Published on May 31, 2022

‘My new baby is perfect, so why do I feel so sad?’

New mom with baby

Postpartum depression is relatively common, affecting approximately one in eight women after delivery, according to Andraya Huldeen, MD, Western OB/GYN, A Division of Ridgeview Clinics. She explains that often there is no clear trigger for postpartum depression and if the baby is healthy, women are reluctant to admit they’re struggling.

Women mask their depression.

“Depression in women tends to have a strong anxiety or guilt component and is often missed because they think ‘I get up in the morning and I am still doing what needs to be done,’” explained Dr. Huldeen. “Women tend to feel obligated to keep moving and doing what is expected of them, which is why depression in women looks much different than it does in men.”

It can be hard to differentiate serious depression from the ‘baby blues.’

Feeling the baby blues is also common in new mothers, and typically happens the first couple weeks after delivery. It’s mainly caused by a drop in hormone levels and often, lack of sleep. The baby blues usually resolve within a few weeks postpartum.

Dr. Huldeen shares that when she sees patients at their six-week postpartum checkup, sometimes it’s unclear whether they are experiencing postpartum depression or the baby blues. She tells new moms that after the six-week mark, they should start to feel a little better each week.

Watch for contributing factors of postpartum depression.

Several factors increase the likelihood of postpartum depression, including a personal history of depression or anxiety, a family history of mood disorders, poor social support, or stressful life events during pregnancy or postpartum—such as the loss of a job or death in the family. Sometimes postpartum depression can begin to manifest near the end of a woman’s pregnancy. “Women often tell me after their depression has been treated that, in retrospect, signs were there before delivery, but they didn't have the insight at the time to realize it,” Dr. Huldeen said.

The most concerning mood disorder during the postpartum period is postpartum psychosis. It can be sudden and is rarer, occurring in one to two out of every 1,000 deliveries. Women can experience delusions, and some women hallucinate—seeing and hearing things that are not there. Postpartum psychosis is a medical emergency, and it is imperative to seek help immediately by calling 911 or going to the nearest Emergency Department.

Talk with a professional who has experience caring for postpartum women.

“Validating and normalizing their experience is helpful. Women often leave feeling better just knowing they are not alone, there are treatment options, and this is not their ‘new normal,’” Dr. Huldeen stressed. “If your provider does not make you feel heard, find another.”

Fortunately, there are effective treatment options. The medications are safe to use while breastfeeding and during future pregnancies, if necessary. These medications typically take a couple of weeks to make an impact and can take up to three months for full effect. Therefore, Dr. Huldeen tells her patients, “I would prefer to catch them ‘on the way down’ as opposed to waiting until they ‘hit rock bottom.’”

Counseling and support groups are also available. Often, a combination of medication and therapy yields the best results. Being active, getting out in nature, eating healthy and other self-care techniques can also support better postpartum mental health and well-being.

Ridgeview offers online education for Postpartum Care which focuses on both physical and mental health in the 12 weeks after birth. Ridgeview also hosts Mom & Baby Connection, a drop-in support group for new moms and their babies, where attendees meet other moms and can gain helpful information from a Ridgeview lactation consultant.