be kind to yourself throughout your journey of motherhood and, remember, you are not failing by asking for help.
Dr. Sonali Mohanty Quantius is a scientist and founder and Haplo Care. She has a Masters from Benaras Hindu University and a Ph.D. from the University of Zürich, Switzerland. Subsequently, she worked in the Pharmaceutical industry for the last 12 years in the fields of Neuroscience and Metabolic Diseases. She is the CEO of Haplo Care, which is an end-to-end digital solution that supports the screening and treatment of mental health conditions during pregnancy and postpartum. The app, Haplo Care will be available to download in September 2022.
Dr. Hitesh Khurana,
Professor, Department of Psychiatry,
Institute of Mental Health,
Pt BD Sharma PGIMS,
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